VA Secretary press conference, Tuesday, January 30, 2023

Terrence Hayes (VA Press Secretary):  Good afternoon, ladies and gentlemen. We welcome you to today’s press conference, our first of the new year. It’s great to see each of you here today. We have a couple of new reporters also in attendance as well as online, so we have some new faces there. So glad to have you each on the VA Beat. I know we have a lot to cover, so I’ll step aside and I will turn the floor over to Secretary McDonough.

Denis McDonough (VA Secretary): Terrence, thanks so much. Let me just say good afternoon to everybody. I hope you and your families shared in a safe, fulfilling holiday season and found some time to unplug and unwind. Last year, VA delivered more care and more benefits to more Veterans than ever before. And in the year ahead, we’re going to keep fighting like hell to reach even more Vets, to continue building trust with them to fit into their lives, rather than asking them to change their lives to fit into our programs. We put that plan into action earlier this month when the Student Veterans of America held their national convention down in Nashville. Nearly 2500 students, military connected students, Veterans, their families, caregivers and survivors were in attendance. And we had over 150 VA staff and Veteran Service Officers on site representing every part of VA ready to get those Vets the care and benefits they earned and so richly deserve. Over those three days, we helped 361 Vets at our Veterans claim clinic–claims clinic. Altogether, our team scheduled over 200 C&P exams for Vets claims, completed 25 of those exams on-site in five mobile Vet clinics and returned to Vets 24 rating decisions for claims they’d submitted at the convention. That’s meeting Vets where they are. That’s the type of experience we wanted to deliver moving forward.

Now, another major priority for us is ending Veteran homelessness. Last Wednesday night in Sacramento, I joined HUD’s point in time count that provides our annual estimate of Veteran homelessness in this country. It was my fourth as secretary, and every Veteran we’ve met on those nights reinforces the tragedy, the avoidable tragedy, that there are Veterans in this country without homes. That’s unacceptable. Every Veteran should have a home. And ending Veteran homelessness is a top priority for VA and for the president. We’ve made good progress. Today, I’m proud to announce that we permanently housed over 46,500 homeless Veterans in 2023, surpassing our goal of 38,000 Veterans last year. And despite a slight increase last year, the number of Veterans experiencing homelessness has fallen by more than 52% since 2010. But make no mistake, even one homeless Veteran is one too many. And we’re not going to rest until Veteran homelessness is a thing of the past. So, to bring you up to date on these critical efforts, I’m pleased to be joined by our indefatigable, tireless, excellent executive director of our Office of Homeless Programs, Monica Diaz. Monica, the floor is yours.

Monica Diaz (Executive Director of Office of Homeless Programs):  Good afternoon, everyone. And thank you, Secretary McDonough. I want to take you back to February 2022, a time when Secretary McDonough gave VA this challenge to permanently house 38,000 homeless Veterans. Then VA and our community partners actually house 40,401 homeless Veterans, exceeding the secretary’s goal by more than 6%. We learned a lot from the work done in 2022. When we look back on the more than 40,000 homeless Veterans who were permanently housed last year, we found that nearly 2500 of those Veterans fell back into homelessness again at some point in 2022. We know that many homeless Veterans face significant barriers to housing stability, including physical disabilities and mental health struggles, to the harsh realities of structural factors such as lack of affordable housing and economic opportunities in their communities. Yet in the face of those challenges, hope persisted. Thanks to the relentlessness of our staff and partners all across the country, 86% of those 2500 Veterans were rehoused again or at least placed back on a pathway to rehousing by the end of the year. But we can and must do better. So, in March 2023, Secretary McDonough vowed to house at least 38,000 homeless Veterans. But he did not just want Veterans to get housed. He challenges to ensure that at least 95% of those Veterans stayed in housing by the end of 2023. And for any Veteran who unfortunately did return to homelessness in 2023, he challenges to ensure that at least 90% of them were rehoused or back on a pathway to rehousing by the end of the year. Last, he challenged us to engage with at least 28,000 unsheltered Veterans to get them back into our care. Today, I am proud to announce the results of our work. From January 1, 2023 through December 31, 2023, 46,554 homeless Veterans have been permanently housed by the VA and our community partners. Of the Veterans who were housed, 95.9% remained in housing at the end of 2023. Of the 1919 Veterans who returned to homelessness, 1850 Veterans, or I should say 96.4%, were rehoused or placed back on a pathway to rehousing. And VA and our grantees engaged 40,203 unsheltered Veterans to help them obtain housing and services. This result significantly exceeded the secretary’s challenge, and each number represents renewed hope, dignity, and a future fuel of possibilities for many of our Veterans, thanks to the dedication of thousands of staff and partners nationwide. While this is cause of celebration, our work is not done. The most recent point in time count estimated on a single night in January 2023, 35,574 Veterans experience homelessness, which reflects an increase from 2022. And although there is still an overall decline in Veteran homelessness, a 52% decline since 2010, again, our work is not done.

Fortunately, we know what works. Veteran homelessness is solvable, and we have the right tools to do the job. From outreach services, which serves at the front door for VA healthcare and benefits, to emergency and transitional housing for Veterans who need a place to stay tonight, to coordinated access to permanent housing and more. At VA, we have a wide array of services to address the full range of housing needs Veterans may have. Yes, in our hands, we hold the tools capable of building a future free from the shadows of homelessness for our Veterans. Yet the truth that we must face is this. We cannot do this alone. We need you, every single one of you, to join us in this cause. We need allies in this fight. The fight against Veteran homelessness. First, if you’re a Veteran who is homeless or at imminent risk of homelessness, I want you to know that it is okay to ask for help. It is a sign of strength. It is a sign of courage. You are not alone. We’re here for you every step of the way. Please let us be your ally in this fight. You do not have to fight this fight alone. Reach out to us by calling the National Call Center for Homeless Veterans at 877-424-3838. The call is free, confidential, staffed 24/7 with trained professionals who will connect you to the services that you need. And to the landlords out there, you’re a critical ally in this fight. When you open your doors to housing a Veteran, you do more than provide a roof. You offer stability. You give hope and a chance for a new beginning. There are tangible benefits, too, like guaranteed income and ongoing support from the VA and community partners. But more importantly, you have the power to make a real difference in the lives of those who have served us all. Choose to be an ally in this fight. The fight against Veteran homelessness. If you’re a business owner, each job opportunity you provide is more than a paycheck. It’s a lifeline, a symbol of hope, and a crucial step forward for stability and dignity to those who have served our nation. Choose to be an ally in this fight. The fight against Veteran homelessness. Finally, whether you’re a Veteran, know a Veteran or work or live in a community alongside Veterans, take the time to familiarize yourself with the nearest VA and the range of services we have available. You can also visit VA.gov/homeless to learn more.

Finally, as we continue this journey, let us remember the power of empathy, the strength found in unity, and the profound impact of extending a helping hand. Our mission stands with housing and starts with housing, but goes beyond that. It is about restoring hope, dignity, and a sense of belonging. It is about real people, real struggles, and the real difference we can make. It is about ensuring that no Veteran ever feels that they’re facing their darkest moment alone. May God bless our nation’s Veterans and their families. Thank you for your time and happy to answer any questions.

Terrence Hayes (VA Press Secretary):  Thank you, Monica. We’ll open the floor to questions. Ellen.

Ellen Milhiser (Congressional Synopsis):  Hello. As always, thank you for doing this. Secretary McDonough, I’m sure you saw the op-ed in the Hill Newspaper last week. I think it was last week or the week before about–written by the VA psychiatrists or psychologists, I forget, about treating trans-Veterans in women’s only spaces. Couple of thoughts. Your thoughts on their opinions and also VA employees writing an article that goes counter to VA policy?

Denis McDonough (VA Secretary):  Yeah, thanks very much. Our goal at VA, my goal as secretary, is to ensure that every Veteran gets care in a safe environment. This is why we have laid out in VHA Directive (1)341 that that is our policy. And we are very serious about ensuring that every Veteran feels safe in that environment. So, wherever Veterans don’t feel that, we’ll make sure that we address that. That’s why, by the way, we hold ourselves to the standard that we lay out in the V-signal, the survey, which really seeks to ensure in every engagement that a Veteran gets timely access, that the treatment the Veteran receives is effective, and third, and importantly, in regard to this question, that every Veteran feels respected and treated with the dignity that they’ve earned. So that’s what I say to all our Veterans, irrespective of identification or orientation.
Ellen Milhiser (Congressional Synopsis):  And what about the idea of VA mental health providers writing this article in a very public forum that goes against VA policy?

Denis McDonough (VA Secretary):  You know, the VA is an agency that, you know, I’ve said this in this room before, that we do not require our employees to choose between their conscience and their career. And so that is the case, 365, 24/7.

Ellen Milhiser (Congressional Synopsis):  Thank you.

Terrence Hayes (VA Press Secretary):  Leo.

Leo Shane (Military Times):  Thank you, Mr. Secretary. To follow on Ellen’s question, is all of that enough, though? I’ve been hearing from employees that they don’t feel supported as LGBT individuals, that they’re seeing more discrimination, more pushback to some of these policies that that op-ed sort of showed an undercurrent of concern that they feel is getting there. And we did just see another legal action filed against VA for the delay in dealing with the trans surgery issue. So, do you feel like those statements are enough, and do you feel like there’s more the VA could be doing–I don’t know, new working groups, new something? But is it enough to just fall back on the policies that have been in place for a few years but may not be providing the protections that you hope?

Denis McDonough (VA Secretary): You know, I think I’d answer your question the following way, Leo, which is that the existence of policies is never enough. That the execution of those policies and the creation of the culture and the environment that draws on the strength of the great diversity of the VA workforce to provide care to a very diverse Veteran populace is what I aspire to and do I think it’s enough? It’s never enough. I think it’s my responsibility every day to create that environment, as I said, where Veterans feel safe to get the care that they have earned and so richly deserve, that our workforce feels valued and safe and able to practice at the top of their license. And there’s no doubt that I may miss the mark on that at various moments, but I aspire to do that every day, and we’ll continue to do that.

Leo Shane (Military Times): So, is there anything you’re looking at now to add on?

Denis McDonough (VA Secretary): Every day we look at, how can we ensure that we’re creating an environment that protects and makes every Veteran feel safe? And as I said, this is why the V-signal is so important, that every engagement a Veteran has, we can hold ourselves to account for the experience that Veteran had from that moment of providing care. And we aspire to ensure that our Veteran satisfaction numbers are 100%. But there’s times when we fall short, and when we fall short, we know where we fall short, and we address it.

Leo Shane (Military Times): And is there any update on the transgender surgery issue that has been–

Denis McDonough (VA Secretary): No.

Leo Shane (Military Times):  What is–is there–

Denis McDonough (VA Secretary):  You and I have had a conversation about this several times in several settings, so I don’t have anything more to report on that.

Leo Shane (Military Times):  Okay. Thanks.

Terrence Hayes (VA Press Secretary):  We’ll go to Carson Frame. Good afternoon, Carson.

Carson Frame (Texas Public Radio):  Thank you so much for taking my question and for holding this press conference. Earlier, just a few minutes ago, you spoke about building trust with Veterans and encouraging VA enrollment. Do you share the concern that Veterans are not going to the VA for mental health care because they’re afraid of losing their guns?

Denis McDonough (VA Secretary): You know, I’m not sure that I can answer your question, yes or no, because I want to make sure that whatever a Veteran is experiencing, I want to validate that, and then I want to make sure that we’re replying to that concern and addressing any concerns. I think what you’re talking about is something that I’ve talked about with a lot of members of Congress, and I worry, as I’ve told members of Congress, that there is a misimpression. The misimpression may stem from a misunderstanding about how VA treats our conversations between a Veteran and the Veteran’s healthcare provider. Those are confidential conversations. Those conversations are only for the Veteran and the Veteran’s provider and the Veteran’s healthcare team. This is why, for example, I have been uneasy about requests from Capitol Hill about information specific to reproductive health treatments available to Veterans. Those conversations are based on a relationship of trust between the provider and the Veteran. We treat that information, therefore, with great care and great discretion. There is a misunderstanding that sometimes that information will be shared with the Department of Justice for the national background check system. It is not. I’ve said in this room many times, and I’ve testified many times, that we do not provide such information to the NIC system. The only place we provide such information is in the instances when a Veteran is not able to maintain their fiduciary responsibilities, and that is a function, a determination made by the Veterans Benefit Administration pursuant to a well-established process. Only then will we provide that information to the NIC system. So, I want all Veterans who are hearing this press conference today and who are following your reporting to understand that your conversations with your healthcare providers, your conversations with your mental health care providers, are your business and your business alone. And we’ll treat that information with great care and great discretion.

Carson Frame (Texas Public Radio):  Just a quick follow-on, sir, if I could. Do you have concerns about the standard that VA is currently required to use? Do you agree that financial mismanagement or financial management concerns equate to being a danger to oneself or others?

Denis McDonough (VA Secretary): You haven’t been to many of our press conferences before, but I think everybody else who has been here knows that when somebody asks me a question that starts with, are you concerned? I’m an anxious person. A concerned person. So generally the answer to questions like that are yes. However, I can just tell you that the standard that is applied related to the fiduciary responsibilities is a standard that we take great care with that has been developed over much time and is meant to address a very delicate situation. And so, I don’t want to characterize it beyond that. I think it’s one that we use effectively, carefully, and as in all things that we try to do here in the best interest of the Veteran.

Carson Frame (Texas Public Radio):  Thank you, sir.

Terrence Hayes (VA Press Secretary):  Patricia.

Patricia Kime (Military.com):   Thank you for doing this. I appreciate it. Talking about the lawsuit between now New York City and the Department of Veterans Affairs and DoD about expansion of the IVF program. On January 25th, the Justice Department attorneys signed a document with those attorneys and said that VA has decided that they’re going to go ahead and follow the DoD’s changes on IVF. Can you comment on that? Is that a final decision? What’s going on with that?

Denis McDonough (VA Secretary): Well, I think we’ve talked about this in this room a lot, and it’s nice to see you, Patricia, by the way. So, we’ve talked about this in this room a lot. We have sought regularly each year to change the existing policy to allow more Veterans to get access to IVF. There’s my belief that no more wonderful thing than to be able to raise a family, and I’d love for more Veterans to have that opportunity. I’ve made that clear in submissions to Congress. The reason–continuously since I’ve gotten here, and in public testimony as well, the reason that the Department of Justice submitted that filing on behalf of the Department of Defense and VA is because existing statute connects VA to a DoD policy memo that was written, I want to say in the mid 2010s. I won’t remember the exact date, but we’ll get you the exact date. As a result of this litigation, DoD has indicated that it will have to change its underlying policy, which is outlined in that memo. And since DoD is changing that memo, we too will change our policy. So that is the bureaucratics of the filing. The intent, however, is consistent with an intent that we’ve had since we arrived here, which is to increase opportunities for access among more Veterans for IVF.

Patricia Kime (Military.com):  So, no time frame on that?

Denis McDonough (VA Secretary): I’m going to be careful to not talk about the timeframe on the litigation. That’s a question for justice, and I can surely only screw that up.

Patricia Kime (Military.com):  Okay. Different topic, just different question.

Denis McDonough (VA Secretary):  No different topic today, new policy for 2024. [laughter]

Patricia Kime (Military.com):  A couple of months ago, you were very outspoken about people filing claims for the first time and not needing the help of an attorney and that there were these sort of bad actors out there that were preying on Veterans. Have you all filed any lawsuits? Has justice filed any lawsuits against any of those companies? Are you aware of pursuing?

Denis McDonough (VA Secretary): I think that’s a question for justice. I don’t know what justice has filed. My position remains as it was, which is I really want Veterans to not think they have to pay someone to get the benefits that they have earned and they so richly deserve. To do that, we’ve made sure that we worked very, very closely and we’ve tried to intensify the relationship with the state Veteran Service Officers, with county Veteran Service Officers. I’ll be going to their next get-together here in a couple of weeks with our Veteran Service Officers in the traditional VSO space. And we will, when we see organizations outside of that community, organizations that are being paid, if we see malfeasance, we’ll definitely report it. I don’t have anything to report for you from our vantage point today, but I’m sure we’ll stay on top of this throughout the year and when we have news on that, we’ll let you know. Last thing is, I’ve just been having a good back and forth with one of our employees on this by email. The most important thing we can do at VA, is execute at a high quality rate and in a timely manner the record number of claims that have come in. When we do that, and we do that well and in a timely, high quality way, as we’re doing now today. Last week, more than 10,000 claims processed each day last week. As a result, the backlog is now approaching a million from the top side. Remember last month when we got together, we were warning that the inventory, not the backlog, the inventory was going to be increasing. That inventory is now coming down. The most important thing we can do is effectively process those claims in a timely way and a high quality way that will make Veterans confident that they don’t have to pay for their services. Meanwhile, though, that team that David Barron’s briefed you about last–two months ago when we were here together, they are going to continue to look for bad actors in this space and make sure that we’re protecting our Vets and not making them lose their hard earned benefits.

Patricia Kime (Military.com):  Thank you.

Denis McDonough (VA Secretary): Thank you.

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

Quil Lawrence (NPR):  Hey, everyone. Nice to see you all. Thanks for holding this. And I think there are about a dozen public radio reporters on the line today. Sorry if we’re overloading you.

Denis McDonough (VA Secretary): None of them had any problem with the audio.

Quil Lawrence (NPR): Is it working? Can you hear me?

Denis McDonough (VA Secretary): Yeah, it turns out we can this time.

Quil Lawrence (NPR):  So, yeah, I wanted to ask about the VAS program, and I know my colleague Chris Arnold will have probably follow-ups on that as well. Any more visibility on what that’s going to look like, when it’s going to be ready? We’re still hearing from Veterans who are confused about their situation, about whether this fix will help them and their servicers also seem to be giving them mixed messages.

Denis McDonough (VA Secretary):  Yeah. Thanks very much, Quil. This is obviously a major priority for us, and I don’t have any update on when VASP will go live. We’ve indicated to you that we wanted to get this done by summer. We’re working through this. We’ve been talking with our interagency partners, that means the Office of Management and Budget, the Department of Housing and Urban Development, making sure that we’re in a position on the governmental side to carry this out. We’ve been talking with our servicer partners on this, making sure that they’re prepared for the VASP program. I think my most recent update was about 90 minutes ago, anticipating you were going to ask a question about it today. I’m getting positive feedback there. I’ll take for action that you’re hearing some confusion from servicers. We’ve not heard that, but I’ll make sure that we’re doubling down and following up on that, especially in this period before we launch. And then, of course, we’re also talking to stakeholders in this space, people associated with nongovernmental organizations who are focusing on access to credit, access to mortgages, and they always help us sharpen our thinking on this as well. Of course, we’re also staying very close to Congress to make sure that they’re understanding what we’re trying to do. There’s some movement afoot, I think, to look at various legislative proposals up there on the hill. We believe we have what we need for the VASP, and if that changes, we’ll obviously let Congress know. The last point is between now and when the VASP is ready to go, we’re obviously making sure that we have paused any foreclosures, and we continue to hear positive things from the servicers there. And we’re finalizing the paperwork on the refund modification program in a back and forth with our interagency colleagues. Each of these steps is meant to make sure that is designed to ensure that our Veterans who have confronted this difficult challenge know that we’re here for them and we can help them manage through this period coming out of the pandemic. If that is not the case, I urge our Veterans to please be in touch with us so that we can address any questions or concerns or confusion that they’re encountering. I hope that’s responsive.

Quil Lawrence (NPR): Yeah. Terrence, if you don’t mind, could I throw to Chris to have the follow up on this?

Denis McDonough (VA Secretary): Go ahead.

Chris Arnold (NPR):  Apologize for the protocol bridge. Okay. Great. Can you guys hear me?

Denis McDonough (VA Secretary): Yeah, we got you, Chris.

Chris Arnold (NPR):  We’re on all cylinders here. This is sort of irresistible not to invoke the building trust idea, but we keep talking with Veterans who sort of experience this bait and switch problem, right, where they were told your payments won’t go up if you take this lifeline, the help through the forbearance plan, same interest rate, same payment. The payments get moved to the back, then PCP ends, and they’re stuck, right. But then a bunch of people, anecdotally we’re hearing from, wound up in loan mods with much higher interest rates, where their payments went up by like a thousand bucks a month and it’s really hard for them, and they feel like they were sucker punched there. And it seems like there’d be a way through the VAS program to say, well, look, if this happened to you, if you’re on a forbearance, can’t be that many people. I mean, it could be thousands, honestly. But, I mean, it’s not going to be like the whole universe of people with VA loans. If this happened to you, why not let those people get help from VASP to sort of fulfill the original promise of the program? Is that something you guys are looking at?

Denis McDonough (VA Secretary): You know, Chris, look, I think your reporting on this has been very profound and very timely, so we’ve really appreciated it. I think rather than kind of talk speculatively about what we are considering, let us keep working this, and then we’ll make sure that we’re rolling this out with you. And by this, I mean the VASP program in particular, and we’ll make sure that we’re working with you as we roll it out so that you understand it and so that you understand why we’ve made the various choices we’ve made that you’re kind of teeing up in your question. I think that’s the more productive way to proceed on this. In the meantime, we’re really eager to make sure that if there are Veterans who are still experiencing something like this, that we get in touch with them so that we can talk them through their available options even before we get to the VASP later this summer. So, I think that’s how I’d respond to your question.

Chris Arnold (NPR):  Okay. Thanks.

Terrence Hayes (VA Press Secretary):  Thanks, Chris. Thanks, Quil. Jory.

Jory Heckman (Federal News Network):  Thanks as always for doing this. Was looking for an update on the VA and also the house VA’s investigation into allegations of sexual harassment at the Office of Diversity–oh, apologies. The Office of Resolution Management, Diversity, and Inclusion. I think the last we heard on this is that VA was hoping to conclude its report on this by the end of this month. What can you tell us at this point?

Denis McDonough (VA Secretary): Yeah, thanks so much. I had assured Chairman Boss that we would get–that our internal investigation would be completed by the end of the month and that we would get the fruits of that investigation, the transcripts, and documents, and so forth, to them by the end of this month. And we’re still on track to do that. It looks like that will be tens of thousands of documents on top of the thousands of pages of documents and transcripts that we’ve already provided. But let me just take a step back for a second, Jory, and just underscore, before we get lost in the minutiae of how we’ve responded to the committee’s oversight requests, and you’ve heard me say in here how seriously I take oversight and how much respect I have for Article One of the constitution. I just want to make very clear that we do not tolerate sexual harassment. We do not tolerate sexual assault. We do not tolerate any disrespectful behavior of our Veterans or of our colleagues. And when we identify that kind of behavior, we’re going to have zero tolerance for it. It kind of goes back to Ellen’s question at the start. Our commitment is born of a recognition that the relationship we have with Veterans and the relationship we have with our colleagues is one built on trust, and we want to earn that trust. In that regard. I was very heartened by the actions taken by our new assistant secretary in HRA OSP, that is the Human Resources Administration, the Office of Security Preparedness, Assistant Secretary Cassandra Law, who she was sworn in on Friday, two weeks ago, and on Monday, the first Monday that she was in the job, she released two directives. One, to review all of our training curriculum related to sexual assault, sexual harassment, and bystander training to make sure that it’s up to snuff. And two, to direct each of our component heads, be they of an office here in VACO or be they of our independent administrations, VHA, NCA, VBA, OINC, that they have a stand down to underscore the importance to their workforce on sexual harassment, sexual abuse, sexual assault, so that we can again remind ourselves of that culture of non-tolerance of such activity.

Jory Heckman (Federal News Network):  All right. And changing gears here a little bit, we heard from the National Archives and Records Administration last week about the Veteran backlog. And obviously, there’s been some complementary work that both VA and HR has been doing on that. As far as future work on digitization and related efforts, what lies ahead and what are the goals?

Denis McDonough (VA Secretary): Yeah. Thanks so much. I was really happy to see that our archives colleagues had made the great progress they’d made. Of course, I’d briefed in this room many times of how much we wanted our Veterans to come directly to us if they had questions about their records, because we, throughout the pandemic, have been able to fulfill those records requests within a day or two, even in those dark days when the backlog at the archives was 500,000 cases long. So, I’m really glad to see that the archives has had that success. I just want to underscore to our Veterans, though, if you have a question about a document at archives, please come to us directly and we’ll help you get to it. Which brings me my second point directly responsive to your question. We have continued to make good progress in digitizing those records at the personnel records center in St. Louis. We’ll continue that work until we’ve digitized all those records. I don’t have an update on the timeline for that Jory, but that might be a good topic for next month’s briefing. Maybe we can have somebody from VBA come in and update where we’ve been on digitization, where we’re headed on digitization because it really informs us things that we’ve talked to you about on automation a couple of times, too. So, thanks for the question.

Jory Heckman (Federal News Network):  And one quick one, if I may. In addition to–

Denis McDonough (VA Secretary):  After Patricia, we threw out the new 2024 policy, so.

Jory Heckman (Federal News Network):  Apologies to be greedy here, but we recently heard from Dr. Elnahal over on the VHA side of things about their new special salary rate for HR hires. That’s in addition to what we see with VA OIT. We also heard that as far as hiring goals for this year, it’s not going to be the volume that we saw last year, the record hiring there. At this point, is it fair to say that the SSR and related the critical skills incentives, that’s more of a retention incentive? I mean, if you guys aren’t looking to grow as much, how are you guys looking at those tools?

Denis McDonough (VA Secretary): Well, the critical skills incentive, remember what it is. We can’t just–each of these things serves a very specific purpose. So, we still have retention possibilities, and we’ll use those, including an aptly named retention incentive. The critical skills incentive, though, is, and I want to just make sure I underscore this point, because I think sometimes with these new programs, our enthusiasm for supporting this awesome workforce gets ahead of us. The critical skills incentive is expressly for incenting providers, teammates, employees with a hard to fill skill. I’ve said to you in this room before that we’re really proud of the fact that we got in the PACT Act. We’re also very mindful of the fact that nobody else in the federal government has gotten it. So how we use it is going to determine whether our other colleagues in the federal government can get it. And so, each of these things, we now have a full range of really helpful tools, thanks to Congress. We also have a great team of HR professionals, thanks to our great HR teams, you know, led by Aaron Lee and Jessica Bonjorney and Lisa Thomas, who came in and briefed us all in this room last year. So, we just want to make sure now we’re just very assiduous about investing in our people, keeping our people, identifying places where we’re short, and making sure that those clinicians are seeing Veterans. And I know that at his monthly press conference with you guys last week, Dr. Elnahal briefed about the access sprints and the good progress we’re seeing on those. I think that’s really exciting because we went and hired those clinicians. Now let’s make sure that they’re seeing our Veterans.

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

Terrence Hayes (VA Press Secretary):  David.

David Elfin (cyberFEDS): Thank you, Secretary McDonough. Happy new year. And, of course, Jory’s third question stole one of mine. More generally, though, beyond the SSRs, I wonder if you could talk about your workforce goals for the year, because, as you mentioned, the PACT Act has happened, SSR has happened, and you had a record hiring year last year. So, what’s your 2024 thought on workforce?

Denis McDonough (VA Secretary):  Yeah. Well, I think the real challenge, and I think the timing of your question is good, because I think we’ll be going live here forthwith with our next PACT Act HR dashboard. So, you’ll see that. I think that’s a Thursday document. Is that right? So, you’ll see that on Thursday this week. So, our priorities for this year are for execution. We’ve talked in this room about the opportunity under Section 103 to expand access for enrollment at VHA. We still have hiring needs at VBA. I’ve been out in the field a lot. I was just at the Oakland regional office on Thursday, or maybe that was Wednesday, last week. Excellent regional office, really hitting its numbers. But we’re going to continue to hire on the VBA side to meet the demands of this historic level of claims filed. But on VHA, it will be more targeted hiring. And then really focused on, as Shereef briefed you, as Dr. Elnahal briefed you guys last week on making sure that those new employees are now seeing Veterans out the vectors that he’s briefed you in terms of our access sprints. And the early returns on the access sprints, on primary care and on mental health care show us that when we’re well staffed like this, we’re going to see engagements with Veterans increase. We’ve seen, for example, on cardiology, wait times go down commensurately. But on something like mental health, we’ve not seen a wait time diminution, which speaks to the large amount of demand. So, where we continue to need to hire, we’ll make sure that we have the resources to do that.

David Elfin (cyberFEDS): Secretary McDonough, the administration’s been in power now three years. You haven’t quite been in the job three years. But if I told you when you took the job, this is where you’d be workforce wise, you’d be pretty pleased?

Denis McDonough (VA Secretary):  I’d just be glad to know that I hadn’t gotten fired yet I guess.

David Elfin (cyberFEDS):  In all seriousness, I mean, you’re glad with the progress you guys have made over three years?

Denis McDonough (VA Secretary):  That was as serious as a heart attack, brother. Believe me, I could not be more serious than that. Let me tell you. I will say this. This is the best workforce in the federal government carrying out the best mission in the federal government. The more I travel, the more I see this. I learned from our team in San Francisco on Wednesday afternoon. We have an orthopedist at the San Francisco hospital who drives five and a half hours once a month to Eureka, California, to see Veterans. You know what that means? That means those Veterans don’t have to drive five and a half hours to San Francisco. There’s not a lot of orthopedics around the country who will make a house call five and a half hours away once a month. Then I went to the Sacramento, the Nor-Cal hospital. There, over 200 times in the last year, our providers provided surgeries to Veterans in clinical settings operated by private providers. That is taking care to Veterans, not expecting the Veterans to change their life to come to us. I also learned in Nor-Cal, that our hospital director there, his name is Stockwell, David Stockwell, great leader, longtime VA colleague, has over–I think he said, over 200 FTE on base at Travis Air Force Base, working out of that MTF to provide care to Veterans and active duty airmen and women. That too is bringing care to our Veterans. So, when I think about the workforce, my main emotion is appreciation and hope that I’ve been able to bring resource and can continue to bring resource to them to keep carrying this out. Last year, thanks to the great work of the HR teams, we had a great hiring year. Now we want to make sure that we get those clinicians out to see the Veterans. Thank you.

Terrence Hayes (VA Press Secretary):  Speaking of great teammates, let’s not waste any of Monica’s time up here as well. Hopefully, folks can ask her any questions while we have her with us. We’re excited to have her with us.

Denis McDonough (VA Secretary): Amen to that. Looks like Ellen’s got her hand up, too.

Terrence Hayes (VA Press Secretary):  Okay. We’ll go to Lucy. Hi, Lucy.

Lucy Bustamante (NBC Philadelphia):   Hey, good afternoon, guys. Thank you so much, Mr. Secretary, Terrence. My first question just has to do with the update to the disparity report. Has Ms. Rawls been able to do any work, any analysis on the disparity issue within benefits?

Denis McDonough (VA Secretary): Yeah. Thanks so much. We do have–actually meant to get some briefing on that. I haven’t gotten the briefing yet, Lucy, but I think that’s coming. I don’t know if it’s this week or next, but I did just get a heads up from Josh that they’ve got some good work back about some actionable steps that we can take. One, and two, we also just learned from the White House that they’re making some plans here relatively soon to make sure that we’re rolling out our equity plans more generally. So, I don’t have any news for you yet, but you’ll be among the first people we call when we have that news. We’ll try to call you all at the same time so we don’t give anybody advantage.

Lucy Bustamante (NBC Philadelphia):   We will obviously attempt to get a leg up on that, but obviously everybody’s got a role in this, no doubt. Given the Navy federal home loan denials, are you all involved in that case? Is the VA doing anything to address the banks who are discriminating against black Veterans and accessing the VA backed home loans?

Denis McDonough (VA Secretary): I’m sorry, I don’t think we have a role in that, Lucy, but I’ll take that and find out. I’ve read a couple of stories about that, but I don’t know of a role that we have there.

Lucy Bustamante (NBC Philadelphia):   Okay. And along the same line, sir, the sexual harassment investigation into Harvey Johnson in the DEI office, has that impacted at all the work that the DEI group is trying to do in figuring out the denial rate being higher among black Veterans compared to other counterparts?

Denis McDonough (VA Secretary): I sure hope not. I sure hope not. But we’re really looking hard at this whole suite of issues, and I’m thrilled about our new assistant secretary and the fact that she took the steps that she took upon assuming that important responsibility and swearing in for that important responsibility. But I don’t have anything more on that for you.

Lucy Bustamante (NBC Philadelphia):   Finally, sir, if I could switch to quick topic here, as far as the PFAS issues, obviously, we’ve seen the Camp Lejeune Water Act do a lot for the community that served there in those years. Is the VA planning to address PFAS exposures and establishing presumptive diseases? The CDC has already associated certain diseases to PFAS. Is there anything that’s being done on the VA side on this?

Denis McDonough (VA Secretary):  Well, you know, PFAS is an issue for us as it is for everybody. We’re obviously responding to new EPA regulations on that, so we’re taking a hard look at what that means for our facilities around the country, of course. As it relates to presumptive service connection from conditions related to PFAS, I don’t have news for you on that. That would be some of the work that, of course, our team at the home effort will be in a position to begin to address. But I don’t have any new announcements on that for you today.

Lucy Bustamante (NBC Philadelphia):   And truly, last question for you, sir. Anything else on what is going on with the investigation into the dissemination of bonus money into certain accounts of senior level executives that eventually retired? What can you tell us about how that investigation is going into the CSI money?

Denis McDonough (VA Secretary): Well, we asked the IG to take a look at it. I don’t have–we’ll find out from him when he’s done with his work on that. I don’t have an update for you on it. I think that the bonus money you’re talking about is specifically a question of critical skills incentives, or CSIs. This was related to a specific set of decisions around CSIs for executives here in the VA central office. We rescinded those. That process of working through those rescinded CSIs is ongoing. And then I wanted to make sure that we learned everything we could in light of the fact that I said earlier that we have this authority for the first time. So, we want to make sure that we’re learning every lesson on it as we deploy it now into its second year, this important program, so that we do it well. We do it consistent with how Congress intended, and we’re doing it in a way that ensures us we can keep this awesome workforce that we have.

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

Terrence Hayes (VA Press Secretary):  Thank you, Lucy. Lisa. Good to see you, Lisa.

Denis McDonough (VA Secretary): Hi, Lisa.

Lisa Rein (The Washington Post):   Nice to see you. Question, following up on a couple of questions about hiring. So, I’ve been on social media, and there are various VA employees who are talking about a $1.5 billion budget deficit that you guys are dealing with that is affecting hiring. Can you just talk a little bit about that?

Denis McDonough (VA Secretary): Sure. I’m not sure about the numbers. We are, as you would expect, in light of the budget agreement and in light of the fact that here we are in February, we still are operating under a CR. So, we’re making sure that we have–and obviously, we’ve been going back and forth with OMB for several months now in FY ‘25 development. So, we’ve been talking about the budget a lot, making sure that we have the budget that we need and that it’s right deployed among our administrations. I’m not sure what else to say about it beyond that, Lisa. I feel like we have the funding that we need to carry out the priorities that we have. We did, as I just said in response to Jory’s questions and to David’s, that I think we did just have a great hiring year. And so, I think we’re going to be focused very aggressively on execution with those new hires. And as we have budget news to make, we’ll make sure that we’re making it.

Lisa Rein (The Washington Post):   So, is there no pause on hiring at VBA? Because that’s what I was hearing.

Denis McDonough (VA Secretary): At VBA? No, I don’t know that there’s a pause on hiring at VBA. I think as it relates to VHA, there may be times when we determine that there are personnel that we don’t need going forward, but that’s consistent with what I was just saying to Jory and to Dave that as we come out of our best hiring year in three decades, we’re now focused on execution. And if there’s specific places we need to hire, we’ll do that. Does that respond to the question? Yeah.

Lisa Rein (The Washington Post):   Yeah. Okay. Thanks.

Terrence Hayes (VA Press Secretary):  Desiree. Good afternoon.

Desiree Diorio (WSHU Public Radio):  Hi. How are you doing?

Terrence Hayes (VA Press Secretary):  Doing well. Thanks for joining us for the first time.

Desiree Diorio (WSHU Public Radio):  Thank you. Mr. Secretary, are you able to–is there a current number of Veterans enrolled in the VA that are transgender? There’s an old number, 134,000, that’s floating around, but I’m wondering if you have an up to date number on that? And then second question. Is there anything that you can say at this point about the movement you’ve made, if any, towards affecting that rule change that transgender Veterans need in order to get those gender affirming surgeries?

Denis McDonough (VA Secretary): Yeah. Thanks so much. We’ll get you the number. I don’t have a number at my fingertips, and I don’t have anything more on what we’ve done to date or on timing.

Desiree Diorio (WSHU Public Radio):  Thank you.

Denis McDonough (VA Secretary): Yep.

Terrence Hayes (VA Press Secretary):  Before I get back to you, Ellen, I have a question from Quil again.

Quil Lawrence (NPR):  And I think this is for Ms. Diaz as well. I’m wondering, with the numbers that were housed, Veterans that were able to get into housing, there is, however, this increase from ‘22 to ‘23. And if I’m correct, that’s also, this is after–rather, these numbers don’t reflect the end of the additional pandemic assistance that was being given out. So, I’m wondering, how do you think that is going to ripple out in future counts, the lack of that extra assistance? And is there a staffing issue where more–

Monica Diaz (Executive Director of Office of Homeless Programs):  I think when we look at the numbers of the Veterans that we housed in 2023, which surpassed the goal, and then we look at the outcome when it comes to the PIT count, which is what you’re referring to, that seven point percent increase, right. There’s various factors that contributed to that. We’re still analyzing the data, but what we know is that there is a prevalence, right, in the communities when it comes to housing affordability. We also see that when we were in the COVID era, there was flexibilities in certain aspects that later on were not necessarily there. We can see the numbers when it comes to the evictions that are very similar to pre-pandemic times, right. So there is different factors that we do think that really impacted the demand. So, there is a higher demand than for the needs and for the services. When it comes to what the future holds for the numbers, I only know what we can provide, right. And so based on what we’re seeing, we’re going to have a more target strategic focus and continue to do more and more and more to make sure that we continue to see the numbers decreasing, because that’s always our intent. When it comes to staffing. I think that the staffing that we were able to gain in 2023 and that we continue to do has been extremely helpful. Our target goals were 90%. At one point, we were close to under 80%, and for the first time, we had 85%, which really helped for us to achieve the goals that we did in 2023. So, I think we’re in a good place as we continue to fill those positions and engaging in that effort.

Denis McDonough (VA Secretary): Yeah, Quil, I might just add one thing, and the beauty about me doing it now is because Monica could correct me if wrong. So, I was in Sacramento the other night, Thursday night. Maybe it was Wednesday night. I don’t know, man. I was hoping to see you there, but that didn’t work out. But I was asking–we have great relationships, and you heard Monica say this. First of all, our HPO, our Homeless Program Office, is just an awesome organization. And you can see how awesome it is by seeing their leader. And then you can see how awesome it is by seeing their great work. You heard her comments, though, talking about our partners in the field. And, boy, I was able to go around with two great partners. One the daughter of a Vet and the niece of a Vet, and then one a Vet herself, a soldier and a Marine at different times in her military service. And all of her 18 brothers and sisters, active duty members themselves. So, talk about a family of service. I did ask them about funding, and there is a specific issue that, as you guys are reporting out you might want to look at. We have different programs. We have one that’s called the grant and per diem program, GPD. I think that–and Monica, if I screw this up, just let me know. There, I think we have a pretty thin administrative support that goes to the maintenance of that grant. So, I think some of our partners say, geez, we would need more money to more effectively run this grant. Especially in this job market, we can’t pay people enough to have them work with us on GPD if this is all you’re giving us in terms of administrative support. So that’s one issue you might be hearing about or you might want to explore. The second issue does go to this question about HUD-VASH, and utilization of that voucher system in particular. There are still places where we leave too many of those vouchers on the table unexercised. Where we exercise them well is where we can work as aggressively as Monica does everywhere with the landlords. You heard her comments about landlords. Because sometimes we have to convince the landlords that this is a relationship with Uncle Sam when they use those vouchers. So, we do have a staffing issue in some places there, too, and Congress is on us on that as well. So that’s another place where staffing comes into play. But that might be some of the issues that you’re hearing about or you might want to investigate or report on a little bit. Is that accurate? Did I screw it up? Okay.

Quil Lawrence (NPR):  I’m just wondering, are you expecting the [inaudible] wave from when the extra benefits, the post pandemic or the pandemic assistance ended? Is that something you’re bracing for?

Denis McDonough (VA Secretary): We actually think that was probably included, but you heard Monica say that we’re trying to understand those PIT count numbers from last year and the 7% and how much of that included the end of some of the pandemic support. Because, remember, a lot of those were local and state supports that came off at different times. So much of that may have been included in the 7% from last year. We just don’t know for sure. We think that a lot of that impact will have been accounted for in the numbers that we saw last year. But again, this is why the PIT count, as kind of old school as it is, is an important tool for us, and we’ll hopefully begin to get that data by the middle of summer once all these local accountings are done.

Quil Lawrence (NPR):  Thanks, both of you.

Terrence Hayes (VA Press Secretary):  Ellen.

Ellen Milhiser (Congressional Synopsis):  Hello again. Just a couple of quick follow-up questions to things that have come up in the last hour about gun ownership. Yesterday, Representative Rosendale expressed concern that artificial intelligence might be used in suicide risk prediction, which might end up resulting in a Veteran losing access to his guns or some other action. Do you have anything to say about that point? And do you think that it’s realistic to notify Veterans every time an analysis is done concerning them using AI?

Denis McDonough (VA Secretary): I think I want to answer that question with kind of three observations. One, I think I’ll follow up with Mr. Rosendale to find out, make sure that I can understand what he’s talking about. One. Two, right now we’re deploying tech sprints consistent with the demands of the president and his EO in two places. And both have to do with the critical issue of healthcare provider burnout. So, we’re testing AI tools to help us keep notes for clinical engagements and then to ingest notes back from clinical engagements that Veterans have in the community, right. So, these are two very time intensive things that if not handled well, we don’t have the benefit of that clinical engagement with a Veteran to be able to ensure high quality outcomes for the Veterans. In either case there, those records are the Veterans records, and they will not be used for anything related to that Veteran and gun ownership, right. So that’s point number one. Point number two, we do have a program called Reach Vet and Reach Vet uses–this is several years old. It’s not an AI tool at all, but it does allow us to make sure that we are identifying at risk Veterans, and then we’re urging our clinicians in each medical center to reach those at risk Veterans to make sure we’re checking in on them once a month or so, right. But again, that’s information that is retained in the Veteran’s record and for only purposes of clinical care and for only the Veteran, the Veteran’s provider, and the Veteran’s care team. Third, I’m not sure I understand your point about, is it reasonable to expect that a Veteran will get a heads up every time we use his or her data?

Ellen Milhiser (Congressional Synopsis):  That’s something that Representative Rosendale wanted.

Denis McDonough (VA Secretary): As we deploy AI. And Shereef, I’m sure, has been talking to you guys about this. We’re going to be really careful on how we do that. And make sure that–this is why we’re starting with these questions as it relates to provider burnout. We’re going to do this in a very Veteran centered way to ensure that in all cases we’re protecting the sanctity of that data. We take very seriously our statutory obligations there. But we also recognize that, as I’ve said, the lifeblood of our relationship with our Veterans is trust. And we do not underscore bold, do not, want to impact that in any way.

Ellen Milhiser (Congressional Synopsis):  And then this is really fast. When you were asked about the budget shortfall, you said that within the VA you might find that there are people you don’t need. Do you think that y’all are going to end up letting go some of the people hired in the past year or just not filling positions?

Denis McDonough (VA Secretary): I think we’re, you know, this has been a conversation I’ve been having with several senators and members, too, as we’ve talked about hiring up for PACT Act. We think that we can manage this through attrition, but this will be something that we work through, right. So I don’t think I have anything more to say on that other than we’re going to make sure that we’re watching this really closely, consistent with an agency that manages its taxpayer resources well, but also mindful that the fundamental goal here is high quality outcomes for our Veterans and that’s going to drive our decision making.

Ellen Milhiser (Congressional Synopsis):  Thank you.

Denis McDonough (VA Secretary): Thank you.

Terrence Hayes (VA Press Secretary):  Any other questions from the floor? Seeing none. Well, thank you again, everybody. Truly appreciate you joining us, and we look forward to seeing you all next month. Thank you, Monica, for joining us. Truly appreciate it.