SecVA press conference, Wednesday, January 8, 2025, 9:00 a.m.

Terrence Hayes (VA Press Secretary):  Good morning, ladies and gentlemen. Welcome to today’s press conference. Before we begin, I’d like to first thank our VA Press Corps for being great professionals these past four years. Your reporting has helped VA educate and inform Veterans, their families, caregivers, and survivors nationwide about the benefits and care available to them. And as a result of your reporting, we have more Veterans than ever before receiving care and benefits. And that’s a win-win for everyone.

I’d also like to show my gratitude to my team of public affairs officers across the VA enterprise. These dedicated professionals answer hundreds of media requests daily, with the goal of being transparent, timely, and truthful each and every time. So to the PAOs at the facilities, regional offices, VISNs, field offices, administrations, and here at central office, you have done a superb job of helping us share the VA story. You should be proud of the work that you’ve done these past four years. You helped us rebuild trust and confidence in our VA.

Lastly, to the women and men behind the camera and in the studio for every press conference, our unsung heroes, we could not have accomplished what the Secretary demanded of me without your expertise, initiative, dedication, and outside-the-box thinking. These press conferences allowed us to speak directly to our stakeholders, Veterans, families, caregivers, survivors, members of Congress, and the American taxpayers. You made that happen, and I hope you know how integral you are to our VA team and our mission here of serving Veterans. Thank you.

And with that, I now turn the floor over to the Honorable Secretary Denis McDonough for my final time to begin today’s press conference. Over to you, sir.

Denis McDonough (VA Secretary):  Terrence, thank you very much for the very generous introduction. I second your shout-out to our awesome team, our PAOs in the field. I was thrilled to know that a bunch of–I learned last week when I was in the field that a bunch were coming to town for this, for the great production team and the great work that you guys do, and obviously to our partners in the press corps. So thank you very much. I just confided to the team in the morning call that I’m normally quite nervous for these. I’m doubly nervous because my wife told me she was going to watch. So I definitely can’t screw up today.

So good morning. During our discussions the last two months, in November and in December, I underscored that we intended to conduct a world-class transition, and we’re doing that. We proactively stood up a transition team this past summer. And since the day of the election, we’ve been ready with detailed briefings and memos on every part of VA to help the incoming team. They received those documents the day the transition officially began. And as of last night, we’ve hosted or scheduled 22 briefings with members of the incoming administration, closed out 74 requests for information. We’re actively working an additional 80 requests for information. We’re responding to every question quickly and transparently. And we’re sharing everything we know with the transition team, detailed information about VA operations, risks, and opportunities, including on VA’s budget, on West LA, on EHRM, on staffing, on physical infrastructure, and more. All so they have the tools they need to hit the ground running on day one, and to make sure they have what they need to deliver for Veterans.

One risk we’ve been certain to brief is the unaddressed budget shortfall that VA faces. We want the incoming team to understand the implications of that shortfall so that they will be prepared for the budget debate before the current CR expires in March. We’ll keep working this transition very hard. In a few minutes, I’ll turn things over to VA’s awesome Deputy Secretary, Tanya Bradsher. And that’s Tanya, not Tanya. Nobody’s fought harder for her sisters and brothers in arms than Tanya. They have no greater advocate.

Just about four years ago, it was Tanya, an Army public affairs officer and combat Veteran, who pushed me to hold monthly press conferences. She knew that we had to be more transparent with the press if we were going to rebuild trust with our external partners, VSOs, Capitol Hill, and the Vets we serve. So as usual, Tanya was right. VA kept its promise to Vets over this period, and we could not do so without you, the journalists who tell Veterans’ stories, whom they trust to provide them reliable information, and who hold us accountable to Veterans. You’ve done just that. You’ve held us accountable on PACT Act, on suicide prevention, on Veteran homelessness, and on so much more. All of VA’s accomplishments for Vets, each and every one of them, is because of our VA teammates. And over the past four years, those teammates have delivered more care and more benefits to more Vets than ever.

I’m thinking of VA teammates like Jaime Salome, first-generation American, Marine Corps Iraq combat Vet. Jaime was a member of the Honor Guard at Fort Bliss National Cemetery when he was on active duty. He remembers being constantly amazed by the way our NCA staff treats Vets, families, funeral home staff, and volunteers. So when he got out of the Marines in 2006, he knew exactly where he wanted to work. Jaime went back to school on a post-9/11 GI bill and started a VA work-study program back at Fort Bliss. He’s been with VA ever since. Today, Jaime’s the assistant director of the Fort Rosecrans National Cemetery, and he takes immense pride in providing his fellow Vets an eternal resting place befitting their service to our country.

I’m also thinking of teammates like Jennifer Wallace, the military sexual trauma, or MST, coordinator at the Des Moines regional office. Jennifer built a monthly meeting with survivors in Des Moines, listening to their stories, building community, and fighting for their claims. Jennifer remembers one Vet in particular, a post-9/11 Army Vet who survived MST and intimate partner violence. She has three kids, was six months behind on her mortgage. Jennifer fought like hell for that Veteran until she received the benefits she’d earned and so richly deserves. Today, those retroactive benefits have allowed her to catch up on her mortgage payments, and her monthly benefits are allowing her to focus squarely on her own healing. Jennifer says helping Veterans is the hardest, most fulfilling work she’s ever done. It impacts you immediately, she said. You see this person who sacrificed so much for all of us, I love being there for them. What a soldier, what a Vet.

And I’m thinking of VA teammates like Dr. Lisa Kearney. Over two decades of service at VA, Lisa’s been completely devoted to preventing Veteran suicide, providing Vets the very best mental health care in the world. A few years ago when she was the new chief of psychology at the San Antonio VA, Lisa was having supper with her parents. Now, anyone who knows Lisa knows she brings joy to every room, every meeting, every interaction. But at supper with her parents, she was distressed, even overwhelmed. The demand for mental health services from young Iraq and Afghan Vets was high, growing every day. She felt like she was fighting an impossible uphill battle. As she told this story, her dad, a Vietnam Vet whose parents both served in World War II, abruptly stood up and walked away from the dinner table. When he came back, he hung his dog tags around Lisa’s neck. He told her, ‘Honey, when times get tough, you keep fighting and you touch these dog tags. You remember who and what we’re fighting for.’ While Lisa’s still fighting, she’s now taken off those dog tags. They hang along her VA badge right next to her heart.

Working with teammates like Tanya, career employees like Jaime, Jennifer, and Lisa, and all of you across this awesome enterprise, has been the blessing of my professional life. I’ve seen your many kindnesses to Vets and their families. And I know that you will never stop serving Vets, in so many cases your fellow Vets, every bit as well as they have served all of us. I’m grateful for your work, and I’m proud to have been a member of your team. Tanya, the floor is yours.

Tanya Bradsher (VA Deputy Secretary):  Thank you, sir. I want to echo my thanks to everyone who puts together this press conference. It is a lot of work. And I am just so incredibly proud, as a public affairs officer, to be with so many of my [inaudible] trained killers across the nation, and to have met so many public affairs folks that are supporting our VA mission across the United States. And Terrence, I just want to also say thank you for everything you’ve done. I’m just so incredibly thankful. I will do my best to get through today. I hope everyone had a peaceful holiday season. It is good to join you this morning.

Now, the reason I get to stand on this podium, as the most senior woman in VA’s history, is because of Secretary McDonough’s advocacy, going back all the way to our days on the National Security Council when I was still on active duty. I am forever grateful for that. As a Veteran, I am forever grateful for the leadership and vision that you brought to VA. From day one, you pushed us to be transparent, to stay on offense, to reach Veterans where they are, and to respect and build trust with our partners in the Veteran Service Organizations, on Capitol Hill, in the press, and with all of our stakeholders. You led us to our four record-breaking years in a row of getting Veterans the benefits and services that they have earned and so rightfully deserved. And you did all of that for Veterans to keep that promise that our country makes when they sign up and serve in the military. Now, you always, and rightly, give all the credit to our great VA employees. But everybody knows that the unyielding passion and drive our employees have demonstrated these last four years, the scope and scale of their accomplishments. Well, you need vision, and you need unity of effort. And in an organization of this size, getting to that doesn’t happen without some extraordinary leadership. Leadership that inspires and extraordinary teammates that the opportunity to drive and to succeed. That’s your kind of leadership. And because of that, VA is on track to keep doing better for Veterans, to keep being better for Veterans, keep building trust with Veterans, and fighting like hell for them. All of which to say, VA has never had a stronger, more committed, more compassionate leader than you. And Veterans have never had a more devoted advocate than you. And on behalf of all of my sisters and brothers in arms and all VA employees, thank you, sir.

Now, I came to VA to work for my old boss, Denis McDonough. What kept me here were the career civil servants, many of whom I served during my time in the Army. America’s greatest, most devoted federal workforce, giving so much of yourselves to serve Veterans, their families, caregivers, and survivors. And when I depart here shortly, what I will miss the most is all of you. I’m thinking about the folks at our beautiful national cemeteries, regional offices, and health care facilities across the country. I’m thinking about our courageous VA police, our Veterans Canteen Service employees serving Veterans, and our colleagues in our stores, cafes, and coffee shops. I’m thinking of our custodial workers who keep all facilities clean and safe for Veterans and for all of us. Each of you is so important to serving Veterans.

Serving alongside you has been the rarest of privileges. I first came to VA in 2013 when I retired from the Army for my care and benefits, and I can tell you from personal experience that today we’re a new VA. It’s thanks to our great employees and their hard, expert work for Veterans that VA is delivering more care, more benefits to more Veterans than at any other time in history. And it’s not just more care you’re delivering. It’s better, world-class care. Veterans’ health outcomes are better when you’re caring for them. It’s not just more benefits. It’s faster, more accessible benefits you’re delivering by meeting Veterans where they are rather than expecting them to come to VA. And it’s not just more Veterans. It’s more Veterans trusting VA at record rates that are remaining at an all-time high. Now, looking ahead, what will always be most important is continuing to do what you all have done for the past four years, fulfill President Lincoln’s promise to care for those who have served in our nation’s military and for their families, caregivers, and survivors.

I know that is what you will keep doing in the years ahead. So to my fellow Veterans, come to VA for your benefits and care if you’re not already. Let us build a relationship with you and your family. If you are, keep coming and let VA continue to build its relationship with you. From the GI Bill to home loans to VA to life to Veterans Legacy Memorial, VA has services that meet every stage of your life after the military. I promise you this, as a Veteran, that’s exactly what I’m going to continue to do. And I promise this as well, for the rest of my time as Deputy Secretary and for the rest of my life, I will keep advocating for my fellow Veterans, for VA, and for all of my VA teammates. Working with you is a gift in which I am deeply grateful. You’ve made me a better person. God bless you all, and thank you.

Terrence Hayes (VA Press Secretary):  Well, ladies and gentlemen, we’ll start the question and answer period. And as always, I’ll start off with Leo. Good morning.

Leo Shane (Military Times): Good morning. Thank you, Terrence. Thank you, Mr. Secretary, Deputy Secretary, for doing these press conferences. Hopefully the next administration will take the example and continue these on because these have been incredibly helpful for us. Mr. Secretary, you talked a little bit about the transition. I wanted you just to go into a little more depth with that. What should Veterans and employees expect? I know you said you’ve been talking about some of the preparations, some of the work that you’ve been doing. But, I mean, I know there will be some policy changes down the road for the next administration. But at least in the short term, should Veterans and workers be expecting anything to be different?

Denis McDonough (VA Secretary):  Yeah, you know, I think what the grand tradition of this country underscores is that unique among democracies in the world, unique among governments in the world, the United States basically does a wholesale change in the management infrastructure of its federal agencies every four years. And the expectation that’s built into that constitutional responsibility is that that’s done seamlessly. And so when we talk about the workforce’s expectations and, most importantly, when we talk about Veterans’ expectations, I think their expectation is that it be seamless. And we’ve taken that very seriously. That’s why we did the preparation we did over the summer, and that’s why we’ve conducted ourselves the way we have conducted ourselves since the transition officially began. So that’s what their expectation should be.

My guess is Tanya and I had a great conversation with the agency review team yesterday. We made clear to them that Tanya obviously knows a lot more about this agency than I do, and Tanya and the agency review team know a lot more about VA than I do. And so I think it’s a very serious team that’s coming in, and we’re going to make sure that they have everything that they need to continue to provide more care and more benefits to more Vets than ever. In terms of changes or anything else from the next team, that’s for them to shine a light on. The seamlessness, though, is ours to perform, and I’m very proud of the team and the way they’ve handled that to date.

Leo Shane (Military Times):  When you’re talking about issues like the electronic medical record restart and some of the other initiatives announced today about more PACT Act benefits and presumptives, does any of that get delayed or bumped back, or does that just remain on schedule as we do the handover in two weeks?

Denis McDonough (VA Secretary):  You know, seamlessness means, as far as I’m concerned, that we continue to perform the duties that the president has been assigned by virtue of his constitutional role. So we’re going to keep working right up until January 20th at 12:01. And so we’re going to make sure that everything is in place for that to continue. What the next team does is up to them to decide and to announce. But seamlessness is on us. That means continue to work until 12:01. That’s why we made the announcement. Well, that’s why Veterans can take a look at the Federal Register to make sure that they see what we intend to do on multiple myeloma, on leukemia, on rare cancers. This is particularly important to the president inasmuch as Veterans who served in K2 in Uzbekistan, which is a place that the president himself visited, I visited with him when he was a senator, that we get to the bottom of what happened there and the toxic chute that is there. And this is the first step in that. But it’s going to require multiple steps, and we’ll make sure that all those pieces are in place for the next team to continue.

Leo Shane (Military Times): Great. Thank you.

Denis McDonough (VA Secretary):  Leo, let me just say one thing before we go to the next questioner, and I don’t mean to make you stand up there, although my son, who interviewed you, he just happened to find you for a class project, wanted me to shout out his man, Leo, today. So I’m shouting out Leo today from my son.

But I want to underscore to Veterans that we’re obviously watching the natural disasters across the country, literally across the country, very, very closely. Got very cold temperatures in the south. Got a lot of snow here throughout the Midwest and central Atlantic. And then, of course, these tremendous fires in Los Angeles, which we’re tracking very, very closely. We’re reaching out to all impacted Veterans in that area of the wildfires and making sure that they know that we’re here for them. This morning we’ll be sending a message directly to California Veterans and their families. The bottom line is this. If you want to know about how VA can help you through this storm or you want to check on your local facility, please call 1-800-MY-VA-411 or visit us at va.gov/resources/disaster-help. That’s 1-800-MY-VA-411 or va.gov/resources/disaster-help. Obviously, for any emergency, call 911.

Our hearts go out to all those in the path of these fires, to all these natural disasters. We’ll make sure that we are here for those Veterans every step of the way. So thanks, Leo.

Leo Shane (Military Times): Thank you.

Terrence Hayes (VA Press Secretary):  Thanks, Leo. We’ll go to Quil. Good morning, Quil.

Quil Lawrence (NPR): Good morning, everybody. Nice to see you all. Thanks for doing this all this time. I’m hoping the next administration will enjoy coming out and getting slightly hectored and slapped around by the press corps. It’s been great. Thank you.

Can you tell me, in terms of, I mean, you’ve got a discussion of a budget shortfall, and then you’ve got another administration coming and saying that they’re going to cut government spending drastically. Is there some practical advice that you’ve been giving them about what just can’t be cut at VA, areas where they might focus if they are looking for cuts, and I guess, yeah, just some areas where that might look like a place you can cut, but trust me, I’ve been in government a long time, and that’s not the hill you want to die on. Can you share any of that advice you’ve been giving the transition team?

Denis McDonough (VA Secretary):  Yeah. You know, if we were to provide such advice, Quil, we’d provide that privately. But as it comes to recommendations on what to cut or where to cut, that’s not something I’m going to be involved in. I think we’ve been very clear that we’ve asked for significant increases in VA budget for the last four years. We’ve been very clear in how and where we spend that. When we’ve needed extra money, we’ve gone to the hill to explain what it is we need it for and why it is that we need it. And inevitably, we only need the extra funding because this is a Veteran-centered organization, meaning we’re going to make every decision based on what the Veterans need.

In terms of what the next administration chooses to do, those will be their decisions to address. I did notice that in the run-up to the last CR expiration in 2020, there was a lot of discussion of potential mandatory cuts in and around debt ceiling debate. I think it would be a mistake, myself, if they were to cut VA benefits, which are mandatorily funded. We saw $187 billion in those benefits payments last year. Congress debated the PACT Act as the Total Cost of War Act. I think that’s true, having watched now each of those 20 years of war from policymaking and staff positions over that time. We ought to make sure that we live up to our commitments to those Veterans.

Quil Lawrence (NPR): Okay, and just a quick follow-up, if you would. In terms of VASP, how much of that team that’s administrating VASP is going to change? Most of that is professional staff and not political?

Denis McDonough (VA Secretary):  Yeah, we’re all professionals around here. So the distinction we make is not between professionals and non-professionals, but rather professional career employees and professional political appointees. We have very, very few political appointees here in VA, Quil. I think we have upwards of 35-ish in an organization with 451,000 employees. So it’s a very small politically appointed staff. Josh is the principal, is obviously the Undersecretary for Benefits, confirmed overwhelmingly by the Senate. He will obviously leave on January 20th, but the rest of that team working on VASP and on housing, finance, and other priorities, that awesome team of professional career employees stays.

Quil Lawrence (NPR): Okay. Thanks. It’s been a pleasure. Take care, y’all. Take care of Terrence, Tanya.

Terrence Hayes (VA Press Secretary):  Thanks, Quil. Appreciate you. Patricia.

Patricia Kime (Military.com): Thank you so much for doing this and having done this for the last four years. As everybody said, it’s been very helpful. I would like to start with the issue of community care that has been discussed so extensively. I’ll probably butcher your paraphrasing, but you said in the last, Mr. Secretary, in the last press conference, that America has to decide what the VA looks like, what it should look like. With all the discussion about community care and people, also Veterans who value their own care at the VA, do you have any words for them who may be worried about the future of their own care if they get it at VA with all the discussion about community care?

Denis McDonough (VA Secretary):  I think it’s a really good question, Patricia. I guess I just want to say to Veterans that I think the way VA providers feel, I think the way VA professionals, professional career staff feel, and surely people like Tanya and I feel, is that we feel honored to provide care to Veterans. I hope that they feel that.

The most important thing is that Veterans continue to tell us what their expectation is. The easiest way to do that is the trust survey, which Veterans get after every engagement in a VA health setting, and to which Veterans respond at a rate higher than any other health care system. So I’d urge Veterans to continue to do that, to tell us where we do well, to tell us where we do badly, and then to tell us what their expectation is. Importantly, that survey experience is being expanded across VA, including to the benefits experience. So we urge Veterans to do the same there. The most important thing, I think, about how this debate shapes up is what Veterans want. And an ancillary part of the debate is how does VA manage its budget, which is typically very, very generous from Congress and very, very generous from the American people.

Nevertheless, even as it is very generous, the demands for health care are very expensive, especially as our existing Veteran patient base ages and reliance on the VA system increases. And as Veterans, especially the Vietnam Veteran era Veterans and combat Veterans, obviously, enter the most expensive stage of health care in their lives, we have to be certain that we are managing prudently those generous resources. And it’s very hard for me to see how kind of some of the characterizations of what we should do with VA becomes affordable if we’re not being very aggressive about providing the Veterans a VA access at every turn. So, one, this is a question of Veterans’ preference. Two, this is a question of prudently managing the taxpayer resources. And then three, we have to make sure as an agency that we’re doing everything that we can to meet those Veteran expectations, which is why I’m really thrilled by Dr. Elnahal, Dr. Lieberman, Dr. Braverman, Dr. Scavela and their aggressive work with clinicians across VA to increase their productivity, to make sure that through, you’ve heard me talk about this before, the radiologist whom I saw down in El Paso having clinic at–opening clinic for radiology appointments at 0600 every morning.

The providers that I’ve seen throughout VISN 8 were having clinics on evenings and weekends. The increased reliance on things that we’ve talked about in this room, like forward deploying oncology care into rural Minnesota so that our Vets up on the northwestern plains or up in the range don’t have to drive five hours to get their chemo and then drive home five hours tired, fatigued by that treatment. All of those innovations, which are dependent on a robust VA system, are both Veteran-centered and cost-effective. And I’m inspired by what I see from our providers in that regard. I hope that answers the question, Patricia.

Patricia Kime (Military.com): It does. I just have one follow-up. So TriWest Healthcare Alliance manages the VA community care in the west and they just added 4.5 million new beneficiaries from the Defense Department. There’s transition issues going on over there with DoD, but are you seeing any impact on Veterans’ care in the community out in the western region or anticipate any issues with Veterans getting appointments in the system with an expanded TriWest?

Denis McDonough (VA Secretary):  That’s a good heads-up. I hadn’t seen the news about this expansion of beneficiaries at TriWest in the west. We get a really robust briefing every morning about flashpoints in the national system. I’ve not heard anything yet on this, but we’ll take your question, as we always do as Intel, and let us get to the bottom of it. We’ll circle back with you on it. I will say this, though, about our third-party administrators. We pay them a king’s ransom for the service that they provide. I think that our expectations have grown and will continue to grow, especially on two things. One, on helping us track down the documentation from community care visits, and then two, and most importantly, on maintaining high-quality networks of providers so that our Veterans can get the best care in the world. I think you’ll see that in iterations of, or I hope you’ll see, you know, enhanced expectations for the third-party administrators in and around those two issues, which is performance on community care and maintenance of high-quality networks for our Veterans in subsequent iterations of contracts.

Patricia Kime (Military.com): Just my last one, I feel like some other colleagues that like to grab a lot of questions. The West LA campus–

Denis McDonough (VA Secretary):  So you’re blaming everybody else for your two follow-ups? [laughter]

Patricia Kime (Military.com):  Not me. The West LA campus is not very far from the Palisades Fire. You touched a little bit on helping Veterans, but how is that campus preparing for any issues and, you know, smoke, that kind of thing? What are you all doing to anticipate that?

Denis McDonough (VA Secretary):  Well, obviously the team’s been working very aggressively, in touch with local and state authorities, as well as with national authorities, to prepare our workforce. We’re communicating clearly with the workforce, communicating clearly, this is why we wanted to underscore today to you guys precisely what we’re doing in Los Angeles, what we’re seeing, and this is why we’ll be emailing millions of Veterans directly yet this morning. So we’re making all the preparations one would expect. We’re staying well integrated with state and local authorities, as well as with national authorities, and we’ll make sure that we’re communicating with you guys as this unfolds during the course of today.

Patricia Kime (Military.com): Thank you all so much.

Denis McDonough (VA Secretary):  Thanks.

Terrence Hayes (VA Press Secretary):  We’ll go to Dan. Good morning, Dan.

Dan Sagalyn (PBS NewsHour):  Hi. Thank you for taking my question. Mr. Secretary, I also want to thank you for doing these press conferences and for staying there and answering all the questions and follow-up questions. Are you disappointed that the VA will not issue a final rule for constrictive bronchiolitis on your watch?

Denis McDonough (VA Secretary):  I was just trying to figure out, was that like kind of a sly criticism of Patricia’s many follow-up questions?

Dan Sagalyn (PBS NewsHour):  No. Absolutely a compliment.

Denis McDonough (VA Secretary):  So you commend her for her follow-up questions?

Dan Sagalyn (PBS NewsHour):  I do, and I commend you for taking them and encouraging them.

Denis McDonough (VA Secretary):  I see. Okay. Well, there you go. Dan, thanks very much. You know, I guess I have this counsel here to our teammates in the press that, you know, the questions that start with are you nervous that, are you anxious that, you know, are you disappointed if, you know, those are all kind of unnecessary because I’m an anxious, nervous character who also oftentimes knows how–I guess I’d say this is what happens when you’re one of 11 kids. I’m uniquely clued into my many, many, many weaknesses. And so any question that starts with are you disappointed in, you know, some lack of action from me, the answer is yes. I routinely disappoint myself.

On PACT Act execution more generally, I’m extraordinarily proud of this team, that they’ve overcome my many weaknesses. I want to just call out Steve Miska and the PACT implementation office for the unbelievably good work that they have done. And I want to call out in particular the work that that team has done in getting the leukemia, multiple myeloma, and rare cancers decision executed in record time. On constrictive bronchiolitis, I think you and I have had an extended back and forth on this, Dan, and this is a very difficult issue that I wish there were an easier test to confirm that condition. The tests that we have are very invasive and ultimately perhaps detrimental in some ways to the health and quality of life of the Veterans, and so we have to continue to work through those claims to ensure that Veterans are getting covered. And I think in large measure we’re making good progress there. But yeah, I surely would like to see a final rule on constrictive bronchiolitis, and my hope is that that comes quickly, not because of how I feel about it, but because there are many, many, many Veterans who are reliant on it, and we owe them some clarity, and we owe them the very firm presumptive connection on that.

Dan Sagalyn (PBS NewsHour):  So the Airborne Hazard and Burn Pit Center of Excellence in New Jersey, they put together a study panel that really sunk their teeth into this over a good period of time. They had two subgroups from that with VA doctors and doctors from the outside, and they came up with recommendations, criteria, for how to rate constrictive bronchiolitis that was completely ignored when the rule was come out. Why was their advice ignored?

Denis McDonough (VA Secretary):  Yeah, let me go get that, and we’ll make sure that we follow up with you on it, Dan.

Dan Sagalyn (PBS NewsHour):  Okay.

Terrence Hayes (VA Press Secretary):  Jory.

Jory Heckman (Federal News Network): Good morning. Thanks for taking our questions both today and over the past couple of years. Really appreciate it. I wanted to circle back to the future of the VA’s workforce and its ability to keep up with its mission. We’ve seen the VA workforce grow in recent years, commensurate with new work under the PACT Act, and also under the PACT Act we’ve seen tools such as critical skills incentives, SSRs, special salary rates, things to incentivize people to come work for the VA and take on this mission. How confident are you in the ability for the VA’s workforce to continue to match pace with its workload? Granted, of course, I know a lot of this rides on Congress’s whether or not they fulfill the VA budget shortfall as it currently exists.

Denis McDonough (VA Secretary):  Yeah, look, I think it’s a really good question. It’s one that we spend a lot of time stressing out about. But this is also something that is a very data-driven effort. And so if you just look at a couple indications here, VBA in the course of the last couple of years, I think has produced more claims decisions per year routinely than the prior year. And remember that each year is basically a new record. So at the same time, those are more decisions, faster, higher quality. And we’re reaching the point now where we believe we can begin to manage that ultimate workforce number through attrition, as we promised Senator Bozeman and many others as we built up the workforce for the initial surge in claims under the PACT Act. And so by watching and keeping our eyes very clearly on performance indicators and being able to meter out things like voluntary overtime and mandatory overtime, I think we’re able to, I believe I have or I do have high confidence that we can manage that, as you said in direct response to your question, going forward at VBA.

VHA, with the number of appointments in FY24, 131 million appointments, again, higher than the year before, those are both record numbers, we map a number of different things. Obviously, Veteran demand and wait times, Veteran options in the community, and then ultimately we track very, very closely Veteran satisfaction and then health outcomes. So just working backwards on that, on health outcomes and on Veteran satisfaction, we’re at very high performance indicators. On things like keeping clinicians with us, retention for two years in a row has been good. I haven’t seen the most recent numbers, but I think the last time I looked at them was October or November, and I think we’re doing quite well on retention. So we’re keeping the providers. And so I have–and then through the efforts of the VBA, sorry, VHA leadership in coordination with the VISN directors and VAMC directors, that is to say our hospital CEOs, this focus on productivity is, I think, very, very positive and we’re meeting very high productivity standards. So that makes me very confident. So that’s the first part of the answer.

Let me just be very candid with you and say that there’s a couple of places I’m worried about. And what am I worried about? Well, one is VR&E, which is a really important benefit–education benefit for Veterans, which is very individualized, counselor-based performance. We’re seeing a massive surge in Veterans exercising their right to VR&E benefits. That’s putting a lot of demand on the system. We’re at about 85% full of projected need for counselors. That’s because of a lot of good innovations that Josh and his team put in place over the course of the last couple of years to increase pathways to becoming a VR&E counselor at VA. But 85% is still, I would have loved 85%. That’s a good solid B, but we have expectations here for 100%. So I’m worried about that.

I’m also worried about time to hire. I’m worried about time to hire in VHA. So if we start softening on retention and we don’t beat this maddeningly stubborn high number of days to fill, we’re going to encounter real problems. And I still don’t really understand how we’re not able to crack that code. So time to hire at the VHA is a big challenge. So am I confident? Yes. Why am I confident? I just gave you the data. Am I concerned? Yes. I’m concerned about two places in particular. But we’re mindful of those. VR&E, I think we’re making great progress, and I really like the path forward. Time to hire, I find it stubborn and I find it maddening, and we just have to crack that code.

Jory Heckman (Federal News Network): To your point about time to hire, is it at least trending in the right direction?

Denis McDonough (VA Secretary):  Yeah, it’s trending in the right direction, but it’s just very lumpy. Meaning there’s places where it really takes a long time, and then there’s places that do it extraordinarily well. And so our team, God bless them, they’re working on trying a lot of different things in a lot of different places. And our workforce team has been awesome. VBA, VHA, NCA–massive efforts on onboarding the last couple of years. Excellent performance on retention. That doesn’t just happen. That’s because that workforce team, led by Dr. Lee, led by Jessica Bongorni, are doing great work. But the lumpiness on time to hire, I still hear these stories in the field of qualified people we’re losing because they just can’t wait six months to get a paying job. Now I’m about to test that, so I’ll let you know how it goes on the outside. But we just got to do a better job on that.

Jory Heckman (Federal News Network): And then I just want to ask one last time, we’ve spoken a lot in this room about the critical skills incentives, the ones that were improperly awarded to VA central office executives. You’ve kept us updated on the recouping of those bonuses. Have those been fully recouped to your satisfaction as far as you know?

Denis McDonough (VA Secretary):  That’s a good question. I don’t know. I haven’t gotten a number on that. We are aggressively executing a timeline. Remember that we asked the IG to look into it. He looked into it. He’s published his report. Part of that report was to ask our Office of Accountability and Whistleblower Protection to look into it. They have done that. They’ve given me their recommendations. We’re executing on those recommendations. That’ll all be done before I leave.

On the recoupment, Jory, I don’t know. The last I saw was like mid-90s percent. Let’s get you guys an answer on that. But your question is, has it been fully executed to my satisfaction? That has two parts. Has it been fully executed? The answer is, I think, as the last I checked, no. And then to my satisfaction, when it’s 100%, I’ll be satisfied. But not until then.

Jory Heckman (Federal News Network): Thank you.

Terrence Hayes (VA Press Secretary):  Yeah, Jory, we’ll circle back with you this morning on that. We’ll go to Chris.

Chris Arnold (NPR): Thanks, Terrence. Can you guys hear me?

Terrence Hayes (VA Press Secretary):  Yeah, good morning.

Chris Arnold (NPR): Good morning. Like other people said, too, thanks. The monthly press conferences have been great. You don’t know sometimes as a reporter if the questions you’re answering are filtering up to decision makers. So here they obviously are. And that’s been very cool. So, of course, I’m going to ask about VASP. But I’m hearing that there’s a simple fix that could have a big impact and help several thousand Vets not lose their homes, even at this stage. And it’s a little nerdy, but basically it’s something that’s called a six-month seasoning requirement. And I think we haven’t brought that up here in the press conferences before. But that just basically means you’ve got to make six payments on a prior loan mod before you can be considered for VASP. But as we’ve been reporting, you know, the whole point is these Vets got stranded and couldn’t afford those loan mods that were available after VA turned off the PCP program.

So there’s a lot of Vets who made a couple payments on a mod they couldn’t afford that they got stuck in, and now they can’t get VASP. And it just seems like I’m hearing that that could be a powerful lever to pull. It would also be pretty simple to just grandfather those folks in. You know, going forward, you could argue whether a seasoning requirement makes sense or not. But at least for those folks who have already been hurt in the past, you know, why not waive that so they could just get access to the program?

Denis McDonough (VA Secretary):  Yeah, look, I think it’s a legit question. You’re right that we haven’t raised it in here, which is kind of surprising because I think we’ve really chewed quite hard on VASP in this room. But this, the seasoning requirement, is not one that we’ve discussed with you in this room, but it is one that is actively being considered. And so I think you’re asking, why don’t you just waive it? I think, you know, that would be one end. Another end would be why not reduce the months required of seasoning, you know? And I guess one could conceive of increasing the number of months required for seasoning. So all those are under active consideration, Chris. And I don’t have news for you on that other than to say there’s a way for us to help Veterans who are at risk of losing their mortgage. We’re going to consider it. I’m really proud of the work that we’ve done to help Veterans who had confronted challenges with their mortgages over the last four years. And if there are new ideas to consider, we will consider them. And, you know, as we always do in answer to your questions, because they’re excellent and we know that Veterans really trust your reporting on this, is please, as Veterans, please be in touch directly with us. There are, we have individualized counselors who can help work with you about developing a variety of options. VASP is one at the end of the waterfall of options. Let’s make sure that we’re in touch with you to figure out which of the available pathways will most effectively address the concerns that the Veterans are confronting.

Chris Arnold (NPR): All right. And, you know, I don’t think we ever heard back from Josh, too. Last week he was saying the IRRRL mods, speaking of nerdy, were up. But it just seems like it stretches credulity to some degree that there’s going to be another affordable option when interest rates are at 7%. And if, you know, only a small percentage of folks are in VASP so far, you know.

Denis McDonough (VA Secretary):  Yeah. Look, we’re really careful not to suggest to you that we’re incredulous about your reporting. We take your reporting at face value and for what it is. And so we’re not suggesting that if you look at the IRRRL or anything else that there’s something that you’re missing. All we’re saying is this is going to be a highly individualized thing for our Veterans. They, as, you know, our Veterans represent the full range of America. And that’s one of the great things about this job. And so what we really, really want to do is to be in direct touch with those Veterans so that we can work with them on a variety of options. We’re not, you know, you have this tendency sometimes when you’re doing a tabletop exercise to fight the exercise. I’m not trying to fight the exercise here, Chris. I think you’ve done important reporting. I think the Veterans you are talking to trust you in a way that we have not gotten their trust. So we think it’s really, really important. We’re not incredulous about it. We’re not suggesting that you’re wrong. We’re just wanting to make sure that we are in direct touch with every Veteran so we can get them the answers that they need.

So on the specific question from last month that I remember was that actually we saw kind of during this period more exercise of the option under that variable rate. So we thought that was analytically interesting. I think Josh was on the hook to get back to you. Let’s make sure that he does. I’ll take that for action to make sure he gets back to you.

Chris Arnold (NPR): Okay. And again, thanks for all these press conferences. It’s really been great.

Denis McDonough (VA Secretary):  I thought that was mean when you trolled Quil by asking if we could hear you.

Chris Arnold (NPR): We do tend to screw up the audio. It’s actually because we’re always doing interviews on three different types of systems.

Denis McDonough (VA Secretary):  I see. Okay. Now that sounds like rationalization to me.

Terrence Hayes (VA Press Secretary):  Gotta love NPR. Orion.

Chris Arnold (NPR): We’re nonprofit.

Orion Donovan-Smith (The Spokesman Review):  Well, thank you. I’ll just echo what everybody else has said. Really appreciate you all doing these pressers every month or so, and grateful to Mr. Secretary, Deputy Secretary Bradsher. Everybody, yeah, I know, and everybody who’s made these happen. So thank you for that. Especially, Mr. Secretary, knowing about your nerves, and I can relate. I get stage fright every time I come up here just knowing I’m about to be on a YouTube livestream. So I’ll miss this, and hopefully won’t have to miss this. We’ll see.

I want to ask just sort of a broader question. I’d appreciate hearing from you, Mr. Secretary, and from Deputy Secretary Bradsher. What do you think is the single biggest challenge that your successors are going to face at VA?

Tanya Bradsher (VA Deputy Secretary):  So I think the budget will probably be something within this year. Operating on a CR is definitely not ideal. So hopefully our staff will be able to have a full 25 budget and be able to have that planning process, as well as to make sure that the shortfalls that we’re currently looking at are identified. I think that that will be job one of the new administration.

Denis McDonough (VA Secretary):  Yeah, you know, just as a general matter, I just think that if I can do this, anybody can do this, right? So do I think there’s going to be big challenges? Yeah. But it’s an amazing job. You get to work with these people who, you know, could really work anywhere. You know, I stood up here with Dr. Kelly. We did a presser–we had gone for a run that morning. The guy ran me into the ground, you know. He’s like one of the world’s leading oncologists, right? And he chooses to work for VA because he loves Veterans. And we know Veterans have a higher rate of lung cancer than any other cadre of Americans. So, yeah, it’s a hard job, but it’s an awesome job, and it’s awesome because the people you get to work with, and they’re here because the mission is so awesome. So I’m going to miss it for the reasons Tanya said in her remarks. And I think, you know, provided you get an opportunity to hear from these professionals, you know, I think the job does itself.

Orion Donovan-Smith (The Spokesman Review):  Well, thank you. And I just, of course, I have to ask about EHRM one more time here.

Denis McDonough (VA Secretary):  The answer is no.

Orion Donovan-Smith (The Spokesman Review):  That program, of course, has been a challenge throughout your tenure here and will continue to be, I’m sure, for the new administration. I just wonder if you could first, Mr. Secretary, sort of sum up where the program stands right now, the status of it as you see it, and what advice you have for the next administration in tackling that program in particular.

Denis McDonough (VA Secretary):  Yeah. The way it stands, and, you know, I know that you and Tanya have been discussing this, and Tanya’s discussed it with all of you, and she’s, you know, discussing it with members of Congress and with our workforce. You know, we basically went into reset because of some of the challenges that we’ve confronted, and nobody’s reported on that more profoundly than you have.

I think we’ve learned some really important lessons in the reset. We’ve learned some really important lessons with the experience of the deployment in Chicago at Lovell, the facility that we run jointly with the United States Navy, and informed by those lessons learned and that experience in Lovell, as well as the follow-on experience in the Northwest and in Ohio. We feel like we’re ready to go to the next level, so we’ve laid out what that plan will look like continuing in VISN 10 in the Michigan system. And so that’s where we stand, and we’ve laid out for you guys the timeline of that and the goals of that. You know, I think that our Deputy Secretary has done an awesome job on this. It’s a very difficult thing in a big system to make any kind of change that needs to be uniform across a system that basically prides itself on its non-uniformity, and it requires a special leader to be able to do that, and I think she’s demonstrated her ability to do that.

And my wish for our providers and for the VA system is that we not lose sight of the why. And the why is that Veterans need an integrated, modernized electronic health record for better health outcomes and for better and overall engagement with the VA. And by better, I mean more accurate claims determinations, ultimately, will be informed by this when it’s fully implemented. And so sometimes I worry that we have lost the why or that we have somehow replaced a metric of provider satisfaction with–we’ve measured that or prioritized that rather than Veteran outcome. And I think our experience at VA is when we do that, that is to say when we make a series of decisions not based on best Veteran interest in a Veteran-centered way, we lose our way. So I think that’s what I’d say about that. Anything you want to add to this or try to clean up whatever I just screwed up?

Tanya Bradsher (VA Deputy Secretary):  Nothing to clean up. First and foremost, I have to thank Dr. Neil Evans and the entire EHRM team. They have been phenomenal partners, and I also want to thank all of our clinicians at the six sites because they have really put their heart and soul in making sure that we are able to get the information that we need to work with Oracle to ensure that we have the health care record that our clinicians need in order to take care of our Veterans.

Ultimately, going back to the why, DoD is done. They finished in March when we went to Lovell. And so with that, we have the ability now from MEPS all the way to when they get out or retirement to not have to carry those medical records and to be able to have them seamlessly integrated into our system ultimately once we’re able to fully successfully deploy across the United States. And so I think that vision is what propelled me to be so active in this along with the fact that I’m also responsible for it. But I really would love to see a time where that service member can just easily have all of their information and data when they go to their very first VA appointment, just pull up everything on their record. And that is the ultimate goal.

And so the partnership that we have had with our clinicians has been phenomenal. They have been incredibly candid. You know, I traveled across all six sites twice. Do not recommend doing that in a week, but it was very, very helpful for me. And we still have been able to see a dramatic decrease in the number of outages. We are seeing uptimes much better. We’re seeing trust scores go up. And so we’re moving in the right direction. And to be able to start the pre-deployment activities for the four sites in Michigan, finish it, we’re starting it this month, and be able to look for deployments in the middle of 2026 as an exciting next step. And so I think we’re moving in the right direction, and I’m just incredibly proud of the teamwork everyone has provided.

Orion Donovan-Smith (The Spokesman Review):  You mentioned Dr. Evans. Do you anticipate he’ll stay on in that role?

Tanya Bradsher (VA Deputy Secretary):  I would love to see him stay on in that role, but, of course, he’ll make the ultimate decision as to what he needs to do for him and his family.

Orion Donovan-Smith (The Spokesman Review):  All right. Thank you all.

Terrence Hayes (VA Press Secretary):  Eric.

Eric Katz (GovExec):  I know you’ve touched on this. First of all, I’ll echo everyone else in thanking you for doing this and just note that since I cover a lot of federal government, this is highly unusual to have this sort of access, so we really do appreciate it. You’ve mentioned this a little bit in your previous answers, but just to drill down on it a little bit, can you just go over where things stand under the CR with VA budget and specifically where that leaves you in terms of hiring, and are you confident as you turn over the keys to the next administration that the workforce is where it needs to be?

Denis McDonough (VA Secretary):  Yeah. So since about the middle of last year, we’ve been concerned about the rates of demand in the VHA system, which is why starting last summer we prioritized access, and then many of our VISN directors put on kind of the back burner new equipment purchases, for example, and they tried to or have, I think, effectively been more strategic about hiring, which is to say making very concerted decisions about when, where, and whom to hire. And we talked in this room about, I remember talking to Julie Flynn, who’s CEO of one of our most active hospitals in San Antonio, and she just had dramatic need for GI experts, and she just made the decision in consultation with Dr. Jones in that VISN to go ahead and hire those GI experts. So that’s how we ended up coming–and then we’ve been very aggressive about ensuring that our Veterans have an option for care in the direct VA system in every interaction, right?

The statute’s very clear that given certain levels of drive time, certain levels of wait time, Veterans qualify for a referral to the community, and we have met those requirements inasmuch as there’s been record levels of community care in the last several years. By the same token, we are offering in each exchange like that Veterans an option in the direct care system so that they can make an informed decision. I don’t know if you’ve seen some of this polling about patient satisfaction in the public system, or maybe you can just maybe apply your own experience. I’m not sure private Americans are overwhelmed by their satisfaction with their health care system, so we want to make sure that we’re competitive there and that we’re giving Veterans a choice, a real choice. And as we’ve done that, we’ve seen–we’ve been able to manage the performance of the budget such that we actually hit the performance numbers on our budget last year.

So where we are under the CR is continuing several of those steps, delaying equipment purchases, for example, being very strategic about hiring decisions. I think now we’re under, I think the last number I saw is we’re under like 399,000 employees at VHA, so we’re near flat for the last fiscal year, even as numbers of appointments have gone up to record highs, and that’s a function of productivity, and that’s a function of community care. So that’s where we are.

And then to your question about am I confident that we have the people for the system going forward. You know, I gave kind of a detailed answer, I think it was to Jory earlier, so I guess I’d just point you to that; one, on people. Two, though, I am increasingly anxious about the fact that our network directors and our VAMC CEOs are forced into this Hobson choice where they have to delay certain equipment purchases because we’re going from CR to CR. And I think there’s real impact on that, and I don’t think at the end of the day it’s more efficiency. I think it’s just more churn, and ultimately I think that’s probably not in the best interest of VA or in the best interest of Veterans.

Eric Katz (GovExec):  And, you know, you’ve mentioned a couple times throughout your tenure, really, how much value you find in communicating with the workforce, rank-and-file, career staff. Has there been any concerns trickling up that you’ve heard in the last couple months as it relates to the approach that the incoming administration took the last time it was in office, you know, because they tried to make it easier to fire VA employees specifically, and they’ve talked about, you know, this new Schedule F provision, and, you know, maybe there’s some concern that that will be brought back to the floor. Has that been brought to your attention, and if so, what has your message been?

Denis McDonough (VA Secretary):  Well, I actually wasn’t going to address this, but there is something I’m really concerned about, and I’ve had it come up from the workforce, and especially since Ron’s walking in the back of the room, I want to underscore this, is that I am a little upset about the Vikings-Lions game on Sunday night. I did think that the Lions actually were cheating, and I’m going to take this up with the inspector general, see what we can do about this. So I don’t really appreciate the candid–the sense that our workforce has that it can just spout off about the Vikings willy-nilly. Okay? I got no time for that.

But, you know, I really pride myself on–not pride myself, I find it a great blessing of this job to be in the field talking to our workforce. I was just in LA on Thursday, and I was in Colorado on Friday, and I saw a lot of great professionals, and what I heard there is what I always hear, concern about Veterans, concern about Veteran-centered decisions. You know, I haven’t really heard a lot on these other issues, but I think it’s–I guess what I would say is it would be intuitive or reasonable to expect that people have those concerns, but that’s not been something that’s come, you know, aggressively to my attention.

Eric Katz (GovExec):  All right. Thank you very much.

Terrence Hayes (VA Press Secretary):  Over to Anne. Good morning, Anne.

Anne Chalmers (The War Horse): Good morning. Can you hear me okay?

Terrence Hayes (VA Press Secretary):  Are you there, Anne?

Anne Chalmers (The War Horse): I am. Can you hear me?

Terrence Hayes (VA Press Secretary):  We can hear you now.

Anne Chalmers (The War Horse): I’m sorry. I’m having some technology issues this morning, so I’m going to stay off camera, but I really do appreciate these monthly press conferences as well, which has been spoken, and thank you so much. So I’ll just keep this very quick. I just have a follow-up question about community care. If it continues to expand at the rate it has over the last several years, you know, I’m hoping, Secretary, that you can sort of walk me through the consequences of that and how Veterans who do seek direct care in the VA, how they might be impacted. Thank you so much.

Denis McDonough (VA Secretary):  Yeah, so, you know, it’s always, I think, treacherous to respond to a question that starts with if, you know, because it is hypothetical. But let me just talk, rather than about the hypothesis, let me just talk about kind of how the system works, right? Because ultimately, how we fund the reimbursement to community providers comes from the same pot in the budget for how we fund, for example, the people we hire at VA. And one could see a period at which the demand for care in the community–for funding for appointments in the community, is so significant that you have to pull back on the amount of the budget you’re dedicating to hiring and maintaining VA providers. And so then the question is, if that is indeed a choice that we make as a country, that we would reduce the number of providers at VA, you know, how would we do that? And what would be the rational basis for that?

Would you just say that, you know, VA is going to get out of certain specialties? Would you rather say that VA is going to maintain the specialties but get out of, you know, primary care? Each of those would end up creating a different scenario for Veterans, and each of those has significant costs. And so, you know, when I said that, you know, that we have to decide what, as a country, what we want the VA to look like, you know, I think we should have a straightforward debate on that. The debate to date has been a suggestion that somehow we’re limiting access to care. I think that’s patently, fundamentally, overwhelmingly inaccurate.

I’m very proud of the way we, as the country’s leading healthcare provider, the way we’ve provided robust, wraparound care, integrated care for our Veterans. And community care has been a key part in how we do that. So the debate isn’t–a fair debate is not a question of whether VA is denying access to care. A fair debate is, what do we want that care to look like for Veterans in an integrated healthcare system over time, and how do we finance that? And I think it’s a difficult but a very important question to resolve. And, you know, we try to resolve it here all the time, and I know that the next team will as well.

Anne Chalmers (The War Horse): Thank you very much.

Terrence Hayes (VA Press Secretary):  Thank you, Anne. Appreciate it. Are there any other questions from our press corps? Leo.

Leo Shane (Military Times):  Mr. Secretary, we tried this last month. I’m going to try it again here to look back at some of what the last four years have been. When you came into office, you said you wanted VA to be more inclusive, to bring in more groups that had felt marginalized. We’ve seen over the years changing in the motto, although some of the work is still unfinished on that. We’ve seen outreach to LGBT Veterans. Can you talk about–not grading yourself, because I know that you’re going to immediately avoid that, but talk about where VA is now four years later, and do you feel like it’s in a fundamentally different place, not necessarily a totally fixed place, but in a different place than it was when you came into office?

Denis McDonough (VA Secretary):  Yeah, look–you keep trying to cut off the exits from the highway here.

Leo Shane (Military Times): It took me four years, but I think I got most of them off. Or if you just want to talk about all the things you’re worried about, that’s fine.

Denis McDonough (VA Secretary):  No, no, there’s still one, which is, the most important way for us to judge how we’re doing is what Veterans think. Who gives a rat’s ass what I think, right? And when one measures what Veterans think right now, one need only look at the trust number. And we feel good about that. Do we feel great? No. But we feel really good about it, because directionally, it’s in the right direction, and it’s pretty high. But we aspire to 100% satisfaction, not just under 93% satisfaction, right? So I think that’s really important.

The other is, then, how are we doing on other indicators? One that is heartbreaking is the suicide number, right? And I am not satisfied with that. I’m heartbroken by that. There’s important indicators of success. There’s important indicators that the interventions we’re undertaking are working. But still losing too many Veterans to suicide.

So what I think is that we still have a lot of work to do. We have a lot of work to do on access. We have a lot of work to do on trust. And ultimately, we’ll know, as I’ve said in this room before, we’ll know that we’re really performing at the level that we know we can and the level that we know we need to when we’re at 100% Veteran satisfaction and when suicides are zero and when Vets are telling each other to come get their care at VA. Now, we have glimmers of that, right? I’ll give you two data points, one I just learned today and one I learned earlier this week. The first is that, as of this morning, we’ve provided just over 6 million toxic exposure screenings. That tells me that in our system, our providers are aware of what this tool is, our Veterans are aware of what this tool is, and overwhelmingly, they’re getting access to that tool. That’s positive.

The second thing is we told you last month that we’d begun an effort to reach out to certain Veterans, including Veterans of the Syria conflict who had been exposed to repeated concussive blasts and who are not yet enrolled in VA care. We’ve reached out to about a million of them. There’s three maybe important data points. One is, ultimately, that enrollments this year, December 2024, relative to December 2023 and December 2022, are about 10% up. Now, that’s interesting, I think, because it’s December to December, it’s year to year, it’s three years post-PACT, and it’s three years in the context of historically large outreach. So we’ve had a 10% increase in enrollments. Hopefully that’s an indication that this outreach is working.

Secondly, open rates on the emails that we’ve been sending out to Veterans are at north of 50%. It’s a very high open rate. That may be, and this is the third point, because Veterans are forwarding those emails on to other Veterans. My hope is not fact or even analysis. This is hopeful review, is that that is an indication that Veterans are reaching out to their battle buddies to say, hey, take another look at VA. When we reach that point, I’ll feel really good about where we are, too.

Leo Shane (Military Times): Great, thank you.

Tanya Bradsher (VA Deputy Secretary):  Can I add a couple of points?

Denis McDonough (VA Secretary):  Yeah, please.

Tanya Bradsher (VA Deputy Secretary):  I just can’t leave without talking about women Veterans. So when we arrived, we had about 569,000 women enrolled in our health care. We’re now up to 729,000. Last year alone, we enrolled 53,000 women Veterans. And so to see that uptick is just amazing and just also want to encourage all of our women Veterans and all Veterans to reach out to VA. But it has really been wonderful to see the constant outreach that we’ve been doing to our women Veterans and that they’re actually deciding to enroll in our health care. And so it’s been a phenomenal opportunity to watch that growth throughout time.

Leo Shane (Military Times):  Thank you, guys.

Terrence Hayes (VA Press Secretary):  Any other questions? Well, Madam Deputy Secretary, Mr. Secretary, this concludes our press conference.

Denis McDonough (VA Secretary):  Thank you to the PAOs up there. Thank you, guys.

Terrence Hayes (VA Press Secretary):  Appreciate you. Thanks for coming, everybody. Appreciate y’all. Thanks, press corps.

Denis McDonough (VA Secretary):  Okay. Thanks, guys.