VA Secretary press conference December 12, 2024

Terrence Hayes (VA Press Secretary):  Good morning, ladies and gentlemen, welcome to today’s press conference. Hopefully everybody’s preparing for the holidays. This will be the last time that we see everybody heading into the holiday period. So we definitely wish each and every one of you a happy holidays.

We have a lot to cover today. We have multiple guests joining us to share some news as well as some overviews. So with that, I’ll go ahead and kick it over to the boss, over to Secretary Denis McDonough.

Denis McDonough (VA Secretary):  All right. Thanks a lot, everybody. It’s really great to be here with you. Really appreciate the opportunity to check in with our valued colleagues in the press, both here in the building and virtually. We had, as we were getting ready for this month’s press conference, we had planned to make sure that VBA was our guest today because VBA is doing amazing work. And just because of the crush of other business the last several months, our guests have been from other elements of the VA. I was really thrilled to learn this morning in preparation, you know, in a timely way for today’s presser that yesterday marked the ninth time in fiscal 2025 that VBA has processed more than 11,000 claims in a day. So we have done that 11 times in our history and nine of those times have obviously been in this fiscal year. So I’m really thrilled by, appreciative of, admiring of, the prompt way VBA is processing claims. And now it’s not obviously uniform. There’s still too many claims that end up having to wait longer than we would like, but we’re going to make sure that we get to a Veteran-centered answer before we rush to a ‘no.’ So I thought it was fitting that the day that Josh and Kenesha were to join us for the presser that we learned of another day of very high performance at VBA. So thanks to my–our VBA colleagues. Thanks for continuing to run a Veteran-centered operation over there. So let me yield the floor to our first guest, the Under Secretary for Benefits, Josh Jacobs, and then he’ll introduce our next guest, our valued teammate, Kenesha.

Josh Jacobs (Under Secretary for Benefits):  Thanks very much, Secretary McDonough, for the invitation to join you here today and for your continued leadership and dedication to the Veterans, families, caregivers, and survivors that we are privileged to serve. Over the past two years, we’ve been delivering more benefits to more Veterans more quickly than ever before in our nation’s history. This success has been largely driven by the PACT Act, which expanded benefits for toxic exposed Veterans and their loved ones, and through enhanced outreach efforts to ensure that Veterans know about and can access the benefits that they’ve earned and deserve.

Building on that momentum, we’ve continued enhancing many of the programs and services Veterans and their families rely on. For example, we’re making meaningful changes to our life insurance programs. We introduced the new VA life insurance program in 2023, which provides coverage up to $40,000 in whole life insurance to all Veterans with service-connected disabilities with no deadlines to apply up to the age of 80.

And in the very near future, we are planning premium discounts for service members group life insurance, SGLI, which insures more than 2 million service members. Due to the strong financial position of the program, we anticipate reducing premiums for service members from $30 to $25 per month for $500,000 in coverage and being able to maintain the discount for the next five to ten years subject to the program experience and market conditions. We’re also planning premium discounts for Veterans and military spouses covered under the SGLI family of programs.

These discounts are expected to take effect between April and July of 2025. In addition to improving the affordability and accessibility of our life insurance programs, we’re also committed to addressing the unique and often deeply personal challenges faced by survivors of military sexual trauma. While there is still much more work to do, we’ve made important changes to provide better support for Veterans who are MST survivors as they pursue their earned benefits.

We recognize the immense courage and strength it takes for MST survivors to come forward and to file a disability compensation claim, and that’s why we treat all claims, but especially those related to MST, with the utmost respect and seriousness they deserve. Over the past several years, VA has instituted a series of reform measures to improve the MST-related claims process for all MST survivors. These reforms were designed to improve trust, encourage more MST survivors to file a claim, and enable VA to deliver more benefits to MST survivors. Some of these reforms include the incorporation of trauma-informed communications principles and human-centered design into the MST claims process, the appointment of a single senior executive to oversee the MST workload, consolidation of all MST claims processing to a single operation center, which has been supplemented more recently by a surge site, and a memorandum of agreement with DoD that allows us unrestricted access to reports of military sexual assault. These efforts are having an impact on the lives of survivors.

MST survivors are applying for their benefits at record rates. We’re completing more MST claims than ever before, and we’re able to grant these MST-related claims at a historically high level. While we’re proud of the progress we’ve made, there’s still much more work to do. The growing MST workload is driving the need for continued prioritization of MST claims, and we’re working to improve the quality of our MST claims decisions. We’re taking action so that every MST survivor knows that help is available now, and they can receive the care and support that they deserve. And at this time, I’ll turn it over to my colleague, Kenesha Britton, who will provide you with more details about the important work we’re doing to support MST survivors.

Kenesha Britton (Assistant Deputy Under Secretary, Field Operations):  Good morning. Thank you, Under Secretary Jacobs, and thank you, Secretary McDonough, for the opportunity to speak today. At VBA, we recognize the remarkable courage it takes for survivors of military sexual trauma to step forward and seek the benefits and support they’ve earned. Our mission is driven by a commitment to ensure survivors are met with care, dignity, and sensitivity throughout the claims process. Over the last several years, VBA has been working aggressively to better serve MST survivors, focusing on simplifying the claims process, improving timeliness, and the quality of MST claims. Over the last 14 months, we’ve completed an unprecedented amount of outreach with over 3,500 events dedicated solely to MST survivors to make them aware of the benefits available to them.

Our efforts are paying off, not just in increased trust, but in tangible outcomes. In fiscal year ‘24 alone, VBA received more than 57,400 MST-related claims, an 18 percent increase in FY’23. And as of November 2024, we’ve already received over 10,700 MST-related claims, a 23 percent increase compared to the same period last year. Since 2020, we’ve quadrupled the amount of completed claims, meaning more Veterans are being served, opening doors to health care and other benefits and services. While the MST inventory has grown from 10,300 claims in FY’20 to more than 36,000 claims in FY’25, we’ve reduced the average day spending by over 16 percent since FY’23. And it’s not just about speed.

The overall grant rate for MST-related claims rose to a combined 63.6 percent in FY’24, up significantly from where we were in 2011 at 41 percent. Looking ahead, we’re focused on further improving the Veteran experience. In 2021, we completed the MST journey map to better understand the survivor’s perspective and address pain points in the process. We will continue to apply trauma-informed principles, partnering with VHA, clinical experts to ensure survivors are treated with care and sensitivity, and working to reduce or eliminate re-traumatization while engaging with VBA. We also recognize the importance of getting claims right the first time. Recent enhancements to our quality assessment process, including expanding the sample sizes and more granular reviews, have been implemented to improve accuracy and outcomes.

At the same time, we’re building cultural competency amongst claims processors and prioritizing their well-being to ensure they are equipped to handle these sensitive and complex cases. Finally, we want every survivor to know that help is available now. You do not have to wait until your claim is decided to seek support. MST-related services are available to Veterans and most formal service members, including those with other than honorable discharges. There is more work to do, but we are determined to make meaningful changes that continue to build trust and instill confidence for all MST survivors. Thank you for your time, and I’ll turn it back over to Terrence.

Terrence Hayes (VA Press Secretary):  Thank you, Kenesha. With that, we’ll open the floor to questions. Leo.

Leo Shane (Military Times): Thank you again for doing this. I wanted to follow up on what you just said, Ms. Britton, at the end there. I don’t know if you guys can gauge how much of the increases you’re seeing are related to outreach and how much of it’s related to trust. You know, obviously, with something like the burn pits and the PACT Act, it’s more related to the outreach and the new benefits there. Is this a situation where it’s just folks haven’t reached out to these people, or these individuals are now seeing this as a more viable path? Or can you even gauge that?

Josh Jacobs (Under Secretary for Benefits):  Leo, thanks very much for the question. I’ll start, and then I’ll turn it over to Kenesha. I think it’s a combination of factors. One, Kenesha mentioned the significant amount of targeted outreach that we have engaged in that’s specifically directed at trying to better reach MST survivors. Secretary gave us a goal, a very clear goal, of working to move VA and meet Veterans in their lives rather than making them adjust to VA and our needs. And that is, in part, what we have been doing through the extensive outreach that is specifically targeted at MST. We also have seen, as a byproduct of the general outreach that we’ve done, more Veterans coming in to apply for benefits. And that, I think, has to do with building trust, because we are actively trying to reach Veterans telling them, we want you to connect with your earned benefits. I saw that up when I was in rural Maine, and I met a Vietnam Veteran who came to try VA for the very first time after decades. And we’re also seeing that with MST survivors who are now coming and filing a claim for the first time.

But let me ask Kenesha to build on that, if she has anything to add.

Kenesha Britton (Assistant Deputy Under Secretary, Field Operations):  The only thing that I will add is, with the enormous amount of outreach that we’ve been doing, we’ve seen that consistently our workload has gone up across the board. So we’ve seen the increase in PACT claims. Consistently with that, we have about 41 percent of our MST workload that also have a PACT claim that’s intertwined with it. So that definitely has an impact on that growth. Also, with the changes in the legislation to make it easier for Veterans to come in, I believe that also has impacted that growth as well. When you look at the numbers over time, you can see, based on the years, the different factors and the different things, particularly when the legislation was passed, we started to see our inventory start to increase. So it really started to increase around that time. And then, again, when we established the 9,000 claims, and then a third time when that PACT legislation was released.

Leo Shane (Military Times): Okay, great. Thank you.

Terrence Hayes (VA Press Secretary):  David, good morning. You there, David?

David Elfin (cyberFEDS): Hold on, Terrence. Trying to get the camera going.

Terrence Hayes (VA Press Secretary):  No worries, my man.

David Elfin (cyberFEDS): May have to do without it. Hold on. Oh, here we go. Well, it should go. Good morning.

Terrence Hayes (VA Press Secretary):  Good morning.

David Elfin (cyberFEDS): Secretary McDonough, if we can switch gears a little bit from the MST we’re talking about.

Denis McDonough (VA Secretary):  Sure.

David Elfin (cyberFEDS):  So I’m hoping to talk to Secretary McDonough there, Terrence.

Terrence Hayes (VA Press Secretary):  Yeah, he’s right here. Trust me, he hasn’t left.

David Elfin (cyberFEDS): Secretary McDonough, we have something like seven weeks left in the administration, and I wondered if you could reflect a little bit on your–what you consider your biggest successes and maybe the issues you feel you didn’t get resolved.

Denis McDonough (VA Secretary):  Yeah. Look, David, I really appreciate the questions, and I think you know I make a good faith effort to reply to your all’s questions down here. But I’ve got to tell you, I haven’t really thought about this in terms of what I have done or anything like that.

David Elfin (cyberFEDS): How about what the department’s accomplished during your time? Put it that way.

Denis McDonough (VA Secretary):  Yeah. So, okay, that’s where I was just about to go. And then I want to just come back and just double tap one more time or double click one more time on what Kenesha ended her opening comments with, which I think were really important.

I think the most important thing that we’ve done in the course of the last four years is underscore to Veterans that we work for them, that the programs are designed for them, that the care that is provided is their care, and the benefits that are delivered are their earned benefits. Josh just made reference to this, and we’ve talked about it a lot in this room. And frankly, our monthly press conferences are a part of this, where we have made a very concerted effort to reach Veterans where they are so that they can be in a position to get the care and the benefits that they’ve earned, that they don’t have to turn their life upside down to fit into our program.

This is, for example, why you’ve seen historic levels of access to Community Care each of the four years that we have been here in the building, because we want to make sure Veterans get access to care where they are. And, you know, I was recently timing at a swim event, and I was timing with another parent who happened to be a Navy Vet, and he talked about how, for the longest time, he did not apply for his benefits because he thought somebody else needed them more, that somehow he was going to take them from somebody else. He now says that he’s the biggest advocate to his fellow battle buddies to make sure that they get in to get their benefits.

I’d like to think that that’s a reflection both of his determination as a Veteran looking out for his fellow Vets, and it’s a manifestation of the fact that Veterans feel like we are more responsive to them. So that’s what I’d say. Let me just double click, as I said, real quick on the concluding paragraph of Kenesha’s remarks. I think she communicated very clearly to MST survivors that we–consistent with what I just answered–how I just answered your question, David, we work for you. The benefits and the care that is here are yours and we want to make sure that you know that that care and those benefits are here. You should not suffer alone. And there is support for you that you have earned, and we want to make sure that you come in and get it. Thanks.

David Elfin (cyberFEDS): Secretary McDonough, a follow up, if you don’t mind. And Terrence knows this. My publication is all about the federal employees, the workforce.

Denis McDonough (VA Secretary):  Yes.

David Elfin (cyberFEDS): I wonder if you could talk about what maybe you’ve achieved on that front, how they’ve done for you, with you over the last four years. And having served in the previous administration, you know, there’s always more work to do. You feel like, you know, there’s things you wish you could have done before you get out the door. I wonder if you could talk about the workforce and anything you really look back–you’ll look back on and say, God, I wish we could have gotten that completed?

Denis McDonough (VA Secretary):  Yeah. Well, look, three things. One, I opened with my comments about the fact that yesterday we processed more than 11,000 claims for the ninth time in this fiscal year. And by we, I mean VBA. And we’ve done that now 11 times in our history, meaning nine of those 11 times have occurred just in this fiscal year, and the other two were late in the last fiscal year. So I’m very proud of the performance of our claims processing teams at VBA. One.

Two. We’ve talked about this in the course of the last several months to include in the course of the debate as we’ve asked for additional funding for VHA. We provided 131 million health care appointments last year, also a record. And we did that at a time when Veteran satisfaction and Veteran trust reached record highs at about 91.8% Veteran trust for VA outpatient services. So I’m really proud of the workforce on that.

Third. We’ve also grown the workforce in the last several years. And so not only–so we’ve been able to grow that through a variety of means. Most profoundly, the mission at VA. This is the best mission in the federal government. Secondly, we’ve been able to make investments using new VA–new tools for pay enhancements, which were a long time in coming at VA, where we are now even more competitive with other, for example, health care providers. Third, something that I wish we could get–that we could have said is done and finished is there are still Veterans whom we have not reached and we have not reached them because we just, we can’t get the right combination of outreach. But we also haven’t reached them because maybe we failed them in the past. Or maybe they just don’t trust us because of what they’ve heard about us.

So look, we go to bed every night here thinking–knowing that there’s a lot of work yet to be done. That work, the trust work is really important. I wish we could–I wish we can do more. I hope and I expect that we will do more. Because there’s 19 million Vets, 18 million Vets in the country, a little over 18 million Vets in the country. We have relationships with just over half of them. We should have a relationship with every single one of them.

David Elfin (cyberFEDS): Terrence, last thing. I just want to say something unsolicited. Secretary McDonough and you and your staff have been unbelievable these last four years. And if every government department had outreached to the press the way you guys do, we’d have a much easier working relationship with the entire government. So thank you guys for all you’ve done.

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

Patricia Kime (Military.com):  Thank you for doing this. I appreciate it. I have a couple questions. Secretary McDonough, over a year ago you talked about doing a review of the hypertension claims. There was like 83% where zero under the PACT Act. Can we get an update? It’s great to have you here Under Secretary Jacobs. That’d be great.

Denis McDonough (VA Secretary):  If we can just go straight to Josh.

Patricia Kime (Military.com):  That’d be great.

Denis McDonough (VA Secretary):  Because he actually knows something.

Josh Jacobs (Under Secretary for Benefits):  Thanks very much for raising that question and concern. The issue that you’re raising is that under the PACT Act, we now cover hypertension as a presumptive for Vietnam Veterans. And we’ve seen a surge of those claims. One of the concerns that we’ve heard as we’re working to deliver those earned benefits is that some Veterans have been receiving a 0% service-connection. That means that they are service connected for hypertension, but they don’t receive compensation for it, albeit there are ways in which they can if it’s combined. It does open the door for additional health care eligibility and enhanced services on the health care side. But the net impact among some Veterans is a belief that they need to go off their medication to receive a higher disability rating. And we are actively communicating to Veterans with hypertension to not do that.

The question that you ask, though, is what are we doing here? And so we’ve developed an IPT to try to make it easier to or we developed an IPT with our cardiologist partners in the health system to identify opportunities to make some improvements there. There is active work in process. It is in the rulemaking process, so I’m somewhat limited in terms of what I can say, but those activities are underway.

Patricia Kime (Military.com):  Okay. So it’s in the rulemaking process, but a preliminary proposed rule hasn’t been published yet, right?

Josh Jacobs (Under Secretary for Benefits):  Correct.

Patricia Kime (Military.com):  Is there any movement afoot? VA has a pretty high threshold for what is high blood pressure. That’s actually very different than what is medically accepted. So is that being considered in that rule?

Josh Jacobs (Under Secretary for Benefits):  That’s actively part of the effort that is underway, is to align it with the current medical understanding of blood pressure readings.

Patricia Kime (Military.com):  Any timeline on that?

Josh Jacobs (Under Secretary for Benefits):  I would have to get back to you on that.

Patricia Kime (Military.com):  Okay. Second follow-up, another question not related to hypertension. It’s December, and we haven’t seen the annual VA suicide report. So where is that, and what’s the holdup?

Denis McDonough (VA Secretary):  Yeah, thanks very much. I want to go back on the hypertension point. I think, I don’t know if it was the AMA or whoever manages the medical evidence on this, but it has changed what’s elevated, what’s high blood pressure, just in the last year or so. So we are making sure that we catch up with that.

Secondly, on the suicide prevention report, I just had a meeting with this today–about this today, this morning, to express my strong feelings about the fact that this report should be public. And so I anticipate it will be public in the very near term. In terms of, I think we’ve been communicating with you guys over the course of the last several months about the process by which we get to the conclusion on this. And so I think we’ve given you updates on some of the procedural hangups that we’ve encountered. But this is important data. This is important data for the community. This is important data for our–meaning the community of Veterans. This is important data for our partners, like Congress and the VSOs. And it’s important data for epidemiologists and other experts who use that data every year to kind of help us determine what works and what’s most effective and what’s least effective. So we want to get it out there and I have every anticipation that it will be out there soon.

Patricia Kime (Military.com):  Okay, thank you very much.

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

Quil Lawrence (NPR): Can you all hear me all right?

Terrence Hayes (VA Press Secretary):  We can, we can.

Quil Lawrence (NPR): I was going to throw a prank and not have any sound just for old times’ sake, but nice to see everybody and thank you as ever for doing this.

Denis McDonough (VA Secretary):  That was what, ‘21, ‘22, and ‘23 that that happened?

Quil Lawrence (NPR): I don’t know if it’s better than ‘24, but I’m glad to be remembered for something.

Denis McDonough (VA Secretary):  Yes.

Quil Lawrence (NPR): So before I jump into a couple questions I have on VASP, and I don’t know if you’ll have numbers on this, but with pardons in the news, I was wondering–you mentioned being able to grant VA benefits, being able to change sort of status, eligibility for VA benefits to MST survivors who have bad paper, and the White House had reiterated today that back in June it pardoned anyone who had been put out of the military for homosexual conduct. I’m just wondering if you’ve got visibility on how much that brings people in to apply to VA for benefits and how often you are recharacterizing service of Vets who have bad paper. And I’ll understand if you don’t have that number at hand, but I’d be interested if you do.

Denis McDonough (VA Secretary):  I think it’s an interesting question, and we’ve gotten preliminary updates on that, and I think we could get those put together and get those to you, Quil, and maybe we can even do a bigger look at this and maybe get it to you next month, too.

Quil Lawrence (NPR):  That’d be great.

Denis McDonough (VA Secretary):  But I think it’s an excellent question. We are prosecuting that data. We have the same question ourselves. And so because we are now–the White House effort on the pardons is one source of that data. The other source of data is reviews of characterization of discharge since we announced the new process by which we will determine eligibility for those with other than honorable discharges. So that’s another source of that data. Let us aggregate that and get it to you guys.

Quil Lawrence (NPR): Wonderful. Thanks so much. And then with apologies, I’ve got more questions about VASP. In our most previous correspondence, we mentioned that there are 1,300 Veterans who had a 50 percent increase in their monthly payment. Our last correspondence was VA was saying it couldn’t do anything to help them. It didn’t have the authority to help them. I’m wondering if you’ve asked Congress for that authority, if you intend to try to get that authority. I mean, these are just by our count 1,300 Vets who, because of the VA error, end up with a huge increase in their monthly payments. And I’m just wondering what you’re able to do to help them.

Josh Jacobs (Under Secretary for Benefits):  Quil, thanks very much for that question, and thanks for your continued focus on housing for Veterans. I would start by saying that since March of 2020, we’ve been able to help more than 750,000 Veterans avoid foreclosure. And nearly 90 percent of all Veterans who completed a loan modification during the pandemic received an interest rate lower than their original rate. Now, you’ve identified a group of Veterans who fall outside of that 90 percent. And what we would say to those Veterans is that we encourage them to work with their servicer, contact VA, talk to a VA loan technician to explore their options. Each of those situations is different, involving different circumstances. We’re actively engaging with our congressional partners in discussions about a variety of different programs and different opportunities. We have the ability to work with them through the entire waterfall of options to help them retain their homes, including things like repayment plans, loan deferments, and much more.

Quil Lawrence (NPR): Right. We’ve had this correspondence, and I think, as you know, these are Veterans who their rate didn’t go down because the economy changed and rates doubled on everybody. And it’s a relatively small number of Veterans we’re talking about here who, again, because of a VA error that you guys have acknowledged and are taking responsibility for, they’re in a very tight spot and nothing in that waterfall is apparently going to help them. I’m just wondering what specifically you could do. You could turn PCP back on, or could you just categorize them? The experts we’ve talked to in the mortgage industry think that the VA does have the authority to do this.

Josh Jacobs (Under Secretary for Benefits):  Well, I’m happy to talk to the experts that you’re referring to. We’ve had extensive conversations exploring our options. And as I mentioned before, we’ve been able to keep 750,000 Veterans in their homes since 2020. We’re actively engaged. We have regular conversations with our servicers who provide the loans that we guarantee. We talk regularly with housing advocates, and we work with our interagency partners to actively explore all potential opportunities to do everything in our power to keep Veterans in their homes and to expand the opportunity for homeownership. But we’re also making sure that we’re monitoring our implementation. So if you’ve got information that I don’t have about those potential opportunities, I’m happy to have that conversation.

Quil Lawrence (NPR): Is that 1300 number, by the way, does that make sense to you? I’ve asked this several times by e-mail. Do you have a different estimate for the number of people who have had a drastic increase in their payments?

Josh Jacobs (Under Secretary for Benefits):  I don’t have those numbers off the top of my head, but I’m happy to take a look.

Quil Lawrence (NPR): Okay. Great. I’ll let other people ask other topics, and I think my colleague will have a couple more questions about VASP going forward into the next administration.

Terrence Hayes (VA Press Secretary):  Thanks. We’ll circle back.

Quil Lawrence (NPR): Thank you.

Terrence Hayes (VA Press Secretary):  Jordan.

Jory Heckman (Federal News Network):  Hi. Thanks again for doing this. I wanted to ask about the upcoming December 20th funding deadline. I know, of course, VA is in a different situation than other agencies when it comes to matters of government shutdowns or CRs or things of that nature. But what impact, if any, is the VA anticipating if there is perhaps a government shutdown or if Congress does get a CR or a CR, a continued resolution, over the finish line, what that would mean for VA, especially given its budget shortfall situation?

Denis McDonough (VA Secretary):  Yeah. Jory, thanks so much for the question. And so I think what I’d say is that, you know, let me desegregate the question. First, I’d say that, you know, we have protocols here internally to make sure that as we approach a CR date that we get the relevant personnel from across the enterprise together to do prudent planning. So that work is ongoing. They just had, I think, their most recent meeting yesterday. So I don’t have, like, a readout of that process on any specifics that we’re focused on. But I can tell you that that team, which is now very experienced, is meeting on a regular basis, planning for eventualities if Congress doesn’t extend the CR by the 20th or, you know, come up with an omnibus appropriations act or something. So that planning is ongoing. I don’t have a readout of that.

It is true that we have requested $6.6 billion in additional funding for the rest of this fiscal year for VHA. We need that funding because we are delivering more care, more benefits to more Vets more quickly, as Josh said, than ever before. And so, you know, with that funding, we’ll be able to hire clinicians, replace aging medical equipment, purchase necessary medications and prosthetics for Veterans, and most importantly, maintain the high-quality health care that the Veterans have come to expect and surely richly deserve. So, you know, we’re answering questions to Congress on this issue. We’ve had testimony in two different hearings in the House in the course of the last four weeks or so, and we’re going to keep working on this to make sure that we can get that funding.

Jory Heckman (Federal News Network):  And until that $6.6 billion gets addressed one way or another, what’s the VA’s hiring picture look like? Is it in this still kind of constrained hiring environment that it’s been in for much of this fiscal year? What does that look like until Congress addresses that?

Denis McDonough (VA Secretary):  Yeah, rather than add new facts or new analysis to this question, let us get you what we’ve said on this, particularly because I may not have the most up-to-date assessment from our VHA colleagues. So let us take that and get that answer from VHA. I do know that one of the things we’re concerned about is, you know, over the course of the last year or so, we have been delaying certain technology purchases and equipment purchases so as to, you know, not compromise other funding needs. So that would be one of the things we’re particularly focused on as I listed that series of investment priorities just a couple of sentences ago. But in terms of hiring, let us get you a very specific answer on that.

Jory Heckman (Federal News Network):  And then finally, I wanted to get your thoughts on, with the incoming Congress, the House and Senate VA leadership have been pretty clear that they want the VA to make full use of the VA Accountability and Whistleblower Protection Act. You’ve told us before, about a year or so ago, that the VA is not using authorities in that legislation to fast-track the firing of VA employees who have been accused of misconduct or poor performance. You’ve said that that language really, you know, was getting the VA more in front of federal courts and losing in those cases more than doing anything productive on the accountability front. Just as that incoming Congress is coming in here, what’s your message to them when it comes to this whole policy area?

Denis McDonough (VA Secretary):  Yeah, you know, when the incoming Congress comes in, if they ask me questions, I’ll give them messages. I don’t need to communicate messages to them through you guys as much as I love you and appreciate you guys. So let me not, you know, suggest that before these people are even sworn in that I’m somehow sending them a message. I look forward to, for the couple of weeks that I’m here while they’re here, I look very much forward to working with them. I do notice that there’s a lot of Veterans in that group. And I think, as I’ve said in this room before, you know, I get to travel the country in this job, and every place I see something interesting happening, inevitably there are Veterans involved in that. That’s definitely the case in Congress as well.

Now, I will just give you my thoughts about the various authorities that we have here. First and foremost, as an HRO, for example, at VHA, the Veterans Health Administration, a high reliability organization, we obsess about failure. We learn everything we can about failure. We empower our clinicians to make decisions at the point of care, informed by their expertise, not informed by somebody telling them what is the optimal investment. So we want our clinicians to feel so empowered. In exchange, we expect accountability for those actions. And when our providers do not live up to that accountability–those accountability requirements, we hold them accountable. We hold them to that. And we’ve talked about in this room a series of examples of us doing that.

Detroit is a good example of that. Denver, Aurora is another good example of that. Those are just two examples in the last year where we, using our existing authorities, have moved with dispatch to change and improve situations where Veterans were not getting the care that they deserve.

Next paragraph. It is true also that there are additional authorities that Congress has enacted that when VA has tried to use them in the last five years, we end up more before federal magistrates and judges than in individual conversations with our providers and holding them to account. I’d much prefer us to be able to just manage our building rather than spend so much time before judges. And so that’s what we’ve tried to do here. The fact that we’re providing more care and more benefits to more Veterans more quickly than ever is evidence that that’s working. It’s not perfect in VA.

Last thing. We also take very seriously our responsibilities to go to Congress to inform them of instances where we are not performing to our highest expectations–not performing to our expectations. And we routinely do that. And you guys are very familiar with all the times that we’ve done that. I’m sure even just this week. And so we take very seriously the congressional role, the role that the founders envisioned for the Article I members of this government. And I hope that continues here because I think Congress is an important partner. And I think any fair assessment will tell you that we have been very forthcoming with Congress. And I’m proud of that fact.

Jory Heckman (Federal News Network):  Thank you.

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

Chris Arnold (NPR):  Can you guys hear me?

Terrence Hayes (VA Press Secretary):  We can.

Chris Arnold (NPR):  Thanks, Terrence. I just have two questions about VASP. One is pretty simple. How is the VASP rollout going so far? Just anecdotally, the Vets who we’ve been in contact with, very few of them have been able to get into an actual VASP mod or new loan through VASP. And the moratorium deadline, I think the end date on it is the end of the month. Are you considering extending the moratorium to give people more time? Or what happens on January 1 to all the folks who haven’t been able to get that sorted out?

Josh Jacobs (Under Secretary for Benefits):  Great. Well, Chris, thanks very much for that question. Right now, we have approximately 90 percent of VA home loans that are held by servicers who are participating in the VASP program. And to date, we have received about approximately 6,000-6,500 applications for VASP. And we’ve certified more than 4,900 of them. And so the large proportion of those VASP submissions are being approved. Some are still pending review and undergoing that process. And we’re continuing to work with servicers to make sure that they understand and are implementing the program appropriately. And I think one of the important points to keep in mind is that we work through a loan retention waterfall. So to the extent that other options to keep Veterans in their home may work, we will work to pursue those before we get to VASP, which is a last option to keep Veterans in their home when nothing else works.

With respect to the foreclosure moratorium, I mentioned earlier to Quil that we have been able to keep more than 750,000 Veterans in their homes since March of 2020. And in that time, for 52 of the 56 months, we’ve had a foreclosure moratorium in place. In the end of May, we provided an announcement encouraging servicers to implement a targeted foreclosure moratorium through the end of December. And that was designed to give servicers the opportunity to implement the VASP program. I mentioned approximately 90 percent of servicers–about 90 percent of the VA home loans, are covered by servicers who are participating in that program. And so as we look towards the end of the month, we feel pretty good about the implementation of the VASP program. We’ve had high utilization from those submissions.

And we encourage Veterans to continue to explore opportunities with their servicer if they’re experiencing financial hardship. And if they need assistance to contact us directly to talk to a loan technician. That number is 877-827-3702. So we’re anticipating the targeted foreclosure moratorium to expire at the end of the month. And we want Veterans to know that we’re here to help if they need assistance.

Chris Arnold (NPR):  Okay. And just when we first started reporting on this, there were 40,000 Vets facing foreclosure according to industry data. So 6,000 is only 15 percent of those people. And interest rates are still at 7 percent. The other loan mod options, you know, double people’s or raise their payments massively. So it doesn’t look–I mean, it looks like only a small portion of folks have gotten VASP. So, you know, we’re just concerned, obviously, like keeping eye on are people going to get the help in time. And my other question is with the 1,300 we identified–and, you know, like we get it. There’s 700,000 people got help, like hats off–we’re not like, you know–at the same time, we’ve identified for you guys, like, hey, look, in your own data, there’s 1,300 Vets who really got hurt here financially. Their payments rose massively, like more than 50 percent every month.

And I understand the answer is often, well, they should reach out to us. Why put the burden on these Veterans to raise their hand again and ask for help from a system that has failed them? Why not–you know, we don’t know who they are. Like we can’t see the personal identification to identify them in the data, but you guys can. I mean, why not reach out and say, hey, look, you know, this seems like it didn’t work out right for you. Do you need help? What’s going on? Have you thought about that?

Josh Jacobs (Under Secretary for Benefits):  We’re actively exploring all opportunities. I’d have to go back and talk to my loan guarantee to talk about the specific outreach that they’ve done. But every day we talk to Veterans who are seeking assistance. We explore all of the opportunities. And we’re doing everything in our power to make sure that Veterans can stay in their homes. And so the programs that you referred to expired, that largely–the partial claims program, that expired largely because we were relying on emergency authority and resources tied to the pandemic. But we have designed a program that we think will help as a last-ditch effort to keep Veterans in their homes. And what we’ve also seen is that the other loss mitigation programs that exist have seen significant increase. So we’ve been able to refinance a number.

We’ve seen, I think, something in the order of a 1,500 percent increase in interest reduction rate refinances. I’ll have to go back and confirm that number just to make sure. But significant increases in utilization of existing authorities. And then the VASP program obviously helping as a backstop when all other opportunities exist. So we’ll continue working as we always have. Each case is different. Each loan is different. And our commitment to Veterans–the Veterans that we serve, is to work with them individually to do everything in our power to help them stay in their homes.

Chris Arnold (NPR):  Okay, and I’ll let you ask–other folks ask questions so we’re not, you know, asking too many VASP questions here.

Terrence Hayes (VA Press Secretary):  Any additional questions in the room? Jordan.

Jordan McDonald (GovCIO): Hello. Thanks for doing this. I had a question about the EHR program. I know we’ve talked about it throughout the year. But thinking about as we get to the end of the year and eventually end of the administration, how are you working with the Presidential Transition Team to prepare and eventually hand off the program?

Denis McDonough (VA Secretary):  Yeah, so, you know, we’re–we don’t have any new news about the transition team. You know, so when the team gets here, we’ll make sure that we make that public. And, you know, this will be among the things that we’re going to want to talk to that team about. So, you know, we don’t have any updates on how we’re talking to the next team about the EHR.

Jordan McDonald (GovCIO): Well, let me ask, how are you preparing for it, you know, going into next year then?

Denis McDonough (VA Secretary):  Well, you know, we’ve been working in the context of the reset to make sure that we’re in a position to learn everything that we possibly can about the performance of the system and the upgrades of the system. We’re making sure that, you know, since the go-live in March 2024 in Chicago, that we’ve been pleased with the progress of the EHR system at the Lovell Joint Facility that we run with the United States Navy. It’s obviously still too early to declare final or unequivocal success. There have been some promising results.

Importantly, I think across each of the EHR systems, we’ve seen increased Veteran trust since the EHR go-lives. We’ve seen decreased wait times. We’ve seen dramatically decreasing disruptions in patient care since January 2024. We’re seeing decreasing numbers of interruptions for clinicians, therefore minimizing the slowdowns for Veterans. We’re seeing an increased clinician and staff satisfaction. But there’s still, I just want to underscore as I will with each of these generally, but let me specifically say here, there’s still room to improve there, dramatic room to improve. But we’re seeing increased clinician and staff satisfaction. And we do feel like the EHR launch in Chicago was a success.

This all adds up to the thing that we care about most, which is better care for Vets that we serve and a better experience for the clinicians who serve them. So we’ll be sharing all of those findings with the transition team. But remember that there’s a relatively small number of political appointees here at VA. So the overwhelming majority of VA professionals who work on EHRM will be working on EHRM on January 21st, just as they were on January 19th. So that team stays, and we’ve benefited greatly from our opportunity to work with them. And I say our, by that I mean those of us who are political appointees. So that work–the reset work continues. We feel good about it. There’s still a lot of work to be done.

We’ll make sure that the transition team has a really good understanding of that. But in all cases, also the team that works–this is a team that’s going to be here, is here now, and will be here deep into the next administration.

Jordan McDonald (GovCIO): Thank you.

Terrence Hayes (VA Press Secretary):  Leo.

Leo Shane (Military Times): Yeah, just two quick questions. I wanted to ask you about all the private conversations you’re having and if you’ll give us all the details. But in seriousness, last time we were here–the new administration hadn’t signed the memorandums needed for the transition work to start. So is that in full effect at this point? Are you working with the next administration having conversations that need to have so that there is a seamless transition at this point? Or are we still waiting for the Trump administration to finalize some of those details?

Denis McDonough (VA Secretary):  I think that’s a better question for the White House, and we’ll help facilitate you getting that question to the White House. Because the key–the on and off key is held by the White House and the transition team. So to be honest with you, I think I could go from memory. But why don’t we just get you the answer from the people who are in charge of the keys.

Leo Shane (Military Times): Okay. And then jumping back to the number of claims that have been processed, and you both mentioned that 11,000 number. The claims backlog has sort of plateaued over the last few months, though. We have talked about this a bunch of times. And I think 2025 was when you thought that we’d be getting back to the pre-pandemic levels. Are we still looking at that kind of timeline here? Or is it getting pushed back by some of the PACT Act claims, some of the increased volume that we’ve seen over the last year?

Josh Jacobs (Under Secretary for Benefits):  We’re actively reevaluating our projections right now based on the latest actuals and the trends that we’re seeing, both in terms of the number of claims we are receiving, historically high levels, and continuing to see robust submissions based on historic levels of outreach, as well as our production capacity. So we’re going to work to revalidate that. We’re mindful, right, if backlog is the only metric of success in this organization, we wouldn’t do things like conduct the largest outreach campaign in VA history. So it is one very important metric, but it is not the only metric. We’re also looking at the total number of Veterans that we can serve. We’re looking at the accuracy. And importantly, we’re looking at the experience, trying to make the experience of applying for and receiving benefits optimized so that we can encourage more Veterans to do it and we can make it easier to do so.

Leo Shane (Military Times): Understood with that. However, if you’re not moving that down, does it point to pulling in too much work for you and too much for the current workforce? Is there a concern that seeing that number starting to flatten out instead of the drop that it had been on is pointing towards either the need for more staff or the need for just a different way to do things?

Josh Jacobs (Under Secretary for Benefits):  Well, we’re always looking at ways to improve the way that we do business, and we’re always looking to serve more Veterans. And so one of the ways that we’ve worked to improve the way we do business is by implementing initiatives like the Overdevelopment Reduction Task Force, where we’re trying to reduce unnecessary medical exams that take additional time and money and require Veterans to go oftentimes long distances. We’re implementing new automation tools to enable our workforce to deliver timelier, higher-accuracy decisions. So we’re looking through all of that, and we’re ultimately going to make a decision based on the data that, again, we’re working to revalidate right now with the updated projections.

Leo Shane (Military Times): Okay. All right. Thank you.

Terrence Hayes (VA Press Secretary):  Back to you, Chris.

Chris Arnold (NPR):  Oh, sorry, guys. I just had my hand up by accident. Although, why not? I’ll ask one more. So I wasn’t clear on the answer of, like, what would you guys consider proactively reaching out? I mean, now that we’ve been like, hey, look, 1,300 people, payments went up massively. We have no way to contact them to say, hey, VA wants you to reach out if this is, like, killing you.

Denis McDonough (VA Secretary):  Yeah. Well, I think the way Josh answered that question, Chris, was to say he’s going to check with his team. He’s under the impression, as am I, that we are reaching out to Veterans regularly. We have a lot of–one of the things we do well–among the things we do well at VA, is homelessness prevention. That was a big priority for us year before last. Because of the prevalence of data we have, we can sometimes identify a Veteran who is encountering challenges, and we do preemptively–not preemptively–proactively reach out to Veterans who we assess may be encountering challenges. And so it’s not that we would consider it. It’s that we do it. And I think we’ll come back to you with kind of the most helpful description of what we’re doing and how we’re doing it and why we’re doing it.

Chris Arnold (NPR):  All right. Thanks, Secretary McDonough. And I’ll circle back on the 1,500 percent increase in IRR mods is interesting. I didn’t know about that, too.

Josh Jacobs (Under Secretary for Benefits):  Yeah. And I’ll work to verify that that number–that’s my recollection, but I’ll just make sure to confirm that if it’s different to get you that number.

Denis McDonough (VA Secretary):  Let me just explain to you what happened there, because Josh used that number, and he thought to himself, I think I remember that number, and it’s a great number. But then he’s like, uh-oh, I hope it’s the accurate number. So what he’s saying to you is we’re going to double check. He’s going to double check that, but I’ve heard–the same thing sticks in my mind. So we’ll get you the 100 percent most accurate version of that and get it back to you. Patricia has a question.

Terrence Hayes (VA Press Secretary):  Yes, sir.

Denis McDonough (VA Secretary):  Are you okay if I call her?

Terrence Hayes (VA Press Secretary):  Are you firing me, sir? My mom only watches these to see if I haven’t gotten fired yet, so–

Denis McDonough (VA Secretary):  Well, Gary’s mom watches to see if I’m gaining weight.

Terrence Hayes (VA Press Secretary):  Patricia.

Patricia Kime (Military.com):  Well, I hate to sound like we’re asking you about everything at the end of the year, but can we talk about the infrastructure review, the commission that was canned, and then you are going to go back and look. What’s the status of that review? Are you going to get that done before the end of your tenure here?

Denis McDonough (VA Secretary):  Yeah. Let me just say some things, and then let’s determine how I can be helpful on the question because when you say, will you get ‘that’ done, I’m not sure what the ‘that’ is. So let me explain to you kind of what the authority is and then what we’re doing and then what I think you should expect.

So the authority of the commission that you talked about is called the AIR Commission. I’m not sure what A and I and R stand for, to be honest with you. But the AIR Commission was enacted by Congress in the middle of the last administration, and it set up a process by which we divvied up the country into a series of markets, and we did an assessment of each of those markets of, most importantly, what do we think the Veteran need is in that market, and importantly, what do we think the Veteran need will be prospectively in a number of years.

That’s kind of a baseline analysis. Overlaying on that is an analysis of what are the existing VA facilities, what are the existing private facilities, how do those two kinds of facilities work together to meet that baseline assessment of what Veterans are going to need in the out years. And then the last piece of that is, okay, in light of all that analysis, what should our infrastructure planning project look like so that we’re in a position to meet that Veteran need.

And that process was set up in large measure to also be able to factor into that analysis that there are VA facilities in many of these markets that are aged or aging. And so, we wanted to have a basis for which to make a determination as to whether those aging facilities should be updated or replaced with something else. So we did that whole project in March 2022. We put it out there. We were hoping that Congress would then appoint the commissioners so those commissioners would look at our plan and either give it thumbs up or give it thumbs down, the whole plan in total. And then that would serve as the basis for our planning going forward. Congress decided not to do that because there were some things in there that they were not comfortable with.

The same law that created that whole process requires us to do that baseline assessment, Veteran need by market overlaying with provider capacity, VA, and private sector in that same market. Requires us to do that every four years. That is the process that we’re engaged in right now. I don’t know what the timeline is, and we can get you, Patricia, what the timeline is for the completion of this next version, the next quadrennial review of that to give that analytic basis. So I’m fairly certain that will not be done by the time I leave. But that work is not tied to me. That work is tied to the statute.

Last thing I’ll say about this. I think you’re also aware of the fact that we are aggressively looking at all–not looking at–we are aggressively using all of our authorities to do as much infrastructure development as we can, and I think probably every VA secretary would say that. I think a thing that is new is that we have worked aggressively with our federal partners, most profoundly DoD, but also USDA, to make sure that where there is infrastructure available in those markets where we have Veterans who have access needs, and even if that’s not VA infrastructure, but it’s DoD infrastructure or USDA infrastructure, we go and access that, and we begin providing care out of those facilities. And so that work is ongoing, and we’ll make sure that we give you an update on that before we leave. But that’s kind of extra, the AIR Commission process. Now, I’ll stop, and you tell me if that’s actually responsive to what you asked, or is there something else I was supposed to–

Patricia Kime (Military.com):  It is. Part of the foundational sort of charge of the commission was to identify buildings that were obsolete, real estate that was obsolete that you all still have on your budget sucks up a lot of money, and they’re just not being used, or it’s just random real estate.

Denis McDonough (VA Secretary):  Correct.

Patricia Kime (Military.com):  Have you been able to shed any of that since Congress scuttled the commission report?

Denis McDonough (VA Secretary):  The verbs in your question, scuttle and shed. I mean, it’s like you have strong feelings about this.

Patricia Kime (Military.com):  I’ve been doing too many crossword puzzles recently. Anyway, have you been able to get rid of some of this burden–burdenous real estate that was a major complaint when you first came into office?

Denis McDonough (VA Secretary):  Yeah, it’s still a major complaint, right? I mean, let’s just take New Hampshire. The facility in New Hampshire, there’s a really, really cold winter year before last. Gets really cold, pipes freeze, pipes burst. We ended up having to shut down. It’s not even a hospital, it’s an outpatient. It’s a major multi-specialty kind of outpatient facility, but it’s an outpatient facility. We had to really curtail access there, and that is a version of the kinds of challenges we face. So we continue to face those challenges. Have we been able to close certain facilities? You know, one on the list is a facility in South Dakota in Hot Springs. That facility is still open. Our plan would have us replace that facility with a multi-specialty community-based outpatient clinic that would allow us to see dramatically more Veterans in that facility, in that geography, than the existing more than 100-year-old facility. We’ve not been able to make that effort.

Nevertheless, we are still continuing to make investments in South Dakota, including in Rapid City proper, as well as new community-based outpatient clinics in other rural settings in South Dakota. So all that process continues. But in that instance, the Hot Springs facility, Congress has made very clear that they have expectations on that.

Patricia Kime (Military.com):  Okay. Thank you.

Denis McDonough (VA Secretary):  Yeah.

Terrence Hayes (VA Press Secretary):  I think we’ve got one last question. Back to you, Quil.

Quil Lawrence (NPR): Hey, thanks. I mean, since we’re waxing philosophical about the Mission Act, I was wanting to know, with the course of that over your tenure here, coming out of the pandemic where the Community Care part was, I guess, thrown a statistical curveball there, how do you feel VA is in terms of its use of Community Care? Do you think you found the sweet spot? Do you think it needs to change? Obviously, there are people who are claiming that that would be a way to cut VA budget, would be to lean more on the community. I just wanted to give you a chance to talk about that big picture.

Denis McDonough (VA Secretary):  Yeah. Well, you want me to talk about my feelings?

Quil Lawrence (NPR): Yeah, your legacy. Please. Will you just please talk about your legacy?

Denis McDonough (VA Secretary):  That will happen exactly never. Leo wanted me to talk about all my private conversations.

Quil Lawrence (NPR): You gave to Leo.

Denis McDonough (VA Secretary):  So that’s good. So let me just establish three things. One, I won’t talk about my private conversations. Two, I’m not talking about my feelings. And three, if you ask me am I concerned about something, the answer is always yes.

On Community Care, kind of how we think about this is in the first instance not that interesting, right? Inasmuch as the statute has requirements, we follow the statute. And we’re a country of laws, so I don’t want to suggest that there’s something more important than the laws, but Veteran satisfaction is exceedingly important to how we provide care at VA. It is the most current, the most up-to-date, I guess. That’s the same as current. It’s the most up-to-date assessment we can get about a Veteran’s belief about what’s happening in the system. And right now, on outpatient care, we’re at 91.8% in the system. So that tells me that Veterans in large measure feel good about what’s happening.

There’s a remarkable story, or just a collection of bullets, I don’t think they write stories, but one of the news agencies last week about their belief–their aggregation of Americans’ views of their health care access. And this is civilians. And the civilians’ views as compared, no, it’s not apples to apples, right? They’re different measurements. But they’re nowhere near 91.8% Veteran satisfaction in the civilian sector, right? So that 91.8 is a really important thing for us.

Also important are health outcomes. And we do a lot of long-term data analysis in the health side. We feel really good about what Veteran access and Veteran care in the direct care system means for Veteran outcomes. And so those, I guess, if you were to say to me, you know, how do you feel about Community Care, I would use those things to answer any question about health care as kind of the guiding lights, which is, I feel good, but there’s inevitably more–not but–and there’s inevitably more work to be done.

Last point. There is, though, a big question for the country to resolve, which is, what do we want this system to be able to do? And that, you know, I get the sense that that’s a debate that, you know, will continue to move along here. But we should just be really clear with Veterans and with the taxpayers about what we mean by that when we do it. I think it would be a shame to lose the strength of this VA system, given all the data I just talked to you about, in terms of what it does for Veterans, and, importantly, for what it does for every other American. We saw that very profoundly in the context of the pandemic, where our providers cared for, kept alive civilians who would not have had access to health care otherwise. And VA innovations on care, VA research about care, routinely impacts outcomes for Veterans as well as non-Veterans.

So, you know, if we want to move away from a system that, you know, has 400,000 VHA professionals, you know, a system that, you know, 75% of health care providers in the country have some of their–of doctors in the country, have some of their training in a VA system, if we’re going to move away from that, let’s make sure that we’re leveling with the American people on that, and make sure that we have a system to make up for the roles that VA plays. I think that would be a shame.

Quil Lawrence (NPR): Great. Thank you. Thank you, Terrence. Hope we’ll get a chance to have one more of these monthly pressers, or, if not, maybe another holiday mixer, since the other one was really Thanksgiving.

Terrence Hayes (VA Press Secretary):  Yeah, we will. We’re not done yet. So we’re going to circle back for January, as we always have. So be on the lookout for that. We will have another press conference with our questions.

Quil Lawrence (NPR):  Great. Thank you so much.

Terrence Hayes (VA Press Secretary):  Thank you, my friend. So I think that concludes the press conference. Thanks for joining us.

Denis McDonough (VA Secretary):  Happy holidays, guys.

Terrence Hayes (VA Press Secretary):  And go Army, beat Navy.