[Senate Hearing 117-072]
[From the U.S. Government Publishing Office]
S. Hrg. 117-072
NOMINATION HEARING OF DENIS R.
McDONOUGH TO BE SECRETARY OF THE
DEPARTMENT OF VETERANS AFFAIRS
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HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED SEVENTEETH CONGRESS
FIRST SESSION
__________
JANUARY 27, 2021
__________
Printed for the use of the Committee on Veterans' Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
45-636 PDF WASHINGTON : 2021
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SENATE COMMITTEE ON VETERANS' AFFAIRS
Jon Tester, Montana, Chairman
Patty Murray, Washington Jerry Moran, Kansas, Ranking
Bernard Sanders, (I) Vermont Member
Sherrod Brown, Ohio John Boozman, Arkansas
Richard Blumenthal, Connecticut Bill Cassidy, Louisiana
Mazie K. Hirono, Hawaii Mike Rounds, South Dakota
Joe Manchin III, West Virginia Thom Tillis, North Carolina
Kyrsten Sinema, Arizona Dan Sullivan, Alaska
Margaret Wood Hassan, New Hampshire Marsha Blackburn, Tennessee
Kevin Cramer, North Dakota
Tommy Tuberville, Alabama
Tony McClain, Democratic Staff Director
Jon Towers, Republican Staff Director
C O N T E N T S
----------
Wednesday, January 27, 2021
SENATORS
Page
Tester, Hon. Jon, Chairman, U.S. Senator from Montana............ 1
Moran, Hon. Jerry, Ranking Member, U.S. Senator from Kansas...... 3
Murray, Hon. Patty, U.S. Senator from Washington................. 13
Boozman, Hon. John, U.S. Senator from Arkansas................... 14
Brown, Hon. Sherrod, U.S. Senator from Ohio...................... 16
Cassidy, Hon. Bill, U.S. Senator from Louisiana.................. 17
Hirono, Hon. Mazie K., U.S. Senator from Hawaii.................. 19
Rounds, Hon. Mike, U.S. Senator from South Dakota................ 20
Blumenthal, Hon. Richard, U.S. Senator from Connecticut.......... 22
Tillis, Hon. Thom, U.S. Senator from North Carolina.............. 24
Sanders, Hon. Bernard, U.S. Senator from Vermont................. 25
Sullivan, Hon. Dan, U.S. Senator from Alaska..................... 27
Manchin III, Hon. Joe, U.S. Senator from West Virginia........... 28
Blackburn, Hon. Marsha, U.S. Senator from Tennessee.............. 30
Sinema, Hon. Kyrsten, U.S. Senator from Arizona.................. 32
Cramer, Hon. Kevin, U.S. Senator from North Dakota............... 33
INTRODUCTION OF WITNESS
The Hon. Amy Klobuchar, U.S. Senator from the State of Minnesota. 5
WITNESS
Denis R. McDonough, Nominee to be Secretary of Veterans Affairs.. 7
APPENDIX
Moran, Hon. Jerry, Ranking member, prepared statement............ 40
Mr. Denis R. McDonough, Nominee to be Secretary of Veterans
Affairs, prepared statement.................................... 42
American Federation of Government Employees, AFL-CIO, prepared
statement...................................................... 44
Questions for the Record
Response to Pre-hearing questions submitted by:
Hon. Jerry Moran........................................... 56
Hon. Jon Tester............................................ 65
Hon. Richard Blumenthal.................................... 71
Hon. Kyrsten Sinema........................................ 74
Hon. Sherrod Brown......................................... 81
Hon. Mazie Hirono.......................................... 83
Hon. Bernie Sanders........................................ 86
Response to Post-hearing questions submitted by:
Hon. Mazie Hirono.......................................... 90
Hon. Joe Manchin........................................... 91
Hon. Jerry Moran........................................... 92
Hon. John Boozman.......................................... 101
Hon. Bill Cassidy.......................................... 103
Hon. Mike Rounds........................................... 104
Hon. Thom Tillis........................................... 106
Hon. Dan Sullivan.......................................... 110
Hon. Marsha Blackburn...................................... 111
Hon. Kevin Cramer.......................................... 114
NOMINATION HEARING OF DENIS R.
McDONOUGH TO BE SECRETARY OF THE DEPARTMENT OF VETERANS AFFAIRS
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WEDNESDAY, JANUARY 27, 2021
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 3:00 p.m., in
room SD-106, Dirksen Senate Office Building, and via Webex,
Hon. Jon Tester, Chairman of the Committee, presiding.
Present: Tester, Murray, Sanders, Brown, Blumenthal,
Hirono, Manchin, Sinema, Moran, Boozman, Cassidy, Rounds,
Tillis, Sullivan, Blackburn, and Cramer.
OPENING STATEMENT OF CHAIRMAN TESTER
Chairman Tester. I call this hearing to order. I want to
welcome everybody. I appreciate all of you that are here, that
are online. The purpose of this hearing is to hear from the
President's nominee to serve as Secretary of Veterans Affairs,
Denis R. McDonough.
Before I talk about Denis I just want to say I appreciate
this Committee for all the reasons that we sit on this
Committee, that it has been bipartisan, it has been non-
political, and we have tried to do the best by our veterans,
whether you are on the Republican side of the aisle or the
Democratic side of the aisle. And I particularly appreciate the
relationship I had with the former Chairman, Johnny Isakson,
and with my good friend, Jerry Moran.
And this is not going to change. We are going to continue
to operate this Committee in a way that the veterans are No. 1,
and that is just the way it is going to be, and we are going to
continue to work together in every way possible and communicate
together, and not surprise one another, and move forth the
policies that work for this country's veterans.
Denis, I appreciate your commitment to public service and
your willingness to step forward. If confirmed, you will be
tasked with ensuring that our Nation's veterans have access to
timely care, services, and the benefits that they have earned
and deserve. Today we are here to determine whether you are
right for this job. I appreciate you taking the time to meet
with members of this Committee over the past few weeks and for
your timely responses to the pre-hearing questions sent by many
of us, and at this time I would ask unanimous consent that
those question and responses be made part of the record of this
hearing.
The transition period between administrations can be a time
of turmoil and confusion, and can generate uncertainty inside
and outside an agency. At VA there is simply too much at stake
to let that happen. The coronavirus pandemic is still raging,
with more than 400,000 Americans succumbing to the virus in
less than a year.
Denis, you will be responsible for ensuring that the VA has
everything it needs to treat our veterans and care for the VA
employees. VA has tested nearly 1.3 million veterans and
employees for COVID-19. The agency is tracking nearly 198,000
cases among veterans, staff, and others admitted to VA for
care, including nearly 14,000 active veteran cases. And now
there are more than 8,300 veteran families who are without
their loved ones, including the more than 3,100 VA has cared
for within its facilities.
Denis, simply put, your chief responsibility during this
unprecedented time will be to save as many lives as possible.
That includes advocating within the administration for VA's
fair share of vaccines and ensuring timely and efficient
deployment of those vaccines. And it includes efforts to ensure
front-line workers have everything they need to take care of
our sick veterans and protect themselves from coronavirus.
How you care for your staff will mean everything. VA
recently reported nearly 3,200 VHA staff with active COVID-19,
and another 2,300 clinical staff are quarantined and unable to
work. Sadly, 118 VA staff have died from this coronavirus. The
virus is taking a toll on those VA heroes who care for veterans
and we are entrusting you with their safety.
I am pleased the administration has kept Dr. Richard Stone
to ensure a smooth transition for VHA, Veterans Health
Administration. But it will be a while before you have a full
leadership team in place, so there is a lot riding on your
shoulders. One area in need of scrutiny is claims processing.
Nearly 500,000 claims are pending, with more than 200,000
considered to be backlogged. While so much focus is on health
care right now we must ensure this important issue gets the
attention it needs.
Additionally, this Committee reaffirms its bipartisan
reputation in the last Congress. A number of historic reforms
were enacted, from John Scott Hannon Veterans Mental Health
Improvement Act to the Deborah Sampson Act to the expansion of
presumptive coverage for thousands of additional Vietnam
veterans exposed to Agent Orange. The implementation of these
reforms must be consistent with congressional intent and it
must be swift. Veterans are counting on it. And with the case
of Vietnam veterans, they have already been waiting for
decades.
There are other critical reforms that have been in the
works for years and need serious attention. From an expansion
of caregiver program that has seen its number of speed bumps to
electronic health record modernization effort that has taken
way too long and cost taxpayers way too much, and everything in
between.
You will certainly have your hands full but know that this
Committee is here to help. If you are transparent and
respectful of oversight, we can be your biggest proponents and
your best partners. During your predecessor's nomination
hearing I told him the sacred mission of serving the veterans
and their families must always transcend personal agendas or
political affiliations. In the end, I believe he lost sight of
that, and I called him out for it, and I will hold you to the
same standard.
There is a great political divide in this Nation, but
veterans across the country and the members of this Committee
are united by a very basic expectation. The next VA Secretary
needs to be an individual of honesty, integrity, and vision,
who listens to the veterans and puts their well-being above all
else. If you keep your head down and live up to that
expectation, you will be successful. And in the end, we all
want you to succeed because veterans across this country need
you to succeed.
I look forward to our discussion today. Thank you again for
your willingness to serve on behalf of our Nation's veterans.
With that I will turn it over to you, Senator Moran.
OPENING STATEMENT OF SENATOR MORAN
Senator Moran. Chairman Tester, thank you. Thank you for
the comments. Thank you for the working relationship, your care
and concern for veterans, the way this Committee has operated
during my chairmanship, and I agree with you that that
cooperation, bipartisanship, should and will continue.
You will be the eighth Chairman. I have served on the House
Veterans' Affairs Committee under Chairman Bob Stump, Chairman
Chris Smith, Chairman Steve Boyer, Chairman Bob Filner, and in
the Senate under Chairwoman Patty Murray, Chairman Bernie
Sanders, Chairman Johnny Isakson, and now you. In all
circumstances I want to be a productive member of this
Committee and want to work with my colleagues to see that good
things happy for all veterans. And I have, in some instances,
when we say things like that we have the sense that we are just
talking. And I am not just talking, and you were not just
talking. We have no option and no desire to do anything other
than the way we have operated in the past, and will continue to
work with you in that way to serve our Nation's veterans.
Mr. McDonough, welcome. No mission is more noble than the
one you will lead if you are confirmed, and so I thank you and
your family for your willingness to re-enter government
service.
We are going into this new Congress with new leadership and
a new administration. The challenges we aim to address on
behalf of our veterans will be a mix of those existing and
ongoing issues we will struggle to sort out, alongside new
challenges and new opportunities for our country to not only
honor our veterans for their service that they provided but to
harness their values and their talents to help them lead again.
Mr. McDonough, in 2014, your White House deputy chief of
staff, Rob Nabors, reviewed the nationwide wait time scandal
and described the root causes using phrases such as ``little
transparency,'' ``corrosive culture,'' ``lack of accountability
across all grade levels,'' and ``significant and chronic system
failures.''
Six years later, thanks to the collective effort of three
VA Secretaries and thousands of dedicated employees, it is fair
to say the VA looks very different now than it did then.
Employee engagement is at its highest level in over a decade.
The VA ranks 6th out of 17 among large government organizations
as the best place to work. A vast improvement in just four
years. And patient trust in VA health care is now over 90
percent. Your job, if confirmed, will be to solidify and build
off those improvements.
At the same time, several major modernization programs are
underway, with electronic health record modernization,
financial business transformation, caregiver expansion, and
Community Care Networks, just to name a few. These and other
modernization efforts will require billions of dollars per year
on top of VA's regular operations, just to catch the VA up with
the latest and best practices. The VA desperately needs strong
leadership to make certain these investments achieve results
and they are not wastes of taxpayer dollars.
With the help of our VSO partners, Congress has enacted
several recent reforms to improve mental health care, protect
educational assistance, enhance disability and survivor
benefits, and expand burial benefits. The next Secretary of
Veterans Affairs must be ready on day one--on day one--to
advance and build on the progress that has been made over the
last four years, must ensure that the laws are faithfully
executed, and must measure results so we know veterans are
benefiting as intended.
Additionally, the next Secretary must continue to fight
against COVID-19, support an already strained work force,
deliver timely vaccinations to VA patients, and be ready to
assist civilian health care system in places where it is
overburdened. Furthermore, backlogs in health care and benefit
claims appointments that have piled up due to the pandemic,
they must be addressed as we return to a more stable operating
environment in the coming months.
A top concern for me, and for, I think, many of my
colleagues, is how the VA will care for veterans living in
rural communities. Before coming to the Senate, I represented a
congressional district roughly the size of Illinois with no VA
medical center. I look at the VA through the eyes of our Kansas
veterans and the feedback I receive in speaking to them is that
health care access has always been a challenge. VA provides
excellent health care in its own facilities but those
facilities are not in every community.
The MISSION Act, the act that you worked on, the Choice
Act, and now the MISSION Act, gives veterans permanent choice
to utilize community health care providers when it makes sense
for them, and not when it is convenient for VA bureaucrats. I
asked President Biden, and will also ask for your commitment,
to uphold the law by supporting this common-sense notion that
it is the veteran who should be at the center of their health
care decisions.
We know that public health measures that reduce the spread
of COVID also increase the risk of social isolation and mental
health conditions. VA has its tools that they can use to help.
Community care authorities, telehealth options, and funding
provided by Congress can work together to mitigate the
pandemic's impact on veterans' physical, mental, social, and
economic well-being.
Furthermore, programs like the GI Bill, Veterans Readiness
and Employment, and transition assistance programs can help
veterans transition out of the military successfully and help
launch them on what the VA terms a ``solid start.'' Entering
the civilian world should not be the challenge that it is
today. Research has shown higher incomes likely lead to better
health and outcomes, so investing in these programs does not
just aid the veteran in his or her transition but it helps the
long-term well-being, and it could reduce the burden on the
VA's health system.
I would ask you to consider not just how the VA is doing at
delivering the benefits provided by law but also what
outcomes--what outcomes--we are trying to achieve for veterans
with these benefits, and if they are doing enough to measure
those outcomes relative to the benefits the VA is providing.
Again, Mr. McDonough, congratulations. Thank you for our
conversations, both in person and by Zoom. Your commitment to
our Nation's veterans is seemingly--let me take out the word
``seemingly''--is sincere and real, and I appreciate that very
much. Caring for our veterans has always been a unifying force
during my time in Congress. It is my great hope that continues
to be the case if you are confirmed as Secretary.
Mr. McDonough, I look forward to hearing your Statement and
engaging with you further on these questions, this
conversation, during the remainder of our hearing, and I thank
the Chairman.
Chairman Tester. Thank you, Senator Moran, and before we
get to Denis McDonough's Statement we have the incredible
pleasure and honor to have our chamber graced by the senior
Senator from Minnesota, Senator Klobuchar, for an introduction.
STATEMENT BY THE HONORABLE AMY KLOBUCHAR
Senator Klobuchar. Well, thank you very much, Mr. Chairman
and Ranking Member Moran, and distinguished members of this
Committee. Thank you for the good work you do, the bipartisan
work you do. That is the hallmark of this Committee. And I am
proud today to introduce my friend and fellow Minnesotan, Denis
McDonough, as President Biden's nominee for Secretary of
Veterans Affairs.
Today Denis is joined by his wonderful wife, Kari, as well
as two of his three kids. Denis grew up in Stillwater,
Minnesota, which is on the Wisconsin border, as opposed to our
other greater border, Senator Rounds, with South Dakota. And he
is the grandson of Irish immigrants, the son of devout Catholic
parents, and brother to 10 siblings. He attended St. John's
College in Collegeville, Minnesota, and in addition to
graduating summa cum laude he played safety on the very proud
championship St. John's football team.
I have been privileged to call Denis a friend for years,
and I know he will serve our country so well as a Secretary. As
he has done his whole life, he will honor the promises our
country has made to our veterans and their families. Denis'
commitment to our Nation's veterans was clear during his time
as President Obama's chief of staff, when he made sure that
every decision impacting our servicemembers, veterans, and
their families was befitting of their sacrifices. Showing
respect and gratitude for our Nation's veterans is not
something he just prioritizes. It is a value for him.
He is an adept manager who understands how to tackle
complex challenges throughout our government, which will be
vital for the next Secretary. As we all know, and you have
mentioned, Chair and Ranking member, the VA is facing a number
of challenges from helping veterans to stay safe during the
pandemic to improving the quality of care for veterans around
the country. And as you also note, great improvements have been
made thanks to all of you and many others. These are not simple
problems, and these are not simple challenges, and they will
require true leadership and vision, which have been, again, the
hallmark of Denis' time in public service.
I also know he will work with you tirelessly to find
bipartisan solutions, which has never been more important as we
move our country forward. So much of our work with veterans is
about keeping our promises and showing respect, not just in our
words but in our actions. When you get to know Denis, for those
of you who are just getting to know him, you will see the
qualities of honor and loyalty in his commitment to his family,
which also includes his family in Minnesota. I know this first
hand. You see it in how he has treated everyone that he works
with, when he worked in the Senate, when he worked as President
Obama's chief of staff. You see it in that loyalty, and he puts
our country first.
During his distinguished career he has approached each and
every job with a spirit of respect, honesty, and collaboration,
and a willingness to make himself accessible to his colleagues
and to his team. Members of the Committee, I know he will do
the same with you in this job. He is deeply committed to
supporting his work force.
One of the things I want to tell our veterans is I know he
will do two things so well. He will listen and then he will get
things done for you. One of my favorite stories about Denis
involves this. We were having a lot of trouble in northern
Minnesota with mines closing down because of steel dumping from
China, and Denis was President Obama's chief of staff and he
went up to northern Minnesota--I think it was very cold, I will
add--and met with about 50 people, and it was this long, long
table. And Denis sat and listened to every single one of them,
and the very last person to speak was a guy named Dan Hill, who
was a miner, an iron ore miner. And Dan told the story of how,
at his son's preschool, when they graduated, the teacher had
asked them, ``What do you want to be when you grow up?'' And
the kids were saying things like an astronaut, and a basketball
player, and Dan Hill's son said, ``I want to be a miner''--and
Joe Manchin can relate to this--``I want to be a miner like my
Daddy.''
And then the miner takes this tee-shirt, a steelworker tee-
shirt, and he throws it down this long table to Denis, saying
the words, ``Make it come true, Mr. McDonough. Make it come
true.'' And I am sitting there next to Denis saying, ``You were
a football star. Catch the tee-shirt,'' and he did. And he not
only caught the tee-shirt but he put Dan back to work, and he
put so many miners back to work, because he came back to
Washington, helped us pass legislation, and most importantly
for this job, implemented things through the bureaucracy of
government by getting many different Cabinet Secretaries and
others to hold hearings and the like.
I tell that story because I believe, in my heart, this is
the guy you are going to get as Veterans Affairs Secretary who
is actually going to follow through and listen and get things
done.
I am going to end with the words of a poet who President
Biden happens to love, Seamus Heaney, and given Denis' Irish
roots I cannot think of a better person to quote at today's
hearing. Heaney once wrote, ``Anyone with gumption and a sharp
mind will take the measures of two things: what is said and
what is done.'' He will not just say the words as your
Secretary. He will get things done. I urge the Committee to
support his nomination. Thank you.
Chairman Tester. Thank you, Senator Klobuchar. Before we
get to your Statement, Mr. McDonough, I would ask you to rise
as I administer the oath. Raise your right hand, please.
Do you, Denis Richard McDonough, solemnly swear or affirm
that the testimony you are about to give before the
U.S. Senate Committee on Veterans Affairs will be the
truth, the whole truth, and nothing but the truth, so help you
God?
Mr. McDonough. I do.
Chairman Tester. Let the record reflect that the nominee
Stated in the affirmative. You have the floor, Denis.
STATEMENT OF DENIS R. McDONOUGH
Mr. McDonough. Thank you, Chairman Tester, Senator Moran,
and members of the Committee. Good afternoon and thank you for
the opportunity to appear before you today. I do so with great
respect for your constitutional obligations to advise and
consent, to fund and oversee the Department of Veterans
Affairs, and the bipartisan tradition of this Committee in
service to our Nation's veterans.
At a moment when our country must come together, the
partnership between the Chairman, Senator Moran, and members of
this Committee is inspiring. If given the honor of serving as
Secretary of Veterans Affairs, I will strive to emulate that
partnership in my work with you, as individual members and as
members of the Committee.
We can meet today in peace and freedom because generations
of servicemembers have stepped forward and sacrificed in our
name. And though only a small percentage of Americans have
served in our armed forces, the President has called on every
American to embrace our responsibility to support our veterans
and their families. President and Dr. Biden take this duty
seriously and personally, as I know each of you do, perhaps
especially since they, like so many of you, are members of a
proud military family.
If confirmed, I will dedicate myself, with every fiber of
my being, to fulfilling what President Biden rightly refers to
as our country's most sacred obligation: to prepare and equip
our troops that we send into harm's way and to care for them,
and their families, when they return.
It is true that I am not a veteran, but in my years of
public service I have had the privilege afforded to relatively
few Americans. I have seen up close, and been deeply moved by,
the excellence, talents, dedication of our men and women in
uniform. When visiting our soldiers, sailors, airmen, Marines,
and Coast Guardsmen on our bases in Afghanistan and Iraq, I
have witnessed the heavy burdens of long deployments away from
their families.
Beside their hospital beds when they come home, I have seen
their resilience in the face of wounds, visible and invisible,
that can last a lifetime. Standing there at Dover, when our
fallen heroes come home one final time, I have seen the
unimaginable grief of military families, to whom we owe a debt
that cannot be repaid, and whom we will stand with forever.
Inside and outside of government I have been inspired how
our veterans continue to strengthen our communities and our
country out of uniform, as teachers, coaches, first responders,
public servants.
Most of all, like every American, I owe a profound debt of
gratitude to those who have worn the cloth of our Nation. It
would be a tremendous honor to serve our veterans and their
families, caregivers, and survivors by leading the VA, to
ensure our Nation serves our veterans as well as they have
served us.
If confirmed, I will make it my mission to fight for our
veterans with a relentless focus on three core responsibilities
of the Department: providing our veterans with timely, world-
class health care; ensuring our veterans and their families
have timely access to their benefits; and honoring our veterans
with their final resting place and lasting tributes to their
service.
At the same time, the President has directed me to focus on
getting our veterans through this pandemic; helping our
veterans build civilian lives of opportunity with the education
and jobs worthy of their skills, talents, and service; ensuring
that the VA welcomes all our veterans, including women,
veterans of color, and LBGTQ veterans; working to eliminate
veteran homelessness and reducing suicide; and keeping faith
with our families and caregivers.
In short, if confirmed, I will work tirelessly to build and
restore VA's trust as the premier agency for ensuring the well-
being of America's veterans. After all, there is no more sacred
obligation nor noble undertaking than to uphold our promises to
our veterans, whether they came home decades ago, or days ago.
I am ready for this mission. As a former White House chief
of staff, I bring a deep, extensive knowledge of government. I
understand how to untangle and solve large, complex challenges,
both across and within large agencies. I have seen first-hand
that when our government is at its best it can help the
American people, including our veterans, and allow them to live
in security and dignity.
This will not be easy. The Department of Veterans Affairs
faces great challenges, challenges made more daunting by the
coronavirus pandemic. Its capabilities have not always risen to
the needs of our veterans. If confirmed, I promise to fight
every single day to ensure that our veterans have the access to
world-class, compassionate care that they have earned.
I look forward to being a true partner with the men and
women of the VA, dedicated, highly skilled professionals, many
veterans themselves, veterans serving veterans, who deserve our
profound respect and support. I will also build strong
partnerships with the veteran service organizations who devote
themselves to their fellow veterans, to their communities, and
to our country.
I have been given a clear mission by President Biden, to be
a fierce, staunch advocate for veterans and their families. If
confirmed, I will embrace that assignment with the solemnity it
demands.
This is not a mission I take on alone. Every Federal agency
has a role in supporting our veterans. If confirmed, I will
make that happen, because again, when it comes to supporting
our veterans and their families, every American has a role to
play.
Chairman Tester, Senator Moran, distinguished members of
this Committee, thank you again for the opportunity to appear
before you today and for the opportunity to join you in caring
for our veterans, who have served and sacrificed so that we can
live in freedom today.
May God bless our troops, our veterans and their families,
and as a nation may we always give them our very best.
I look forward to your questions.
Chairman Tester. Thank you for your Statement, Denis. I
appreciate that. Amy, you are welcome to leave if you want, but
you can stay to watch the best Committee in the Senate work, if
you would like.
Senator Klobuchar. I think he is in good hands with you.
Chairman Tester. All right. I will just start out. Denis,
out of the top jobs in this administration which you would be
well-qualified for, why this one?
Mr. McDonough. Mr. Chairman, I am a fighter and I am
relentless, and I am particularly relentless about things I
have a passion for. And having had the professional experience
of the last 20 years, since September 11, 2001, and having
witnessed up close the tremendous service, excellence, and
sacrifice of our military and our veterans, I have great
passion for making sure that we treat them as well as they have
treated us.
So, when the President called me to talk about this
assignment I could not have been more excited, more humbled,
and more committed to seeing it through. And if confirmed, I
will apply that fight and that passion to ensure that we do
live up to our promises.
Chairman Tester. Okay. Thank you. Do you have the autonomy
to do what you believe is best for this Nation's veterans, even
when you disagree with the President?
Mr. McDonough. I do. I would also say I have a very good
relationship with the President. He encouraged me to be very
candid with him. So, in the event that there is a disagreement,
I am confident that I would have an opportunity to vigorously
make my case, draw on the experience and expertise in the
Department to bolster that case, and to work with you all to
fulfill that case.
Chairman Tester. Many, if not all of us, on this Committee
believe the importance of the inspector general, the IG. If
confirmed, will you commit to not interfere or hinder with the
independent work of the IG?
Mr. McDonough. Yes, I will so commit.
Chairman Tester. All right. We have passed a number of
bills, and if you are not familiar with them you can certainly
ask. But two of the bills that we passed, and we passed many of
them, need a timeline for implementation, the John Scott Hannon
Veterans Mental Health Bill, that Senator Moran was so gracious
to co-sponsor, and the Deborah Sampson Act, which Senator
Boozman was so gracious to co-sponsor.
Will you agree to provide a timeline for implementation of
both those bills, and if so, would you agree to provide regular
updates to the Committee on the progress of the implementation?
Mr. McDonough. I will absolutely provide an implementation
timeline on those bills. I will keep you updated on the
progress of that, but more than that, Mr. Chairman, I have
discussed these bills at length, both with you, with Senator
Moran, and with Senator Boozman, and my commitment to you is to
not just give you updates but to consult with you and to work
with you in true bipartisan consultative fashion to ensure that
we are implementing them, that the Department implements them,
if confirmed, consistent with the intent of this Committee.
Chairman Tester. Coming into the most senior role at the
VA, how are you going to approach reviewing VA's COVID-19
response to date and determining if changes need to be made?
Mr. McDonough. Thank you, Mr. Chairman. Every question that
I approach, if confirmed, at the Department will be around two
questions: will it give greater access to veterans and will it
ensure better outcomes, as you and Senator Moran both laid out
in your opening Statements.
As it relates to a review on COVID-19, I will review
whether performance to date has been as good as it can be on
those two questions for our veterans. The questions are going
to be around communication, around access, both to vaccines but
then access to care in the case of infections.
Similarly, we have to be serious about communicating
clearly with the work force, ensuring that the work force has
access to vaccinations and protection, and the work force has,
as you said in your opening remarks, access to all the material
that they will need to do their job safely.
Chairman Tester. Numerous reports, oversight reports, have
shown that sexual harassment assault remains a key issue across
the Department. Creating a self-welcoming environment for all
veterans, staff, and guests at the VA is critical. Defense
Secretary Austin recently issued a memo to the Pentagon
leadership requesting an expedited review of DoD's sexual
harassment, assault prevention, and accountability measures. As
head of the VA, do you plan on doing something similar?
Mr. McDonough. I do, Chairman. If confirmed, on day one I
will lean into this issue to try to set a culture that
underscores that such activity will not be tolerated, that the
Department has to ensure that not only the Department's work
force but also importantly the fastest-growing cohort of
veterans, namely women veterans, have confidence that they will
be treated with respect and given the access that they have
earned.
Chairman Tester. Thank you, Denis McDonough. Senator Moran?
Senator Moran. Chairman Tester, thank you. Mr. McDonough, I
have been a critic of what I describe as executive overreach. I
happen to believe that Article I has the ability to give
Congress significant and important responsibilities. And
administrations, over a long period of time, have chipped away
at that balance that I think would be better if the Executive
branch was less aggressive and the congressional Legislative
branch was more aggressive.
You were involved in an administration which I criticized
for being so aggressive on Executive orders, for example, but I
always tried to balance that by saying, well, part of the
problem is that Congress does not do its job, and so it leaves
this wide space open for an executive of either party to
advance their agenda. And I would love to see this Congress
work better than it does, and I want to try to make certain
that I do my part that that occurs.
But where I would find fault is the area in which agencies,
the Executive branch, the Department of Veterans Affairs, and
others, when there is clear legislation, and clear legislative
intent, so both language and intention, that then that language
and intention is not followed. In our conversation that you and
I have had, I would love, for the record, for you to confirm
your understanding. And let me give you a couple of topics in
which that will become important.
The President's campaign, President Biden's campaign, and
your own response to my pre-hearing questions, mentioned
rebalancing Community Care. I am concerned that these plans
may, depending on what those words mean, may erode the core
tenets of the mission's Community Care program, and that would
cross a red line for me. Access standards, in particular, are
the cornerstone of the Community Care program, and veterans
have come to rely on those standards over the past 2 years.
One of the difficulties we have had is as we move from
Choice to MISSION things changed. Veterans got accustomed to
something and then it was something new. And I take serious
issue with any effort to change those access standards or
restrict veterans' eligibility for the program.
If confirmed, will you uphold the current access standards
that veterans--my notes here say ``universally understand.'' I
wish that was the case--but understand, and do you plan to
change those standards as part of that rebalance?
Mr. McDonough. Thank you, Senator Moran. Let me be very
clear that Community Care will continue to be a key part of how
the Department cares for our veterans, full stop. I intend to
implement the statutes that you all have enacted consistent
with your intention, and to do that in consultation with you on
any decisions that come before me. And as it relates to access
standards, I will treat those sets of questions in exactly that
same way, which is that I will work on those fully in
consultation with you.
Senator Moran. Let me highlight a reason that I have the
concern that I am expressing to you. One of your responses to
my pre-hearing question, you promised to work with Congress, as
you just did, to ensure that veterans are the center of their
own health care decisions. However, one of the proposed
Community Care updates in the campaign plan would allow the VA
to send veterans back to the VA when community providers failed
to meet the yet determined access in quality standards. This
directly contradicts the mission's intent by enabling the VA to
override the veteran's choice.
So what I am hoping to hear you say is that you understand
that the MISSION Act is designed, in fact written, for the
veteran and his or her provider at the VA to make a choice
about where to receive care, based upon what is in the best
interest of the veteran. Is there anything there that, in your
view or the Biden administration's plans, that I should have
concern about overriding that decision between the VA provider
and the veteran?
Mr. McDonough. No, Senator. There is not.
Senator Moran. The same theme I would have with the John
Hannon act that Senator Tester and I introduced and got passed
through this Committee and the Senate and the House and signed
by the President. Will you faithfully commit that you will
implement the John Hannon Act in that same manner?
Mr. McDonough. Yes, Senator, I will.
Senator Moran. If confirmed, will you commit your staff to
work with the Committee staff and to my staff, to me, to ensure
congressional intent is met during each of the phases of
implementation for that bill and other legislation?
Mr. McDonough. Yes.
Senator Moran. So, Mr. McDonough, one of the complaints
that I have had for a long time is that when Congress does act,
on the occasions in which we get our act together and succeed
in passing legislation, that the VA, in particular, but I
assume it is true in other departments, the VA, in particular,
seems to ignore the things that we have just talked about. And
what I think you are telling me is that that I should be less
concerned about with you in charge than what I have experienced
over the eight--one, two, three, four, five, six, seven,
eight--nine Secretaries that have been in office while I have
been a member of the Veterans' Committee. Is that a fair
assessment that I can trust you to fulfill the role that the
Executive has in implementing legislation passed by Congress?
Mr. McDonough. Yes, Senator, and I would elaborate on that
in the following way. One is that I believe, as you do, and as
I said earlier, everybody has a role to play in supporting the
veterans. The Constitution actually divvies that up quite
clearly for you all and for the Executive, in Articles I and
II, so it is a constitutional question. Second, I also believe
it is a question of best outcome. When the Executive works
closely with Congress, in a collaborative and consultative way,
that is the best way to ensure more durable policy, more
durable outcomes, and especially if we are both working with
the fundamental premise that every decision should answer, is
this getting better access and better outcomes for our
veterans.
Senator Moran. Mr. McDonough, thank you. Your comments
remind me about durability. What that really means is that a
veteran can come to expect a certain outcome or a response to a
question and it is not different from 1 day to the next, 1 week
to the next, or one location to the next.
Mr. McDonough. Correct.
Senator Moran. And the point I would make is that in so
many instances, over a long period of time, no particular
administration to be specific about, the conversations I have
with the Secretary or his or her team resulted in assuring me
that this problem is being taken care of and this is our plan,
but what I discover when I am home, that has never been
communicated to the people who implement the plan and care for
veterans at home in Kansas. And so there is a communication
issue related to this. You can assure me that you support
implementing with congressional intent, but it has to be told
and insisted on by those who actually provide the services to
veterans at home. And I would encourage you to make certain
that when you tell me and other Members of Congress this is the
policy at the Department, that that policy is then known and
implemented by those across the country.
Mr. McDonough. Understood.
Senator Moran. Thank you very much. Thank you, Mr.
Chairman.
Chairman Tester. We are going by seniority order, so next
we have Senator Murray, remotely.
SENATOR PATTY MURRAY
Senator Murray. McDonough. I am Delighted to see you today.
Welcome, and we all really appreciate your being with us today.
You know, the VA is the largest integrated health care system
in the country so it really demands a strong, effective
leadership, so we appreciate your willingness to take this one.
You and I have had a chance to talk about some issues in
December, and I wanted to ask you about some of those again
today for the record. Let me just start, as part of the MISSION
Act, Congress expanded eligibility for the caregivers program
to make sure veterans of all eras suffering from service-
connected illnesses would have access to caregiver support.
However, under the previous administration, regulations were
imposed that limit that eligibility and remove many veterans
needing assistance from that caregivers program. Those
restricting regulations like requiring a minimum 70 percent
service-connected disability rating as well as the need for
assistance each time an ADL is performed unduly restricts
eligibility in a way Congress never intended, and make it
harder for our veterans to get care.
So if confirmed, will you take action to roll back those
recently imposed restrictions and make it a top priority for VA
to fully implement the caregivers' law as Congress intended?
Mr. McDonough. Thank you, Senator, and I appreciate the
question and I appreciated our discussion of it. My commitment,
as I indicated earlier, is to immediately begin to address this
issue upon confirmation, to work closely with you and the rest
of the members of this Committee as it relates to
implementation of that act, and to ensure that we do it
consistent with the expectation and the intention of Congress.
Senator Murray. Thank you very much. Let me turn to another
part of our promise to take care of our veterans after they
return from duty, which is allowing them to fulfill their dream
of having a family. Congress has given the VA authority
appropriations to provide IVF and other necessary fertility
treatments for ill or injured veterans and their spouses, but
access to that care is far too difficult, and I have been
working for nearly a decade to fix this. My bill, which is the
Women Veterans and Families Health Care Services Act will
permanently authorize fertility treatment and counseling for
veterans and their spouses and provide adoption assistance.
Mr. McDonough, it is extremely important that we empower
veterans to start families when the time is right for them.
Will you commit to work with me to make sure veterans have ease
of access to IVF and other fertility treatments?
Mr. McDonough. Senator, I will.
Senator Murray. Thank you. I look forward to working with
you.
One of the largest challenges that is facing the VA is the
implementation of the electronic health record modernization
program. The VA Medical Center in Spokane, my State, is the
pilot site for this project. The process has highlighted
infrastructure and staffing shortfalls, and veterans in Spokane
have experienced unacceptable delays in getting care. Full
implementation across every VA medical center is expected to
take at least seven more years. Given that timeline and the
scope of this project, if confirmed, how will you protect
veterans' access to high-quality care at the VA while ensuring
the success of this modernization effort?
Mr. McDonough. Thank you, Senator. As I indicated, every
decision that I am involved in, if confirmed as Secretary, will
come back to the fundamental premise of whether the decision is
increasing access and improving outcomes for veterans. This has
got to be the case as it relates to the electronic health
record as well, and my commitment to you and to members of this
Committee is to continue to work in a collaborative,
consultative fashion with you in the implementation of that
program, to ensure that, at the end of the day, increased
access and better outcome for veterans is the result of that
health record, that the work force understands and can use the
health record consistent with those principles, and that I can
continue to confirm to this Committee that that is the outcome
of that process.
Senator Murray. Okay. And one final question. Improving the
information VA shares with veterans on the GI Bill comparison
tool is essential to make sure veterans can get informed
choices about their education. I have previously called for DoD
and VA to develop a joint policy to counter aggressive
recruiting and misleading marketing aimed at our veterans, and
I want to see improved availability of crucial information such
as levels of student debt and transferability of credits. Can
you commit to providing thorough oversight of the GI Bill
funds, fully implementing the protections in the GI Bill Act,
and making sure that when there is evidence of fraudulent
conduct you will take steps to make sure the schools are not
allowed to continue to recruit veterans?
Mr. McDonough. Thank you, Senator. The President has
indicated to me that a fundamental priority for me, if
confirmed, must be ensuring that our vets have access to
employment and education opportunities consistent with their
experience, skills, and talent. And consistent with that, I
would intend to, working collaboratively with you and this
Committee, ensure that there is appropriate, aggressive
oversight and measurement on quality outcomes of that
programming.
Senator Murray. Okay. Thank you very much, and thank you,
Mr. Chairman. I appreciate the opportunity.
Chairman Tester. Senator Boozman.
SENATOR JOHN BOOZMAN
Senator Boozman. Thank you, Mr. Chairman, and thank you for
being here. You served in a variety of different ways in the
Executive branch, I know in national security and then also
chief of staff to President Obama. And I have had the
opportunity to be around the table with you on many occasions
and always found you somebody that was willing to listen and
then also very, very informed on whatever issue that we were
talking about.
Mr. McDonough. Thank you.
Senator Boozman. And then, very importantly, I know that
the President has a great deal of trust in you and respects
your opinion. So I think that is good for veterans. So we
appreciate your willingness to serve very, very much and look
forward to working with you.
We had a good conversation not too long ago. I want to
followup on something that really is a significant issue facing
veterans in the country. Some of these are too large for any
one organization or department to solve. Veteran's suicide is
one of those enormous issues. Last Congress we passed a
bipartisan bill, the Commander John Scott Hannon bill, to begin
to encourage the VA to work more closely with communities in
trying to address the issue of veteran suicide.
If confirmed, would you describe how you would lead the VA
to create more partnerships with veteran-serving community
organizations while, at the same time, incentivizing those same
organizations to partner and work with the VA?
Mr. McDonough. Thank you so much, Senator. The crisis
facing the country related to veteran suicide is tragic. We
face a national crisis on suicide as well. The first and most
important thing that I will do, if confirmed, is underscore
that comprehensive health for our veterans includes mental
health, it includes effective mental health, includes reducing
the stigma associated with seeking help, and that also includes
increasing access to mental health services through any number
of opportunities, and in particular, given the enhanced
authorities that you have now made available to the Department
through community organizations.
So, using those resources and using the networks that are
being built around Community Care gives the Department a unique
opportunity to ensure that it is drawing on all the available
resources on this national crisis.
Senator Boozman. We appreciate that. The VA does a very,
very good job and works really hard at this crisis. On the
other hand, there are so many entities out in the community
that also are doing a very good job and ready and willing. So
many of these people fall through the cracks, and for one
reason are not in the VA. So, if we can get them in a program
and then encourage those programs to get them back into the VA
we will be in good stead.
One of the most common things I hear from veterans in
Arkansas is regarding the multiple different enrollment
processes for VHA, VBA, sometimes NCA, when in fact they are
all part of the same agency. So you have got different
processes within the same agency.
If confirmed, can we work together, can we work together as
a committee, and explore a more human-centric design approach,
in other words, making it simpler to help the enrollment
process for veterans, more of a one-shop approach?
Mr. McDonough. Absolutely, Senator. I would look forward to
the opportunity to work together on that.
Senator Boozman. Very good. And I yield back. Thank you,
Mr. Chairman.
Chairman Tester. Thank you, Senator Boozman. Senator Brown
remotely.
SENATOR SHERROD BROWN
Senator Brown. Thank you, Mr. Chairman. Nice to see you
there and call you that. And I thank Senator Moran for his
gracious comments also. Mr. McDonough, I enjoyed the
conversation we had remote or remotely--whatever is
grammatically correct--the other day. Thank you, and thanks for
your commitment to work with VSOs and VA employees and VA
unions like AFGE, so thank you for that.
We see unprecedented backlog in claims processing in
compensation and pension exams because of the pandemic, and the
pandemic is affecting operations in National Personnel Records
Center. I know you will be busy on day one, working on that and
so many other things. With my staff I met with veterans and VA
employees throughout Ohio. Recently there have been concerns
about VA closing units and downsizing services, at one specific
facility especially, because of the virus. The VA has not
committed as of yet to reopening the unit once the pandemic is
over. My concern with that approach is that if VA starts to
close units or services or facilities it will push veterans
into the community for care. Some want to do that, but others,
most want the option of always going back to the VA.
Would you commit to reopening those units or services lines
closed due to COVID-19, and will you work with OMB and the
White House to make sure that VA has the resources and
personnel to reopen those facilities?
Mr. McDonough. Thank you very much, Senator. Obviously the
slow-down in fulfillment of claims processing as a result of
the pandemic is a principal concern that I would have, if
confirmed, and making sure then that we have the resourcing
after the pandemic to not fall back into backlog once the
Department gets its hands around the existing cases would be
really important.
So, I will absolutely take this question of those
facilities. I will work with the White House and work with OMB
on it, to make sure that we have the resources to fulfill a
critical assignment of timely access to benefits that veterans
and their families have earned.
Senator Brown. Okay. Thank you. We have seen far too many
veterans and military families targeted by predatory, for-
profit institutions since passing the post-9/11 GI Bill. Those
institutions misrepresent themselves and often saddle student
veterans with mounds of debt. Do you plan to exercise
additional oversight to root out misrepresentation of
predatory, for-profit institutions that target student
veterans?
Mr. McDonough. Every decision that I make, if confirmed as
Secretary of the Department, will be asking two simple
questions and to advance two simple principles, which is are
the decisions we are taking increasing access for veterans and
are they improving outcomes for veterans? Outcomes on education
programming and employment programming have to be a critical
part of how the Department implements that and executes those
programs, so the short answer is yes.
Senator Brown. Thank you. And we know that the Protect the
GI Bill Act's provisions bans the deceptive recruiting of
college third-party lead generators and following the law to
cutoff the flow of GI benefits to those kinds of schools.
Obviously that is really important.
Let me shift. I hope you will come to Dayton at some point
to visit the National VA History Center. I will followup and
talk to you about that. I wanted to talk about veteran
homelessness. I will soon be the chair of the Banking Housing
Committee. Veteran homelessness is an important part of your
mission and an important part of my mission too there. We made
great progress there but still have a way to go to complete the
job, including making sure that VA has adequate staffing to
support the successful HUD-VASH housing voucher program. Will
you work with Chairman Tester and HUD nominee Marcia Fudge,
whom I just spoke to literally 30 minutes ago, and make sure
all veterans have a place to call home? That is a really high
priority.
Mr. McDonough. Yes, I will.
Senator Brown. Okay. Thank you. Last thing, last month VA
proposed a program that would require military borrowers
exiting a COVID-19 mortgage forbearance to pay back their
missed payments with interest within 10 years. This is more
expensive than what other Fed mortgage programs are offering.
It would make it more likely that VA borrowers will fall behind
on these new highly monthly payments. Veterans and
servicemembers should not be given worse options than other
borrowers with federally backed loans. Do you agree with that?
Mr. McDonough. I do.
Senator Brown. Okay. Will you look into the rule and work
with us, look into the rule and make sure that no VA homeowner
is left with worse options than borrowers in other federally
backed loan programs?
Mr. McDonough. I would be happy to work with you on that.
Senator Brown. Okay. We will followup. Thank you, Mr.
McDonough and good luck on your confirmation.
Chairman Tester. Thank you, Senator Brown. Senator Cassidy.
SENATOR BILL CASSIDY
Senator Cassidy. Hey, thanks for being here.
Mr. McDonough. Thank you.
Senator Cassidy. I enjoyed our conversations. Thank you for
the phone conversation. Some of this will be repeated, just
because I think it is so important for my colleagues. We spoke
about how those of us on this Committee will ask questions of
the VA--I used the term ``rope-a-dope'' and you immediately got
it. We got a reply back which is off-point, about 2 months
later. We asked for clarification and 2 months later we get
another slightly off-point, or more than off-point. And then
finally it just kind of tapers out.
You have a different philosophy, so do you mind sharing
with us all how you intend to share data with us as regards the
VA itself?
Mr. McDonough. Thank you for the question, Senator. I think
the free flow of accurate data is the lifeblood of a well-
functioning organization. Consistent with that and consistent
with the view I have been espousing of close collaborative,
consultative relationship with this Committee and with
Congress, I would intend to make sure that we have the free
flow of information between and among us. I also said, when we
talked earlier, that it could be that because we are moving
quickly we provide inaccurate information, and I will work to
quickly come back with more accurate information on that. But
as I said, the lifeblood of any well-functioning agency or
organization is accurate, timely data.
Senator Cassidy. You know, you used a couple of adjectives
there, and I am going to explore them because I loved them--
``quickly'' and ``timely.''
Mr. McDonough. Yes, fair enough.
Senator Cassidy. Which is not really--now the VA, by the
way, recently they answered a question very quickly, and so I
am saying that at times it works and at times it does not. But
can you just give me a sense of, when you say ``quickly'' and
``timely,'' like the timeframes that you would be considering
quick and timely?
Mr. McDonough. Well, it is hard to answer that question in
the abstract, but I guess what I would say to that question,
Senator, is I would want it back to you in a timeframe that is
useful to you.
Senator Cassidy. That works. Okay. Thank you.
Following up on something that Senator Brown said, that
Senator Murray alluded to, Senators Carper, Lankford, Tester,
and I will soon be reintroducing the Protect Vets Act. Now I do
not expect you to be up to speed on this because you are just
starting, but it seeks to close the 90/10 loophole to ensure
that veterans' educational benefits, such as the GI Bill, are
treated as Federal funds for accountability purposes. And just
kind of background, if a for-profit university is allowed to
get 90 percent of its funds from the Federal Government and 10
percent from outside the Federal Government, veterans' benefits
have been included in that 10 percent.
And so when Senator Murray speaks of targeting veterans,
yes, they have been targeted because they would fill up this
gap that the free market would not provide, but rather people
with veterans' benefits could provide that 10 percent match for
the remainder of the 90.
We worked very hard to get a compromise that would protect
the veteran, protect the good schools, and that would kind of
be sensitive to sensibilities in both the Republican and the
Democratic caucus. And again, protecting the good schools but
isolating out the bad.
So just to say that we are going to be bringing this
forward, knowing that you will have to look at this, but we
would love your engagement on this issue because we think it is
important that we address it.
Mr. McDonough. I would be happy to work with you on it, and
I commit to being engaged, if confirmed. Absolutely.
Senator Cassidy. I appreciate that. With that I yield back.
Chairman Tester. Thank you, Senator Cassidy. Remotely,
Senator Hirono.
SENATOR MAZIE HIRONO
Senator Hirono. Thank you very much, Mr. Chairman, and
welcome, Mr. McDonough. It was good to talk with you when I had
the opportunity.
I think my colleague, Amy Klobuchar, gave one of the best
testimonies where she made it very clear that you listen and
then you actually do something. You get things done. And you
are about to head, should you be confirmed, one of the largest
Federal agencies and the largest health care system, and very
uniquely the VA actually provides health care across 50 States
and territories. So this is a very unique agency with just
ongoing challenges--homelessness, mental health, health
disparity treatments, all kinds of things.
Not to mention, by the way, when I talked with you, you
said that from a very pragmatic standpoint that getting the
veterans vaccinated and dealing with the pandemic is one of
your first priorities. Joe Biden has said that he is going to
have 100 million people vaccinated within the first 100 days,
so should you be confirmed, do you have an idea, or would you
determine how many veterans you would want to get vaccinated,
and would you have a way to determine whether you are actually
meeting those goals? Would that be one of the ways that you
will tackle this pandemic with regard to our veterans?
Mr. McDonough. Thank you, Senator. In fact, it would be. A
principal priority in helping veterans through the pandemic is
ensuring that they have access to care, if sick, and
vaccinations to prevent getting sick. The way I intend to work
this question is I will demand a seat at the table, and I will,
as the President has asked me to do, be a staunch and fierce
advocate for veterans getting access to the kind of care and
the kind of resources that ensures the kind of outcome that you
have just highlighted.
Senator Hirono. I think that you actually have to have
numbers, such as you are going to have X percent of the
veterans out there, and you are going to need to find some of
them because they are not all in the system. And then you need
to figure out a way to make sure that those vaccinations are
actually occurring.
One of the initial questions I ask of every nominee for
these kinds of appointed positions, just to ensure their
fitness to serve, I ask the following two questions, which I
will now ask you. Since you became a legal adult, have you ever
made unwanted requests for sexual favors or committed any
verbal or physical harassment or assault of a sexual nature?
Mr. McDonough. No, I have not.
Senator Hirono. Have you ever faced discipline or entered
into a settlement relating to this kind of conduct?
Mr. McDonough. No, I have not.
Senator Hirono. One of the ways that we can really ensure
that our veterans get the health care they need is to create
community-based outpatient clinics, and I talked with you about
some of the long delays with regard to some of these clinics on
Oahu as well as on some of the neighbor islands. And each one
of these projects is unique. There may be some unique State
requirements or limitations that make it really hard for these
projects to proceed.
So it requires somebody within the VA to pay attention and
move these projects along, whatever the specific concern might
be, so that the veterans in these places are not waiting for a
decade, as is the case with some of the projects in Hawaii.
I would just like you to really focus on the need for
community-based clinics where the veterans can have access to
the care that they need. Will you commit to making that happen?
Mr. McDonough. Senator, I will. If confirmed, I will.
Senator Hirono. So one of your predecessors made
eliminating homelessness among veterans to be a top priority,
and he engaged a whole-of-government kind of approach and yet
homelessness continues to be a concern. And yes, you responded
to my questions to you, but truly, what are you going to do
that is different from what one of your predecessors, who said,
``I am going to eliminate homelessness among veterans,'' and
that did not happen. What are you going to do to ensure that
there will be more measurable success in eliminating
homelessness among veterans?
Mr. McDonough. Thank you, Senator. The President has made
clear that this will be a priority of the administration. What
I will do to implement that priority is obviously make it an
intentional priority, one. Two, work with the other agencies in
the Federal Government to increase access to available options.
And three, make sure that the VA is providing access to all the
other services that are important as it relates to access to
mental health, access to substance use disorder, treatment,
access to education, employment, and training support. And
using all of those tools, working with other Federal agencies,
and the holding ourselves to account to you to measure that
progress is how we fulfill that objective.
Senator Hirono. I think you have a commitment from Sherrod
Brown and from Marcia Fudge to enable you to succeed, and I
will certainly be wanting to engage with you on that score,
because nothing could be as important as to have a roof over
their head, food, and a job, if that is what is available to
them, made available to them.
I do not know. I cannot see the timer.
Chairman Tester. You are over by about a minute and a half,
and we can have a second round if you would like.
Senator Hirono. Thank you very much.
Chairman Tester. You bet. Thank you, Senator Hirono.
Senator Rounds.
SENATOR MIKE ROUNDS
Senator Rounds. Thank you, Mr. Chairman, and it is truly
refreshing to see that we have a Chairman and a Ranking Member
who are both concerned about our rural veterans as well, and I
thank you and I look forward to working with you.
Mr. McDonough, first of all, I want to thank you for the
phone call the other day. The opportunity to visit with you was
good, and I appreciate the knowledge that you bring, your
preparation for our visit, and your understanding of some of
the challenges that the VA faces. I also--look, I plan on
supporting you in your nomination for this position, and I
thank you for your service to our country.
Mr. McDonough, the Hot Springs VA facility in Hot Springs,
South Dakota, is a critical part of the Department's Black
Hills health care system. In October, Secretary Wilkie
rescinded a record of decision on the future of the campus
which provides vital health care services not only to South
Dakotans but to residents of Nebraska, Colorado, Wyoming, and
so forth.
I would like your commitment, if confirmed, to work on
moving the Hot Springs facility and literally the Black Hills
facilities themselves up into the century with regard to the
services that they are providing, and literally lay out a long-
term plan for their success for the veterans in the rural
areas.
Mr. McDonough. Thank you, Senator. I really appreciated our
conversation on this, and I committed to you then, and I
recommit myself to you now to work closely with you on this,
and addressing the needs in and around the Hot Springs
facility, in as much as it is such a critical piece of the
delivery capability, not only in South Dakota, but as you say,
in Nebraska, Montana, Wyoming.
Senator Rounds. The MISSION Act, which is what we operate
under now for our health care, is an item that I did not vote
for. I did not vote for it because it took away guarantees of a
veteran to be able to find a physician of their own choice if
they could not get an appointment within 30 days or if they
were more than 40 miles away from a health care facility that
the VA sponsored. I thought they were making promises in the
MISSION Act that we might not be able to keep.
I think you step into the administration of this facility,
of this agency, this administration, in which you are being
asked to do a lot of things and you are going to get pulled in
a lot of different directions. I do not expect you to be able
to see the detail of this chart, but this is a chart of the VA
and what it has. You are expected to provide educational
opportunities, you are expected to provide housing, you are
expected to provide final expenses, a final resting place, and
you are also expected to provide health care to VAs across the
entire country.
If you look at this, you can go down 13 levels before you
actually get to where a real doctor is at, where a hospital is
at in the chart. And for me, that says a lot about the
challenge that you face. I do not think that is something that
a lot of people realize, when they talk about the VA and what
happens. When you promise everything to everybody and lay it
within an administration like this, whether it is a Republican
or a Democrat administration, the challenges of handling a
bureaucracy are huge. You walk into a bureaucracy with perhaps
as many as 380,000 individuals, some of which are providing
direct care, others of which are trying to find reasons why the
care can't be provided.
Specifically, what my concern is, is this. Right now, in
the approval process, when we ask for someone to participate in
the care for the community, it is not veteran-friendly. Too
many of the approvals are made by people who work to make sure
that the veteran stays within the VA system, regardless of
whether or not it is good for the veteran or not. While the
flow chart says that the veteran's decision is the veteran's
decision, as Senator Moran suggested it always come back to the
VA for approval. In my opinion, it is tailored for an urban
veteran with easy access to tertiary services and not the rural
veteran who may have to drive well over 50 miles for access to
see a primary care provider.
If confirmed, what will you do to afford veterans their
choices as to where they receive their health care?
Mr. McDonough. Thank you, Senator, and I really appreciated
our conversation before on these questions as well. Any
credible strategy as it relates to rural care for our vets has
to have at least three components. One, community care, and
community care has to ensure that more timely payment of bills.
It also has to ensure a more vibrant network of providers,
providers who want to be part of that network. And I think in
both of those cases a more active, or a higher set of
expectations for the third-party administration, for example,
is probably wise.
The second thing is using access to new platforms. We had a
very useful conversation, I thought, about telehealth, as I did
with several other members of the Committee. Consolidating
those gains and growing those.
And then third is getting more aggressive about using the
authorities that you have given the Department to recruit and
to fill the vacancies in the facilities that VA already has.
And so, among those three prongs of a strategy I think are
the answers to ensure that the best medical outcome for the
vet, which as I read the statute is what you all have demanded,
ends up being the deciding variable in the equation.
Senator Rounds. My time has more than expired, Mr.
Chairman. Thank you for your thoughts, and particularly the one
about timely payments for those providers.
Mr. McDonough. Thank you.
Senator Rounds. Thank you, sir.
Chairman Tester. Thank you, Senator Rounds. Senator
Blumenthal.
SENATOR RICHARD BLUMENTHAL
Senator Blumenthal. Thanks, Mr. Chairman. Thank you for
having the hearing. Thank you, Mr. McDonough, for your service,
your very extensive service, your commitment to veterans, your
conversation with me about your dedication to them, and your
testimony here today, which has been excellent. I have been
following it from afar, and apologize I was not here before
now.
I want to first of all followup on part of a conversation
we had about the VA facility in West Haven, where there were
two deaths. It is an aging, in fact, aged facility that is
badly in need of reconstruction Like many facilities across the
country, it was built in another century, literally, and we owe
it to our veterans to rebuild that infrastructure. There are
several critical construction projects in the design phase at
the West Haven VA, including a new sterile processing service
building and surgical and clinical space tower, but what is
really needed is a reconstruction of the entire facility, which
does great care for our veterans. The doctors, nurses,
administrative staff are superlative, and they are really
dedicated patriots, but they are working a structure of bricks
and mortar that fails to keep faith with our veterans.
So I would like your commitment to work with this Committee
and ensure that the VA prioritizes infrastructure, rebuilding,
and most especially, obviously, for the interests of our
Connecticut veterans, the facility in West Haven.
Mr. McDonough. Thank you, Senator, and my commitment--my
recommitment now, as it was in our earlier conversation, is to
really dig in on these questions upon confirmation, to keep a
very close collaborative relationship with you on it, to ensure
that it is proceeding consistent with the needs of our vets and
consistent with the two principles that I have laid out, which
is increasing access for vets and improving outcome for vets.
Senator Blumenthal. And I would like to invite you to West
Haven, as I did privately, to come visit. They are doing a
great job there, by the way, on vaccines. I have visited the
clinic where they are administering vaccinations. They are
increasing the number.
I would like to know from you how you will ensure that
there is adequate access to vaccinations by minority veterans,
communities of black and brown veterans, and staff members in
that category.
Mr. McDonough. So, I thank you very much, Senator. The
President has made clear that equity will be a fundamental
consideration across the pandemic preparedness and response,
and it would be my expectation, if confirmed, that I will
assume my seat at that table, in those deliberations, and I
will be a fierce, staunch advocate for all vets to have access
to care and treatment and vaccines, consistent with the
improved access and the improved outcomes that will drive any
decision I make as Secretary, if confirmed.
Senator Blumenthal. You are familiar, no doubt, with the
reports about the numbers of veterans who were involved in the
assault on the Capitol, which reflects a phenomenon that
probably is no news to a lot of folks, that white supremacists,
extremists ideology often find fertile ground among veterans,
just as they do in the general population, regretfully,
tragically, and unnecessarily. So I wonder if you could tell us
a little bit about how, under your leadership, you will take
steps to educate veterans about online disinformation and
coordinate with other agencies like the Department of Defense
in this effort.
Mr. McDonough. Thank you, Senator. I would just say I was
struck by the activity, the actions that you and your
colleagues took the evening of January 6th, reconvening to
continue the democratic process. I thought that was a very
strong Statement. I am also struck that both throughout that
day and in the days hence there were remarkable stories of
veterans associated with the Washington D.C. police force,
Capitol police force, veterans who are members themselves, all
taking valiant action to defend democracy, a continuation, as
we have said throughout the day, of how veterans continue to
serve outside of uniform.
On the question of the threat of mis-and disinformation, it
is as important an assignment to protect our democracy as any.
I could see a variety of opportunities for the VA to be an
important actor in those efforts, to protect vets, to highlight
the threats of online activity, trying to provide or insert
disinformation. And it would be my intention to work with my
interagency colleagues, the NSC and others, to make sure that
is receiving appropriate consideration.
Senator Blumenthal. Thank you. My time has expired but I
want to congratulate and thank you again, and I will very
enthusiastically support your nomination on the condition that
you come to Connecticut and visit us there.
Mr. McDonough. I would be happy to go to Connecticut. Thank
you, Senator.
Senator Blumenthal. Thank you.
Chairman Tester. Thank you, Senator Blumenthal. Senator
Tillis.
SENATOR THOM TILLIS
Senator Tillis. Thank you, Mr. Chairman. Mr. McDonough,
congratulations to you and your family and thank you for years
of service, including a lot up here on Capitol Hill.
First I want to apologize for our not being able to talk
before the hearing. I think you did have an opportunity to
speak with everyone else, and I would like to get your
commitment between now and the time we report you out of
Committee to go in, maybe to have a discussion----
Mr. McDonough. Happy to.
Senator Tillis [continuing]. so that we could drill down on
some issues that cannot be covered in 5 minutes. So thank you.
I think in your testimony you made reference to rebuilding
trust in the VA, and I think always we take steps forward, we
take steps back, and we have always got to make sure that we
have the trust for our veterans.
I just wanted to note that I think we are at about 80
percent in trust at the VA overall and about 90 percent on
outpatient health care, so it seems like we are doing something
right. One of the things I would be curious, if you are
confirmed, is if the metrics that we are using right now to
measure our progress are appropriate, and then if you deem them
appropriate then continue to commit to reporting back so that
we can see the trend lines moving the right direction. If you
do not think they are appropriate then make suggestions on
things that we can better tailor to make sure that we are doing
the best for our veterans.
So I suspect that when you get into this role, and some
questions have already been asked, the question of your not
being a veteran--I am not a veteran; I think there are some
here who have not also served. But can you talk a little bit
about the experience that you bring and why you think it makes
you well-suited to take on the role of Secretary of the VA?
Mr. McDonough. Yes, thank you very much, Senator. One, I am
fighter and I am relentless. I think anybody you talk to who
has worked with me will affirm that. Those attributes will
serve me well to fulfill the fundamental assignment the
President asked me to carry out, which is to be a fierce and
stanch advocate for our veterans.
Two, I know and understand the Federal Government, from
both ends of Pennsylvania Avenue. I can unstick problems inside
agencies and across agencies, and especially an agency as large
as VA, that is an important skill, and in fact, I have spent a
lot of time working with many members of this Committee on
doing just that.
And then there is something more. Going back to those
attacks on 9/11, for 20 years I have been afforded, in my
public service, something relatively few Americans are granted,
which is to see up close the excellence, the execution, the
talent of Armed Forces. And I have been deeply moved by that.
And I have also seen, in trips into the field, in Iraq and
Afghanistan, on a very regular basis, the impact of our troops
and the impact of long deployments on them and their families.
And I have made it a point to visit at Walter Reed, and to even
be at Dover on the final arrival home for some of our heroes.
And I am not telling you that I am a vet, but I am telling
you that I have come to understand the massive sacrifices that
they have made, and I have come to witness the amazing skill
with which they have done it. And there is no higher calling
than to use my skills to ensure that we make good on our
promises to them, to serve them as well as they have served us.
Senator Tillis. Well, thank you. I am going to try to keep
to time for my other colleagues who have yet to speak.
But I actually wanted to thank the Chairman. For the past,
I do not know, Jon, going back four years, with Chairman
Isakson's approval, he and I met with two Secretaries to track
on some of the transformation efforts, the electronic health
record system, which is something I want to continue to be
focused on. I am hoping the Chair, now that you are in that
lofty role of Chair you may want to have somebody else on the
Committee meet with them. But to meet with you all on a regular
basis. I really believe in the electronic health record
implementation. I think the integration with the DoD, as I
think some other member may have alluded to it, is critical to
provide that seamless transition. There are some other
transformation projects that I am very interested in. Also,
when we have a follow-up discussion, I want to talk about the
concept of rebalancing Community Care, what that would really
mean. And I look forward to setting up a phone call or in-
person visit over the next few days.
Thank you all. Again, congratulations to your family. Did
you say you came from a family of 10 kids?
Mr. McDonough. Yes, 11. So I have 10 brothers and sister.
Senator Tillis. Were you an altar boy?
Mr. McDonough. I was.
Senator Tillis. One of the best jobs I ever head.
Mr. McDonough. Yes. There is a nice honoraria every once in
a while.
Senator Tillis. Yes. Thank you.
Chairman Tester. Thank you, Senator Tillis, and we will
continue to work on EHR. Thank you.
Next we have up Senator Bernie Sanders, remotely.
SENATOR BERNIE SANDERS
Senator Sanders. Mr. Chairman, thank you very much, and
Denis, great to see you again.
Mr. McDonough. Nice to see you, sir.
Senator Sanders. I am sorry we did not have a chance to
chat before the hearing, but I am more than aware of your years
of public service, and I have absolute confidence that your
knowledge of the bureaucracy is exactly what we need to head up
the VA and make that important institution as efficient and
useful to our veterans as it can be. So I look forward to
working with you. And if it's Okay with you, let's see if we
can chat a little bit in the next couple of days. Is that
something we can do?
Mr. McDonough. Very much. Yes, I would very much appreciate
that.
Senator Sanders. Okay. I would also love to welcome you to
come to Vermont and chat with some of the folks at our very
good hospital in White River Junction. They would love to meet
with you and have you learn a little bit about the problems
facing veterans' care in rural America. Is that something you
might be interested in?
Mr. McDonough. I would be happy to do that. I would be
happy to do that, absolutely.
Senator Sanders. Okay. A couple of issues that I wanted to
touch on--and I apologize, I was in another meeting--is the
trend that we have seen in recent years toward privatization.
In talking to veterans in Vermont, and as former Chair of the
VA Committee, talking to veterans all across this country, I
find that veterans, by and large, with exception, feel that the
quality of care that they are getting at the VA is very good,
and they very much appreciate the level of staffing and people
who often come from their backgrounds, and many of them
veterans themselves, who understand the particular problems
that veterans face.
Can you say a word about trying to maybe reverse the
efforts toward privatization and adequately fund the VA so that
veterans can get the quality care in a timely manner that they
deserve?
Mr. McDonough. Thank you, Senator. I have indicated that
every decision that I make will flow from two principles, which
is does the decision increase access for veterans and does it
improve outcomes for veterans. And that, at the end of the day,
has got to be the defining set of principles on every decision.
I think, as I have discussed with many members of the
Committee, I do not support privatization. I do recognize that
Community Care will continue to be a part of how the VA
provides care to veterans, so we have to ensure that Community
Care, that VA is being a good partner in Community Care, timely
paying of bills, maintaining an effective, vibrant network.
At the same time, we have to ensure that this integrated
health model continues to draw on the success and the
excellence that is obvious throughout its work force. So that
is how I see this, Senator.
Senator Sanders. And I would agree with you. I just wanted
to touch on an issue which is of concern in Vermont, and I
think nationally. When I look at health care, Dennis, I see
dental care as an integral part of health care, and yet dental
care is not available to the average veteran except when there
is--when it is associated with an injury, a service-related
injury. Would you work with me in trying, perhaps, to expand
dental care as a basic benefit for our veterans?
Mr. McDonough. Thank you, Senator. I will absolutely dig
into this question, if confirmed, and continue to work with you
and other members of the Committee in a consultative,
collaborative way to try to address these concerns, absolutely.
Senator Sanders. Okay. Well, Mr. Chairman, that is all that
I have. I think we are looking at somebody who stands the
chance of being a really, really great VA Secretary, and I
certainly look forward to working with him in the future. So
thank you very much, Denis, and I look forward to chatting with
you shortly.
Mr. McDonough. Thank you so much, Senator.
Chairman Tester. Yes, thank you, Senator Sanders. Next we
have Senator Sullivan.
SENATOR DAN SULLIVAN
Senator Sullivan. Thank you, Mr. Chairman, and Mr.
McDonough, thanks for your conversation and meeting yesterday.
As I mentioned, I am proudly serving the State with more vets
per capita than any State in the country--Joe, it is true,
sorry. West Virginia is close, patriotic communities, both of
ours. And I reached out to a number of our veterans for
questions that they can ask you, and I got a lot, of course.
And I would say that you could boil them down to a couple
things. They want a Secretary who understands what it means to
serve, who will vigorously tackle the benefit and health care
challenges facing them, and who listens, who does not
prioritize the needs of, say, a veteran in Los Angeles or a big
city over the needs of those in rural communities like
Utqiagvik or Kotzebue, who works with Congress on finding
solutions, not politicizing.
And in the spirit of a great Marine, former constituent of
mine, unfortunately we lost him last year, Marine Gunnery
Sargent ``Cajun Bob'' Thoms from Wasilla, Alaska, six Purple
hearts, on the cover of Life magazine, for his Silver Star of
valiant heroic for his tour in Vietnam, in the confirmation of
Secretary Shulkin, he had asked the question of saying he
simply wants a VA Secretary who ``will kick ass and take
names.''
So what do you say to my veterans on these issues, and can
you take a minute--I know you did with Senator Tillis--to speak
directly to the legitimate concerns that Alaska veterans have
raised who feel as though military experience is the
prerequisite for the VA Secretary, to understand and have a
baseline understanding of their needs, their service, their
experience.
So if you can address all those I would appreciate it.
Mr. McDonough. Thank you, Senator, and I appreciate the
question, and I appreciate the concern at the heart of the
question about who is best prepared to be VA Secretary.
I am not a gunnery sergeant, but I am a fighter and I am
relentless. Anybody who has worked with me knows that. Two, I
know how the government works, and importantly, I know when and
how it does not work. And I will fight relentlessly to ensure
that it works for our vets.
Senator Sullivan. So I think my constituents, my veterans,
their families, they want to know, will you have their back?
Mr. McDonough. I have spent the last 20 years involved in
decisions about when and where--as a staff person I am not
going to over state my role, but as a staff person, when and
where our men and women go to fight. And I have gone and seen
and met and witnessed what they are doing, and I have gone to
visit them when they are injured, here at home. And I have seen
and internalized their excellence, and I know that the basic
requirement of VA Secretary is to have their back, to ensure
that I will fight like hell to take as good a care of them as
they have taken of us.
Senator Sullivan. So in the immortal words of Cajun Bob,
you will----
Mr. McDonough. Kick ass and take names.
Senator Sullivan [continuing]. kick ass and take names on
behalf of our veterans?
Mr. McDonough. Yes, sir.
Senator Sullivan. That is important. They need to know it.
Mr. McDonough. Yes, sir.
Senator Sullivan. I also want to get your commitment, first
year of your tenure, to get up to Alaska and meet with my
veterans, see our State, see the challenges. Can I get your
commitment on that?
Mr. McDonough. You have got that commitment.
Senator Sullivan. Can I get your commitment--you know, if
confirmed you are going to be running a big bureaucracy--can I
get your commitment to kind of do a VFR direct with all of us
on this Committee, when we have issues, we can go directly to
you and not through the 18 layers of bureaucracy?
Mr. McDonough. Yes, you have that commitment.
Senator Sullivan. Let me ask one final question. Again,
these were concerns from my veterans. You served in the Obama
Administration. My first 2 years in the Senate were the last 2
years of the Obama Administration. A lot of the issues I was
dealing with were some of the big VA problems. The Choice
program, which, in my State, the implementation was an utter
disaster. It actually collapsed the system in Alaska. I mean,
total disaster. The Phoenix wait time scandal. What did you
learn from these, and do you think that experience is going to
help you? Is that a liability, give your background? And can
you assure my veterans that we are not going to go back to
those days, which I do not think anyone on this Committee
thinks were good days for our veterans. We have made a lot of
progress since that, we have made a lot of progress back home
in Alaska, particularly as it relates to putting together an
Alaska plan that got us out of the hole the Choice program put
us in.
Mr. McDonough. Thank you, Senator. The lifeblood of a well-
run, well-functioning organization or agency is timely,
accurate information. That was not the case in Phoenix. The
lifeblood of a well-run organization is accountability.
Accountability happened in Phoenix, but it was slow. You all
have subsequently changed the statute to make that easier, and
it will not ever happen again.
At the end of the day, the principle that will inform my
leadership of the VA, if I am confirmed, is whether any
decision increases access and improves outcomes for our vets.
That is what we owe the vets. That is what my commitment to
you, to the VSOs, and to them, and to the President, is that I
will deliver, if confirmed as Secretary.
Senator Sullivan. Thank you. Thank you, Mr. Chairman.
Chairman Tester. Thank you, Senator Sullivan. Senator Joe
Manchin III. Hallelujah.
SENATOR JOE MANCHIN
Senator Manchin. Thank you, Mr. Chairman, and
congratulations on your lofty position. First of all, Mr.
McDonough, thank you very much, and if I may say, Denis, we
have known each other for a while, and I am glad my colleagues
brought up about, you know, sometimes they think we need to be
veterans, and I never had the honor and the pleasure of being
able to be a veteran. I think that is a void in my life. I
think back--I was an altar boy for 12 years. I was a Boy Scout
for a long time. I never made it to the military, and that is
something I really think there is a void, and I think it is a
special opportunity. But we know that it takes a person who
cares and has the experience to do the job, and that is where
you come in. And I think, Denis, that says everything.
Let me tell you a little bit of what you are facing and
what I have faced in the 5-years I have been on this Committee.
I came on this Committee in the 114th Congress in 2015. Since
then, they talked about the wait time scandals. That led to the
VA Choice Act. It led to the MISSION Act, which needs a lot of
repairs, as you know. The veterans' unemployment and hiring
after the financial crisis, we had more veterans unemployed. It
took longer to get them back employed, and we started I Hire a
Vet, a campaign all over the country.
Toxic exposure, Agent Orange, burn pits--I know you are
very much aware of those and it is really wreaking havoc today.
The veteran suicide and mental health that we deal with on a
daily basis. Veteran homelessness is something that I cannot
comprehend at all how we can have any veterans that we would
not have better care for.
The women veteran health care access. Women think they have
been left out or are not a high priority, and they are an
integral part of our military and our defense today. The hiring
backlog, over 40,000 vacancies in the VA. Veterans Affairs IT
infrastructure delay. At Clarksburg VA, murders. If anything I
have ever experienced in my life is knowing that we could have
veterans who were murdered in a veteran's hospital, and we have
eight confirmed, a woman that will be serving many life
sentences over and over. And there might be as many as three
more. We have had sexual abuse, just found it in another
Beckley VA hospital, four veterans we know of and probably 40
more over a 25-year span.
There is a breakdown somewhere, sir, and we are just going
to need someone like you who can dig into that, because to me
it would be vetting. We are not vetting people properly. We are
not having strict rules adhered to.
But more importantly, we passed, in 2017, the
Accountability and Whistleblower Protection Act. We wanted to
make sure that we could basically get rid of the people that
were not doing their job. I do not think that has been
exercised much since then, and I will give you a perfect
example. The people that I hold responsible for the VA hospital
deaths in Clarksburg have been moved to other places in the VA
system. Unheard of. And I knew way back when this happened, in
a meeting with them, that someone was either lying to me or
totally incompetent. And now when I found out, we brought new
leadership in, they were moved somewhere. I cannot find them.
And I would like to know on that, if we could bring that to the
highest priority.
I think to put the credibility back in the VA, the care and
the desire for the care that they deserve, I would ask you, as
one of your first visits, to come to Clarksburg VA and set down
what your mission would be. And I think, sir, that could set
the tone for the entire VA system all over the country. It is
just unbelievable, totally unbelievable. And now families--I
have families calling me daily. Did my father or grandfather
lose their life because someone murdered them when they were
there, still not knowing for sure. These are all the things
that we are dealing with today. You can help ease that pain, I
think.
But, Denis, I look forward to you. We need someone of your
ability more now than ever, and like I said, I am in awe today
of every person I see in uniform, all the people you see out
here guarding this great republic of ours, and anybody who has
served, to give them the greatest care.
So with that I know the challenges are great. If you would
like to comment on any of that, I know you have probably been
following some of this, but I do not know to what extent on
that.
Mr. McDonough. Well, I thank you very much, Senator, and I
have been following it, and we had a very good conversation,
which I appreciated.
Senator Manchin. Thank you for that.
Mr. McDonough. And my commitment is, as I assured you
before, which is to work in close consultation and
collaboratively with you and with the rest of the members of
the Committee on these question.
Senator Manchin. I think you are going to find a committee
that has worked in--I am just about finished--a committee that
has worked in a most bipartisan way. And I have said this
before, and I mean this with all my heart. Men and women in
uniform are the glue of this country. They keep us together.
They keep us talking. They keep us finding ways to work
together, to make sure that we are taking care of those who are
taking care of us. So you have got it in your hands now, the
cradle, basically, of the people who have made the country what
we are today, and we owe it to them.
So with that being said, you are going to find all the
support. If we do not have a piece of legislation that allows
you to reorganize, that allows you to basically get rid of the
dead wood and the people who do not care--my grandmother always
said, ``People don't care how much you know until they know how
much you care.'' I know how much you care. Now you have to show
the rest of the world.
Mr. McDonough. Thank you.
Senator Manchin. Thank you, sir. I look forward to voting
for you too.
Mr. McDonough. Thank you.
Senator Manchin. Count me in. Put me in again, Coach.
Chairman Tester. You have got it, big boy. Thank you,
Senator Manchin. Remotely we have Senator Blackburn.
SENATOR MARSHA BLACKBURN
Senator Blackburn. Yes, thank you. I appreciate that, and
Mr. McDonough, thank you so much for the time this week. It was
wonderful to visit with you by phone. Let me just--and I
appreciate your commitment. You have talked some about your
passion and that relentless commitment to doing the job and to
public service. So very quickly, what would uniquely qualify
you to lead the VA, with a budget that is nearly a quarter of a
trillion dollars and 400,000 employees, and it serves 9 million
enrolled veterans? So kind of following on to Senator Manchin's
question, what is your unique qualification?
Mr. McDonough. Thank you, Senator. As you have indicated, I
am a fighter and I am relentless, and that means I will fight
to get our vets' backs, and I will ensure, relentlessly, that
the resources that you have authorized and appropriated for the
Committee are invested wisely and with the veteran at the
center of those investments.
I also understand how the government works, from both ends
of Pennsylvania Avenue. That means demanding excellence. That
means enforcing accountability. That means being in close
collaboration and consultation with you and other members of
this Committee, to ensure that we are using all the available
power of the U.S. Government to get our vets' backs.
Lastly, for 20 years now I have been involved in these
decisions about when and where to send our men and women to
war, not as a decider--I am not trying to over state my role---
but as a staff person. And I have also seen the excellence of
our military and I have seen the challenges of long
deployments, and I have seen the sacrifices, but I have seen
the resilience. And there is no higher calling than to be able
to use my skills and my experience to repay and to ensure that
we live up to the promises we have made to our vets.
Senator Blackburn. Yes. Let me jump in there, because
Senator Moran and others have talked about Community Care, and
you and I talked a little bit about this. You have got Choice.
You have got MISSION. We have got, as part of repaying these
veterans, many that want to get care in their communities. You
talked about the right balance of care, and I would like for
you to bring just a little bit of clarity to that. What do you
see as the right balance of care, and would you commit that you
are not going to roll back on standards and reverse the intent
of a veteran-centric care and addressing the whole health of
the veteran?
Mr. McDonough. Thank you, Senator. Community Care will
continue to be a fundamental way that the Department provides
care to our veterans, one. Two, the statute is clear on this.
It says that best medical outcome for the veteran is the
objective, and that will continue to be my priority, if
confirmed as Secretary.
Third, every decision I make as Secretary will come back to
this principle, which is, is it increasing access for veterans
and is it improving outcomes for veterans? If the answer to
those questions are no then we will not do it.
Senator Blackburn. Okay. Well, and you and I discussed the
health records, the electronic health records.
Mr. McDonough. Yes, ma'am.
Senator Blackburn. And others have brought that up today.
And, you know, my frustration with a $4 billion IT budget and
they cannot seem to get it right, indeed Senator Tester and I
had legislation this year that would have improved the
management of that. And for the record, we are about out of
time. I will send you a QFR on the management of those
programs, and then you and I also discussed purchasing, and for
the record I will send you a question delving a little bit more
into that purchasing.
But thank you for the time today. Thank you for your
commitment. And, Mr. Chairman, I will send the time back to
you.
Chairman Tester. Thank you, Senator Blackburn. Next we
have, remotely, Senator Sinema.
SENATOR KYRSTEN SINEMA
Senator Sinema. Thank you, Mr. Chairman. I appreciate Mr.
McDonough joining us today. My office is increasingly hearing
from Arizona veterans asking for clarification on how to
receive the COVID vaccine from the VA and when they will be
able to receive it. My staff has been working locally to make
sure information is getting out to the community, and this
highlights the importance of having Senate-confirmed leadership
at the Department of Veterans Affairs as quickly as possible.
I have introduced, with Senator Tillis, the Ensuring
Survivor Benefits During COVID legislation to address concerns
that survivors of veterans who died from COVID may not be
granted their earned benefits if the death certificate only
identifies COVID-19 as the cause of death, without considering
the impact of other service-connected illnesses.
If confirmed, will you work with me to ensure that
processes are in place to address these concerns?
Mr. McDonough. Yes, Senator, I will.
Senator Sinema. Thank you. Over the last year, my office
has worked with the VA, American Legion, and Philips North
America to bring an Atlas site to Arizona. We hope to provide
more details about that site in the coming weeks. The Atlas, or
the Accessing Telehealth through Local Area Stations program,
is part of VA's Anywhere to Anywhere telehealth initiative to
bring a VA telehealth access point to underserved communities.
In Arizona, there may be many rural and tribal communities that
could benefit from this and other telehealth initiatives.
If confirmed, will you continue to work with our office to
expand telehealth opportunities to rural and tribal
communities?
Mr. McDonough. Yes, I will.
Senator Sinema. As we consider expansion, we have to
acknowledge the challenges of access to broadband in these
communities. As the VA continues to expand its telehealth
initiatives, what role do you feel the VA should play in
addressing broadband access?
Mr. McDonough. Thank you, Senator. I think the VA has a key
role to play in coordinating with other Federal agencies and
with the FCC to ensure that the kinds of access questions that
VA can lead on, including on telehealth, can be expanded by
better broadband access more universally available. So I think
there is a critical role to play within the interagency, and
that, if confirmed, would be precisely what I intend to do.
Senator Sinema. Thank you. You know, in Arizona the Navajo
Nation has been hit particularly hard by COVID. The CDC notes
that Native Americans are at a disproportionate risk for
complications from COVID due to health and socioeconomic
disparities in these communities. They also experience other
inequities such as high instances of homelessness and
challenges accessing clean drinking water and sanitation.
If confirmed, what steps will you take to ensure the VA is
best serving Native American veterans?
Mr. McDonough. This would be a fundamental priority,
consistent with the President's Stated priorities on equity and
consistent with what I have said throughout the day today,
which is how are we increasing access and improving outcomes
for all vets. And third, consistent with the direction to me
from the President to ensure that VA is welcoming of all
veterans, including, obviously, Navajo and other Native
American veterans.
So, there is a fundamental role for us, for the VA to play
there, and if confirmed I would intend to play that role.
Senator Sinema. I appreciate that. Thank you.
Information technology modernization has been and continues
to be a central focus for the VA. If confirmed, you will be
responsible for overseeing these major modernization efforts.
As cybersecurity threats continue to increase across the U.S.,
what steps will you take to ensure that VA is equipped to
protect against cyber threats and is practicing good cyber
hygiene?
Mr. McDonough. Thank you, Senator. Obviously, the range of
cyber threats that we confront as a country is only growing.
Having cybersecurity, cyber hygiene front and center, not only
for the major programmatic efforts at the Department but also
for individuals in the work force at the Department will have
to be a fundamental priority for the next Secretary, and if
that is me I would intend to make cybersecurity a key priority.
Senator Sinema. Thanks. You know, the VA still has a number
of legacy systems it is supporting. These cannot only be costly
but also generally do not follow or accommodate today's
security best practices.
Mr. McDonough. Right.
Senator Sinema. What would be your approach to addressing
legacy systems, if confirmed as VA Secretary?
Mr. McDonough. Thank you, Senator. Obviously there has to
be a fundamental focus on cybersecurity and cyber hygiene
across the enterprise, one, and then two is effectively
performing on the modernization efforts will allow VA to not
only increase security and increase performance and outcomes
for vets but will also reduce costs over time of these legacy
systems. So executing on the modernization has to be a key
priority.
Senator Sinema. And I see that my time has expired. With
your indulgence, Mr. Chair, I will submit the rest of my
questions for our nominee, and I want to thank him for joining
us here today.
Chairman Tester. Thank you, Senator Sinema, and in that
regard the questions need to be in by tomorrow at 5 p.m.
Last but certainly not least, and I have been in your
position before, Senator Cramer. Senator Cramer.
SENATOR KEVIN CRAMER
Senator Cramer. Thank you, Mr. Chairman. Thank you, Mr.
McDonough, and I do not mind, frankly. It means that I do not
have to ask Denis about rural veterans, Native American
veterans, telehealth, COVID-19, MISSION Act or Community Care
Network. So we can get right down to the business of Clemens
Stadium, Johnnies football, and Jake Christiansen Stadium
versus the Cobbers. How about that?
Mr. McDonough. I like that.
Senator Cramer. All right. Well, we will get to that on
your way to Alaska, when you stop in Fargo. Okay? But you and I
did have a wonderful discussion. I want to tell you how much I
appreciated the meeting we had earlier this week. We did drill
down on a number of these issues, as well as one of my most
important issues, that is probably a little more unique to me,
and that is, of course, the use of alternative forms of
therapies, treatments, particularly hyperbaric oxygen
treatment.
And the reason I am such a proponent of hyperbaric oxygen
treatment and therapies for veterans is because I have seen it
work so well. A number of veterans that I know have really had
their lives changed, and in some cases saved, by this important
therapy, as well as others, who have had injuries that come
from sports, particularly head trauma, traumatic brain
injuries.
And so I am a strong proponent of it, and by the way, I
very much appreciated your dialog with Senator Moran, because
he was getting to the heart of an issue that I think a lot of
us, as you could probably tell, are challenged by, and that is
just how large the bureaucracy is and how difficult it can be
to maneuver it, and how often we will actually pass legislation
that is signed into law only to have it sort of either slow
walked, whether intentionally or unintentionally, and I happen
to believe that most of the time it is with good intentions.
But with regard to HBOT, I was able to get language in the
John Scott legislation, that you are very familiar with, that
would authorize the Secretary of the VA to enter into public-
private partnerships to research the effectiveness of
hyperbaric oxygen therapy. And it would require--and I stress
require--the VA to use an objective test to measure the
effectiveness of hyperbaric oxygen therapy, and it would
commission a comprehensive review and study of HBOT, both
within the VA, and I think importantly, with outside
organizations as well, because there is just a lot of
experience out there that, to this point, has not been brought,
in my view, into a good peer-reviewed objective study. But it
would be completed with a recommendation then from the VA about
the effectiveness of HBOT.
I stress that because that is language in the bill that
makes it law, and I believe there are, as I said, real benefits
to this innovative therapy, and by the way, other innovative
therapies. And I think you and I talked about the important
role the VA has played, the leadership role it has played in
some very effective alternatives to traditional medicine or in
addition to traditional medicine.
And really want to just, I guess again, thank you for
listening and get a reaffirmation of your commitment to fulfill
both the letter of that law and then the spirit of it, and then
accept my invitation to Fargo on your way to Alaska to see Dan
Sullivan.
Mr. McDonough. Any time I can go to Fargo I will take it,
one. Two is I would be happy to recommit to making sure that we
dig into the analysis of the therapy, consistent with the
intent in the statute, and consistent with getting to the brass
tack here, to find out what is the best way and best vehicle to
deliver the kind of care to our vets that they have earned.
Senator Cramer. I appreciate that. I have written down a
number of the things you have said, in quotes. I will not
repeat all of them, but one thing you have said a couple of
times in response to the question about your cred, if you will,
your street cred for this job--and I love when you say ``I know
how government works.'' I think that is oftentimes an
underappreciated skill set and gift and experience. So I
believe you when you say that. You have every reason to know
how government works. As you have said, you have seen it from
both ends of Pennsylvania Avenue. And count me as an
affirmative vote----
Mr. McDonough. Thank you.
Senator Cramer [continuing]. and someone who looks forward
to working with you once you are confirmed.
Mr. McDonough. Thank you, Senator.
Senator Cramer. And with that I yield the rest of my time,
Mr. Chairman.
Mr. McDonough. Thank you.
Chairman Tester. Yes, thank you, Senator Cramer. Before I
have my closing remarks I will turn it over to the Ranking
Member, Senator Moran.
Senator Moran. Chairman Tester, thank you very much. It was
tolerable to have you in the chair today, and it is not exactly
what I wanted but it is not a bad deal either, so thank you for
working with me and my colleagues on this side of the aisle as
we commit to do to you and your colleagues.
Mr. McDonough, before I ask you a question I wanted to
point out to the Committee that we have a new staff director,
now on the minority side, who came from the House minority side
but was in both the minority and majority staff world in the
Senate, and is returning now to the Senate. This is his first
meeting since his arrival, and John Towers is behind me, and we
look forward to having him and his help. And we make him
available to you, Mr. McDonough, should you be confirmed.
Mr. McDonough. Thank you.
Senator Moran. Mr. McDonough, would you commit to me that
you are a fan of the Chiefs?
[Laughter.]
Mr. McDonough. Senator Moran, I am a big fan of Patrick
Mahomes, but I am a Vikings fan, and I hate to admit that I am
kind of old school that way.
Senator Moran. Well, you could have answered the question
in a worse way.
Mr. McDonough, I thank you for your interest in serving as
the Secretary of the Department of Veterans Affairs. I thank
you for your testimony today. I just wanted you to know, based
upon what you have said and what I have learned about you that
I will vote for your confirmation.
Mr. McDonough. Thank you.
Senator Moran. And I will ask my Republican colleagues to
do the same. And I look forward to working with you, and your
commitment is evident to me, and I think we can accomplish a
lot on behalf of those who served our Nation, working together.
So best wishes to you and your family, and I thank them. I
know your wife, in particular, is involved in veterans'
services, and I would express my gratitude, as I did personally
to her, but here publicly, for her efforts. And so as a family
we wish you all well in this new endeavor----
Mr. McDonough. Thank you very much.
Senator Moran [continuing]. and I am grateful for your
service. Thank you.
Mr. McDonough. Thank you so much, Senator.
Chairman Tester. Senator Moran, Mr. McDonough, I do not
know if Moran had that question that he asked you and knew the
real impact of it, but not only is Jerry Moran a Chiefs fan but
my Committee director is also a Chiefs fan. So, you know, I
mean, I guess it does not matter if you are a Vikings fan as
long as you root for the Chiefs in the Super Bowl. So, Okay.
I also want to welcome John Towers. John is somebody that
both Jerry and I had the opportunity to work with when he was
in the House. And as you well know, Denis, oftentimes a
relationship between the principles is important, but the
relationship between the staff is more important.
Mr. McDonough. Hear, hear.
Chairman Tester. And so I want to welcome you on board,
John.
And I also want to thank your wife and your family that
have sat attentively behind you, nodding their heads and paying
attention. I cannot see their eyes so I do not think they
nodded off, very often anyway.
But the truth is, as we all know, that the power and the
ability for any of us to serve in any of these positions,
whether it is elected or staffed, really relies with the family
and how important they are to our ability to do our job. And I
want to thank our Committee today for their thoughtful
questions and their belief and the way they put across the fact
that veterans are No. 1 in this Committee, and that is why we
work on this Committee so well.
You know, I looked at the FBI report the day before
yesterday, and I think Senator Moran is going to do it
tomorrow, and I do not think I am out of school by saying that
it was pretty darn stellar. In fact, I told the lady that
brought it in I would have to pay a lot of money to get this
many recommendations of what a fine fellow I am. And so you are
a highly qualified candidate, and I believe that you will work
with this Committee to ensure that we keep the promises to the
men and women who have served their country, and their families
too, by the way.
And Senator Moran visited, and we have an agreement that we
plan to meet again on Tuesday to vote on Denis McDonough's
nomination to be Secretary of the Veterans Affairs, as well the
Committee rules and the budget. And that is what we are going
to do. I think the fact that you had not met with Senator
Tillis or Senator Sanders yet, and the fact that the Ranking
Member had not seen the FBI report requires us to do it then.
Otherwise, I would have tried to move it up, but I am not going
to, based on that.
I would ask, as I pointed out to Senator Sinema, that any
post-hearing questions be sent to the clerk by tomorrow at 5
p.m. And then we will need those responses back from you before
we vote on Tuesday.
With that once again I want to thank you and your family
for being here. Always a pleasure to work with Senator Moran.
This hearing is adjourned.
Mr. McDonough. Thank you.
[Whereupon, at 5:08 p.m., the Committee was adjourned.]
APPENDIX
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