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“Budget Hearing – U.S. Department of Veterans Affairs”

House Appropriations Committee, Military Construction, Veterans Affairs, and Related Agencies Subcommittee

May 15, 2025 (recording here)

HEARING INFORMATION

Witness:

• The Honorable Doug Collins: Secretary, Department of Veterans Affairs

Keywords mentioned:

• Electronic healthcare, backlog, disability claims, PACT Act, community care, staffing concerns, behavioral health, veteran suicide, clinical trials, construction projects

IN THEIR WORDS

OPENING STATEMENTS FROM THE SUBCOMMITTEE

• Chairman John Carter welcomed VA Secretary Doug Collins to his first appearance before the Subcommittee and expressed eagerness to discuss details of the FY26 VA budget. He acknowledged challenges with the Electronic Health Record Modernization (EHRM) initiative, citing delays and budget overruns, but supported continued investment with expectations of improvement. The Chairman warned against the potential harmful impacts of proposed budget cuts and staffing reductions while urging thoughtful execution to protect veteran care. He criticized partisan rhetoric around VA funding and highlighted past inaccuracies in VA budgeting, calling for careful reform.

• Ranking Member Debbie Wasserman Schultz opposed the minimal information provided by the administration's "skinny budget," calling it inadequate for meaningful oversight. She condemned recent actions by President Donald Trump, characterizing his initial months as chaotic and harmful to veterans, referencing abrupt freezes on vital grants and reckless firings that jeopardized critical services like the Veterans Crisis Line (VCL). She specifically mentioned issues such as understaffed clinics, cuts impacting women and minority veterans, unexplained cancellation of numerous contracts, and politically motivated actions detrimental to diverse veteran communities. She challenged Secretary Collins to provide concrete explanations and evidence of improvements rather than political gestures that harmed veterans.

SUMMARY OF KEY POINTS

• Secretary Doug Collins opened by addressing criticisms and misconceptions about his first 100 days, asserting that his efforts had been consistently misrepresented. He underscored his commitment to reforming the VA and improving service delivery and efficiency without harming veteran care, aiming to reduce bureaucracy and wasteful spending. Sec. Collins criticized the previous administration for failing to address critical issues despite significant personnel growth, pointing to continued backlogs and increased wait times for veterans. He affirmed his commitment to the VA MISSION Act and improving community care access, arguing that the VA must refocus on its primary mission—effectively serving veterans, not maintaining federal employment numbers.

• Chairman Carter mentioned concerns raised by an Inspector General’s (IG) report regarding the VA's inaccurate budget forecasting from the previous administration. He asked how the VA planned to improve its fiscal management and forecasting for future budgets. Sec. Collins acknowledged past inaccuracies, explaining that they arose from miscalculations related to community care and PACT Act benefits, and committed to instituting rigorous checks and balances to ensure more accurate budget projections moving forward.

• When asked about veteran enrollment projections under the PACT Act, Sec. Collins stated that nearly one million new veterans had enrolled in two years. He estimated continued growth at around two to three hundred thousand per year for the next few years, tapering afterward.

• Ranking Member Wasserman Schultz strongly questioned the Secretary regarding his previous claims of redirecting significant savings from canceled programs and contracts directly to veteran medical care, claiming that the Subcommittee had not received required reprogramming requests or any supporting evidence. Sec. Collins responded that notifications were sent following Office of Management and Budget (OMB) guidance, specifically referencing a transfer notification sent on April 24, which involved $343 million redirected to community care.

• The Ranking Member insisted that notifications were insufficient, underlining that reprogramming requests requiring congressional approval were mandated by law. Sec. Collins disagreed, maintaining that his administration followed existing guidelines, leading to an unresolved dispute with Ranking Member Wasserman Schultz committing to vigorously pursue compliance.

• Rep. Stephanie Bice asked Sec. Collins to elaborate on the VA’s staffing restructuring plan and how it would address increased wait times and backlogs despite recent expansions in personnel. Sec. Collins detailed that despite hiring tens of thousands of new staff under the previous administration, metrics like wait times for primary care, specialty care, mental health, and disability claims backlogs worsened significantly. He also described ongoing restructuring efforts, aiming to reduce administrative duplication and redirect staff toward direct veteran care.

• Rep. Sanford Bishop challenged Sec. Collins's critical characterization of the previous administration’s backlog management, pointing out that veteran claims significantly increased due to effective outreach and new eligibility from the PACT Act. He specifically asked the Secretary about canceled diversity, equity, and inclusion (DEI) initiatives. Sec. Collins clarified that the eliminated DEI programs were primarily internal workforce initiatives, stating that these cuts did not impact direct outreach efforts to diverse veteran populations or women veterans' specialized care.

• When Rep. Bishop voiced concerns over erroneous layoffs at the VCL, Sec. Collins insisted that safeguards and oversight protocols were already effective. He reaffirmed that frontline call responders were never laid off and claimed that no veterans' calls went unanswered.

• Full Committee Chairman Tom Cole shared his appreciation for Sec. Collins’s appointment and expressed the importance of following proper congressional protocol regarding budget reprogramming. He asked the Secretary for clarification on the status of recently notified fund transfers intended for community care. Sec. Collins replied that the transfers would take effect on May 24, reiterating that no veteran services would be negatively impacted and promising continued transparency and detailed follow-up. Full Committee Chairman Cole urged Sec. Collins to communicate with OMB about providing timely and detailed budget information to Congress, aiming to prevent delays and ensure effective bipartisan collaboration on the VA budget.

• Rep. Mike Levin highlighted Sec. Collins’ previous bipartisan work on veterans' issues, requesting his commitment to fully funding the CVSO Act to provide grants to improve outreach to veterans through county veteran service officers. Sec. Collins strongly committed to funding the program, speaking on the importance of local veteran interactions.

• Rep. Levin also questioned Sec. Collins about potential automation at VA call centers, expressing concern that veterans might lose human interaction when scheduling appointments. The Secretary reassured the Subcommittee that human interaction would remain available, although the VA was exploring ways to streamline calls through automated initial options.

• Rep. Scott Franklin underscored the importance of efficiently managing research funds, particularly clinical trials, noting significant waste and under-enrollment issues. Sec. Collins clarified that no clinical trials had been canceled but acknowledged systemic issues, including the lack of centralized oversight for around 1,500 clinical trials.

• Rep. Franklin further asked about whistleblower protections, especially concerning sexual harassment, and requested Sec. Collins’s commitment to ensuring thorough investigations rather than allowing offenders to retire or transfer. The Secretary firmly pledged to improve accountability, vowing not to tolerate employees harming veterans or undermining VA integrity.

• Rep. Henry Cuellar stressed the importance of enforcing existing accountability laws related to performance reviews, procurement oversight, and contract penalties, urging better congressional oversight and implementation. Sec. Collins agreed, providing an example of wasteful contracting practices, including a redundant $5.8 million management contract.

• Rep. Cuellar raised concerns about overpayments causing hardship to veterans when recouped later. Sec. Collins acknowledged the issue, comparing it to similar Department of Defense (DOD) errors, and committed to addressing administrative errors proactively.

• Vice Chairman Mark Alford asked about the timeline for addressing the disability claims backlog. Sec. Collins responded that claims had already been reduced by 21% within his first 100 days and pledged continued progress. Vice Chairman Alford then raised concerns about delays in mailed prescriptions, and Sec. Collins promised a thorough review to improve medication distribution.

• When asked about delayed responses to congressional inquiries, Sec. Collins committed to immediately addressing the issue by improving his legislative affairs team. Vice Chairman Alford concluded with questions about behavioral health staffing and veteran suicide prevention. Sec. Collins emphatically pledged no cuts to behavioral health positions and described new outreach initiatives to reduce veteran suicide rates.

• Rep. Veronica Escobar criticized the firing of federal employees, claiming that many were veterans, and expressed concern about costly and delayed construction projects. She requested the Secretary’s commitment to working closely with her office on oversight mechanisms, such as transparency dashboards and town halls, to prevent a repeat in the upcoming El Paso VA clinic project. Sec. Collins affirmed her concerns, admitting that VA construction processes were fundamentally broken, lacked accountability, and required significant reforms. He committed to collaborating on her oversight suggestions and addressing specific concerns, including home health aide hour reductions.

• Rep. Michael Guest praised Sec. Collins’s initial actions, noting improvements in reducing disability backlogs and canceling duplicative contracts. He mentioned discrepancies between increased VA staffing and funding versus worsening performance metrics over the past decade. He also addressed rumors of massive employee layoffs, clarifying that only probationary positions were cut and defending Sec. Collins against criticisms. He expressed bipartisan support for the Secretary’s reform efforts and his commitment to ensuring that veterans receive timely, high-quality care.

• Chairman Carter asked about delays concerning the construction of a VA clinic in Bakersfield, California, expressing frustration over legal obstacles delaying the project since 2010. Sec. Collins acknowledged the issue, agreed with the Chairman's frustrations, and indicated that the VA was actively seeking a resolution.

• Ranking Member Wasserman Schultz revisited concerns regarding clinical trials, specifically citing leaked internal VA emails indicating that veterans would lose treatment opportunities due to staffing decisions. She pressed the Secretary repeatedly to confirm whether enrollment in any clinical trials or research projects had been halted. Sec. Collins initially stated that no clinical trials had been canceled but acknowledged the complexity of oversight.

• The Ranking Member insisted on receiving a definitive written follow-up confirming if any planned cancer research or clinical trial enrollments had ceased during Sec. Collins’s tenure. The Secretary agreed to provide further clarification in writing.

• Rep. Franklin asked about the future role of community care, pointing to challenges in rural areas and issues of VA resistance in referring veterans externally for care. Sec. Collins responded that community care was essential, stating that previous VA employees actively discouraged its use due to fears of funding loss, causing unnecessary delays and frustrations for veterans. He committed to removing bureaucratic obstacles, standardizing the referral process, and ending the unnecessary oversight by VA doctors of community providers.

• Rep. Franklin also inquired about psychedelic treatments for PTSD. Sec. Collins responded positively, confirming ongoing VA-supported clinical trials and expressing openness to treatments that could help reduce veteran suicides.

• Ranking Member Wasserman Schultz reiterated her earlier concerns about VA cancer research and clinical trial enrollments being potentially halted due to staffing cuts, seeking further clarification. Sec. Collins clarified that no research trials had been canceled, though he acknowledged some organizational confusion and a lack of centralized management for clinical trials. He committed explicitly to providing detailed follow-up information confirming whether any planned clinical trials or research had been halted during his tenure.

• Rep. Escobar questioned the termination of the VA Servicing Purchase (VASP) Program, expressing concern over veterans potentially losing foreclosure prevention support without alternative programs in place. The Secretary explained that VASP, initiated internally by the previous administration without congressional direction, was ended because it placed significant financial liabilities on the VA without adequately addressing the root causes of veteran foreclosure issues. He confirmed that no existing participants were removed but agreed to provide specific follow-up data.

• Rep. Ryan Zinke asked about improving employee compliance with mandatory training for the EHR system, which previously faced issues due to poor attendance. Sec. Collins stated that attendance would now be enforced strictly, with mandatory training standardized across sites to ensure compliance.

• Rep. Zinke also raised concerns about poor responsiveness and inefficiency from TriWest, a major community care third-party administrator, requesting the Secretary prioritize improvements. Sec. Collins committed to reforming VA oversight and future contract negotiations to hold TriWest and similar vendors accountable for better performance.

• Rep. Levin expressed concerns about understaffing within Veterans Readiness and Employment (VR&E) and HUD-VASH homelessness programs, questioning whether these positions were exempt from current hiring freezes. Sec. Collins confirmed that both VR&E and HUD-VASH positions were exempt and assured Rep. Levin that staffing shortages due to miscommunications were being addressed.

• Rep. Levin also inquired about potential Office of Personnel Management (OPM)-related hiring delays for critical healthcare providers. The Secretary clarified that those delays were not occurring, noting that the VA was proactively streamlining processes to expedite new hires. Rep. Levin encouraged Sec. Collins to maintain direct communication with VA regional offices and offered ongoing support.

• Vice Chairman Alford revisited community care concerns, specifically regarding veterans' lack of awareness about available benefits, suggesting that the VA had a marketing or communication problem. Sec. Collins agreed, citing problematic internal resistance at VA facilities aimed at discouraging veterans from seeking community care. He echoed his commitment to clearly communicating veteran benefit options and removing internal cultural barriers that limited community referrals.

• Ranking Member Wasserman Schultz clarified previous comments about VA employee growth, claiming that the increase in VA personnel was necessary for successfully implementing the PACT Act. She spoke on the ongoing importance of community care, noting that its utilization had increased significantly since implementation. She also noted veterans' preference for VA-provided care due to cultural competence and specialized understanding, reaffirming her commitment to working collaboratively with Sec. Collins to support veterans effectively.

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