the troops in iraq and he followed them after they came home. pdi book is about ptsd and and it is a hard read, a very painful read to see what not only the soldiers are going through, but what their wives and kids are going through. how do we deal with the reality that some 500,000 people who served in iraq and afghanistan come home with ptsd? if you had unlimited amounts of money, that would be a very difficult challenge. it is unprecedented. furthermore, it is my strong opinion that if the v.a. is going to do the quality health care it needs to do, we are going to simply need more doctors, more nurses, more medical personnel, more productivity. at a time when we have a shortage of primary care doctors, psychiatrists and many

other health professionals, how do we bring those people into our system? health care is certainly a major issue, but that is not the only challenge that our new secretary will face. we have the veterans benefits administration, which is now in the midst of one of the largest transformations in modern history. that is going from a paper system to a paperless system. in my view they have done a good job, but problems remain. we want to make sure that in that transformation, as we bring down the wait times for benefits claims, that we do it in an accurate way. that is a challenge that you are going to have to face. scandals in the modern history of this country has been the number of homeless veterans that we have seen all over the country. in recent years, general

general -- general this,ki played a role in that number has gone down. that is another challenge that you are going to face. let me close by suggesting that i think that mr. mcdonald brings to us two very important qualities. he is familiar with the military the cause he has served in the military for many years. he brings with that service a passion to take care of our veterans. that is obviously an essential quality that we want from our secretary. the other quality that he brings is he has been the ceo of one of the major american corporations which has many employees, maybe not quite as many as the v.a.

that many employees. there is no question that we .eed a good quality management we need transparency, accountability. i hope that mr. mcdonald's corporate experience will give him the tools that he needs to create a well-run and accountable v.a.. i would like to turn the mic over to my colleague for his opening remarks and then we will proceed with the introduction of the nominee. senator burr. >> thank you, mr. chairman. we chuckle a little bit over here when we look at the table. we thought, maybe we could afford a little bigger table for these three individuals. i think it says a lot to have two members of the united states senate on both sides of the aisle to introduce you. mr. chairman, thank you for calling this hearing. welcome. comments.rnie's

it is tough to envision why somebody would take this job. that we haveknow got people that think enough about the future of this country and the next generations and the promises we made to so many americans that we would be there to take care of them. as you acknowledged in your testimony, the v.a. is an agency in crisis. by nation has been rocked revelations that the veterans health administration was manipulating wait time data, leaving tens of thousands waiting for the care they needed and deserved. in the wake of this scandal, it has become clear that officials failed to act on warnings of a national scheduling crisis. the president's team found this was fueled by a corrosive culture in which officials tended to minimize problems or refuse to acknowledge problems

altogether. although v.a. has started taking steps to improve access to care, much more work is needed to understand and resolve the full scope of the issues. international -- the ongoing internal in valuation and investigations by other offices will be critical in understanding that effort. as the head of v.a., mr. mcdonald, it will be essential that you embrace the findings of these investigations and urgently work to bring about reform. perhaps more importantly, you must usher in a new culture throughout v.a. employees at all levels must be willing to proactively identify and address problems in every corner of this vast department. we need a culture where warning signs will not be ignored. and twisting performance metrics to make it appear that veterans

are being well served will not be tolerated. neededradigm shift is not only on the health care side of v.a. but on the benefit side as well. in recent weeks, the inspector general and general accounting office have shed light on troubling issues at the veterans benefit administration which is nots that v.b.a. upholding its responsibility to veterans or taxpayers. counted inat is not the disability claims backlog is piling up. hundreds of millions in taxpayer dollars have been improperly paid out and there are serious questions about the integrity of v.a.'s data. in response, v.a. continues to tout suspect data as proof that v.a. is working well. my hope and expectation is that you will not allow v.a. to

ignore the signs of deep but willon atv.b.a. work to resolve systemic problems immediately. your charge moving forward will be to ensure that this entire department is refocused on providing our nation's veterans with the high quality service they have earned and deserve. i look forward to working with you to help v.a. live up to the expectations of veterans. i thank the chair and i yield the floor. >> thank you, senator. brown is they senior senator from ohio, the state where mr. mcdonald hails from. he and senator portman are going to introduce mr. mcdonald. >> angst, mr. chairman. it is an honor to introduce bob mcdonald. i am honored to do that. i also think it is appropriate

-- one of the first veterans hospitals in the country was in dayton, ohio. understand there are 6.5 million veterans last year and i assume roughly the same number this year in the veterans health care system that have gotten care. some 85 million patient visits. the responsibility that i hope secretary mcdonald will assume is great. we know he is qualified. when the president asked mr. mcdonald to be the secretary of the v.a., we know his qualifications. ana graduate of west point, army captain and a ceo of one of the most successful corporations in this country with thousands of employees and millions of customers. we know he is qualified to do

this. we also know the problems we have seen in the v.a. 10 years ago, we went to war. the government didn't envision the number or the severity of injuries that would come out of the afghan and iraq war. we probably also undercounted the number of agent orange men and women exposed that would be under presumptive eligibility in the v.a. system with illnesses that were serious and took a high level of care. we know that those who are in the system could get good care. the three issues -- when mr. mcdonald came to my office, we had face-to-face conversations. re-examining the

v.a. and valuations and how important that is. restoring accountability on senior managers and ensuring the focus of the entire department always be on the v.a. that is why the importance of caring for those who have waited -- makinghan 30 days sure that happens, making sure who are responsible for the problems that senator burr pointed out, that they be held accountable, and that we scale up capacity. doctors, nurses, physical therapists, beds at hospitals in our state. there is no doubt in my mind that bob mcdonald understands the gravity of this mission. there is no doubt in my mind that he is qualified to do it and he has the heart and the work ethic and the empathy.

he has an uncommon empathy among people that come to this city. that is why i support him 100%. thank you. >> thank you, senator portman. >> tank you, mr. chairman. i appreciate letting us come today. it is a pleasure to be here with my colleague from ohio. i think he said it well. this is a distinguished atria who is willing to step forward for his company -- for his country. i hope you will consider his nomination, that the right questions are asked, and we can get him there as soon as possible to get some direction to an agency that needs it badly. but is a friend. i am delighted that we can be here today. bobs a tough job as i told when he asked me about it. we had town call meetings all

across the state of ohio. no one in the senate knows more about this than the members of this committee. there are a lot of concerns right now. some have to do with the health care side, others to do with disability and the long wait lists on both sides. we have got an opportunity in this leader to help turn this around. he does understand the problem. we talked about his record as an army ranger and west point graduate. he understands how critical the need is at this point. having talked to him, he also believes his experience having been involved in managing and helping to reform a huge organization will come in handy. he also understands the health care industry. i think that is important at this point. ie thing i will say is that think one thing bob mcdonald did which is impressive is push accountability to every level.

he can talk more about that specifically. he started off as assistant and when all the way to become chief executive. he also launched an effort to be sure that everyone feels that accountability that the ceo must feel to provide a good product for consumers. that is really critical right now with our accountability issues at the v.a. been involved in some government issues. he would talk to me about trade. he has been on president obama's advisory committee and president bush's. he has some interaction with government at some high levels. when it comes to running a big organization, he is a world-class business person. his experience in the military is equally important. said, fore, as you

bob mcdonald, this is not about a job. this is about a mission. he has answered the call to serve his country. he is prepared to make the sacrifices again. laser on these problems in a nonpartisan way to thate the kind of service our veterans deserve. i hope that you will see fit to send him to the floor and get his leadership at a v.a. that needs it badly. thank you, mr. chairman. >> thank you, senator. we will proceed with opening remarks based on how early people came. we will start with senator murray. mr. chairman, thank you so much for holding this hearing. it was just last week that we heard about the current state of v.a. health care and the efforts to address the many challenges. i wanted to start by taking a moment to thank acting secretary gibson who took immediate action

to help increase transparency around the wait times and plan an external audit and begin the procurement of a modern scheduling system. as acting secretary, he identified about $17.6 billion in critical funding needs including 10,000 more medical providers and support staff, improved i.t. systems and additional clinic space. outactions that he laid before the committee are important. even with some of the policy changes and additional funding, it is going to take time to see improvement and veterans are going to still be waiting too long. as we know, the ability to carry out this mission is going to remain hampered as long as there is a number of key leadership vacancies. even while we work to break down these wait times and improve

accountability, there are many other serious challenges that have to be addressed. taking theirterans own lives each day. thousands of veterans are alone coping with sexual assault. while the department has made some progress, it will be an uphill battle as we work to eliminate veterans homelessness and the claims backlog. the secretary is going to have to grapple with all of these and more. thank you for accepting the call to serve your fellow veterans. areink you know that you faced with a monumental task. if confirmed, you will be billion,le for $163 310,000 employees, and the care of over 9 million veterans. the next secretary has to build can meet the veterans' needs today and for years to come. the secretary has to overcome

and transform a corrosive culture unworthy of a department dedicated to help our veterans. thesecretary has to reform poor management and communication structures that exist at all levels of v.a. met in myld, when we office, you told me you were one of the veterans that was lost in the system during your transition to military -- to civilian life. i trust that you understand what a critical moment this is for the v.a. and why we have to fix these challenges. i look forward to hearing your plans for addressing these. we all know that our men and women in uniform have earned a v.a. that provides high-quality benefits when they need them. thank you very much for answering the call.

mr. chairman, thank you for having this hearing. >> senator isakson. much for beingry willing to accept this challenge. i think you will do a great job. your primary job as head ceo of procter & gamble was accountability and bringing a return to your shareholders. your shareholders bought their stock with their own money. at the v.a., you also have shareholders, the veterans who bought their stock by risking their life for the safety of this country. there is no greater calling for us but to bring that value back to those veterans. the v.a. has many great people in it but unfortunately we have uncovered a culture not conducive to the best interest of our veterans. in some cases this has caused many veterans to have problems they should not have had because of people who are more motivated to make numbers look good on paper than the results of the veterans in their lives.

i appreciate that you are willing to accept this challenge. i have questions that we have discussed before that i want to ask. thank you for being willing to accept this responsibility. i hope you will bring the value to our veterans like you brought value to the shareholders of procter & gamble. >> senator tester. >> thank you. i want to thank you, bob, for be willing tofor being serve as the v.a. secretary. theh annans -- montana has second highest per capita number of veterans in this country. this is a personal issue for me. that arends mean a lot. -- veterans mean a lot. forward to doing good things under your administration. whether it is in mental health, making sure we have the doctors

and nurses, we need to support the problems of the veterans that are coming back. meeting, i appreciated your focus on the v.a.'s capacity to better serve veterans. there are some that want to privatize the the i -- the v.a. i am not one of those. there are others who want to build the v.a. i am in that camp. i appreciate your willingness to serve. you have got a full plate. i think you have got the tools that we need to fix what is wrong with the v.a. and improve what is right. with that i want to thank you once again. our veterans deserve our best. thank you, mr. chairman. >> thank you, senator. and rankingman member, thank you for convening the hearing today. mr. mcdonald, i thank you for

being here. opportunity the that we had this morning to sit down and talk about some of the issues you will be facing. in the midst of this crisis, it is imperative that we swiftly move to fill this vacancy at the top position in the organization. when secretary shinseki resigned, his resignation could not be an end to the crisis. so often that is the washington way. we make a change in the organization, suite the mess under the rug, move on, deal with other issues and eventually it is all forgotten. but the problems aren't solved. needs is aa. transformative leader that can bring about true and lasting change. as we have seen, a culture of

complacency if not corruption, has spread throughout the v.a.. it is going to be a monumental task that you have ahead of you. it is not an easy task. it will be especially difficult when the v.a. has been racked by scandal after scandal and there could be more. today we consider your nomination with that as the backdrop. unlike previous v.a. secretaries, you bring management leadership experience from the private sector. perhaps that is just what the v.a. needs. someone who has experience in reorganizing, reallocating resources to make an organization as efficient and effective as possible. in past years, this congress and this committee has made v.a. a priority. we provide the budget, personnel

effort to in an ensure quality of care. we were promised that was occurring. have we have seen among the v.a. has failed our veterans. just last week, acting secretary gibson said the v.a. could solve its problems with another $17.6 billion. i can't believe that just throwing more money at the v.a. is the answer. we know it is not the only answer because since 2000, the v.a.'s budget has tripled. however, we continue to uncover new problems. needsjudgment, the v.a. what you have experience in your lifetime. if you didn't provide good service and products, your competitors took your business away from you. i believe that the v.a. needs

competition. only then will the v.a. see that it needs to get its act together. only then will we start to see the v.a. get back to its mission of serving veterans. without serious changes at the reports of mismanagement, fraud, whistleblower retaliation and more, will continue. your job will be to root this out and do everything you can to turn the v.a. in a different direction. i look forward to hearing from you. i think your confirmation is assured. i do believe you are the right person for the job. i wish you the very best. our veterans depend upon you. thank you, mr. chairman. >> like you, senator. >> thank you, mr. chairman.

aloha, mr. mcdonald. it was a pleasure to meet with you yesterday. position,e to this the issues confronting the veterans administration of course do not go away with the change in leadership at the top. we all know that. i want to publicly thank secretary shinseki for doing what he believed would be in the best interest of the veterans administration. i thank him for his decades of service. here you come with your sense of commitment, your background in the private sector and a desire to really listen to the veterans, to hear what their concerns are and respond to them. pretty much not a top-down but a bottom-up kind of leadership style that i think will stand

you in good stead. while the number one issue based on all the information that has come out over the last several months is of course making sure the veterans at the health care needs met. at the same time, we know that there are other ongoing concerns at the v.a. and some of them were articulated by my colleagues, including homelessness, overprescription of drugs that may make them dependent, issues of educational opportunities, jobs, training. so you will have a full plate. i expect this committee will work with you in a very open and transparent way, in a frank way though that we can work together to move the ball and get the veterans a kind of attention that they very much earned. yes i understand that there are

capacity issues. i am not going to sit here and say that you do not need more money to hire more caregivers to other necessary personnel take care of our veterans and at the same time, you are sure me me that you would review the actions of your employees and take appropriate action as necessary to discipline and hold them accountable. thank you very much, mr. chairman. >> thank you, senator. >> thank you. welcome, mr. mcdonald. to your wife also, welcome. thank you, by the way, for the discussion we had in my office. in a short number of months, congress has had a glimpse into the failure of the v.a. to

provide quality care to veterans across this nation. it is disturbing that many veterans went without health care because employees decided to cheat the system. every time i am home, i repeatedly hear about stories and difficulties with the v.a. many are doubtful that it will ever improve. hospital, vegas v.a. more than 160 veterans were forced to wait more than 30 days for an appointment. a veteran waited more than six hours in the emergency room before seeing a nurse or doctor. in a small town outside of las vegas, 6000 veterans have waited more than two years for a clinic to be built. officials have not provided a timeline for approval of this facility. these problems extend beyond v.a. health care. veterans are also facing difficulty receiving benefits through disability claims

backlog. mr. mcdonald, i bring this issue up and continue to do so because of the claims backlog impact veterans of my state face, which is worse than any other. nevadans still have the longest wait in the nation. regional office remains the worst performer in the country. a few months ago, a veteran wrote to me saying, after seven months of no retroactive payment, i returned to borrow again. i spoke with the advisor and he told me because i was retired from the navy and received retirement benefits, i was considered low priority. i don't -- i believe you would agree with me that no veteran should ever be told that they are low priority. that is why i have been working hard with senator casey to have a hearing on our comprehensive

bipartisan legislation, the 21st century backlog on veterans benefits delivery act. you told me you had an opportunity to look at this. i thank you for taking the time. of access to quality health care, rural clinics are just a few of the concerns in nevada and i expect the new v.a. secretary to tackle these. it needs substantial reform from . in hopes toa restore veterans confidence in their system. to change it in the long term, your leadership must be unrelenting.

secretary tonew restore accountability and integrity to this organization. as a member of this committee with jurisdiction over the v.a., i want absolute assurance that the new secretary will committed to transparency and accountability. you, mr. mcdonald, for your willingness to take this particular position. it is also a challenging task. i need to be fully confident that you are prepared to transform the v.a. and meet the needs of nevada citizens. you have been a veteran.

you understood that. you put yourself in harm's way. to me about, should you be confirmed, which i feel certain you will, that you plan to get into some of those waiting lines, no staff, just you, and may be the veterans will notice you and maybe they won't, but the world -- the word will get around. a lot of leadership works on small symbols or you do things that others have not done. therefore, you are judged to be different, that you hold yourself to a higher standard and you are willing to do the difference. is that you have this extraordinary combination of having served in very dangerous ways at a very high level. i don't know you're right, i'm sorry, sir.

but you have run a great company. when you run a grand -- a great company and you have hundreds of thousands of people working for you, you cannot afford to make mistakes. here, we give you oversight. it is sad. america, youporate get oversight every day from your shareholders and corporate america. you don't have time to run from mistakes. yet you had to keep the larger interest of the corporation at iart, which you do, which think it was considered one of the best run corporations in the world or something like that when you are the head of it. so for me, it is not just a

question of what you are going to do. i think the real question is what we are going to do. how can people possibly talk about all the needs as people here have at the panel about the need for nurses, for mental health, 22 suicides per day come a figure so shocking that it is honest and compensable, the homelessness. shinseki cut the waiting time from one year in half. don't need to be told that because you know it intuitively. everything counts. you are very much into corporate culture. you are very much into personnel in evaluation and taking that into a very serious process, not in the sense of intimidating but in truth telling. that is a hard thing to do. metand i talked when we

about the problem in some of our great agencies. you are right up there with the department of defense in terms of numbers of people. so what are we going to do? you,n talk to you, after that we want you to go ahead and get all those nurses and this and all kinds of experimental research and cut down the waiting lines and get people the fantastic care and not give you a dime to do anything about it. that is what i fear. i have no fear about what you will do when you are in that position. i have a fear about what we will do as a congress to support you. so that we are not just blathering bromides of good feeling and goodwill sympathizing with the veterans and then putting up no money for you to do something. you cannot hire people without higher -- without paying them. you cannot build stuff without

paying for it. in a culturedo, where you cannot put up money for anything because you cannot possibly win the next election or at against the constitution or the founding fathers would never have allowed it. good about it but you are not going to help veterans. through a superb chairman and people like eddie murray and head of the budget committee and others that we will provide you with the resources that you need to be able to pay for what it is you want to do. you are here to do the job. you are not sentimental about it. you are realistic. but you need money and we have to give it to you. good luck.

>> mr. chairman, thank you very much. mr. mcdonald, thank you very much for the conversation we have had. i would like to use my opening statement as an opportunity to talk about a different topic. i would try to highlight some things that i would like to hear your response to. mr. chairman, i would like to encourage you and senator byrd michelle ryann german military sure before we depart that we have a report, a conference committee report on the veterans choice act. while i certainly believe that a iw secretary was necessary, indicated at the time that i asked for the previous y's resignation would not be enough.

it would be terrible on the part of the u.s. house of representatives if we failed to reach an agreement to conclude this work. i spoke on the senate floor prior to the passage of that legislation which passed 93 -zero. it indicates how disturbing it is to come to the united states senate and we do nothing to solve the problems of the american people because the senate does not function. we don't have bills on the senate floor. we don't offer amendments. committees do not do their work. there is not oversight. anwe can't come together on issue related to veterans, this of all issues that we face at this point in time in the united states senate ought to be one that we can resolve. and the failure to do so would be a terrible for the united

states senate but more importantly terrible for the veterans of our country. theone more time remind american people how dysfunctional the united states than it is today. so what troubles me at the moment is the announcement yesterday by the majority leader that he believes it is unlikely we will resolve our differences and have a vote on a conference committee. we ought not let that be the case and we ought not adjourn for an august recess in the absence of us reaching a conclusion. don't walk away from this issue. the leadership of the senate, the leadership of this committee, individual members of this committee, individual members of the senate, it is our responsibility to complete the task that we set forth for the veterans of the united states of america. while it has been easy to criticize the department of s, the unitedir

states senate is deserving of that same condemnation. thank you. >> senator blumenthal. thank you, mr. chairman. thank you mr. mcdonald for your willingness to undertake this very serious and challenging responsibility. i'm sure your family listening to us here wonder if you were in your right mind in except the president's offer. i want to join my colleagues in thanking you for coming by to see me. public service is in your blood. it is part of who you are and i thank you for that ethic and tradition. to at to draw a comparison world more familiar to you than perhaps this one. are about to takeover a bankrupt corporation. the threat is financial but the real insolvency is in a rally in

management -- in morality in management. your qualifications and skills are extraordinarily well-suited to these challenges. you know about the importance of truth telling. with 60,000 employees reporting to you and the soundness of your , theions on products service depending on accurate data and in permission, -- and information, you know that an organization like the v.a. which has a bankrupt truth telling operation cannot last long in serving its customers well. that includes providing bad news which you know may sometimes be more useful than good news. i am very interested and grateful that, in your testimony, you cite the west point ethos of choose the harder

right than the easier wrong. that is exactly what the v.a. needs. second, in addition to demanding accurate information, i think you will need to change leadership after the v.a. your background in developing leadership at dr. and gamble makes you well-suited -- at procter & gamble makes you well-suited. and your culture of striving to and at theeadership same time rewarding people for conveying bad news that has to be known and acting on the data in ways that are important. our nations heroes are our public trust. so the corporation that you are about to take over won't be measured by its profitability but how well it serves our nation's heroes in health care, , job training, skill

preparation, and all kinds of areas that may not be directly involved in the crisis that brought you to this position. in addition to the continued edition -- attention to wait times as a result of the data analysis and improved access to care, we need concern about the predatory practices of some for-profit colleges that received funding for g.i. benefits, care for our female veterans who often lack access to the best care especially when gs orhave been victims of p military sexual assault, and strong whistleblower protection from retaliation for those employees who may come to you with those concerns and the truth telling that is so necessary. i want to affirm my own commitment in helping you in any way that i can.

i believe that we are all rooting for you. not just in some abstract or conceptual way. we are in your korner. we are rooting for you. i believe you have a unique and historic opportunity to get done a job that all our nations euros will be grateful -- nations heroes will be grateful to you for doing. thank you. >> senator boozman. >> thank you mr. chairman and thank you mr. mcdonald for being here. i appreciate the visit from you last week. you have an impressive resume. your commitments to family and country are obvious from our discussion. i know you will remain rooted in these as we move forward. today, v.a. is failing our veterans. the problems plaguing v.a. are

systemic and need change. certainly, the curtain bash the current altar -- certainly, the current culture. deliverility of v.a. to timely, quality care and allegations of manipulation of patient data has given a black eye to the agency. tasked with caring for and theing our nation's heroes, stories coming across the country are heartbreaking and unacceptable. i firmly believe the lack of accountability is the root cause of the problems facing v.a. today. ishough the mission of v.a. different from other federal agencies, it is still part of the bureaucracy in washington. as we all know, your accuracy must be managed accordingly. failing to do so will only lead to the path of failure itself.

the position comes with tremendous responsibility and commands someone who understands the sacrifices and the needs of both our veterans and their families. the next secretary of v.a. must be willing and ready to lead v.a. in a new direction. while i am grateful of the -- i believe the current state of the affairs at v.a. demands bold leadership and the complete transformation in the culture at the agency. the problems did not happen overnight and solving them will not he an easy task. despite this, with the right person at the helm, a person willing to work with congress and other stakeholders, the challenges facing v.a. can be met and expectations exceeded. we must never forget our nation's veterans. their sacrifice and service to this nation are second to none.

not only do they deserve our gratitude, but they deserve the benefits they have earned, delivered consistently untimely. anything less is unacceptable. their commitment to country is without question and our commitment to them must be the same. i believe choosing the next v.a. secretary is only the first of many to getting v.a. headed back in the right direction. i am committed along with my colleagues to seeing that the next secretary of v.a. delivers the change that the agency so desperately needs. once again, i welcome you and thank you for your willingness to serve, for being here today and i look forward to hearing directly from you in your testimony on your vision for v.a. thank you. thank you for your willingness to serve your country and be a public servant.

thank you to your family because it is going to be a lot of stress on them. it is a lot of work and a lot of commitment to participate in the federal government in this way, especially at this unique time with the v.a. have preparedy opening -- let me just say this. you are going to hear a lot of noise out there. is theng about d.c. noise happens every minute and it changes every minute. my hope is -- i am very supportive of seeing you as the next secretary -- i think it is important that you hone in and be bold about what needs to be done and not hesitate when you think there needs to be changes and when people need to be let go you let them go. your experience in the private sector has taught you to run an efficient operation. i understand it is important. i used to be the mayor of a city. you had to let some people go.

maybe it wasn't the best time for them but it was important for the broader perspective of what you are trying to do in the delivery of services. as i look at the work you have done, i commend you for it and i think a lot of of people are putting a lot of expectation on you. i look at you and think this is an opportunity to take a situation of the v.a. which is struggling with trust among the public and its recipients, to legislative hearties to figure out how to do next and how to do it. you are going to hear this from both sides. i'm hopeful, too, that we have a comprehensive reform bill for our veterans health care system. but that is not going to be the only answer. there are many of those things that we will put into that legislation that you can do right now. you can take charge and do these things. i would ask you not to wait for us. the minute you are confirmed, get busy.

there are too many needs in alaska with 77,000 veterans waiting for care. we didn't wait around five years ago when i was elected. this is not new. last week, i presented a report. in 2003, 11 years ago, the same story. it's like déjà vu, here we go again. i wasn't around in 2003. i am here now. in alaska, we have done some things that are very innovative. we don't have a veterans hospital. we have a clinic. size of the country is alaska, its size and vastness. so we have to do -- so we have to figure how to deliver health care so every veteran has access. we have done that to manage expectations. i think some people will say just open up the system to every

private doctor in the world and it will all be solved. i don't know how long it takes you to get a doctors appointment. i know how long it takes me. if anyone needs mental health services in this country, the waiting list is a mile-long. i think it is important and i am anxious for you to get on the job. upope you don't get caught into the politics of what goes on around this place. i know by your disclosure we may have differences in maybe our past politics. but that is the greatest thing about this body, this committee. we don't look at the politics. we look at what you can do. your history tells me you are the right guy at the right time. i am looking forward to it. you will probably hear a lot for me. we have done it in alaska. we have more improvements to do. i think there are huge opportunities around the country that you can take right now. waiting for us -- i would hope

that we would have a bill before we take a break but we don't. when you get confirmed, get busy. be bold. not reckless, but the bold. inform us as you move forward. keep us in the loop. moving forward is more important to keep that v.a. moving forward. your public service is an important part of serving this country and i thank you a second time for serving our country. >> thank you. are pleasedald, we to hear from you. let me swear you and, please. do you solemnly swear or affirm that the testimony you are about to give before the senate committee on veterans affairs will be the truth, the whole truth, and nothing but the truth so help you god? thank you very much.

now, mr. mcdonald, we are very pleased to hear your testimony. >> thank you, chairman sanders, ranking member burr. therans here and across country, thank you for the privilege of addressing you today. i am honored to be before you seeking your endorsement to become the secretary of veterans affairs. thank you for scheduling this hearing so expeditiously. i would like to introduce my wife of nearly 37 years, diane, who is sitting behind me. we are blessed with a wonderful family. however, only diane was able to be here today. i would also like to thank senators brown and senator portman for their kind theiructions and for friendship and their partnership over the many years we have worked together to make ohio greater and to make the procter & gamble company greater. i very much appreciate the

confidence that -- confidence of president obama in this nomination. the mission is to fulfill president lincoln's promise to care for him who shall have war in the battle and for his widow and his orphan. by serving and honoring the men and women who are merrick is veterans, i also want to create an organization that lives by its core values, integrity, commitment, advocacy, respect, and excellence. over the last several weeks, i have had the opportunity to meet with many of you individually and i deeply appreciate the committee's concern and unwavering support for our veterans and for the mission of the dependent of veterans affairs. i've listened carefully to your concerns and advice and i benefited from your counsel. as explained by senators brown and portman, my life's purpose

has been to improve the lives of others. my time at west point and as an airborne ranger captain in the 82nd airborne division instilled in me a lifelong sense of duty to country. my values are steeped in my experience at west point and in the military. those values have allowed me to be an effective leader at the procter & gamble company and those values are what i will bring to the management of v.a. weststill guided by that point prayer which encourages us to choose the harder right rather than the easier wrong. for me, taking care of veterans is very personal. i come from and care deeply for military families. my father served in the army air corps after world war ii. my wife's father was shot down over europe and survived harsh treatment as a pow. her uncle was exposed to agent orange in vietnam and still receives care from the v.a.

and my nephew right now is in the air force flying missions over the middle east. my 33 years with dr. and gamble taught me the importance -- of proctor and gamble taught me the importance of strong leadership and being responsive to the needs of customers. when i joined the company, we recorded $10 billion in sales. today, it is $84 billion with almost double the number of employees and the brands are present in nearly every country of the world. i helped lead this transformation. i am a forward-looking leader who spent my business career new andg png to serve underserved customers. that is the experience needed to modernize the v.a. as i met with members of this committee in the past few weeks. you told me the depth of crisis of that the department of veterans affairs. while there is much that is going well, there have been

systematic failures that suggests that some in the organization have lost track of the mission and core values. department's problems with axes, transparency, and accountability are all well documented. there is a lot of work to do to transform the department. it will be easy but it is essential and it can be achieved. the seriousness of this moment demands action. and if confirmed, i pledge to the committee and to our nation's veterans to take a series of immediate actions over the first 90 days to deliver the needed reforms our veterans deserve. i will put the veteran at the center of everything that we do consistent with our mission. willnfirmed, on day one, i lay out my leadership vision to all employees. my charge will be to provide veterans the care they have earned in the most effective way possible. i will ask v.a. employees to join me in reconfirming our

commitment to v.a.'s mission and core values. i also plan to ask all employees to bring forward any information, any concerns, any problems that exist so that i, as a leader, will know the old picture of what is going wrong and what we can improve. if confirmed, it will be important to incentivize this process and reward those that constructively come forward to solve problem's. looking forward to gaining valuable input and insights from its employees as well as veterans and other stakeholders. will also renew the department's strategic plan and ensure it is properly deployed so that every individual in the organization knows how their work every single day ties back to the strategic plan and to the mission of caring for veterans. by getting out in the field and talking with veterans and employees, i will learn much

about the organization as possible. i will be able to determine the processes that will need to be reorganized or streamlined. in order to regain the trust of the american people and most importantly veterans, we must ensure every employee has an action plan in their annual performance review that rolls up to the strategic plan and the mission for the department. the majority of the employees of the v.a. are dedicated to the mission and the values of the organization. but those employees who have violated the trust of the nation and of veterans must be and will be held accountable. plan to improve the communication between the field structure and the central office, between the employees and the leadership. i also plan to travel extensively over the first several months to hear directly from employees, veterans, and other stakeholders. oflan to establish a board physicians to advise the secretary on best practices for delivering timely and quality health care.

i will focus on reorganizing the department to more efficiently and more effectively use our resources to get care that the veterans deserve and have earned. and develop a strategy for meeting increased thdemands. i believe that apartment will need to expand the use of digital technology to free human resources that can be applied more to the care of veterans. i plan to take advantage of the scale to improve productivity and the flow of people to the work. it is clear the v.a. needs to be more efficient and productive. the department needs to demonstrate they can manage a complex if it -- facility portfolio, it can create with the department of defense and integrated record system, they can regularly and accurately produce key data for oversight invidious.

most importantly, provide the veterans highest-quality and cost-effective benefits possible. all of these things are possible. they are possible through some of the steps i outlined. if confirmed, i will work to transform the department of veterans affairs. i will continue to partner with you in all the departments stakeholders. made great strides in serving veterans thing to the commitment of many dedicated employees and the hard work with our partners and advocates in the community. the v.a. is in crisis. the veterans are in need. there is much to do. i can think of no higher calling, no higher calling than to serve our veterans who have so self weight -- selflessly served all of us. with your support, i am confident we will succeed at the department of veterans affairs. th

that we would become the most digitized company in the world creating molecules digitally and shipping to our customers using digital technology. i think the same thing needs to be true for v.a. i plan to do that. >> thank you. mcdonald., mr.

we are truly grateful to you and your family for this. i want to start with a couple of housekeeping questions. as ranking member, part of my role is to give oversight with regard to the activities. staff toes me or my request information, statistics, or other materials. will you ensure that my staff and i will be provided with the requested information in a timely fashion? senator burr, you and i talked when we were together, you will have my cell phone number. every member of the committee will have my number. inould expect if we are not your need, you will call me. when you are on a large corporation globally, you have a cell phone that is on 24 hours a day, seven days a week. if you have concerns, i want to know about them and react to them. >> will you be proactive in alerting this committee, including both sides of the

aisle, about significant issues involving the v.a. ? >> no leader can do a job this big by themselves. i need your help if confirmed. >> he has deep concerns that the veterans needs are not being met. i think teachers to new york hospital. he told me this morning the medical staff is the same medical staff that we use at the v.a. facility. that we actually leverage the hospital staff to staff the v.a. is that a model we could expand around the country and leverage for any shortages that exist? is that a possibility? that iswhat i know, relatively common. i know that -- i think from what i read, two thirds of health care professionals in the united states have at least trained in the v.a.

that would certainly be something we would want to look at, particularly in a case where capacity is trained and we need help. told that inn 2011, v.a. began an initiative called the harmony project. this was to explore the pros and cons of further integrating emerging operations of the v.a. and the department of defense health care systems. resulted in effort a report suggesting the agencies could improve access and continuity of care while saving billions of dollars annually, but it is unclear to me whether the v.a. ever discussed the findings of that project with the department of defense and whether any action was ever taken on that report. i do not expect you to know anything about the harmony project. can i get your commitment that you will go back and ask was there a harmony project, that you will review it, and then you

will provide the committee with a copy of the conclusions of that project? >> yes, sir, i was certainly like to learn about. demonstrating my own commitment to the importance of the department of defense and veterans affairs working together, i had the opportunity to meet with secretary hagel. we had a great meeting. we both committed to a partnership, a partnership that acting secretary gibson had also had it with secretary hagel. we both agree that it should not thehe veterans fault or service members fault that there was a scene in the united states government between the department of veterans affairs and department of defense. that should be absolutely seamless for those who have taken the oath and became veterans. i pledge and i know secretary hegel does the same to make that as seamless as possible. >> if i could get your tomitment, excuse me,

report back to congress or the committee if what or any interactions taking place between the v.a. and the department of defense about the concepts highlighted in the harmony project. >> i am not familiar with the project, but we will take a look at it and get back to you on what we think about the different items in the harmony report. >> i appreciate that. i thank the chair. >> thank you senator burr. >> thank you mr. chairman. reallyonald, i was troubled to hear secretary shinseki say he felt like he was misled. cannotartment, they function at the secretary is not given honest information from the field and taking appropriate action. how are you going to create a better team and build trust and transparency?

>> i think that is an excellent question. isday one, what i have to do meet as many employees as i can. how they understand think about their role in the department. one of the things i pointed out is i think we have a pretty good strategic plan. when i looked at the strategic plan on the internet -- i am only looking at publicly available information. the behavior of every employee in the department is not consistent with that strategic plan. we have to develop a way to make sure the department -- the behavior of every employee and their expectations on their performance each year ties back to the strategic plan. >> do think that was happening? >> i do not want to judge but at the procter & gamble company, what we work hard to do is to take the strategic plan and make sure every blow ranking and

every employee in the entire company, if you roll up the behavior, it will be based on the strategic plan. >> with secretary shinseki was saying he was misled about people that were not telling him the truth. how do you build that trust so that you can -- >> i have to be out there with the people in the field and we have to have the leaders who are vigilant, making sure that trust israel. real. it is unconscionable to me that you have an organization where one of the stated values, one of the stated values -- the first they did value is integrity, yet you have people lying. you have people tolerating it. the west point honor code says we do not lie, cheat, steal the we do not tolerate people who do.

you don't want people in your community line. ying. we have to get into this and understand it. >> i appreciate that commitment. i have talked with prior v.a. leaders. many of thoseess, facilities for some further investigation. time andrecent wait quality data released shows shortcomings and washington medical facilities. i have raised real concerns about what is happening with the spokane medical center, including whether staffing and budget shortfalls are hurting health care. if you are confirmed, how were you going to confirm oversight of these facilities and make sure the resources are getting to the places where it is needed? >> i think that is part of the forecasting and projecting that i was talking about in conjunction with the strategic

plan. what i heard from secretary gibson last week during his testimony was that the da had not done a bottoms up forecast before. he was having some trouble getting that done. we got to do a better job of that. we got to be very open and transparent with all of you and all of our constituents as to what we are forecasting. we have to put the systems in place that can make sure our veterans are getting the appropriate care. we have to be able to have doctors and nurses and physicians on the ground to be able to do that. i think digital technology will play a role because it will help us -- i know we have at the v.a. very good electronic medical records. if we can get a scheduling system that is equally world class, there is no reason we can't, i think we can use that to help better care for the veterans.

>> you talk a lot about health care. thed want to ask you about veterans transition into civilian life. many of them are using their g.i. jenna -- g.i. education benefit. back in 2012, i pass legislation to make sure they had something available to them so they can have resources available to them. schools may provide inaccurate or incomplete information to andpective student veterans that veterans themselves want independent, objective advice when it came to making their education decisions. yetow you are not in there but one of the things i hope you focus on is making sure the veterans make good choices when they use of those education dollars. >> i will certainly focus on that. i myself am of the -- the beneficiary of the g.i. bill. my graduatei got

degree with my g.i. bill. my father was a g.i. bill user as well. it is ia very important part of this country. we need to make sure it is robust. >> thank you very much. >> thank you, senator murray. your 90 day plan, you're going to travel the v.a. system and meet with providers within the v.a. and veterans and stakeholders. when that is older, will you report back to was what you found and what you were going to do to correct what is wrong? >> i would love to do that because my ideas are laid out in my opening statement are based out on publicly available information. as i learn more, that will be modified. troubled love to report back to you as to what i saw and how that -- i would love to report back to you as to what i saw and

he indicated actions going forward. >> your answer is perfect because all the discoveries we have made beginning with phoenix and other facilities in the country have been information that is not publicly available. it took whistleblowers to bring it forward to us which reflects the culture within the v.a. system right now which is a protective culture. you have to open up. there are only two motivators and running a business -- one is fear and the other is report. it is the fact you are doing a good job. i hope you will give us a game plan and make it public and make the employees know you are not just passing through. we are going to insist on accountability. >> i cannot agree with you more. for in organization to succeed, it has to learn. organization to learn, people have to admit when things go wrong. we try to do the same thing as at procter & gamble company.

if something goes wrong or right, you need to learn from it and share it through the organization so it does not happen again. in this culture, you're not getting bad news, you are not correcting mistakes. everything becomes a one-off. that is why we are seeing so many reports and it seems like there was a bit from a different location somewhere in the country. we have to create a learning organization. your testimony, you mentioned creating a position advisory board. -- you complement contemplate those physician becoming only the a physicians or do you have outside physicians? initial thought was to get the very best medical talent in the world. been very heartened by the number of people who come forward to me and said they

would like to participate and like to help. i think the greatest thing about this nomination at this moment in time is the original question about the mission about caring for veterans. there is an unusual coming together of everyone in this country to take care of those veterans. i have got a lot of offers already. i will like to the very best medical minds we could find inside the v.a. and outside. >> i think you have discovered what i have found in my travels over the past six months dealing with this issue and that is a lot of people want help. there is a lot of help out there. there is an example in atlanta today and one of the finest centers in the world and recognizing. they tried to get the v.a. to cooperate. they finally cracked into it last year and now they are taking voluntarily in raising the money to do it. taking spinal cord injury

patients. the more we open the door and make the v.a. accessible to the private sector providers, those people -- many of them are veterans -- the better the v.a. will be because there is support from the outside. >> it is a great institution. it is lead innovation in so many areas and does so many unique things that i do not think can be done as well by the private sector. nevertheless, any organization like the v.a. needs the benchmark itself consistently against activities elsewhere to become better. company, we& gamble benchmark ourselves against the very best companies in the world in order to make ourselves better. i think we would need to do that as well if i am confirmed. >> thank you for your service to the country and thank you for the willingness to take this job. >> thank you, mr. chairman.

i want to thank you, bob, for willing to take this job. i don't know what you thought about what you will do on your first day. you mention your testimony about the 90 days. what is on the very top of your list? >> the very top of my list is getting the leadership and the entire organization together and sharing with them what i plan to do. and how important to me the mission and the values of the organization are and how on acceptable it is to behave in a way that is inconsistent with the mission and the valleys. that is what i am going -- and the values. that is what i will do on day one. i know you talked about leading by example. is there anything you can do to restore trust by the veterans to

the v.a. again? >> i have already made calls to the veterans service organizations. i have talked to other veterans. what i would like to do as i travel is to get together with the veteran service organizations and veterans around the country and listen to their concerns. i want to do that as a veteran. i want to do that as one of them. i do not want to do that as a secretary with an entourage. >> good. i want to talk about perception. you said you have gone health care from the v.a. in the past, is that correct? >> my family has, i have not personally. >> it still applies. has your perception of ea changed over the last 30 some years? >> my father-in-law before he passed away suffered tremendous treatment as a pow.

he loved the v.a. he loved going to meet with his fellow pows. he very much benefited from that. agentle who suffered from orange and still is under the care of the v.a. speaks very highly of the v.a.. his personal experiences have been all been positive. became ayou nominee, has anything changed from your perception of the v.a. in the last month or three weeks? when you run a large organization, there are always things that go wrong. the people i have met seem very dedicated to the mission and the core values. what we have to do is figure out who was not. >> right. most peoplee that

are talking about is access because once it goes to the door, 90% of them think -- there is another issue and that is mental health. the injuries coming out of iraq and afghanistan deal with -- the majority deal with ptsd. we have a shortage of providers. there is also a big shortage in the private sector. how are you going to solve that problem because it is a problem that will not go away. you will have a better success rate if you get to them early. >> i agree with your comment. it is a great comment which is we do have an issue on mental health, not just in the v.a., but in the country. we have to find ways to meet this need. it is one of the most pressing needs that we have within the v.a. and one of the most pressing needs within the country. i think partnerships may be one way to look at it. -- this is alking

longer-term solution -- talking to people interested in careers. this is a great career for someone to be able to make a difference in the life of another person through effective mental health is fantastic. we do need more. we do need more. -- we have aion conference committee going on right now. and major cost to those bills deals with outsourcing health care to the private sector. it costs more money. sloan gibson says it costs more to give the private sector than what the ba can provide -- the v.a. can provide. it is an emergent situation, i believe. that aside, what is your number one priority coming out of that conference committee? >> again, i am dealing with publicly available information.

sloan gibson for over 40 years, having gone to west point together and serve together and in the military, i trust what he has to say. i think he has talked about the resourcing needs that we have. that is all about access. >> thank you. i appreciate your time. >> thank you. senator heller. >> thank you. mr. donald, thank you for being here. i don't think there was any secret to my priorities on this committee. the backlog. especially in light of the fact that i has the worst backlog in the country. v.a. continues to provide is a very rosy picture of how it has reduced the claims backlog. i want to assure you that this depiction is false. last monday, a report was

released about how the claims initiative clicled to inaccurate processing in part of them feeling pressure to complete claims. i want to go nationwide and then a little locally. nationwide, 32% of the claims reviewed had errors. some claims were denied without waiting for evidence needed to decide. some claims were filed without a final decision. some claims without a final decision were counted as closed. my question is -- do you think is responsible for the v.a. to count as progress in light of this report? >> i think we need to improve the claims backlog. i read the report which you shared with me. i am thankful for that but i am also embarrassed for the organization that you had to go

to that. we have to get ahead of this claims backlog and we have to find a way to get it down and get it down quickly so that the veterans are getting the care they deserve. >> if i can get a commitment from you that you will review the entire claims process, whether management has tried to manipulate these numbers. >> absolutely. one of the things i am trained quality where it is a technique taught by a doctor where you take a look at a work process and you work to find out where the constraints are and you streamline that process. given the challenges with the claims process and the backlog, that will be one of my first jobs is to take a look at that. reporte was an ig recently of the va hospital in reno.

found that 51% of the claims reviewed were inaccurate and that management had contributed to inaccuracies and other problems. many months ago, i was promised by your predecessor or would be predecessor that there would be changes. i personally have call froed for new leadership. would you review the management of each regional offices including that of reno? >> certainly, i will. one of the first tasks of the leader, i think i wrote this in my submission, is to get the right people on the bus and get them on the right seat on the bus. fortune care for the 500 ceo you talk to, it took them too long. it always tasted too long to get the right leadership team in place but it is the first priority. >> i think you just answered my question. you are willing to make

leadership changes when they are necessary? >> i have done that throughout my careers, beginning in the u.s. army. >> ok. thank you, mr. chairman. >> senator brown. >> we have heard of my colleagues refer to me around the country. very critical of the v.a. we have seen some of this criticism directed at v.a. employees generally. i think it is important -- i know you will be dealing with very serious morale issues. we had terrible morality shoes at the dayton va.a .a. to always point out that 30% of the v.a. employees are veterans and close to 100% of the employees chose to serve veterans. how important morale is and how important it is that we

recognize most of the employees are doing a good job. that me ask a couple of questions -- let me ask a couple of questions. he did threesor, things that he was working on that want to ask if you plan to continue. an self-imposed a plan for ending the blacacklog. we have seen major improvements. he worked hard in reducing veterans home was less -- highlighting and one of the nba's that were considered some of the best in the country a meeting unique needs of women's veterans. want to ask you of what you know if you plan to continue his efforts on those three broad issues. >> i do, senator brown.

in fact, i was reviewing the strategic plan. i noticed the agency priority goals are two of the three things you mentioned. chronichat one of the groups of homelessness is women. absolutely, we will continue work on those three areas you targeted. >> the bea conducts of appointment each year. i. 6.5 million veterans, 80 million appointments. some of those are conducted by private providers. i hear it from these groups about delays and payments for the services. sometimes they go for as long as a year. i want to ask you to commit to dealing with payment and working on this issue on behalf of veterans affecting those health-care people and institutions outside of the v.a. >> yes.

>> last is one is on a further field we talked about in my office on your first visit. that is legislation that i have worked on called the significant event tracker where a number of soldiers in combat will get head marine or ranger may say he got his bell rung. it is not recorded anywhere. a soldier gets four or five of these and a space of a year or a space of two or three years of duty. six years later, his behavior changes. his kids notice it. he has no documentation of it. it makes it hard to diagnose it because they do not have the records. it makes it more difficult for the v.a. when this soldier or veteran filed for disability. often times, it is difficult to put together what happened.

therefore, increasing the backlog, delaying it when the v.a. does have the information tha. weather this legislation passes or not, would you commit to working with the department of defense so they keep that her records on these so-called embeddable -- invisible minor injuries, injuries that have a long-term effect on that soldier? >> i think that is a really important idea. secretary hagel and i discussed that. i think if anything this really shows why we need a v.a. because the v.a. and the dod working together can do this and they are going to be on the forefront of innovation on mental health thesedeals with significant events that occur. we have to do that but we have to find a way to do it. it will be all new and innovative. it'll be something that has

never been done before but it has to be done. >> the burden rests with dod more. you urging dod to do it just like trying to eliminate what between theall soldier and the v.a. and how that is so important to smooth that over. >> we will own the outcome. understanding that outcome and being able to trace that back to the significant events that occurred that created the head injury is going to be critical. i think it is very important that we work hard on that. >> thank you. >> thank you. again, thank you so much for being here, mr. mcdonald. is a pretty extensive interview with whatever the subject from the press. isthe end of the interview, there anything that i left out,

is there any question i have not asked. i usually reply not. i think you are at that point right now. i just want to say i am very impressed with the answers you have given. i do not think it is feared to get to specific since you're in the position that you were just getting your feet wet. you talked about process, your approach to how he will solve problems -- i think it is excellent. i want to mention a couple of things that i think is important. just mention a couple of things that are on my mind. one of them is the fact that right now when a better and goes octor, heicare d gets a prescription and in order to get that filled at the v.a. which is a pretty good deal for the veteran, he has to go see a be a doctor which -- ava dr. which makes no sense.

i would like you to think about that in the future. scheduling is a huge problem. you mentioned getting some of the providers, getting the best providers and visiting with them. certainly, the administrative people would be good to do along the same lines. that really is the backbone of health care and whatever you are looking at. suicide, prescription drug prescribing -- i think there is too much of that. not prescription drug that the schedule drugs. we put tremendous pressure on the v.a. to get rid of their backlogs and specifically, these things. in treating our veterans that have issues. there has been a lot of pressure to get that solved and eliminate

the black log -- the backlog. the easiest thing is to prescribe a drug rather than working on the problem. again, the prescription drug abuse. there is so much of the stuff on the street that when i am sheriffs, ih my talk about veterans regarding that and selling that to supplement their income. that i wouldng like a commitment from you is one of the things that really frustrates the committee and as you are seeing -- the committee is a bipartisan entity when it comes to the veterans, congress works very well together whether it is in the senate or the house. republicans and democrats. one of the most frustrating things is trying to get information and not being able to get that information in a timely way, to be stonewalled. i think you find the committee

really does want to help you as we go forward. i would like you to commit that when we do ask for things that that is honored. this is -- we have oversight, recognizing that fact. and that you will try -- i know you would try to have a good relationship between the committees, but i think that is probably one of the most important things and most frustrating things we had. >> it is certainly my intention to be responsive to whatever questions or demand you may have. i realize the role you have an oversight and are realize that you have people in your state who have needs. it is going to be our responsibility to try to help you meet those needs. toill plan to, if confirmed, give every member of the committee my cell phone number.

i will expect you to use it and call me when you have a concern. we will try don't -- we will try to do what the together. >> thank you, mr. chairman. >> thank you. i think you were probably the first person to give all of us your cell phone number so i hope this is not a situation where it is be careful what you ask for. >> i mean it. >> we appreciate it. senator brown brought up the question of the significant to ourof that occurred enlisted people, our soldiers that never get into the records as i have heard of veterans as they are trying to make their claims, they are not able to get the information to back up those claims. whenads me to ask you general gates and secretary shinseki were leading the dod

and the v.a. respectively, they talked about seamless records so that the records follow the person, the individual. here we are. we still do not have the compatible systems. is this something you would pursue so that when our people leave active service and become veterans as their records are with them, it follows them. apparently this require some kind of a huge computer change now we have not been able to achieve even if a lot of money has been spent. would you pursue this course? >> yes, senator. importanthink it is that the dod and the v.a. operate seamlessly. it is not the veterans fault there is a boundary between those two organizations. we need to operate seamlessly.

i think when i met with secretary hagel, he had the exact same interest that i do. in fact, he asked for the meeting which i thought was incredibly jaded -- gracias for him to do since i am only a nominee. i think that recognizes how well we can work together to get these things done. i know progress has been made on the record. interoperability between the two organizations but more progress needs to be made. >> apparently, there is some tremendous difficulties of getting this done because six years later, we are going to follow up with you. i intend to see how you're getting along with that. you mentioned in your testimony that the v.a. operates as loosely connected individual administrations so various decisions are being made at the

local and state level perhaps. orre is not compatibility procedures that are being utilized that would enable you to decide or prepare -- compare what is going on with the v.a. and one state versus another state. in a situation like that, how would you address the fact that across the v.a. system systemic problems will be difficult to address when there are multiple organizational management structures in place? >> i think your question is insightful because any large organization needs to operate with one team and one dream. you cannot have separate organizations going different directions. put to howought is do you break down boundaries in organizations?

my experience over the last 40 years has been if there is a problem in the organization, typically a curse as a boundary. how do you make those boundaries permeable so that resources, information can flow between those boundaries? one of the ways we have to do that is by putting in place systems that will work so that we get predictably good results every time something happens. scheduling system is an example. that allowsing is you to flow resources across the boundaries so that each individual entity is not asking for more resources when in fact the resources may exist somewhere else and we need to flow them there. a good example of that is migration that is a currently happening with the veterans. they are migrating to different places than you may have expected. we are going to have to be flexible enough to make sure we follow that migration. >> when you're dealing with the

huge system like the v.a. system, you are going to get a lot of pushback from people who are used to being left alone in their regions or wherever. makingyou the best in sure that we really are working with the system that responds to the way it should. >> thank you, senator. senator moran. >> thank you very much for your presence today. thank you for earlier willingness to serve as the secretary of veterans affairs. i hope you'll consider me and other members of this committee allies as you try to develop a strategy and implement that strategy that benefits those that serve our country. i want to talk broadly for a moment and bring kansas into the topic of conversation. first of all, in the hearing most of held in may, the veterans service organizations testified.

i think without exception, those organizations that have consistently requested additional resources from congress to support the activities of the department. my summary of the testimony was that each and every organization, those seven esos all caps the five that while in the past there is additional money going to the president, the indicated earlier this year that during his time in office, the department of veterans affairs and more resourced than any other agency or department in hi administrations. yes, wet they made was probably could use more resources, but without exception it seems like the testimony was the money is going to the wrong place. it does not result in better care. it does not result in more providers. and resulted in more paperwork and bureaucracy.

as we have conversations about more money, when you make a budget request, we need to make certain this is not about standing the number of people. in theold whicith headquarters, there were 800 people in 1990 and now it is 11,000. the focus has to be on the people who provide patient care, not the folks who get into the way of that patient care. i indicated to you in our commerce station that i am looking forward to somebody who can rebuild the trust. that i want and the department of veterans affairs and what our veterans deserve to have in the department for their benefit. i look forward to working with you to accomplish that. i want to highlight for you how rural our state is.

i served in the house of representatives for a district that is larger than the state of illinois. toneed to continue to work provide services to folks who do not happen to live any place close to where there is a va hospital. over the course of my time in congress, working with the department of veterans affairs, we have had outpatient clinics that has helped. or five hoursour from a va hospital, how do you get there, particularly if you are 92-year-old world war ii veteran? if you are 92 when you live 2.5 hours from the outpatient clinic, it doesn't make that much difference that you are two hours closer to a facility if you cannot get there anyway. one of the things i am pleased about and the legislation that is pending that i hope the conference committee reaches a result when we come back and the idea if you

live long distances from ava facility that the ba will provide care for you. the v.a. today has the ability to do that. they have the ability to pay for outside services. they are seemingly reluctant and often unwilling to do so. you need to understand that when the v.a. fails to provide those services to those veterans, most likely what happens is that better and no service at all. hometown -- we were successful in opening an outpatient clinic. 1100 veterans of northwest kansas was able to access care. that 1100 or waking -- making their way to wichita, this would be closer. the amount doubled because prior to that those veterans were not receiving care.

i look forward to my opportunity with you. i want to help explain the challenges that we face in a st ate like ours. one of the ongoing complaint i will like you to solve is we have an outpatient clinic in kansas that has not had a physician for more than three years. while i have raised this issue with the department of veterans affairs, over that time, the problem i had is that -- i understand it is difficult to recruit and retain physicians, there is been no plan to fix the problem. we need to help you implement it. all want to bring home to you the unique natures of places like my state. thank you. >> as you said, i think it is all about the mission which is care for the veterans. we have to look at all these decisions through that lens and

tried to get access for the people in rural america. >> thank you, senator moran. >> you have done a terrific job here today. tests thatvariety of have not surfaced at this point within the workings of the congress and united states government. been thatys a has when you give testimony, it is different. when you give testimony or your people at a higher level give ortimony to this committee any other committee in congress, it has to be approved before it can be given by the office. that is a restraint because the white house is saying to you that you can say what you want but it has to be within our parameters. i do not have any fear in your case because the veterans

administration's deficiencies and the need for money is so your roadhat i think will be easier. that is a restraint. it is an unknown restraint for most of the american people. you will find that we in the congress are terrifically skillful at finding problems, things we think have gone wrong in your agency. then, we want those problems fixed. there you are sitting. the press is always available and people use the press very liberally often to make criticisms which they themselves are not willing to step up to the plate to solve. do it talk a lot here about accountability. i think it is part of your

responsibility -- and i am not sure what i mean when i say this because i am not sure how you do ways.you can find people here say well, let's not throw more money. there are plenty of resources. you have talked about that -- putting the i.t. people on other positions. the fact of the matter is the the enormous boundary and growth is yet to be seen. people who were seeking help at the v.a., the whole series of .ew problems to the v.a. system part of the accountability is you being frank with us when we are not giving you what you need to do the job. you cannot allow us to sit here and say that there is plenty of money available. you you know perfectly well

are going to go out and hire the right kind of nurses and doctors which has profound the dsp solutions -- ptsd solutions. all of that costs money. this congress is divided from the people who want to spend money and think you need to spend money when you of a particular problem. and those who would say there is no problem with veterans but they do not want to spend money to do anything about it. maybe it is ideology or fear or leadership or whatever. boy, does that hate you in the face. hihate you in the face -- you in the facet. the bea has done better than any other institution in getting money. that is still not saying much.

we have shut the government down, we have sequestration. will yound, it if you will be labeled a big spender and you will lose the next election. i am just saying as a friend to you, when people say they will be your ally, make sure they really are and make sure they are doing for you what they should be doing for you. we ohs the ac accountability on ourselves and we hope you will do for us. we are not an easy group to deal with. it is easy to talk and complain but it is hard to solve problems. be a superb the secretary. to be frank with us. >> i do when on it being a two-way partnership and want to give you my cell phone number and i want yours at the same time. [laughter]

>> thank you. senator blumenthal. >> you can have my cell phone number. is not worth as much a senator rockefeller's. thank you for being here in answering all of our questions as well as you have. statement, i raised a special of the ba, herbal to a bankrupt corporation unlike a lot of bankrupt corporations or these corporations that fold. the v.a. has a lot of assets. it is very dedicated people. it is trained professionals who do such great work day in and day out regardless of the headlines and the paper and the disparagement they may see in the congress. we see it in connecticut. we have a lot of great docs and

medical care in connecticut. most especially at the west haven v.a. facility which is our main hospital. my question is -- what can we do to attract more of those trained professionals to the v.a. facility in connecticut and others around the country which really provide the day-to-day >> and that is a great question. i have been thinking a lot about this. knowing the shortage we have. and also the more relatively organization -- morale of the organization. health careme that professionals want to make a inference in the lives of others. they want to be on the cutting edge. we are going to start correlating ptsd with events that occurred during the military