VA Secretary Press Conference March 23, 2023

Terrence Hayes (Press Secretary): Good afternoon, ladies and gentlemen. Thank you for joining us again today. I’ll begin today’s press conference with the ground rules. To our press in attendance, once I open the Q&A period, please raise your hand and wait for me to recognize you. Once called upon, please step to the microphone. To those joining virtually, please remember to remain on mute for the duration of the press conference. During the Q&A, please use the raise-your-hand function, and a member of my team will recognize you. Once called upon, please unmute and turn on your camera. Remember to return to mute immediately following your question. As I shared at our last press conference, we are excited about next week’s National Disabled Veterans Winter Sports Clinic. Today we have Teresa Parks, the National Disabled Veterans Winter Sports Clinic director, joining us to highlight what you can expect to see in Colorado. Since lots have occurred since March 2^nd, let’s jump right in. Mr. Secretary, I yield the floor to you, sir.

Secretary Denis McDonough: Terrence, thanks so much. Every month I come here hoping that I don’t have to wear my reading glasses, but I do. First off, we’re celebrating Women’s History Month at VA by honoring women Veterans who have defended our freedom in every conflict since the Revolutionary War and the women who are still defending our freedom across the world today. We’re also honoring our women VA employees. We’re so grateful for everything they accomplish, caring for all of our Veterans, their families, caregivers, and survivors. Yesterday, we hosted a joint DOD/VA Veterans PACT Act Claims Clinic at the Pentagon. Twenty-four VBA claims representatives and many other VA staff were in attendance to share information on how to apply for VA benefits and services. During this clinic, we met over 1,300 Veterans and current service members, and we will continue taking every opportunity to communicate directly with Veterans and transitioning service members, and their families, in communities all across the country about the PACT Act, how to file a claim, how to enroll in VA health care, and all other VA benefits and services. It’s equally important that we continue processing claims as quickly as possible and with our traditional high quality. The first three days of this week have set new records for VBA claims completion ranging from 8,204 to 8,504 claims completed each day. Now, I’m old enough to remember when I used to brief that we were happy that we processed 6,500 claims a day. This is good progress. To date, we’ve completed 12.3 percent more claims than our record-setting numbers last year. We’re also mindful, however, that even as we are processing more claims, we are also receiving more claims, as many as 26 to 30 percent more claims this year than the same period last year, so we will have to continue to increase this terrific output. That output is a testament to our incredible VA team, which has been more productive this year than ever before. Lastly, a quick update on our hiring efforts here at VA. Nothing, nothing is more critical to our success than the people we hire. The people who serve America’s Veterans as well as our Veterans have served us. We are dramatically increasing hiring, holding surge events to onboard staff more quickly, and increasing incentives to retain more personnel. Thanks to our nationwide onboarding event last November, we hired more new staff at VHA in the first quarter of this fiscal year than in the same period of any previous year. I’m proud to report that we hired 2,465 registered nurses, 465 licensed practical nurses, and 788 nursing assistants. We have hired more people in these three critical occupations than at any time in the past 20 years, and only five months into the new year, we’ve onboarded a total of nearly 23,000 new hires, that’s 22,759, resulting in a 2.5% growth rate. That puts us well on our way to hitting our goal of 52,000 new VHA employees this fiscal year, which would mean about a 3% increase in the overall size of the VHA workforce. We’re seeing the same sort of success in VBA hires, so we can continue to build our claims processing capability. Last month, we launched our first series of PACT Act Career and Hiring Fairs at eight regional offices around the country. At each of these events, we welcomed applicants, conducted interviews, and then extended job offers to nearly 1,100 applicants, again, putting us on track to fill all 1,871 of the newly authorized PACT Act positions by the end of the year. These new members of the VA team joined the best workforce in the federal government. We’ll continue sharing career opportunities at careers.va.gov. That’s careers.va.gov, as well as on the USAJobs website, on social media, and through community outreach. For any prospective applicants, we’re planning to conduct another round of Career and Hiring Fairs later this summer. There is no better mission than serving Veterans, their families, caregivers, and survivors, and we encourage folks to apply to join our team today. Now, as Terrence said, I’m joined today by Teresa Parks, director of the National Disabled Veterans Winter Sports Clinic. She’s joining us live from Snowmass, Colorado, where a VA will be hosting its annual Winter Sports Clinic this weekend alongside our co-sponsor, an invaluable partner, Disabled American Veterans. Over to you, Teresa. Teresa, you might be muted.

Teresa Parks (VA Winter Sports Clinic director): There we go. Can you hear me?

Secretary Denis McDonough: Yes, we can hear you.

Teresa Parks (VA Winter Sports Clinic director): Thank you, sir. Good afternoon. The National Disabled Veterans Winter Sports Clinic is one of six national programs offered by VA. On Saturday, we will be kicking off the 37th National Disabled Veterans Winter Sports Clinic here in Snowmass Village, Colorado. We are expecting over 300 profoundly disabled Veterans to embark upon Snowmass Village, coming from across the country. Of those, 130 will be first-time Veteran participants. We will also be bringing in 200 adaptive-certified ski instructors from across the country to include Canada, VA clinicians from across VA, and a multitude of volunteers. In addition, we will be unloading the most amount of adaptive equipment by any adaptive ski program in the country. I think what really makes what we do great is the fact that VA embraces this concept in realizing early on that traditional health care and rehabilitation doesn’t work the same for everyone. This outside-the-box approach and rehabilitation has proven time and again to be very successful. On Day One, the Veterans will get to be here. I love Day One; it’s my favorite day. They’re nervous. They’re excited. They don’t know what to expect, and the Veterans who have come before actually embrace those 130 new Veterans that are coming in, kind of tell them what they can expect and let them know that they’re going to have a great week. From there, we run them through a seating and prosthetics clinic that’s open to every Veteran, and we walk them through, make sure they’re in the appropriate adaptive ski equipment. We make sure that they’re fitted appropriately in that equipment. We make sure that their prosthetic limbs are secure and dialed in to be appropriate on the mountain. At the end of every day, and again, what I think really makes Winter Sports Clinic great, the ski instructors go in and, after every lesson, document on where that Veteran’s goals were, where they got to, what type of equipment they were using, what kind of terrain they’re skiing on, so that when they get home, every clinician across VA can access that documentation and know where to carry on once that Veteran gets home. That way, every Veteran isn’t starting over every time they go somewhere to do what we do during this week. We have a slogan at Winter Sports Clinic; it’s called, “Miracles on a Mountainside.” I’d like to close by sharing a story of one of those miracles. Adam Greathouse, an Army Veteran, was on a peacekeeping mission in Kosovo in 2001. Adam got a bacterial infection in his lung, went into acute respiratory failure, and suffered a traumatic brain injury. Doctors gave Adam twenty-four hours to live. Fortunately for us, Adam survived and went through a lot of rehab and was discharged home. At that point, Adam realized his life had drastically changed. He was feeling like a failure, living with his parents, suffering from severe depression, and was isolating from everybody from the entire world. Fortunately for us, Adam met his recreation therapist at the West Virginia VA Medical Center, who encouraged him to come to the Winter Sports Clinic. I met Adam on his first day here. He was very reserved, wasn’t really sure why he was coming and what he was going to gain from that. On Day Three, Adam was all smiles, couldn’t stop talking, and today Adam mentors other Veterans, he volunteers at the West Virginia VA Medical Center on a regular basis, and credits, to this day, the Winters Sports Clinic for saving his life. There are a multitude of powerful stories like Adam Greathouse that come out of this event every week, that we’re here, every day. If you’d like to get more information on the Winter Sports Clinic, reach out to us, please, at Winters Sports Clinic at va.gov. Thank you, sir.

Secretary Denis McDonough: Awesome.

Terrence Hayes (Press Secretary): Thank you, Teresa. Truly appreciate you joining us today. Well, we’ll begin the Q&A session. Leo.

Leo Shane (Military Times): Thank you, Mr. Secretary, for doing this. You were up on the Hill earlier today for a pretty long session talking about the budget.

Secretary Denis McDonough: Yeah.

Leo Shane (Military Times): A lot of concerns from lawmakers about some of the way that the budget’s structured this year. That, combined with some of the budget pressures you already know about that are separate from VA. What’s your concern level about getting a VA budget on time, before or close to the start of the new fiscal year?

Secretary Denis McDonough: Yeah, Leo, thanks very much. Look, I think the budget that we’ve submitted underscores the president’s commitment to Veterans. It’s obviously the biggest, and I’d say most innovative, budget that has ever been submitted on behalf of VA. I thought today was– Obviously, I really appreciate the opportunity to appear before the committee. I think that questions are natural and understandable. I hope I began to address them. As you know, I’m a worrier, but I’m not going to preemptively worry on this. We’re just at the start of this process, really, and we’re going to continue to answer questions forthrightly, completely. As I say, you know, we come out with our hands up. We got nothing to hide here, and we’re going to make sure that we answer those questions. I’m confident that when we do, Congress will do the right thing as it does every year, including for this fiscal year, when last December they passed us a very generous appropriation. So, again, I’ll worry about the rest of it when that time comes. Right now, we’re just going to execute on making sure they understand what’s in this budget and why it’s important.

Leo Shane (Military Times): And that generosity was one of the issues that did come up there. VA budget has been has seen significant increases over the last 20 years.

Secretary Denis McDonough: Yes.

Leo Shane (Military Times): Do you feel, from the questioning, that you’re getting some pushback on that? Obviously, you said that you feel like you can defend this budget, and that this is what’s needed to serve Veterans, but do you feel like you’re getting some real pushback on whether or not that money is being spent wisely?

Secretary Denis McDonough: No, I think Congress is doing exactly what it should and exactly what the Founders anticipated in divvying up our responsibilities between Article I, Article II, and Article III. I’ve said it in this room a lot, and I’ve said it because I believe it, that congressional oversight makes us better. I don’t call pushback; I call it oversight. I think it’s the right set of questions. I think we’re out of the gates strong in our briefings with the members of the staff up there with our VSO partners, and we’ll continue answering the members’ questions and the staffs’ questions to make sure that we get this right.

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

Secretary Denis McDonough: Thank you.

Terrence Hayes (Press Secretary): Good afternoon, Quil.

Quil Lawrence (NPR): Hey, I should ask, can you hear me?

Terrence Hayes (Press Secretary): We can hear you, Quil.

Quil Lawrence (NPR): I want to ask about racial discrimination in VBA decisions. I think you’re aware there’s a document that from 2017 outlining a serious disparity in outcomes for black Veterans as opposed to non-Hispanic white Veterans applying for PTSD, and I’m wondering when you became aware of that document and that discussion, what the rationale was for apparently not, and I realize this was back in 2017, but apparently not do anything to change that. And as recently as 2021, it seemed the VA was saying that they did not have the ability to track that sort of demographic in VBA decisions. Can you tell me whether that’s still the case?

Secretary Denis McDonough: Yeah, Quil, thanks very much for the question, and I want to just make sure that I’m as clear this month as I was about three weeks ago when we talked about this and as I was today in my testimony, that black Vets have served and sacrificed for this country, and they deserve access to world-class equitable health care and benefits that they’ve earned. To all black Vets out there who are watching, I promise you this: we’re actively looking into any disparities that exist at VA, and we’re going to eliminate them. We’re going to earn your trust, day by day, through execution of our programming here, and we’re going to do that by being transparent about what we’re doing and by ensuring that you get the health care and the benefits that you’ve earned. So, please, don’t wait. Apply for VA care and the benefits that you’ve earned today, particularly those Veterans who have served in Central Command in the last three decades. I’ve said before, not based on any particular data, but based on common sense and by what I know about the makeup of the United States military today, the force that’s served in these conflicts covered by the PACT Act, Vietnam and then in Central Command after 1991, is not only the strongest fighting force in the history of the planet, but the most diverse, by race and by gender. So, obviously, Quil, we’re working this issue very aggressively. We have been working this issue since we arrived. I’m not sure the reference about how we’re able to track it, but we’ll make sure that we get to the bottom of whatever that was. This effort, as I announced last month, was kind of given added impetus by the president’s executive order to us to make sure that we have an active equity team in VA that’s actively tracking and adjusting, adapting, fixing any inequities that we identify. As we, as I said last week, have specific announcements from that team, we’ll let you know. As we get data in this effort, we will make that data and that information public, and job number one for that team will be ensuring that we are taking every opportunity to ensure that every Veteran who served during these last three decades of war in the Central Command is able to access the benefits and the care that he or she, that they have earned. So, we’ll stay on top of this, and as I said today on the Hill, I’m obviously very concerned about any lack of trust that’s developed as a result of historic disparate treatment of our Veterans. We’re going to get to the bottom of that and make sure that we earn that trust back.

Quil Lawrence (NPR): You’ve seen the 2017 draft report that came up with those numbers on the disparities?

Secretary Denis McDonough: I’m not sure that I have seen that draft report, Leo, but I do know that I’ve been reading a lot about it. There’s been a lot of reportage on it. I am familiar with our desire and, frankly, my priority since we arrived, to ensure that every single Veteran, every single Veteran gets access to the care and the benefits that they’ve earned and that they so rightly deserve. So, this is something that we watch very closely.

Quil Lawrence (NPR): And is VBA now tracking racial data in its decisions, and how quickly is that information going to be acted upon?

Secretary Denis McDonough: Yeah, well, how precisely VBA tracks the data, I don’t have that specifically in front of me, Quil. We could surely work with you guys to get that, and that will obviously be something also that we’ll be asking the equity team, consistent with the president’s demands to do. That effort at the equity team will be like everything else that I’ve done with you guys. We’ll handle it the way we’ve handled everything else, which is transparently and making available to you the data and the information we have when we can do that.

Quil Lawrence (NPR): Okay. Just the last one. When is that equity team going to be delivering next to you?

Secretary Denis McDonough: Yeah, what I said last month is that we’re standing that up. We are on the hook to the president of the United States to deliver a series of answers on that. When we have those answers ready for him, we’ll also make them available to you.

Quil Lawrence (NPR): Thanks very much. You called me Leo, but I’ll take it as a compliment.

Secretary Denis McDonough: Did I call you Leo?

Terrence Hayes (Press Secretary): You did.

Quil Lawrence (NPR): Compliment.

Secretary Denis McDonough: Well, it’s because you’re coming in so clearly today. Sorry.

Terrence Hayes (Press Secretary): Hey, we love you still, Quil. It’s all good. Ellen.

Ellen Milhiser (Congressional Synopsis): Hi. Thanks for doing this.

Secretary Denis McDonough: Of course.

Ellen Milhiser (Congressional Synopsis): At the hearing this morning, there was a lot of talk about the VA’s infrastructure.

Secretary Denis McDonough: Yes.

Ellen Milhiser (Congressional Synopsis): Do you think that y’all will be releasing updated market assessments any time soon as part of the budget process to bolster your argument?

Secretary Denis McDonough: That’s a great question. Can I just, not only because I’m embarrassed that I called Quil Leo, but partly. I do want to say, Quil, that I thought your reporting– I read all your all’s reporting. I want to just note in particular, Quil, that I thought the 20-year Iraq reporting that you did last week was very moving and very powerful. Ellen, the first part of my answer to your question is the following: included in the president’s budget is the single highest, largest request for infrastructure in the history of VA. It is a really important indication of how strongly the president feels about the need for us to modernize our VA infrastructure. There were questions today about the format and the form of that request. What the format demonstrates is that the traditional way we have gone about funding our infrastructure modernization has not succeeded, so it is true that this is a different way to fund our infrastructure request. That’s because the traditional way does not work. The best evidence that the traditional way does not work is that each time I’ve testified, Congress has asked me, “Why aren’t you asking for more?” And I say, “Well, we’re asking for the most we’ve ever asked for.” And they say, “Yes, but don’t you need more?” This year, after a series of consultations I had with the OMB director where I said we need help, OMB and, most importantly, the president of the United States have gone out of their way to do this. The second way we know the traditional way of funding infrastructure has not worked well is that in the last 10 years in VA, even though the average age of our hospitals is 62 years old, we’ve built four hospitals. In 10 years, we’ve built four hospitals. So, we have to change how we fund our infrastructure, and that’s what the president’s budget proposes to do. Now, in direct answer to your question, as I indicated today, we have a process, which is data driven, called the Strategic Capital Investment Program, the SCIP, and that process helps us decide where these precious dollars, these generous dollars from the American taxpayers are invested. Data informs those decisions. Some of the data that will inform that are updated market assessments. At the conclusion of the AIR Commission process last year, I told you guys that we are directing our team to go back into the field at the VISN level to work with our VISN directors, with our hospital leadership, with our CBOC leadership, and, most importantly, with Veterans, with Veteran Service Organizations, and with our partners in private sector health care and in community health care to ensure that we have the best data available to inform those decisions. So, we’re generating that. We’re working that. We’re having interactions with that or, well, at least our VISN directors are having interactions on that in their networks. I think it stands to reason that at some point when that’s ripe, we’ll make that public. I don’t want to give you the impression that it’s imminent.

Ellen Milhiser (Congressional Synopsis): Okay.

Secretary Denis McDonough: Because frankly, I haven’t seen anything fresh on it now in months, so that tells me it’s still being worked. Just so I don’t leave a misimpression.

Ellen Milhiser (Congressional Synopsis): One of the members at the committee hearing today said that basically the private sector does everything more efficiently than the public sector. The allegation was also made that the VA spends more per Veteran than the UK National Health Service per person, and I was hoping you would respond to those comments.

Secretary Denis McDonough: Well, I think you saw my response in the hearing, and I don’t want to look like I’m kind of going back at it because I thought it was a very respectful back and forth on a very reasonable set of questions from the committee. I thought it was exactly what, frankly, we should hope it should be, which is a fact-based, substantive back and forth. I felt really good standing behind this budget, and every day I will stand behind the workforce in VA and the great work that they do, and every bit of data says Veterans in our care do better. I’m just so appreciative of our workforce for making sure that that’s the case and, therefore, even more eager to get more Veterans into our care.

Ellen Milhiser (Congressional Synopsis): Thank you.

Secretary Denis McDonough: Thank you.

Terrence Hayes (Press Secretary): Thank you, Ellen. Lucy. Good afternoon, Lucy.

Lucy Bustamante (NBC News): Good afternoon. Thank you, Terrence. Thank you, Secretary. I’m interested in more information on the 2017 report, sir, on the PTSD grant rate analysis. I know you said that you hadn’t read it, but I’m interested in how the equity team that you’re getting ready to stand up will be different from what the Center for Minority Veterans has already done. We’ve read over the emails that have been released through a FOIA to the Black Veterans Project members, and what I can see in here is that there’s plenty of conversation regarding the need to add the race and ethnicity category to the actual disability claim form that every Veteran needs to fill out in order to even start the process to get services connected. Knowing that, and knowing that that is such an active conversation through the years, do you believe, or can you say that this is something that, you know you want to add to the disability claim forms moving forward?

Secretary Denis McDonough: Yeah, Lucy, thanks so much. I don’t have anything more to release to you today on the team. We’re, obviously, as I said, working to develop that team, standing that team up, and as we have more information on that, we’ll definitely make that available to you. On what data goes into the forms and whether it’s appropriate, I think is a very reasonable question. That is also something that will continue to be reviewed. I don’t have a particular set of views to share with you on that today, but this has been an issue that has informed our work here, as long as I’ve been here. I’m confident it will continue to inform our work. My commitment to you is to continue to talk it through with you, but on the two specific questions you raised today, both on the team and how we’ll answer specific questions and then on the forms and what kind of data we’ll ask for on the forms, I’m not in a position to make anything new public on that today.

Lucy Bustamante (NBC News): And just two very quick questions, sir.

Secretary Denis McDonough: Sure.

Lucy Bustamante (NBC News): The Black Veterans Project and the Yale Law School Veterans Legal Services Clinic, they both characterize what they learned as a coverup by the previous administration saying that they didn’t release this particular report on purpose, that it wasn’t made public on purpose. Would you go as far as calling it a coverup, as someone who is now leading this administration?

Secretary Denis McDonough: Let me say two things. One is, the most important thing I can do is ensure that Veterans have trust in VA, that when they apply for a claim, it’s going to get judged and processed in a timely and fair way. I don’t spend a lot of time looking back at the last administration. I spend a lot of time looking forward at what is it that we can do to make sure that this process is conducted transparently, in a timely way, and in a way that deepens trust, including trust that has been damaged over time. That’s the first thing I’d say. Second thing, I just want to say again, to black Vets who are watching this press conference today, and this is exactly what I said to Congress today too, which is black Vets have served and sacrificed for this country in every conflict we fought, and particularly so in those conflicts covered by this new set of authorities in the PACT Act, Vietnam and in Central Command since 1991. So, to every black Veteran out there, we will eliminate disparities. We will earn your trust. We will do right by you. You had our back. It’s now our turn to get yours. So, please give us another shot, or please give us your first shot, and apply for your benefits today. Va.gov/pact [Link: www.va.gov/pact] or 1-800-MyVA411.

Lucy Bustamante (NBC News): And finally, Secretary, very last question for you. If you can say whether the equity team will be staffed with fairly new workers or people from the past that have institutional knowledge from the conversations that have happened through the years through the advisory committees? Or do you believe that using those workers and advisors from the past may actually taint the transparency of the problem? In other words, they would be investigating themselves. What do you say to that?

Secretary Denis McDonough: Yeah, again, we’re going to build this team consistent with the demands that the president has made of us. I don’t have anything new beyond that to announce, but I can guarantee you that whoever’s on that team will be getting to the bottom of this and making sure that we’re doing everything we can to earn the trust of those Veterans who have done so much for us. As we have additional information about this, names of participants, ground rules for their work, we’ll obviously make that public.

Lucy Bustamante (NBC News): Thank you, Secretary.

Secretary Denis McDonough: Thank you.

Terrence Hayes (Press Secretary): Eric. Good afternoon. How are you?

Eric Katz (GovExec): Mr. Secretary, you mentioned at the top the sort of record hiring that VA has seen over recent months. Earlier this week, we heard from Think Tank and Union that said it’s still not enough and things are very dire, and I think 96% of Union’s members responded to a poll saying that they’re having a crisis on their front lines in terms of staffing. So, who’s right? Are these groups setting unrealistic expectations based on the progress that you’re making?

Secretary Denis McDonough: Thanks so much. I did read the study from the Union. I thought it was useful. In many ways it reflects why we have set the number one priority this year as hiring, which is what I’ve said to you guys every time that I’ve been in here. As excited as I am about the numbers, and the reason I wanted to share those numbers with you is because I am proud of the team and the good progress we’re making on this, I don’t want to leave you with the impression that we’re done, right? We are going to keep hiring and keep hiring until we have the team that can ensure that Veterans get timely access to world-class care, timely access to their hard-earned benefits, and access to a lasting resting place. We have more work to do, so I don’t think this is a question about who’s right and who’s wrong. I think this is a question of whether we are making every effort to grow this team commensurate with the needs that we have here. I think we’re making good progress, but we got a ways to go yet. Our partnership, by the way, with labor is a key part of our ability to provide that care and to grow this team. I feel really good about where I am on that as well. So, we don’t have anything to announce now, but we’re working that really aggressively. I feel quite good about it.

Eric Katz (GovExec): Is there a ceiling for how much you can do based on internal capacity? You know, there’s labor shortages in health care generally, so is there a ceiling there? In terms of how fast you can do it?

Secretary Denis McDonough: In terms of how quickly we can onboard people, how many people we can hire, that kind of stuff?

Eric Katz (GovExec): Yeah.

Secretary Denis McDonough: Yeah. I think that the really important thing to think about is, we need to fill important slots in VA, but we also need to recognize that we are changing the way we do business also. We’ve talked in here about telehealth. I thought, at last month’s session, I’m going to start stopping these because people like Teresa and people like Matt last month are so awesome that they make me look like a bum, but we’re making great progress on the way we deliver care, and that’s changing. We are trying innovative new things. I talked in here last month about the peer support specialists we’re using; we’re investing in Veterans in recovery to help other Veterans who are earlier in recovery, basically supercharging, catalyzing Veterans helping Veterans. That’s a new tool for us to access care. Then, of course, we have the relationship with the community, and we are seeing historic levels of referrals to the community. So, I want to just say to those Vets who are watching out there, there is no cap on our ability to provide care for you. When you have care needs, we are going to meet those care needs for you. Some will be in the community, some will be in the direct care system, some will be telehealth, some will be in person, but we’re going to get that done.

Eric Katz (GovExec): Thanks.

Secretary Denis McDonough: Thanks.

Terrence Hayes (Press Secretary): Good afternoon, Orion.

Orion Donovan-Smith (The Spokesman-Review): Thanks, Terrence. Shutoff plan here. Sorry, Mr. Secretary, if I sound weird. It’s because I’m crammed into a little phone booth at the Capitol. It’s good to see you.

Secretary Denis McDonough: Good to see you.

Orion Donovan-Smith (The Spokesman-Review): I’m actually going to ask a couple questions on behalf of my colleague in Spokane who’s been writing about efforts to get homeless Veterans housed.

Secretary Denis McDonough: Great.

Orion Donovan-Smith (The Spokesman-Review): First, VA said that its aim is to permanently house the same number of Veterans this year as you did last year, but the voucher payment standard in Spokane County, for instance, which was just increased in January to a thousand dollars a month for a one-bedroom apartment, is already not enough to cover the median rent for a one bedroom in Spokane Valley, for instance, one of the neighboring towns. Is there a way to make the voucher system more reactive to overall rising housing costs?

Secretary Denis McDonough: Yeah. Thanks, Orion, nice to see you too. I don’t want you sneaking around the Hill, you know what I mean? You should be, like, not hiding in the phone booth. I chair the Interagency Council on Homelessness now. We had our meeting here last week. This issue about vouchers, their utilization, their timely utilization, their value, is an issue that we’re facing, including in different markets with variable rent demand. The short answer is we are looking expressly at this question, and we do know that more effective to meet our goal again next year, which we exceeded last year, but to meet our goal next year of 38,000, we are going to need to increase voucher utilization. We’re going to have to get higher values for the vouchers, and then we’re going to have to figure out how we address another issue, which is in another one of our programs, the Grant and Per Diem program, it looks like the contractors that we work with cannot keep employees in some markets. I was in Western Washington last week in Seattle, where this is a major issue. I don’t know if this is an issue in Spokane, but that’s another issue we’re going to have to get our hands around. The bottom line on this is, this is a high priority, but we also have our eyes wide open that we can’t just do the same things this year that we did last, especially because the market is so variable. We have to be flexible and agile, and I think we’re in a position to do that.

Orion Donovan-Smith (The Spokesman-Review): Thank you. Second question, on that. My understanding is the rules as they’re written now allow VA to spend most of the dollars when a Veteran is within 14 days of becoming homeless, for the most urgent cases. That means that many Vets who are in dire straits but not yet in an emergency are turned away from services, based on what we’ve heard in Spokane. In addition to emergency housing, is there more that VA can do to prevent homelessness and help those Vets in need before they’re in crisis?

Secretary Denis McDonough: Yeah, a big priority for us this year, Orion, is prevention and, in fact, in the 3.1 billion for fighting homelessness in next year’s budget, a big chunk of that is on prevention. We believe, actually, that we have prevented as many as a million Veterans and family members from being homeless since 2009 through effective use of early identification of problems, paying rent for Veterans or managing mortgages for Veterans, timely speeding of relief, for example, on mortgages, or assistance on rent, or assistance on utilities. Yes, absolutely we can do more and need to do more on prevention. I will get you the exact number, Orion, but I want to say of the 40,400 some that we permanently housed last year, we’ve already seen as much as 3% of those Veterans falling out of being housed, so we have to get them back in and then we have to do an even better job this year ahead of making sure that those in housing stay. So, yes, there’s a lot of prevention we can do. The president’s budget envisions that, our programming envisions that, and if there’s something more we can get you or your colleague on that question, I’d be more than happy to set that up, or Terrence can set that up for you.

Orion Donovan-Smith (The Spokesman-Review): I appreciate that. Lastly, just a quick question on the EHR. Last week, I understand VA staff briefed senate staff on six incidents catastrophic harm, four of which resulted in the death of a Veteran, that are linked in some way to the Oracle Cerner EHR When did you first become aware of those six incidents?

Secretary Denis McDonough: Yeah, I think maybe a better thing to do here, just so I don’t misspeak, Orion, is why don’t we set up to make sure that you have opportunity to talk directly to VHA on that. We’ll make sure that we get y’all the data on that.

Orion Donovan-Smith (The Spokesman-Review): I did actually have a chance to ask Dr. Elnahal earlier this week about it, and I appreciate that opportunity. I just wanted to ask you when you first heard of those incidents.

Secretary Denis McDonough: Yeah. I don’t… You know, it’s been in the last couple of months, surely since the last time you and I had a discussion about the patient safety issues in this room, but that’s maybe five, six months ago that we had that conversation, but so–

Orion Donovan-Smith (The Spokesman-Review): Mm-hmm.

Secretary Denis McDonough: I just can’t put a specific time on it.

Orion Donovan-Smith (The Spokesman-Review): Okay. Thank you.

Secretary Denis McDonough: Yep.

Terrence Hayes (Press Secretary): Melissa.

Melissa Burke (The Detroit News): Hi, Secretary. Thanks for doing this. The Michigan senators today sent you a letter. I’m not sure if you’ve had a chance to review it yet, but it had to do with the series of interim directors at the Detroit VA.

Secretary Denis McDonough: Mm-hmm.

Melissa Burke (The Detroit News): They were calling on you to install someone permanent there to kind of move things along. I wondered if you could respond to that or say how soon it might be that the Detroit VA might get a permanent director.

Secretary Denis McDonough: Yeah. Thanks so much. Thanks for the question. I haven’t seen their letter, but obviously I attached great importance to it. I’ve been keeping in close touch with Senator Peters and Senator Stabenow, as well as other members of the delegation, including Ms. Dingell, Ms. Tlaib, and Ms. Slotkin, and others on this. I think, as you know, that there’s a certain number of days that we are limited to detail somebody into that position, hence the requirement to keep changing. We are, obviously, actively looking for replacement personnel there, but we’re also making sure we get to the bottom of what’s happened and what is going on, at the bottom of making sure– I’ve been talking, obviously, as I said to you, the last month, talking to the IG about whether we are fulfilling the twelve fixes we need to make. That’s the overwhelming priority for us right now, is assuring our Vets in Detroit that they can have confidence that we’ve made those improvements. They can have confidence in their care. The personnel will closely follow that, but I can’t give you a timeline on that. We’re going to make sure that that historic and really important system can count on a leadership that will serve them as well as the Vets have served us.

Melissa Burke (The Detroit News): Is it your expectation that the next director would be like somebody permanent or is it too early to say?

Secretary Denis McDonough: Yeah. What I was mentioning before is it’s just too early for me to put a specific timeline on that.

Melissa Burke (The Detroit News): Okay. Thanks.

Terrence Hayes (Press Secretary): Jory.

Jory Heckman (Federal News Network): Good afternoon, Mr. Secretary, and thanks again for doing this.

Secretary Denis McDonough: You bet.

Jory Heckman (Federal News Network): My question’s in regards to the report that Eric was mentioning just a moment ago. A number of union officials, with the release of that report, were pretty concerned about what they’ve seen so far from the pay, the retention and recruitment incentives that you guys have under the PACT Act and that it has made some difference, but they would like to see more as a result of that. From your perspective on things, are there hurdles that are preventing those incentives from being used more effectively? Are there things you guys would like to see implemented more fully that has yet to happen just yet?

Secretary Denis McDonough: Not – [coughs] excuse me – nothing specific, aside from our execution of it. We’re obviously moving out smartly on this, aggressively on this, but inevitably, the longer we have these new authorities, the better we’ll get at them. So, that’s one, is just that we’re going to get better at the execution. Two, we still need people. I think we are, importantly, seeing our ability to hire and attract HR professionals, which I’ve said in here in this room many times, is really the key to this expansion of our personnel. We are becoming much more competitive in attracting those personnel because of these authorities. Then, there are some additional authorities we need, and I’m sure you saw this testimony yesterday from two total gems in our workforce, two just absolute first-rate professionals – Jessica Bonjorni, who is Chief Human Resource Officer for VHA and Tracey Therit, who works in our HRNA unit – where they talked through the VA Careers Act, where we would really like to get that additional authority that will allow us to get beyond this aggregate pay cap for some of our physicians, which puts us at a strategic disadvantage. So, we would like that. On the question of the use of authorities for awards, for retention, I think those are a question of execution. I saw the references in the report, too, and we’ll obviously continue to talk to our labor partners about that.

Jory Heckman (Federal News Network): Okay. And then there was a memo that was making the rounds earlier this month regarding the VA Accountability and Whistleblower Protection Act. In terms of the Section 714, the provision that concerns removal, demotion, suspension of employees regarding alleged wrongdoing, poor performance, misconduct, things of that nature, and that VA leadership are instructed to not implement Section 714 going forward. I know that members of Congress have been concerned about VA’s ability to discipline poor performers in the VA. Do you feel confident that the agency has the tools it needs to discipline employees who are in that kind of situation.

Secretary Denis McDonough: Yeah. Thanks very much. What’s the memo you’re referring to?

Jory Heckman (Federal News Network): It was a memo dated March 5th. It was just in regards to the use of–

Secretary Denis McDonough: The use of 714?

Jory Heckman (Federal News Network): The use of that authority, yeah.

Secretary Denis McDonough: I see. Yeah. Okay. Thank you very much.

Jory Heckman (Federal News Network): I know it’s a very granular question, so…

Secretary Denis McDonough: No, no, it’s not at all, actually. I actually had a question on this from Congressman Self at the end of the hearing. It’d be worth getting that transcript, if you’d like, which I think would amplify on your question, but on the specific question, do I think we have the authorities? I do. To be honest, for example, the exercise of the Section 714 wasn’t really helping us necessarily manage our workforce as much as it was getting us in front of federal judges and in front of administrative bodies, so we just want to make sure that we’re exercising the authorities that we do have, and we can exercise those transparently and make sure that we are in a position where we’re actively managing our workforce rather than finding ourselves, as I said, before administrative bodies or before federal judges trying to explain this provision, which in many ways, through jurisprudence, through administrative court action, has been really changed from what I think was initially intended. In all cases, we do think that we have what we need to manage our authorities outside that, Section 714, and we’ll keep working that.

Jory Heckman (Federal News Network): All right, I got one quick one. One last one, if I may, going back to the AFGE and their report.

Secretary Denis McDonough: Yeah.

Jory Heckman (Federal News Network): Some frustration. They were expressing some frustration with HR modernization and the centralization of HR authorities. A lot of them were saying that that should be a decision made more at the local level where that hiring’s being done.

Secretary Denis McDonough: Yes.

Jory Heckman (Federal News Network): In terms of the way forward for HR modernization as a concept that began under the previous administration, are there elements of that are going forward? Are there elements of that you guys are not moving forward on? What’s the [unclear] on that?

Secretary Denis McDonough: Yeah. Thanks so much. I actually just talked with one of our leading, in fact, our biggest labor union about this yesterday. I had a great visit with the assembled AFGE leadership. I meet with that group twice annually. It was nice to meet with them for the first time in person yesterday. This is one of the issues we discussed. My view on this is that HR modernization has not yet been fully tested because we just have not invested in it the way we should have. As I said, we are now getting more HR professionals on board that will allow us to really test the HR modernization effort. Second way we can test the HR modernization effort is if we can set up joint training among union professionals, management professionals, training those new HR hires in the VISN level on things like the contract, so we can show active collaboration among union and management members. When we get to that more collaborative state, when we have it adequately invested in HR modernization, then I think we should make the determination whether it’s succeeding. Until then, we just got to muscle this thing through and make it happen. Going back to a system that was not near as effective as it should have been is, I don’t think, the answer here.

Jory Heckman (Federal News Network): Okay. Thanks so much.

Secretary Denis McDonough: Thanks.

Terrence Hayes (Press Secretary): Thanks, Jory. We’ll go to Bill. Good afternoon, Bill.

Bill Hodges (Veterans Corner Radio): Good afternoon. Thank you, Mr. Secretary.

Secretary Denis McDonough: You bet.

Bill Hodges (Veterans Corner Radio): You began this presentation by talking about the number of claims processed and the fact that we’re processing more and more claims. Recently, Secretary, Hayes came on my show, brought that same number up, but then he added something to it that I used in the speech recently when I gave the total number, and somebody in the audience said, “Yeah, but how many of them are they turning down? It’s easy to process if you stamp no on it.” How are we doing on processing and keeping those numbers up?

Secretary Denis McDonough: Yeah. Fair question. This is a good opportunity for me, Bill, to give the numbers as they stand right now. Disability claims backlog number right now: 204,766. The total inventory right now is about 780,000 claims. Now, this data might be slightly more responsive to your question. Disability claims under the PACT Act received since August 10th: 403,338. Disability claims processed since January 1 when we started processing PACT Act claims: 180,043. Disability claims granted: 145,432. Now, I can’t do the math there on that, what the percentage of those disability claims are, but I think 145,432 over 180,043 gives you a sense that this is not just a…what did you call it? Turn and burn? I think we’re processing claims at a high rate (fastest ever, in fact), high quality, awarding at a high rate, and all of that execution along that chain is really important for us to get that trust from our Vets.

Bill Hodges (Veterans Corner Radio): When I was able to tell my audience that in the speech I was giving, it rippled through the entire audience because many of them lived through the land of ‘no,’ where we got a lot of claims turned down.

Secretary Denis McDonough: Yeah.

Bill Hodges (Veterans Corner Radio): Just, boom, they’re gone.

Secretary Denis McDonough: Yeah.

Bill Hodges (Veterans Corner Radio): And I, for one, am very happy to see this percentage go up. Thank you very much.

Secretary Denis McDonough: Thank you, Bill.

Terrence Hayes (Press Secretary): Leo.

Leo Shane (Military Times): One more for you here, Mr. Secretary.

Secretary Denis McDonough: Sure.

Leo Shane (Military Times): The CBO put out a report yesterday looking at some longer-term savings issues dealing with DOD and VA. These are some issues that have come up a couple of times in the past. There weren’t recommendations, but it’s made a little bit of noise on social media because concerns included some things like means testing for Veterans’ disability claims with higher income, ending individual unemployability payments to some older Veterans, things that have been discussed several times in the past but sort of dismissed by Congress. Are you having any active conversations about these kind of significant overhaul changes, either internally here or with anyone on Capitol Hill?

Secretary Denis McDonough: You know, I’ve gotten a lot of blow back myself about that CBO report, so let me just be very clear on this, Leo. We don’t think this is a good idea. It looked like that comes from a list that CBO sends out every year of things that they might proffer to policy makers as cost savers. We don’t think that’s a good idea here at VA.

Leo Shane (Military Times): Okay, and no one on Capitol Hill is actively engaging you in those conversations?

Secretary Denis McDonough: No. No. Nobody inside VA, nobody inside the executive branch, and I haven’t heard it from Congress.

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

Secretary Denis McDonough: Okay. Thank you.

Terrence Hayes (Press Secretary): Patricia.

Patricia Kime (Military.com): Thank you so much for doing this. I appreciate it, sir. Leo just asked my question, but I have another one. Secretary McDonough, at the hearing today, you restated your commitment to rural Veterans. There was a GAO report about the AIR commission earlier this week that said that rural facilities were going to be disproportionately affected, either closed or downsized under the old AIR Commission recommendations, or sorry, VA’s Commission recommendations. I’m wondering, what do you have to say to rural Veterans who may be concerned about the new process for looking at their facilities and your commitment to how you’re going to provide services if you plan to close rural facilities.

Secretary Denis McDonough: Yeah. Thanks very much, Patricia. That 10-billion-dollar request from the president for infrastructure this year for our three-pronged strategy to modernize VA’s infrastructure is not to fund closing facilities. It’s fund to maintain the facilities that we have and, through non-current maintenance, fund minor construction and leases to increase access, including through CBOCs and multi-specialty CBOCs, including in rural settings, and then funding for a full replacement hospital in St. Louis. That’s what that strategy looks like right now. As it relates to the data that informed the last set of decisions, I just go back to what I said to Ellen, which is we are actively reviewing that information, making sure that we have the best sense of both what our Veterans are going to need there and then what the local market can provide, including in conjunction with VA facilities. So, I feel very confident. I feel very proud of the fact that at a time when investments in rural health care are going down, VA is going in the other direction, increasing investments in rural settings. Not only that, but we’re using new modes of getting care into rural settings, and we will continue to innovate there because we take very seriously our commitment to rural Vets. We want to make sure that when they have a choice, they choose to stick with us, and if they don’t have a choice because they’re living in resource-constrained areas, we want to be the resource that’s there for them.

Patricia Kime (Military.com): Thank you, and just one more follow-up to the question about the OMB observations, I guess. Can we get your commitment that means testing will not be used under your watch for basically tightening benefits for Vets?

Secretary Denis McDonough: You have my commitment, which is exactly what I said to Leo when I said that. We think that’s a bad idea, and we’re not going to do it. You have my commitment that we won’t do it.

Terrence Hayes (Press Secretary): Glenda.

[Microphone malfunction]

Secretary Denis McDonough: Uh-oh.

Terrence Hayes (Press Secretary): You there, Glenda?

Glenda Smith (America’s Heroes Group): Yes. [“Yes” echoes]

Terrence Hayes (Press Secretary): Do you have a microphone on as well, Glenda? We can’t hear you now, Glenda.

[Microphone malfunction]

Terrence Hayes (Press Secretary): Yeah, we’ll follow up with you, Glenda, at the end. I’ll give you a call. Thank you. Are there any additional questions? Seeing none, so this concludes today’s press conference. Thank you, everybody. Seems like we just did this, like, two weeks ago, but it’s been three, but I would look forward to having you again next month. Thanks, everybody.

Secretary Denis McDonough: [Laughs] Does that mean you liked what I had to say?

Terrence Hayes (Press Secretary): [Laughs] Hey, you know I love you, sir. [Laughs again]