when b? guest: additional economic growth. let's put attention on creating small businesses. putting more resources and strengthening the ecosystem for entrepreneurship. host: i apologize for the abrupt ending. christopher masingill, cochair of the delta regional authority. find more information on dra.gov. the house is about to come into session for morning business. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2014] [captioning made possible by the national captioning institute, inc., in cooperation with the united states house of representatives. any use of the closed-captioned coverage of the house proceedings for political or commercial purposes is expressly prohibited by the u.s. house of representatives.] the speaker pro tempore: the house will be in order.

the chair lays before the house a communication from the speaker. the clerk: the speaker's room, washington, d.c., july 24, 2014. i hereby appoint the honorable john j. duncan jr. to act as speaker pro tempore on this day. signed, john a. boehner, speaker of the house of representatives. the speaker pro tempore: pursuant to the order of the house of january 7, 2014, the chair will now recognize members from lists submitted by the majority and minority leaders for morning hour ebate. the chair will alternate recognition between the parties with each party limited to one hour and each member other than the majority and minority leaders and the minority whip imited to five minutes each, but in no event shall debate continue beyond 11:50 a.m. the chair recognizes the gentleman from oregon, mr. blumenauer, for five minutes. mr. blumenauer: thank you, mr. speaker. i rise this morning to urge,

indeed to plead with my colleagues to co-sponsor bipartisan legislation that representative kinzinger and i will have this afternoon which will allow the united states to bring our afghan allies to safety here in the united states. earlier this week senators mccain and she houston introduced identical legislation in the other body. the need for this bill is urgent. indeed, congress should have acted yesterday. that's because the state department has confirmed now they've completely run out of the visas we authorized in december. anyway, that's good news. remember how in previous years the state and other agencies never remotely came close to using the visas that were authorized. they consigned these poor souls to bureaucratic hell. processing was so slow and abysmal that only 32 of our afghan allies received a visa

in 2012. people were left in limbo or worse while the taliban hunted them down, kidnaped their siblings, murdered their parents, capturing them, tore during, beheading them -- torturing, beheading them. but the administration had significant reform in the program and the agency has aggressively attacked the visa eligible backlog. but despite processing, on average 400 visas since january, years of a failed system means that today there remains an astonishing 6,340 brave men and women waiting in limbo. if congress does not act before we adjourn for the august recess, that means we'll be slamming the door to safety for hundreds of our afghan allies and their families. with each day that passes, these are people whose lives and those of their families are left to the tender mercies of

the taliban seeking revenge. mr. speaker, representative kinzinger and i have a nonpartisan, fully paid for bill. house leadership willing that could pass on the floor in the blink of an eye. all we have to do, what we must do is choose to make it a priority. remember, we've done this before. reforms that enabled the program to work passed as an amendment to the national defense authorization act on this floor by, i found an inspiring 423-3 margin. passing this bill is not only the right thing to do for these poor souls, it's in our own national security interest. as secretary kerry pointed out in urging congress to grant more visas, the way a country winds down a war in a farahway place and stands by those -- faraway place and stands by those that help us in the fight

sends a powerful message to the world that is not soon forgotten. whether or not you supported the wars in iraq or afghanistan, what matters now is where we stand in keeping our commitments. this bill authorizing an additional 1,000 visas for the balance of this current fiscal year is a band-aid but a critical one. we're going to have to act again in the coming months to deal with fiscal year 2015 starting in october. for too long it was the state and other agencies that failed to make this the priority it needed. now they uped the attention, the focus, resources and commitment, let's not let congress be the obstacle. lives are at stake, american honor is on the line. i urge my colleagues to do everything they can in the coming days to bring this bill to the floor. it is our duty to save the lives of those who risked so much to help us when we needed them.

the speaker pro tempore: the gentleman yields back. for what purpose does the gentleman from pennsylvania rise? without objection, so ordered. >> mr. speaker, this week the largest ever study of schizophrenia reported that the condition is tied to more than 100 genes. mr. murphy: the discovery shows that schizophrenia is a clinical condition, just like other medical conditions. severe schizophrenia needs to use evidence-based therapies that work. we know that 50% of those suffer of a neurological impairment. this lack of awareness is the leading cause of noncompliance with psychiatric treatment. this neurological problem helps to explain why 40% of americans with a serious mental illness do not receive treatment and explains how our system fails to help those most in need. this occurs more frequently when schizophrenia or bipolar

disorders suffers the frontal lobe. the patient is neurologically unable to comprehend that their delusions or hallucinations are not real. this is different than denial. this is a change in the wiring of the brain. these individuals don't recognize they're ill. when they don't meet the 200-year-old definition of being in imminent danger to harm themselves and others, their friends and families are powerless to help them. uninformed observers wrongly believe that because patients can look at them and talk to them they must be fully functional and aware but they are not. much like if they had alzheimer's disease or in a coma, these individuals with schizophrenia can't voluntarily request treatment on their own. would never deny a stroke victim or with alzheimer's. yet in cases of serious brain disorders we allow millions to suffer because of the chaotic patchwork of state and federal laws that says we can't even act when we know we must. further, a patient when discharged from a hospital

anything from a minor cut to a heart transplant needs a treatment plan. this is not so with serious mental illness. again, we would not do this with someone with alzheimer's. i can't reach your grandmother until she is well enough to treat her but i can't tell her about her treatment until she gives you permission. these mentally ill men and women end up sleeping in jails, sleeping behind dumpsters or chained to gurneys in and out of the hospital rooms. that is the lifestyle we relegated 3.6 million americans to. we deny people the right to treatment. we denied them the right to get petr. how cruel is that? as a result, one million americans last year attempted suicide, 40,000 people died from suicide. there are 300,000 homeless, 500,000 in jail and 700,000 in other prisons. the mentally ill are more likely to be robbed, physically assaulted, raped and while

states and counties have taken bowled action who are cast aside in our current system, the federal government sits aside oblivious to the problem. serious mental illness is more detrimental to the long-term health than being a heavy smoker and increases your risk of heart disease and cancer. it reduces your life span by some 25 years. there's also a financial toll. a study conducted by duke university determined the -- that assisted outpatient treatment saves taxpayers $50,000 per patient and increases medication compliance and decreases incarceration, hospitalization and homelessness. and most county health systems haven't implemented and each time an individual with a mental illness experiences a break from reality their brain suffers some permanent injury. all this happens at the time when we know more about the brain than we ever have. we tell families that federal law prohibits you from telling you why your loved one is in a

mental health crisis and the doctor says your son is only a little dangerous right now but please bring them back when they become more violent. how absurd? how about telling someone, we'll wait until you're a diabetic shock? they would be sued. families in a mental health crisis, this scenario plays out every single day and not a word is spoken about it. the reason is people don't understand the nor logical base of mental illness. what we need is a congress to confront its own denial and change the laws that need to be changed. we can fix the mental health system but not if congress does not act. we must pass the helping families in mental health crisis act because ignoring this problem won't make it go away and where there is no help there is no help, there is no hope at all. i yield back. the speaker pro tempore: the gentleman yields back. for what purpose does the gentleman from north carolina rise?

>> perm -- permission to address the house for five minutes. the speaker pro tempore: without objection, so ordered. mr. butterfield: thank you, mr. speaker, for yielding time this morning. mr. speaker, i rise to congratulate a company in my district called the ideal faster in corporation. recently, they announced a $5.7 million expansion of their facility in oxford, north carolina. this expansion, mr. speaker, will create 155 jobs by the year 2019, and is welcomed news for the county which is an important part of my congressional district. now, mr. speaker, 155 jobs in some communities across our great country may be relatively small, but in this rural community this is a big deal. the corporation was established in 1936 by ely goot and has been a strong member of the oxford community since moving

its corporate headquarters there in 1966. ideal faster in corporation is still family-owned and is operated by ralph and mary goot and their three children, jeff, steven and michelle. since bringing their world headquarters to oxford, ideal faster in corporation has grown to become the second largest zipper manufacturer in the entire world with production and sales facilities in over 20 countries. they are in the process now of launching three new products and are making major capital investments that will benefit their employees and the north carolina economy. mr. speaker, on monday of this week, july 21, i marked my 10th anniversary here in the house of representatives, and if there's one thing that i've come to recognize and appreciate is that it's small business and small industries that drive our economy. companies like ideal faster in corporation are the lifeblood. they are the lifeblood of our

economy, and so i congratulate ideal faster ins and the goot family on this tremendous, tremendous announcement. i wish them nothing but continued success in the future. i thank you, mr. speaker, for the time. i yield back. the speaker pro tempore: for what purpose does -- the gentleman yields back. for what purpose does the gentleman from texas rise? >> to address the floor for five minutes. the speaker pro tempore: the chair recognizes the gentleman from texas. >> before president obama leaves for his two-week vacation in martha's vineyard, he has a lot of work to do. americans are not better off than when he took office in 2009. mr. williams: in fact, his policies are hurting families and businesses everywhere. he should focus on house republicans -- on what house republicans are doing and cooperate by getting his party leaders in the senate to act on more than 40 bills to get our economy moving, get people back to work and roll back his administration's harmful olicies, like dodd-frank and

obamacare. under president obama, the average unemployment rate tops 8%. we got 47 million people on food stamps. 48 million people between the ages of 18 and 64, the very heart of our work force, hasn't worked one day in the last 12 mobts and nearly 91 million people over aged 16 aren't working at all. almost 50% of the unemployed have stopped looking for work nd 76% of americans are living paycheck-to-paycheck and the list goes on and on. we can fix this through real tax reform, getting the government out of health care, energizing the energy business and ensuring america remains the world's superpower with a strong and well-equipped military. as a business owner and job creator for more than 40 years, i know that the constant threat of tax hikes, overregulation, massive government overhauls hurts businesses. it burdens families, lowers income and stiffles the economy. everyone is simply playing defense in america. that's why the house continues

to pass pro-job bills that empower americans and strengthen the economy. these are real solutions that will improve the quality of life for generations to come. so i urge harry reid and the democrats in the senate to take up these bills now before president obama leaves for vacation. in god we trust. i yield back. . the speaker pro tempore: for what purpose does the gentleman from virginia rise? the gentleman is recognized for ive minutes. mr. wolf: mr. speaker, imagine if a fundamentalist christian secretary captured the french city of leon and started a purge of muslims. their mosque destroyed, the koran burned, and then all muslims forced to flee. such an event would be unthinkable today, if it did occur pope francis and all other christian leaders would denounce it and support efforts by governments to stop it, yet that is essentially what is happening in reverse now in mosul as the islamic state of iraq drives all

signs of christianity from the ancient city. christians have lived in mosul for nearly 2,000 years, and today they are reliving the muslim religious wars in the middle east. these are not my words. these are the words of the first two paragraphs of an editorial from the "wall street journal" earlier this week. i want to read parts of an email i received yesterday from someone on the ground in iraq. quote, all mosul churches and monasteries are being seized by isis, they are around 30. the cross is being removed from all of them. many are burned or destroyed and looted. many of them are used as isis centers where the religious sunni, shiite, and christian tombs are being destroyed. this is endangering the very ancient sites, including the jonas tomb. it has been widely reported that the isis soldiers have painted an n on the doors of christians to signify that they are christian. shiite homes are painted with the letter r meaning resectors

or protectant. christianity as we now know it is being wiped ow. with the exception of israel, the bible contains more references to the cities and regions and nations of ancient iraq than any other country. i believe what is happening to the christian community in iraq is genocide. i also believe it is a crime against humanity. where is the west? where is the obama administration? where is this congress? the silence is deafening. the west particularly the church needs to speak out. the obama administration needs to make protecting this ancient community a priority. president obama and secretary of state kerry need to have the same courage that president bush and former secretary of state colin powell had when they said genocide was taking place in darfur. the united nations has a role. it should immediately initiate proceedings in the international

accord for isis for crimes against humanity. i will close today by reading the final two paragraphs of the "wall street journal" editorial. it said, quote, today religious extremism is almost entirely islamic. while isis purge may be the most brutal, islamists have driven thousands of coptic christians from homes they have occupied for centrist. the same is true across muslim parts of africa. this does not mean all muslims are extremists, but it does mean that all muslims have an obligation to denounce the extremist who murdered in the name of allah. too few imams will speak up. as for the post christian west, most elites may now be nonbelievers. but a culture that fails to protect believers may find a lack of self-belief to protect itself. the british parliamentarian and

abolitionist who abolished slavery famously told his colleagues as i they will house and administration, having heard all of this, you may choose to look the other way. but you can never again, you can never again say you did not know. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the chair now recognizes the gentleman from south carolina, r. duncan, for five minutes. mr. duncan: mr. speaker, on june 26, south carolina and the united states lost a hero. sergeant bob reezer in was a world war ii united states army air corps veteran and tail gunner asiped to the 68th squadron with the famous 44th bomber group known as the flying eight balls. the event of december 7, 1941 compelled him to serve in world war ii. survived three life threatening missions, a year in german p.o.w. camps, 2 1/2 years in a

hospital undergoing multiple surgeries from his injuries. during his military career, he participated in 21 successful bombing missions over germany and france. during the return flight of one of those missions, bob's plane was unexpectedly diverted, ran out of fuel, and crashed. while he was at the hospital recuperating from his injuries, bob was given the option to return to the united states but turned down that offer so he could continue to serve his country. on october 1, 1943, he flew his last mission during which his b-24 liberator, the black jack as it was known, was attacked and caught fire. parachuting to the ground with his head engulfed in flames, remember that the sergeant was a tail gunner. he had a long way to travel from the rear of that aircraft as it burned falling from the sky.

as he was parachuting down, he passed out from his injuries and he woke up in a hospital, his head and his eyes were wrapped in bandages. and all he could hear was german. he was now a p.o.w. captured by the german soldiers. the his captors allowed him only a week long hospital stay before shuffling him between different p.o.w. camps over the next year. and on his 26th birthday, september 26, 1944, he returned home to the united states of america. he told me, he said, that was the first time i felt safe. seeing the statue of liberty was an amazing feeling because i knew then that i was home. he earned three purple hearts for his service to our country, but if bob was still alive today, he would say that he wouldn't want his service defined by his numeries distinctions that he was rewarded but rather he would

want us to remember the 21 successful missions he was a part of to help secure freedom for this country and many other countries. had the opportunity to meet bob in my hometown of clinton, south carolina, where he was in a retirement home and i heard his stories first hand. after talking to bob i went on to learn more about how heroic actions of the 44th bomb group. during my research i came across a great complileation from a ground crewman on the 67th bomb squadron called the roll of honor and casualties. i recommend everyone look that up and read t the stories are amazing. this compilation documents these stories of these men, including my friend, bob reisner. he lived his life quietly among us. bearing the scars of war and service. his ear was mangled. his eye lids had been reconstructed. he bore the scars of numerous burns. i'm especially grateful for his bravery and protecting the united states and i grieve with his family and friends during the loss of a great man, an

american soldier and true american hero. may god bless the men and women who served in world war ii. may god continue to bless those who serve our country and have served our country and may god continue to bless the united states of america. i yield back. the speaker pro tempore: the gentleman yields back. the chair now recognizes the gentleman from california, mr. cclintock, for five minutes. mr. mcclintock: mr. speaker, wherever i go, people express a growing anger over the illegal immigration that is overwhelming our southern border. people ask me, how can we talk about securing the border in ukraine or iraq while our own border is wide open? how can we talk about supporting the population of central america when we are nearly $18 trillion in debt? how can we talk about giving jobs to millions of illegal immigrants when fewer americans are working today than when this so-called recovery began?

they ask if the federal government can't defend our own border, what good is it? mr. speaker, i cannot answer them. the fact is, our southern border is wide open, it is practically undefended and everybody knows t the many thousands streaming across it know that if they break our laws and enter our country illegally, they'll be rewarded with free food, clothing, housing, medical care, transportation, legal representation, and relocation all at the expense of struggling american families. 95% of them believe they'll get permission to stay and at the moment they are right. until we fundamentally change this reality, the mass incursion at our borders will continue and our nation's sovereignty will slowly fade away. american people are awakening to the danger that illegal immigration poses to our country.

it's crowding out millions of jobs, desperately needed by american workers. it's overwhelming our schools, our hospitals, our courts, law enforcement, prisons, and our local and state budgets. perhaps worst of all it is undermining the process of legal immigration upon which our country is founded. why should anyone go to the expense and trouble of owe cage our immigration laws -- obeying our immigration laws when they can reap rich rewards simply by defying them? this administration is actively encouraged this crisis with its promises of amnesty and it now needs another $4 billion to feed, clothe, and house this new surge. conspicuously lacking from the president's proposal is any serious effort at enforcement or deportation. the advocates of illegal immigration tell us we need comprehensive immigration reform , but what they really mean is extending some form of amnesty

to those now illegally in this country. yet it is precisely these promises of amnesty that are causing and encouraging the mass migration we are now seeing. any short-term measure this house approves must include provisions first to rescind the president's unlawful deferred action for childhood arrivals order that is clearly encouraged the current surge. second, to detain all of these new arrivals while expedited deportation hearings proceed. third, to provide unrestricted access for law enforcement to all federal lands at the border. and fourth, to activate the national guard in whatever numbers are necessary to secure our born border now. once the immediate tide's been turned back, it's imperative that existing laws are enforced before any new laws are considered, including rigorous enforcement of sanctions against any employer who hires an illegal immigrant, completion of the border fence that was

authorized in 2006, deportation of any illegal immigrant who comes into contact with law enforcement or who illegally applies for government assistance, and resumption of federal cooperation with local and state law enforcement agencies to ensure enforcement of our immigration law. if we are not willing to enforce our current laws, there is no reason to believe that any future laws will be enforced. and until we enforce them, we really can't accurately assess what changes might be needed. the people with whom i talk are tired of excuses. they are tired of promises of future reforms. they want to see our current laws enforced and our borders secured and every act of this house should be focused on pressuring the president to do so. history is shouting this warning at us. nations that either cannot or will not defend their borders

aren't around very long. let that not be the legacy of this administration and let it not be the ep at that time -- epy taft of the american republic. i yield back. the speaker pro tempore: the chair now recognizes the gentleman from alabama, mr. urn, for five minutes. -- mr. byrne, for five minutes. mr. byrne: i have been in this house now for six months and i regrettably rise today to express my frustration, and i know the frustration of thousands of people in my district and southwest alabama, and i believe people all over the united states of america. people are tired of the stagnation coming from washington. just look at the disapproval rating of this congress and the disapproval rating of our president. the people of this country want to see action. action growing our economy.

action on cutting spending. action on health care. action on immigration. action on the crisis at the v.a. action on foreign policy, and all the problems we see around the world that involve our interest. they want to see action. just earlier this week i was at the white house for a bill signing ceremony for the work force investment act, or the skills act, as we called it here in the house. the skills act was a great example of democrats and republicans in this house and the senate coming together behind a common goal of improving our nation's work force training programs, so important at this time in our recovering economy. during the bill signing ceremony, the president implored us to send more bipartisan job creating bills his way. the problem is the president

doesn't need to lecture this house on that. the president looks -- needs to look no further than the majority leader in the senate, the gentleman from nevada. and the house -- in the house we have passed nearly 300 bills that are sitting in the senate waiting for action. at least 40 of those bills are job creating bills. we have continued in this house to do the people's work, making our way through seven of the appropriation bills that we are required by the constitution to pass to fund the government. . the senate has not completed a single one. now, some may say the issue is that republican senators have demanded to have amendments considered. i don't think that's too much to ask. here in the house, we have considered at least 180

minority amendments to appropriation bills alone. 180. one of my colleagues in the house from the other side of the aisle was quoted in an article saying that she wanted to, quote, thank the republicans for their generosity. i'm just grateful for the bipartisanship here, closed quote. that's not the same message coming out of the do-nothing senate. one democratic senator was quoted as saying that he has, quote, a hard time getting on the train in the morning. former senate leaders tom daschle and trent lot have said the -- trent lott have said hat the senate has gone into a polarized mess. this shouldn't come to much of a surprise to us because yet again this year the senate failed to even pass a budget. i was just elected this past year. prior to that i was in the alabama state senate and the

state of alabama, as in most states, our legislature is required to pass a budget and appropriations bills every year on time and they have to be balanced. and so every year the alabama legislature passes budgets on time and they're balanced. and the united states congress can't do that, the greatest debating body ever known to the world, the united states senate can't do that? i can't imagine what the people in my district would think if they saw the inaction coming from the united states senate. but they see the results of it and it troubles them greatly. we have seen this song and dance before, and most of us now know how it's going to end. at some point, sooner rather than later, the house will be forced to consider a continuing resolution to prevent a government shutdown. the senate can prevent this by following the house and regular order, doing the people's work,

making the hard decisions and advancing individual appropriations bills as we have done in the house. that's how government is supposed to work, and that's the only way we're going to be able to make serious reforms to spending programs. i've come to this body a number of times to offer amendments to pending bills that would have cut spending, and i'm going to keep pushing for these type of strategic spending reductions. but when the senate refuses to do its part, it makes this process impossible. the senate's inaction is going to force those in the house to make an unfair choice, and i ask them to act differently for the people of this country so we can get things done. and i yield back. the speaker pro tempore: the time of the gentleman from alabama has expired. the chair recognizes the gentlewoman from west virginia, mrs. capito, for five minutes. mrs. capito: thank you. thank you, mr. speaker. i rise today to talk about

education. a quality, affordable education is vital to ensuring that the american students are prepared for the jobs of the 21st century. for west virginians, for americans to compete for jobs they need to have the skills, knowledge and training to make them attractive to employers. education opens doors. a diploma or degree brings with it the promise of a better future, better wages, a better quality of life, a better future for one's family. without a quality education, the possibilities of life are truly limited, not limitless. and in the house of representatives, we're taking action today to ensure that every american has access to quality education and an education that's affordable and understandable. later today, we'll pass two bills to help students pay for college and better manage the debt that they accrue. the empowering students through

enhanced financial counseling act will better educate students about the financial implications of student loans and help them borrow the money they need, not all of the money that they're offered. we hear time and time again of the crushing debt that our students are coming out of college in higher education with. we want to help them better manage that, understand that and know on the front end with counseling know what they're actually getting into instead of waiting to the back end and hitting them with a hammer of this is where you are now so you've got to deal with it. we'll also pass the student and family tax simplification act which simply makes permanent the american opportunity tax credit. west virginians want to work, americans want to work, west virginian employees want to hire at home. they want to have access to an educated work force, and by investing in education, we invest in our nation's future. we invest in our growing -- in growing our nation's economy and we invest in future

generations yet to come. with that i yield back. the speaker pro tempore: the gentlewoman yields back. the chair now recognizes the gentleman from pennsylvania, mr. thompson, for five minutes. mr. thompson: thank you, mr. speaker. mr. speaker, each day we hear about new opportunities as a result of developing our own domestic energy resources. what we hear less about is how many crisis we avoided as america has moved from energy scarcity to energy abundance. last week on july 15, historian pulitzer prize winner, the renowned energy expert, daniel jurgen, stated that without the recent domestic boom in oil production, the united states would be in deep economic trouble. quote, i'm convinced were not for what happened these last few years we had eab looking at covering mr.

jurgen's remarks. we'd have a panic in the public. we'd have angry motorists. we'd have inflamed congressional hearings and we'd have the u.s. economy falling back into recession, he added, end quotes. not only that, mr. speaker, we have jobs coming back to the united states that were previously headed overseas due to cheaper labor and other competitive advantages. today the u.s. is looking a bit more welcoming for businesses and job growth and for the american worker. from "the wall street journal" earlier this week, and i quote, the competitive advantage that u.s. companies will receive from the lower costs provided by shell gas is attracting investment from some of the industry's bigger names. just last week, the international energy agency said some 30 million european jobs are at risk as manufacturers of petro chemicals, plastics and fertilizers are relocating to the united states of america. additionally, as reported in "politico" earlier this week, and i quote, a strange thing

happened in the last few months as ukraine battled with russian sprittists. -- separatists. gasoline prices for u.s. motorists stayed pretty much flat. the price at the pump has even fallen in the past week, even after the tragic malaysian irline crashed over ukraine. it's yet another sign of the unexpected change rocked by the u.s. energy boom which has turned the united states into one of the world's largest oil producers and the biggest producer of natural gas, end of quote. mr. speaker, the opportunities of domestic energy production are apparent. as a result, we have new opportunities here at home and abroad. americans are keeping more money in their pocket due to lower heating costs and prices at the pump. u.s. businesses are bringing operations back to the u.s. to create jobs here at home. companies from across the globe are bringing their operations to the united states so they

can do business at a lower cost. american families are able to find good-paying jobs. we're helping the u.s. from being competitive and we're becoming more economically secure. thank you, mr. speaker, and i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. pursuant to clause 12-a of rule 1, the chair declares the house in recess until noon today. make permanent tuition tax credits that were created in 2009 by the 2009 economic stimulus law. we'll have live coverage of the house when they return noon here on c-span. in the meantime, we'll take you to the house veterans' affairs committee. they this morning are hearing from the acting veterans'

affairs secretary sloan gibson and announced that a senate hearing last week that the v.a. would need an additional $1617.6 billion over the next -- $17.6 billion over the next few years. >> women veterans face and they are less likely to seek out care. they're often called our silent veterans. but when they do we found that the v.a. served 390,000 female vets last year yet nearly one in four of the v.a. hospitals does not have a permanent gynecologist on staff. and one out of every two female veterans receive medication that could -- was determined could have caused birth defects even though they are at an age where they might want to have children. these are unacceptable statistics, and they really address the question of quality of care. i sent a letter, along with 50 of my colleagues here in the house, asking that this be addressed. i know you've been busy.

i haven't heard back from you, but i wonder if you could speak to that this morning. >> well, i owe you an answer, first of all. apologieses, and we'll get you one. -- apologies, and we'll get you one. we're frankly playing catch-up. the growth rate of women veterans coming to v.a. for care radically outstrips the overall growth rate in the number of veterans that are coming to v.a. for care. we have not historically been well-positioned to provide that care. we are doing things, training for existing providers, hiring additional providers as well as -- i know what a big deal it is every time we're able to cut the ribbon on a new women's clinic and i get invited and attend as many of those as i can. it's a really big deal but we're playing catch-up and we have work to do. >> well, i appreciate that and i thank you for your answers because sometimes we're locking at this in the big picture and

we forget there are certain veterans who are perhaps being overlooked and i want our improvement of services to go for all our veterans because they have all served and sacrifice as have their families. thank you. i yield back. >> thank you very much, ms. titus. looks like, dr. benishek, you're recognized for five minutes. >> thank you, mr. chairman. and thank you, mr. secretary. frankly, your story of coming in in the interim like this and trying to pick up the pieces of a system that's obviously been under, you know, a lot of stress is admirable. i appreciate what you're doing. i've a couple of quick questions that i hope you will be able to help me with. first of all, i want to address a personal issue. you know, the cbok in traverse

city, michigan, is scheduled to e increased in size for years. actually, money is apparently in your department and all it needs is a signature from you to get that to happen. so i'd like to get your signature on that to make -- my district has been waiting for this for years. the money has been appropriated and it's in the budget. we've been trying to get this to happen for a long time. hopefully you can fix that. >> we'll dig into that one. >> let me -- i've been trying to get this to happen for a long time. >> when i'm out in the field i run into all kinds of instances. >> i appreciate the fact that you're out there. i appreciate that you're out there. you're seeing what's happening on the ground because, you know, my problem with management is that when somebody is sitting back behind their desk and listening to their subordinates tell them how things are, that's when trouble happens. >> yes. >> and i think that's what's happened in the past frankly here. now the question that we

brought up and some of the members brought it up earlier, what does the secretary need to do his job? you mentioned how difficult it is to remove people. so what would your recommendations be to -- what should the -- what powers should the secretary have that he doesn't have now to make sure that change happens? >> that's not an -- it's not an easy question to answer. i've said repeatedly, i will use whatever authority i got and use it to the maximum extent that i can to hold people accountable. there are different proposals out there about granting additional authority to the secretary, and foes are -- if those are provided, then we'll use them. we recognize that to the extent that those are targeted solely at the department of veterans affairs, that has an impact over time. i believe -- >> you're explaining a lot but you're not giving me an answer. what do you need to make this happen better? >> well, somebody asked a

question earlier about, is that how it worked in the private sector? i tell you, let's work like we do in the private sector. but that -- that ignores a century of -- >> what's -- let's take a step forward. what would the number one thing that you would recommend, make it easier for the secretary to do his job and promote accountability and action? >> well, i think the flexibility to exat the died personnel actions. >> all right. thank you. >> that would be a big deal. >> let me ask another question and that is, we're trying to get patients off of waiting lists and into the private sector. you know, my experience with the v.a. is it's very difficult to make that happen because there's like so much paperwork that the veterans have to go through. what have you done in this emergency situation to make it easier for the veteran to actually get out in the private sector and make it happen and the guys get paid and it all

happens quickly? what have you actually done to make this happen? >> that's a good question. congressman benishek, one of the things we have done is we have created these new tools. i know we talked about them before, non-v.a. coordination. it helps us document the automation of the referral. what it also allows us to do, for the first time, we get to look at that referral through all of its stages and we get to manage it. so we get to look at when was the referral created, when was it authorized, did we sit on it too long before we authorized it, after it was authorized, when was the appointment scheduled, how much time passed and then finally when was the care delivered and the documentation returned? that's helping us. it's not perfect yet. we still have work to do. >> what are you doing to get people off the waiting lists and into the doctor office? how does that phone call works? >> call to the veteran.

we're using our pc-3 partners. >> it's not in place for the first part. >> not fully. where it is, pc-3 will coordinate it. we're working with veterans. if they know a provider, they'll work with their own provider. if not we'll work to set up with that provider we have relationships with. we have scripted process. we still have a lot of work to do to get that done right. actually, we've even talked to some v.s.o.'s to help look at that process from a veteran's perspective. is it easy to understand, is it easy to follow through? i think we have work to do that. >> i'm glad you admit to that. thank you. >> dr. reese, you're recognized -- excuse me -- mrs. kirkpatrick, you're recognized for five minutes. >> thank you, mr. chairman. secretary, thank you for being here today. on monday i was out on the navajo nation in my district and talking with lots of folks

and we had a lot of veterans. many of them live in areas with no cell phone coverage or broadband coverage. i know one of your goals is to expand telemedicine and that's a great opportunity for my district. but my first question is, in your budget, did you have money for expanding broadband infrastructure in those areas where we have veterans who have no access? >> i think it's one of the things we need to look at. in the supplemental we did have request for i.t. to include hardware and bandwidth for expanded care. i think we need to look at that specifically. i don't want to give you a false answer. >> and i'd love to be part of that conversation as we continue on because it's going to be so critical to getting them the care they need. my other question is for the secretary. you know, the inspector general's reports have been very valuable to this committee in trying to unravel the

problems at the v.a. and come up with real solutions and just would like to know what you have done, what you have put in place since the interim report from the inspector general in may. >> there were a series of findings and recommendations that were included in the i.g.'s may report. st of them having to do with first working the list of 1,700 veterans that they had turned newspaper their process which we've reached out to every single one of those. i think roughly 1,000 appointments -- or appointments for 1,000 veterans have been scheduled as a result of that particular process. there were recommendations in that report about producing the near report, the new enrollee appointment request report, producing that at the medical center level and distributing that out so it can be worked. that has worked. as i mentioned, the near list

has gone from 64,000 to it was 2,100 which was the last time i looked which will be the bottom of that. other items that i'm not remembering, seems like there were one or two others. >> yeah. each one of them became a specific action plan. we worked on them. we i think closed them -- we've implemented their recommendations in the interim. whatever the i.g. -- sorry, sir. >> there was also a recommendation regarding reviewing wait list nationwide which obviously we do. we're producing them and publishing them every two weeks. and those are really the four, five recommendations and we've vigorously pursued every single one of them. >> i thank you for that effort. i met with a doctor at flagstaff medical center and they entered into a contract with the v.a. to treat local veterans. they were very happy and pleased to do that. with that i yield back. thank you, mr. chairman. >> thank you very much.

dr. wenstrup, you're recognized. >> thank you, mr. chairman. and thank you, mr. secretary, for being here today and for your many years of service to our country in many, many ways. you know, let me just start by -- let's take the assumption that the goal of the v.a. is to see all those that are eligible for care as soon as possible and provide quality care. and that i think should be the assumption there, but what i find is that the motivational factors that are really needed to accomplish that and to achieve that on a regular basis and to comply with human nature don't really exist. in other words, the incentives aren't necessarily there that would exist in the private sector, etc. and i'm curious how you propose in this mass bureaucracy that e're dealing with from administratorses to physicians to nurses to --

administratorses -- administrators to physicians to nurses to staff, seeing veterans is an asset rather . an a liability to the system >> interesting way to frame the issue. as i mentioned in my opening statement, i -- i continue to believe when i go out to the field -- i was in phoenix several weeks ago and visited with a room full of employees. you know, that is clearly our most troubled location, faced with what i have characterized as leadership failure, mismanagement and chronic underinvestment and yet person after person raised their hand and talked about the things they were doing, the things they had to overcome in order to be able to take care of their veterans. i still find everywhere i go the vast majority of people care deeply about the veterans that we're serving. i'd tell you if we didn't have

that, i wouldn't have anything to reach in and grab a hold of as i try to take this organization in the direction we need to go in, being able to reach in there and grab a hold to the fact they care, they want to do the right thing is the -- is the absolute -- is a critical, critical element of what we're doing. i'd tell you other structural things. again, i alluded to it in my opening statement. i got situations where quality of care at a medical center is declining and medical center directors are getting top box scores on their evaluations. and that was what prompted my direction to say we're going to overhaul the standard performance contract for medical center directors and visiting directors because we're not going to have a contract where their result isn't aligned with the patient outcomes we're delivering. it will take those kinds of structural changes as well to ensure we have people focused on veterans.

last thing i would say to this point. you know, we've gotten -- so focused on wait times. as we think about how we gauge timely access in the future, i think the centerpiece of that is going to be a much more robust focus on patient satisfaction. i think that helps us recenter back on the veteran that we're serving and not looking at wait times and the 700 other metrics that we have people trying -- >> and those types of responses should be the driving force to whether someone gets a bonus or how they're compensated. >> yes. >> the inspector general implied to us money over the -- as money over the last -- aid increased it led to more layers of administratives a pecks rather than actual care and that really is a concern. as you know i had a meeting this morning with several members on measuring productivity and efficiency which we've done a couple times with some of the doctors here. i think they're going in the right direction. i still think there are some things missing. when you evaluate just on

r.v.u.'s, what you look at how many we're paying the doctor per that. this comes to when we're asking for $17 billion, right? and so, for example, if you have an old physical plan, you got to take a look how much you're spending for productivity in r.v.u.'s and you might better close that facility and put everybody in that community in that particular spot but we're not measuring that. those are the types of things we have to measure as well. because when you talk about outsourcing and saying it costs, maybe it doesn't cost more if your physical plant is costing you so much more. those are business decisions and that's got to be the approach. we can't assume that where we are is the best place to be always. so i'm going to continue to work with that group and with you and hopefully we can see these type of changes. i appreciate and i'm out of time and i yield back. >> thank you very much.

ms. brownley, you're recognized for five minutes. >> thank you, mr. chairman. i appreciate it very much and thank you, mr. secretary. mr. secretary, the way i nderstand your proposal of the $17.6 billion, predominantly for additional space, additional personnel, professionals and some money for i.t. i certainly agree that in terms of facilities and personnel, there's a need. my cbok in oxnard, california, has, as you stated in your testimony, as one that had double-digit increases each year over the last couple of years. and not much has been done over those last couple of years, i'll add. i am -- i think what i have learned through all of the hearings that we have had that the care for veterans once they get in the system is pretty

good. it's accessing the system is where we have seen is truly broken. and when i see the i.t. proposal there, it concerns me. it's a red flag for me because you did mention off the shelf products you're looking at, off-the-shelf technology that you're looking at, but i really want to know, we got to fix the access part of this. and i don't want to invest more money into a broken system. i want to invest money and to -- into new technologies and innovation and getting the v.a. into the 21st century, much like the private sector is and the tools that they have to access the health care system. so if you could just comment on that, please. >> first of all, i'd say the majority of the i.t. resources, as i understand the proposal here, are associated with the activation of the facilities. so it's the i.t. infrastructure

that we need as we activate facilities and bring on additional clinical staff. there are a number of things under way to really take us into the 21st century. part of it is the commercial off-the-shelf scheduling system which is not included here. it's already provided within the core funding. but there are other things we were talking earlier about interoperability for purchase care and there are technology investments that are included here, associated with that. so anything else to add? >> sure. i'll add a couple of items relative to i.t. part of it is we have a capital request if there and requesting i think 13 million square feet for lease space but we have to outfit that lease space with i.t. to actually make it useful to make it connect, cables, wireless, telecoms, etc. so that's built into it. it's not -- it's not all raw

development work. it's what you need to make use of the space you get and then to actually connect the staff you're hiring. you need i.t. to make that happen, so that's part of the request. >> so mr. secretary, then, in terms of off-the-shelf solutions that you're speaking of, what's the time frame in that? what are we looking at? >> sure. there are actually three or four different initiatives kind of parallel initiatives on the scheduling front. we've already led a contract to deal with some of the most challenging aspects of the current system, and we're expecting those to begin to be fielded within the next six to 12 months. the time line for the purchase of the commercial off-the-shelf system is still a bit up in the airbased upon the contracting approach that we're going to have to pursue there, but i think 2016 is probably the best-case scenario for the introduction of that particular system. does that sound right, philip?

and so that's one of the reasons we're making the investment in the fixes to the existing system so we don't wait two years to have that improved functionality. >> thank you. and very quickly in your opening comments as well, you talked about the v.b.a. and the improvements there. . >> i perceive that walking in the door the morning of my third day at v.a. i was over at the white house talking about the backlog. this laser sharp focus on the disability claims backlog, we have not been as focused as we needed to be on nonrating

claims, on -- and on appeals, on our fiduciary claims. that's what we are talking about doing here, particularly with appeals. where the majority, 90% of the number of appeals in process sit at v.b.a. we have allocated additional resources, thank you very much, to congress' support, to the board of veterans appeals, which is helping us, and we have used technology there to make them more efficient. we have work to do in the v.b.a. site. >> thank you. i yield back. >> mr. huelskamp, you're recognized for five minutes. >> thank you, mr. chairman. appreciate your continued leadership on so many issues. appreciate the opportunity to question the acting secretary. i want to bring attention first to a very famous publication, life magazine, may 22, 1970, i presume you're somewhat familiar with this publication. also the photo that gained much

attention across the country of, again, may, 1970, in which the v.a. was found to have abused the trust and neglected our veterans. mr. gibson, i think we sit here today, and that's the same topic. how are we going to restore the trust to our american veterans and the american people? what i have heard from you today so far has been that we'll give you another $17.6 billion, somehow that will restore that trust. i don't think that does that for my constituents. certainly not for my veterans. i have some very specific questions i'd like to ask of you first of all. have all secret waiting lists been eliminated and identified? >> to the best of my knowledge, yes, they have. >> you have identified at least, mr. mccloskey, identified those on the electronic waiting lists, there are 18 different schemes identified internally? you're absolutely certain every

one of those waiting lists have been identified. >> i don't know where the number 18 comes from. >> that comes from the o.i.g. report and actually from a memo in 2010, from your department. i just -- >> i.g. is in over 80 locations right now and i'm not privy to what they are finding. until the i.g. completes the reviews in all those locations and comes back and issues their reports, i can't tell you that. >> how do we restore that trust if we don't know the extent of the problem? >> i think you start where you are. >> you start by spending money. >> you start where you are. you start by articulating expectations about how we are going to -- how we are going to operate. you start by getting veterans off wait lists and into clinics. you start by fixing the chronic scheduling problems that exist within the organization. >> how do we know we are achieving progress? what we have heard and i'm sure you are aware of, numerous employees from the v.a. have come before this committee and

identified, falsified data, fake data, presented to this committee, and you come in here today and present data, hey, we are making progress. how do we restore the trust that we can believe the data you are presenting to the committee? >> i tell you when i directed all the medical center directors to go out and spend time in each of their clinics and engage with their schedulers, people have asked me, gee, that doesn't sound like much of a check and balance because they are on the inside. the real motivation behind that direction was for them to be out there on the ground and to take ownership for the quality of health care that's being delivered, including the timeline. >> the whistle blowers that i hear from -- i'm short on time. you're saying that has not changed? >> we are coming behind that with an independent audit. comprehensive audit of scheduling practices across the organization because we need to restore that trust. >> has anyone lost their job for retaliating against --

>> no. there are two whistleblower retaliation referrals that have just come from the office of special counsel. and i have got tuesday morning i will have investigators on the ground pursuing those. >> how many ongoing investigations are currently under way for investigating these retaliation complaints? >> the number -- it's 70 or something. the number's huge. >> the other 68 are still ongoing? >> these are ongoing at the office of special counsel. i'm waiting it for the office of special counsel to provide me the results of their investigation. > what are you doing about it? let me describe what we have heard from whistle blowers. they said we get an email once a year that says we have a right to whistle blow. then we are faced -- i'm hearing this, still going on today. >> i have no doubt that it is. i can articulate over and over again the expectation that we

are not going to tolerate that behavior. but until i've got a set of facts that i can act on, i can't take the action. i can't take the personnel action. and so nobody's more anxious than i am to have that opportunity. that's why, in fact, this morning i checked again, have we gotten anything from the office of special counsel? the answer was yes, we just got two. tuesday morning, we'll have investigators on the ground. >> i asked in the last meeting, following the last meeting, information of contacts between whistleblower here that had contacted the chief of staff it it to the president. i don't believe we received that information. you have access to that information. that hasn't been looked into. that hasn't been responded to. these are very serious allegations, mr. secretary. i presume we'll have a new secretary in a couple weeks. but to come in and say we are going to restore the trust but we haven't addressed the whistleblower problem because

that's somebody else's job. >> it's not somebody else's job. it's my job. i just can't -- i just can't take action until i've got the results of the investigation. >> from the o.i.g. >> either from the o.i.g. or office of special counsel. one or the other. >> have you issued any new statements to the v.a. system about whistle blowers? >> yes. >> can you provide that to the committee? >> yes. >> i yield bag. >> thank you very much. >> thank you so much, mr. chairman. thank you, secretary, for your hard work. before i begin i want to recognize a friend of all of ours, nancy brown park from the national -- she's the national president of the american legion women's auxiliary who is here in our room today. she's visiting us from my district, california's 36th, as you know it's in southern california. it's a long trek. thank you for being here and all your hard work. hasknow, recently my office

really done an incredible detailed, thorough investigation of the different issues that face our veterans, not only when i started off this last summer when we held community forums, stakeholders analysis, research, but also key stakeholder interviews, we underwent that again in light of this crises. we have a veterans advisory board that is just topnotch. we conducted surveys. we have done more interviews and had multiple meetings with many the v.a. and v.a. administration. and we recently conducted this informal survey of veterans in my district to assess their satisfaction with access to the v.a. health care. when our approach means the world of a different -- of difference to our veterans, and we approach this with the spirit of problem solving.

we approach this with the spirit of partnerships for solutions. we approach this with the spirit of honoring our veterans with our relentless determination to serve and put them above anything else. and we found, and i'm going to give you some information, though, and we understand there's some selection bias here, so i take these numbers with a grain of salt, nevertheless they tell a story. we found the vast majority of my district veterans who responded said they waited more than 60 days. these are individuals who are upset and willing to conduct this survey. when asked what issues were preventing them from obtaining timely care, about a third said that the -- they cited a shortage of staff, echoes secretary gibson. even more troubling, when asked what could be improved to better provide timely care, the vast

majority again said, quote, people who care. and we heard that on multiple occasions. so we also heard that there's this culture where the v.a. system believes that perhaps it's about them. and we need to change that culture to make it a more high performance veteran centered culture. the v.a. exists to honor, respect, and give dignity and care for our veterans who have put their lives at risk. the veterans do not exist to serve the v.a. health care system. that is very important for that sentiment to penetrate every level of the v.a. health care system. now, my question to you is, what

is the plan for a systemwide cultural change that will create a culture of high performance veteran centered system? >> i think as you look at organizational change, cultural change in an organization, the critical ingredient in all my experience is leadership. part of that has to do with articulating expectations and holding people accountable for behavior that's aligned with those expectations. we are working hard to do the first part. we are working hard to get ready to do the secretary part. and we are anxious to do the second part as well, because quite frankly i think that's where we begin to get real traction. i will also tell you on the leadership part, i agree with you completely. i think we need -- there is a fundamental shift in culture

that has to happen. one of the things that i talk about an awful lot internally is ownership. really at all levels. we are talking about leaders not at the top of the organization, but leaders at all levels, taking ownership for issues that are getting in the way of delivering care to veterans. some instance it is could be a leader that's taking ownership or a greeter's less than cordial welcome of a veteran. it could be more fundamental in terms of a leader taking ownership for the steps that need to be taken to get x-ray machines repaired in an operating room, as i ran into in phoenix. but it's really about taking ownership and understanding that my job as i said earlier, my job is to create the conditions for them to successfully take care of veterans. >> i believe that that is very important. that leads to a culture of accountability which we

absolutely need. however we need a veteran centered culture. what are you being held accountable for? what are the institutionalized tools that you're going to use to make sure that our eyes aren't necessarily on the spread sheet but are always on the veterans themselves and that can be done with veterans advisory board, that can be done with veterans surveys, that can be done with tying promotions to veteran satisfaction. that can be done in a lot of different ways that focuses on all of our eyes, all of our accountability, everything we do, everything that we strive for and exist even in our high performance, is always answer the question through the lens of the veterans. >> agreed. >> thank you. yield back my time. >> thank you very much. dr. rue i. -- dr. rue i.

-- ruiz. colonel cook, recognized for five minutes. >> thank you, mr. secretary. appreciate you being here. we are talking about trust and confidence. i'll be honest with you, i lost a lot of trust and confidence in the v.a. when i was in a platoon, felt very, very confident with the troops i had. the company, company commander, trust and confidence, battalion, all the way up there. and i'm trying to not let the events of the past influence my judgment. about three months ago i called one of the v.a.'s. i'm not going to call as congressman cook, i'm not going to call as colonel cook, i just said, hey, this is paul cook. i'm on file. i just want to get an appointment.

i couldn't even get past the switchboard, ok. called the v.a., the regional office and told them about that. but i didn't -- there's part of me that wanted to go to war, if you will, but there's part of me that my office, they do a great job handling the veterans. i didn't want to endanger other cases that are on file. i said to myself, ok, cook, what are you going to do? you're a dumb marine. i said all right. here's what's going to happen. i'm going to walk in to a v.a. and i'm going to try and get an appointment. i'm going to bring my i.d. card. i probably will not show them first, i just want to give them my driver's license. they are going to look at it. right away they are going to see i'm older than dirt, but it will have my social security number

on there, and what i want to know from you guys, if you can, what five questions should i have answered right then and there so i can go forward with the process? because if i think those questions are working, i'm going to spread that through every veteran, hey, you're going to v.a., make sure you have blah, blah, blah. and you ask these because i'm going to say if they didn't answer those questions, then we have a problem and we have to address it and i'll come back to you. and here we go again. sorry, it's a long question. >> i think to get care at the v.a. you should ask only one question. am i enrolled? if you are enrolled, you should be getting care. the second questions after that would be what kind of care would you want. if you are not encontrolled, the question after that would be, i would like to enroll, how do i

do that? >> let's go with that. >> that should be one question i'm enrolled, i would like to get an appointment. >> then the next one? just ask -- >> i would like to see my primary care provider, this provider, that's it. you shouldn't be asking any other questions. >> ok. so two questions. >> yes, sir. >> or three questions. >> ok. got a couple of questions on i.g. you might not be able to answer. how many of the i.g. visits are unannounced? >> sorry how many i.g. visits? >> are unannounced? >> i would say the large majority. >> ok. so they don't know in advance that -- ok. >> oftentimes they are responding to a hotline call or something like that. i don't even know where the i.g.'s are. >> i mentioned this before about the principle -- i was an i.g. this thing about managing by walking around, sometimes you

walk into a battalion or what have you, you don't like to do that when you have evidence that there's something going on with the unit. i walked in one time, i found a live mortar in a place with the safety pin off. unbelievable. and yet when you come in like at, particularly if you're worried about an organization based upon the statistics going on out there, i don't know. i'm kind of excited about you being here. answer your question. i still understand granue late. the -- gran layerity. it's the third time i have heard it in the last two days. it took me a long time to understand some other words, and now you throw that at me. i'm just a dumb marine but i'm glad we are going to start over again and we are focused on it.

dr. ruiz is right. it's about that culture of the military and we can never forget that. thank you. i yield back. >> thank you very much. doctor o'rourke, you're recognized for -- mr. o'rourke, you're recognized for five minutes. >> thank you, mr. chairman. let me begin by thanking you not only for being here but the amazing job you have done under two months as the acting secretary. you have been incredibly responsive. you have been transparent. you focused on issues of accountability. and i believe you have defined a vision for excellence, even in the first two minutes of your opening statement. my hope is that as we have a new secretary for the v.a., that you will still be part of this organization at the very highest level, continuing that very aggressive, ambitious push towards excellence and accountability, and changing this culture that all of us have been working on and talking

about for so many months and some cases years now. let me quickly switch to el paso, and i realize it's parochial, but i hope it has some implications for others who have similar situations in their districts and for the system as a whole. you visited 13 facilities i believe, el paso was one of them of the the amazing vernea jones and american legion also set up a command center there within the last month. that shows us that you're taking this issue seriously, but it also shows us we have a problem in el paso. the access rankings that we saw from the v.h.a. reported in june show that out of 151 facilities, we were dead last, absolute worst for established veterans access to mental health care appointments. we were fourth worst for new veterans access to mental health, and second worst for specialty care. you and some of your comments you made while in el paso talked

about problems with the capacity of the facility that we have, the quality of the facility that we have. i'd love for you right now to say that i'm going to help you with a full service veterans hospital. i'm not going to ask you to make a commitment that you can't follow through on and don't have the power to implement, but i will ask you this. will you work with me to ensure that we can increase capacity that we can improve the level and quality and access to care in el paso? and similarly underserved poor performing facilities in this country? >> i absolutely will. el paso's one of those locations that's grown almost 20% over the last three years. it's located as we both know in a medically underserved market. and so we've got challenges there as it relates to space, as it relates to the scope of services that we are providing organically in that particular location. and challenges in some instances which you have personally helped

us with, in terms of trying to attract clinnishans -- clinicians. >> i told you friday that i was going to call a psychologist who we were trying to recruit to el paso. when i was sworn in in january of 2013, we had 19 1/2 vacancies in mental health care in el paso. as of last month we had 19 1/2 vacancies in el paso. i have been making recruitment calls. i spoke to a wonderful psychologist yesterday, a leader in ptsd care. i learned that because we are a clinic she will be a gs-13 most likely. that will be the pay scale f she were coming to a hospital she would be a gs-14. i cannot blame her or anyone who would make a decision based on what they would be able to earn in a position given the fact they will be coming into a historically underserved area. it's another piece of the case that i'm making that we need a full service v.h.a. full service

hospital. the chairman and ranking member convened an amazing panel week before last of survivors of service members who have taken their lives as they transitioned into civilian life. and we talked about ptsd and the need to do a better job of taking care of these service members when they come back. and the parents of daniel summers, dr. and mrs. summers, also provided a potential solution, or at least a suggestion for us to explore. and that was kind of picking up on something that dr. roe said about how we coordinate with community care and private care. could the v.h.a. become a center of excellence for war related injuries? for survivors of ptsd? t.b.i.? of muscular skeletal injuries of exposure to toxins like agent orange and those that our service members were exposed to in the gulf war, and have

community care for all other services. i'm not endorsing the idea, but i'd love to get your thoughts, and perhaps thoughts with the chairman's permission since i'm close to running out of time. >> i think the first part of the question should we become a center of excellence around a lot of those practice areas, i would tell you we either are or should be. so those are instances where we need to have deep knowledge and expertise, but also exceptional capacity to be able to meet the needs of service members there. how that fits in to a revised model of v.a. care delivery, i don't know that i'm ready to give you a view on that, but clearly in those particular areas, as i learned from our friends at p.v.a., oftentimes the things that v.a. has over the decades developed deep specialties in are absolutely vital to our veterans. these are great examples of

today's areas. >> as i yield back, i ask that we continue to work together to at least explore this concept, perhaps the v.a. cannot be everything to all veterans, and maybe we should focus on centers of excellence. with that i yield back. >> thank you, mr. o'rourke. >> thank you, mr. chairman. secretary gibson, it's an honor to be you. i appreciate you being here. i want to take a second and let you know why i'm stymied by this request for $17 billion because i just want to take you back how this started on the committee. i'm from the state of indiana. we have 6.2 million hoosiers who live in the state of indiana. we have half a million veterans out of 6.2 million people. our state is passionate. and they are freedom fighters. we love the military. we embrace the v.a. in the state of indiana.

we have the fourth largest national guard in the nation. a little tiny state in the northwest behind california and texas. we love -- we are patriots in our state. so i am passionate about this issue because i believe that when our little state, a half a million people, answered the call and they heard a promise from this government, and i sat here for 18 months with my fellow freshmen on the committee, and i still have for you today the original questions i ask when the hearings began because we never got an answer from the v.a. all we wanted to know, all i wanted to know was, what is the status of my state? what's happening? i have gone to several hospitals in my state. i have a hospital that's not even a fully functioning hospital. they don't even have an i.c.u. if you are a veteran that comes n. you are going to be looked at in the e.r. and shipped across the street in the private facility, yet taxpayers are paying for both. i have a large institution in indiana i went to two weeks ago that had probably 2/3 beds empty. they have never been called by the v.a. on this supposed

nationwide check. they showed up on the list of 122 original audits that the v.a. had additional questions from, and the c.e.o. personally told me, he's never heard a word. nobody's ever checked with him. there's been no checks. nobody's been fired. they are still harassing whistle blowers. there's been no checks. we don't know the status of our state. we can't get the answers to the questions we started with. and i guess the question i want to ask you but i'm almost mortified to hear your answer, is when will we know the status of our state? i'm sure i have asked those questions from day one. when are we going to hear the status of our state? don't tell me it's up to counsel general, i.g., and everybody's cryptic and mysterious and anonymous. >> monday and wednesday of next week, congresswoman walorski, myself and pearce will be conducting briefings here to the committees, senate, house, and

state delegations. we'll send that data out to the field as well. and the ovide to you facilities. >> yeah, that's been a huge concern. my second question goes back to representative brownley. we sat in here on many, many hearings on i.t. in fact i'll never forget the gentleman in charge of i.t. was sitting where that blank microphone is now. your i.t., according to the hearings we have, has been a disaster. there's been many breaches. our veterans have been the information could he opted and breached. the the gentleman in charge of i.t. sat there and i said to him, do you have enough money to do what you need to do to protect our v.a. and vetance and upgrade the system that you need? yes, ma'am. we find out during a subsequent hearing that -- $17 billion request, that we have allocated long before i got here, this committee has consistently, faithfully allocated all the money the v.a.i.t. department

has asked for, and then we found a revelation in a loft these hearings they are using 1985 scheduling shot wear. that's one of the most shocking revelations i heard. one of the hearings i said, where are the billions of dollars, where did they go in this giant v.a.? they obviously weren't addressing i.t. when you come to us and ask for $17 billion and nobody can answer the question why we are using antiquated equipment, when ever request has been funded, the i.t. at the v.a. is a disaster, what is the answer to the question of how can we possibly trust you now? even for another billion, just for i.t.? when all that money has been unaccounted for and the revelation under oath was, we are using 1985 software. i think that's shocking. i think the american taxpayers deserve an answer where the money went and how they can trust you with another $17 billion or $1 billion in i.t. upgrade? either of you.

>> i was listening for a question there. >> my question is how can the american people trust you for more money? even a billion. >> be glad to give you a lay down of the work that i.t. does on an annual basis. the projects that are undertaken. the systems that are both maintained and developed. and the functionality that's delivered. >> i guess, mr. chairman, if i could indulge one final question. i guess the information we heard that day from your i.t., the guy in charge of i.t., was incorrect. it could not have possibly been incorrect information when we find out under hearing where people take an oather with we are using 1985 scheduling software when he sat there with me and said we are fine. thank you very much. the information he gave wasn't true, correct? >> i think he gave you an honest answer. i think what you heard was the result of an organization that's

managing to a budget as opposed to an organization that's managing to requirements. i would tell you one of the things we need a schedulingcies tefment we have it built into our budget for 2015 and 2016. >> all due respect, according to your professional, it was built into the budget for years and we were funding it and trusting that it was used for the allocation that was requested. >> there was a highly reported failed development effort that occurred back years ago where v.a. invested a substantial amount of money in a scheduling system, and it wasn't able to deliver. i would tell you in the years since that time, starting in 2010, when v.a. developed the project management accountability system, and i would refer to you, and i'll make sure we get you a copy of the recent g.a.o. report, where they looked at seven major departments, and their i.t. departments have done, the v.a. was the overwhelm one of the

seven departments that passed the grade with g.a.o. >> i appreciate it. the other question is, if that guy who is in charge of your i.t. got a bonus, i'm curious, to the information he's provided for the lack of adequate resources you have, i want to know if he got a bonus. thank you. i yield back. >> for mrs. walorski's knowledge and records, we were going to have an oversight hearing this week in regards to i.t. we were not able to do it because the person who is responsible for i.t. is out of the country on a long planned family vacation. the so we canceled in hopes that he will be able to attend. >> thank you. i for one am thankful and grateful this nation still produces citizens like yourself. i have had the privilege of working with you in other capacities on the u.s.o. and your commitment is unquestioned. i think when you started out, mr. secretary, when you talk about, i agree with you. this is one of our greatest

opportunities to make lasting improvement. what we do possibly within the next weeks and months, will have decades long implications. that's why it's important we get it right, not just done. they are hand in hand. i have been advocating what's been missing is the national veteran strategy, very similar to the quadrennial review that set that priority, that get that transition. i'll ask you in a minute about your commander's intent and transition, if you will, as it goes to the next commander as we all know, and how that will work. what i'm hearing and i think what you're hearing, the concern on this is, this nation is committed to getting this right. this nation is committed to providing the resources. we also have a commitment and they are not mutually exclusive to ask every dollar be spent in a wise manner. going back to best practice, i want to clarify when we talk about the private sector, let's be clear, eight out of 10 businesses failed in the private sector. don't pick the eight where you're getting your information. this oversimplification, the government's going to do it right and get into these

ideological differences, that clouds it and takes us away from the mission as best practices, things that are out there. i would ask you this, and this is what i would like to get your take on, mr. secretary, i have the privilege of representing the number one hospital in the nation in the mayo clinic. i have watched and i have looked at and understand how mayo has done this. one of the things that mayo has always of course been focused on is the patient first. the veteran first. the systems analysis from the very beginning, over 100 years ago, has been the mantra of what they have done. these things as performance excellence drives what they do. it starts on the flow chart with leadership. it ends with results. my question is, in mayo they have a quality academy. all those things. they are asking basically -- many don't though this. mayo was basically founded on battlefield medicine. they are deeply ingrained in battlefield medicine, the v.a., they have partnerships with you.

they are asking now what they can do. i guess my question is when undersecretary hickey sat here she talked about about i.s.o. and certification so she could answer. what are you suggesting what can e done in the h.a. to ensure a baldridge-type mayo type performance so we know if we give you the money how it's going to be implemented? >> interestingly enough when we did a review of scheduling practices and access practices, we invited folks from mayo to brief us. when we looked at water safety practices, we envinetted engineers -- invited engineers to cofment i agree with you they are a model organization. i agree with your characterization we should look at it as a system and look at our entire health care system as a system. not just focusing on a metric here, metric there, but looking at concepts like through-put. being veteran centered, how do we measure, manage, how do we

assess that? i think over the next couple of months we are going to go take a look at some of our productivity work that we have done. we briefed dr. wenstrup on it. bring folks from the outside. help us look at doing purposeful system changes. not spot initiatives here and there, but looking at what the practice would look like if we changed it. mackized through put. we'll physicians. can we deploy, test t. measure t. use the principles of measurement. i think for the long-term sustainability, v.h.a. and v.a., especially v.h.a., used to have these academies that were really great. we sort of let that erode. we have to bring them back and have to build leaders by focusing on the travening and investing to succeed. >> that's what we want to hear. i think this is an opportunity to build that hi bread. not this either-or. the private sector does it best.

the core mission of the v.a. needs to remain intact. there are certainly positive lessons out there in the private sector. and we heard last week from panel that offered up great suggestions. i thought that was great one coming from indiana, indiana university -- he knows on any given day they are using 79% of their capacity. let's tap that other 21. mr. secretary. >> i was just going to say, i was in st. louis on tuesday and had the opportunity to visit our training academy on the cemetery side of the business. and cited that as an internal best practice we need to import into the v.h.a. because we don't have the kind of talent development and succession planning inside v.h.a. you would find in the private sector. >> i think it's important you bring that back up again. the older members will remember this. the crisis at our cementtaries out at arlington and others, and the focus put on that and the turn around that's been there

and the verifiable turn around and quality that's been made, we can do this. but if we miss this opportunity, or don't rise to the occasion, shame on all of us. i yield back. >> thank you very much. mr. ryun, you're recognized for five minutes. >> thank you, mr. chairman. i'm going to probably throw out a couple of rhetorical questions . the one you probably won't answer. i just want to throw it out there and see if you can respond to why someone would even ask it. is v.a. too big to fail? that's something that we have dealt with in other sectors in the last decade. i think it's a legitimate question. when we talk about trust and prophecies, how are we going to get there? as representative floor rest --

flores said earlier, and mr. huelskamp question about process, and your quote was, on the personnel side, you need a set of facts to act on. that could be done in a budgetary process. i'll use the aalcy. go back to your high school, college days. your girlfriend broke up with you. you made up the next day but you didn't ask her to marry her that day. legitimate process of gaining trust over time. to go to that and i love the act that you brought up manage two requirements. there's seven, eight members on this committee that serve on armed services. mr. walz brought up quadrennial defense review. i think most of us sit on that committee believes the d.o.d. does the same thing. they tweak the requirements to meet the budget. they don't lay the whole thing

out to congress and allow us to say, at some point we are going to have to prioritize what we are going to do because there's only so much to go around, but we have to know what's out there. and when we are dealing with a crisis like this, and i ask the question to undersecretary hickey last week, i said, when we are attacking something and maybe the chairman -- the claims backlog, that's a category of claims. now, when you do your analysis to say we need this much money to solve this problem, are we going all the way back into everything from -- it changes on a daily basis. could you do it on a quarterly basis. to say to eliminate all of the claims in -- whether it's death benefits, whether it's burials, whether it's education, pension, all that kind of stuff, is that

even possible to move the overlay of what we are making definitions of putting claims in piles to say, do you have an idea of even what that number is ? because you have alluded to it on several patient aspects, about in an overall claims -- we continue to say, we are only going to ask for this much because i put this overlay on it. what is this overlay picture? what is that requirement to eliminate this once and for all? i don't think these questions really get asked and/or answered on a regular basis. >> you're talking about on the claim side, on the benefits side? >> just boil the whole thing down. let's just say claims. every single one of them that is sitting on a desk in an r.o. somewhere, what is that number? and what is fiscal number that

goes to eliminate that? a lot of times i know, you talk a lot about modeling and all that. your models, you're using filters to ack wait those numbers that come out of those models. what is the big picture? is the crisis bigger than we -- i think we are realizing it's bigger than we thought it was a year ago. can we at some point push all this back and really say, we really got to step back and take a look at this and realize this is a bigger problem and we need to dive into this deep? >> i think as it relates both to the claims side of the benefit side of the business, if you will, and health care side of the business. part of what you're saying and v.v.a. has done this for some period of time, this regular weekly publication of detailed information. the disability claims.

but also now detailed information about all the nonrating claims. so that people have that complete picture. the same thing on wait times. we ntil six weeks ago weren't putting detailed wait time information out on every single location. care quality and patient safety information out on every single location, so that we are creating that kind of openness and transparency so that people can understand the magnitude of the problem. i sit here and say it's 641,000 veterans that have got appointments that are more than 30 days from when they wanted to see -- >> i know my time reas running out. i want to tell you, i have experienced this in my four years in congress. as you built trust and we say we are going to do them one step at a time, i don't think there's anybody on this committee that would have a problem coming in here and you tackling this $10 million at a time. i don't think they would. as we do that and make sure we

get it right, and have that set of facts that we can act on, as you said. with that i yield back. >> thank you, mr. runyan. >> thank you, mr. chair. thank you so much, secretary gibson, for being with us today and thank you for taking on this extraordinary task. we appreciate it. i want to echo the comments of my colleagues. i think you'll find that this is one of the very rare bipartisan committees on capitol hill right now when we strife to work together. -- strive to work tofplgt i want to focus in on the issue you mentioned and the work on ethics and accountability because what my concern is is while i wholeheartedly believe that we need to do every possible thing to ensure that our veterans get the care that they deserve, i have a hard time addressing the funding request before we get

into how the v.a. is going to fix this underlying systemic issue of integrity. in particular the testimony that we have heard here about this scandal of people receiving manipulated upon data. thank of truthfulness. honesty and integrity, that not only the veterans deserve but frankly the american taxpayer deserves. if you could address before we get into the additional funding how do you intend to restore that level of integrity whatghout this system each will be the actions taken for defeat and failure to abide by basic, basic issues of

integrity? when the president told me he was going to tap me to be the acting secretary, i said don't expect me to behave like acting as in front of the job title. and i have tried not to do that consistently. we have moved out on every front that we can conceivably move out on. it's been a process of of -- of working not sequentially on issues but working on a much broader front. working to get veterans off the wait list. and simultaneously working to build the processes so we can hold people accountable for woeful misconduct, and management negligence when it arises. as we went through this process, i perceived the need for additional expertise in that area, which is why i went and

recruited lee bradley. with secretary hagel's strong support to come over to the department, to return to the department. we have built underneath her a team of senior leaders from across the organization -- part of the challenge we are going through right now is, part of it is just what it takes in the federal government to pursue personnel actions and to have them done in a way that you at least hope it's going to stand up to and appeal. the other challenge that we are working through right now is really the recalibration of the department's yardstick, if you will. that behavior that looks like this which in the past might not have had any accountability action associated with it at all may in the future be an appropriate -- deemed appropriate for removal from federal service or for very extended period of suspension.

what we have done, as we have done mentioned earlier as we got the cases from the i.g. are exercising that process. following due process but also managing through this reset that has to happen. this recalibration that has to happen to ensure that appropriate accountability actions are taken for the wrongdoing that's been identified. >> if there's anything that we can do in our capacity in congress, i know that including passing a bill to give you the authority to literally fire employees -- because i think that is the only thing that's going to bring this integrity back. and i just want to say for the record i had a tremendous honor this week, my constituent, sergeant ryan pitts, received the presidential medal of honor. i was there for the ceremony with he and his wife and son at

the white house and again as he was inducted into the hall of fame at the pentagon, i was very interested in his comments this morning on national television when asked about his own care at the v.a., that the care he has received in new hampshire has been of very high quality. i want to say for the record that every veteran deserves that care. my time is coming up, but i do want to say that i hope you will pursue best practices because i think we have some exemplary care in new hampshire and i would like to see that throughout the country. on that i yield back. >> mr. secretary, i apologize, some members are going to have to depart to go to a conference committee meeting over in the visitors center, which is at 12:00 noon. we tried every way we could to find a time that was agreeable for everybody, but i'm going to

turn the chair over to mr. bilirakis at this time and recognize him for his statements. thank you, sir, for your service, your candor, and i look forward to continuing to work with you. >> thank you, mr. chairman. i appreciate that. i'll recognize myself for five minutes. mr. secretary, again, thank you for your service to our country. mr. secretary, are you aware of this incident that occurred, i believe, on monday, orange county, florida, facility, where a marine, veteran, was actually -- waited for three hours for care, did not receive that care,

and then he was subsequently locked into a facility during closing time, it was inadvertent, obviously. what are we going to do about this? this accountability. are you investigating this? will the people responsible, the administrators, be held accountable? >> all i know about it is what i read in the clippings this morning. it will be an object of intensive review to determine what happened and ensure nothing like that happens again. >> can you report back to me, mr. secretary, with regard to that? >> yes, sir. will do. >> it's outrageous as far as i'm concerned. next question, you have directed that an independent external audit of v.a. scheduling practices be performed. what do you expect the e. ternal audit to reveal the v.a.'s own audit has not? has a contract been awarded? how long do you anticipate this to go on? i have a couple other questions. >> sure. the contract has not been

awarded yet, which is why i'm not in a position to be able to reveal the entity that we are working with. i believe once it's announced, the reaction will be that they must be pretty serious about making sure this gets done right. quite frankly i hope it doesn't tell us anything that we don't already know. i hope it confirms that what we now have in place are scheduling practices that are aligned with our policies. i think to some of the earlier questions that were asked about the need for some verification, how do you believe we are publishing wait time data every two weeks, is it valid data? one of the issues for us there is to look at the scheduling practices, a rigorous independent review. determine they are sound practices aligned with our policy and therefore we have credible data for external consumption as well as for our own internal actions. >> what is the expected cost of the audit?

>> i don't have a number for you. i'll take that for the record. >> very good. thank you. again, with regard to the bonuses, have any bonuses been scinded so far to woeful misconduct or negligence? can you answer that question? >> i will give you the best answer as i know it. there were some bonus that is were rescinded recently that were associated with administrative error. the law allows us to do that. where there is something is learned after the end of the performance period and after the performance contract has been officially, the performance review has been officially approved, we don't legally have the ability to go back and change that performance evaluation and therefore claw

back that particular bonus. we do have the ability to go and reduce salary and take other actions which would be the typical actions upon some subsequent learning -- learning of some subsequent information that affected performance during a permanent formance period. >> ok. last question. i understand you implemented hiring freeze for the v.h.a., central office, and with the exception of so-called critical positions to be approved by you on a case by case manner. what would you consider a critical position for v.h.a. central office and -- >> i would say, for example, we currently have, if my memory serves me right, four vacant visn director positions. if we were where we had the right person identified to step into one of those key leadership roles, then i would be prepared to grant an exception for that personnel action.

>> have you granted an exception? >> i have not for that purpose. there is one employee that i granted an exception for where he had already been made an offer and accepted an offer. and had already begun to relocate. for that instance i did grant an exception. this is really focused on roughly 3,000 people that comprise the vissin headquarters leadership as well as the v.h.a. central office leadership. there are other staff that are associated with those particular areas such as call centers. we have thousands of people that work in our call centers in v.h.a. those would not be positions because they are providing -- that would be subject to the hiring freeze, because they are providing direct service to veterans. >> how long will the hiring freeze be in effect? >> don't know. >> you can't anticipate how long. >> the real purpose of that hiring freeze was to very directly here was to basically

send a shout across the bow of the bureaucracy to say, we've got to get ourselves refocused here on delivering the support that the frontline needs, the people that are taking care of veterans day in and day out. that's really the purpose behind that particular freeze. >> thank you very much. i appreciate that. i have ms. -- ms. mccloud. you are recognized for five minutes. >> thank you, mr. chairman. thank you acting secretary for being here. however being near the end all of the questions have been asked so rather than being redundant i yield my time. >> thank you very much. i apologize. thank you. i'll recognize mr. fitzpatrick for five minutes. mr. fitzpatrick: i also thank the chairman. and thank the acting second for

your time here today. i know that we all honor and appreciate your service. it hasn't been said here today about your time at the u.s.o. which was a real turn around. great success. great american story. and want to thank you for that. we saw that in philadelphia with the u.s.o. organization there. of course we all hope you can bring that enthusiasm and that success and bring it back to the organization at the v.a. desperately needs your leadership there and echo the comments of some of the -- my previous colleagues that said we hope you stick around the v.a. >> i plan to. it's a stool with three legs. we have the health administration here, benefits administration here. the third is the cemetery administration. as mr. walz said, in the past not been without its issues. we have a new national cementtary, the washington

crossing national cementtary, beautifully being developed. serving very well the constituents of southeastern pennsylvania and the greater region. so the veteran community, the families of military and the bigger community is left with the very positive view of the veterans administration because of the cemetery administration there in the community. not so much with the benefits administration. mr. secretary, i'm sure that you're familiar with the hearing that we had here last week went well into the early hours of the morning. there was a whistleblower from philadelphia, outstanding employee, very dedicated employee, who parenthetically is a whistleblower for her work, providing direct, outstanding service to veterans, and indirect service by going to middle managers, pointing out flaws in the system much she's pointed out backlog and delays. she's pointed out duplicate payments she thinks should be recalled.

she pointed out shredding of documents. for that she's been sort of vilified. and setaside. and made a victim had herself. when really the administration and the management there at the philadelphia v.a. r.o. should be embracing her. i know you were in philadelphia a couple weeks ago, my staff appreciated your time and commitment in going there. but based on what you saw in philadelphia and based on what you heard and what you now know, i would ask what is the plan, what are the action steps to turn around the philadelphia office which would apply to many of the other r.o.'s across the country? >> it's a great question. >> reminder you can continue watching that hearing,et the remainder of the hearing online at c-span.org. shortly online, the conference meeting between the house and senate veterans committee on that legislation. that will get under way shortly. follow it live on c-span.org. u.s. house beginning their legislative work coming up shortly. they'll debate a cusm bills this

afternoon dealing with college tuition. one revising financial counseling requirements. and another measure up for debate would make changes and make permanent the tuition tax credits created in 2009. now live house coverage. will b in order. the prayer will be offered today by our guest chaplain, reverend thomas coys, saint james catholic church, lamont, illinois. the chaplain: heavenly father, i give you thanks and i ask your blessing upon all gathered here. lord, i beg you to enlighten us and i ask you to be merciful to our country as we strive to win that kind of peace that you desire. as these people debate the best ways to order our society, give them humble hearts to seek that order that flows from your supreme intelligence.