VA Secretary press conference May 28, 2024

Terrence Hayes (VA Press Secretary):  Good afternoon, ladies and gentlemen, and thank you for joining us for this month’s press conference. We hope you had a reflective Memorial Day yesterday. We’ll go ahead and get started. We’ve got a lot to cover. And with that, I’ll go ahead and turn it over to Secretary Denis McDonough. Over to you, Mr. Secretary.

Denis McDonough (VA Secretary):  Terrence, thanks so much. Good to see everybody. Thank you for joining us, both those of you on the line and those of you in the room, I have nothing this week other than to say I am thrilled that Barbara Morton will be briefing us today on the latest trust data from across the VA enterprise. We often have talked to you about Veteran satisfaction, Veteran trust scores as it relates to outpatient care, but Barbara is going to brief us today on our most recent data and kind of how it fits historically. And I will say that, you know, if there’s somebody more admired and appreciated in our VA central office than Barbara Morton, I don’t know who it is, which is to say the whole team, and I am very confident that I speak for the whole team on this fact, recognizes her as a great partner, a great teammate, and a great leader on ensuring that VA runs itself as a Veteran-centered, Veteran-focused operation. And it is then, with some disappointment that I report to you, too, that shortly she’ll be going to a six month detail at the White House to work on customer experience for all of the federal agencies. It’s a relatively short detail, but any minute she spends outside this building is one that we’re not going to be happy about. And you’ll see why when you get this briefing. So, Barbara, over to you.

Barbara Morton (Deputy Chief, Veteran Experience Office):  Hello, everybody. It is great to be with you. Can you hear me? Everybody can hear me okay? Awesome. Well, I’m thrilled to be here to talk about my favorite topic on the planet, which is Veteran trust in VA. And so, I’ll give a few brief remarks and wanted to just to highlight that we’ve got a slide — a timeline slide that I’ve included in the materials, as well as a Veterans experience journey map, patient experience journey map, so you have some takeaways as well. So going back in time a little bit, in 2016, we VA set a very audacious goal to earn 90% trust from Veterans and those that we serve. At that time, when we first started to measure trust, Veteran trust, as you can see on this slide, stood at 55%. We knew back then we had a lot of work to do. Today, I am thrilled to announce that we are closer to that 90% goal than ever before, with 80.4% of Veterans surveyed who use VA services, saying that they trust us to deliver on our country’s commitment to them. We also measure ease, effectiveness, and emotion, and those three measures are also the highest they have ever been, with effectiveness reaching 80.5% for the first time. This achievement is meaningful for a number of reasons. It’s meaningful because it is the voice of the Veterans that we serve from across all different ages, service eras, locations, demographics, signaling to us how we are delivering for them. We are measuring our performance based on how they feel about us, how they trust us. Not how we think we’re doing, but how Veterans are telling us we are doing. And I can tell you, being in VA for about 18 years, I don’t think we had these conversations ten years ago. So, it’s pretty remarkable that we’re talking about trust. It is also a testament to the 400,000 strong VA workforce, public servants who, individually and as a collective, are responsible each day for delivering VA services across the nation. This milestone is also significant because it signifies a long term, year over year organizational commitment to earning trust with Veterans by keeping the Veteran at the center of what we do each day to build and sustain lifelong relationships with them now and in the future. 

So, as you can see in the slide, I’ll hit a couple of highlights from it. VA started this journey back in 2017, by focusing on healthcare, building the first ever VA patient experience program based on moments that matter most to Veterans, which we gleaned from actually talking to Veterans and doing our research with them. We delivered training and tangible tools to frontline employees at scale with Veteran trust and outpatient services now reaching a record high of 91.8% and exceeding patient satisfaction scores in non-VA hospitals. We also transformed the digital experience, most recently by launching the VA flagship mobile app, which earns a 4.8 out of 5-star rating in the app store. I was just doing a little research on the app store, by the way, to see what other organizations have that rating. Amazon, Bank of America, other industry leaders have that 4.8 out of 5 Star. So really a true testament to this type of development. We VA designed this app with and for Veterans based on what matters most to them. There are other examples of how we have listened to Veterans and what they’ve told us, and how we have taken action accordingly. But we have more work to do, of course. While today marks a significant milestone in our lifelong journey together with Veterans, their families, caregivers, and survivors, we will continue to drive towards earning that 90% goal. Veterans deserve no less. They are the best of us and deserve the best from us. Thank you.
     
Terrence Hayes (VA Press Secretary):  Thank you, Barbara, for joining us. And you can see, as the secretary said, why we love Barbara here at VA. We’ll go ahead and start the question-and-answer period. We’ll start with Leo. Good morning, Leo — or excuse me. Good afternoon, Leo.
     
Leo Shane (Military Times):  Good afternoon. Thank you for doing this. A question about those trust scores and that change. Do you have any breakdown as to what the response is in terms of newer Veterans? I know the PACT Act has brought in a lot of folks. Is that part of what it is or like, is there any way to check and see folks who might have been somewhat dissatisfied before getting more satisfied? Or is it newer folks coming in and feeling like they had a better experience?
     
Barbara Morton (Deputy Chief, Veteran Experience Office):  So, it could be a combination. I mean, I certainly could take that back to our team. But essentially for the VA wide trust score, essentially, it’s a quarterly survey that we send out to roughly 40,000 Veterans who have used VA services, whether that’s healthcare benefits, appeals, memorial services. And so obviously, because we VA have brought in more Veterans than ever before, it would make sense that there would be some sort of maybe correlation or potential relationship between more Veterans coming in and having better experiences. But that breakdown we certainly can look into and can take back.
    
Leo Shane (Military Times):  And Mr. Secretary, with that 90% goal in mind there you still have, what is it, one out of every five Veterans who are saying they aren’t satisfied? So, what is, I guess, what is the plan to accelerate that even quicker so it’s not another six years, eight years to move it ahead to get to those?
     
Denis McDonough (VA Secretary):  Very fair question. I want to just start by saying thank you to Barbara. I also want to just take a minute and thank the VA workforce for really taking this to heart. I think it’s been a major culture change at VA, as I think Barbara’s comments suggested. Third, I also want to thank Secretary Bob McDonald, who really pushed us to start discussing satisfaction focus, this Veteran trust focus. So that’s the first three things. Fourth thing, in response to your last question, I hope that part of what’s reflected in these numbers is a sense from Veterans that we want to have a relationship with them. You know, as you’re saying, it could be that we do have new relationships with Veterans and they’re finding it better than they might have otherwise feared or experienced themselves in the past. But I also hope our efforts to reach out to Veterans, to say to them, we want a relationship with you are conveying a sense that we want them in our care, that we want them getting their earned benefits, that we want a relationship with their caregivers and their survivors and their families. Lastly, part of getting to the 90% is holding ourselves to account quarter by quarter. That’s why when I first got here, I asked John and Barbara at the Veterans Experience Office to publish those raw data every quarter at VA.gov/trust. And so that’s just the raw data there. You know, data scientists, statisticians, others are, you know, it’s all there for them to consume as well. And that process of holding ourselves to account to that publicly available data will force us to increase our performance. Secondly, we also are applying the Veteran trust tool to the pension and compensation line of our effort. We announced that in this room now several months ago last year in 2023. And so, we are now measuring ourselves across the entire enterprise, including, you know, for the longest time we thought — I think some people in VA thought, hey, we can only in the best-case award a service-connection in 75% of cases. So, doesn’t that mean that 75% is the high watermark? That’s just not how we see it. So, the other point I’m trying to make here, Leo, is by subjecting all of the enterprise to the trust score, we’re going to up our game and then that means we should be getting to that 90% satisfaction faster. Lastly, what all this means is we are saying to the individual Veteran that we judge ourselves not on averages, but on that individual Veteran’s experience and hopefully that accrues over time. So that one, as you say, one in five are not feeling unsatisfied. That is to say 100%, not just 90, 100 percent are satisfied, but by putting ourselves under the microscope of that activity, by releasing the outcome of those assessments in the quarterly data releases and by subjecting the entire enterprise to this, we think that we’ll continue to grow this slope at a much, much steeper incline so we can get, we can meet that goal and then exceed it.

Leo Shane (Military Times):  All right, thank you.

Terrence Hayes (VA Press Secretary):  Thanks, Leo. We’ll go to David. Good afternoon, David.
   
David Elfin (cyberFEDS):  Good afternoon, Terrence. I’ve got two questions. First, I guess is for Barbara because there’s a nuance here I’m missing. Very few weeks ago, John Boerstler gave us a number of something was like 91.8 Veteran satisfaction, and I believe that was VHA. Is that the difference between the 80.4 and the 91.8 or 91.2, whatever it was he cited? 

Barbara Morton (Deputy Chief, Veteran Experience Office):  Yes. Correct.

David Elfin (cyberFEDS):  This is enterprise wide?

Barbara Morton (Deputy Chief, Veteran Experience Office):  Correct. You got it.

David Elfin (cyberFEDS):  Okay. And then Barbara, second question. Secretary — Deputy Secretary, Under Secretary Elnahal has said you can’t have a great Veteran experience without a great employee experience. I know you’ve spent most of your time, if not all, on the customer side, but could you speak to that in terms of the employees being satisfied, being happy, engaged, whatever you want to use, how is that impacting the numbers you’re seeing?
 
Barbara Morton (Deputy Chief, Veteran Experience Office):  Yeah, absolutely. I really appreciate you asking that question. And so, if you can see on the timeline slide, one of the areas that we started, we VEO started to look at, was exactly what you’re talking about. So, understanding the VA employee experience at a macro level, we did the same type of research with Veterans in the early days of VEO to understand the macro Veteran experience, did the same using a practice called human centered design to talk to VA employees, understand the moments that matter most to them in their journey, their pain points, bright spots. And what we’ve been able to do is really sort of map their journey and start to develop internal tools using the same methodology that we’ve done in the healthcare space as well. One thing I’ll mention in addition, and we can kind of share this out, we back in November, we VA published an article together with our siblings in OMB about a promising correlation, to your point, David, about the employee experience and the Veteran experience. The data utilized was really with respect to healthcare and VHA employees, but we can certainly share that out. That’s published on performance.gov, but showing that connectivity, I think you’re spot on, super, super important, and we’re excited to continue to build out that capability and build that data set, too.

David Elfin (cyberFEDS):  Barbara, quick follow-up. VA obviously is a huge agency, but there are so many agencies in government. If I was from Agency X, Agency Y, and I came to Barbara Morton and said, okay, so how can I make my employees more satisfied with their jobs so that therefore my customers can be more satisfied? Are there lessons learned or best practices that you can offer to other agencies right now from everything you’ve done?

Barbara Morton (Deputy Chief, Veteran Experience Office):  Absolutely. What I would say is start always with human centered design. And for those of you that may not be familiar with it, it’s an industry best practice. Essentially a fancy way of saying, saying, go out and talk to your employees, whether you’re an agency director or division director, understand what their pain points are, understand what moments matter most to them, and then start to what I would say, co-design with your employees. So don’t try to come up with a solution all by yourself. Bring the employees into the co-design process to develop a tool that’s going to work for everybody.
 
David Elfin (cyberFEDS):  Thank you very much.

Barbara Morton (Deputy Chief, Veteran Experience Office):  Thank you so much.

Terrence Hayes (VA Press Secretary):  Thanks, David. We’ll go to Jory.

Jory Heckman (Federal News Network):  Good afternoon. Thanks as always for doing this. Following up on David’s questions about the workforce, we recently saw the release of the annual best places to work in the federal government. I believe VA ranks in the top five for large agencies. Just extrapolating from that data, what you guys saw from that, what do you take away as kind of the highlights? How does it serve as a driver for some of the Veteran experience things you guys have been seeing and kind of what are some next steps there?

Barbara Morton (Deputy Chief, Veteran Experience Office):  So, for us, I think landing on number five spot for large agencies of best places to work, to me, is a testament to our workforce feeling such a strong sense of purpose. So, we know from internal VEO surveys of employees that purpose is the strongest sentiment. There may be other pain points that employees feel, but having that sense of connectivity to the mission of the population we serve is really something that consistently employees feel really, really good about. So, I would argue that that’s probably why we remain on the top five. Thanks.
 
Denis McDonough (VA Secretary):  Yeah. Just back to David’s question, the bad news is that the rest of government agencies are asking Barbara what to do about this. This is why she’s leaving us. And if you don’t get a sense of how I feel about it, let’s just say I feel salty about it. Secondly, one way, David, for those federal employees to feel really good about their job is to come join us here at VA. We are having historically low quit rates, historically low turnover, meaning we have historically high retention. So that’s another thing that we look at. Third, and maybe most important about the all-employee survey, and we’ve been talking about this with our workforce over the course of the last six weeks or so as we get prepared to go to the field — as we’re getting prepared to go to the field, as we did last week with the start of the all-employee survey for this year, is we need our employees to feel that there is a connection between what they say their experience is and what we do about it. And this is the really important thing about the customer satisfaction tools in the first instance, which is if we just would have Veterans submitting their survey answers but not feeling like they were not getting responses, our survey response rates would go down. You know, at between 13 and 14%, our survey response rates are very competitive with private sector participants in such tools, and our response rates on the all-employee survey are also very competitive with the rest of the federal agencies. So, one, that tells us our employees, like our Veterans, feel that participation in the survey, in this case the all-employee survey, makes sense and is a useful investment of their time. And secondly, that’s because today we’ve been able to show changes resulting from their feedback, and it’s really incumbent on us to continue to show that. And if we don’t, then we’ll have problems. And so, this is what we’ve been talking with our managers about over the course, as I say, in the last six weeks or so, as we got ready to go to the field. So, again, all those things lead to other positive outcomes to include, as I say, historically low quit rates, historically high retention rates, which we also believe leads to, to the most important measurement, which is better health outcomes, better quality of life outcomes, better customer satisfaction with the NCA experience that comes from more engaged employees.

Jory Heckman (Federal News Network):  And just quick follow up to that, we’ve heard a lot in this room about VA’s efforts to reduce burnout. We’ve heard about the reboot task force and things of that nature. Can you maybe expand upon efforts to not just meet a high level of satisfaction, but to sustain that for kind of the long term?
 
Denis McDonough (VA Secretary):  Yeah, well, I mean, the nice thing is that we measure it year by year. And actually, with the employee survey, we actually get data more regularly than the year by year. But the all-employee survey, which is kind of the real load bearing piece of this effort now going back many years, does give us the ability to kind of dig into that on a very regular basis, and we take it really very seriously. And incidentally, I just say that this is obviously far less statistically significant. But each of us, when we travel in the field, we are through things like we call — what we call the employee clutch, with the labor clutch, where in each facility we visit, we have an off the record session with high performing employees at those facilities without their supervisors in the room, and then have similarly unsupervised conversations with elected labor leaders in each organization. We get, I think, pretty candid feedback, and the extent to which we use that to plow back into our feedback loop to make sure that we’re continuing to invest in our employees means that the outcomes for our Veterans will be better. So, we’ll continue to use these tools, and we won’t be waiting even for the year by year, right, as important as the year by year is, and as seriously as we take it, we’re going to be looking for indicators along the way. And again, the fact that we now do the employee survey, the employee trust survey, on the more routine basis, that’s going to get us, you know, dialed in even better, I think.

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

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

Quil Lawrence (NPR):  Hey, thanks. Can you all hear me?

Terrence Hayes (VA Press Secretary):  Yep. We got you.
 
Quil Lawrence (NPR):  Miraculous. Thank you. I was wondering above VASP, actually, since the moratorium on foreclosures is within days now. And I see on the VASP website that servicers are being sort of allowed to familiarize themselves with this process until October 1st. But it seems like Veterans are now exposed to a risk of foreclosure again. And I’m just still hearing from a lot of people that they have not been able to get with their servicers and get current. So, I’m wondering, is that moratorium going to be extended? Any change? Any announcements on that?

Denis McDonough (VA Secretary):  Yeah. So, Quil, thanks so much. I’m glad that you asked about this question. We anticipated you might. I’m not sure why we thought that. But, you know, we’re very focused on this. We’re obviously mindful that May 31st, which is Friday, is an important date as it relates to the moratorium. So, we’re very focused on that. We’re also — so as a near term tool, we’re very focused on that. And then on the VASP for Veterans who encounter, as a result of the dynamics in the market encounter challenges after working through a number of these steps, which we call working down the waterfall, we see both of these important tools as being meaningful to Veterans. And I don’t have anything to announce today, but as soon as we have something to announce on both of those things, you guys will be among the first to know about that.
 
Quil Lawrence (NPR):  Thanks very much. A quick follow-up is whether you have visibility on whether and how many foreclosures have continued since you — or rather, how many?

Denis McDonough (VA Secretary):  How many have been avoided?

Quil Lawrence (NPR):  Yeah, exactly.

Denis McDonough (VA Secretary):  I don’t have that, but maybe our team does, Quill, so let me take that and Terrence will work with the team over at LGY, and we’ll get that information to you if we have it.

Quil Lawrence (NPR):  Okay. Great. Thanks a lot. And, of course, my colleague Chris Arnold is on here, too. He’ll ask a question later.
   
Terrence Hayes (VA Press Secretary):  Thanks again, Quil. We’ll go to Jordan.
 
Jordan McDonald (GovCIO):  Hi, everyone. Thanks for doing this. I had a question for Barbara about the trust scores. Could you sort of give us a rundown or breakdown of how technologies like the mobile app sort of contributed to these trust scores over the years?

Barbara Morton (Deputy Chief, Veteran Experience Office):  Yeah. So, I mean, don’t know that I could correlate the technology with the mobile app specifically, because a lot of the surveys go out based on Veterans having direct care, let’s say, from VHA, VBA, NCA, or the board of Veterans appeals. But I do think, you know, to the secretary’s point earlier, when Veterans kind of tell us there’s a pain point or like, hey, you know, VA.gov previously was really hard to navigate. Us responding to that and then kind of going the extra step of not thinking we have the best solution ourselves. But actually, consulting with Veterans and doing that research, to me, is really an organic way to build trust. If we respond to what people are telling us, Veterans or employees, that inherently, I think, is going to build a level — a better relationship and a level of trust.

Jordan McDonald (GovCIO):  Excellent. Thank you.

Barbara Morton (Deputy Chief, Veteran Experience Office):  Thanks.

Terrence Hayes (VA Press Secretary):  Thanks, Jordan. We’ll go to Lucy. Good afternoon, Lucy.

Lucy Bustamante (NBC Philadelphia):  Hey. Good afternoon, everyone. Thank you once again for doing this. I am interested in two reports that we are waiting to receive. I’ll start with the K2 toxins report, not just dealing with radioactive uranium, but also we’ve been doing a lot of reporting on toxins on stateside bases such as PFAS for our local base, Willow Grove, which is one of the seven sites in a multi-site study done by the CDC in conjunction with Pennsylvania and others. So, we’re waiting for the K2 report, and we’re also waiting to see how diagnostics is being impacted by this. Will there be any conversation as to whether a Veteran can go pay for their blood work to see if they have PFAS in their blood and be able to submit it to the VA? And then also, I know we’re due for an update on the bronchiolitis exam. I know that there was a way that you all were analyzing whether it could be done not as invasive. Just wanted to see if we can get an update on that, just diagnosing toxin exposure?

Denis McDonough (VA Secretary):  Yeah. Thanks so much, Lucy. And it’s good to see you. Thanks for joining us again. I don’t have a particular update on any of the three reports that you asked. I did have a recent meeting, sit down, with several K2 Veterans to hear more carefully about their concerns. We’ve had some follow up to that, and I think we have a pending public session with K2 Vets. I think the dates run together, but I’ll make sure that we get you that exact date. I feel like it’s late this month. Sorry, late this next month, meaning late June on K2. But I don’t have anything on the PFAS study of the seven sites that CDC is doing with the states in question. And then the last one was — what was the last one, Lucy?
 
Lucy Bustamante (NBC Philadelphia):  Well, I will — it’s actually — it’s a separate one, but bronchiolitis.

Denis McDonough (VA Secretary):  Bronchiolitis, yeah. So, we, you know, I think as we’ve said in this room before and as we’ve assured several of our Veteran — Veterans and Veteran groups who are focused on this issue, we are working through to get diagnostic codes on that. You know, it’s obviously a process that’s related to rulemaking. So, we got to be very careful what we say under the Administrative Procedures Act on that. And so, I don’t have an update on that other than to say that this continues to be obviously a major priority because there are Veterans who are impacted by this and we want to make sure that, and it’s quite clear that Congress wanted us to address this issue given it’s one of the enumerated conditions in the act. So, we’re seized of it and I just don’t have an update for you because, you know, pursuant to established processes here, we gotta make those rules public when they’re ready to be made public.

Lucy Bustamante (NBC Philadelphia):  So also, the MITRE study on disparities in the denial rates, the 2023, not the 2021, is that being worked on still? What is the status of this and when we will be able to see the results of that study?
 
Denis McDonough (VA Secretary):  I don’t know that. I know the MITRE study you’re referring to. This is a study that — that was concluded — that was ordered and concluded basically before we arrived here. That is one of the reasons we stood up our agency, equity assurance team. That equity assurance team is continuing to work. They did announce two really important findings from their internal work on this, which is, and those findings are that the earlier a Veteran files a claim, that is to say earlier to that Veteran’s service completing, and the likelier that Veteran is to use a VSO in the filing of that claim, those result — those two steps result in higher service connect — service disability connection ratings. And so, as a result of that, we are traveling the country with a bunch of outreach at different facilities with transitioning Veterans to ensure that we can see as a result of those two important variables, more Veterans filing their claims and more of those claims getting higher service-connection ratings. So, we don’t have an update out of that process for you guys. But that’s surely one of the goals of the equity assurance team, which is to routinely update out of that work on what we’re finding in those outreach efforts.

Lucy Bustamante (NBC Philadelphia):  But just to be very clear, it will be released at some point? And do you have a date for when? And then finally, the K2 report, is that still coming out at the end of June? Is that the intention as well?

Denis McDonough (VA Secretary):  When you say that it on the first question, can you explain to me what the it is? I’m sorry.

Lucy Bustamante (NBC Philadelphia):  Just the release of the MITRE study to be able to see the 2023 report. I know that the 2021 was in conversation for a little while. We FOIAd some information on this MITRE study for 2023. Just wondering if that’s going to be a report that is delivered in our inboxes kind of thing, or just what to expect.
 
Denis McDonough (VA Secretary):  Yeah, so let me take that one, Lucy. I think I’m not remembering the specific reports, so just that I know, before I make a commitment to you, I want to make sure that I know what report I’m talking about on that. And then on the K2, we anticipate, as I said, a next public meeting at the end of June. Whether there’s a report associated with that, I just don’t know. But we can get you an answer on that as well.

Lucy Bustamante (NBC Philadelphia):  Okay. Thank you very much. And two more when you’re done with everyone, if you don’t mind.

Terrence Hayes (VA Press Secretary):  We figured that, Lucy. We’ll go to Orion.

Orion Donovan-Smith (The Spokesman Review):  Thank you, Terrence. And hi, Mr. Secretary. Thanks for doing this, as always. I just wanted to ask a couple quick EHR questions. First, we’re a few months past go live now at the Lovell FHCC in North Chicago. Just curious what you’re hearing about how that’s gone so far.

Denis McDonough (VA Secretary):  You know, I think — I haven’t heard anything additional to what I said to you, I think in this room last month, which is kind of on the high end of expectation, but that’s such a kind of anecdotal report. I think rather than me repeat that, let me just say that I think the most measurable statistic I’ve heard is that in terms of pathway back to pre go-live productivity levels, that trend line was very positive on that, but I don’t have a specific number on it, so that’s surely a thing that we could take back to the Office of Electronic Health Record modernization and try to get you some data on that.

Orion Donovan-Smith (The Spokesman Review):  Thank you. And on that — related to that, with all the caveats that always apply with legislation in Congress, I’m wondering if this EHR Reset Act, that’s part of the Dole Act package of Veterans legislation in Congress, if that’s something that VA generally supports or thinks is implementable? Again, that’s just the part of that legislation that would authorize the EHRM program and give you basically two years to meet those metrics.

Denis McDonough (VA Secretary):  Yeah. I want to be really careful to not kind of get into a public negotiation about that law because we’re also, or sorry, that proposed law, that bill that generally because, you know, something that we’re talking to our interagency partners about, including the OMB. So, I want to be really careful on that, to not enunciate a specific position on the overall bill. I will just note a specific, a general concern about it, which is, as you know, last month’s press briefing with you guys really focused on the budget and whether we had the budget over the course of ‘24 and ‘25 to meet the many demands that we’re under. And I am concerned about, and I’ve communicated generally to members of Congress my concern about a series of new authorizations and mandates that don’t come with any new money. So, I am worried about that as a general matter on that bill. And then the last point on your specific question, I’ve also communicated to members of Congress that I’ve really appreciated how much they’ve heard us out on our concerns going back to January, and heard us out, I think, made meaningful changes to their proposal, you know, on the things that I have a lot of concerns about up there. And again, being careful not to enunciate a specific position yet, you know, the EHRM Reset Act is not among them. You know, I feel like they’ve made a lot of good changes in reaction to our requests.

Orion Donovan-Smith (The Spokesman Review):  Well, thank you. I know I’ve taken more than my share of time in the past briefing, so I’m gonna leave it there.

Denis McDonough (VA Secretary):  Look at you. Let’s go.

Terrence Hayes (VA Press Secretary):  Lisa.

Lisa Rein (The Washington Post):  Hi. I had a question about your outreach efforts, which I know you’ve been really focused on in the disability benefits area. And I wanted to know, is this something that hasn’t been done before? I mean, I know you’ve been doing it all along, but I was looking at the list of claims clinics, and there are a lot coming up, you know, through the rest of the year. Is that something that you guys started, and can you just tell me sort of what happens in them? 

Denis McDonough (VA Secretary):  Yeah. You know, I think I’ve heard people say that the level of outreach that we’re doing is unprecedented. So, if you were to say to me, what’s your evidence of that? I guess so I’m being really careful to not claim that it’s unprecedented because I couldn’t give you soup to nuts here on it. But, for example, in the course of the last year, we’ve — sorry. Over the course of 2024, we have announced that there will be 550 outreach events. That strikes me at least as a number to be higher than before, if not entirely unprecedented. Secondly, we announced on Friday, I think, or when did Josh do his press conference? Wednesday. Josh announced on Wednesday that you may recall last year, as we approached August 9, 2023, that was a really important time that if a Veteran were to have filed her claim on or before August 9, 2023, that Veteran would get an effective — would be guaranteed an effective date for their benefits payments of August 10, 2022. So, you recall that there’s a big amount of outreach leading up to that point. Also, as we approached that point, we knew that Veterans would not necessarily be able to complete an entire claim in that period. So, we also said to them at that time, remember, if you file an intent to file, an ITF, on or before August 9, you then have a year to complete that claim, which would then guarantee you still an August 2022 effective date. So, Josh announced last Wednesday that we will be contacting each of those roughly 300,000 Veterans who filed an intent to file to say, hey, during the course of the summer, let’s finish that claim so we can protect your effective date. That’s another example of outreach, and I am not aware of any time in the past when we at VA have outreached to intent to filers to encourage them to close that intent to file into an actual claim filing. So those are a couple examples of outreach efforts. So, your next question is what happens in, for example, a claims clinic? Or let me just give you an example, which I talked about in this room before. Last summer during the VSO national conventions, we would, in fact, or at the student Veterans of America National Convention last fall, I think it was, in Nashville. On site, we had claims personnel, VHA health personnel, including mental health professionals, associated, for example, with the Vet centers — mobile Vet centers. And then third, we had mobile C&P exam trailers so that a Veteran could actually come to the Student of Vets of America Conference, file a claim, get a C&P exam, and then even as happened in, I forget the exact number, but we can get you the number, get a service-connection rating, all during the course of that Veteran’s stay at the national convention for SVA. We did the same thing for the VFW, the American Legion, the DAV, the Vietnam Vets last summer. So that’s what happens there. The whole question then is why? I think that’s what you’re kind of driving at. This goes to what I said partially in response to a question from one of the — one of your mates about the trust scores. And it goes to something that John Boerstler and Barbara Morton say all the time, which I took to heart when I first got here, which is, we strive to be an agency that fits our programs into Veteran’s lives, rather than expecting Veterans to change their lives to fit into our programs, which I think, frankly, for a long time, is what government programs did and what VA did. So, what we’re trying to communicate by reaching out to Veterans in these outreach efforts is precisely that, which is, we work for you, so we’re trying to build our programs into your life rather than expecting the opposite. I hope that that has led to a sense among Veterans that we want a relationship with them. I’ve said that in this room a lot. I’m really proud of the relationship that we have with slightly over half of the 19 million Veterans in this country, but I’d like a relationship with 19 million Veterans.
  
Lisa Rein (The Washington Post):  Yeah. Wow. Okay. And these could be not only PACT Act claims that you’re trying to encourage Veterans to file. I mean, it’s all kinds of disability?

Denis McDonough (VA Secretary):  We had more claims filed last year by a quantum of 30% than ever before. This year, we are 16% over last year. So, 16% over the 30%. And remember, the year before that was an all-time high. So, there’s no doubt since we announced a million last week, for example, that a lot of those are PACT Act claims, but by no means are they all PACT Act. And by the way, us bringing the claims reviewers and the claims clinic to Veterans, says to them, we want your claim because we want a relationship with you, because we work for you. Not only we want your PACT Act claim, right. And as long as we’re talking about this, I might just say that the backlog right now, since the last time we talked, is down more than 130,000 claims since it’s high in January, so it’s at 285,000 currently. The inventory is under 900,000. I wrote this number down this morning, but I grabbed the — no, I didn’t grab the wrong card. So, the number on inventory is slightly under 950,000 overall claims. So, yeah, that’s a lot of claims. It’s not just PACT Act claims, but there are also a lot of PACT Act claims. And the importance of a claim, obviously, is that that’s the way that we make good on what the president calls the solemn obligation to our Veterans. 

Lisa Rein (The Washington Post):  Thank you. Okay. One last question, and Terrence and I have been in touch a little bit via email. But if I wanted to go to a claims clinic, I could do that, right?

Denis McDonough (VA Secretary):  Have you filed your claim yet?

Lisa Rein (The Washington Post):  I’m not a Veteran, but I could go as a reporter, right?

Denis McDonough (VA Secretary):  Listen, man, we’re an open book here. So, you want to go to a claims clinic? Sure. You know, if you can fit them in, we’d like you to cover all 550 of them.

Lisa Rein (The Washington Post):  I’ll try with a couple. But thank you. I’d like to try.

Denis McDonough (VA Secretary):  The 550 is not, you know, it’s not all. It’s, you know, the 550 may not — there’ll be differences among them.

Lisa Rein (The Washington Post):   Yes, that’s what I’m gathering reading about. 

Denis McDonough (VA Secretary):  But, yeah, we’d love to have you cover. 
 
Lisa Rein (The Washington Post):  Okay. Thank you.

Terrence Hayes (VA Press Secretary):  Lisa, I feel like you’re trying to get the secretary to check my work when I told you you could come. No, we appreciate you. Chris.

Chris Arnold (NPR):  Okay. Sorry. Taking me a second to unmute. To follow up on the VASP stuff that Quil was asking about, too. You guys can hear me, right?

Denis McDonough (VA Secretary):  Yep. All clear.

Chris Arnold (NPR):  The group of people where, okay, TCP ended, which was the only option in the toolkit that servicers were using from VA that didn’t mean your interest rate was going to go to 7%. We’re still chasing down exact numbers, but it’s looking like several thousand Veterans got put into loan mods coming off of forbearance after TCP ended, where they ended up in kind of a much worse deal, you know, as much costlier mod. And if it’s a few thousand people that that unfortunate thing happened to and they feel like, look, the servicer told me my payments wouldn’t go up and everything was going to be okay, and now I’m — I got hammered here and I’m paying $1,000 more a month or whatever. If, you know, there’s 40,000 spots for VASP, for people who are unresolved, is there any thought to, like, once it’s figured out how many people that happened to, you know, why not allow them access to the program so they don’t have to get hurt that way? Does that make sense? It’s a little complicated. I apologize. But why not offer that to them, too?

Terrence Hayes (VA Press Secretary):  Yeah, Chris, I think — I think Josh addressed that the last time you spoke with him. Am I not correct?

Chris Arnold (NPR):  I don’t think he said anything definite. I think he just said, you know, we’re still—
  
Terrence Hayes (VA Press Secretary):  Yeah, I think from what I remember is that the issue is, of course, that in order to be eligible for VASP, unfortunately, folks would have to be in a delinquency type of situation. Those individuals who have, since, you know, I guess, modified their loans and now, as you state, potentially have higher interest rates now, unfortunately don’t fall into that category. But again, as Josh has said previously, what we want is to hear from those Veterans. So, if you are in contact with those Veterans, please have them, you know, reach out to us and we can see what may be available to them. VASP may not be that option, but there may be some other opportunities available to those Veterans.

Chris Arnold (NPR):  Okay. I guess, you know, and as we get the numbers, we’ll circle back. I understand.

Terrence Hayes (VA Press Secretary):  Yeah. And again, and as you and I have been conversing back and forth, if you are in contact as you had before, you’ve placed some of those Veterans in our reach, and we’ve been able to immediately contact those folks and provide them with resources. Again, that is on the table. So, each time you’re chatting with these folks, please give me a call or our team a call, and we’ll make good on that, too, or reach those Veterans as quickly as possible.
 
Chris Arnold (NPR):  And I understand, it’s just since VA created VASP, so it sounds, he’s saying, like, well, you know, the rules don’t let us do it, but you guys are writing the rules. So, I’m just asking, like, you know, is there any thought as this becomes more apparent? But anyway, I appreciate it.

Denis McDonough (VA Secretary):  Yeah, Chris. I just want to make sure, you know, I think the most important thing is you talked to Josh about this last Wednesday, and we can resend the transcript or whatever on that, but I don’t think you’ve heard anybody say the VASP rules won’t let us do it, and we never want to be, so that’s why we’re not doing it. We never want to be in a position where we’re saying to a Veteran, we’re not going to help you. That’s why we’re asking to be in direct touch with them and urging them to come see us because we have a lot of options. I think what Josh is saying is that the VASP is the final step on a multi-step engagement process as the Veteran is wrestling through the challenges of an interest rate market and a mortgage market that has just had a very, you know, after, you know, many years of relative stability, had a period of pretty significant challenge. So, I don’t want anybody, and I don’t want you to take from what we’ve said in our multiple conversations or your conversations with Josh to mean, hey, we can’t do this because as you just said the VASP program that we created doesn’t allow us to do it. We’re saying that the VASP is kind of, as we work down that waterfall of options for the Veterans is at the end of that process. So, we want to get in conversation with those Veterans if they are encountering challenges, even if they’re not currently delinquent or late on a payment is a better word. You know, that’s what we mean by what we’re saying, and I hope our Veteran customers feel that and know that.
  
Chris Arnold (NPR):  All right, thanks.

Terrence Hayes (VA Press Secretary):  Thanks, Chris. I will go to Ellen.
 
Ellen Milhiser (Congressional Synopsis):  Hi, y’all. Thank you for doing this. On April 16th, the VHA said they’re at 91.4% on that trust score, and now the entire VA is at 80.4, which means the VHA is bringing the rest of the department up. Which elements are bringing them down?

Terrence Hayes (VA Press Secretary):  Say that again, Ellen.

Ellen Milhiser (Congressional Synopsis):  Which elements within the VA total are bringing the total down? If the VHA is over 90 and the entire department is at 80, someone within the VA is below 80. Which elements might it be, and how are you addressing that? 

Barbara Morton (Deputy Chief, Veteran Experience Office):  Yep. So, thanks so much for that question. I think that the power of this measure is that we can sort of start to dig into what is that difference, right. If VHA outpatient is so high, to your point, you know, where do we have opportunities for more improvement? One of the things over the last year or so that we’ve been working very closely with Josh Jacobs and his team with is the benefits experience. We know from doing some human centered design research with Veterans that the compensation experience can be a little bumpy at times, right. It’s a very kind of legal process. I have a background at the board of Veterans appeals, so firsthand knowledge of how difficult that process is to understand. So, we’ve been working with them to really understand the moments that matter most in that journey. Some of them really center around communications. Are we setting expectations properly with Veterans who are filing for compensation? There are other elements of medical exams, you know, how might we be able to improve that experience? So, there are a number of those areas that we’re exploring together with Josh and his team as well. 

Ellen Milhiser (Congressional Synopsis):  Are you involving the Veterans Service Organizations in that process? 

Barbara Morton (Deputy Chief, Veteran Experience Office):  So, I will have to get back with you on that. I think we did brief out — I’m trying to think about if we briefed out the VSOs on this project. I’ll take that back. We certainly welcome anybody’s thoughts and perspectives certainly. Typically, our research, though, goes directly to Veterans who are actually in the process, but certainly the VSO feedback is equally as valuable. The other thing I would say as well is we do know from our research, and this dates back, way back to the first Veterans journey map we did way back in 2015. As you all probably know, Veterans, if you’re on the call, the transition experience can also be pretty bumpy. And so that’s something that we’ve also been working on as part of the president’s management agenda. It’s called the Life Experience Initiative. Imagine this. We VA, along with siblings in DoD, Department of Labor, Small Business Administration, together across agencies, are working on how we address those kind of pain points that transitioning service members and their families are experiencing. More to come on that, but you can see updates on that initiative on performance.gov and again can share links and updates to that. So great question. And we are diving right into that, and we feel like we’re at a maturity level now where we started with healthcare, and we’re excited to support the Veteran experience across all business lines. 

Ellen Milhiser (Congressional Synopsis):  Thank you so much. 

Barbara Morton (Deputy Chief, Veteran Experience Office):  Thank you, ma’am.
 
Denis McDonough (VA Secretary):  Hey, Ellen, I might just add one thing here. So, this idea of kind of digging into the Veteran experience through a Veteran journey map. Recently, I met with a Veteran who actually flew across the country with his caregiver at his own expense. This is a guy I met, actually, when I used to work for the government, and he relies on the prosthetics team and the adaptive driving team. And I’ll tell you, his experience was terrible. Not anything that I would expect, whether we managed his expectations appropriately or not, just in an absolute sense, his service that he was receiving was deplorable. And Barbara and her team have now sat with him. He’s pulled together a group of similarly situated battle buddies to explain to us that experience and those pain points so then that we can work with VHA and with the prosthetics team to ensure that that process improves. So, when you ask, so what are you doing about it where it’s soft? Remember, VHA itself is a big organization. And we’ve also, the other thing that the data allows us to do is to recognize that the likelier that a Veteran is a woman, the likelier that the Veteran is of color, means the lower the trust score, including for outpatient care. And so that means that that becomes actionable intelligence for us as an organization to be able to also identify places where maybe that there’s underperformance that we want to talk to the leadership about. So, we’re constantly looking at that data to — and so are our leaders, you know, this is routinely on the briefing slide when I go see our teams out in the field where they tell me where they are on their trust journey with their Veterans. So, it allows us as a constant matter to update our performance.

Terrence Hayes (VA Press Secretary):  Thank you, Ellen. We’ll go back to Lucy.

Lucy Bustamante (NBC Philadelphia):  Thank you very much, Terrence. Okay. Two quick questions on this. Are you all tracking the education benefits for Gold Star children in the state of Virginia? And what’s going on with those families right now that are trying to appeal to the governor? And I know that California is talking about introducing some changes as well to their financial aid for — available to Gold Star students. If you are tracking that, does the VA have a position on what needs to happen there?
 
Denis McDonough (VA Secretary):  You know, Lucy, I’m not familiar with either of those two cases, but if you have more on it, we can take that and we can get back to you on it and maybe something that in fact, we are working. I just don’t — nothing springs immediately to mind.
 
Lucy Bustamante (NBC Philadelphia):  I appreciate that. And finally, the VA whistleblower situation that we’ve covered in the past. In our conversations, we understood that there was also some repair that needed to happen to the process of reporting sexual harassment within the VA. Has any recommendation for change happened within your conversations, or is that still a work in progress or is it pretty much all on the whistleblower at this point?

Denis McDonough (VA Secretary):  So, thanks very much for the question, Lucy. We’ve taken a — we’ve kind of revamped the leadership in the HR&A component of our VACO. So, in our human resources and administration component of our VA central office leadership team, they are undertaking a series of steps to include making sure that how we are structured — I think what you’re referring to is how we are structured related to the EEO process.
 
Lucy Bustamante (NBC Philadelphia):  Yes, sir.
 
Denis McDonough (VA Secretary):  So, they’re undertaking that whole set of efforts and so they’re working that out. I don’t have anything to announce on that with you today. We’re staying in close touch with Congress on that. This is a subject of our hearings and as well as subsequent hearings. Hearings I participated in, as well as subsequent hearings that assistant secretary of law participated in. We don’t have any specific announcements on that, but when we have them, you’ll be among the first to know.

Lucy Bustamante (NBC Philadelphia):  Thank you, Mr. Secretary. Thank you, Terrence.

Terrence Hayes (VA Press Secretary):  Leo.
 
Leo Shane (Military Times):  Mr. Secretary, last week we heard from, I think it was a dozen Senate Republicans who said they’re upset over the VA bonus scandal that you’ve talked about in the past, and they expect the resignation or firing of several senior leaders, including Under Secretary Elnahal and Under Secretary Jacobs. I know the House Veterans Affairs Committee also wants them to come and testify next week. Do you still have full confidence in the leadership team after this? And should we expect those two to be testifying next week up on Capitol Hill?

Denis McDonough (VA Secretary):  Yeah. So obviously, we take that hearing really, really importantly. We consider it very important. Obviously, as I’ve said in this room a lot, I believe that congressional oversight strengthens us, makes us better. That’s true in this case as well. I don’t have any announcements on who’s going to be testifying, but I think I want to underscore to you guys, and we’ll communicate directly to the committee how seriously we take that hearing. That’s one. Two, the inspector general wrote a very clear, very helpful report that includes a series of important steps. We are moving with dispatch to not just having concurred with them, but to implement them. That includes referring the whole set of actions to the Office of Accountability and Whistleblower Protection. And so, we’ll be watching our team for recommendations from our teammates at OAWP to include recommendations for me. I’ve been very clear that responsibility for this rests with me. You know, I’ve made clear that I should have put this into governance to make sure that everybody is tracking and we are able to move forthrightly and with full transparency on this issue. So, you know, obviously the OAWP will look at all of that. Third, we also move with dispatch to withdraw the incentives. And, you know, we’re at roughly 90% of those incentives being returned. And I think that’s important, but we’ll make sure that we’re following through on this. And fifth, I have made clear that partially as, because of, you know, some of the data that Barbara briefed, which is that trust is at an all-time high, we are now providing more care and more benefits to more Veterans than ever. Based on that performance, I have communicated to Dr. Elnahal and Mr. Jacobs that they have my confidence, and I would hope that we can count on them staying in their jobs, because I think it’s really important that we continue to perform at this high level. And so, I think I’ve answered all the questions.

Leo Shane (Military Times):  Great. Thanks, sir.

Terrence Hayes (VA Press Secretary):  Appreciate it, colleagues. I think that does it. I don’t see any other questions. This concludes our press conference. Ms. Morton, thank you for joining us again, and we look forward to seeing everybody again next month. Thanks, everybody. Appreciate you.