SecVA press conference

Terrence Hayes (VA Press Secretary):  Good afternoon, ladies and gentlemen. Thank you for joining us for this month’s press conference. I’ll be pretty brief. I know we have some new reporters in the, in the room today. So, to those who are new, just, if you have a question when we get to that period, just raise your hand, I’ll call upon you, and you’ll just step to the mic to address the Secretary.

To those online, as always, if you have a question, use the raise your hand function. A member of my team will recognize you and then I’ll call upon you when that time comes forth.

So, I’ll go ahead and get out the way, and I’ll bring up Secretary McDonough. Sir.

Denis McDonough (VA Secretary):  Thanks so much. Nice to see everybody. Thanks, thanks Terrence for the, for kicking us off today. Before we get to today’s guest, whom I’m very excited about, I wanna recognize that I was just discussing at Howard University. Today is 75th anniversary of President Truman signing Executive Order 9981. The 75th anniversary of the Integration of our Armed Forces. President Truman signed that Executive Order 75 years ago, he didn’t just make our military stronger, though he did do that. He made our country stronger. Because the United States of America, the strongest and most diverse country on the face of the planet, is strongest when it draws on the talents of all our people, each made in the image of the Creator and endowed with certain unalienable rights.  Make no mistake, this day would not have come 75 years ago if not for Black, Native-American, Latino, Asian, and other minority Veterans across America.  Since our founding, these heroes have fought for a better America.  They fought for our country at home and abroad, even when our country did not fight for them.  So today and every day, we at VA honor those heroes, and we pledge to serve them as well as they’ve served us because we are, all of us, forever in their debt.  With that, I want to turn it over to Prince Taylor, VA’s National Director for the VA Center for Development and Civic Engagement.  Among other important responsibilities, Prince makes sure that we maintain the active community relationships and volunteer-base to make our VAMCs and our CBOCs, and our cemeteries function as well as they do.  So sometimes I think Prince and his team get the sense that they’re not on the radar in VA.  I want to underscore, as I did to you this morning you’re very much on the radar and very much recognized as pivotal to our ability to now be providing more care and more benefits to more Vets than ever before. 

Prince, over to you.       

Prince Taylor (Director of National VA Center for Development and Civic Engagement):   Mr. Secretary, members of the press, thank you for the opportunity to discuss how VA’s Center for Development and Civic Engagement impacts the lives of Veterans, their families, and caregivers.  As a US Navy Veteran turned civil servant and the proud brother of a female Veteran, named Ada, I’m honored and very grateful to be a servant leader for the largest integrated volunteer workforce in the federal government.  At CDCE, we primarily leverage voluntary service, philanthropic engagement, and community partnerships to help improve Veterans’ lives by bridging need gaps, reducing barriers to accessing care, and maintaining Veteran trust. 

Our volunteer force is more than 22,000 strong and in fiscal year 2022, they worked 3.3 million hours alongside our paid staff to support VA’s mission.  In fact, volunteers touch every facet of our organization.  Take my friend Ms. Georgie Krell, for instance, who works at the Bruce W.  Carter VA Medical Center in Miami.  She’s a red coat ambassador.  The medical center is named after her son who threw himself on a grenade in Vietnam to save the lives of his fellow Marines.  Ms. Krell, like many other red code ambassadors, can be found at the main entrance of the VA with a smiling face and positive demeanor.  Ambassadors like her provide wayfinding support and answer basic questions for Veterans and visitors at our facilities. 

At the beginning of the COVID-19 pandemic, we established a social prescribing program called  Compassionate Contact Corps.  This program is comprised of over 600 trained volunteers across 81 VA Medical Centers that place regular friendly support calls to Veterans experiencing loneliness and or social isolation.  So far this year, these callers have logged 42,682 hours and counting.  We do this in partnership with our nurses, primary care physicians, psychiatrists, and social workers like Lori Murphy in Columbus, Ohio.  Additionally, CDCE is collaborating with the US Surgeon General, who you may have heard has a soft spot about loneliness.  We’re helping to reduce the stigma and frame the narrative on the impact of loneliness in our country and some practical solutions to address these issues.  This falls right along with VA’s Whole Health framework where we’re not just asking “what’s the matter with you”, we’re asking what matters to you.  And more and more, a lot of our Veterans are saying rich, meaningful connections matter to them. 

Perhaps one of the most recognizable VA volunteer efforts that we oversee is the Volunteer Transportation Network, which in FY22 provided over 156,000 Veterans with transportation to and from their medical appointments.  Nearly 3000 volunteer drivers traveled more than 7 million miles to minimize transportation as a barrier to care for our Veterans. We are always looking for drivers for this program.  All that plus gifts and monetary donations from Veteran service organizations, community organizations, and philanthropic individuals support supplemental VA services such as community outings for enrolled Veterans in recreational therapy and VA’s adaptive sports and creative arts programs. These donations help us to offer financial assistance, clothing accessories, and other goods to Veterans in need, including those experiencing homelessness.  We support Veterans experiencing food insecurity by hosting drive-through food banks and on-site food pantries at many local VA facilities.  We support Fisher Houses to ensure family members staying with us are afforded as much of the comforts of home as possible while visiting their hospitalized Veterans. And we even provide baby showers to expectant parents.  Our volunteers are also supporting initiatives at the National Cemetery Administration, like Honor Guards and headstone rejuvenation for Veterans from the Civil War era.  And of course, we’re also there for Veterans Benefits Administration, Veterans Experience office, and many of our other staff offices.  These are just a few of the exciting opportunities CDCE offers to support Veterans. 

To our volunteers, thank you for choosing VA and volunteering your time and your talents in service to Veterans.  To our donors, thank you for your generosity.  And to our Veteran Service Organizations, thank you for your continued endearing partnership.  I would also like to give a quick shout-out to the local CDCE offices across the country where frontline practitioners coordinate the endeavors I just mentioned, along with an array of others to strengthen the Veteran experience.  There is no shortage of volunteer opportunities at VA as long as you have a positive attitude of gratitude, a compassion for Veterans, and you pass our background check. 

With that, I would invite you to visit volunteer.VA.gov today for more information.  Thank you for your time.

Terrence Hayes (VA Press Secretary):  Thank you, Prince.  Truly appreciate you joining us today.  With that, we will begin the question period. 

Leo Shane (Military Times): ?  Good afternoon, sir.

Leo Shane (Military Times):  Good afternoon, Mr. Secretary.  I wanted to ask you about the budget bill that’s working its way through the House this week. It has a number of provisions.  The White House already said that the President would consider vetoing it.  Are you concerned that the VA budget is going to get caught up in some of these social issue controversies and that may be delayed?  And have you had any conversations with Republicans on the Hill to try and find a path forward on this?

Denis McDonough (VA Secretary):  You know, I’m always talking to Republicans on the Hill about any number of things and have had some good conversations about our budget.  I will say that OMB speaks for us as an administration.  You saw the SAP Statement of Administration Policy earlier this week.  I think you accurately characterize it.  So obviously VA strongly supports that Statement of Administration Policy.  That’s point one. 

Point two.  Am I worried?  Of course.  You know me well enough now to know that I worry about everything, and I spend a lot of time worrying.  But we have time to work this out, and I want to make sure that we take that time because it would be a shame if we end up in a situation where we’ve had CRs in the past.  And even though we have multi-year funding for VHA, which is obviously important, nevertheless, it’s, you know the best thing for Veteran outcomes is straightforward year-long budgets and year-long appropriations bills.  So, we’re hoping that that happens.

Leo Shane (Military Times):  Along the same lines but slightly different topic, your Deputy Secretary nominee, Tanya Bradsher, has been delayed in the Senate.  Have you had a chance to talk to Senator Grassley and some of the Republicans who have expressed concerns there about the whistleblower issues and some of the other, I guess, the VIEWS system issues that they’ve brought up?

Denis McDonough (VA Secretary):  I have not spoken personally with Senator Grassley, although we’ve hosted members of his team, for example, to make sure that they could understand the VIEWS system and take a hard look at it and see how it functions.  And I have spoken to many members, Republicans and Democrats, on our Committee of Jurisdiction and underscored how important it is that we have all of our positions filled with confirmed nominees.  So, we’re really hopeful that they confirm Tanya Bradsher, I think, as the hearing demonstrated, I think there is strong support for her qualifications and her experiences, and I think they’re right to feel that way about her.
 

Leo Shane (Military Times):  Thank you.

Terrence Hayes (VA Press Secretary):  Tracy.

Tracee Wilkins (NBC Washington):  Mr. Secretary, Tracy Wilkins of NBC Washington.  The Gao report looking into disparities was released today. I understand you haven’t had an opportunity to read through the entire report, but in your briefings and on its face, what were your takeaways?

Denis McDonough (VA Secretary):  Thanks so much.  I really appreciate you coming in, especially given the ongoing conversations we’ve been having on this.  There’s no place for any disparities at VA.  We’ll stop at nothing to make sure that we’re providing all Veterans, including Black Veterans, with the world-class care and benefits they deserve.  That’s why we recently established an Agency Equity Team and a VBA, Veterans Benefits Administration Equity Assurance Office, whose first order of business is to identify any disparities that exist at VA, understand them, and eliminate them.  So, we’re grateful for GAOs work, as your question suggested.  We’ve been in close touch with GAO, had many briefings, and back and forth with them.  We think that their work will help us better serve Veterans, and we concur with the recommendations laid out in the report.  This is a top priority for VA.  This is a top priority for the President.  This is a top priority for me.  And we will not rest until every Veteran gets world-class care and access to benefits that they have earned, no matter their age, race, ethnicity, gender, religion, disability, or sexual identity.  I recognize that this will require our determined effort every day to address what is too often a trust gap that we have with some of our Vets.  And I commit to our Veterans who are watching that we will actively get to the bottom of any disparities that exist at VA, and we will eliminate them.  We’re going to earn your trust day by day, and we’re going to do that by being transparent and by getting you the care and the benefits that you’ve earned and so richly deserve.  Just say one last thing about this contemplating Leo Shane (Military Times): ‘s question.  This is why it’s so important to us to have the ability to develop tools like the Equity Assurance Office and the Agency Equity Team.  And while I haven’t done a detailed analysis of some of the prohibitions that are in the bill that is currently before the House, I would have concern that some of those prohibitions would upend our ability to get to the bottom of things like these findings at the GAO.

Tracee Wilkins (NBC Washington):  We’ve been speaking with advocates for Veterans who say that the VA has stood up these kinds of task force to look into what’s going on with equity within the, for Veterans and looking at these disparities. But the GAO report is saying that it wants a plan and a timeline.

Denis McDonough (VA Secretary):  Yeah.

Tracee Wilkins (NBC Washington):  Are you able to promise them and Black Vets that you’ll have one?
       

Denis McDonough (VA Secretary):  You know, we’ve obviously been working with the GAO for some time on this.  It’s been a study that has been undertaken at the request of Congress.  So, we’ve been back and forth with GAO, which I think that back and forth makes us stronger as a general matter.  And so, I think they’re familiar with our efforts to date, we were certainly familiar with the report even before it hit the street here today in its final form.  So, we believe several of the steps we have begun to take are responsive to what the GAO is looking for.  As I said a minute ago, we take it very seriously and support and concur with the recommendations that GAO has put on.  As for timing, I want Veterans to see and to understand, and ultimately to feel and experience that we’re approaching this with urgency.  And so, I understand the call for a timeline in the GAO report and we’ll make sure that we are approaching this with the kind of urgency that it demands.  But I can’t promise anything yet on a specific timeline. 

Thank you.
       

Terrence Hayes (VA Press Secretary):  Melissa, good afternoon.
     

Melissa Burke (The Detroit News):  Can you hear me?
 

Terrence Hayes (VA Press Secretary):  Yes, we can hear you.
       

Melissa Burke (The Detroit News):  Great.  Mr. Secretary, I know you were in Detroit last week.  I’m sorry I missed you there.  I hoped you could maybe talk a little bit after your visit, how you are going to ensure that these new recommendations, these new fixes recommended by the OIG last week are adopted at the Detroit VA. 

Denis McDonough (VA Secretary):   Yeah, I’m sorry I missed you there too, Melissa.  But I was gratified to know that your colleague, who was asking me similarly probing and difficult questions, assured me that she was doing that on your behalf. It sure felt like the kind of probing and hard-hitting questions that I’m used to from you.  One, I was very happy to be able to be in Detroit.  One of the things that you have pressed us on, that the congressional delegation has pressed us on, and obviously they did that on behalf of Veterans in Detroit.  And one of the things that comes through in the IG’s report is that the lack of stable and consistent leadership in the facility over the course of the last couple of years has contributed to a sense of irresponsiveness and a sense of lack of psychological safety for our employees to speak their minds about problems that they see. 

So, the first thing I want to underscore is I was very happy to have been in a position where we could reassure Veterans in the Veteran Town Hall and reassure our workforce in the workforce town hall, that the acting director, Chris Collie, would no longer be acting, that we are finalizing, and he will soon be the permanent Director at the facility, one.

Two, obviously we have plans in place, and I think the IG refers to many of those in his report to make sure that we are implementing those recommendations.  I’m particularly grateful for the work of VISN 10, which has deployed additional talent and leadership into the facility to make sure that we meet those requirements as laid out by the Office of the Medical Inspector and as affirmed by the IG.  So that’s the second thing. 

The third thing I would say is just that among the most troubling things in the IG’s findings and the reason I thought it was so excellent that he could speak directly to our workforce and to Veterans in Detroit last Friday, I was very grateful that he chose to go there.  His independence and his seriousness serves us well and challenges us to provide better care to Veterans.  His finding of a culture, psychological safety for care providers to speak their minds when they see problems, but also a general culture of siloed communication where we’re not sharing information with one another.  Those findings are particularly troubling to me because they’re over and above the recommendations laid out by OMI, and they speak to a very real challenge as to whether we’re living up to our belief that we are a highly reliable organization. 

Becoming an HRO is a central tenet of VHA, Veteran-centered managed care, and integrated care.  And so, I will be personally working with VHA and with our leaders, including our network directors, to ensure that they are redoubling our efforts, to ensure that we are dedicated to and are implementing the fundamental tenets at the heart of HRO. 

Among those are the ability for us to have clear, candid, and professional conversation and communication that goes two ways in our facilities, from our leadership down and from our care providers closest to the point of providing care to Veterans back.  And so that’s my third point, Melissa, which is, I personally will be demanding that we redouble our efforts on those important HRO principles.

Melissa Burke (The Detroit News):  Thank you.  I had one more, if you are able to address this, perhaps not–

Denis McDonough (VA Secretary):   I’ll try my best.

Melissa Burke (The Detroit News):  But given the OIG findings, I wondered if you could say anything about why the Former Chief of Surgery there was allowed to retire with full benefits and pension earlier this year.

Denis McDonough (VA Secretary):   Yeah, thanks so much for the question.  So, I’ve talked at length with our leadership there about this decision.  As you can imagine, and as we’ve seen, it’s been a very tumultuous period in the Detroit VA Medical Center, the Dingle VA Medical Center, and the ongoing review required many of our personnel to go through very difficult conversations, distressing conversations, and the leadership therefore, made the decision to proceed as you’ve suggested. 

However, and importantly, they also made sure that they reported all of the activity of concern to the National Provider Database.  They have shared the data about the troublesome data with twelve separate state licensing boards. 

Third, they stopped the proposed transfer of the person in question to one of our VA facilities in Chicago, and they made the entire thing contingent on that provider, never again even applying to work at VA.  So, we’ve made very clear our concerns in this regard. 

My last point, you may be asking the question because it’s striking, especially in relation to the fact that we took the necessary steps as it related to the VAMC Director.  And I’m very appreciative of the careful steps, the clear and transparent execution of those steps consistent with the requirements of civil service law to ensure that that proceeded as it did.  And I think that is evidence that when allowed to manage our people, we do it well and we do it forthrightly.  And I am grateful for the team out there for having so done it.
 

Melissa Burke (The Detroit News):  Thank you.

Terrence Hayes (VA Press Secretary):  Thank you, Melissa. Patricia.

Patricia Kime (Military.com):   Thank you very much.  This is a follow-up to Leo Shane (Military Times): ‘s question.  There are a number of amendments which we discussed to the VA Aprops Bill.  One of them would restrict the VA from spending any money on removing the motto that is currently on your buildings.  Obviously, it changed the motto this past whenever, June.  And I’m wondering what the progress is on swapping over those signs, and what your plans were originally and then what your opinion is obviously of this amendment?

Denis McDonough (VA Secretary):   That’s a good question.  I’m not sure I can take a position on an amendment without clearing my views through OMB.  So let me do that and let me make sure that you know what that is.  So, I’ll do that out of the back of this meeting, if that’s okay. 

Patricia Kime (Military.com):   Yeah.

Denis McDonough (VA Secretary):  I want to make sure that I’m a good team player here and that I don’t go out beyond my rid at the moment.  So that’s point one.  Point two, I feel very strongly about the decision we made, and I feel good about the decision we made.  And in fact, just Sunday afternoon when I was in Phoenix, you know, I just had a great trip by the way, I was in Arizona all last week.  I spent Sunday afternoon in Phoenix with a group of Vietnam Veterans and Central Command War Veterans talking about the PACT Act with leadership of the Congressional Hispanic Caucus.  I spent all day Monday in Congressman Eli Crane’s district with Mr. Crane, including talking to Navajo and Hopi Veterans about the PACT Act, and then spent yesterday at the VFW Convention in Phoenix, where we are running for the first time ever a complete claims clinic at the convention.  We had as of yesterday afternoon, something like 167 Veterans come to the claims clinic.  And we even have eight Veterans leaving that claims clinic with processed and decided claims. So, I’m very happy about that. 

But back to the question.  On Sunday afternoon, I heard again from a senior, very senior Veteran how excited she is and how appreciative she is of the new mission statement. 

Third, our plans you’ll hear more about them as we get past August about our plans on signage.  I think you’ll remember when we announced the mission statement change, we indicated that we’d be making decisions about permanent signage in many facilities like the one here on Vermont Avenue as we have budget to address those issues.  So, we’ll have more to say about that when we’re back from the August recess.  And I think I answered all the questions.

Patricia Kime (Military.com):  Yes.  So, you haven’t really started the process yet.  The sign is still I didn’t say that.
 

Denis McDonough (VA Secretary):  I didn’t say that. I didn’t say we haven’t started.  I told you we’ll tell more about it.

Patricia Kime (Military.com):  The process of removing signs, there’s still a sign out front here.

Denis McDonough (VA Secretary):  Meaning we haven’t removed any signs yet.
      

Patricia Kime (Military.com):  Okay.
      

Denis McDonough (VA Secretary):  Yes, that’s correct.

Patricia Kime (Military.com):  All right.  Follow up to something else.  You mentioned the PACT Act deadline.  I know you all are doing an all-out PR effort to get Veterans to know that it’s going on.  I’ve heard from a lot of Veterans who are ill from domestic exposures, like Fort McClellan I think you mentioned them earlier, and missileers and people that have what efforts are you doing to help Veterans who believe that living on base or working on a base has made them sick, but they were never deployed.

Denis McDonough (VA Secretary):  Yeah.  So, what we would say is we urge every Veteran to file a claim.  Right.  And remember, the strength of and the importance of the PACT Act is it establishes a presumptive connection between several conditions and that member’s service.  And so that’s really important.  And I got to tell you, we have, you’ll hear more about this from Josh this afternoon in the hearing.  But we have received 772,461 PACT Act claims. We have processed 425,735 of those, and we have granted 335,312.  So, we’re granting at 79% right now.  That grant rate of 79% is because of the presumption of service connection between the conditions and the service period. For those Veterans who did not serve in Central Command but who have been exposed to toxins, we urge them to file a claim, and then we’ll work through with them establishing a service connection.  There won’t be the presumption, that only comes from statute or comes from our process.  And I’ll come to that in a second. 

But as you’re talking to those Veterans and I know this is not your job, but I hope you’ll make sure that they’re aware of how they can also file a claim, because we do make determinations of service connection even without the presumption of connection that comes with the statute. 

Third, we also have the ability to establish such presumptions of our own authority as President Biden insisted we do in 2021, May of 2021 when we did that for sinusitis, asthma, and rhinitis. The PACT Act did codify our existing process for airborne hazards and establishing those presumptions, and we are making sure that we now use that process aggressively.  And as we make progress there establishing new presumptives, we will make sure, obviously our Vets are aware of that, and they can file claims with the benefit of that presumption.

Patricia Kime (Military.com):  Just one more question. 

Denis McDonough (VA Secretary):Yes. 

Patricia Kime (Military.com):  Do you have any idea of the 79% grant rate, how many of those are 0% disability ratings?  Because that’s granting does that include, like–

Denis McDonough (VA Secretary):  When you give, that’s a good question.  You know what, maybe it was even here last month, but sometime in the relative near past, I’ve been asked a similar question, which is what’s the average grant rating? 

Patricia Kime (Military.com):  Right.

Denis McDonough (VA Secretary):  That’s a fair question.

Patricia Kime (Military.com):  Just asked how much were zero.  I was the one who asked about the average grant rate, but not–

Denis McDonough (VA Secretary):  Did you get an answer on that before?
       

Patricia Kime (Military.com):  I did get an answer.
       

Denis McDonough (VA Secretary):  You did?  Okay, well, let us get you an answer on this one too.
      

Patricia Kime (Military.com):  Okay.

Denis McDonough (VA Secretary):  I don’t know.  I do know that it’s a source of some frustration.  I heard a little bit about this from the VFW yesterday, and I heard about it from some of the Vets at Guadalupe in Phoenix on Sunday that some of the Vets with hypertension are getting a 0%.  And by the way, I also heard it from at our breakfast with the VSOs this month.  I do a breakfast at least quarterly with them.  So that issue is out there.  I’m glad you asked it.  Let me get an answer to that for you.
       

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

Denis McDonough (VA Secretary):  But not me, let Terrence get you an answer.
     

Patricia Kime (Military.com):  Appreciate it.
     

Terrence Hayes (VA Press Secretary):   Appreciate you not doing that staff work for me, sir. We’ll go to, I think, Quill’s online.  Good afternoon, Quill.       

Quil Lawrence (NPR):  Hi there.  Thanks so much for holding this yet again.  I’ve got a question to follow up about discrimination in disability ratings and racial bias in those decisions on the GAO Report. I just want to take another crack at it.  Sir, in your considerable and very successful career in Washington, have you found that a public deadline and a timeline is helpful in sort of holding these accountability to getting things done?

Denis McDonough (VA Secretary):  Yeah, I find deadlines are generally pretty good, Quill, but the thing that’s best is effective execution. Because at the end of the day and I think it’s Michelle, right, or I’m sorry, Denise, why am I not remembering your name?  Tracy.  I’m sorry.  Thank you.  It was part of Tracy’s question really, which is like, hey, there’s been promises like this in the past, so even a timeline is a promise.  What we’re really interested in here is delivery and execution. 

And I keep saying to Veterans and we keep talking as a team and I keep talking with members of Congress that as effective as we’ve been, for example, at making sure that veterans know more about the PACT Act.  And as a result, we now have the highest inventory of claims we’ve ever had.  The way we will ultimately be most successful is when Veterans, and I’ve said this to you in the past, Veterans are telling each other that the process was workable, it led to outcomes, and they felt trusted, they felt respected in the process.  That’s why we have added the trust score, the trust survey to the benefits process.  And ultimately that’s what’s going to work best here, Quill, which is when black Veterans who felt that they had not been given a fair shake in the past get a fair shake.  And I am of the conviction that that’s happening in some places today. I just want it to happen in more places so our black Veterans are reassuring each other that we’ve gotten to the bottom of what is the issue here and we’re getting toward–getting on with execution. I hope that answered your question. I’m not tryin’ to be obtuse, but that’s the thing that works best. We’ve lost you now.

Denis McDonough (VA Secretary): I think we’ve lost you Quill. Did you have a follow-up?

Quil Lawrence (NPR):  I did. I’m dropping my video for the bandwidth. Can you hear me?

Denis McDonough (VA Secretary): We can hear you.

Quil Lawrence (NPR):  Yeah. So, is it, I mean, you’ve talked about the complexities and some of the unexpected statistics you found in black Veterans’ decisions in the past.  Is that–can you just address that again? Is it just because you’re still trying to understand why this happens and what point it happens?  Is that–so, you’re trying not to promise action when it’s not yet understood what the pressure points need to be, is that right?

Denis McDonough (VA Secretary): Yeah.  So, you’re saying we’re not promising–we’re not promising a timeline.  That’s what you’re–that’s what you’re saying when you say we’re not promising action, we’re not promising timeline.

Quil Lawrence (NPR):  I misspoke. You’re right, timeline, yeah.

Denis McDonough (VA Secretary):  Right. So, yeah, I mean part of the process we’re going through here, and I think the GAO report is a good example of this.  I think your reporting is a good example of this.  I think Tracy and Lucy’s reporting is a good example of this, is we’re putting the data out there to make sure that we can understand what the data says.  You know, the data that went out before our last monthly briefing, you know, one can draw a variety of conclusions from it.  And so, we think sunlight and transparency will help us get to what precisely is happening, one of the big challenges of the GAO to us, and then a question of why.  And so, you’re right that we do want to understand why, but the why is very, very difficult.  So, while we’re working on all those things, I want to make sure we’re executing and we’re using this opportunity with the PACT Act.  As I’ve said to you guys before, PACT Act covers Vietnam and then Central Command from ‘91 to 2021.  There have not been more diverse as measured by gender participation or–and measured by racial participation.  There have not been more diverse forces fighting anywhere in the world, as diverse as those.  So, we need to take advantage of the PACT Act to get to Veterans of color, women Veterans, both of whom are less likely to file claims, native American Vets in particular, by the way.  So, I want us to take advantage of the opportunity we have in the PACT Act to get to the most diverse force to ever have fought and to execute and to deliver. As we understand, as I said last week–last month, that’s chalk line forward.  We do have to understand chalk line back and why it happened the way it happened.  But I’m just not giving a timeline because we just had Loreen Carson getting the job, right?  We’ve just stood up these two bodies.  I’m not ruling out a timeline.  I’m just telling you I can’t give you one now.  What I’m ruling in is execution.  That’s what we want.  That will be the proof point.  Not more promises, but actual execution and outcomes.

Quil Lawrence (NPR):  Thank you so much.  And while we’re on that subject of minority Veterans, there was a petition sent by, I think, 14 minority Veterans organizations and Senator Blumenthal that you mentioned to get the VA to issue regulations implementing the Affordable Care Act prohibition on discrimination.  You’ve received that and you’ve given a response?

Denis McDonough (VA Secretary): You know, I saw the reporting on it, and you know what, Quill?  I had something smart to say about it last week, and I forget now, to be honest with you.  So, if you’re okay with that, can I take that one and make sure that we get back to you?  Because the fact is, I think, obviously, I think you know, personally, I feel very strongly about the Affordable Care Act. But I think we have statutory requirements as it relates to access to care for Veterans that we take very strongly that are our own statutory obligations that predated the Affordable Care Act.  And I think some of that had to do with the nature or the character of the discharge of the Veterans seeking the care.  So, Veterans with other than honorables. We obviously take that very seriously too.  We talked about this last month where we, since 2021, have been aggressively reaching out to Veterans to try to increase opportunities for us to address characters of discharge.  It used to be that we’d do, until 2022, we’d do between three and five thousand of those a year.  2022, we did between eleven and twelve thousand.  That’s still not enough.  But that’s a substantial increase over the baseline because we have made it a priority. It continues to be a priority this year, and we will continue to reach out to our other than honorable Vets so that we can address the charac–review the characters of those discharges and where possible, get them into care.  So, I hope I’m not mixing apples and oranges, but that’s what I remember about Senator Blumenthal’s press conference.

Quil Lawrence (NPR):  Yeah, I’ll let Terrence get back to me on that. That’s good. Thank you very much.

Terrence Hayes (VA Press Secretary): Thank you, Quill. Ellen, good afternoon.

Ellen Milhiser (Congressional Synopsis): Hello.

Denis McDonough (VA Secretary): Hey, Ellen.

Ellen Milhiser (Congressional Synopsis):  I’m gonna use that word you’re hating today.

Denis McDonough (VA Secretary):  Uh oh.  Timeline.

Ellen Milhiser (Congressional Synopsis):   Yes. Do you have a timeline for the new research for the presumptions for under PACT Act.

Denis McDonough (VA Secretary):  I don’t–I don’t have one for you today.

Ellen Milhiser (Congressional Synopsis):   All right. Do you have any kind of estimate?  Can we expect something in the next six months?  Two years? Five years?

Denis McDonough (VA Secretary):  When you say something, can we expect something?  What do you mean?

Ellen Milhiser (Congressional Synopsis):   Any kind of new presumptions.

Denis McDonough (VA Secretary):  New presumptions? Like, we want to do new presumptions as soon as we possibly can.  I think we demonstrated that by doing three of them in May of 2021, just a couple of months after we got here.  So, we’re gonna–we’re gonna add them as aggressively as we can.

Ellen Milhiser (Congressional Synopsis):  Okay.  Switching topics a little.

Denis McDonough (VA Secretary):  Yes.

Ellen Milhiser (Congressional Synopsis):   The new CMS star ratings.

Denis McDonough (VA Secretary):  Yes.

Ellen Milhiser (Congressional Synopsis):   There are nine VA hospitals with one-star ratings.

Denis McDonough (VA Secretary):  Yes.

Ellen Milhiser (Congressional Synopsis):   First of all, Terrence, could you supply us with a list of those?  And second of all, there is a twelve-month time lag in data for the CMS star ratings, and I assume that the SAIL gives you more timely data.  Is there any way of telling us how many of the one- and two-star facilities had already been identified as problematic under SAIL and were already receiving assistance to improve?

Denis McDonough (VA Secretary):  That’s a good question. So, you know, I think–didn’t Shariff talk about this publicly yesterday?  I think–were you in that briefing? 

Ellen Milhiser (Congressional Synopsis):   Mm-hmm.

Denis McDonough (VA Secretary):  Okay. So, what I was gonna say is let us get you that briefing. So, I can’t speak to the lag of the data as it relates to the facilities that you mentioned.  Obviously, we have aggressive plans in place mostly led by the VISNs to address shortcomings.  You know, among the things that we’re focused on are things like readmissions.  And so, we track that data very aggressively. And that would be in SAIL.  And so, I think maybe the best way to answer that question is why don’t we, you know, arrange for a briefing with Jerry Cox and his team so you can kind of go through– we can walk you through how we use the SAIL data.  What does the SAIL data tell us at any given time? And then see if that addresses the question.

Ellen Milhiser (Congressional Synopsis):  One small question, maybe not so small.  You only improve what’s measured.  CMS star ratings measure specific metrics, and they have like five categories in each of their five categories.

Denis McDonough (VA Secretary):  Yes.

Ellen Milhiser (Congressional Synopsis):  Does the SAIL data match up with the CMS data?

Denis McDonough (VA Secretary):  No.  Look, this is a better question for Shariff, but from what I understand about the CMS data is that we also–I think the SAIL data is more comprehensive.  And as important as the CMS data is, we’re constantly reviewing our internal data as well.

Ellen Milhiser (Congressional Synopsis):  That leads to my final question.  Given that SAIL is more comprehensive than the CMS, which is what I figured, do you think that any of the one- or two-star hospitals under CMS might actually, for Veterans, be of higher quality than the CMS star rating indicates?

Denis McDonough (VA Secretary):  I think the beauty of that is that I don’t have to intuit that for you.  Every Veteran has that conversation specifically with their provider and then is in a position to be surveyed on that in every individual intervention. So, you know, I think. So, that’s how I’d answer your question.  I guess I’d just volley one back to you and say, Ellen, that I think what you’re trying–the questions you’re answering are kind of challenging whether the CMS data is meaningful.  I think it is, right?  And I think I’m really proud of the fact that overwhelmingly the VA hospitals exceed other hospitals in all those markets.

Ellen Milhiser (Congressional Synopsis):  Thank you.

Terrence Hayes (VA Press Secretary): Lucy, good to see you.

Lucy Bustamante (NBC Philadelphia):  Good to meet you both in person.  You too, sir.  Lucy Bustamante from NBC in Philadelphia.  A couple of things on the continued reporting that we’re doing on Veterans of color.  Today, the AG out of Boston sent out a letter with the signatures of a total of 23 Attorney Generals, all urging that Congress pass basically the GI Bill Restoration Act that would restore benefits for Veterans of color that were denied and the generations after them.  Your opinion on how you feel about the passage of that bill and how that compares to your relationship with the case in court right now–in Federal Court, where we know the VA is trying to dismiss that which was filed by Yale Veterans Services Clinic and Veterans of Color that are saying, you owe us the benefits that we lost. Tell us how you can basically mitigate the two issues and how the VA sees best fit to solve this problem.

Denis McDonough (VA Secretary):  Yeah, thanks.  I’ve avoided commenting on the ongoing litigation. And I’m going to continue doing that just because it’s not my business.  I have not seen the AG’s letter about the VA restoration.  The VA–what is it?  The GI Bill Restoration Act.  So, I haven’t seen their letter.  Is the letter to me?

Lucy Bustamante (NBC Philadelphia):  The letter is to Congress.  They are urging that everyone support the passage.

Denis McDonough (VA Secretary):  Good.  So, which brings me to my third point, which is I’ll find out precisely what our position is on this, but I want to make sure. I need to clear my positions through OMB, so let me do that.  We’ll get right back to you today on that.

Lucy Bustamante (NBC Philadelphia):  I appreciate that.  If you can also talk about whether you all are going to continue revealing the data on the disparities willingly, openly, or will we have to file FOIAs to be able to get the disaggregated data?

Denis McDonough (VA Secretary):  My guess is you’re going to keep filing FOIAs no matter what, right? I think that’s a good thing, that’s–the FOIA is an amazing tool.  So, my guess is you’re going to continue to do that. And I think that’s obviously a really important tool for democracy, a really important tool for our reporters, and for a really strong undergirding of the First Amendment and the freedom of the press.  One. Two, I just said a couple of minutes ago that I do think that our publicly sharing the data that we have is an important accountability metric. An important accountability tool. Also allows us to get to bottom, you know, get the perspectives of many different analysts so we can get to the bottom of what’s happening.  Because as I said in response to Quill’s question, and as the GAO makes clear today that they recommend, one, a clear accounting, and then, two, some scrub for why we’re doing both of those things, having the benefit of your all’s eyes on that and on the data helps us do, so.  So, that’s how I’d answer the question.  I think I’m not directly answering it because I don’t want to get in a position to tell you what to do or what not to do.  But my sense is that having your reporting makes us stronger.

Lucy Bustamante (NBC Philadelphia):  Mr. Secretary, if you could also discuss what it looks like on the inside, the conversations with people that have worked in these centers for Minority Veterans Departments through the years, that have seen this data, that have pushed to reveal this data.  What’s the tone behind the scenes like?  Is it a conversation with the past or is it an investigation of a new administration on a previous one?

Denis McDonough (VA Secretary):  I would say that–I think I would say one, what you see is what you get here.  Meaning, I’m trying to accurately portray how I feel about these things.  How I feel about these things is informed by what I learned from my teammates and the Center for Minority Vets, the Center for Women Vets, my teammates who have been working the equity issues, our teammates in the Office of General Counsel.  So, we feel really strongly here about providing for each and every Veteran.  I’ve said that to you before.  The President didn’t say that I should come over here and fight like hell for some Vets.  He said, come over here and fight like hell for all Vets.  And when there’s a Vet who doesn’t feel like we’re fighting for him or for her, nobody likes that. Does that lead to some sparky conversations?  You bet, right?  So that’s what I’d say about that.  But I guess the other thing I’d say is nobody’s harder on our performance than we are on ourselves behind closed doors.  And I think that’s as it should be.  But you guys will keep us honest on that, I’m confident with that.

Lucy Bustamante (NBC Philadelphia):  Two more topics, if you don’t mind, sir. Talking on the topic of claim sharks and unaccredited companies that are filing Veterans claims, is there any clarity that you can offer as to how the VA is vetting these companies that are aiming for Veterans to be able to charge them to file a claim?  How big is the loss right now?

Denis McDonough (VA Secretary):   So, I think what would be interesting here is to make sure that we just have our accreditation team from OGC come brief you. You know this has been a topic of great interest.  I think your–this is another example of your reporting and your interest on this helping us sharpen our tools.  As we reported to many of you shortly after we got together last time, we were made aware of one of these companies actually being on one of our websites.  I think it was you who asked me about it the last meeting.  So continued conversation about this is in our interest and in the Vets’ interest.  So, let’s keep doing it.  As to the specific steps we take on accreditation, I think it’d be much more worth your time hearing from our OGC team than from me on that.

Lucy Bustamante (NBC Philadelphia):  And last question on this topic.  Have you had a count done yet on how many companies are in violation of Section 38 VA Federal Regulations?

Denis McDonough (VA Secretary):   I have not. I know that I’ve sent or we’ve sent a series of cease and desist letters since I’ve been here.  I couldn’t tell you how many that is, but we can find that out.  That would be one way to slice that metric, but let’s try to get you a good answer on that question.  You know, this is obviously a topic we care a lot about.  I just talked about it with the VFW yesterday, so.

Lucy Bustamante (NBC Philadelphia):  And if I could address the cancer screenings.  We’re talking to some Veterans that say that they’ve gone through the process.  They have filled out the questions.

Denis McDonough (VA Secretary):   These are cancer screenings or toxic exposure screenings?

Lucy Bustamante (NBC Philadelphia):  Well, if we could do both, but this is specifically cancer right now.  Some disability ratings have come back at 0% in certain cases.  Obviously, I’m happy to provide you some of these letters. But if you can talk about how fast it’s moving to actually get the diagnosis and getting beyond the exposure screening. And then also what’s being done to get the Veterans closer care to some of these cancer centers.  Many of the ones we’re speaking to have to go very far away from their homes to be able to access cancer care.

Denis McDonough (VA Secretary):   So, I think I’d answer the question the following way.  One, we’ve done just over 4 million, almost 4.1 million toxic exposure screenings.  Those would not be cancer screenings per se.  However, the way the toxic exposure screening works, and we’ve talked at length with you guys about this is, is it allows us to begin a conversation with Veterans about exposures that they are aware of, that we may not be aware of.  And of the 4.1 million such screenings, between 35 and 40% of those screenings result in Veterans telling us something about their service and exposure that we didn’t know anything about.  And these are all, by definition, Veterans that we already have a relationship with.  So that’s a very meaningful finding. That then leads to deeper conversations with other specialists in the VA.  And those proceed, I’m certain, in some cases, very well, and with dispatch. And I think in other cases maddeningly slowly.  And so, we have to keep pressing on the system to increase to meet timeliness standards.  If there are specific cases where a Veteran has a concern about cancer, I think that I can say two things about that.  One is, if you know a specific case, please let us know and let’s work that, right.  Two is–I’ll say three things.  Two is the President pushed us, as you guys remember, to front-run the rest of the PACT Act filings with the cancer filings.  So, we started taking those claims earliest, in fact, about a month before we started receiving other PACT Act claims. So, we should have data back on that, and we can get you that specific data.  Third is Veterans who need access to cancer treatment.  Now, because of as we’ve briefed you guys in this setting, because of our use of telehealth, we now have tele-oncology.  And we even have higher rates of instances of rural and highly rural Veterans participating in clinical trials on various cancers using telehealth modalities.  So that’s what we had one of our docs from the Durham VA come in and talk to us about here in this setting last year.  So, I think that’s all I have useful to say about that question.  And if I’m not getting to the nub of it, please let me know.

Lucy Bustamante (NBC Philadelphia):  Just an example of this very quickly.  For example, Brandywine Hospital that was getting ready to close in Pennsylvania.  They have a partnership now, Penn Medicine in the VA, to be able to use that old hospital.  How many more of those do we have not just in the Delaware Valley where I cover, but just nationwide?

Denis McDonough (VA Secretary):   Well, that was a really cutting edge, really exciting opportunity.  And the promise I made to everybody is after the Air Commission a year ago–this was a commission, I think, Lucy, before you were just spending time with us regularly, that by statute required us to look at our full bricks and mortar hospital clinic infrastructure and try to build it for the future.  That encountered a few problems along the way that we can talk about more at a different time.  Out of that, we’ve stood up a new process where we are actively looking for opportunities to improve and modernize our facility–our facilities.  This agreement in Pennsylvania mirrors agreements like one in Northern California.  Those are the first two out of the chute, but we got others that we hope we can get to fruition soon.  And those include partnerships with local providers, like UPenn, in your instance.  Or it may include partnerships with the Department of Defense, where the Department of Defense has facilities but fewer patients and fewer providers.  And we have a lot of patients and a lot of providers, but fewer facilities.  Did I say that right?  So, DoD has facilities. We have patients and providers.  We want to marry up those two things to make sure that we’re providing more timely access to care. So, you’ll hear more about this.  I don’t have any new ones up my sleeve for the Delaware Valley, but I’m hoping that over the course of these next two years, provided I don’t get fired, we can talk about very regularly some of those innovations.

Lucy Bustamante (NBC Philadelphia):  Thank you very much.

Terrence Hayes (VA Press Secretary):  Neal. I know we just gave NBC an exclusive [laughter] Good to see you there, brother.

Nihal Krishan (FedScoop):  Good to see you, too, Terrence.  And Secretary McDonough.  Thanks for having me.  So, I wanted to start off asking you about some major changes in acquisition efforts that the VA–that are going through Congress right now and potentially at the VA.  So focused on the VA IT Modernization Improvement Act, the VA Acquisition Review Board Act, and then of course, the Acquisition Review Board and Cost Assessment Act.  So, these are all sort of going through.

Denis McDonough (VA Secretary):   These are bills.

Nihal Krishan (FedScoop):  Yeah, bills, correct.  And the Review Board Act, as far as I know–The Acquisition Review Board Act, as far as I know, the VA is in support of. And I just–I wanted to get your thoughts on how far these bills go and the ramifications of them.  Primarily because, as we know, the VA has experienced some significant challenges with the EHR modernization program, their financial and accounting system, and the Human Resources Services as well.  So, these bills could play a big role by creating an accountability system to try and solve some of these major problems. So, I’m curious if you see this Review Board Act and if it were to be created and I think it’d be given $25 million, do you see that as enough?  And could it make significant and noteworthy changes to some of these three big areas of improvement?

Denis McDonough (VA Secretary):   Thanks so much. You know, I just am not–I don’t have the specifics of these bills at my fingertips, so if we got the names of the three, let us get you those.  And I know we’ve been testifying on these or similar measures, we’ll get you answers on them.  One. Two is, where we can hold ourselves to account, we do. And we’re not waiting for Congress on that.  And I think we’ve been quite transparent with you about where we think our failings are. And you’ve also helped us identify some as well as I know our next questioner will also remind us.  So, happy to get you answers on the specific bills, but I just don’t have those at my fingertips.  But I also don’t want anybody to think that we’re waiting for additional authorities to hold ourselves to account to these things.  At the end of the day, we hold ourselves to account because we owe Vets the timely access to world class care.

Nihal Krishan (FedScoop):  Gotcha. But just to confirm, the VA is in support of the VA–

Denis McDonough (VA Secretary):   What I’m telling you–what I’m telling you is I don’t know that.  And we’ll get you an answer on it specifically.  I’m sure we have a view of it.  I don’t–I may know it by the number, or I may know it by a different name.  I just want to make sure I don’t confuse you.  So let us take it and we’ll get you the exact information.

Nihal Krishan (FedScoop):  Gotcha. And so, also presumably, the fact that it would be one contractor evaluating independently whether other contractors have done their job and potentially central conflict of interest that Congressmen have talked about–

Denis McDonough (VA Secretary):   This is, in as much as it’s part of the same bill that I’m going to let you know our views on, I’ll let you know our views on it.

Nihal Krishan (FedScoop):  Okay, sounds good.  And then second area I wanted to quickly check in with you on is on artificial intelligence.  So, we broke a story in April talking to your AI Director, Gail Alturowitz, about a new Artificial Intelligence Review Board and an AI oversight committee for evaluating the fairness and transparency of AI tools within research and clinical operations and sort of more broadly. Obviously, there’s a lot of pilot projects going on in the federal government using AI, including within the VA, as I said, on the research and clinical side, but also using general AI tools.  I’m curious if you see these two oversight functions as being enough and where the VA stands in terms of regulating AI, but also allowing it to flourish.

Denis McDonough (VA Secretary):   Yeah, the two oversight functions you’re talking about are Gill’s efforts that he briefed you about earlier this spring.  Well, what I’d say is we are–I think those are two important first steps.  I think that Gill is a great talent and we have other great talent at OIT, for example, who are helping make sure that we understand precisely where we are as it relates to procurement of AI and our needs for new AI tools going forward.  That’s the first point–or the second point. The third point would be that the President has demanded of the Cabinet various vigorous efforts as it relates to safety, as it relates to trust, and as it relates to security on AI.  And so, we’re working as a cabinet on the development of executive order.  The president’s talked about this in his efforts as he’s led the effort with voluntary standards among leading AI companies in the US.  And we’re proud to be part of that.  And obviously we’re eager to meet the President’s urgent demands as it relates to how we proceed on AI.  So, I think I guess this is now point 3A is, watch this space. I’m sure the White House is going to have more to say about this, and we’re really proud of our role on that team with the rest of the interagency.

Nihal Krishan (FedScoop):  Thank you, Secretary.  So just a quick follow-up.  Do you feel like the VA is in a good place regarding regulating, keeping AI safe, but also allowing it to innovate and take on pilot projects?  Is it sort of where it needs to be and well prepared for this explosion?

Denis McDonough (VA Secretary):   I think that I’m glad, I’m gratified to know that we have in place and have been demanding of our team that we have in place infrastructure to make sure that we’re best positioned to use AI in a safe and trustworthy way that protects Veterans’ information and improves Veterans’ outcomes. Do I–am I 100% confident that we have everything we need?  We’re going to be constantly asking ourselves that question every day.  This is a very dynamic field. And we’re mindful of the fact that we owe it to Vets to trust–to protect their information and to ensure best possible outcomes.  And so those will be the drivers for us.  Meanwhile, yeah, we’re going to continue to have a role as the rest of the government, the interagency puts together a principle-based framework to proceed.

Nihal Krishan (FedScoop):  Great.  And last but not least, wanted to ask you about–give you a chance kindly to give us any updates on the electronic health modernization program, either in terms of bills in Congress that are going through right now that would hold more accountability and support or not for those.  And then second, if there’s any update on the rollout of hospitals?

Denis McDonough (VA Secretary):   If there’s specific bills that you want us to comment on, just get us the bills and we’ll make sure that we work to get you those.  In terms of where we are in HER. I mean, obviously we’re continuing to work through this period of reassess, and we’re determined to get it right at the five sites, and that’s what we’re doing.

Nihal Krishan (FedScoop):  So, it’s still in the process. Okay. Thank you very much, Secretary.

Denis McDonough (VA Secretary):   Don’t call on Orion. Oh, shoot, did he hear that?

Terrence Hayes (VA Press Secretary):  He heard that. Orion [laughter]

Denis McDonough (VA Secretary):   Poor guy’s had his hand up the whole time.

Terrence Hayes (VA Press Secretary):  I know, I thought it was gonna fall off [laughter]

Orion Donovan-Smith (The Spokesman Review):  All right. Well, thank you guys for doing this.  Since you made me wait, I got to ask you a really tough question, Mr. Secretary. Has the President at any point told you to fight like hell for only some Vets?

Denis McDonough (VA Secretary):   Never.

Orion Donovan-Smith (The Spokesman Review):  Okay, I want to ask, as we are coming up on the August 9th deadline for retroactive PACT Act benefits. I don’t want to make you rehash all of that, but I’ve heard some concerns that folks in our area are having trouble reaching, particularly Vietnam era Vets.

Denis McDonough (VA Secretary):   Yes.

Orion Donovan-Smith (The Spokesman Review):  I wonder, excuse me. I don’t normally ask you to give me a sound bite, but if you can just tell me briefly what the VA is doing to reach those older Vets in particular and what your message is for them.

Denis McDonough (VA Secretary):   Yeah. Thanks so much. The PACT Act does two important things.  One, it says to Vietnam Veterans who are currently experience hypertension and who were exposed to Agent Orange.  We now believe that your hypertension is connected to your service in Vietnam.  So, we want you to file a claim. Two Veterans of the wars in Central Command.  We now believe that some several dozen conditions that include cancers, asthma, respiratory illnesses, we believe those conditions are service-connected, are related to your service in Central Command between 1991 and 2021.  So, we are urging you as Veterans to file a claim or an intent to file a claim on or before August 9th. To do that, you can call us. 1-800-MyVA-411. You can visit us at VA.gov/PACT, P-A-C-T. Or you can check out our website and find out about an event in your area.  We have 109 at least events across the country. I want to make sure that we’re working with you, Orion, to identify those in Eastern Washington, northern Idaho, Western Montana that are actual claims clinics.  So, Veterans can come to those clinics and actually file.  Yesterday we had a claims clinic at the VFW convention in Phoenix.  Lastly, you can also contact your county Veteran Service office.  You can contact your Washington State Department of Veterans Affairs Office. Or you can contact your local VFW, American Legion, Vietnam Vets of America, or Disabled American Vets, Paralyzed Vets of America, or The Vietnam Vets of America and they will help you file a claim.  You need not go anywhere.  You can do this over the phone with a partner.  And I reiterate you can just do it directly with us.  1-800-MyVA-411 is manned.  We’re actively tracking how long it takes somebody to pick up that phone.  We’re actively tracking how long you’re on the phone.  So please contact us in any of those ways.  Thank you.

Orion Donovan-Smith (The Spokesman Review):   Thank you. That covers it.  And lastly, and very briefly on the EHRM, we’re a little more than three months into the reset period.  I’m not going to ask you about timeline, but has VA so far identified metrics to show when the system is ready to go?

Denis McDonough (VA Secretary):   Yeah, you know, we have–when like everything will turn green–

Orion Donovan-Smith (The Spokesman Review):   So, if VA’s assessed that it’s not currently ready to launch at other sites, have you established benchmarks–metrics to figure out when it will be ready to launch at other sites?

Denis McDonough (VA Secretary):   So, I want to answer that in two ways.  One, let’s have you talk to Dr. Evans about when, kinda, when the ‘go sign’ rings.  I don’t have an answer to that.  That’s not to say there isn’t one, but I don’t know the answer to it.  Secondly, we do have metrics that are associated with the contract, right?  And you recall as we talked in here many times, we wanted there to be greater accountability on the contractor as it relates to performance particularly on something you’ve reported on endlessly, which is site reliability and uptime.  So, we–I was made aware this morning, are getting that data now. We–in fact, we got some, I’m told, yesterday. We have not verified that data yet.  But that kind of data I think is responsive to your question, although not directly responsive to your question.  And we’ll be measuring that both taking it, verifying it, making sure that it helps us answer the question.  And then that will then feed into the decisions that Dr. Evans is thinking through about when or if we get to a ‘go sign’ for everybody else.

Orion Donovan-Smith (The Spokesman Review):   All right. Well, thank you.  look forward to talking to Dr. Evans and I just want to say thank you and press folks and camera folks and everybody for staying late.  I don’t take it for granted that we get to ask you these questions, so I appreciate it.

Denis McDonough (VA Secretary):   Thank you.  I appreciate it. 

Terrence Hayes (VA Press Secretary):  I think that completes it. I see that, sir. And I appreciate spending my last day in 44 with them, too.  So, it’s a long one.  I’ll be 45 tomorrow.  But I appreciate everybody, and thanks for joining us.  And we will not have a press conference next month.  We’ll see you again in September.