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tv   Politics and Public Policy Today  CSPAN  October 26, 2015 11:00am-1:01pm EDT

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a/k/a alice. there were real concerns about false errors reporting. i'm just curious, have we resolved some software issues alice was facing? thank you very much. >> i'll give you the technical answer and i'll let the general give you the warfighter's perspective. since your visit down there, we took a look at that health reporting code problem and done a number of things since then that have improved the situation. the first thing we did was put a new increment and software capability into the alice system we call it alice 2.41. that fixed some of the problem. the other problem was we did not have a completed list of codes that were false, so to speak, at the time. we were worried if we made the list too big, a code that wasn't false would get overlook.
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we have a lot more time and more maturity in the airplane we have upgraded that list. the 80% number you heard at eglin, which was accurate, for the entire fleet today is about half that now. that's not the best part of the story. that's the whole fleet. the best part is the lot 6 and 7 airplanes we're fielding today we're improving today because of the things in the last two years, they are only seeing a handful of 1s and 2s everyday. and that 40% includes the 80% includes all the older airplanes that until they are upgraded, they are going to still have that issue but the newer airplanes, much better. the general has experience with the new airplanes at hill air force base that they have been using. he might be able to tell you more.
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>> those airplanes, ma'am, we have three of them up there. they have not lost a sortie since they delivered them. as we have delivered these newer airplanes, they are performing really well. eglin still has older ones and struggle with the older systems the program office has continued with overtime as the general points out. having said that, there will still be challenges as we understand a.l.i.c.e. and put our maintainers with the system in the program office. one of the things we did, we had our senior logistic leaders from the f-35 bases and folks come together to talk about what are the big issues. this was one of them. we provided a list of specific things, this false reporting code issue being one of them we
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worked closely with the program office to get the feedback from the airman in the field to work through and priority ties those and get the most important issues to insure we're fixing the right things on the airplane. >> that is really great to hear. i could hear the frustration they were faced with all these false negatives they were -- these false negatives they were having to deal with. are they using the same software system? are they using a.l.i.c.e.? >> all the airplanes in the fleet are using a.l.i.c.e. the newer planes have the fixes in terms of t software on the older airplanes. on their flight line they have airlines in the block 1 configuration and 2-a configuration. when they get upgraded to the 2-b configuration or block 3, they have gone away and we haven't had time to back fit or
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>> good positive update, thank you. >> thank you for the accommodation and for your presentation and your service. did you say in your opening testimony that you have received 79 f-35s to date? >> yes, ma'am, in the air force, we have. >> with the 79 that you have received, do they all have this ejection seat issue? >> yes, ma'am. i understand you tested the
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ejection seat on a man kin that was 135 pounds. i have also understood you have more recently tested it on a 245-pound mannequin. it has not been tested on a mannequin between 135 and 245, is that correct? >> in the development test program, we have those test points planned out u are correct, as of today, we have done the high-end and the low-end. >> my concern is this, if we know there is a problem on the low end, we haven't tested it for those who are likely to be most pilots between the weight of 135 and 245 and we have them in these planes now testing them, are we putting any of them at risk?
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>> the answer to that is, no, ma'am, because we have done the risk analysis on the test points that we have had on the ejection seat, and what we have found is the only area where we have a problem today is with the lightweight pilot below 136 pounds because when we have tested throughout the envelope, you can't test every point for every weight, but the areas that we have tested indicate that in the heart of the envelope for the heart of the pilot population, there is not any increased risk of injury at all. and i can show you that analysis, ma'am. >> all right. thank you. >> ma'am, from the service perspective, we have a life cycle management center that is part of our air worthiness organization, and they have -- ma'am, to be clear. i talked with the guys who have been working with this for 30 years. because clearly it's an important issue for us and we share and talk very closely with
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the program office with this. and exactly what general bogdan said is how it was communicated to us. in fact they've shown us the chart, how it lays out and what the risk levels are. as the general said, there is certain risks there we've accepted it. except at the low end beneath 136 pounds. >> well, there's been some report that there's been a memo that you accepted, general bogdan, that accepted a 1 in 4 risk of death if -- with the -- with the problem with the ejection system as being a risk that is worth taking i guess. is that correct? >> ma'am, that is incorrect. the data that you have came from
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a reporter who got a copy of an official use only internal dod document that my team put together to assess the risks of a lightweight pilot and a pilot between 136 and 165 pounds. that document should have never been publicly released. i have an investigation ongoing to figure out how that reporter got it. but the worst part of this is, the reporter did not know how to read the report, ma'am, so let me give you the actual facts. today, a pilot that weighs less than 136 pounds if he steps to the airplane, he or she, has a 1 in 50,000 chance of hurting their neck from an ejection. a pilot between 136 pounds and 165 pounds has a 1 in 200,000 probability of having neck injury from ejection. the individual who reported on this is not an expert in system safety --
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>> okay, let me -- my time is running out. as i understand it, the test was done under ideal circumstances. is there any reason to feel that the results would be any different in circumstances where it was going not at ideal speeds but -- and not going straight but going up? >> your time has expired. general, i want to thank you for being here. you have continued to provide the information as required by this committee, and we will continue to hold this program accountable and provide oversight. not just because there are issues or problems that have arisen, which there are, but because this program is so incredibly important. it needs to be safe for our pilots. it needs to be safe for our country, and it needs to be able to perform at the level that it
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has been asked to perform because the gap that this plane is going to fill is incredibly important. so, with that, i thank you both for your service, and i know that you both know that we'll continue to work both through the committee hearing structure and throughout the calendar year to both inquire and to work with you to ensure this plane can deliver. thank you. congress returns to a busy week. the house takes up a bill for import and export bank. if it is successful, it would go to the senate for approval. tomorrow, work on highway funding legislation and wednesday, house republicans will vote for their nominee to be the next speaker with a vote by the full house on thursday. the house may consider legislation to raise the debt limit to avoid a government default by the november 3rd deadline. the senate will be in voting on a judicial nomination and tomorrow, working on cyber security information sharing.
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watch live house coverage on c-span and the senate on cspan2. >> tonight on the communicators, marsha blackburn talking about cybersecurity and data breach legislation. she is joined by john mcken non, technology reporter for "the wall street journal." >> as individuals become subjected to these breaches, they have come to realize it is not if you have your data breach. it is when is your data going to be breached. having a federal standard and exercising some preemption and setting a period of time, a framework of time that companies have to conduct that information and then to inform consumers. and set penalties for
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enforcement, those are appropriate steps that should be taken and they are the steps that are covered in the data security legislation that we have worked on at jen and commerce committee. >> tonight at 8:00 eastern on the communicators on cspan2.
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i would like to give a pre-announcement in the interest of all three senators, as soon as we have eight members, we will go into session to act on the nomination. so if you don't mind, i'll interrupt you for a brief time once we get to eight, if we get to eight during your testimony. >> we are pleased to have three members of the senate to discuss legislation they have proposed to the senate. we also have two distinguished panels that will comment on their legislation as well as others. we are delighted you are here. as i said, we are going to use this meeting for a markup. when we get to a quorum of eight, we will have tower vote on mike mishu to be in his position to send that on to the floor. i appreciated the ranking member and all the members cooperation
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in moving quickly on mike the bills we have there are land use and in west los angeles. >> that access to mental health. i look forward to the senators testimony. i will recognize senator blumenthal for any remark he has. >> in the interest of our colleagues time, i want to thank you for being here. these measures you have proposed are very worthwhile and we look forward to your testimony. thank you. >> each member will get five minutes. it is the committee's tradition not to ask quegs. as soon as you have made your testimony, if you would like to be excused, you are welcome to. senator feinstein, we are delighted to have you. >> thank you, mr. chairman. >> i am going to be speaking
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about a bill i introduced with senator boxer. i would like to thank david norris on the california chapter of the veterans of foreign wars. this would allow on the northside a veteran's cemetery and on the south side, a very large complex, including a hospital, several buildings, a ucla baseball diamond and many other things. >> it is run down. it needs help. the largest amount of veterans in america live in los angeles. there are 3,000 and more than 4,000 have no place to go. they are, in fact, homeless. 10% of the veterans in this
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country live in southern california. simply put, we need to get things right at the west l.a. va. i would like to briefly recap the history. every v.a. facility in the country has the leasing authority provided in my bill, except for the west lava. in 2007, congress took that authority away. after it became clear that leases were granted to commercial entities that were not serving veterans. this includes everything from a movie lot to a laundry facility. it led to a 2011 lawsuit settled earlier this year. thanks to the leader ship, we are back on the right track. since he has taken over, we have spoken many times about the issue l.a. veterans face. he has put an excellent new team together.
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i have met with with them in los angeles last month. i believe with he now have a path forward to make sure the campus fulfills its obligation to serve the veterans. here is why. this land is a grant from a former senator and the bandini family in 1888. the grant says it has to be used exclusively for veterans. at a time, they were rented out to ucla for a baseball stadium, to a laundry, a rental car business. that's not for veterans. this enhanced lease would enable the v.a. to use nonprofits and access $600 million of the state of california's money, which has been specifically earmarked for
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veterans. it is an essential tool to implement the new master plan. it will allow the department to build housing more quickly and more affordably than it would be able to through the traditional v.a. construction process. i also want to thank this committee. you authorized funds for homeless. we have 55 units and $35 million for the second building. the thrust is to allow nonprofits to come in for the specific purpose of building veteran's housing. i am hopeful that -- let me just point a couple of things out. new leases must be consistent with the master plan.
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it will regularly report and if they are not in compliance, new leases will be prohibited. the va must submit a report to congress 45 days before entering into any new lease agreement. i truly believe and i have worked on this for ten years, that this plan will help turn the page and ensure we are doing everything we possibly can for veterans in los angeles going forward. mr. chairman, i would like to insert letters of support from local officials, homeless advocates and into the record. >> thank you, senator feinstein. >> i want the committee to know that senator feinstein has worked with me diligently to try and bring this to a conclusion. today's testimony is very helpful. they will have the master plan completed by the 22nd of october. is that not correct? >> we tend to move forward
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quickly and expeditiously. we are going to go into executive session for two minutes. i call an executive session for the committee for the purpose of considering the nomination of assistant secretary of labor michael h.mishu. >> now that we have a quarum present, i make the following motion and move that the committee favorably report the nomination of michael h.mishu to the assistant secretary of labor for veterans employment and training department of labor. >> is there a second? >> all those in favor say aye. >> none opposed, let the record reflect that by unanimous vote, it will go to the senate floor. next, we will hear from senator donley. welcome to the committee. >> thank you, mr. chairman, ranking member blumenthal and members of the committee, thank you for holding this hearing i
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appreciate the opportunity to speak briefly about s-717. the community provider. the suicide rate among our military service members and veterans veterans, it is not just a tragedy but a describe sis, last year 453 members to suicide. last week, we have seen more than 200 military sue sides in the first half of this year. the statistic that 22 veterans every day take their own lives. in indiana, we've lost too many hoosier veterans to discourage. i'm sure each member of this committee can say the same about your home state. despite the effort we have put into combatting military and veteran suicide, these numbers and the stories of each of these preventable deaths tell us how much more work we have to do. the key challenge we must overcome is tackling this program with a clear-eyed understanding of how stigma, provider shortages and budget constraints impact when and where service members seek care.
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i worked over the past three years to advance common sense bipartisan legislation to meet that challenge. we took an important step forward last year with the suicide prevention act, which was part of the national defense authorization last year. this year, i'm working with several republican colleagues to advance the service member and veterans mental health care package. three bills aimed at improving the accessibility and quality of mental health care, for vets, service members and their families. i'm here today to talk about one of those care package bills that is on the agenda, s-717. i've been working with my colleague, senator ernst, who as an officer in the iowa national guard has been indispensable. this bill creates a special designation for private sector, community mental health providers who demonstrate a strong knowledge of military culture and evidence-based therapies for mental health issues common to veterans and service members. it creates a regularly updated online registry, so vets and service members can search for these special providers.
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due to an increasing demand for mental health services, use of community providers by service members and veterans has increased dramatically. if we know veterans and service members are accessing care through private community providers, we owe it to them to do our best to improve the quality of care they receive in those settings, and to provide resources to help them select providers who understand their unique challenges and how best to treat them. that's the goal of s-717. multiple internal and independent reviews of d.o.d. and v.a., purchase care networks have identified the need to improve military cultural competency and the use of d.o.d./v.a. clinical practice guidelines and evidence-based therapies to enhance the quality of care service members and vets receive from community providers. i have a few examples with me today. the task force report. the institute of medicine's 2014 assessment of ptsd treatment for
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military and veteran populations. and the 2014 report entitled "ready to serve." we know more and more veterans each year are going to be seeking care from non-v.a. providers. we need to be sure as many of those providers as possible are trained to provide high quality care. and we need to give vets tools to help them make decisions on where to seek care, whether or not they're using their v.a. benefits. both d.o.d. and v.a. are working to push out trainings in military culture, in evidence-based therapies for providers. it will come as no surprise to know the uptake rates on those trainings needs to improve. we need to give providers better incentives to participate. many of the trainings are
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already free. many already grant continuing medical education credit. we could require the training. we could tell providers they can't be in d.o.d. and v.a. purchase care networks unless they complete it. imposing those kinds of mandatory requirements can backfire. at a time when our vets and service members desperately need more options. s-717 gives providers an incentivee to voluntarily access military and veteran-specific training. by receiving military veteran friendly designation if they fulfill their requirements. the star program, which was begun in indiana, has now expanded to seven states, including the home states of a number of members of this committee. mr. chairman, as you know, georgia is one of those states and it's an extraordinary program. the d.o.d. provisions of this legislation were included in the fy-16 ndaa conference report, under section 717 with unanimous bipartisan support.
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can i have an additional 30 seconds? thank you, sir. assuming we keep intact our record of passing the ndaa, this legislation will become law by year's end, but only from military personnel and their families. not for veterans. the ndaa deals only with this program as it would impact d.o.d., service members and families. it does not address veteran or the department of veterans' affairs. that's why i'm here to ensure the services are available to not only current military personnel, but also to the veterans that we care for so much. mr. chairman, thank you for your time. >> thank you, senator donnelly, appreciate your testimony. senator shaheen? >> thank you, mr. chairman. and ranking member blumenthal, all of the members of this committee for holding this hearing today and for giving me
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the opportunity to speak in support of my legislation to expand the number of judges on the u.s. court of appeals for veterans claims. as every member of this committee knows full well, one of the most complex challenges facing this committee in congress over the next several years will be the growing backlog of veterans disability claim appeals. veterans denied benefits by the v.a. continue to face a complicated, frustrating, and unacceptably prolonged process to receive additional consideration of their disability claims. the growth in the number of claims awaiting appeal over the past several years is staggering. as you know, the board of veteran appeals is the highest appellate level within the v.a. over the past four years, the number of disability claims appeals received by the board has increased 65% from 49,611 in 2012 to 81,640 in 2016. the board is now receiving almost twice as many claims per year as it has the capacity to decide. in 2014, it began the year with 65,000 unresolved cases.
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over the course of the year, it received an additional 56,600 cases. as a result of this growing workload, the average number of days to resolve a case increased from 289 to 335 between 2014 and 2015, and i've personally spoken with veterans in new hampshire who have waited three, five, even one nine years to resolve a claim. as a matter of basic fairness to our nation's veterans, we have got to do better. we have to take a serious look at every level of the appeals process. and the bill i'm here to talk about this afternoon is very simple. it would reauthorize the court of appeals for veterans' claims to employ nine judges instead of seven. since 2002, congress has granted temporary authorizations for the court to increase to nine judges.
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before that, it was authorized at seven. that authority ended in 2013. and as a result, the court has been reduced to eight active judges, and it would return to seven if we don't act soon. the court noted in its 2014 annual report that given the anticipated increase in the number of decisions to be rendered by the board, we perceive a need to reauthorize nine judges. as we see unprecedented and unrelenting growth in the backlog of appeals, now is not the time to reduce our capacity to pre-2002 levels. i urged the committee to support the simple measure which provides immediate help to relieve the crisis. and i look forward to answering any questions or further discussions about how we streamline the appeals process in the future. thank you very much, mr. chairman. >> thank you, senator shaheen. thank you very much for your testimony. we'll go into our committee meeting now. we appreciate your being here. thank you. we have two distinguished panels. the first panel is thomas lynch,
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assistant deputy undersecretary for health clinical operations, veterans' health administration, u.s. department of veterans accompanied by vince kaine, and jennifer grey, staff attorney office. if our first panel would come forward. we welcome all of you for being at the committee today. i think, mr. lynch, you'll be the one to testify, is that correct? welcome. you have the floor. >> thank you. good afternoon, mr. chairman, ranking member, and members of the committee. thank you for the invitation to present our views on several bills that would affect v.a. benefits, programs and services. seated beside me to my right is
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vincent kane and to my left is jennifer gray. i'd like to begin by thanking senator feinstein for introducing the veterans leasing ability of 2015. for the support from other congressional members, including senator barbara boxer and congressman ted lieu. the bill would authorize v.a. to enter into enhanced house usage benefiting veterans and their families. the v.a. firmly supports this bill as it will enhance our current efforts to revitalize the campus and help end veteran homelessness in greater los angeles. this legislation will help us in three ways. first, it will allow v.a. to enter into agreements with housing providers, local governments, community partners, and non-profits to provide housing and services for those veterans and their families that are homeless or at risk for homelessness.
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second, it will allow v.a. to revitalize the campus into a rich and vibrant community that puts the needs of veterans first in a manner consistent with v.a.'s ongoing efforts to complete a new master plan for the campus. and third, it will ensure the campus honors the underlying deed that transferred the property to the federal government in 1888, to be a safe, welcoming, and healing environment for veterans. we appreciate the committee's support for this needed legislation and look forward to working closely with each of you and other veterans stake holders on this passage and implementation. the v.a. also supports s-2022, which would increase pensions for medal of honor recipients. the v.a. recognizes the extraordinary bravery and unparalleled service that our medal of honor recipients have provided on behalf of our nation. an increase in their pension is an important step in demonstrating our commitment and gratitude. v.a. supports sections 2, 6, and 7. the veterans housing stability act of 2015. a bill which seeks to improve the benefits and services we provide to homeless veterans and their families. v.a. does not yet have clear views on sections 5 and 8, however we will be working with
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the committee to from provide views and costs at a later date. there are several other provisions of the bill that we believe are not needed. there are several other provisions that we believe are not needed or may benefit from further discussion with the committee. these have been highlighted in our written statement. s-717, the community provider ready recognition act in 2017 established a special designation through d.o.d. and v.a. for nondepartment mental health care providers that demonstrate a strong knowledge of military culture and evidence-based medical treatment. the v.a. does not support the provisions of thisily abo bill. they did recognize the need to ensure that our nondepartment clinicians were equipped with the necessary education and training to properly care for and treat our nation's veterans. through joint collaboration, we created a military cultural
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competence course and community provider tool kit which accomplishes the intent of this bill. in addition, this would require nondepartment providers to be helpful, we have concerns about the way such a certification would be developed and maintained. with respect to s-1754, the veterans court after appeals support act of 2015, the v.a. would defer on whether this bill should be enacted as it would primarily affect the court and not v.a. operations. lastly, s-1676, delivering opportunities for care and services veteran act in 2015 addresses many important issues related to medical education and
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training. as well as recruitment to provide this at lay later date. thank you for the opportunity to provide views on several important bills. we would be please to answer any questions that you or other members of the committee may have at this time. what could you expect the committee to receive the master plan for the west l.a. property? >> it should be received by the committee in mid-october. >> the 22nd is the date i have been hearing. we expect to put it out to public comment shortly there after. in and around thest, we should be able to get something. >> how long is the comment period? 60 days? >> we are proposing.
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that's still being debated. >> does the feinstein bill incorporate the you can stadium and the school? >> it does not directly incorporate the ucla stadium but notes the importance of a partnership noting that that's our academic affiliate. the focus is on housing and services that directly benefit the veterans. the secretary is working directly with all of us through the master plan and other legal issues but it does not give special permission for the continuation of the stadium. >> is it not true that the stadium and the school are the two controversial portions of the property? >> they are two of the most controversial aspects of the property. our intent is to make the entire
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property veteran focused. >> do you intend to deal with whether or not the v.a. is going to recommend the baseball stadium or the school or whether they are not? >> the master plan looks at how the campus can be revitalized to be a community. it will talk about how different zones on that campus, the 388 acres, can be best utilized. decisions related to the continuation of the stadium are addressed in that zone process but are separate discussions of what they have submitted and how they can provide services that really truly are veteran focused and how that stadium can be repurposed to have a focus on veterans. so, it will not be directly addressed in the master plan. but it will be addressed as sort of an outcome and a by-product of our discussions and the master planning process. >> when the property was conveyed to the va by mr. jones
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in 1888 i believe -- is that the correct date? >> yes. >> was that by covenant on the deed or was that by agreement of some type? >> it was the deed. >> it was on the deed. >> yes. >> so the definitions of benefiting veterans is a broad one, not a narrow one? >> correct. although we've been very clear through our process, through the master planning, and through the activities that we've undertaken since the settlement back in january that the intent is to revitalize that campus as the home for our veterans and to make sure that the health care is state of the art, 21st century, as well that all the services on that campus are focused in prioritizing the veterans. >> the reason i'm spending so much time on the question of the west l.a. property is that i'm one that believes there's potential revenue to the government and to the va on surplus property around the country the veteran
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administration owns and this particular master plan may be a template for what we might do in the future for other properties that are vacant that could otherwise be leased to generate pen fit to the va or the veterans. >> we agree. we think that this master plan can be a template for creating what we want the new va to be and to be focused on which is 21st century health care with the other services that really dignify and respect the men and women that serve this country. >> senator blumenthal. >> thanks, mr. chairman. i think this hearing is very important because it deals with mental health, with the quality of justice and with homelessness. and i appreciate all my colleagues' efforts to address a
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number of the issues that veterans and their families face ranging from those issues to the recruitment of va health care professionals and housing instability. there is a real and pressing need to move forward on many of these issues. and i want to offer my strong support for the bills mentioned by my colleagues as well as for the docs for veterans act which is the next step in enhancing the va medical workforce, in particular it seeks to tackle the problem of vacancies at the network and facility level across the va. and, of course, my own measure which i have offered, the veterans housing stability act. and i want to ask you, mr.
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lynch, i notice that there are some provisions that you do not support in this measure. would you tell me why. >> there's one provision that v.a. does not support, which is section 3, which would require v.a. to create a new program to provide intensive case management interventions for homeless veterans in at least six locations. va feels that we already have a very strong program, tied to hud-vash, but we feel in addition to that, that there are other opportunities for outreach to veterans and homeless veterans at this time. veterans at this time. the va has an extensive network
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that has outreach to the street under bridges, soup kitchens, prisons and court. there are gap analyses being done to ensure there's a focus on cities, the veterans population and their needs. >> and you feel the outreach already is sufficient? >> we do. >> well, i would respectfully disagree. i think that there is a need for more outreach to the homeless from what i've seen at least in connecticut, although we are on the verge of purportedly ending frontline homelessness in connecticut, there is a need for outreach every day that apparently is lacking or inadequate. so, i would just urge that perhaps you consider working with me on that issue. let me ask you about the veterans court, increasing the number of judges in the board of appeals. i understand you don't run the veterans court of appeals, but wouldn't you agree that the backlog and the increase in caseload warrant this step? >> the case sounds compelling. i just feel on behalf of v.a. we're not in a position to decide for the court. but i certainly acknowledge
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there is backlog, and there could be value in additional judges. >> perhaps you could consult with others at the va and come back to us, submit in writing, further position on this issue? i think it is within the purview of your responsibility to make sure that disability claims for the benefit of veterans are processed as expeditiously as possible. >> yes, sir, we'll do that. >> finally, let me ask you about the delivering opportunities for care and services for veterans act of 2015, which has been sponsored by senator tesser and others. i gather -- maybe you could restate your position on this bill. >> the v.a. has not developed formal positions, but i think i can safely say looking particularly at sections 101 and 102, which deal with residency
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slots, the use of provisions of -- regulations that we feel strongly that these would be a positive aspect to allow us to develop more residencesy programs in va to have the potential to recruit residents from those programs to provide care for veterans. i think also looking at section 300, which deals with additional provisions that put network directors and medical center directors under title 38 and allow us to be more competitive as we recruit in all localities and address complexity challenges that are facing a number of our locations, these are all going to be very positive actions that will help us i think be competitive in the health care market today. >> i'm going to join as a co-sponsor of this measure.
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i think it is absolutely vital and i thank to thank senator tester for his leadership. thank you, mr. chairman. >> senator rounds, followed by senator tester. >> thank you, mr. chairman. i just wanted to follow-up also on senator tester's proposed legislation 1676. it would appear that it does a lot to help deliver health care long term to the rural parts of the country. and i'm just curious, originally you indicated that you did not have a position, and yet you
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just gave some reasons why you would support it. i'd like to go a little bit more in depth on it. would you share with us the reasons why you were not interested in supporting it? >> we are not in a position to say we're not supporting this bill. we just have not developed our views yet in a formal fashion at this point. but looking at the provisions in sections of the bill, i see that there are opportunities particularly for rural health. if you look back at the legislation, it identify residency positions that would be focused in rural and highly rural areas. over the last year we were actually able to get 400 requests for residency positions, 163 positions have been filled and we expect to fill the rest the coming academic year. i think the value of this bill moving forward is to begin to work with smaller medical centers apart from our major academic medical centers and osteopathic schools is going to require time to develop those residencies, probably a couple of years to develop them and another couple of years to get it accredited and probably three years to fill the residency, so there is advantage to extending provisions of the legislation from five years to ten years. >> sounds like a bureaucratic mess to me.
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let me just go on. let me try another one. 717, which is the donnelly-ernst proposal. you indicated it was not okay with the v,a. and this is the one which would designate certain nondepartmental mental health care providers who treat members of the armed forces and veterans who have particular knowledge related to mental health care for the armed forces and veterans and other purposes. i'm curious, it looks like a lot of veterans leaving dod, stepping in and now coming under the care of the va, i suspect that if they could go directly to a va facility and receive the care, they probably would look at that. and yet what we're looking at with this particular proposal is for those individuals who could not access the va facility,
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you've indicated that you've got some other alternatives out there that would be comparable to this particular one. looks to me like if it's working right now, we wouldn't have the request for the bill. are you thinking that right now the ability to provide for those services is already there within the framework that you have laid out versus the alternative that's been proposed by this legislation? >> v.a.'s position is that we feel there is a need to educate the community and we think we have vehicles out there to provide that education. v.a. is also embarking on another provision of the defense authorization act that requested that v.a. begin to outreach to the community providers and engage them in providing mental health services. our real concern is that we don't feel that we can adequately develop a program that certifies or recognizes somebody because while they've taken the training, it's very
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difficult to determine the competency for people who don't work for us and also to determine long range whether they maintain that competency. >> a lot of folks that work for you right now, good, hard working individuals that provide good, professional services, they don't start out with a program that you've trained them to begin with, they come from the outside in the civil world. you provide them with training courses to make them better at what they do. they get experiences working with veterans today. it seems to me the same type of approach would be comparable in these other non-va-employed facilities. i would hope that you might reconsider the position just in terms of being able to provide services in those parts of the country that don't have access to the va expertise that we do in some of our larger communities. >> yes, sir. >> thank you. thank you, mr. chairman. >> senator tester? >> thank you, mr. chairman, and ranking members for including
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1676 on the day's agenda, and i appreciate your support, senator blumenthal. on this bill, you know, this legislation simply put was really to address the chronic shortage of v.a. medical professionals really allow you to better complete -- compete for the skilled staffing that compete for the skills you need over the next many years as v.a. continues to get pressure for services. just as background, it incorporates a number of great ideas from folks and veterans. it has been endorsed by 17 organizations representing everyone from medical colleges to mental health counselors to physician assistants and disabled vets. and i want to thank the medical college and the american legion for the early engagement in support of this bill. in july this committee announced provisions for this legislation, and i am hopeful we can advance the remaining provisions. and in particular, i want to highlight the section that you highlighted, mr. lynch. section 101 regarding medical
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residencies, which i believe are the surest way to get a pipeline docs into rural america and into the areas we need to address our veterans' needs. congress included a critical vision in the number of residents training. you're familiar with this, mr. lynch. >> yes, sir. >> by increasing the facilities over the next five years, but to date the v.a. has only been able to fill about 163 of those positions, is that correct? >> yes, senator. >> okay. so after speaking with a number of folks in the v.a., it is clear that filling all 1500 authorized residency positions as congress intends simply cannot happen. is that a fair statement? >> that's a fair statement. >> and is that because the v.a. no longer runs its own stand-alone residency program and must partner with non-v.a.
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affiliated establishments? >> in most cases to my knowledge, we need to partner with academic affiliates or community hospitals, yes. >> okay. and the problem with that is even though the v.a. is willing, non-v.a. affiliates are hamstrung by the current cap on medicare funded residencies, is that correct? >> yes. >> okay, well that cap was established in 1997 for the committee's information. it is woefully insignificant. insufficient, i should say, to meet the needs that are out there. and that's why section 101 of this bill would establish those 1500 residency positions that were authorized by the choice act. they would allow to make direct medical education payments for choice students who are in the teaching caps. i just think this is critically important if we're going to be able to address the medical needs we have on the ground. and i think it plays not only to rural but also urban v.a.
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centers. but it absolutely has benefits to rural america, make no mistake about it, and big ones. that will lead to more v.a. and non-v.a. affiliations. more docs joining the workforce. does the doc act give the tools and needs it needs to fill the residency positions? >> i think it gives us the ex d extended timeframe to develop residencies, particularly in rural areas with osteopathic facilities. we may not have had relationships with them before to allow us to have outreach to highly rural areas. >> do you see this as a strategy to fill the docs that you need? >> i think this is a good strategy, senator. >> okay. i want to talk about the other section you talked about. section 300. very quickly, and it has to do with -- filling positions and
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making sure folks are held accountable in leadership positions because leadership does matter. whether it's v.a. directors or medical directors at the medical facilities. do you believe a major hindrance to filling the positions has been the v.a.'s inability to compete within the health care industry. >> yes, sir. >> for executive leaders in the private sector. >> yes, sir. >> do you think the gap is wide? >> yes, sir. >> can you give me the indication of what the gap could be on average? >> i don't have average numbers but can tell you the salary paid in the private sector is significantly greater than what we're paying our v.a. medical center directors and network directors. >> okay. and so that -- i mean, like right now, what kind of vacancies do you have now? and let's just say the medical director? >> medical center directors i think is in the range of 25% to 30%. >> okay. yeah. so now 25% to 30% less salary or
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25% to 30% of those medical facilities don't have directors? >> don't have directors. >> that's what i thought. and so you guys know, this is like having a hospital with no ceo. and it's a huge, huge problem. i would hope that we could kick out both sections, 101 and 300 out of this committee and would love to have your help getting that done as we move forward. i appreciate all of you being on the panel. thank you for your hard work. >> thank you. >> and i want to underscore what senator tester has said. there are far too many vacancies, far too many acting directors and far too many who don't have permanent responsibility at the v.a. i have talked about that before and appreciate you bringing that up. just an editorial comment to pass on to secretary mcdonald. >> yes, sir. >> i would second that editorial comment.
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again, it is just something we simply have to do. it is common sense and good business practices, but i know it is difficult in the situation you're in. dr. lynch, in your testimony, you noted that you were supportive of senator graham's legislation, s-20 and s-22, and the idea of that and your testimony was to provide our mental owners with a small pinch going forward. these are men and individuals that have done such heroic things. and i have had the opportunity to be around them at different events. and they are so good to come out. you see young people, all ages, that learn about the military and things and it is just a very positive experience. one of the problems is8"zy is t the reason i support this is many times they come at their own expense. and so they are very willing to do things, but like i say, many
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times, there's expense incurred by themselves. and they are in situations where perhaps it's difficult. so i think that's another reason that the legislation would be beneficial. would you agree with that? with the importance of them being and then adding so much, whatever the event is in helping us highlight the sacrifice and the importance of our military? >> senator, absolutely. >> very good. tell me about -- i understand you are all not supportive of senator donnelly and ernst legislation concern iing designating non-mental health care providers who treat members of the armed services and veterans as providers who specialize in providing mental health care to veterans and service members. tell me a little about that. it is not uncommon at all in the private sector for them to be
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credentialed through medical societies and things like that. why is it so difficult for the v.a. to be able to do that? >> i think, senator, the v.a. and d.o.d. looked at this several years ago with respect to another program related to mental health services in rural areas. and found that there were significant, what they felt to be legal obstacles to this. there were also felt to be some potential conflicts with state licensing and professional review boards. i think -- so one aspect is legal. the other aspect is developing a process that would allow us to assess their competency beyond a simple self-administered educational program. and to follow the progress of their treatment over time. right now we just don't feel we
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have the resources to do that properly. >> i would encourage us to perhaps visit with the american psychiatric association and the american psychological association and really see if we can figure that out. the reason being is mental health care issues have been a crisis in the past, but they really are reaching a breaking point now. not only in v.a. but throughout our society. and so we have to start thinking outside the box. so it's something that i would appreciate and i think the committee would appreciate. if you really look hard and see how we can expand the services that we're providing, and yet it's very difficult to provide the service without ancillary help. and that's why we see the medical societies and things credentially stop at people. >> yes, sir. >> thank you, mr. chairman. >> senator moran.
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>> thank you, secretary, for your presence today. i may be following up on what senator bozeman was talking about. i want to explore the issue of the use of community mental health providers within the v.a. and my understanding is under the choice act, the v.a. is required to provide services to those who can't receive the service they need within 30 days or who live more than 40 miles from the v.a. facility. and the facility has now been redefined. >> yes. >> so one of the only places in kansas that you can access mental health services in rural parts of our state, but generally across our state, are what we call community mental health centers. and they provide the wide array of mental health services. and my impression is, we have been working on this long before choice was ever enacted, but we have been trying to convince the
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v.a. to enter into agreements with the mental health centers to allow veterans to receive care through there. it really hasn't developed. and so my question is, in today's circumstance where the v.a. is required to provide those services, maybe the -- it still doesn't seem to be happening, but maybe the bottleneck is how the v.a. or tri-west decides which organizations to contract with to provide those services. can you explain to me how that process works? >> to my understanding, tri-west, on behalf of the v.a., reaches out to providers in the community to engage them in a choice program. there are some requirements, they do have to be medicare eligible in order to participate. they do have to provide a copy of their records within 30 days of the provision of services.
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but -- and we can reimburse them at rates up to medicare. so a lot of the challenges are related to working with the providers and getting them to engage in choice. we have been working with tri-west to improve those engagements. we have been working to try to make it easier through some recent legislation, which would actually let us work within the 30-day interval and avoid 60-day reauthorizations to make this process easier to implement. and there are some recommendations going forward as of november 1st that will help us, i think, more greatly integrate the v.a. care in the community beyond what we're doing right now. >> would there be, secretary lynch, any circumstances in which the v.a. would decide we don't want to have an outside provider provide this kind of
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service? and therefore, tri-west would never enter into negotiations with the provider? >> not to my knowledge as long as they meet the provisions of the choice act. >> so there wouldn't be an approach within the v.a. that says we want to retain the only ability, in a sense, the revenue is not the right word, but the revenue that flows from that veteran, we want to maintain that within the v.a. and not allow an outside provider to provide that service. >> no, senator. i think the secretary has made it clear that we're coming into a new era in v.a. that we need to collaborate with the community. that we need to partner with them to provide care to veterans. and that we can't do it all ourself. >> one of the community mental health centers told me in kansas that they were allowed to contract but only to provide screening services but not the actual care of the veteran. does that make any sense? >> not -- >> they were interested in providing the wide array of
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services but the v.a. says, no, we are only going to contract -- or sky says -- not sky, tri-west says they are only going to allow you to do screening. >> i don't understand. but i would be happy to get more information and explore it with you. >> and do you have the sense that the implementation of the choice act is pretty uniform across the country division to division, or is it different, because kansas happens to be a certain visit? >> it varies across the country depending upon our ability to recruit community partners. but we are working aggressively, i can assure you, with both our third party administrators to engage the community and to have choice providers available. >> and under the clay hunt act, you're also up instructed, the v.a. is also instructed to provide additional mental health community services. any development there or does the choice act fully and appropriately take care of that mandate? >> i would have to look at the
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provisions of the clay hunt act that you're referring to. but i think that we have a number of resources that we need through choice. i think the other thing that i mentioned earlier through the defense authorization act or mental health services, that they are required to reach out to provide mental health care. >> our family and medical professionals, therapists, does the law require you to hire them within the v.a.? >> i don't know if the law requires this. i know that we have been reaching out to involve them more in v.a. services. i've had that discussion with our mental health program office. and we are beginning to look for ways to engage these individuals further. >> my final question, mr. chairman, is that i was told that a community mental health center could be, could not be reimbursed for any services provided by a family and marriage therapist.
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and that, i think, makes no sense in part based upon what you just said, but i know there's an effort to integrate that profession into the v.a. and yet the community mental health center says they can't use family and marriage therapists and be reimbursed. >> i would have to look more specifically at that. >> thank you very much. >> senator tillis. >> thank you, mr. chair. i'm sorry i was running late. i'm not going to talk long except to just lend words of support for two bills. senator shaheen's bill, i don't think you have taken a position on it, but i think it's a valuable resource in drawing down the claim's back load and give certainty to the veterans going through the appeals process. and senator graham's senate bill 2022. i look forward to seeing them make their way through the committee. the only thing i won't do, since i don't think any of y'all have
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anything to do with the camp lejeune toxic waste issue, but i'm looking forward to a future meeting to get resolution to questions i posed in the last meeting. thank you, mr. chair. >> thank you. senator sullivan. >> thank you, mr. chair. and dr. lynch, good to see you again. >> yes, sir. >> i think you'll probably not be surprised when i talk about a topic that you and i have been spending a lot of time on lately. and that's the issues in alaska. again, i appreciate the chairman and ranking members' support for our hearings out in the state in august that i think were hopefully very helpful to you and your team and certainly are helpful to me and my team. you know, when i was here last, we had -- at the latest hearing we talked about dr. shulken's six points with regard to an alaska plan and alaska pilot program to fix what i think everybody recognizes has been a
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real problem in terms of the implementation of the choice act. and i appreciate you following up, you and your team just recently with my staff. my understanding is that most of what dr. shulken is going to do, and i'm sure you have the six points in front of you at this time, is not going to require -- >> you do? >> absolutely. >> i do, too. i won't grill you on them, though. for most of that, we are not going to need legislation. i do think that on the issue, my understanding, particularly from the call yesterday is, on the pilot project and the valley in terms of the partnerships, that you might need some legislative authority there. and i just want to get a commitment from you. i know i'm going to get it, is you'll work with my team and the committee here that we can make sure we know what that is. so whatever bills are moving
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soon that we can make sure we have that in hand working with you, can i get that commitment from you on that? >> yes, sir. >> what i wanted to do, just because you saw how passionate our veterans were on the issue, i just wanted to work through -- first the timeline on the issues in alaska. i think you saw how urgent the issues are. and in the last hearing, i talked about the ability for you guys to move up a timeline. again, can i get a commitment as soon as possible, we can work with you to announce what we're going to do there in terms of alaska pilot plan, particularly in the areas where you have authority, so we can get that out and start giving our veterans hope? >> yes, sir. i think we talked yesterday about two phases. one, we have already implemented a virtual integration between tri-west and the integrated care service in anchorage.
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so that there is a direct connection between those individuals at v.a. alaska who have worked for a long time with the community providers. tri-west is going out and recruiting seven additional individuals who will actually be physically present in the integrated care service center. i think what came across in the phone call yesterday is we want to make sure we do this right and make sure we get the right people. right now we think they will be in place by mid-november. >> okay. >> including recruitment. >> you don't think there's a way to move that up at all or -- >> sir, it's my understanding they are moving as quickly as possible. they want this almost as bad as you do. because i -- >> i doubt it, but that's okay. >> well, i can tell you -- >> maybe they do and that's great. we are work together, that's the key. >> having walked through and talked with the people in that unit, they are very committed to the veterans and the vendors working with our veterans.
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and anything they can do to facilitate the communication between veteran and vendor and make that work, is going to be something they are going to push as quickly as they can do that to put in place a good service. remember, this is a pilot -- it will probably be implemented in other places across v.a. we want to make sure it's successful. >> good, i appreciate that constructive answer. let me ask, you know, we're still getting a ton of veterans weighing in with my office on this issue. and what i thought would be useful just in the remaining time i have is just, have them speak directly to you and see if you can answer a couple of their questions. one, miss kathy bloge of anchorage, she works at the v.a. as an air force veteran. that the alaska v.a. takes pride and service to our veterans, but are spending dozens of hours on the phone trying to fix the contractor shortcomings and our
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employees cannot do the jobs they are hired to do. because they are spending so much time on resolving the choice act issues. and i will just throw one other out there because i'm trying to get in under the buzzer. a board certified doctor in anchorage, saked ambesh, he said, he's a disabled vet, he wrote into my office and said, he's provided care to 1,036 patients out of 7,994 over the last several years, but in the last several weeks he's only been able to see two v.a. patients out of close to 100. again, from choice act implementation. will the alaska plan kind of address some of these issues that are directly coming from our vets and people who have worked with the v.a. or in the v.a.? >> i think you illustrated the point i just made. that the people at the v.a., the people in the integrated care
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service center care as much as you do about serving the veteran and resolving those problems and working efficiently and reestablishing what is important in alaska, which are relationships between the veteran and the v.a., between the v.a. and its vendors. so i think you've made my point as well as your point. >> so will the plan allow these kind of things to be fixed? >> i think it will, sir. >> thank you. >> thank you, mr. chairman. >> thank you, senator sullivan. i want to thank our panel lists for their testimony. thank you for being here today. we'll recognize the second panel to come forward at this time.
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>> take care, good job. we'll keep working for you. >> let me bring the committee back to order. before i introduce our panelists, i want to say a thank you, if i can, to the legion and the vfw and the iraqi and afghan organizations and all the other vsos. over the past seven or eight months we have had a difficult situation in denver, colorado, with the denver hospital. and i want to thank the ranking member in this eulogy as well, not eulogy, but whatever it is, anyway. testimony. because of the support of the vsos and the cooperation of the
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rank in member, we pulled off something nobody thought we could do by getting the v.a. hospital authorized in denver. finding the money to fund the hospital without going outside the v.a., and the vsos were extremely helpful in the waning days of that debate. and i want to publicly help them and i hope you tell your commanders the say. i want to thank senator blumenthal in the waning members when we were channeled, he stuck behind the committee and what we did. we appreciate that very much. >> thank you, mr. chairman. i want to thank the chairman for his leadership on this issue and others. although i'm not sure i'm holy in accord with his eulogy. >> trilogy. testimony. >> but i do want to thank him very seriously for his leadership. and second, emphasize how important the veteran service organizations have been. and i think the most telling
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word in that title is service. you have truly been of service to the veterans of america as well as to all of us who have a responsibility to try to provide for them and the partnership that we have with the vsos is enormously beneficial to the work we do, trying as hard as we can and working as hard as you do to serve our common goal. so i want to join in thanking you and hope you will pass that message along, not only to your leadership but to your membership. because they are the ones who truly deserve credit for helping us serve the veterans of america and for their service to our country in uniform. thank you. >> i want like to introduce our panel, lauren augustine. second is lou cheli of the
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american legion. great name here. elijah herald blaine, what a great name. and david norris, vice chairman of veteran of foreign wars. we appreciate you being here today. please limit your testimony to five minutes each if at all possible, and we'll start with miss usaugustine. >> on behalf of veterans of america and more than 425,000 members and supporters, we want to thank you for the kind welcome and our opportunity to share our views on these pleases of legislation. iva supports these bills before the committee today. i would like to focus my testimony on two areas our members have expressed the greatest concern. one, increasing access to health care and mental health care and two, eliminating homelessness. this remains a top priority for iva and its members. according to iva, 40% of
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respondents knew one iraq or afghanistan who had died by suicide. and 47% of respondents knew one veteran who attempted suicide. while the work conducted by this committee on the clay hunt act is greatly appreciated, there's much more work to be done. first and foremost is the need to make sure the clay hunt save act is being conducted appropriately and the iva wants them to hold an oversight meeting before the end of 2015 to this end. i understand the v.a. is staffing medical providers specifically with medical providers and evidence that is leading effective. many veterans do choose to seek care outside of the v.a. system. according to the 2014 ieva survey, 50% of respondents use v.a. health care to leave a sizable number of members not seeking v.a. care. we are identifying non-mental
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health care providers who have competencies. thus practices of care among non-v.a. providers will strengthen the overall care available to community veterans. ieva recognizes the potential benefit of this program and work together to help connect veterans to a valuable network of providers. tied to the mental health care needs of veterans and ensuring access to v.a. health care must remain a top priority to prevent a repeat of the situation that came to light out of phoenix in 2014. while the choice act created foundation for change at the v.a., there are additional areas of concern that still need to be resolved and understanding that ieva understands the numerous provisions and the docs act to build on the initiatives to ensure the v.a. is adequately meeting the need of veterans. the residencies are currently included in the cap for medicare funded residencies and impacting the need to fully utilize this provision. this will give the v.a. and its
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local partners the ability to increase this in the manner it was intended. ieva also supported the five-year extension and would like to see the program made permanent. additionally, they support the provision to increase the number of behavioral health residencies in rural areas and encourages the committee to use the pilot program for a model for increased behavioral residencies across the entire country. another area of concern highlighted by some of today's legislation addresses the continued effort to end veteran homelessness. there's been considerable progress made in addressing this issue in recent years but there's now a need to address some of the concerns that can arise when a veteran may no longer be homeless but still needs traditional assistance. and communities should do forward moving forward with the housing committee to address homelessness. ieva supports the veteran stability act. after homelessness is ended, there's a new need to ensure veterans can sustain permanent housing and provide the use of transitional housing.
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the provisions included in the legislation will help the v.a. and its community partners establish support services to help prevent veterans crawling back to homelessness. ieva applauds the type of legislation this focuses on to continue ending homelessness and future veterans facing similar issues. focusing on a specific regional homelessness concern, the west l.a. leasing act, will end homelessness in an area greatly affected by the issue. as a strong supporter of the accountability and oversight, ieva believes under the oversight provided in this legislation, the west l.a. campus is poising a strong community for veterans and it is time the v.a. uses the support from the community for the original purpose. that support being stated, we are in close contact with our key activists on the ground in l.a. listening to their concerns and we must express concern there's a special status granted to the ucla baseball stadium. it is imperative that congress and the v.a. work together to
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address this issue and ensure no competing directors and a veteran e centric model of care remain the priority. at ieva we deserve the veterans need the best care possible. there's no doubt every member of this committee has the best in mind when drafting this legislation. thank you for your time and attention. i will answer any questions you have. >> thank you, members of if committee. the over 2 million members of this leenl, we thank you for this opportunity to testify regarding the merge legion's position on legislation pending before this committee and appreciate the committee's focusing on these critical issues that will have a direct effect on veterans and their families. it's a rare and gratifying experience for the american legion when we testify and behind every bill being offered for consideration during a hearing and the american legion would like to take this
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opportunity to thank and congratulate this committee and especially the leadership here today for their excellent bipartisan efforts on behalf of the nation's veterans who have been numbed by the constant nongoing drone of negative press regarding their department of veteran affairs. the most comprehensive bill considered today is 1676 which broadens the ability of v.a. to fill its ranks with qualified medical staff. while attempted to compensate for income disparity suffered by certain geographical areas. while the american legion supports this proposed legislation, we take a moment to recognize some of the non-monetary benefits of serving our veteran community while employed by the v.a. set schedules, defined hours, protection from malpractice claims, a vast network of resources, cutting edge research opportunities and the personal pull filament of noble service, just to name a few. no one at this witness table or sitting at that dias is here because we were offered maximum earning potential.
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so while the american legion certainly supports competitive pay for all v.a. employees, we are also mindful of the need to make v.a. employment more attractive employment options through non-monetary incentives. while money is going to be helpful, the best people to serve veterans are the ones motivated by an internal code nethos. we can't give a financial reward, but we shouldn't make that the primary recruitment tool either. this addresses a critical need for the quote of veteran of appeals. the attempt to clear the claims backlog has grown to a fever pitch and the backlog of claims appeals has grown to unprecedented levels. insuring that the court will remain fully staffed with law judges couldn't be more important than it is today and with the transitioning administration set to coincide with several projected retirements at the court, the time to insure veterans aren't suffering needlessly due to a crippled court is now. a little over a year from now the american legion together with our sister vsos will host
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an inaugural ball honoring the 78 living recipients and the 3500 heroes who are no longer with us who earned the nation's highest military award, the medal of honor. at that event it will be an honor for us to let them know that this committee supported adjusting their monthly congressmenation to a more realistic value, something that hasn't been done in over ten years. and while a handful of them currently live in california, they will also be interested to hear an update about the west los angeles campus. i was particularly encouraged, chairman, to hear your comments regarding the template that you look forward to hearing about to see if we can generate revenue in other v.a. facilities across the nation. the american legion has been protesting the misuse of the west los angeles campus v.a. medical center land use since 1983 and we applaud v.a.'s efforts to work with litigants to come to an agreement that benefits veterans while honoring the original deed set forth by the jones and bakers families in 1888. while we absolutely support moving forward on legislation
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that establishes limited future leasing that only benefits los angeles area veterans, we remain angered over the lack of accountability of revenue that was lost and remains unaccounted for over the last several years through the illegal leasing practices employed by v.a. millions of dollars remain unaccounted for and the employees responsible continue to retire and move on before answering for the missing money that was supposed to support veterans in los angeles. when the american legion asked v.a. officials for an accounting of those funds, we were repeatedly told we'll get back to you. we need accountability and we need it now. and finally, the american legion notices that there's no advisory committee involved in this process that includes any veteran service organizations. we ask you how will the veterans' voices be heard if not so much as being asked. thank you. >> thank you, mr. chairman. on behalf of the more than 19,000 cities, villages and
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towns represented by the national league of cities, i thank you and the community for the opportunity to provide testimony this afternoon. as required by law, i would like to disclose i'm currently serving as a member of the v.a.'s advisory committee on homeless veterans and see it is dedicated to helping city leaders build better communities. we serve as a resource for municipalities as well as 49 state municipal leagues on a range of issues. our work on veterans issues has been grounded in the areas of housing and community development. we are the lead partner with the administration on the mayor's challenge to end veteran homelessness and to date more than 800 leaders have accepted this challenge including 628 mayors, 9 governors and 165 county and city officials. in addition, our program work supports national technical assistance initiatives accelerating local efforts to end homelessness. given the focus on homelessness, my testimony will remain
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concentrated on 1885 and 20-s-13. and we welcome to opportunity to look at the staff under review. s-1885 makes many needed amendments to improve how the v.a. can and should serve veterans and their families but we believe there are opportunities to enhance the proposals. sections three and four of the bill propose new programs and require v.a. to issue reports analyzing their effectiveness. for the report analyzing the effectiveness of a program providing intensive case management services to veterans, we encourage the v.a. also to be required to include costs that are incurred beyond the department alone. we encourage the collection of information regarding costs that are incurred by other entities including cities, counties and states as well as costs not related to the provision of health care and benefits. for example, costs associated by the interactions veterans have with public safety, judicial and penal systems while not incurred
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by the v.a. should be measured to allow for a more robust cost benefit analysis of the intensive case management intervention services that the department would provide as part of this program. by documenting the costs incurred by entities outside of the v.a., the report can support municipal leaders in their efforts to insure local limited resources are used in the most cost effective manner to end homelessness. for the report analyzing success of grants to provide transitional housing providers of facilities into permanent housing, we encourage the analysis of this program to include the de-personalized information regarding mental health diagnosis and histories of substance abuse. the collection of this information can help develop and/or further our understanding about the impact that mental health and substance abuse plays in the retention of housing. in regards to the legislation's direction that hud and v.a. collaborate with outside partners to include outreach to landlords, we recommend that v.a. and hud be separately but
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not end pen up dent will provide a report to the veterans affairs on this committee an how they work within their organizational structures and with key partners. finally, in regards to the establishment of the national center on homelessness among veterans, nlc has seen the tremendous impact they have played in advancing local efforts to end homelessness. as cities across the country begin to see what the end of veteran homelessness looks like, they must be able to work with federal partners and insure the proper resources are in place to keep veteran homelessness rare, brief and nonrecurring. the national center's work allowing this to happen, the national center's work allows this to happen and we support the bill's efforts to formally establish the sent. and furthermore, we want this to be authorized as quickly as possible. they strongly encourage the committee to advance this bill and we'll work closely with your colleagues in the house and
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senate to pass this legislation as soon as possible. as the committee is aware, the support for this bill has come from the l.a. county board of supervisors and mayor eric garcedi. in addition, bob plumenfield has written a letter that we have attached to our testimony. and we have also filed a resolution in support of this bill for consideration and approval by the full city council. a copy of the resolution is attached with our testimony and it is expected that the resolution will pass when voted upon tomorrow. mr. chairman, i again express the national league's appreciation for the opportunity to speak before the committee today and welcome the opportunity to answer any questions. >> thank you very much. mr. norris. >> i would like to start off this afternoon by thanking committee chairman, johnny isaacson and ranking member richard blumenthal for allowing me the opportunity to testify on s-2013. i would also like to thank
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senator dianne feinstein and senator barbara boxer for sponsoring this bill. i'm here today along with nick guest, our national chaplain and the veteran of foreign wars of california quarter master. he was also a vso in l.a. and he uses the l.a. v.a. facilities. we are here representing the over 88,000 vfw members from the state of california what are all in complete support of s-2013. which lays the groundwork to return the west l.a. campus to where it belongs, veterans. while this bill specifically addresses the property located in los angeles, the larger issue of v.a. doing the right thing is important to all veterans. i'm also the student veterans of american chairman for the veteran of foreign wars in california. and as i travel to the different college campuses, i hear the same questions from the young veterans as i have for years
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from our older veterans. what is the v.a. doing to help those who are really needing? to help our homeless and to help our veterans with ptsd? i don't have the answer. but i think this is a start. california has one of the largest homeless veterans populations in the country. a lot of these veterans with also female veterans. some of them have problems with drug and alcohol addiction, while others are contemplating suicide. if housing could be approved under the master plan or be able to increase housing for these veterans and their families, we may be able to bring some of our veterans back into becoming productive citizens of our great country. they served for us, now let's help serve them. we now have a new v.a. director in southern california and now is the perfect time to put this property back on track. i'm not here to throw anyone
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under the bus for things that happened in the past. we cannot change the past or the things that have happened in the past, it would be a waste of your time to sit and listen to the old stories. the west l.a. campus was deeded through a will to the federal government with the explicit intent of the property to be used to assist veterans. over time v.a. lost sight of that intent and leased out parts of this property, which is over 300 acres, to private entities and has made little to no repairs or improvements for the veterans it was intended for. this bill returns the property to its veterans and congress would work quickly to pass this law into law now. along with us, the vfw, we are currently working with the american legion, purple heart association, dav and many other member service organizations to make sure things are done correctly as we move forward.
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again, thank you for allowing me to testify for all the veterans in california and around the world. stand with us today and help us move this important bill forward. thank you. >> thank you, mr. norris. i want to commend all of you and your comments regarding west l.a. particularly mr. sully, i think you made a great comment when you talked about being angry with the funds and the proceeds of those leases and how they have been handled. we don't know how they have been handled to tell you the truth. if you don't have a plan to execute and you don't have a goal to execute and you don't have an understanding of what you've got in the asset that you've got, you never can maximize your return. and this is a very valuable piece of real estate that's been used here or there with no direct tracking of the money. so i commend you for your testimony. you, too, mr. norris. this is a time to get it right. i hope when the v.a. puts out their master plan all of you will comment on that use because we need to get it right.
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it kind of reminds me of the denver hospital. the denver hospital got kicked down the road for 13 years. the cost overruns, nobody had a plan. now we have a plan and will finish it but it's costing a lot of money. it's costing deprived veterans a lot of benefits over the years by not having a master plan that we could follow. also, i agree on the question of homelessness. it's unbelievable to have a piece of land to help the homeless in west los angeles, california. and i support that entirely and think senator feinstein has done a good job of raising the attention of the senate on this piece of legislation. and we will move forward, but we want your input and support. so when the v.a. publishes their master plan, i hope each and every one of you will get your organization to give us feedback on those plans. and i'm hoping as chairman of this committee that this will be a template for how we deal with other surplus land the v.a. owns around the country today. we're sitting on a ham sandwich
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starving to death, in my opinion, by having a lot of vacant property that could be benefiting us that we're not because we don't have a plan. it's time we had a plan to see that revenue went to the benefit of our veterans. the -- let me find my notes here. on the court going to nine judges, i understand we have eight judges now, is that correct? the ninth one would be a presidential appointee. that's why the legislation is proposed. the legislation proposes the authority to take it to nine. my question is, miss augustine, i happen to understand the backlog and think it is an important need. but at some point in the future, if that's not the necessary number of judges we need, should that be a floating cap or permanent cap? in terms of the numbers of judges. >> mr. chairman, there's currently a great need to address the significant backlog. until that is addressed and
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focused, i think it is smart to make that a permanent increase and then re-evaluate the need as it is no longer needed down the road. there will be a significant backlog for the foreseeable future and that should be our focus. >> i want to thank all of you for your testimony regarding senator graham's proposal on the medal of honor winners. i happened to associate myself with the comments each and every one of you made. as chairman of the committee, there's nothing we can't do. millions of dollars often, this is a $16 million price tag to see to it that those medal of honor winners get enhanced compaensation compensation, but i support that as well. but if you could tell us what you would do in offset to that benefit, we would appreciate that very much. with that said, we'll go to senator blumenthal. >> thank you, mr. chairman. i think all of this system has been enormously valuable and appreciate mr. norris, your
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mention of both homelessness and post-traumatic stress, pts. in fact, the two are linked, aren't they? >> correct. >> because somebody who is suffering from pts is more likely to also suffer from addiction and homelessness and lack of employment and a combination of factors that, in effect, result from the medical condition often invisible, obviously, that is the source of it. and so i appreciate your comments on that issue. miss augustine, i also thank you for your support of all those measures. the five or six, i should say, that you mentioned. and on the numbers of veterans -- well, the number of
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judges on the united states court of appeals for veterans claims, you rightly mentioned the likelihood of a continuing large case load there. in fact, the case load has been rising, has it not? >> to my knowledge, yes, it has been rising. >> and, in fact, that is in part the result of the v.a. doing better on disability claims at the first level because the more cases that are processed, the more likely there are to be appeals in higher numbers, is that correct? >> yes, that is also what ieva has supported in the past. >> so the increase in my view really aught to be a permanent one. it's always possible to contract the court, but that number should not be a temporary one in my view. let me ask you about the community provider readiness
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recognition act, which would recognize providers for families in the health care community. there's such a desperate shortage. i support this measure. i have some questions about possibly endorsing the use of certain mental health providers who may not have the same training as v.a. providers. do you have a suggestion as to how we can possibly address that shortcoming? >> yes, sir. i think the best case to do here is to utilize the success of the star behavioral health problem and dod and replicate the same successes in the v.a. it's been a successful program for veterans in the national guard and i think it is time to open up the same successes to veterans. >> great. great answer. and with respect to the veteran housing stability act of 2015, i
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can see some people saying, well, we've already done so much on homelessness and housing. do you have a response to them? >> yes, sir. having spoken with your staff extensively about this bill, as i understand it, this bill is actually looking at the next stage of addressing veteran homelessness, not necessarily chronic homelessness or the immediate need for stable housing. but what is the next step? we applaud the long-term planning that this legislation focuses on and thinks that it is the correct thinking and looking at what needs to come next to prevent the same sort of epidemic from happening in the future. >> in fact, the goal here is to go beyond meeting the immediate as you say, the urgent apparent need that may be on the streets right now, but to provide a more permanent solution. and that's the goal here and an equally difficult goal, but one that i think we have an obligation to solve. i thank every one of you for your testimony today. it's been, as i mentioned
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earlier, enormously valuable and thank you for your service to our country. thank you, mr. chairman. >> senator bozeman. >> thank you, mr. chairman. miss augustine, in the v.a. voiced opposition to s-717 with concerns of legal credentially privacy issues, tell me a little bit, have your organizations looked into this as far as what it would take, as far as credentially and this and that? can you comment a little further about that particular bill? >> we haven't specifically looked into the credentially issue because we understand that v.a. does have a good credentialing program in place. however, this bill was very comprehensive as we discussed earlier on in the testimony. and the american legion knows that the current need is not being met. and we support any legislation that seeks to increase that need. we supported the choice act. we did support the choice act as
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a template to see where the v.a. needed some additional resources. and these are the types of pieces of legislation that are starting to address that. and what was what came out of the choice act. >> i was say using this behavioral project as a model has been proven to be effective and we can replicate that for veterans. >> very good. miss augustine, you mentioned about the progress we have made in homelessness in the v.a. and that they have been working hard to do that and that we are moving in the right direction. the west l.a. plant, you know, having a strong community for veterans needs, which seems to be something that is very beneficial, are there other areas of the country where you feel like the same ability,
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other locations would be effective? >> i would be happy to provide your office with specific locations that our members have expressed concern. i don't have them in front of me today but would be happy to get back to your office about what the members are telling us. >> thank you. the rest of you guys? >> specifically south dakota, we are looking at some really great land out there, south dakota is being downsized. and we think there's an opportunity to have a center of excellence out there, specifically for ptsd. and i think that the v.a. needs to take a serious look at that. >> very good. well, thank you all so much for being here. we really do appreciate your advocacy and your hard work. i'll let you represent. >> thank you, mr. chairman. >> thank you, senator bozeman. senator tillis. >> thank you, mr. chair. thank you all for what you do. i want to go back -- first up, i should have mentioned when i was talking about bills, i think the ranking member blumenthal for
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1885, i think it's a great idea or a great opportunity. the work on making sure that we have the partnerships with the right ngos to provide the service is something i look forward to working with you on and appreciate your efforts. i wanted to go back to the judges and the backlog. and again, i may have found a way to actually wave the camp lejeune toxic subject into this hearing after all. i promised you. you know, a part of what i think we need to do, as long as we have the backlog that we do, then we need the judicial capacity to clear the backlog. but then it does raise a question, to your knowledge, what kind of work has been done to try to reduce -- get to the root causes of some of these appeals.
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for example, in the lejeune incident right now, they have an 87% decline rate. we are guessing it should be somewhere north of 50. i don't know the root causes of all the appeals, but you all know of any particular area where the experience rate that causes an appeal may raise questions about the criteria to begin with? i'll just go down the line and start with miss augustine if you have a comment. >> as was mentioned earlier, as there have been an increase in the number of benefit claims submitted to the v.a., there's naturally going to be an increase in the number of appeals submitted to the v.a. as well. i think that secretary mcdonald has done a considerable amount of work in the past year to address some of the training, some of the dissemination of issues of information being shared earlier. and i think that continuing to train v.a. employees well we'll begin to see a decrease in the number of appeals. but until that time, the increase in appeals or benefit
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claims is going to have an increase in appeals. >> so as we all know, claims are complicated business. and so are appeals. if -- when the appeal is -- if the claim is remandeded to the amc and the work isn't done that the law judge says needs to be done, it just goes back to the board and gets into this hamster wheel. so there has to be a much healthier relationship between the board and the amc. and i know there's some legislation right now that seeks to address that. with regard to making those positions permanent, i guess on the day where we see that there are nine law judges that don't have enough to do, then maybe we can consider reducing it then. >> that hasn't been an issue that we have focused on. >> i would like to refer us back to the washington work -- we have a representative here from our washington office, alex is back there, and maybe he can get
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with your staff. >> i think, and this is not trying to find fault, i think i have developed a reputation for doing everything i can to work with the department. so it's not necessarily faulting -- i mean, they are doing what they are doing within the parameters they have been given, but it's a question, do you go back and rethink it. and either come up with an acceptable disposition that the veteran may accept and not seek an appeal, or find other circumstances where maybe they should have been granted their request for disability to begin with. so it is more about just looking at the process and seeing if we're doing the best job we can. i also wanted to talk briefly about a couple committee hearings ago where we had the discussion about homelessness and the v.a.'s goal to end veterans homelessness or at least provide the capacity that we don't currently have. if your opinion, though, and i think it's a very -- there's a very aggressive goal out there
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to end homelessness. do you think current course and speed programs already in place, that we actually have the ability to meet the goal that ending homelessness or providing the capacity to supporting any homeless veteran in the united states? and i may have to just go off script here for a minute. i can't remember, mr. lynch, you may be able to help me, but what is the date? there's a specific date out there with the goal for being able to provide that capacity. do you recall what that date was? >> senator, i could help you with that. >> thank you. >> the u.s. interagency council on homelessness, which is the lead entity, the u.s. center on homelessness, they have set out the strategic plan for ending homelessness and they have identified the end of this year as -- >> see, i find that unimaginable, given the
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discussion about west l.a. i worked and we worked to secure another another veterans benefit north of raleigh. i think it's great to stretch goals but in this particular case when you back in the population that's not served today into the calendar, it doesn't seem to make sense. so it makes me wonder whether or not we're using our resources wisely to attain that goal and that could be a subject of a -- maybe a future committee meeting. last thing i'll say is just on crisis intervention, it relates somewhat to senator blumenthal's bill out of the weekend. this happens to stem out of a conversation i had with a special operator, 100% disabled vet who, himself, he has his own issues, but he spends most of his days helping other vets. and he literally he has someone living with him today because he called the crisis line, was explaining that he was in a very
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dangerous situation with his wife, wanted to remove himself from that situation and the person on the crisis line said that they could get back to him in four days. this is -- if anybody knows anything about domestic violence knows, it's in that moment. and we have to have the processes in place to deal with it in that moment. and i'm spending time this week with my staff to get to the bottom of it. but these sorts of situations are critically important for the veteran's safety and the spouse's safety. and it may just be an outlier, but i think it's something we have to look at. so we're responding in a very timely basis, whether it's a suicide threat, whether it's a domestic violence threat. and i don't know if we're using the wonderful resources at the v.a. in these sort of crisis situations to the fullest extent of their capabilities. thank you, mr. chair. >> could i add one thing? >> absolutely. >> one of the things that the american legion's extremely concerned with is not only
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what's being called now functional homelessness, but also there's a category that's not being recognized at all, which is the veterans who don't qualify for v.a. services. those with quote/unquote bad paper. the percentage of those who don't qualify for the v.a. services is increasing as we lower the backlog or as we lower the homeless rate. we're looking at better than 10% veterans that fall through the crack who will never be recognized until we step up and do something about that. >> and on the subject of veteran homelessness, i want to commend the committee because in seven days, we took -- we took him from the markup to approval today, to be undersecretary of labor for veterans employment. other than opioids and drugs and pharmaceutical problems that our veterans have and ptsd and tbi, unemployment is a huge contributor to homelessness. i'm going to talk to secretary perez and mr. mischo said his
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focus is to see to it that we get employment benefits together so they have more opportunities for jobs and less homelessness. we appreciate your comments today. i appreciate all the members' comments today. we'll leave the record out -- >> mr. chair, may i make a comment -- i'm sorry to interrupt, i apologize. i wanted to just follow up on the comment you made, mr. kelly, about veterans with bad paper. you may know that there was a lawsuit brought by the yale law school legal clinic on behalf of a connecticut veteran who suffered from pts, received a less-than-honorable discharge. and for two decades, suffered that black mark. he became addicted, unemployed and homeless. his name is connelly monk. he brought a lawsuit against the department of defense. i joined in the lawsuit, i
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supported it. and then i reached out to then-secretary of defense hagel, who after some consideration, responded positively and revised the internal procedures to enable more veterans with less-than-honorable discharges or dishonorable discharges, in other words bad paper, to seek review by the boards of appeals within the department of defense. the procedure is complicated. it's needlessly fraught with red tape, but it is part of that cycle that often afflicts veterans. we are talking about veterans of past wars, vietnam. connelly monk was a veteran of vietnam. when he was in vietnam and for more than a decade later, post-traumatic stress was not a term in our vocabulary, not a diagnosis in medical circles.
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only in the 1980s did it become really recognized, long after connelly monk was denied the very medical services that he needed to overcome the pts. he was doubly a victim in the discharge that resulted from pts, acting up, and then from the denial of health care services that would have helped him overcome that pts. so i want to thank you for recognizing this very, very important topic. and ms. augustine has very correctly recognized the need for us to conduct some oversight on the clay hunt bill. i think there's a need for us to conduct some oversight on the change in policy that i believe
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with the best of intensions, secretary hagel have implemented and the successors have committed to follow, but i would suggest to the chairman and we'll have a chance to talk about it that both of these oversight hearings and inquiries are very much appropriate. and i just want to commend the vsos for their help and support in recognizing this issue and problem. thank you. >> we'll leave the record open for seven days for any revision, any extension of remarks or any additional comments that anybody wants to put in before the committee. there being no further business to come before the committee, we stand adjourned.
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congress faces three major deadlines, raising the debt limit, continuing highway funding and the likely end of speaker john boehner's tenure. the hill writes the house ways and chairs committee chair paul ryan appears to have the support from the conference to bin the house speaker leeks. last week, received endorsements as well as a supermajority of the hard line freedom caucus. still a handful of holdouts in the conference election and on the floor. some conservatives still plan to support long shot congressman daniel webster of florida for speaker, who remains in the race and some tea party groups have been trying to stoke opposition against congressman ryan in recent days. assuming congressman ryan gets the house gop's nomination, this week will be just the fifth time
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in the last century that the house has voted to elect a new speaker midway through a term. that news, again, from the hill. and today, the house takes up a measure to reauthorize the export/import bank by the way of a special procedure which gets a bill to the floor without having to go through the committee or house leadership. i'm craig kaplan, c-span's house capital hill producer, usually cover the house and senate floors while legislation is going on and other key events on capitol hill. we, as a network, committed to covering the hearings gavel-to-gavel was a very high-profile hearing, covered all the hearings by the select committee on benghazi in the house of representatives >> so this is one of the next in the series that we have covered. i got there at 7:00 in the morning, the crews were already set up, they had put cameras in before and got in places very early in the morning for our
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morning show, "washington journal", so they could show what was going on in the hearing room, even before anybody was getting there. i was starting to tweet out things that were happening outside the room as well as inside the room. i was showing what the camera crews were doing, how the committee was setting up, how we made sure that we were as close as possible getting the key moment when she came into the building and then she went into an annex room across the hall with her team, with her aides, with her staff. the reporters were assigned whether they were print, online or tv reporters, assigned desks that they could report from. a lot of people i talked to from the public said it was their first hearing, they wanted to be there as they called it, an historic moment, so it was interesting to see and hear from them. i tweeted out a picture at the end that shows secretary clinton talking to other members of the house, again mainly democrats, and she seemed very pleased, had a big smile on her face and chairman gowdy, who was-


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