MILITARY CONSTRUCTION, VETERANS AFFAIRS, 

AND RELATED AGENCIES APPROPRIATIONS 

FOR 2015 

HEARINGS

BEFORE A 

SUBCOMMITTEE OF THE 

COMMITTEE ON APPROPRIATIONS 

HOUSE OF REPRESENTATIVES 

ONE HUNDRED THIRTEENTH CONGRESS 

SECOND SESSION 

SUBCOMMITTEE ON MILITARY CONSTRUCTION, VETERANS AFFAIRS, 

AND RELATED AGENCIES APPROPRIATIONS 

JOHN ABNEY CULBERSON, Texas, Chairman

ALAN NUNNELEE, Mississippi 

JEFF FORTENBERRY, Nebraska 

THOMAS J. ROONEY, Florida 

TOM GRAVES, Georgia 

DAVID G. VALADAO, California 

MARTHA ROBY, Alabama 

SANFORD D. BISHOP, JR., Georgia 

SAM FARR, California 

DAVID E. PRICE, North Carolina 

CHAKA FATTAH, Pennsylvania 

NOTE: Under Committee Rules, Mr. Rogers, as Chairman of the Full Committee, and Mrs. Lowey, as Ranking 

Minority Member of the Full Committee, are authorized to sit as Members of all Subcommittees. 

DONNA SHAHBAZ, SUE QUANTIUS, SARAH YOUNG, and TRACEY E. RUSSELL,

Subcommittee Staff 

PART 3A 

DEPARTMENT OF VETERANS AFFAIRS BUDGET 

( 

U.S. GOVERNMENT PRINTING OFFICE 

89–726 WASHINGTON : 2014 
COMMITTEE ON APPROPRIATIONS 

HAROLD ROGERS, Kentucky, Chairman

FRANK R. WOLF, Virginia 

JACK KINGSTON, Georgia 

RODNEY P. FRELINGHUYSEN, New Jersey 

TOM LATHAM, Iowa 

ROBERT B. ADERHOLT, Alabama 

KAY GRANGER, Texas 

MICHAEL K. SIMPSON, Idaho 

JOHN ABNEY CULBERSON, Texas 

ANDER CRENSHAW, Florida 

JOHN R. CARTER, Texas 

KEN CALVERT, California 

TOM COLE, Oklahoma 

MARIO DIAZ-BALART, Florida 

CHARLES W. DENT, Pennsylvania 

TOM GRAVES, Georgia 

KEVIN YODER, Kansas 

STEVE WOMACK, Arkansas 

ALAN NUNNELEE, Mississippi 

JEFF FORTENBERRY, Nebraska 

THOMAS J. ROONEY, Florida 

CHARLES J. FLEISCHMANN, Tennessee 

JAIME HERRERA BEUTLER, Washington 

DAVID P. JOYCE, Ohio 

DAVID G. VALADAO, California 

ANDY HARRIS, Maryland 

MARTHA ROBY, Alabama 

MARK E. AMODEI, Nevada 

CHRIS STEWART, Utah 

NITA M. LOWEY, New York 

MARCY KAPTUR, Ohio 

PETER J. VISCLOSKY, Indiana 

JOSE ́ E. SERRANO, New York 

ROSA L. DELAURO, Connecticut 

JAMES P. MORAN, Virginia 

ED PASTOR, Arizona 

DAVID E. PRICE, North Carolina 

LUCILLE ROYBAL-ALLARD, California 

SAM FARR, California 

CHAKA FATTAH, Pennsylvania 

SANFORD D. BISHOP, JR., Georgia 

BARBARA LEE, California 

ADAM B. SCHIFF, California 

MICHAEL M. HONDA, California 

BETTY MCCOLLUM, Minnesota 

TIM RYAN, Ohio 

DEBBIE WASSERMAN SCHULTZ, Florida 

HENRY CUELLAR, Texas 

CHELLIE PINGREE, Maine 

MIKE QUIGLEY, Illinois 

WILLIAM L. OWENS, New York 

WILLIAM E. SMITH, Clerk and Staff Director 

(II)
C O N T E N T S 

PART 3A 

Page

Hearing — Department of Veterans Affairs Budget ................. 1 

FY 2015 Budget Submission; Department of Veterans 

Affairs:

Summary Volume 1 ............................................................. 99 

Summary Volume 2 ............................................................. 301 

Summary Volume 3 ............................................................. 717 

(III)

(1)

MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES APPROPRIATIONS FOR 2015 

THURSDAY, MARCH 27, 2014. 

DEPARTMENT OF VETERANS AFFAIRS 

WITNESS

HON. ERIK K. SHINSEKI, SECRETARY OF VETERANS AFFAIRS 

CHAIRMAN CULBERSON OPENING STATEMENT

Mr. CULBERSON. The Appropriations Subcommittee on Military 

Construction and VA will come to order. 

We are delighted to have with us today the Honorable Eric 

Shinseki, the Secretary of Veterans Affairs, who is accompanied 

today to help answer any questions the Committee might have by 

Dr. Robert Petzel, who is Under Secretary for Health—honor to 

have you here with us today, sir—Allison Hickey, Under Secretary 

for Benefits; Steve Muro, Under Secretary for Memorial Affairs; 

Stephen Warren, Executive in Charge for Information Technology; 

Helen Tierney, Executive in Charge for Office of Management and 

Chief Financial Officer. 

And we are delighted today to welcome you, Mr. Secretary, for 

discussion of the President’s proposed 2015 budget request. 

And truly, among all the agencies in the Federal government, 

you know you are in a very special position because you have got 

the largest proposed increase for any cabinet department by our 

scoring, nearly $1.9 billion, or 3 percent. The mandatory programs 

in your budget increased by a substantial $8.8 billion, or more than 

8 percent, to $93.5 billion. 

And while we, the Subcommittee, know the work that you have 

undertaken, the progress that you have made in the last year reducing the backlog of disability compensation claims, it remains 

something that we are all deeply concerned about. 

Delighted for the progress you have made, but the continuing 

backlog of 300,000 claims is a deep concern to the Committee and 

the Congress and certainly something I know that disturbs you 

deeply. We are continuing to be immensely frustrated with that 

and are going to want to visit about that today. 

Since we had our hearing with you last year, sir, the landscape 

on electronic health records has shifted dramatically. 

I always remember vividly when I first was privileged to have 

this assignment Chairman Rogers bringing to our attention—I 

think you were here that day—he had a terrible story of the young 
2

man who had lost his vision in one eye as a result of his service 

to the country overseas. 

And when he left active duty and went into the VA system, because of the inability of the medical records in the Department of 

Defense to be read by the VA, couldn’t get access to them quickly 

enough, this young man’s eyesight was lost in his second eye and 

he is now permanently blinded. So it is just not acceptable. 

I know that all of us in the Subcommittee and in the Congress 

want to see the medical records of a person in uniform transition 

seamlessly, immediately, to the Veterans Affairs when they leave 

active duty service. 

However, the departments have chosen to go down separate 

paths, of course, as you know, developing electronic health records. 

So we need to, as a Subcommittee and as a Congress, do our best 

to help ensure that these two records are interoperable. 

And we will be especially vigilant, Mr. Secretary, to be sure that, 

after the VA has spent billions of dollars on VistA, which we continue to hear good things about your medical records system that 

you have developed, that VA doctors will be able to exchange that 

information with the DOD and outside providers. 

We will have questions for you today on these topics and other 

areas in your budget request. And because I know the press of 

time, that we finished a little earlier today on the floor than we 

thought, I would welcome at this time any comments from my dear 

good friend, Sanford Bishop, from the great state of Georgia. 

Mr. BISHOP. Mr. Chairman, would it be in order for me to yield 

to the ranking member of the full Committee, Mrs. Lowey, who is 

with us, the gentlelady from New York? 

Mr. CULBERSON. Yes. And if you will please forgive me, Mrs. 

Lowey.

MRS. LOWEY OPENING STATEMENT

Mrs. LOWEY. I will always forgive you. And I am very grateful 

because, as our distinguished ranking member knows, today has 

been a day where you could use roller skates running from one to 

another.

So I join you, Mr. Chairman, Mr. Ranking Member, in welcoming. We certainly are delighted that Secretary Shinseki is here 

with your team. We thank you for the very important work you do, 

and we know how essential it is to those who have fought for our 

country.

As the subcommittee works on the fiscal year 2015 bill, we must 

ensure that the men and women who have faithfully served our 

Nation receive the recognition and benefits they earned. We can 

never renege on the promises made to our veterans. 

Mr. Secretary, I commend you on the excellent work you have 

done in the past to substantially reduce veterans’ homelessness. I 

am also pleased with your progress to help facilitate a smoother 

transition from active duty to civilian life, which will now be more 

important than ever. 

But I cannot express how outraged I am with the veteran claims 

backlog. Last year, when you sat before this committee, the number was almost 600,000. The backlog of 350,000 today is still too 

high.
3

And the impending drawdown of forces in the military will only 

increase the number of men and women exiting the services and 

looking to the VA for health care and benefits. I worry that this 

will be too much pressure to add on to an already strained system. 

We all want to fix this shameful problem, yet it persists. I hope we 

can work together to address this pressing issue. 

And, Mr. Secretary, I look forward to hearing your testimony. 

Thank you again for your service to our country. 

Mr. BISHOP. Thank you, Mr. Chairman, Madam Ranking Member.

RANKING MINORITY MEMBER MR. BISHOP OPENING STATEMENT

Welcome to Secretary Shinseki and your executive team. 

Mr. Chairman, we have done a lot to ease the burden of military 

service. For example, Congress passed the 9/11 GI Bill, the Hiring 

Heroes Act, the Caregiver’s Act, all with strong bipartisan majorities.

However, we are still struggling in the claims process area, but 

we are making progress. The last update I saw, there were a total 

of 672,000 claims and, of that, 389,000 are considered backlogged. 

So, Mr. Secretary, we still have a ton of work to do on this. 

I have heard from many on the reasons for the backlog: Inclusion 

of Agent Orange, the winding down of the wars in Iraq and Afghanistan, the complexity of the new wounds, both physical and 

mental, which are causing multiple claims by our veterans, and 

then many more. 

I completely understand this. But, Mr. Secretary, I am concerned 

about the current drawdown of troops and what effect it will have 

on the claims process. I look forward to a discussion on what the 

VA’s plans are to handle this developing situation, which may very 

well in the not-too-distant future become a surge. 

I want to talk about results and how this fiscal year 2015 budget 

is going to achieve these results, how are the initiatives and funding in this budget going to meet the Department’s goal to end the 

backlog by 2015, which, if the VA stays on the current pace, the 

backlog would end November 2, 2015. So you will be cutting it pretty close. 

Now, we can talk about increases in spending for VA until we 

are blue in the face with no results. We are just wasting time and 

resources. When it comes to wasting resources in the current budget climate, I can’t tell you how frustrated and disappointed I am 

and all of us are with the electronic health record program. 

Mr. Secretary, I hope that this new path that you and Secretary 

Hagel are going down will have some results, and I look forward 

to an update on this issue. 

When I talk to veterans, their number one issue is always VA 

claims, and the number one issue being worked by my constituent 

services staff in Georgia is VA claims. The veterans in my district 

are growing impatient, and so am I. 

But today is a very important hearing. I know I speak for all of 

my colleagues as well as for you, Mr. Secretary, when I say how 

frustrated we all are with the situation. 

I know this is a problem that won’t be fixed overnight, but it is 

my hope today that we can focus on how we can fix the problem 
4

together and quickly, not just for the veterans waiting today, but 

for the future generations of veterans to come. 

So, Mr. Chairman, I thank you for the opportunity to share my 

concerns. And I yield back and looked forward to hearing from our 

witness.

Mr. CULBERSON. Thank you, Mr. Bishop. 

It is our privilege to recognize you, Mr. Secretary. And, of course, 

your written statement will be entered into the record in its entirety. And we welcome you today, sir, and any summary of your 

testimony that you would like to do, sir. 

OPENING STATEMENT OF SECRETARY SHINSEKI

Secretary SHINSEKI. Okay. Well, thank you, Chairman Culberson, Ranking Member Bishop, Ranking Member Lowey, other distinguished members of the Subcommittee. 

Thank you for this opportunity to present the President’s 2015 

budget and 2016 advance appropriations requests for the Department of Veterans Affairs. 

I am now working my sixth budget cycle, Mr. Chairman, and I 

always say my thanks to the members of this committee. I deeply 

appreciate your unwavering support for veterans and all the help 

you have provided us over the years to get our programs right for 

them.

I want to also acknowledge representatives of our Veterans Service Organizations who are present here in the room today. Their 

insights and support have been very helpful to me personally over 

the past 5 years. They have been helpful in enabling us to craft 

programs that better care for, better support, our veterans, their 

families, and survivors. 

Mr. Chairman, thanks for introducing the members of the panel 

sitting here with me today. I also have a written statement which 

I ask to be submitted for the record. 

Mr. CULBERSON. Without objection. It will be submitted for the 

record.

Secretary SHINSEKI. Thank you, Mr. Chairman. 

The fiscal year 2015 budget and 2016 advance appropriations request demonstrate once again President Obama’s steadfast commitment to our Nation’s veterans. 

His leadership, the support of the Congress, especially the members of this Subcommittee, and the insights of the Veterans Service 

Organizations I just referred to have allowed us for 5 years now 

to answer President Lincoln’s charge from 149 years ago when he 

asked the American people to care for those who shall have borne 

the battle and for their families and survivors. 

I thank the Members again for your commitment to veterans, 

and I seek once again your support of these budget requests. 

The President’s vision reflected in these budget requests is about 

empowering veterans to help lead the rebuilding of the middle class 

in this country, much as they did following World War II, through 

access to quality health care, to benefits, to education and training 

and employment opportunities that enable achieving the American 

dream.

VA’s 2015 budget request seeks $163.9 billion. $68.4 billion of 

that amount is in discretionary funding, including medical care col-
5

lections, an increase of 3 percent above our 2014 enacted funding 

level, and $95.6 billion goes to mandatory funding. This budget also requests $58.7 billion for the fiscal year 2016 advance appropriations for medical care, an increase of $2.7 billion, 

Mr. Chairman, as you reflected, or 4.7 percent above the 2015 

budget request we are submitting. 

This is another strong budget, and your support of it is critical 

to our providing veterans the care and benefits they have earned 

through their service and sacrifice. It will enable VA to further the 

three key priorities that we have had now for 5 years. They have 

been the same three: Expanding veterans’ access to benefits and 

services, eliminating the disability claims backlog in 2015, and ending the rescue of homeless veterans in 2015 as well. 

Since 2009, we have focused the resources you have provided to 

address these three key priorities, not just these three, but primarily and heavily underwriting these three to best serve veterans. 

In terms of access, more than 2 million additional veterans have 

enrolled in VA health care. We opened our 151st VA Medical Center, the first in 17 years, and we have increased our communitybased outpatient clinics by a net total of 55, bringing our total 

CBOC count to 820. 

More than a million veteran and family member students have 

received educational assistance and vocational training. Nearly 90 

percent of all veterans now have a burial option within 75 miles 

of where they live, and we expect to increase that to roughly 96 

percent by 2017. 

In terms of disability claims, the backlog has declined over 40 

percent in the past 12 months. We are transitioning from paper to 

digital processing, and we are on track to end the backlog next 

year, in 2015. 

In terms of veterans’ homelessness, the estimated number of 

homeless veterans fell by 24 percent between 2010 and 2013, and 

we expect another reduction when this year’s point-in-time count, 

which was just conducted in January, is tallied. 

These are some of the key accomplishments that we have reported. Momentum is up. We are making good progress across the 

board.

We will continue to leverage every resource in these budget requests to do what is right for veterans and, as we have for 5 years 

now, I assure you that we will use these resources that Congress 

provides effectively, efficiently and accountably, for the best care 

for our veterans. 

Again, Mr. Chairman, thank you for the opportunity to appear 

here today, and we look toward to your questions. 

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ENDING THE BACKLOG BY 2015

Mr. CULBERSON. Thank you very much, Mr. Secretary. 

We realize you have responded to the concerns of the Congress 

and the veterans service organizations in doing what you can to 

deal with the continuing backlog, but it is, as everyone in the Committee has said, inexcusable, a deep source of concern. And I want 

to focus first on that. 

I know that you have increased automation. You have done additional training, overtime, shifting staff from other areas to claims 

processing, brokering of claims, et cetera. 

But even with all this effort, it is difficult to see how it is going 

to be possible for you to make your target of ending the backlog by 

the end of 2015 because, at the end of fiscal year 2013, September 

30, you still had 59 percent of the disability claims inventory in 

backlog.

And we note that that 59 percent number is virtually unchanged 

in this week’s Monday morning report. Nearly 6 months have gone 

by and you are still at about 59 percent. 

But the goal you have set is to reach 50 percent of ending the 

backlog for fiscal year 2014, and that is just a short time away, the 

end of fiscal year 2014. 

And then to have no backlog by the end of 2015. 

But at that rate, I don’t see how that can happen when you have 

got a slow creep downward in that measure. It just seems unrealistic.

How do you expect to be able to drop from half the cases being 

in the backlog to no backlog in the course of a year when the 

progress so far has been so slow and so halting? What is going to 

be done differently? 

Secretary SHINSEKI. Mr. Chairman, let me begin by saying no 

veteran should have to wait for the benefits they have earned, and 

that has been our commitment now for my 5 years here. And 5 

years ago we committed to ending the backlog in 2015. 

We have briefed the Congress on our plan to do that, and you 

have been very generous in supporting us. At the same time that 

we committed to ending the backlog, we also looked at unfinished 

business from previous wars. 

48 years ago, Vietnam, we had veterans who had never been 

given eligibility to file a claim. 20 years ago, Desert Storm, again, 

veterans who were not eligible to file a claim because service connection was not granted. 

Combat PTSD. For as long as we have had combat, PTSD has 

been a fact of life. We called it by different names. Today we recognize it and we discuss it openly, where in times past we weren’t 

willing to do that. 

For those veterans who have been dealing with PTSD for decades, we took the step of granting them service connection if they 

had been in combat and they had medically verifiable PTSD. This 

is called the access. So when you grant those opportunities, you expect the claims will be submitted, and they were. 

For Agent Orange alone, almost overnight 260,000 claims were 

added to the inventory. All told, as we look back, over a million vet-
31

erans were able to submit disability claims, where 5 years ago they 

were not eligible. 

When we briefed our plan to do this and said that we would expect that this growth and increase would occur up to 2013, the 

high-water mark would be hit in 2013, we couldn’t predict exactly 

when in 2013 it would occur. But, in fact, we were pretty sure that 

we were going to hit a high-water mark and things would then 

begin to recede. 

We also knew that it gave us 3 years to develop an automation 

tool that we did not have 3 years ago. It is called the Veterans Benefits Management System. It took us 3 years to design, develop, 

test, pilot, and then field it. 

We committed to fielding that automation tool before 31 December 2013 and, in fact, finished fielding it 6 months ahead of schedule, a large program. In June 2013, all 56 of Secretary Hickey’s regional offices were fielded with this program. 

The high-water mark occurred on 25 March 2013, 611,000 

claims. That has dropped by 43 percent in the last 12 months. And 

we have essentially 18 months to go. And I understand your concerns. I would also tell you I think we are in a good position to deliver on our promise. 

Mr. CULBERSON. My question is, sir we all agree with you in your 

commitment. We know your service to the country, and God bless 

you for it and to the veterans. 

We know about the surge where that has come from. And as Ms. 

Lowey and Mr. Bishop pointed out, you are going to see even more 

of an increase as folks leave the military. 

My question really is: What are you going to do differently in the 

months ahead? The Committee will probably be thinking about 

some creative techniques to help you reach your goal because we 

are deeply concerned. It is only 20 months until December 31, 

2015. What are you going to do differently? 

Secretary SHINSEKI. I would like to check numbers with you 

here. But we have, by our count, 43 percent reduction in the last 

12 months, and we think we have enough time. 

Now, I would also agree that very recently DOD has announced 

this plan to downsize. We work with DOD, and we are looking forward to having a plan from them that shows rate, time, and date 

at which they will be downsizing. 

Mr. CULBERSON. So you got a whole new surge of folks coming 

into the VA system. 

Secretary SHINSEKI. And we will have to calculate that. 5 years 

ago, when we put out our plan—the downsizing aspect of this is 

rather recent. We will have to adjust. 

Mr. CULBERSON. What will you do differently in the future to 

make sure that you hit your target? 

Secretary SHINSEKI. We expect that VBMS, the automation tool 

that has been fielded—and we are in this transition year going 

from paper to digits—that we are going to get significant lift from 

that investment this year. 

Mr. CULBERSON. What kind of lift? 

Secretary SHINSEKI. We have some estimates that I am happy to 

share with you. I will provide that for the record. 

[The information follows:] 
32

VA anticipates a 3–5 percent increase in production in FY 2014 over FY 2013 

based on technology improvements. VBMS is the largest single technology initiative 

in VBA in FY 2014. 

Mr. CULBERSON. I am just looking for you to give us some encouragement because, truly, we are going to need to come up with 

some creative mechanisms, this year to help encourage the VA to 

hit your mark. Thank you very much. 

I am going turn to Mr. Bishop. 

Mr. BISHOP. I yield to Mrs. Lowey. 

Mr. CULBERSON. I am quite sorry about that, Mrs. Lowey. 

Mrs. LOWEY. You don’t have to be sorry at all, and I appreciate 

your consideration. 

I have been very concerned for a long time about our veterans 

who come home and have real issues with mental health. It is such 

a serious issue. There have been numerous articles detailing the 

escalating problems for those veterans, to include an increased 

number of suicides. 

VA HELPING VETERANS WITH MENTAL ILLNESS

If you could share with us how the VA is helping veterans who 

are suffering from mental illness, how many cases of post-traumatic stress have been reported among women. And are there any 

special programs tailored towards our female veterans? 

We are well aware that the treatment of PTSD can take a substantial amount of time and support by the family members. And 

what programs are available for family members of veterans who 

are diagnosed with PTSD? And how many veterans who committed 

suicide in 2013 can be traced to PTSD? 

Thank you. 

Secretary SHINSEKI. Congresswoman, let me begin with just talking about mental health in particular. And then I will call on Dr. 

Petzel to address the suicide-PTSD-specific issues. 

I agree we have a large and growing set of responsibilities here 

in the mental health arena. We have been at war for 10 years. 

That is the longest war in our history. We are also conducting 

these operations with a small professional force which requires repeated redeployments. 

We ought to all be very proud of the youngsters who have out 

carried these missions. We have asked a lot of them. They haven’t 

wobbled. They haven’t complained. And now it is our obligation to 

make sure we take care of them. So I share those concerns with 

you.

I would also say, between 2009 and 2014, our mental health 

budget was increased by 61 percent through the support of this 

Committee. This year alone for mental health overall, there is 

about $7 billion that we are putting into this. 

We are sensitive to this and watching. And where we are not 

having the access numbers that we would like to see, then we adjust and hire more people. And we just went through that here last 

year. So I would offer to you that we are sensitive to this. 

And in the specific areas of suicides and PTSD, let me call on Dr. 

Petzel.

Dr. PETZEL. Thank you, Mr. Secretary. 
33

Congresswoman Lowey, the prevalence of suicide is a national 

tragedy. The fact that there is one individual who served our country, was in conflict, and then finds themselves unable to continue 

living their life and takes their life is a tragedy. And we believe 

strongly that we have an obligation to provide the kinds of services 

that will prevent this from happening in the future. 

As the Secretary said, we are spending almost $7 billion in 2015 

on mental health services, much of it devoted to suicide. We have 

suicide prevention coordinators at each one of our medical centers 

and large clinics. We case-manage every individual that we identify 

as being at risk for suicide. 

All patients that come to us for health care are screened for suicidal ideation and for the antecedents of suicide: Depression, substance misuse, chemical dependency, PTSD, sleep disorders, and 

pain management. Those are things that we frequently find in our 

population preceded an attempt to take one’s life. 

There is good evidence that, when people are under our care and 

we are able to reach them, that we can reduce the rates of selfharm, the rates of repeated attempts at suicide are decreased, the 

rates of suicide in that population of people are reduced. 

So our biggest obligation to these veterans is to reach out to 

them and to bring them into our system. We are not seeing everybody that is eligible. We are not seeing everybody that needs our 

care.

So we are spending a tremendous amount of effort to reach out 

to these veterans and to their families to bring them under care because there is, again, just to reiterate it, evidence that, when we 

treat, people do get better. 

The other thing that you mentioned was PTSD. And, as I said 

before, it is an antecedent of suicide. There is a tremendous 

amount of research money being devoted to looking at, again, the 

causes, being able to identify, again, the antecedents of PTSD. 

VA and DOD have combined to put $25 million apiece into a 

PTSD research consortium, as well as a TBI research consortium. 

We are going to be spending probably $30 million in our own research budget looking at issues related to PTSD in 2015. 

We are absolutely committed. This is something that we are 

international experts in, and we are determined to get better at 

identifying it and at treating it. 

Mrs. LOWEY. Thank you, Mr. Chairman. 

Mr. CULBERSON. Thank you very much. 

We are going to do our best. Normally, I allow folks plenty of 

extra time, but let’s try, if we could, to stick to the 5-minute rule 

today so we can get everybody out in time to catch their airplanes. 

At this time we go to Mr. Fortenberry. 

Mr. FORTENBERRY. Thank you, Mr. Chairman. 

Mr. Secretary, welcome and thank you for your commitment and 

service to our Nation’s veterans. We all obviously agree that they 

deserve all of our highest commitment and highest level of quality 

services, given the extraordinary sacrifices that they and their families have made. So I want to thank you and welcome you all. 
34

CREATIVE OPTIONS FOR CONSTRUCTION

Let me turn quickly to some questions I have, the first regarding 

construction. We use lease-back arrangements for the construction 

of clinics, but why not hospitals? 

Why can we use a finance program with a lease-back arrangement—effectively, a finance program through lease-back for the 

construction of smaller clinics, but not large construction projects? 

If we don’t do this, the problem is the opportunity cost of waiting—for instance, in Omaha, as you are quite aware, we are on the 

list for a new hospital. The operating rooms were shut down a little 

while back because of problems. So, thankfully, we are on the list 

for new construction, but the potential for that to come in the near 

term is more and more limited. 

There are other creative options out there for getting this done 

quicker, which we do use on a smaller scale. Somebody has made 

a decision along the way—and I would like to understand why— 

why we do not apply the same finance model to larger construction 

projects.

Secretary SHINSEKI. That is a fair question, Congressman. 

And on this particular point, why we couldn’t use the same 

model for major construction, I think it is in the law, and I would 

have to do a little more research. 

But this is a key significant difference, that for major construction, we are required to set the money aside up front and fund the 

entire project. 

Our challenge has been that there is—you know, the amount of 

resources available. We prioritize what we go to work on, and we 

put safety at the very top. We put security in the next spot. 

And I would say the third place goes to taking care of what we 

have. So wherever veterans are being seen, they are being seen in 

an environment that is, you know, respectful. 

And then new construction where we don’t have a capability becomes part of that discussion. Now, these are not absolutes. I 

mean, there is some blending here. But, overall, those are the general priorities. 

Mr. FORTENBERRY. Of course, you are sharing the goal of getting 

highest quality level of service to veterans as quickly as possible. 

And somewhere along the way a distinction was made between a 

smaller construction project, which, apparently, qualifies for creative financing, versus larger types of projects. 

I am just trying to figure out if that is somebody else’s decision 

a long time ago that no longer makes sense, that can we potentially 

set up new forms of financing arrangement that would allow the 

private sector to develop this with a guarantee of payment from the 

government, again, like the clinic model or smaller institutional 

models, and rapidly clear out the building of inventory of need that 

you have for new construction facilities without exposing the budget in the long term to significant increases because of the potential 

problems with the client. 

Obviously, the government is a stable client and is going to be 

in a pretty good position to guarantee lease payment. So it makes 

sense to me—well, given our time is short, tell me a pathway in 

which we can explore changing this, potentially. 
35

Secretary SHINSEKI. I will be happy to work with you on that. In 

a previous life, in a similar situation, when one of the services had 

family housing issues and, similarly, not enough funding to cover 

it, we created an opportunity. So there is some history here. 

Mr. FORTENBERRY. That is another precedent out there. That is 

exactly right. Military housing. Same issue. 

CONSEQUENCES OF CLAIMS WORKLOAD SHIFTS

The second question is: Regarding the backlog of VA claims, as 

you are potentially aware, Nebraska has done an extraordinary job. 

In fact, I think we are one of the best outcomes in the Nation. So 

what that has meant is that more and more work is shifting to Nebraska.

So there is some concerns that—obviously, we have the magnanimity of spirit to want to help out, but don’t want to be penalized, 

our own veterans from our own state, by being forced further back 

in the line because we are trying to bail out other systems that 

aren’t operating as effectively as ours. So I want to bring that concern to you. 

I’m done. I’ve got the hook. 

Thank you, Mr. Secretary. 

Mr. CULBERSON. We will get back to you, if we can, but we have 

got folks trying to catch airplanes. Forgive me. 

Mr. Bishop. 

Mr. BISHOP. Thank you very much. 

SEGMENTED LANES CONCEPT

Mr. Secretary, the VA’s strategic plan to eliminate the compensation claims backlog talks about teams working together on one of 

three segmented lanes: Express, special ops or core. 

In the plan, it states that the VBA projects that segmented lanes 

can accelerate 350,000 express claims from 262 days to completion 

to 80 days, a reduction of 182 days, reducing the average days to 

complete for all claims by 54 days. 

How many of the regional offices are currently using the segmented lanes structure? And what results are you seeing from utilizing this initiative? 

Secretary SHINSEKI. Under Secretary Hickey. 

Ms. HICKEY. Thank you, Congressman Bishop. 

100 percent is the quick and simple answer. In fact, we went into 

those segmented lanes a full 9 months ahead of schedule because 

we had done it in about six stations and we saw immediate results 

with those segmented work lanes. 

I have subsequently taken and put fully developed claims as another way to speed up our claims. And those are also now going 

into express lanes and getting some priority because they take less 

time to do. 

I acknowledge the help of our Veterans Service Organizations in 

this: We have gone from 3 percent this time last year of fully developed claims in our system to now more than 28 percent fully developed claims in our system. 

And they are going substantially faster. The average days to 

complete those is 140 days, and they are getting done quicker at 

a high-quality answer. 
36

I can tell you that the people who are working in those segmented claims lanes are hardworking VBA employees, 52 percent 

of whom are veterans themselves, many more a direct family member of a veteran, and more are service member family members 

who come to work with us every day. 

They really do care about doing a great job, and they have. We 

did 1.17 million claims last year, the highest ever in our history at 

VBA, and we are on track to meet the 1.3 million claims that we 

will do this year. So that is part of how we will make the 2015 

numbers in the future. 

We are producing more and we are producing them at a higher 

quality as well, a full 7 percent age points higher than 2011 at the 

claim level, meaning above 90 percent now in our accuracy rates 

at the claim level, and 96.7 percent at the medical issue level as 

well.

So many things are going on, but, most important, is continued 

IT support. 

Mr. BISHOP. Thank you. 

THE VBMS SYSTEM

Last year we also discussed the benefits of the VBMS system, 

which you believe will transition the VA from paper to electronic 

claims.

I just want to confirm that the VBMS is currently in every regional office. Is that correct? 

Ms. HICKEY. Yes, Congressman. VBMS is fully deployed 6 

months early. We just this weekend did another release of a new 

enhancement, new upgrades, that we are doing on an every-12- 

week cycle. And we are adding more and more functionality every 

12 weeks. 

Mr. BISHOP. What is the current percentage of claims that are 

filed on paper? How many have been processed using the VBMS? 

And how long will it take for us to see the tangible progress on reducing the backlog using the VBMS? 

Ms. HICKEY. Congressman, we have 84.5 percent of our claims 

that are now electronically scanned into VBMS, nearly a billion 

pieces of mail that have been turned into digits that are now in the 

system that we are avoiding having to move—— 

Mr. BISHOP. You say a ‘‘billion’’ or a ‘‘million’’? 

Ms. HICKEY. A ‘‘billion.’’ Nearly a billion pieces of paper we have 

turned into digits. 

Mr. BISHOP. With a ‘‘B.’’ All right. 

Ms. HICKEY. We have, of our inventory, less than 100,000 claims 

in the entire system of the 623,000 that are still in paper. 

So we are predominantly now moving more and more into the 

electronic environment, leveraging the tools and the IT. 

Mr. BISHOP. You are making substantial progress. 

Ms. HICKEY. We are making substantial progress. 

INCREMENTAL VERIFICATION OF CLAIMS

Mr. BISHOP. The average number of claimed conditions for recently separated service members is now in the 12 to 16 range, 

which is an increase in the number of disabilities claimed by veterans from earlier eras. 
37

Do claims processors have to have all of the claimed conditions 

verified before a claim can be processed or do you now—as conditions are verified, you work on that claim as the conditions are 

verified and approve the various individual claims within a veteran’s package? 

Ms. HICKEY. Congressman, that is our intention in 2015 and beyond, to have the functionality to be able to do that, hence the reason our IT budget is so critical for this budget, because that will 

help us do some of the rules. 

Now, I will tell you, if you are watching a very specific number 

in a backlog and you don’t do every medical condition in that claim, 

it will not come out of backlog. So we will have to have a different 

discussion around how we measure the metrics. 

Mr. BISHOP. I am sorry. But I thought I understood from some 

earlier conversations that, because of the multiple claims, in order 

to accelerate the backlog and to service the veterans, that if you 

had all of the information for one of the claims, although you didn’t 

have it for the other nine or ten, that you would go ahead and process that one. 

Ms. HICKEY. We do about 10 percent of those today, and we try 

to if we need to move that forward. But we need to get fully 

through all the paper and fully into the electronic system with all 

the automation to really leverage that strongly. But that is our intention. That is our vision. 

Mr. BISHOP. Okay. I thought I was giving you a softball question. 

Mr. CULBERSON. Mr. Graves. We are just working out who got 

here first and who’s got airplanes. 

Mr. GRAVES. Spirit of cooperation. 

Thank you, Mr. Chairman. 

And thank each of you for being here. And I want to thank you 

for the undertaking that you have committed to take on. And I 

know it has got to be difficult. And I see the progress that has been 

made with the backlog issue. 

And I know your history and service to our country, Secretary, 

and I want to thank you for that. 

And I imagine there is no one at that table that more desires to 

serve our veterans than you, and I want to thank you for that and 

your commitment over the many budget cycles to come back each 

time and address this very, very important issue. 

HOLDING EMPLOYEES ACCOUNTABLE

Before I ask you about the backlogs, I wanted to address a question that was asked to Mr. Petzel previously in another hearing, 

and it was at the Veterans Affairs Subcommittee on Health hearing.

And it was Dr. Dan Benishek, you might remember, who asked 

you a question about—to provide a list of everything that the VA 

has done to hold employees accountable in response to the preventable veterans’ deaths in Pittsburgh, Augusta, Memphis and Atlanta.

Has that report been provided to Dr. Benishek yet or the committee?
38

Dr. PETZEL. Congressman Graves, I can’t tell you. I don’t know 

whether it has or not, and I will certainly find out as soon as I get 

back.

Mr. GRAVES. Okay. That would be great. And, one, if it hasn’t, 

I hope that you provide that report soon. And maybe you could include this Committee as well. 

I know there are many members of this Committee that would 

have an interest in the progress that has been—or the report, what 

it provides. 

But maybe you could tell the Committee a little bit what has 

been done, if you know some of it, prior to the report being released.

Dr. PETZEL. Yes, I would, Congressman. 

The VA takes this issue of accountability very seriously. We hire 

people. We train them. We tell them what they are accountable to 

do. And when they don’t perform as they are supposed to or when 

they complete criminal acts or malfeasance, we do indeed hold 

them accountable. 

Last year over 3,000 employees were released from the VA, fired, 

in your terms. And in the previous year, more than 3,000 were. 

In addition to that, over the last 2 years, six senior executives 

have been removed from Federal service, as well as a number that 

have been seriously disciplined. 

There is, I think, good evidence that the VA does take the problem of holding people accountable very seriously and has demonstrated in the past that they indeed do that. 

Mr. GRAVES. And we can wait on the report. And I know that 

there is going to be limited time. Thank you for that brief synopsis. 

It is good to hear that accountability is taking place there, and we 

will look forward to a more full and thorough analysis. 

PERFORMANCE RATINGS

Along those lines, Mr. Secretary, it was reported that all but one 

of the VA senior executive service employees received a high performance rating in the fiscal year 2012. I am hearing some of the 

conversation today about the backlog and other concerns. 

Do you see that that was appropriate? Is that something that you 

are going to look to do? 

Secretary SHINSEKI. I am not familiar with that number. But I 

would reiterate, if we are talking about the backlog, Congressman, 

three decisions created this growth in claims. And the very people 

that you are asking me about are the people that are delivering, 

solving a problem. 

And the problem was, for years, since Vietnam, there are people 

who haven’t been recognized. We have now recognized them. We 

have to work it down. But veterans have been served. 

Mr. GRAVES. And that is a fair explanation. You are right. There 

has been tremendous progress made. 

Secretary SHINSEKI. In those cases where we have evidence that 

someone has not performed to our standards—and I come from a 

background where the institution has the responsibility to set very 

clear standards so people know what is expected of them—we have 

the responsibility to train them to those standards. 
39

If we haven’t done either one of those, it is hard to hold someone 

accountable. We are doing that now. We probably were not as 

strong in these areas as we should have been. 

We now have a formal training program, set clear standards, expect the leadership to motivate people to come to work and do their 

best every day. 

And when we have evidence that people are not meeting the 

standards or are doing things that are wrong, we have tools to take 

them out of position, and evidenced from Dr. Petzel, we do use 

them.

Mr. GRAVES. Thank you. 

And you have set a laudable goal as well, and we might point 

out 2015 to have the backlog cleared. 

DEFINITION OF BACKLOG

And, Mr. Chairman, if I could just ask the Secretary to maybe 

define what—I guess the backlog. 

When does that begin? What does that mean? Because maybe we 

are not clear on exactly what that definition is. 

Secretary SHINSEKI. This is an excellent question, Congressman. 

Five years ago we didn’t have a definition for a backlog. We had 

a large inventory of claims and our mission was to just do more 

claims better and reduce the numbers. It wasn’t good enough. 

So we defined the backlog as any claim over 125 days. It was a 

number that we picked because it was a stretch goal. We weren’t 

anywhere near meeting it. 125 days. No claim over 125 days. Not 

an average. 

So you don’t do 250 days and 1 day and you get the average of 

125. No claim over 125 days. And all of it done at 98 percent accuracy so we didn’t turn into a paper mill just ginning decisions. 

With those two factors, we took a look at how long it would take 

us to deal with the inventory we had then, knowing that we were 

going make those three big decisions I talked about that would 

grow this. And then we set our target on 2015. Very ambitious. 

We didn’t have an automation tool then. We had to design and 

develop it. And we thought we could do that. We have done it. We 

are on track so that, in 2015, when we say we have ended the 

backlog, there should be no claim over 125 days. And we track our 

accuracy here. 

I would also offer, Congressman, that when we hit 125/98 in 

2015 and we know that we can do that without fail, we can hit that 

number regularly, Secretary Hickey won’t want to hear this, but 

my push is going to be, ‘‘What is wrong with 110?’’ 

I mean, our mission is to get, as I said earlier, high-quality decisions on benefits and services veterans have earned. So we have a 

requirement to do that as quickly as possible. 

The minute I say 100 days, there is going to be another backlog, 

and you’ll be asking me why. I will tell you it is because we will 

have made the right decisions. Our business here is to take care 

of veterans. 

And I don’t want VA to be in a position sometime down the road 

to shy from making those decisions that benefit veterans because 

we are afraid of dealing with the backlog. Our job is to take care 

of veterans. 
40

Mr. CULBERSON. Thank you, Mr. Secretary. If I could recognize 

Dr. Price. 

MOTIVATING THE WORKFORCE

Mr. PRICE. Thank you, Mr. Chairman. 

Mr. Secretary, I want to ask you what may seem like an unusual 

question, but it is one I have been thinking about for quite a while. 

And, actually, you set it up somewhat in your answer to the last 

question.

I want to ask you to reflect a bit on how to motivate a workforce, 

how to bring forth their best performance. You have a lot of background in that. You have spent a career motivating the men and 

women in the military, and now you are doing the same thing in 

a large Federal department. 

As I understand the tools of management, they are both positive 

and negative, high expectations, pressures, accountability, but, 

also, appreciation for hard work, rewards for a job well done. It is 

a familiar mix, although not always skillfully applied. 

I have to tell you I have watched with some dismay and puzzlement at how we have handled this backlog from the congressional 

side. I sometimes wonder what view my colleagues have of human 

psychology. How do they think management works? 

It has just been so relentlessly negative. How can you bring forth 

good results in dealing with a complicated backbreaking task? 

There has certainly been a lot of criticism, even berating of personnel, usually referred to as bureaucrats. There is much talk of 

demands and pressures and all of this in a context that arguably 

has denigrated public service. 

I am talking about repeated pay freezes. I am talking about benefit reductions for Federal employees. And then I am talking about 

the shutdown. That damaged government performance in so many 

ways, but especially on a critical crash program like reducing the 

backlog.

You haven’t complained a lot about what the shutdown did to 

you, but I can’t imagine it helped. In fact, I can’t imagine that it 

wasn’t a major factor that you had to overcome. 

So under the circumstances, I don’t think it is too surprising that 

the VA has a morale challenge. You rank 14th, as you know, out 

of 19 Federal departments and agencies. Honestly, I am surprised 

it is not lower. 

But it does raise the question with which I began: How, as an 

experienced and skilled administrator, do you develop the mix of 

pressures and rewards, blame and praise, to get optimal performance out of your workforce? How do you do it? How do you raise 

morale? How do you sustain a sense of positive engagement, teamwork, to get this job done? 

I assume that is more effective than constantly berating people. 

But I think maybe we all need a lesson in human psychology here. 

How do you get the most out of a workforce to get a complicated 

job done? 

Mr. CULBERSON. Superb question, and I would like to second. 

Do you have the authority to give bonuses where somebody exceeds expectations, for example? 
41

Secretary SHINSEKI. We do have the authority to provide performance awards. And I think, as the chairman knows, performance awards are part of the compensation plan for all Federal 

workers. It begins for us with hiring the right person to begin with; 

so, we are very diligent. 

We do ask a lot of our workforce. And right now the hardest 

working folks, perhaps, are in the benefits administration, where 

they are working overtime—and I do mean overtime—to drive 

those backlog numbers down. 

And then the responsibility is to grow a sense of teamwork in an 

organization. And that begins with growing trust amongst all of the 

participants, trust, worker to worker, trust between leader and led, 

and trust within the administrations of this organization. 

5 years ago we were very siloed, very stove piped. Today we are 

much more a single department because of the work that goes on, 

without any effort on my part, across the department. 

Day to day it is assuring people that success in leadership is 

about making them successful, and part of making them successful 

is making sure they understand what it is we expect them to do, 

so it is clear, there are no question marks, and then training them 

to do those tasks and then expecting them to come to work every 

day to excel at doing that. 

Leadership has to be involved. You can’t sit in your office. You 

have to walk the hallways. You have to make corrections as well 

as compliment people who are doing good work. It is all the tasks 

of hands-on leadership that comes with this. At the end of the day, 

you say thank you to folks. 

My great challenge—and this is something we focus on every day 

in this leadership team—the big challenge for us, as Congressman 

Price has indicated, is making sure people—their morale is such 

that they do come to work every day. At times, we ask a lot of 

them, and they never fail to deliver. 

These numbers, the 40 percent decrease, Mr. Chairman, is why 

I am so confident that they are going to deliver for us in 2015. 

This is not about technology, although they deserve the best tools 

that we can provide. And they didn’t have them 5 years ago. They 

have got them now. 

About these tools, as powerful as they are—I come from a background where I had something to do with a great tank called the 

M1, best tank in the world. Even my Russian counterpart admitted 

that. The best attack helicopter in the world, I have some familiarity with that. 

But the fact is not one of those pieces of equipment turned itself 

on. That helicopter never lifted itself off the ground. That tank 

never shot itself in qualification gunnery. 

There was always some youngster at the controls who we trained 

to do what we expected, and then they outperformed all of our expectations. They shot better, farther, faster than even our books, 

firing tables, had asked. And that is why it was a great Army. 

And we intend to do the same kind of thing here. We have given 

the people in VBA a great tool, and we expect that they are going 

to turn this tool around and perform in a way that will make all 

of us proud. 

Mr. PRICE. Thank you. Thank you very much. 
42

Thank you, Mr. Chairman. 

Mr. CULBERSON. Mr. Rooney. 

Mr. ROONEY. Thank you, Mr. Chairman. 

General, again, I spoke with you last year. I am not really sure 

what the last questioner was referring to when he was alluding to 

what our responsibility here on this Committee is and your responsibility and the people that work for you’s responsibility is when it 

comes to serving our veterans. 

I can speak for myself. I am accountable every two years for a 

whole lot of veterans in South Central Florida that know that I am 

on this Committee and they are not always very happy with the 

results that we are all providing, collectively, we. 

So when it comes to how do you do your job, I think you were 

hired—as I think I said before, I am probably the only person up 

here that actually served under you in the Army—I think that you 

were hired because the administration believed that you could do 

this job, as I do. 

And, you know, with the things that you have said today, I 

mean, obviously, that is bearing out. But let’s make no mistake. 

Our constituents, my constituents, are not collectively happy with 

the job that we are all doing as a group here trying to serve them, 

yet.

I think that we are moving in the right direction, so much so 

that we are kind of the butt of the jokes. We are repeatedly on the 

Daily Show and, believe me, people use that as a news source. So 

if you could go back on there, by the way, and revisit some of the 

things that he said, that would be helpful. 

CONTINUITY OF SERVICES BETWEEN DOD AND VA

But I want to talk about something else that I hear a lot back 

home, and that deals with the continuity of services between DOD 

and the VA, as you have been somebody who has served in both. 

And I talked a little bit about this last year. 

What is the status when it comes to somebody who enlists or is 

commissioned, gets out of the military, gets a disability in the VA? 

What is the breakdown? Why is there a breakdown? 

Because I can’t keep going home saying, you know, ‘‘When you 

all get out of the Army and then you have a disability and you go 

in the VA, it is like a different system. There are different computer systems or something like that.’’ That is just maddening. Are 

we any closer to making that a more seamless transition? 

Secretary SHINSEKI. Congressman, a lot has been done and a lot 

more needs to be done. I would say today and 5 years ago, we have 

two separate electronic health records, both of them with varying 

qualities.

We happen to be very proud of ours. We feel that, in 1997—and 

you hear often that technology turns every 18 months and, in some 

cases, some of it turns even faster, 9 months. 

So here you have an electronic health record that has been in 

place since 1997 and it is still considered one of the best in the 

country, and we intend to upgrade it. 

DOD has its own electronic health record, but they also have a 

mission to deploy medical capability overseas, life-saving procedures, medical evacuation. So the missions are slightly different. 
43

But today we have created a joint viewer that is able to pull data 

out of both databases and allow clinicians, whether VA or DOD clinician to be able to see the entire record and make decisions. Much 

better than 5 years ago, but still not good enough. 

Mr. ROONEY. Is it an ego thing between the two agencies? Or is 

there something we can try to do to change that? I mean, when we 

give these budget requests—or these appropriation requests, is 

there some kind of force of those requests that we can make either 

to DOD or to you to say this has got to be—this can’t—it has got 

to continue to keep getting better, but it has to be the same or 

similar enough that it is—— 

Secretary SHINSEKI. Sure. 

Mr. ROONEY [continuing]. Easily read. 

Secretary SHINSEKI. We started out a discussion with Secretary 

Gates, to see if we could get to a single, joint, common, integrated 

electronic health record. And that is what he and I pursued. We 

did this for several years with Secretary Panetta as well. 

When Secretary Hagel arrived, he looked at how he was structured to deliver on his half of this, and he wasn’t satisfied. And so 

he asked to take a pause, which he did. And then decided to pursue 

an acquisition strategy. 

We, on the other hand, have what we have. It is a great electronic health record. And we are evolving it from where it is today 

to a much more capable system. And that is what part of this budget request is about to unencumber some funds here that have been 

held from 2013 and 2014 budgets. 

We are on a complementary path. We are watching what he is 

doing in acquisition. And this is a discussion, ongoing discussion. 

As he declares requirements, if we don’t have the capability, we are 

going to include it in our electronic health record. So that as we 

get down to where they are ready to make a decision, 3, maybe 4 

years from now, we want our electronic health record to be competitive. And I have been assured by Secretary Hagel that we will 

be in the hunt. And that is why I need to get us moving. However 

it turns out, even if we get to the point they decide to select another commercial vendor, we have put our code, the MUMPS code 

from VistA, we put it in the commercial marketplace. Contractors 

are picking up on it, using it, and providing it as solutions in the 

competition for the DOD acquisition. 

I am hoping that we are good enough to win the competition. But 

even if we don’t, we are going to be so very close in interoperability 

it would be entirely seamless, and that is where we are both headed.

Mr. ROONEY. General, my time has expired, but I can tell you, 

this is a huge issue for people in my district when it comes to them 

leaving DOD and going into the VA. It doesn’t seem to be the same 

right now. And it has to be able to help with backlogs and everything if you can just basically log in the same Social Security number and have it all right there. So I appreciate your work on that. 

And I hope I have impressed upon you that it is an important—— 

Secretary SHINSEKI. You have. And I would add just one thing. 

So this is not just waiting for technology to deliver. Between DOD 

and VA, and Department of Labor as well, we have created a transition assistance program. You may be familiar with it. It is that 
44

last phase before the uniform comes off. It is a DOD program. VA 

and our benefits opportunities, the school opportunities for entrepreneurship for veterans who want to start their own businesses. 

We are integrated into that week. So we are doing the warm handoff, if you will, which is relatively new. We weren’t doing that 3 

years ago. We are doing it now. Just started in the last year. 

And part of that is an exit physical exam so that we have a baseline read on everyone’s medical condition, everyone, 100 percent of 

the folks leaving the military now. That is what we are doing between the two departments. We are underwriting a good portion of 

that.

Mr. ROONEY. Thank you, sir. 

Mr. CULBERSON. Thank you very much. 

I recognize the gentleman from Philadelphia, Mr. Fattah. 

Mr. FATTAH. General, good to see you again. And I want to thank 

you for your extraordinary public service. I also want to thank the 

President for all that has been done to help veterans. Every time 

I turn on the news, we see one of these young people coming home. 

And so the first thing that the administration has done is ended 

this war in Iraq so that our young people, rather than being killed 

and maimed, are coming home. And we see these celebrations all 

over the country. That adds to your caseload. 

But I think when we talk about the backlog, I want the public 

to know that every single veteran gets 5 years of health care while 

you are working through these various claims. There is nobody that 

is not being treated. Or not being helped. Is that correct? 

Secretary SHINSEKI. That is correct. 

Mr. FATTAH. So I think it is very important that the public understand what is going on here. 

BRAIN DISEASES

I met with your team around all of the brain-related diseases 

and disorders. And we got an extraordinary briefing about the 

great work that is being done. I want to say this is an area that 

I am very interested in and focused on. I know that the VA has 

been part of the interagency working group that I created with the 

language out of my other job as Ranking Member on Commerce, 

Justice, Science. The VA has played an extraordinary part with the 

recommendations about how we might deal with some of these 

brain-related diseases and disorders is very important. 

EPILEPSY CENTERS OF EXCELLENCE

And I am working with the Chairman of this subcommittee to 

make sure that the VA’s work—and that is why I want to focus my 

question—is as robust as possible. You are doing a lot of great 

work for over 6 million veterans. I just want to focus in just for the 

day on one area, that is the Epilepsy Centers of Excellence. This 

is something that has been remarkable inside the VA. There is an 

issue in the 2014 spend plan about whether we meant $6 or whether we meant $8 million. And there have been some efforts, particularly in the Chairman’s State, to expand in San Antonio on the epilepsy front. 

So it is my intention, General, to see that in 2015 that we are 

clear that we mean $8 million, not $6 million. I think that the 
45

staffing view of this is a little different. But I am going to work 

with the Chairman, because I would hate for us to have to retrench 

those efforts in Texas. This is very important. 

Epilepsy is not just an issue for the VA, it is an issue for the entire country. And the work you are doing is at the very cutting 

edge. So we don’t want any retreat, we don’t want to equivocate. 

I could talk to you about 100 other brain-related diseases and challenges. I just want to put this one on your mind. And remind you 

that, in addition to that, we are going to have the basketball, 

wheelchair championships in Philadelphia. I was at the VA on Valentine’s Day. I spent Valentine’s Day with our veterans at the VA 

Hospital in Philly. A lot of happy veterans. I didn’t find any complaints. And I know I talked to the veterans. And they believe they 

were getting excellent service at the hospital from your team. And, 

I also want to make sure you know that you are welcome to come 

and toss that ball up. 

Secretary SHINSEKI. Let me just ask Dr. Petzel to make a comment on the Epilepsy Centers. 

Dr. PETZEL. Thank you, Mr. Secretary, Congressman Fattah. I 

am familiar, very familiar with the specific example that you mentioned, broad epilepsy. 

Our veterans are really getting a particularly good deal, if you 

will, from the investments that have been made in neurosciences. 

I don’t think there is anybody in the country that invested as much 

research money particularly, but also patient care money in these 

specific Centers of Excellence. Amyotrophic lateral sclerosis, epilepsy, a number of other—— 

Mr. FATTAH. And you have got an MS process going on. You have 

a lot of great things going on. 

Dr. PETZEL. We do. 

Mr. FATTAH. The Chairman and I are going to work together. We 

are going to beef these up even more robustly. But go ahead. 

Dr. PETZEL. We think it is extremely important the veterans, 

again, that were returning with these neurologic injuries from conflicts, are presented with absolute best care that is available. And 

we do that in these Centers of Excellence. 

I would be happy to talk to you about epilepsy particularly. 

Mr. FATTAH. I thank you. Sam said that I was making sure that 

the chairman heard me. I know that the ranking member and 

Chairman are going to make these decisions. But there is one thing 

I am interested in is making sure that we get from $6 to $8 million 

on the Epilepsy Centers. So I am going to be aggressive and interested in this matter. Thank you. 

Mr. CULBERSON. What a privilege it is to work with you on the 

National Science Foundation, the CJS Subcommittee, to make sure 

we are also making those investments in the sciences end in addition to the work that you all are doing. 

Thank you. 

Mr. BISHOP. Would the gentleman yield? 

Mr. CULBERSON. Yes. 

Mr. BISHOP. I am certain all of us appreciate the great work that 

the gentleman from Pennsylvania does on behalf of veterans and 

for brain—— 

Mr. FATTAH. Thank you. 
46

Mr. BISHOP. Thank you, sir. 

Mr. CULBERSON. At this time, we recognize Ms. Roby. 

Mrs. ROBY. Thank you, Chairman. And thank you, Secretary 

Shinseki, for being here today, all of your support staff. We appreciate all of your service to our country and all the hard work and 

challenges that you have that clearly we all have recognized here 

today. But thank you again for your service. 

PATIENT CENTERED COMMUNITY CARE PROGRAM

I have been looking forward to this hearing for a while now. I 

am the newest member, one of the newest members of the Appropriations Committee. And it has been something that I have really 

been looking forward to have the opportunity to hear from you, Mr. 

Secretary, regarding the Patient Centered Community Care program, also known as PC3. 

This program is of great importance to me. And it is a new national program operated by the Veterans Health Administration 

that would allow veteran patients to seek care from community 

providers when the local VA medical center is not capable of providing timely care or adequate care. 

I have almost 70,000 veterans in my district, and I am all too 

familiar with the challenges and the frustrations our veterans face 

while seeking treatment from the VA. And so that is why I am cautiously optimistic that the PC3 program might mitigate some of the 

challenges inhibiting our veterans from receiving timely treatment. 

In recent conversations with veterans in my district, they are 

hopeful that the PC3 program will be successful. That being said, 

I think there needs to be more effort to ensure that veterans are 

aware of the program so that they can take advantage of it. 

Mr. Secretary, I have been tracking this program for some time, 

the last couple of months. And it has come to my attention that 

there may be some reluctance by some VA personnel to fully embrace the program. Would you please share with the committee 

what efforts are in place to ensure that all personal representing 

all aspects of the VA are dutifully embracing this program so that 

it has a chance to succeed? 

Secretary SHINSEKI. I am going to ask Dr. Petzel to comment on 

the implementation of PC3. 

PC3 is fact. We are going to do this. And Dr. Petzel is implementing it, and he can give you an update of where we are. 

Mrs. ROBY. That is great. Thank you. 

Dr. PETZEL. Thank you, Congresswoman Roby. The PC3 is designed to provide veterans, particularly in rural areas but veterans 

in other areas as well, with specialty care particularly in their communities when we are not able to, either in a timely fashion or a 

distance fashion—— 

Mrs. ROBY. Right. 

Dr. PETZEL [continuing]. To provide that. 

We have two contracts with two large networks, TriWest and 

Health Net, around the country. They have, in kind, developed networks of providers in the areas where they are responsible. Done 

this quite successfully, actually. 

Mrs. ROBY. And I—just because we have—we are so limited on 

time today. And I understand the successes. That is why I am ask-
47

ing this question, because I think that this program could really 

mitigate—we have talked about backlog and all of this. But veterans’ opportunities to have the appropriate treatment. 

What I want to know is what you guys are doing to help VA personnel embrace this, because we feel like there is some real 

pushback from those that are on VA’s payroll that are not embracing this, and it is going to prohibit this program from being the 

success that we think it can be. 

Secretary SHINSEKI. Congresswoman, I think anytime you initiate a new program, there is this, what you are referring to. Your 

insights are helpful. We will go redouble our efforts to make sure 

this decision is, in fact reinforced all the way down. We are going 

to do this. And it makes great sense. Earlier we had discussions 

about construction and—— 

Mrs. ROBY. Absolutely. This plays right into that. So. 

Secretary SHINSEKI. When we talk about access, we are talking 

brick and mortar because that is access. We are also talking about 

fee for non-VA care, having it available in the community. And PC3 

is part of that effort. 

We are also talking about State veterans homes. We finance 65 percent of the cost of those. And I think we are putting about $1 

billion into maintaining the veterans who are in those State veterans’ homes. So it is another aspect of access. But this PC3 is an 

important part of this. 

Mrs. ROBY. And you know the importance of leadership and that 

all these things start from the top. So I would just encourage you 

guys in your positions. And again, I appreciate the great challenges 

that you have. To the extent that I can. But just really want to encourage you to continue to push this program, because—— 

Secretary SHINSEKI. We will do that. 

Mrs. ROBY [continuing]. Representing very rural areas in my district and seeing how this program can be successful, I think it 

could be a really huge benefit to our veterans. 

RECRUITING PHYSICIANS

It appears to me that one of the contributing factors preventing 

veterans from receiving timely medical treatment is the VA’s inability to recruit and retain physicians. We have seen this again 

right in Alabama’s second district. Not only primary care physicians, but dentists as well. And one veteran recently said he loved 

his dentist at the VA but typically had to wait months for an appointment.

I am going to—my time—the red light is on, and there are others 

that are waiting to ask you questions. But I really would like to 

also address this issue. I think it is multifaceted in what some of 

the problems are in recruitment and retention. But, again, I will 

submit this to you in writing. But would like to continue to have 

this conversation. Again, thank you all for your service. 

And, Under Secretary Hickey, I appreciate your willingness to 

come and help brief the entire Alabama delegation in a couple of 

weeks. So I just appreciate all of your service. So thank you. 

Mr. CULBERSON. Thank you, Ms. Roby. 

I recognize my friend from California, Mr. Farr. 

Mr. FARR. Thank you very much, Mr. Chairman. 
48

Mr. Secretary, my army fellow is sitting behind you, engineering, 

not armament. But he is still appreciative of your remarks about 

the armament and capability of the soldiers and likes to see—we 

are both proud to see you here. 

I want to start off with some really thank you’s. First of all, I 

am grateful for your personal attention and hard work you have 

done in creating this joint VA–DOD clinic at the former Fort Ord. 

And it wouldn’t have happened without your personal involvement. 

I think you, better than anybody else, understand, the link between VA and DoD. It appears to me that Veterans’ Department 

is really standing up to its responsibility. And in this integration 

of records and everything has been more of a letdown by DOD. 

I think they care about the soldier up to the day they leave. And 

then, they have to realize that there is a big responsibility for them 

to also help with the transition in the VA. 

You know, we have also had workings with your department. 

State of California finally submitted a grant application for a State 

cemetery. And it is very complicated. California is a complicated 

State. But if it hadn’t been for your staff members and George 

Eisenbach and Tom Paquelet would have just—they really stepped 

in. And would you please give them my appreciation for their hard 

work? Been a great resource to us. 

VETERAN SUICIDE

If you average it out, over 1,000 people a day will transition from 

DOD to the VA. And it is a huge responsibility. And obviously with 

those that aren’t even transitioned, but coming home, we have a 

huge issue with suicides. 

And I just wondered. We have 22 veterans a day that are committing suicide. And we are going to be here for a couple hours. So 

just the time we are here, we will lose some lives. I know we all 

care about this. And I think we have a lot of reactive treatment 

and care. And probably not enough proactive treatment and analysis.

And I just wanted to share with you that the Army has set up 

a group in Monterey, with all the DOD data manpower, historically, not just presently, but historically that power is there. And 

this is the Army Analytics Group Research Facilitation Team. And 

essentially what they are is big data; smart people. 

And I wonder if they—if there might be ability for you to reach 

out with them as they analyze the ability to identify potential 

traits, both mental and physical, that could indicate a higher risk 

for suicide. They are doing this by analyzing all the DOD databases, following all the compliance with privacy regulations. 

So if you could just look at whether there might be an opportunity to develop a memorandum of understanding with DOD so 

the VA can utilize the Army Analytics Group Research Facilitation 

Team in Monterey to identify suicidal behavior and characteristics 

and trends in veterans, it might be helpful. 

Secretary SHINSEKI. Congressman, we will pick up on that. We 

have worked this very hard. And any opportunity for us to understand this complex issue better, we will pick up on that. 

Mr. FARR. I know how sincere you are about that, and I appreciate that very much. 
49

SERVICES TO RURAL VETERANS

You know, I have been doing a lot to focus services for veterans 

in rural areas. Most of my district is very rural. And even though 

we have got the clinic coming in, the major hospitals in Palo Alto, 

veterans have to go up there. It is far away, especially some of the 

towns in the rural part. Veterans feel like that is too far away, particularly trying to deal with the services. 

And one of the things that we asked you to do was give us a report on how you could better help veterans in rural areas, kind of 

underserved or not well served, or not best served. And I don’t 

know where the status of that report is. But I think there is also 

a question in there, a timeline for implementation of five new burial sites in rural locations. 

You know, the VA has established a 75-mile, I don’t know if you 

know this, Mr. Chairman, but 75-mile distance as a guidance that 

will not create any new cemeteries that are not—where there is an 

existing cemetery within a 75-mile circumference, as the crow flies. 

It is not a statutory provision. Congress didn’t order it. It is an administrative position. It can be waived. And the VA has waived the 

75-mile radius by creating urban columbarium programs in fiscal 

year 2011. That program was created. They didn’t come to Congress for that. They just did it. It serves the veterans in urban 

areas even though as we now know it, they still had an access to 

a cemetery served them within a 75-mile radius. 

So the question is, how can we use either waiver or ability to get 

more veterans cemetery services in the rural areas of America? I 

would like it if you could look into that. 

Mr. CULBERSON. We need to keep it as short as we can. Mr. 

Nunnelee needs to leave at 3:00. 

Mr. FARR. That is the end on that. I have other questions. If you 

have time, I will take them. 

Mr. CULBERSON. Mr. Nunnelee. 

Mr. NUNNELEE. Thank you, Mr. Chairman. I want to thank Mr. 

Valadao for yielding time. 

RELIGIOUS FREEDOM IN VA

Mr. Secretary, I know you are very much aware that your Department deals with individuals on some of the most difficult days 

of their life. You are dealing with teenagers, 20 year olds that have 

suffered very serious injuries trying to figure out how to go on with 

their lives, as well as 70-, 80-, 90-year-old World War II, Korean, 

Vietnam veterans that are dealing with serious illnesses at the end 

of their life. 

And for so many of these Americans and their families, their 

faith is an important part of their ability to deal with the situation 

in life that they found themselves. And I continue to see an outright hostile attitude, whether it is in the military or in the VA toward religion and religious freedom in general, and Christianity in 

particular.

I will just cite a couple of examples in the interest of time. I 

could cite more. Major Steven Firtko, U.S. Army, and Navy Lieutenant Commander Dan Klender filed a lawsuit against the VA. 

They claimed that their religious beliefs—they weren’t allowed to 
50

practice their religious beliefs or pray or read scripture at a San 

Diego clinic. 

The Alleluia Community School Choral group was told by administrators at the Charlie Norwood VA Medical Center Augusta, they 

couldn’t sing Christmas carols or religious songs when they visited 

the hospital. 

The Central Alabama Veterans Healthcare System in Montgomery refused to allow a young woman to distribute her handmade Christmas cards for veterans. 

And so I need to know, what are you and what is the administration doing to foster an atmosphere that allows people to exercise 

their constitutionally guaranteed right of freedom of religion? 

Secretary SHINSEKI. Congressman, what I would tell you is, 

Christmas is a Federal holiday. And we in VA observe it. There is 

no prohibition in VA for any of the things that you have described. 

Christmas cards, caroling. 

Mr. NUNNELEE. But these people were prohibited. 

Secretary SHINSEKI. Sometimes the actions of a few on the 

ground aren’t what we would like. And so then we get in there and 

make sure we take corrective action. 

I regret these things happened. But what I would tell you is 

there is no policy that denies this. 

What we do need to be better at is for all these volunteers, Veteran Service Organizations, individuals, other communities that 

want to support veterans, we need to be sure we accept their gifts 

and then distribute them in the appropriate manner. 

I think you would also understand we try to be sensitive to the 

fact that there are varying religious beliefs. And we try to get the 

right gifts to the right people, the right cards to the right people. 

And I think sometimes our execution of that gets a little fuzzy. We 

need to be better at it. We will. 

Mr. NUNNELEE. I will be submitting questions for the record. Because what we see time and time again when we ask about these 

issues in Committee, the answer we get from the various agencies, 

oh, that was an isolated incident, it won’t happen again. And it 

does happen again. And so I need to know what is being done, once 

these incidents happen, what is being done with the employees 

that cause them? And, secondly, what is being done to make sure 

they don’t happen again when you are back here this time next 

year.

Secretary SHINSEKI. I am happy to provide that for the record. 

[The information follows:] 
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Mr. NUNNELEE. Thank you. 

Thank you, Mr. Chairman. 

Mr. CULBERSON. A really important question, and I appreciate it. 

Mr. Farr, go back to you? Or Mr. Valadao. 

Mr. VALADAO. I would like to go if possible. 

Mr. CULBERSON. Thank you very much. Thank you for letting 

Mr. Nunnelee go first too. 

Thank you, Sam. 

UNDERPERFORMANCE AT OAKLAND REGIONAL OFFICE

Mr. VALADAO. Thank you, Mr. Chairman. Thank you Mr. Farr, 

for allowing me to cut in line a little bit. 

Mr. Shinseki, as you stated, one of the VA’s top goals is to eliminate the disability claims backlog by 2015. As I am sure you are 

aware, the problem with this backlog is particularly severe at the 

Oakland Regional Office, which serves the constituents in my district. One means to reduce the backlog that is being utilized by the 

VA is brokering the claims to other offices. By doing so, it seems 

as though we are shifting work off of underperforming services 

without addressing the underlying problem. What is the VA doing 

to address the underperformance of these offices? Or is there something different about these offices to make their claims backlog 

worse than other regional offices? 

Secretary SHINSEKI. We have done considerable work here, particularly with Oakland. 

Let me call on Under Secretary Hickey to review that with you. 

Mr. HICKEY. Congressman Valadao, thank you for the question. 

Let me just tell you very quickly, conditions have significantly 

improved in Oakland. The backlog is down 76 percent, a very significant number, from 28,000 down to 6,900. How did we do that? 

The same way that we are training every person who joins VA to 

do this very important work, many of them are veterans. 

We have a challenge training. Part of our budget, an important 

part of our budget, is a new training process over the last 3 years. 

We take and put every new person through that, where they are 

doing live cases, where they are doing it in a way that we have 

found, time and time and time again, is improving the both production and the quality of the outcome of those individuals. 

We went specifically into Oakland. And specifically at Oakland 

we took and stood, as you well know, the entire station down here 

about 2 years ago now, and retrained every single person there. 

And I can tell you, you can see that in the production by Oakland 

alone. Even without brokering, they have exceeded their claims 

production by 3,000 claims this year. Their quality is much higher 

than it has been. They are up over 90 percent, both claims and 

issues.

Mr. VALADAO. In January, the Oakland VA director, Douglas 

Bragg, retired. It is important to select a qualified director that is 

capable of addressing this issue. Where is the VA process of hiring 

a new director for the Oakland Regional Office? 

Ms. HICKEY. Congressman, I can tell you that the proposed candidate has gone through the initial hiring board selection process, 

is going through the approval processes, and then he will have to 

go through OPM for final approval. 
54

Mr. VALADAO. Okay. Well, I think that is all I have got. Thank 

you. I yield back. 

Mr. CULBERSON. Thank you, Mr. Valadao. 

INTEROPERABILITY OF THE ELECTRONIC HEALTH RECORDS

I wanted to ask, if I could, Mr. Secretary, about the electronic 

health record. In answer to a question from one of the other members, I thought I heard you say that in 3 to 5 years, you are going 

to be in the hunt to get a seamless transition. I hope I misunderstood.

Secretary SHINSEKI. I am speaking roughly here. Because DOD 

is following an acquisition path. And I am just guessing that in 

about 3 to 4 years, they will be making their decision on the record 

that they are going to select as theirs. 

In about 2 years, maybe 21⁄2 years, I think we can be at level 4, 

which would put us in a position to compete. That is what I would 

like to do. And try to keep us on track with getting a high degree 

of interoperability, if not a single record. 

Mr. CULBERSON. Well, if you could tell us a little bit more. I am 

happy for you to turn to the executive team, because a lot of the 

discussion of the VA budget describes how VistA will improve patient care, but neither the budget documents or the testimony 

today really gives us a whole lot of information on interoperability. 

Could you reassure the Committee that you guys will be able to be 

completely interoperable and get as seamless a transition as you 

can for these young men and women as they leave the Armed 

Forces to go into civilian life? 

Let me call on Mr. Warren, who is our technical expert here. 

Mr. WARREN. Thank you, Mr. Secretary, Mr. Culberson. Broad 

questions about interoperability and electronic record—— 

Mr. CULBERSON. Yes. And what we will be doing differently in 

the future to give us assurance that you will actually hit these targets.

Mr. WARREN. Glad to, sir. And if I could hit three key areas. 

One of the key goals we had set out, the Secretary had set out 

for us, was to take that electronic health record, and make it a veterans’. And so we talked about the Blue Button program, which allowed a veteran to download their electronic record, their personal 

health record, and take it to their physician and be able to take the 

information and use it. Done that as a single thing that they could 

take, the interoperability program, not just with DOD, also with 

third-party providers, is how do we do that securely, electronically? 

So as an example, Walgreen’s this year, if a veteran went in to 

get a flu shot, we now pick that information up in the VistA system 

so we can see that and continue driving those types of programs. 

We also have an exchange with the Indian Health Service, in 

terms of care given at their locations. The information flows into 

the VistA system, so we have that complete electronic health 

record.

On the DOD side, there is a lot of information that moved in the 

back office systems. But the Secretary already talked about the 

joint viewer, Janus, which allows the clinicians to see veteran data 

and service member data in the same view. So when they are in 

a care situation, the clinician can see VA data and DOD data in 
55

a way that is actionable. Same units, the ability to fire off opportunities. Yes, the blood level is this, we need to do something here. 

As well as starting to look at drug-drug interactions, third party, 

DOD, and VA. So how do we do that today? Janus does that. So 

the focus has been seamless interoperability of data. 

You had also touched on another area with my colleague, Under 

Secretary Hickey, in terms of moving that electronic health record 

through the Haims system. So now we are able to bring the data 

over electronically from our partners in DOD so it is part of the 

benefits determination process. 

A lot of work to move data, a lot of work to work together with 

our partners in DOD. That personal health record that the veteran 

can take, make that electronic and do it not just with DOD but 

third-party providers. Making sure the data is seen real-time, in 

the clinical setting, DOD data and VA data. 

As we continue to expand that, we need to evolve the VistA system. The more data that we share, the more stress we put on our 

back-end systems. Which is why your support to continue to evolve 

VistA so we can continue to support that high quality care that we 

give.

Hopefully, that answered your question, sir. 

Mr. CULBERSON. Yes, sir. Thank you. And we will have more follow-up for the record in detail. 

Mr. Farr. 

ADEQUATE IT FUNDING

Mr. FARR. Thank you very much, Mr. Chairman. I have just sort 

of a general question on all of this improvement of medical records 

and the Veterans Benefits Management System, the paperless system. And the question is, did OMB allow you sufficient funding in 

this year to make your goal? I think your goal is to have your IT 

capability operational, fully paperless by 2015. And you have indicated that if you do that, you can reduce the claim process to less 

than 125 days per claim. So it would meet those goals that you 

talked about. 

But do you have enough money to get there from here, for IT? 

Secretary SHINSEKI. Our 2015 budget request for IT, $3.9 billion, 

will cover that. But that was created before the DOD downsizing 

decision. So we are working closely with DOD, as we have been for 

3 years. Show us a plan so that we can ensure that we have both 

capability in terms of hardware and automation assets as well as 

people to be able to support them as they draw their forces down. 

They have a requirement to flow forces out. They have a set 

deadline when their strength levels must be at a certain number. 

If we are not able to process people out, they have trouble meeting that. So this is important for them from a readiness standpoint 

and important to us to get veterans into our system and being 

cared for. 

Mr. FARR. So I would imagine that today’s records, modern 

records, are much more complete for your purposes than the old 

records. So if these 1,000-plus people are going to be out every day, 

coming to you, isn’t this going to happen quickly in the next couple 

years? Are they listening to you? It sounds like you are way ahead, 
56

and we ought to do more in Congress to push DOD to help you because you can’t do anything without them having stuff ready. 

Secretary SHINSEKI. I worked this personally with both Secretary 

Hagel and Chairman Dempsey. They have been very supportive. 

They have had to wait to see what their budget numbers are 

going to be, and then write the plan to get their force structure to 

fit that budget. We are now in contact with them as they develop 

those numbers, that flow. We are to be able to tie ourselves into 

that plan. 

Mr. FARR. I am sure the chair would appreciate, and committee 

would appreciate, if tis anything we can do to push them a little 

bit more. Because essentially, they have got to pack the suitcase. 

And if it is not properly packed, the burden then falls on you. 

Secretary SHINSEKI. It has been an ongoing discussion for 3 

years. And they have been very cooperative. Now we are at the 

point wwe have got to put together hard plans. 

Mr. FARR. We have heard in the past that it hasn’t been the 

fact—I mean, that all the Secretaries have gotten together and 

made these agreements have been great. But it has been the trickle-down effect of that wthave been people in DOD who don’t want 

this to happen. Because they have got their vendors, they have got 

their way of doing it. And they are slowing down the change. So 

if tis anything we can do to help that our—in this Appropriations 

Committee and our other—you know, the defense side of it, let us 

know. We would be glad to push. 

Secretary SHINSEKI. Thank you. 

Mr. FARR. I don’t have any other questions. I would just like to 

say I am really proud of this Department. And I think, you know, 

we need to, in our whole discussion of military budgets, I think we 

need to start thinking about how VA and DOD are really one and 

the same and not—because those are big budgets. And we have got 

to run them just administratively smarter. And technology is probably the way to do it. But it also takes, intuition. 

Thank you for your service. 

Mr. CULBERSON. Thank you, Mr. Farr. 

You do indeed lead a wonderful team of people. And it is important for everyone in the VA that is listening and tracking this 

hearing to know how deeply we appreciate them. I do agree very 

much with Dr. Price, Mr. Farr’s statement that it is too often our 

concern about how our tax dollars are spent. I don’t want them to 

feel like we are being critical of the hard work that all those men 

and women that you lead do to make sure that those veterans that 

they represent are getting everything that they earned as soon as 

humanly possible. And we will do everything we can, as we have 

in previous years, sir, to make sure that you get funding you need, 

the support you need, the language that is necessary in the bill, 

whatever changes we can do to help make your job easier and to 

be able to reward those and your agency that are exceeding expectations and to give you the tools that you had in the Army, I hope, 

to be able to take care of those that are not meeting their standards.

But, above all, we want to thank you for your service to the country. We will have additional questions for the record. Deeply appre-
57

ciate all the hard work that you all do. And we will look forward 

to working with you, sir. 

And at this point, we will adjourn the hearing. We will submit 

our additional questions for the record. 

Thank you, sir. 

Secretary SHINSEKI. I would just say, Mr. Chairman, thank you 

for your leadership and great support for me for all these many 

years here. 

Mr. CULBERSON. It is a real privilege. 

Hearing is adjourned. Thank you. 
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