00:00Proceed with questions. However, before I do that, I would like to make sure the record is clear
00:04regarding not just mental health services that are offered at the Hampton VA. We've pushed and
00:09will continue to push veterans to receive the care we need it. That's why I've advocated for
00:13additional facilities in my district that provide these these services. And in addition, and more
00:19specifically, that North Battlefield VA clinic in Chesapeake, I wanted to clarify and echo
00:23Secretary Collins' words about that facility. It's opening in deliberate phases to ensure safe,
00:29effective, and high-quality care as services and staffing scale up responsibly. While some public
00:34comments have mischaracterized this phase rollout, the facts are clear. The clinic opened in April
00:392025. I was at the ribbon-cutting with 150 staff and core services, including primary care, mental
00:45health, and pharmacy. To quote Dr. Elliott, that was 27 percent, and it was always intended to expand in
00:51waves. In July, dental and additional mental health services came online, and by January 2026, the
00:57facility is scheduled to be fully operational with radiology, optometry, telehealth, and more.
01:03This is a standard and prudent approach for bringing a major healthcare facility online.
01:07As we grow more patients, we grow more staff. Spreading misinformation about staffing levels or
01:12service delays only undermines the hard work being done to provide the best possible care to our
01:16veterans. I remain committed to ensuring this facility and all our VA healthcare facilities reach
01:22full potential and deliver the timely, high-quality care the veterans in Chesapeake and across Hampton
01:26Roads have earned. In conclusion, and for clarification additionally from Secretary Collins,
01:31I'm pleased the Department of the VA is not going to pursue a large-scale reduction of force
01:36and have been reassured that any early retirements will come from redundant positions and non-essential
01:40personnel. This will safeguard operations at the VA and thus ensure services to our veterans.
01:45I'm confident that Secretary Collins will prioritize maintaining a robust healthcare workforce at the
01:49VA to ensure veteran care and benefits are not impacted. We can all agree that giving our veterans
01:54the care they need is essential. Under President Trump, I know that our veterans will be put first.
01:59In fact, the VA's performance has continued to improve under his leadership with disability
02:03claim backlog already down nearly 30 percent. The work Secretary Collins is doing to modernize
02:08the VA's operations and get our veterans the quality of care they need is a breath of fresh air.
02:13By June, the VA had already processed two million disability claims, accelerated the implementation
02:18of the integrated electronic health record system, and made it easier for survivors to get benefits.
02:23These accomplishments on behalf of our veterans deserve recognition. And with that, I have questions.
02:28And my first question will be for Ms. Therritt. Ms. Therritt, the OIG found that the visiting quality
02:33assurance teams conducted reviews after the incentives were awarded. Can you explain why the VA's review
02:38process appears to be reactive instead of proactive?
02:43Chairwoman Kegans, regarding the VISN's review process, I'm going to ask Mr. Perry to respond to
02:48that question. That's fine. Thank you, Chairman, for that question. We agree where the VISN is needed
02:55to do a more proactive approach. We are shifting that responsibility over to the compensation aspect
03:00of the VISN to do that on the front end versus the back end. So we recognize that that is a gap in our
03:05process that we're making a modification adjustment to now. And will the VISN's be talking to each
03:11other then to come up with a more standard approach? Yes. Overall, we are taking that approach to look
03:15at standardization. I think what we saw back in 2017, where it was down at the facility level,
03:21we had about 150 ways of doing it. We have made improvements. That is 18, but we do have some areas
03:26to improve to make sure that the 18 are doing it consistently according to policy. That would be
03:32great consistency. It would be helpful. And I go back to Ms. Therritt, but either Ms. Therritt or Mr.
03:36Perry, would you please explain step by step how one of these three incentive payments would be approved,
03:41starting with the first step to the actual payment to the employee. So Chairwoman Kegans,
03:47I appreciate the work of the Office of the Inspector General because their very detailed,
03:50actionable reporting helps us to improve. And we made improvements from the 2017 report,
03:55and we'll continue to make improvements based on the 2025 report. So recruitment and relocation
04:01incentives are one category of three Rs. The recruitment incentive is to attract individuals
04:06into the federal government. The relocation incentive is to help move employees into locations that are
04:11hard to fill or where there's a specific need. There is a standard form 10016 that is completed for both
04:18of those incentives. One of the deficiencies in 2017 that we rectified in 2025 was that our department
04:25policy and procedures did not align with regulation. So now we have a department-wide policy, everybody
04:32should follow it consistently, and we have standard forms that every supervisor who's recommending an
04:38incentive, every HR official who's reviewing an incentive, and every approving official would utilize.
04:44So that's for the recruitment and relocation process. We have a similar 10017 that's used for retention.
04:51Retention incentives are typically shorter term. Recruitment and relocation can be up to a four-year
04:56service obligation. Retention incentives, we typically look at a one-year retention incentive
05:01service period. And the reason being for retention purposes, we're looking at somebody who's likely to
05:07leave federal service and has a unique skill that we can't afford to walk out the door. And we need a short
05:13period of time to put that succession plan in place to either develop someone with those skills to step in when
05:20they depart or to be able to recruit somebody before they leave. So that's the the process and the steps
05:28from someone recommending an incentive for an individual under one of those three sets of parameters
05:34to then HR reviewing the requirements based on recommendation and then for the approving official
05:41to sign off on it. Once the individual is identified, then they too have responsibilities. Signing the service
05:47obligation, making sure that they relocate if it is a relocation incentive, making sure they are new to
05:54the federal service if it's a recruitment incentive. And for retention incentives, we have a one-year hard
05:59stop where supervisors need to review and recertify that that is still needed. Otherwise, it will be
06:05terminated automatically. So those are just some of the steps that we take with recruitment, relocation,
06:10and retention incentives. Some of the things that we have in place and where the IG has identified more
06:15steps that we need to take to be have better oversight and compliance that we are willing and currently
06:20in the process of doing that. And that approving official, who is in their next step in the chain
06:25of command? Who would they report to? So Chairwoman Kiggins, we have delegations of authority for our
06:30three R's incentives. Typically in the Veterans Health Administration, which is the subject matter of
06:35the report, a recommending official would be a medical center director. Approving official could be up to a
06:41network director. It depends on the percentages of the incentives that are being offered. Sometimes
06:45it's higher, but that's typically how the delegations of authority flow. Now we also have breach of
06:52agreement procedures that we follow to make sure that if somebody does not fulfill their obligation,
06:58that we are going back and initiating and collecting those debts. Again, these are taxpayer dollars.
07:03We don't want to see these incentives misused or abused. I know there were instances in the report
07:08that were identified. We don't want that to continue to happen. The breach process is the individual
07:15employee who's asking for a waiver of repayment will go to their supervisor. That supervisor will
07:20take it the whole way up the chain of command to the Undersecretary of Health and the Veterans
07:24Health Administration. If they approve that request to waive payment, then it comes to my office
07:30and our Assistant Secretary for Human Resources and Administration Operations Security and Preparedness
07:36would be responsible for that process. That's just an example of the levels at which these are reviewed
07:42and the seriousness with which we take things like breach of agreements. Thank you for that
07:46very thorough explanation. How long has that that exact chain that you just described been in place?
07:51Is that new this year in 2025? So I would say it dates back to 2020 when we revised our departmental policy
07:59and we do have statistics if the committee is interested in terms of how many cases go through that
08:03process. The percentage that reach my office it's a small percentage maybe one a month and a very low
08:09percentage that is approved because the standard for waiving a breach of a service obligation is very
08:15high. It has to be it's it's stipulated in law as repayment would be against equity and good conscious
08:22or not in the best interest of the government. And when we are paying individuals and they are not
08:27upholding their end of the agreement that is something that we want to pursue. Thank you.
08:33My time has expired I'm sure that we will have a second round of questioning but I will yield to our
08:37ranking member. Thank you.
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