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“Nomination of the Honorable Douglas A. Collins to be Secretary of Veterans Affairs”

Senate Veterans Affairs Committee Hearing

January 21, 2025 (recording here)

HEARING INFORMATION

Witness & Written Testimony (linked):

• The Honorable Douglas A. Collins: Nominee to be Secretary of Veterans Affairs

Keywords mentioned:

• VA MISSION Act, electronic health records (EHR), backlog, transition, community care, accountability, staffing, transparency, efficiency, culture, leadership, communication

IN THEIR WORDS

OPENING STATEMENTS FROM THE COMMITTEE

• Chairman Jerry Moran convened the Senate Veterans Affairs Committee for the 119th Congress and welcomed both returning and new members. He committed to working in a bipartisan manner to ensure veterans receive quality care and benefits. The Chairman underscored the importance of the VA Secretary’s role, noting the department’s vast scope, significant budget, and need for efficiency. He introduced former Congressman Doug Collins as the nominee for VA Secretary, recognized his family, and expressed gratitude to outgoing VA Secretary Denis McDonough.

• Ranking Member Richard Blumenthal thanked the Chairman and welcomed Mr. Collins and his family. He expressed disappointment over the new administration’s lack of mention of veterans in the inaugural address and cautioned against potential cost-cutting measures at the VA. Ranking Member Blumenthal stressed the importance of preserving direct VA care, strengthening mental health services, and modernizing infrastructure. He also voiced concern about external influences on VA decision-making, advocated for Afghan allies, and called for leadership that upholds veterans’ rights.

SUMMARY OF KEY POINTS

• Sen. Kevin Cramer expressed gratitude for the opportunity to introduce Mr. Collins, whom he described as a former House colleague, a Navy veteran, a military chaplain, and an accomplished attorney. He praised Mr. Collins’s engaging personality and legal expertise, claiming that these traits made him uniquely qualified for the position of VA Secretary. Sen. Cramer reviewed Mr. Collins’s legislative achievements, including work on bipartisan efforts and VA-related legislation such as the VA MISSION Act and the VA Accountability and Whistleblower Protection Act. He believed Mr. Collins would prioritize veterans’ needs over bureaucratic concerns and pledged his full support for the nominee.

• Mr. Doug Collins thanked the Committee members, acknowledged his family’s support, and expressed appreciation to President Donald Trump for the nomination. He noted his military background as a Navy veteran and current Air Force reservist, illustrating his understanding of veterans’ experiences and issues like burn pit exposure. Mr. Collins pledged to focus on providing timely access to care and benefits, building on laws such as the VA MISSION Act and the PACT Act. He reiterated his commitment to collaboration, accountability, and leadership grounded in compassion.

• Chairman Moran asked Mr. Collins if he would ensure the VA MISSION Act was fully implemented, particularly for veterans in rural areas, and whether he would guarantee that every VA employee followed both the letter and spirit of that law. Mr. Collins confirmed his commitment to uphold the law, stating that the VA should prioritize the needs of the veteran over bureaucratic hurdles.

• Chairman Moran then discussed the importance of addressing mental health care, addiction issues, and smooth transitions from active duty to veteran status. Mr. Collins agreed that mental health support must be accessible, especially given the high rate of suicides among veterans who have never engaged with the VA. He pledged to improve transition services by working closely with both the Department of Defense (DoD) and community resources to connect service members with VA benefits as they leave active duty.

• Ranking Member Blumenthal asked if Mr. Collins would respond promptly to Committee inquiries, be transparent with information requests, and collaborate with veterans service organizations (VSOs) and stakeholders. Mr. Collins committed to full transparency and pledged to work closely with Congress, VSOs, and oversight agencies like the Inspector General, Government Accountability Office (GAO), and the Office of Special Counsel.

• The Ranking Member then pressed the nominee to oppose any means-testing proposals or budget cuts that would diminish VA disability compensation, and he sought assurance regarding adequate funding for VA construction projects. Mr. Collins stated that he would not support balancing budgets by reducing veterans’ benefits or imposing means tests, emphasizing that veterans should remain the VA’s priority. He also agreed that major and minor construction projects for VA facilities needed more decisive and efficient action to address veterans’ healthcare needs nationwide.

• Sen. Tim Sheehy focused on the importance of expanding community care options for veterans in rural regions, noting that many face long drives to VA facilities. Mr. Collins acknowledged that rural veterans often struggle with distance and access to VA facilities, and he promised to publicize community care opportunities more effectively.

• Sen. Sheehy also raised concerns about the difficult handoff from active duty healthcare to VA coverage, stressing that medical record transfers and coordination must be seamless. Mr. Collins claimed that improving the VA’s electronic health record (EHR) system would be a top priority so medical records could transfer smoothly from the DoD to the VA.

• Sen. Patty Murray expressed frustration with the Oracle Cerner EHR rollout in Washington State, noting patient safety risks and insufficient training at affected sites. She asked Mr. Collins to clarify how he would prioritize fixing the EHR system. Mr. Collins pledged to take a fresh, top-down approach to the EHR project, promising to meet with Oracle Cerner, clinicians, and staff at impacted facilities to identify and correct shortcomings.

• Sen. Murray shifted gears to VA abortion services for women veterans. Mr. Collins referred to the existing 1992 law limiting VA-provided abortion, acknowledged a more recent revision, and promised to examine the legal requirements to ensure correct implementation. He stressed that his main goal was to uphold the law while prioritizing veterans’ care and well-being.

• Sen. Dan Sullivan noted Alaska’s high population of veterans, large geographic size, and lack of a full-service VA hospital. He described the persistent problem of lower-48 call centers scheduling appointments for Alaskan veterans, causing severe backlogs and confusion. He asked Mr. Collins to commit to addressing this issue by improving community care, moving call centers back to Alaska, and visiting the state. Mr. Collins promised to work on the backlog problem, agreed that the VA must consider Alaska’s unique circumstances, and confirmed his willingness to explore solutions and visit the region.

• Sen. Mazie Hirono first asked Mr. Collins about whether he had ever engaged in sexual harassment or assault, to which he answered “no.” She then questioned Mr. Collins on whether he would refuse an illegal directive from President Trump and pressed him on whether he would rescind the interim final rule allowing abortions in limited circumstances at VA facilities. Mr. Collins responded that he would follow the law as written, examine the legality of the 2022 rule, and ensure VA actions align with congressional intent.

• Sen. Cramer followed up on Sen. Hirono’s line of questioning, asking if Mr. Collins would consider rescinding an illegal rule put in place by a prior administration. Mr. Collins reiterated his stance that he would review the existing rule on VA-provided abortions to ensure it complied with the law, unequivocally stating that the VA must follow legal requirements set by Congress.

• Sen. Cramer then discussed community care, particularly in rural areas where veterans live far from VA facilities. Mr. Collins agreed that the VA should proactively find ways to say “yes” to veterans and called for leadership that empowers VA employees to serve veterans efficiently.

• Sen. Angus King underscored the importance of transitioning from active duty to veteran status, stressing that a smooth handoff involves the DoD, the VA, and state-level veterans organizations. Mr. Collins confirmed that he intended to make this transition process a priority, noting the urgent need to connect departing service members with the VA.

• Sen. King also mentioned the costly and protracted rollout of the Oracle Cerner EHR system, suggesting that the VA might adopt proven private-sector products instead of trying to build a unique system. Mr. Collins agreed that the VA is “special but not unique” and pledged to consider alternatives that deliver effective, modernized health records more quickly and affordably.

• Sen. Jim Banks pointed out the significant successes under the Trump administration’s first term, such as expanding the VA MISSION Act, holding the VA more accountable, and improving the GI Bill. He requested Mr. Collins’s commitment to begin construction on a new VA Medical Center in Indianapolis, which currently lacks full funding. Mr. Collins acknowledged that VA facilities on average are older than private-sector hospitals and stressed the need for focused planning and leadership on construction and modernization. He also pledged better communication with Congress on new clinic locations and emphasized that his leadership would include a proactive Legislative Affairs team dedicated to promptly identifying and resolving constituent concerns with the VA.

• Sen. Elissa Slotkin shared her pride in helping pass key veterans’ legislation such as the PACT Act and the Elizabeth Dole Act. She asked Mr. Collins to commit to speaking up on behalf of veterans if pressured by the administration to slash the VA workforce, which could undermine veteran care. She also sought his assurance that he would not alter veterans’ discharge statuses or rescind benefits based on personal or political beliefs, noting the importance of respecting the original DoD determinations. Mr. Collins pledged to prioritize veterans’ interests, maintain benefits tied to discharge status, and refrain from applying any political litmus test.

• Sen. John Boozman praised the VA’s State Veterans Home Program but noted that an Arkansas facility needed upgrades and had dropped in priority for funding. He asked for Mr. Collins’s pledge to continue working with him and the state to address these needs. Mr. Collins agreed to collaborate on the critical service of long-term care for veterans.

• Sen. Boozman also addressed the PACT Act’s implementation and asked how Mr. Collins would maintain the Toxic Exposure Fund’s viability. Mr. Collins promised to provide accurate data to Congress about future funding needs and to ensure that new benefits and programs are managed responsibly.

• Sen. Ruben Gallego described Arizona’s “Be Connected” program, which helps with mental health and other services for veterans. He voiced concern that the Phoenix VA would stop funding the program and asked Mr. Collins to explore alternative funding sources. Mr. Collins pledged to look into it and reiterated his focus on preventing suicides and homelessness among veterans.

• Sen. Gallego also stressed the importance of the HUD-VASH program for homeless veterans and asked how the nominee would collaborate with HUD. Mr. Collins affirmed his willingness to work jointly with other agencies.

• Sen. Tommy Tuberville noted that the VA is the largest healthcare system in the world and expressed concerns about personnel management, including the possibility of rehiring individuals who were dismissed under the previous administration. Mr. Collins reaffirmed his intention to enforce accountability via the VA Accountability and Whistleblower Protection Act.

• Sen. Tuberville also asked about VA funding potentially used for services to undocumented immigrants, and Mr. Collins stated he would investigate any misuse of funds.

• Furthermore, Sen. Tuberville criticized the EHR project’s high cost and lack of progress. Mr. Collins agreed that the program’s current status was unacceptable and pledged to address it.

• Sen. Bernie Sanders described multiple independent assessments showing that the VA outperforms private-sector hospitals in many areas. He underscored three visions for the VA: one that privatizes care entirely; a “hybrid” focus only on specialized care; and the view that the VA should provide comprehensive care. Mr. Collins assured the Committee of his commitment to maintaining a strong VA system while also implementing community care as authorized by law.

• Sen. Sanders also requested faster progress on opening new clinics in Vermont and urged Mr. Collins to stand against the hiring freeze if it hindered adequate VA staffing. Mr. Collins pledged to ensure the VA had the staff required to care for every veteran, while also seeking to address inefficiencies.

• Sen. Thom Tillis criticized the federal government’s protracted and costly implementation of the VA’s EHR system, calling it “a bipartisan, multi-administration disaster.” He asked Mr. Collins to commit to an urgent and thorough project review to get the EHR rollout on track, and Mr. Collins agreed. Sen. Tillis concluded by voicing concerns about the PACT Act’s funding shortfalls and offering his help with fixes.

• Sen. Maggie Hassan thanked Mr. Collins for his commitment to advocate for veterans’ care when budget challenges arise. She pointed to New Hampshire’s lack of a full-service VA hospital and the multiple pipe-burst incidents at the nearly 75-year-old Manchester VA Medical Center. She asked for Mr. Collins’s assurance that he would continue upgrading the Manchester facility and visit New Hampshire. Mr. Collins pledged to do both.

• Sen. Hassan also explained the difficulties rural veterans face in scheduling multiple appointments in one trip and referenced her bipartisan bill, co-sponsored with Sen. Boozman, to create a more streamlined scheduling system. Mr. Collins acknowledged that consolidating appointment scheduling should already be possible, and he promised to work with her on it.

• Sen. Hassan then briefly mentioned her interest in home-based care as supported by the Elizabeth Dole Act, and Mr. Collins expressed a commitment to implementing that law effectively.

• Sen. Bill Cassidy voiced support for Mr. Collins’s nomination and raised concerns about the backlog in VA disability benefit applications, suggesting that the VA leverage artificial intelligence (AI) to speed up claims processing. He urged Mr. Collins to set firm timelines for any technology upgrades, rather than repeatedly funding efforts that produce few results. Mr. Collins agreed that the VA must set deadlines and metrics for success, pledging to ensure money spent on technology yields tangible improvements.

• Sen. Tammy Duckworth thanked Mr. Collins and confirmed they both favored maintaining a robust VA healthcare system rather than privatizing services. She pointed out that while community care can be important for specialized procedures like mammograms, the VA offers uniquely specialized services for veterans’ broader health needs. Mr. Collins agreed, underscoring the VA’s distinct role and emphasizing that any choice of private services must still center on what best serves the veteran.

• Sen. Duckworth also advocated for eliminating co-pays for preventive healthcare in the VA system. Mr. Collins agreed to work with the Committee on exploring preventive care solutions, noting the importance of early intervention for both veterans’ health and cost savings.

• Sen. Marsha Blackburn noted her past service with Mr. Collins in the House and recognized his consensus-building and problem-solving reputation. She underlined the importance of having VA employees return to in-person work, expressing concern that some VA employees worked in-person only 2 out of 10 days. She echoed the need for more robust community care and better electronic health records to reduce excessive wait times. Mr. Collins agreed that telework policies should not compromise veterans’ care and pledged to encourage VA employees to be physically present when necessary.

• Ranking Member Blumenthal raised concerns about a federal hiring freeze memo from the White House that appeared to spare employees working on veterans’ benefits but did not explicitly exempt those delivering health care in VA facilities or working in national cemeteries. He asked Mr. Collins whether he would fight for an exemption so the VA could continue hiring doctors, nurses, and other direct-care personnel. Mr. Collins said he supported President Trump’s right to assess the federal workforce through a hiring freeze but did not believe it would negatively impact veterans’ access to care. He stated that, if confirmed, he would “fight for what the VA needs” and ensure essential roles remain filled.

• Sen. King praised the work of the VA Inspector General and asked how Mr. Collins would utilize IG reports. Mr. Collins said he recognized the importance of the Inspector General’s oversight and planned to collaborate closely, even when he might not always agree with the IG’s conclusions.

• The Chairman stressed that passing a bill is only half the battle—proper implementation is critical. Mr. Collins agreed, highlighting his unique vantage point as someone who had served in Congress; he assured the committee he would diligently follow through with implementation.

• Chairman Moran also noted that the VA often took months to respond to congressional inquiries. Mr. Collins promised more timely and accurate feedback, committing to a proactive Legislative Affairs Office that would improve communication with Members of Congress.

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