Nomination Hearing of Denis R. Mcdonough to Be Secretary of the Department of Veterans Affairs, Senate hearing transcript (January 27, 2021), GovInfo CHRG-117shrg45636, PDF
Summary
This is the printed (PDF) edition of the transcript of the Senate Committee on Veterans' Affairs hearing of January 27, 2021 on Denis R. McDonough's nomination as Secretary of Veterans Affairs, chaired by Jon Tester with Jerry Moran as ranking member. Tester said VA had tested nearly 1.3 million veterans and employees for COVID-19 and was tracking nearly 198,000 cases. McDonough said President Biden had given McDonough a clear mission "to be a fierce, staunch advocate for veterans and their families." The appendix includes submitted material, among it a comment to the CDC's Advisory Committee on Immunization Practices on vaccine priority for VHA patients.
Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used
Full text
S. HRG. 117–072
NOMINATION HEARING OF DENIS R.
McDONOUGH TO BE SECRETARY OF THE
DEPARTMENT OF VETERANS AFFAIRS
HEARING
BEFORE THE
COMMITTEE ON VETERANS’ AFFAIRS
UNITED STATES SENATE
ONE HUNDRED SEVENTEETH CONGRESS
FIRST SESSION
JANUARY 27, 2021
Printed for the use of the Committee on Veterans’ Affairs
(
Available via the World Wide Web: http://www.govinfo.gov
U.S. GOVERNMENT PUBLISHING OFFICE
45–636 PDF WASHINGTON : 2021
SENATE COMMITTEE ON VETERANS’ AFFAIRS
JON TESTER, Montana, Chairman
PATTY MURRAY, Washington JERRY MORAN, Kansas, Ranking Member
BERNARD SANDERS, (I) Vermont JOHN BOOZMAN, Arkansas
SHERROD BROWN, Ohio BILL CASSIDY, Louisiana
RICHARD BLUMENTHAL, Connecticut MIKE ROUNDS, South Dakota
MAZIE K. HIRONO, Hawaii THOM TILLIS, North Carolina
JOE MANCHIN III, West Virginia DAN SULLIVAN, Alaska
KYRSTEN SINEMA, Arizona MARSHA BLACKBURN, Tennessee
KEVIN CRAMER, North Dakota
TONY MCCLAIN, Democratic Staff Director
JON TOWERS, Republican Staff Director
(II)
C O N T E N T S
WEDNESDAY, JANUARY 27, 2021
SENATORS
Page
Tester, Hon. Jon, Chairman, U.S. Senator from Montana ................................... 1
Moran, Hon. Jerry, Ranking Member, U.S. Senator from Kansas ...................... 3
Murray, Hon. Patty, U.S. Senator from Washington ........................................... 13
Boozman, Hon. John, U.S. Senator from Arkansas .............................................. 14
Brown, Hon. Sherrod, U.S. Senator from Ohio ..................................................... 16
Cassidy, Hon. Bill, U.S. Senator from Louisiana .................................................. 17
Hirono, Hon. Mazie K., U.S. Senator from Hawaii ............................................... 19
Rounds, Hon. Mike, U.S. Senator from South Dakota ......................................... 20
Blumenthal, Hon. Richard, U.S. Senator from Connecticut ................................ 22
Tillis, Hon. Thom, U.S. Senator from North Carolina .......................................... 24
Sanders, Hon. Bernard, U.S. Senator from Vermont ........................................... 25
Sullivan, Hon. Dan, U.S. Senator from Alaska ..................................................... 27
Manchin III, Hon. Joe, U.S. Senator from West Virginia .................................... 28
Blackburn, Hon. Marsha, U.S. Senator from Tennessee ...................................... 30
Sinema, Hon. Kyrsten, U.S. Senator from Arizona .............................................. 32
Cramer, Hon. Kevin, U.S. Senator from North Dakota ....................................... 33
INTRODUCTION OF WITNESS
The Hon. Amy Klobuchar, U.S. Senator from the State of Minnesota ............... 5
WITNESS
Denis R. McDonough, Nominee to be Secretary of Veterans Affairs .................. 7
APPENDIX
Moran, Hon. Jerry, Ranking member, prepared statement ................................. 40
Mr. Denis R. McDonough, Nominee to be Secretary of Veterans Affairs, pre-
pared statement ................................................................................................... 42
American Federation of Government Employees, AFL–CIO, prepared state-
ment ...................................................................................................................... 44
QUESTIONS FOR THE RECORD
Response to Pre-hearing questions submitted by:
Hon. Jerry Moran ......................................................................................... 56
Hon. Jon Tester ............................................................................................. 65
Hon. Richard Blumenthal ............................................................................ 71
Hon. Kyrsten Sinema ................................................................................... 74
Hon. Sherrod Brown ..................................................................................... 81
Hon. Mazie Hirono ........................................................................................ 83
Hon. Bernie Sanders ..................................................................................... 86
Response to Post-hearing questions submitted by:
Hon. Mazie Hirono ........................................................................................ 90
Hon. Joe Manchin ......................................................................................... 91
Hon. Jerry Moran ......................................................................................... 92
Hon. John Boozman ...................................................................................... 101
(III)
IV
Page
—Continued
Hon. Bill Cassidy .......................................................................................... 103
Hon. Mike Rounds ........................................................................................ 104
Hon. Thom Tillis ........................................................................................... 106
Hon. Dan Sullivan ........................................................................................ 110
Hon. Marsha Blackburn ............................................................................... 111
Hon. Kevin Cramer ....................................................................................... 114
NOMINATION HEARING OF DENIS R.
McDONOUGH TO BE SECRETARY OF THE
DEPARTMENT OF VETERANS AFFAIRS
WEDNESDAY, JANUARY 27, 2021
U.S. SENATE,
COMMITTEE ON VETERANS’ AFFAIRS,
Washington, DC.
The Committee met, pursuant to notice, at 3:00 p.m., in room
SD–106, Dirksen Senate Office Building, and via Webex, Hon. Jon
Tester, Chairman of the Committee, presiding.
Present: Tester, Murray, Sanders, Brown, Blumenthal, Hirono,
Manchin, Sinema, Moran, Boozman, Cassidy, Rounds, Tillis, Sul-
livan, Blackburn, and Cramer.
OPENING STATEMENT OF CHAIRMAN TESTER
Chairman TESTER. I call this hearing to order. I want to welcome
everybody. I appreciate all of you that are here, that are online.
The purpose of this hearing is to hear from the President’s nominee
to serve as Secretary of Veterans Affairs, Denis R. McDonough.
Before I talk about Denis I just want to say I appreciate this
Committee for all the reasons that we sit on this Committee, that
it has been bipartisan, it has been non-political, and we have tried
to do the best by our veterans, whether you are on the Republican
side of the aisle or the Democratic side of the aisle. And I particu-
larly appreciate the relationship I had with the former Chairman,
Johnny Isakson, and with my good friend, Jerry Moran.
And this is not going to change. We are going to continue to oper-
ate this Committee in a way that the veterans are No. 1, and that
is just the way it is going to be, and we are going to continue to
work together in every way possible and communicate together,
and not surprise one another, and move forth the policies that
work for this country’s veterans.
Denis, I appreciate your commitment to public service and your
willingness to step forward. If confirmed, you will be tasked with
ensuring that our Nation’s veterans have access to timely care,
services, and the benefits that they have earned and deserve.
Today we are here to determine whether you are right for this job.
I appreciate you taking the time to meet with members of this
Committee over the past few weeks and for your timely responses
to the pre-hearing questions sent by many of us, and at this time
I would ask unanimous consent that those question and responses
be made part of the record of this hearing.
(1)
2
The transition period between administrations can be a time of
turmoil and confusion, and can generate uncertainty inside and
outside an agency. At VA there is simply too much at stake to let
that happen. The coronavirus pandemic is still raging, with more
than 400,000 Americans succumbing to the virus in less than a
year.
Denis, you will be responsible for ensuring that the VA has ev-
erything it needs to treat our veterans and care for the VA employ-
ees. VA has tested nearly 1.3 million veterans and employees for
COVID–19. The agency is tracking nearly 198,000 cases among
veterans, staff, and others admitted to VA for care, including near-
ly 14,000 active veteran cases. And now there are more than 8,300
veteran families who are without their loved ones, including the
more than 3,100 VA has cared for within its facilities.
Denis, simply put, your chief responsibility during this unprece-
dented time will be to save as many lives as possible. That includes
advocating within the administration for VA’s fair share of vaccines
and ensuring timely and efficient deployment of those vaccines.
And it includes efforts to ensure front-line workers have everything
they need to take care of our sick veterans and protect themselves
from coronavirus.
How you care for your staff will mean everything. VA recently
reported nearly 3,200 VHA staff with active COVID–19, and an-
other 2,300 clinical staff are quarantined and unable to work.
Sadly, 118 VA staff have died from this coronavirus. The virus is
taking a toll on those VA heroes who care for veterans and we are
entrusting you with their safety.
I am pleased the administration has kept Dr. Richard Stone to
ensure a smooth transition for VHA, Veterans Health Administra-
tion. But it will be a while before you have a full leadership team
in place, so there is a lot riding on your shoulders. One area in
need of scrutiny is claims processing. Nearly 500,000 claims are
pending, with more than 200,000 considered to be backlogged.
While so much focus is on health care right now we must ensure
this important issue gets the attention it needs.
Additionally, this Committee reaffirms its bipartisan reputation
in the last Congress. A number of historic reforms were enacted,
from John Scott Hannon Veterans Mental Health Improvement Act
to the Deborah Sampson Act to the expansion of presumptive cov-
erage for thousands of additional Vietnam veterans exposed to
Agent Orange. The implementation of these reforms must be con-
sistent with congressional intent and it must be swift. Veterans are
counting on it. And with the case of Vietnam veterans, they have
already been waiting for decades.
There are other critical reforms that have been in the works for
years and need serious attention. From an expansion of caregiver
program that has seen its number of speed bumps to electronic
health record modernization effort that has taken way too long and
cost taxpayers way too much, and everything in between.
You will certainly have your hands full but know that this Com-
mittee is here to help. If you are transparent and respectful of
oversight, we can be your biggest proponents and your best part-
ners. During your predecessor’s nomination hearing I told him the
sacred mission of serving the veterans and their families must al-
3
ways transcend personal agendas or political affiliations. In the
end, I believe he lost sight of that, and I called him out for it, and
I will hold you to the same standard.
There is a great political divide in this Nation, but veterans
across the country and the members of this Committee are united
by a very basic expectation. The next VA Secretary needs to be an
individual of honesty, integrity, and vision, who listens to the vet-
erans and puts their well-being above all else. If you keep your
head down and live up to that expectation, you will be successful.
And in the end, we all want you to succeed because veterans across
this country need you to succeed.
I look forward to our discussion today. Thank you again for your
willingness to serve on behalf of our Nation’s veterans. With that
I will turn it over to you, Senator Moran.
OPENING STATEMENT OF SENATOR MORAN
Senator MORAN. Chairman Tester, thank you. Thank you for the
comments. Thank you for the working relationship, your care and
concern for veterans, the way this Committee has operated during
my chairmanship, and I agree with you that that cooperation, bi-
partisanship, should and will continue.
You will be the eighth Chairman. I have served on the House
Veterans’ Affairs Committee under Chairman Bob Stump, Chair-
man Chris Smith, Chairman Steve Boyer, Chairman Bob Filner,
and in the Senate under Chairwoman Patty Murray, Chairman
Bernie Sanders, Chairman Johnny Isakson, and now you. In all cir-
cumstances I want to be a productive member of this Committee
and want to work with my colleagues to see that good things happy
for all veterans. And I have, in some instances, when we say things
like that we have the sense that we are just talking. And I am not
just talking, and you were not just talking. We have no option and
no desire to do anything other than the way we have operated in
the past, and will continue to work with you in that way to serve
our Nation’s veterans.
Mr. McDonough, welcome. No mission is more noble than the one
you will lead if you are confirmed, and so I thank you and your
family for your willingness to re-enter government service.
We are going into this new Congress with new leadership and a
new administration. The challenges we aim to address on behalf of
our veterans will be a mix of those existing and ongoing issues we
will struggle to sort out, alongside new challenges and new oppor-
tunities for our country to not only honor our veterans for their
service that they provided but to harness their values and their tal-
ents to help them lead again.
Mr. McDonough, in 2014, your White House deputy chief of staff,
Rob Nabors, reviewed the nationwide wait time scandal and de-
scribed the root causes using phrases such as ‘‘little transparency,’’
‘‘corrosive culture,’’ ‘‘lack of accountability across all grade levels,’’
and ‘‘significant and chronic system failures.’’
Six years later, thanks to the collective effort of three VA Secre-
taries and thousands of dedicated employees, it is fair to say the
VA looks very different now than it did then. Employee engage-
ment is at its highest level in over a decade. The VA ranks 6th out
of 17 among large government organizations as the best place to
4
work. A vast improvement in just four years. And patient trust in
VA health care is now over 90 percent. Your job, if confirmed, will
be to solidify and build off those improvements.
At the same time, several major modernization programs are un-
derway, with electronic health record modernization, financial busi-
ness transformation, caregiver expansion, and Community Care
Networks, just to name a few. These and other modernization ef-
forts will require billions of dollars per year on top of VA’s regular
operations, just to catch the VA up with the latest and best prac-
tices. The VA desperately needs strong leadership to make certain
these investments achieve results and they are not wastes of tax-
payer dollars.
With the help of our VSO partners, Congress has enacted several
recent reforms to improve mental health care, protect educational
assistance, enhance disability and survivor benefits, and expand
burial benefits. The next Secretary of Veterans Affairs must be
ready on day one—on day one—to advance and build on the
progress that has been made over the last four years, must ensure
that the laws are faithfully executed, and must measure results so
we know veterans are benefiting as intended.
Additionally, the next Secretary must continue to fight against
COVID–19, support an already strained work force, deliver timely
vaccinations to VA patients, and be ready to assist civilian health
care system in places where it is overburdened. Furthermore, back-
logs in health care and benefit claims appointments that have piled
up due to the pandemic, they must be addressed as we return to
a more stable operating environment in the coming months.
A top concern for me, and for, I think, many of my colleagues,
is how the VA will care for veterans living in rural communities.
Before coming to the Senate, I represented a congressional district
roughly the size of Illinois with no VA medical center. I look at the
VA through the eyes of our Kansas veterans and the feedback I re-
ceive in speaking to them is that health care access has always
been a challenge. VA provides excellent health care in its own fa-
cilities but those facilities are not in every community.
The MISSION Act, the act that you worked on, the Choice Act,
and now the MISSION Act, gives veterans permanent choice to uti-
lize community health care providers when it makes sense for
them, and not when it is convenient for VA bureaucrats. I asked
President Biden, and will also ask for your commitment, to uphold
the law by supporting this common-sense notion that it is the vet-
eran who should be at the center of their health care decisions.
We know that public health measures that reduce the spread of
COVID also increase the risk of social isolation and mental health
conditions. VA has its tools that they can use to help. Community
care authorities, telehealth options, and funding provided by Con-
gress can work together to mitigate the pandemic’s impact on vet-
erans’ physical, mental, social, and economic well-being.
Furthermore, programs like the GI Bill, Veterans Readiness and
Employment, and transition assistance programs can help veterans
transition out of the military successfully and help launch them on
what the VA terms a ‘‘solid start.’’ Entering the civilian world
should not be the challenge that it is today. Research has shown
higher incomes likely lead to better health and outcomes, so invest-
5
ing in these programs does not just aid the veteran in his or her
transition but it helps the long-term well-being, and it could reduce
the burden on the VA’s health system.
I would ask you to consider not just how the VA is doing at deliv-
ering the benefits provided by law but also what outcomes—what
outcomes—we are trying to achieve for veterans with these bene-
fits, and if they are doing enough to measure those outcomes rel-
ative to the benefits the VA is providing.
Again, Mr. McDonough, congratulations. Thank you for our con-
versations, both in person and by Zoom. Your commitment to our
Nation’s veterans is seemingly—let me take out the word ‘‘seem-
ingly’’—is sincere and real, and I appreciate that very much. Car-
ing for our veterans has always been a unifying force during my
time in Congress. It is my great hope that continues to be the case
if you are confirmed as Secretary.
Mr. McDonough, I look forward to hearing your Statement and
engaging with you further on these questions, this conversation,
during the remainder of our hearing, and I thank the Chairman.
Chairman TESTER. Thank you, Senator Moran, and before we get
to Denis McDonough’s Statement we have the incredible pleasure
and honor to have our chamber graced by the senior Senator from
Minnesota, Senator Klobuchar, for an introduction.
STATEMENT BY THE HONORABLE AMY KLOBUCHAR
Senator KLOBUCHAR. Well, thank you very much, Mr. Chairman
and Ranking Member Moran, and distinguished members of this
Committee. Thank you for the good work you do, the bipartisan
work you do. That is the hallmark of this Committee. And I am
proud today to introduce my friend and fellow Minnesotan, Denis
McDonough, as President Biden’s nominee for Secretary of Vet-
erans Affairs.
Today Denis is joined by his wonderful wife, Kari, as well as two
of his three kids. Denis grew up in Stillwater, Minnesota, which is
on the Wisconsin border, as opposed to our other greater border,
Senator Rounds, with South Dakota. And he is the grandson of
Irish immigrants, the son of devout Catholic parents, and brother
to 10 siblings. He attended St. John’s College in Collegeville, Min-
nesota, and in addition to graduating summa cum laude he played
safety on the very proud championship St. John’s football team.
I have been privileged to call Denis a friend for years, and I
know he will serve our country so well as a Secretary. As he has
done his whole life, he will honor the promises our country has
made to our veterans and their families. Denis’ commitment to our
Nation’s veterans was clear during his time as President Obama’s
chief of staff, when he made sure that every decision impacting our
servicemembers, veterans, and their families was befitting of their
sacrifices. Showing respect and gratitude for our Nation’s veterans
is not something he just prioritizes. It is a value for him.
He is an adept manager who understands how to tackle complex
challenges throughout our government, which will be vital for the
next Secretary. As we all know, and you have mentioned, Chair
and Ranking member, the VA is facing a number of challenges
from helping veterans to stay safe during the pandemic to improv-
ing the quality of care for veterans around the country. And as you
6
also note, great improvements have been made thanks to all of you
and many others. These are not simple problems, and these are not
simple challenges, and they will require true leadership and vision,
which have been, again, the hallmark of Denis’ time in public serv-
ice.
I also know he will work with you tirelessly to find bipartisan so-
lutions, which has never been more important as we move our
country forward. So much of our work with veterans is about keep-
ing our promises and showing respect, not just in our words but in
our actions. When you get to know Denis, for those of you who are
just getting to know him, you will see the qualities of honor and
loyalty in his commitment to his family, which also includes his
family in Minnesota. I know this first hand. You see it in how he
has treated everyone that he works with, when he worked in the
Senate, when he worked as President Obama’s chief of staff. You
see it in that loyalty, and he puts our country first.
During his distinguished career he has approached each and
every job with a spirit of respect, honesty, and collaboration, and
a willingness to make himself accessible to his colleagues and to
his team. Members of the Committee, I know he will do the same
with you in this job. He is deeply committed to supporting his work
force.
One of the things I want to tell our veterans is I know he will
do two things so well. He will listen and then he will get things
done for you. One of my favorite stories about Denis involves this.
We were having a lot of trouble in northern Minnesota with mines
closing down because of steel dumping from China, and Denis was
President Obama’s chief of staff and he went up to northern Min-
nesota—I think it was very cold, I will add—and met with about
50 people, and it was this long, long table. And Denis sat and lis-
tened to every single one of them, and the very last person to speak
was a guy named Dan Hill, who was a miner, an iron ore miner.
And Dan told the story of how, at his son’s preschool, when they
graduated, the teacher had asked them, ‘‘What do you want to be
when you grow up?’’ And the kids were saying things like an astro-
naut, and a basketball player, and Dan Hill’s son said, ‘‘I want to
be a miner’’—and Joe Manchin can relate to this—‘‘I want to be a
miner like my Daddy.’’
And then the miner takes this tee-shirt, a steelworker tee-shirt,
and he throws it down this long table to Denis, saying the words,
‘‘Make it come true, Mr. McDonough. Make it come true.’’ And I am
sitting there next to Denis saying, ‘‘You were a football star. Catch
the tee-shirt,’’ and he did. And he not only caught the tee-shirt but
he put Dan back to work, and he put so many miners back to work,
because he came back to Washington, helped us pass legislation,
and most importantly for this job, implemented things through the
bureaucracy of government by getting many different Cabinet Sec-
retaries and others to hold hearings and the like.
I tell that story because I believe, in my heart, this is the guy
you are going to get as Veterans Affairs Secretary who is actually
going to follow through and listen and get things done.
I am going to end with the words of a poet who President Biden
happens to love, Seamus Heaney, and given Denis’ Irish roots I
cannot think of a better person to quote at today’s hearing. Heaney
7
once wrote, ‘‘Anyone with gumption and a sharp mind will take the
measures of two things: what is said and what is done.’’ He will
not just say the words as your Secretary. He will get things done.
I urge the Committee to support his nomination. Thank you.
Chairman TESTER. Thank you, Senator Klobuchar. Before we get
to your Statement, Mr. McDonough, I would ask you to rise as I
administer the oath. Raise your right hand, please.
Do you, Denis Richard McDonough, solemnly swear or affirm
that the testimony you are about to give before the
U.S. Senate Committee on Veterans Affairs will be the truth, the
whole truth, and nothing but the truth, so help you God?
Mr. MCDONOUGH. I do.
Chairman TESTER. Let the record reflect that the nominee Stated
in the affirmative. You have the floor, Denis.
STATEMENT OF DENIS R. McDONOUGH
Mr. MCDONOUGH. Thank you, Chairman Tester, Senator Moran,
and members of the Committee. Good afternoon and thank you for
the opportunity to appear before you today. I do so with great re-
spect for your constitutional obligations to advise and consent, to
fund and oversee the Department of Veterans Affairs, and the bi-
partisan tradition of this Committee in service to our Nation’s vet-
erans.
At a moment when our country must come together, the partner-
ship between the Chairman, Senator Moran, and members of this
Committee is inspiring. If given the honor of serving as Secretary
of Veterans Affairs, I will strive to emulate that partnership in my
work with you, as individual members and as members of the Com-
mittee.
We can meet today in peace and freedom because generations of
servicemembers have stepped forward and sacrificed in our name.
And though only a small percentage of Americans have served in
our armed forces, the President has called on every American to
embrace our responsibility to support our veterans and their fami-
lies. President and Dr. Biden take this duty seriously and person-
ally, as I know each of you do, perhaps especially since they, like
so many of you, are members of a proud military family.
If confirmed, I will dedicate myself, with every fiber of my being,
to fulfilling what President Biden rightly refers to as our country’s
most sacred obligation: to prepare and equip our troops that we
send into harm’s way and to care for them, and their families,
when they return.
It is true that I am not a veteran, but in my years of public serv-
ice I have had the privilege afforded to relatively few Americans.
I have seen up close, and been deeply moved by, the excellence, tal-
ents, dedication of our men and women in uniform. When visiting
our soldiers, sailors, airmen, Marines, and Coast Guardsmen on
our bases in Afghanistan and Iraq, I have witnessed the heavy bur-
dens of long deployments away from their families.
Beside their hospital beds when they come home, I have seen
their resilience in the face of wounds, visible and invisible, that can
last a lifetime. Standing there at Dover, when our fallen heroes
come home one final time, I have seen the unimaginable grief of
8
military families, to whom we owe a debt that cannot be repaid,
and whom we will stand with forever.
Inside and outside of government I have been inspired how our
veterans continue to strengthen our communities and our country
out of uniform, as teachers, coaches, first responders, public serv-
ants.
Most of all, like every American, I owe a profound debt of grati-
tude to those who have worn the cloth of our Nation. It would be
a tremendous honor to serve our veterans and their families, care-
givers, and survivors by leading the VA, to ensure our Nation
serves our veterans as well as they have served us.
If confirmed, I will make it my mission to fight for our veterans
with a relentless focus on three core responsibilities of the Depart-
ment: providing our veterans with timely, world-class health care;
ensuring our veterans and their families have timely access to their
benefits; and honoring our veterans with their final resting place
and lasting tributes to their service.
At the same time, the President has directed me to focus on get-
ting our veterans through this pandemic; helping our veterans
build civilian lives of opportunity with the education and jobs wor-
thy of their skills, talents, and service; ensuring that the VA wel-
comes all our veterans, including women, veterans of color, and
LBGTQ veterans; working to eliminate veteran homelessness and
reducing suicide; and keeping faith with our families and care-
givers.
In short, if confirmed, I will work tirelessly to build and restore
VA’s trust as the premier agency for ensuring the well-being of
America’s veterans. After all, there is no more sacred obligation nor
noble undertaking than to uphold our promises to our veterans,
whether they came home decades ago, or days ago.
I am ready for this mission. As a former White House chief of
staff, I bring a deep, extensive knowledge of government. I under-
stand how to untangle and solve large, complex challenges, both
across and within large agencies. I have seen first-hand that when
our government is at its best it can help the American people, in-
cluding our veterans, and allow them to live in security and dig-
nity.
This will not be easy. The Department of Veterans Affairs faces
great challenges, challenges made more daunting by the
coronavirus pandemic. Its capabilities have not always risen to the
needs of our veterans. If confirmed, I promise to fight every single
day to ensure that our veterans have the access to world-class,
compassionate care that they have earned.
I look forward to being a true partner with the men and women
of the VA, dedicated, highly skilled professionals, many veterans
themselves, veterans serving veterans, who deserve our profound
respect and support. I will also build strong partnerships with the
veteran service organizations who devote themselves to their fellow
veterans, to their communities, and to our country.
I have been given a clear mission by President Biden, to be a
fierce, staunch advocate for veterans and their families. If con-
firmed, I will embrace that assignment with the solemnity it de-
mands.
9
This is not a mission I take on alone. Every Federal agency has
a role in supporting our veterans. If confirmed, I will make that
happen, because again, when it comes to supporting our veterans
and their families, every American has a role to play.
Chairman Tester, Senator Moran, distinguished members of this
Committee, thank you again for the opportunity to appear before
you today and for the opportunity to join you in caring for our vet-
erans, who have served and sacrificed so that we can live in free-
dom today.
May God bless our troops, our veterans and their families, and
as a nation may we always give them our very best.
I look forward to your questions.
Chairman TESTER. Thank you for your Statement, Denis. I ap-
preciate that. Amy, you are welcome to leave if you want, but you
can stay to watch the best Committee in the Senate work, if you
would like.
Senator KLOBUCHAR. I think he is in good hands with you.
Chairman TESTER. All right. I will just start out. Denis, out of
the top jobs in this administration which you would be well-quali-
fied for, why this one?
Mr. MCDONOUGH. Mr. Chairman, I am a fighter and I am relent-
less, and I am particularly relentless about things I have a passion
for. And having had the professional experience of the last 20
years, since September 11, 2001, and having witnessed up close the
tremendous service, excellence, and sacrifice of our military and
our veterans, I have great passion for making sure that we treat
them as well as they have treated us.
So, when the President called me to talk about this assignment
I could not have been more excited, more humbled, and more com-
mitted to seeing it through. And if confirmed, I will apply that fight
and that passion to ensure that we do live up to our promises.
Chairman TESTER. Okay. Thank you. Do you have the autonomy
to do what you believe is best for this Nation’s veterans, even when
you disagree with the President?
Mr. MCDONOUGH. I do. I would also say I have a very good rela-
tionship with the President. He encouraged me to be very candid
with him. So, in the event that there is a disagreement, I am con-
fident that I would have an opportunity to vigorously make my
case, draw on the experience and expertise in the Department to
bolster that case, and to work with you all to fulfill that case.
Chairman TESTER. Many, if not all of us, on this Committee be-
lieve the importance of the inspector general, the IG. If confirmed,
will you commit to not interfere or hinder with the independent
work of the IG?
Mr. MCDONOUGH. Yes, I will so commit.
Chairman TESTER. All right. We have passed a number of bills,
and if you are not familiar with them you can certainly ask. But
two of the bills that we passed, and we passed many of them, need
a timeline for implementation, the John Scott Hannon Veterans
Mental Health Bill, that Senator Moran was so gracious to co-spon-
sor, and the Deborah Sampson Act, which Senator Boozman was
so gracious to co-sponsor.
10
Will you agree to provide a timeline for implementation of both
those bills, and if so, would you agree to provide regular updates
to the Committee on the progress of the implementation?
Mr. MCDONOUGH. I will absolutely provide an implementation
timeline on those bills. I will keep you updated on the progress of
that, but more than that, Mr. Chairman, I have discussed these
bills at length, both with you, with Senator Moran, and with Sen-
ator Boozman, and my commitment to you is to not just give you
updates but to consult with you and to work with you in true bipar-
tisan consultative fashion to ensure that we are implementing
them, that the Department implements them, if confirmed, con-
sistent with the intent of this Committee.
Chairman TESTER. Coming into the most senior role at the VA,
how are you going to approach reviewing VA’s COVID–19 response
to date and determining if changes need to be made?
Mr. MCDONOUGH. Thank you, Mr. Chairman. Every question
that I approach, if confirmed, at the Department will be around
two questions: will it give greater access to veterans and will it en-
sure better outcomes, as you and Senator Moran both laid out in
your opening Statements.
As it relates to a review on COVID–19, I will review whether
performance to date has been as good as it can be on those two
questions for our veterans. The questions are going to be around
communication, around access, both to vaccines but then access to
care in the case of infections.
Similarly, we have to be serious about communicating clearly
with the work force, ensuring that the work force has access to vac-
cinations and protection, and the work force has, as you said in
your opening remarks, access to all the material that they will
need to do their job safely.
Chairman TESTER. Numerous reports, oversight reports, have
shown that sexual harassment assault remains a key issue across
the Department. Creating a self-welcoming environment for all vet-
erans, staff, and guests at the VA is critical. Defense Secretary
Austin recently issued a memo to the Pentagon leadership request-
ing an expedited review of DoD’s sexual harassment, assault pre-
vention, and accountability measures. As head of the VA, do you
plan on doing something similar?
Mr. MCDONOUGH. I do, Chairman. If confirmed, on day one I will
lean into this issue to try to set a culture that underscores that
such activity will not be tolerated, that the Department has to en-
sure that not only the Department’s work force but also impor-
tantly the fastest-growing cohort of veterans, namely women vet-
erans, have confidence that they will be treated with respect and
given the access that they have earned.
Chairman TESTER. Thank you, Denis McDonough. Senator
Moran?
Senator MORAN. Chairman Tester, thank you. Mr. McDonough,
I have been a critic of what I describe as executive overreach. I
happen to believe that Article I has the ability to give Congress sig-
nificant and important responsibilities. And administrations, over
a long period of time, have chipped away at that balance that I
think would be better if the Executive branch was less aggressive
and the congressional Legislative branch was more aggressive.
11
You were involved in an administration which I criticized for
being so aggressive on Executive orders, for example, but I always
tried to balance that by saying, well, part of the problem is that
Congress does not do its job, and so it leaves this wide space open
for an executive of either party to advance their agenda. And I
would love to see this Congress work better than it does, and I
want to try to make certain that I do my part that that occurs.
But where I would find fault is the area in which agencies, the
Executive branch, the Department of Veterans Affairs, and others,
when there is clear legislation, and clear legislative intent, so both
language and intention, that then that language and intention is
not followed. In our conversation that you and I have had, I would
love, for the record, for you to confirm your understanding. And let
me give you a couple of topics in which that will become important.
The President’s campaign, President Biden’s campaign, and your
own response to my pre-hearing questions, mentioned rebalancing
Community Care. I am concerned that these plans may, depending
on what those words mean, may erode the core tenets of the mis-
sion’s Community Care program, and that would cross a red line
for me. Access standards, in particular, are the cornerstone of the
Community Care program, and veterans have come to rely on those
standards over the past 2 years.
One of the difficulties we have had is as we move from Choice
to MISSION things changed. Veterans got accustomed to some-
thing and then it was something new. And I take serious issue
with any effort to change those access standards or restrict vet-
erans’ eligibility for the program.
If confirmed, will you uphold the current access standards that
veterans—my notes here say ‘‘universally understand.’’ I wish that
was the case—but understand, and do you plan to change those
standards as part of that rebalance?
Mr. MCDONOUGH. Thank you, Senator Moran. Let me be very
clear that Community Care will continue to be a key part of how
the Department cares for our veterans, full stop. I intend to imple-
ment the statutes that you all have enacted consistent with your
intention, and to do that in consultation with you on any decisions
that come before me. And as it relates to access standards, I will
treat those sets of questions in exactly that same way, which is
that I will work on those fully in consultation with you.
Senator MORAN. Let me highlight a reason that I have the con-
cern that I am expressing to you. One of your responses to my pre-
hearing question, you promised to work with Congress, as you just
did, to ensure that veterans are the center of their own health care
decisions. However, one of the proposed Community Care updates
in the campaign plan would allow the VA to send veterans back to
the VA when community providers failed to meet the yet deter-
mined access in quality standards. This directly contradicts the
mission’s intent by enabling the VA to override the veteran’s
choice.
So what I am hoping to hear you say is that you understand that
the MISSION Act is designed, in fact written, for the veteran and
his or her provider at the VA to make a choice about where to re-
ceive care, based upon what is in the best interest of the veteran.
Is there anything there that, in your view or the Biden administra-
12
tion’s plans, that I should have concern about overriding that deci-
sion between the VA provider and the veteran?
Mr. MCDONOUGH. No, Senator. There is not.
Senator MORAN. The same theme I would have with the John
Hannon act that Senator Tester and I introduced and got passed
through this Committee and the Senate and the House and signed
by the President. Will you faithfully commit that you will imple-
ment the John Hannon Act in that same manner?
Mr. MCDONOUGH. Yes, Senator, I will.
Senator MORAN. If confirmed, will you commit your staff to work
with the Committee staff and to my staff, to me, to ensure congres-
sional intent is met during each of the phases of implementation
for that bill and other legislation?
Mr. MCDONOUGH. Yes.
Senator MORAN. So, Mr. McDonough, one of the complaints that
I have had for a long time is that when Congress does act, on the
occasions in which we get our act together and succeed in passing
legislation, that the VA, in particular, but I assume it is true in
other departments, the VA, in particular, seems to ignore the
things that we have just talked about. And what I think you are
telling me is that that I should be less concerned about with you
in charge than what I have experienced over the eight—one, two,
three, four, five, six, seven, eight—nine Secretaries that have been
in office while I have been a member of the Veterans’ Committee.
Is that a fair assessment that I can trust you to fulfill the role that
the Executive has in implementing legislation passed by Congress?
Mr. MCDONOUGH. Yes, Senator, and I would elaborate on that in
the following way. One is that I believe, as you do, and as I said
earlier, everybody has a role to play in supporting the veterans.
The Constitution actually divvies that up quite clearly for you all
and for the Executive, in Articles I and II, so it is a constitutional
question. Second, I also believe it is a question of best outcome.
When the Executive works closely with Congress, in a collaborative
and consultative way, that is the best way to ensure more durable
policy, more durable outcomes, and especially if we are both work-
ing with the fundamental premise that every decision should an-
swer, is this getting better access and better outcomes for our vet-
erans.
Senator MORAN. Mr. McDonough, thank you. Your comments re-
mind me about durability. What that really means is that a vet-
eran can come to expect a certain outcome or a response to a ques-
tion and it is not different from 1 day to the next, 1 week to the
next, or one location to the next.
Mr. MCDONOUGH. Correct.
Senator MORAN. And the point I would make is that in so many
instances, over a long period of time, no particular administration
to be specific about, the conversations I have with the Secretary or
his or her team resulted in assuring me that this problem is being
taken care of and this is our plan, but what I discover when I am
home, that has never been communicated to the people who imple-
ment the plan and care for veterans at home in Kansas. And so
there is a communication issue related to this. You can assure me
that you support implementing with congressional intent, but it
has to be told and insisted on by those who actually provide the
13
services to veterans at home. And I would encourage you to make
certain that when you tell me and other Members of Congress this
is the policy at the Department, that that policy is then known and
implemented by those across the country.
Mr. MCDONOUGH. Understood.
Senator MORAN. Thank you very much. Thank you, Mr. Chair-
man.
Chairman TESTER. We are going by seniority order, so next we
have Senator Murray, remotely.
SENATOR PATTY MURRAY
Senator MURRAY. McDonough. I am Delighted to see you today.
Welcome, and we all really appreciate your being with us today.
You know, the VA is the largest integrated health care system in
the country so it really demands a strong, effective leadership, so
we appreciate your willingness to take this one.
You and I have had a chance to talk about some issues in De-
cember, and I wanted to ask you about some of those again today
for the record. Let me just start, as part of the MISSION Act, Con-
gress expanded eligibility for the caregivers program to make sure
veterans of all eras suffering from service-connected illnesses would
have access to caregiver support. However, under the previous ad-
ministration, regulations were imposed that limit that eligibility
and remove many veterans needing assistance from that caregivers
program. Those restricting regulations like requiring a minimum
70 percent service-connected disability rating as well as the need
for assistance each time an ADL is performed unduly restricts eli-
gibility in a way Congress never intended, and make it harder for
our veterans to get care.
So if confirmed, will you take action to roll back those recently
imposed restrictions and make it a top priority for VA to fully im-
plement the caregivers’ law as Congress intended?
Mr. MCDONOUGH. Thank you, Senator, and I appreciate the
question and I appreciated our discussion of it. My commitment, as
I indicated earlier, is to immediately begin to address this issue
upon confirmation, to work closely with you and the rest of the
members of this Committee as it relates to implementation of that
act, and to ensure that we do it consistent with the expectation and
the intention of Congress.
Senator MURRAY. Thank you very much. Let me turn to another
part of our promise to take care of our veterans after they return
from duty, which is allowing them to fulfill their dream of having
a family. Congress has given the VA authority appropriations to
provide IVF and other necessary fertility treatments for ill or in-
jured veterans and their spouses, but access to that care is far too
difficult, and I have been working for nearly a decade to fix this.
My bill, which is the Women Veterans and Families Health Care
Services Act will permanently authorize fertility treatment and
counseling for veterans and their spouses and provide adoption as-
sistance.
Mr. McDonough, it is extremely important that we empower vet-
erans to start families when the time is right for them. Will you
commit to work with me to make sure veterans have ease of access
to IVF and other fertility treatments?
14
Mr. MCDONOUGH. Senator, I will.
Senator MURRAY. Thank you. I look forward to working with you.
One of the largest challenges that is facing the VA is the imple-
mentation of the electronic health record modernization program.
The VA Medical Center in Spokane, my State, is the pilot site for
this project. The process has highlighted infrastructure and staffing
shortfalls, and veterans in Spokane have experienced unacceptable
delays in getting care. Full implementation across every VA med-
ical center is expected to take at least seven more years. Given that
timeline and the scope of this project, if confirmed, how will you
protect veterans’ access to high-quality care at the VA while ensur-
ing the success of this modernization effort?
Mr. MCDONOUGH. Thank you, Senator. As I indicated, every deci-
sion that I am involved in, if confirmed as Secretary, will come
back to the fundamental premise of whether the decision is increas-
ing access and improving outcomes for veterans. This has got to be
the case as it relates to the electronic health record as well, and
my commitment to you and to members of this Committee is to
continue to work in a collaborative, consultative fashion with you
in the implementation of that program, to ensure that, at the end
of the day, increased access and better outcome for veterans is the
result of that health record, that the work force understands and
can use the health record consistent with those principles, and that
I can continue to confirm to this Committee that that is the out-
come of that process.
Senator MURRAY. Okay. And one final question. Improving the
information VA shares with veterans on the GI Bill comparison tool
is essential to make sure veterans can get informed choices about
their education. I have previously called for DoD and VA to develop
a joint policy to counter aggressive recruiting and misleading mar-
keting aimed at our veterans, and I want to see improved avail-
ability of crucial information such as levels of student debt and
transferability of credits. Can you commit to providing thorough
oversight of the GI Bill funds, fully implementing the protections
in the GI Bill Act, and making sure that when there is evidence
of fraudulent conduct you will take steps to make sure the schools
are not allowed to continue to recruit veterans?
Mr. MCDONOUGH. Thank you, Senator. The President has indi-
cated to me that a fundamental priority for me, if confirmed, must
be ensuring that our vets have access to employment and education
opportunities consistent with their experience, skills, and talent.
And consistent with that, I would intend to, working collaboratively
with you and this Committee, ensure that there is appropriate, ag-
gressive oversight and measurement on quality outcomes of that
programming.
Senator MURRAY. Okay. Thank you very much, and thank you,
Mr. Chairman. I appreciate the opportunity.
Chairman TESTER. Senator Boozman.
SENATOR JOHN BOOZMAN
Senator BOOZMAN. Thank you, Mr. Chairman, and thank you for
being here. You served in a variety of different ways in the Execu-
tive branch, I know in national security and then also chief of staff
to President Obama. And I have had the opportunity to be around
15
the table with you on many occasions and always found you some-
body that was willing to listen and then also very, very informed
on whatever issue that we were talking about.
Mr. MCDONOUGH. Thank you.
Senator BOOZMAN. And then, very importantly, I know that the
President has a great deal of trust in you and respects your opin-
ion. So I think that is good for veterans. So we appreciate your
willingness to serve very, very much and look forward to working
with you.
We had a good conversation not too long ago. I want to followup
on something that really is a significant issue facing veterans in
the country. Some of these are too large for any one organization
or department to solve. Veteran’s suicide is one of those enormous
issues. Last Congress we passed a bipartisan bill, the Commander
John Scott Hannon bill, to begin to encourage the VA to work more
closely with communities in trying to address the issue of veteran
suicide.
If confirmed, would you describe how you would lead the VA to
create more partnerships with veteran-serving community organi-
zations while, at the same time, incentivizing those same organiza-
tions to partner and work with the VA?
Mr. MCDONOUGH. Thank you so much, Senator. The crisis facing
the country related to veteran suicide is tragic. We face a national
crisis on suicide as well. The first and most important thing that
I will do, if confirmed, is underscore that comprehensive health for
our veterans includes mental health, it includes effective mental
health, includes reducing the stigma associated with seeking help,
and that also includes increasing access to mental health services
through any number of opportunities, and in particular, given the
enhanced authorities that you have now made available to the De-
partment through community organizations.
So, using those resources and using the networks that are being
built around Community Care gives the Department a unique op-
portunity to ensure that it is drawing on all the available resources
on this national crisis.
Senator BOOZMAN. We appreciate that. The VA does a very, very
good job and works really hard at this crisis. On the other hand,
there are so many entities out in the community that also are
doing a very good job and ready and willing. So many of these peo-
ple fall through the cracks, and for one reason are not in the VA.
So, if we can get them in a program and then encourage those pro-
grams to get them back into the VA we will be in good stead.
One of the most common things I hear from veterans in Arkan-
sas is regarding the multiple different enrollment processes for
VHA, VBA, sometimes NCA, when in fact they are all part of the
same agency. So you have got different processes within the same
agency.
If confirmed, can we work together, can we work together as a
committee, and explore a more human-centric design approach, in
other words, making it simpler to help the enrollment process for
veterans, more of a one-shop approach?
Mr. MCDONOUGH. Absolutely, Senator. I would look forward to
the opportunity to work together on that.
16
Senator BOOZMAN. Very good. And I yield back. Thank you, Mr.
Chairman.
Chairman TESTER. Thank you, Senator Boozman. Senator Brown
remotely.
SENATOR SHERROD BROWN
Senator BROWN. Thank you, Mr. Chairman. Nice to see you there
and call you that. And I thank Senator Moran for his gracious com-
ments also. Mr. McDonough, I enjoyed the conversation we had re-
mote or remotely—whatever is grammatically correct—the other
day. Thank you, and thanks for your commitment to work with
VSOs and VA employees and VA unions like AFGE, so thank you
for that.
We see unprecedented backlog in claims processing in compensa-
tion and pension exams because of the pandemic, and the pandemic
is affecting operations in National Personnel Records Center. I
know you will be busy on day one, working on that and so many
other things. With my staff I met with veterans and VA employees
throughout Ohio. Recently there have been concerns about VA clos-
ing units and downsizing services, at one specific facility especially,
because of the virus. The VA has not committed as of yet to reopen-
ing the unit once the pandemic is over. My concern with that ap-
proach is that if VA starts to close units or services or facilities it
will push veterans into the community for care. Some want to do
that, but others, most want the option of always going back to the
VA.
Would you commit to reopening those units or services lines
closed due to COVID–19, and will you work with OMB and the
White House to make sure that VA has the resources and per-
sonnel to reopen those facilities?
Mr. MCDONOUGH. Thank you very much, Senator. Obviously the
slow-down in fulfillment of claims processing as a result of the pan-
demic is a principal concern that I would have, if confirmed, and
making sure then that we have the resourcing after the pandemic
to not fall back into backlog once the Department gets its hands
around the existing cases would be really important.
So, I will absolutely take this question of those facilities. I will
work with the White House and work with OMB on it, to make
sure that we have the resources to fulfill a critical assignment of
timely access to benefits that veterans and their families have
earned.
Senator BROWN. Okay. Thank you. We have seen far too many
veterans and military families targeted by predatory, for-profit in-
stitutions since passing the post-9/11 GI Bill. Those institutions
misrepresent themselves and often saddle student veterans with
mounds of debt. Do you plan to exercise additional oversight to root
out misrepresentation of predatory, for-profit institutions that tar-
get student veterans?
Mr. MCDONOUGH. Every decision that I make, if confirmed as
Secretary of the Department, will be asking two simple questions
and to advance two simple principles, which is are the decisions we
are taking increasing access for veterans and are they improving
outcomes for veterans? Outcomes on education programming and
employment programming have to be a critical part of how the De-
17
partment implements that and executes those programs, so the
short answer is yes.
Senator BROWN. Thank you. And we know that the Protect the
GI Bill Act’s provisions bans the deceptive recruiting of college
third-party lead generators and following the law to cutoff the flow
of GI benefits to those kinds of schools. Obviously that is really im-
portant.
Let me shift. I hope you will come to Dayton at some point to
visit the National VA History Center. I will followup and talk to
you about that. I wanted to talk about veteran homelessness. I will
soon be the chair of the Banking Housing Committee. Veteran
homelessness is an important part of your mission and an impor-
tant part of my mission too there. We made great progress there
but still have a way to go to complete the job, including making
sure that VA has adequate staffing to support the successful HUD-
VASH housing voucher program. Will you work with Chairman
Tester and HUD nominee Marcia Fudge, whom I just spoke to lit-
erally 30 minutes ago, and make sure all veterans have a place to
call home? That is a really high priority.
Mr. MCDONOUGH. Yes, I will.
Senator BROWN. Okay. Thank you. Last thing, last month VA
proposed a program that would require military borrowers exiting
a COVID–19 mortgage forbearance to pay back their missed pay-
ments with interest within 10 years. This is more expensive than
what other Fed mortgage programs are offering. It would make it
more likely that VA borrowers will fall behind on these new highly
monthly payments. Veterans and servicemembers should not be
given worse options than other borrowers with federally backed
loans. Do you agree with that?
Mr. MCDONOUGH. I do.
Senator BROWN. Okay. Will you look into the rule and work with
us, look into the rule and make sure that no VA homeowner is left
with worse options than borrowers in other federally backed loan
programs?
Mr. MCDONOUGH. I would be happy to work with you on that.
Senator BROWN. Okay. We will followup. Thank you, Mr.
McDonough and good luck on your confirmation.
Chairman TESTER. Thank you, Senator Brown. Senator Cassidy.
SENATOR BILL CASSIDY
Senator CASSIDY. Hey, thanks for being here.
Mr. MCDONOUGH. Thank you.
Senator CASSIDY. I enjoyed our conversations. Thank you for the
phone conversation. Some of this will be repeated, just because I
think it is so important for my colleagues. We spoke about how
those of us on this Committee will ask questions of the VA—I used
the term ‘‘rope-a-dope’’ and you immediately got it. We got a reply
back which is off-point, about 2 months later. We asked for clari-
fication and 2 months later we get another slightly off-point, or
more than off-point. And then finally it just kind of tapers out.
You have a different philosophy, so do you mind sharing with us
all how you intend to share data with us as regards the VA itself?
Mr. MCDONOUGH. Thank you for the question, Senator. I think
the free flow of accurate data is the lifeblood of a well-functioning
18
organization. Consistent with that and consistent with the view I
have been espousing of close collaborative, consultative relationship
with this Committee and with Congress, I would intend to make
sure that we have the free flow of information between and among
us. I also said, when we talked earlier, that it could be that be-
cause we are moving quickly we provide inaccurate information,
and I will work to quickly come back with more accurate informa-
tion on that. But as I said, the lifeblood of any well-functioning
agency or organization is accurate, timely data.
Senator CASSIDY. You know, you used a couple of adjectives
there, and I am going to explore them because I loved them—
‘‘quickly’’ and ‘‘timely.’’
Mr. MCDONOUGH. Yes, fair enough.
Senator CASSIDY. Which is not really—now the VA, by the way,
recently they answered a question very quickly, and so I am saying
that at times it works and at times it does not. But can you just
give me a sense of, when you say ‘‘quickly’’ and ‘‘timely,’’ like the
timeframes that you would be considering quick and timely?
Mr. MCDONOUGH. Well, it is hard to answer that question in the
abstract, but I guess what I would say to that question, Senator,
is I would want it back to you in a timeframe that is useful to you.
Senator CASSIDY. That works. Okay. Thank you.
Following up on something that Senator Brown said, that Sen-
ator Murray alluded to, Senators Carper, Lankford, Tester, and I
will soon be reintroducing the Protect Vets Act. Now I do not ex-
pect you to be up to speed on this because you are just starting,
but it seeks to close the 90/10 loophole to ensure that veterans’
educational benefits, such as the GI Bill, are treated as Federal
funds for accountability purposes. And just kind of background, if
a for-profit university is allowed to get 90 percent of its funds from
the Federal Government and 10 percent from outside the Federal
Government, veterans’ benefits have been included in that 10 per-
cent.
And so when Senator Murray speaks of targeting veterans, yes,
they have been targeted because they would fill up this gap that
the free market would not provide, but rather people with veterans’
benefits could provide that 10 percent match for the remainder of
the 90.
We worked very hard to get a compromise that would protect the
veteran, protect the good schools, and that would kind of be sen-
sitive to sensibilities in both the Republican and the Democratic
caucus. And again, protecting the good schools but isolating out the
bad.
So just to say that we are going to be bringing this forward,
knowing that you will have to look at this, but we would love your
engagement on this issue because we think it is important that we
address it.
Mr. MCDONOUGH. I would be happy to work with you on it, and
I commit to being engaged, if confirmed. Absolutely.
Senator CASSIDY. I appreciate that. With that I yield back.
Chairman TESTER. Thank you, Senator Cassidy. Remotely, Sen-
ator Hirono.
19
SENATOR MAZIE HIRONO
Senator HIRONO. Thank you very much, Mr. Chairman, and wel-
come, Mr. McDonough. It was good to talk with you when I had
the opportunity.
I think my colleague, Amy Klobuchar, gave one of the best testi-
monies where she made it very clear that you listen and then you
actually do something. You get things done. And you are about to
head, should you be confirmed, one of the largest Federal agencies
and the largest health care system, and very uniquely the VA actu-
ally provides health care across 50 States and territories. So this
is a very unique agency with just ongoing challenges—homeless-
ness, mental health, health disparity treatments, all kinds of
things.
Not to mention, by the way, when I talked with you, you said
that from a very pragmatic standpoint that getting the veterans
vaccinated and dealing with the pandemic is one of your first prior-
ities. Joe Biden has said that he is going to have 100 million people
vaccinated within the first 100 days, so should you be confirmed,
do you have an idea, or would you determine how many veterans
you would want to get vaccinated, and would you have a way to
determine whether you are actually meeting those goals? Would
that be one of the ways that you will tackle this pandemic with re-
gard to our veterans?
Mr. MCDONOUGH. Thank you, Senator. In fact, it would be. A
principal priority in helping veterans through the pandemic is en-
suring that they have access to care, if sick, and vaccinations to
prevent getting sick. The way I intend to work this question is I
will demand a seat at the table, and I will, as the President has
asked me to do, be a staunch and fierce advocate for veterans get-
ting access to the kind of care and the kind of resources that en-
sures the kind of outcome that you have just highlighted.
Senator HIRONO. I think that you actually have to have numbers,
such as you are going to have X percent of the veterans out there,
and you are going to need to find some of them because they are
not all in the system. And then you need to figure out a way to
make sure that those vaccinations are actually occurring.
One of the initial questions I ask of every nominee for these
kinds of appointed positions, just to ensure their fitness to serve,
I ask the following two questions, which I will now ask you. Since
you became a legal adult, have you ever made unwanted requests
for sexual favors or committed any verbal or physical harassment
or assault of a sexual nature?
Mr. MCDONOUGH. No, I have not.
Senator HIRONO. Have you ever faced discipline or entered into
a settlement relating to this kind of conduct?
Mr. MCDONOUGH. No, I have not.
Senator HIRONO. One of the ways that we can really ensure that
our veterans get the health care they need is to create community-
based outpatient clinics, and I talked with you about some of the
long delays with regard to some of these clinics on Oahu as well
as on some of the neighbor islands. And each one of these projects
is unique. There may be some unique State requirements or limita-
tions that make it really hard for these projects to proceed.
20
So it requires somebody within the VA to pay attention and move
these projects along, whatever the specific concern might be, so
that the veterans in these places are not waiting for a decade, as
is the case with some of the projects in Hawaii.
I would just like you to really focus on the need for community-
based clinics where the veterans can have access to the care that
they need. Will you commit to making that happen?
Mr. MCDONOUGH. Senator, I will. If confirmed, I will.
Senator HIRONO. So one of your predecessors made eliminating
homelessness among veterans to be a top priority, and he engaged
a whole-of-government kind of approach and yet homelessness con-
tinues to be a concern. And yes, you responded to my questions to
you, but truly, what are you going to do that is different from what
one of your predecessors, who said, ‘‘I am going to eliminate home-
lessness among veterans,’’ and that did not happen. What are you
going to do to ensure that there will be more measurable success
in eliminating homelessness among veterans?
Mr. MCDONOUGH. Thank you, Senator. The President has made
clear that this will be a priority of the administration. What I will
do to implement that priority is obviously make it an intentional
priority, one. Two, work with the other agencies in the Federal
Government to increase access to available options. And three,
make sure that the VA is providing access to all the other services
that are important as it relates to access to mental health, access
to substance use disorder, treatment, access to education, employ-
ment, and training support. And using all of those tools, working
with other Federal agencies, and the holding ourselves to account
to you to measure that progress is how we fulfill that objective.
Senator HIRONO. I think you have a commitment from Sherrod
Brown and from Marcia Fudge to enable you to succeed, and I will
certainly be wanting to engage with you on that score, because
nothing could be as important as to have a roof over their head,
food, and a job, if that is what is available to them, made available
to them.
I do not know. I cannot see the timer.
Chairman TESTER. You are over by about a minute and a half,
and we can have a second round if you would like.
Senator HIRONO. Thank you very much.
Chairman TESTER. You bet. Thank you, Senator Hirono. Senator
Rounds.
SENATOR MIKE ROUNDS
Senator ROUNDS. Thank you, Mr. Chairman, and it is truly re-
freshing to see that we have a Chairman and a Ranking Member
who are both concerned about our rural veterans as well, and I
thank you and I look forward to working with you.
Mr. McDonough, first of all, I want to thank you for the phone
call the other day. The opportunity to visit with you was good, and
I appreciate the knowledge that you bring, your preparation for our
visit, and your understanding of some of the challenges that the
VA faces. I also—look, I plan on supporting you in your nomination
for this position, and I thank you for your service to our country.
Mr. McDonough, the Hot Springs VA facility in Hot Springs,
South Dakota, is a critical part of the Department’s Black Hills
21
health care system. In October, Secretary Wilkie rescinded a record
of decision on the future of the campus which provides vital health
care services not only to South Dakotans but to residents of Ne-
braska, Colorado, Wyoming, and so forth.
I would like your commitment, if confirmed, to work on moving
the Hot Springs facility and literally the Black Hills facilities them-
selves up into the century with regard to the services that they are
providing, and literally lay out a long-term plan for their success
for the veterans in the rural areas.
Mr. MCDONOUGH. Thank you, Senator. I really appreciated our
conversation on this, and I committed to you then, and I recommit
myself to you now to work closely with you on this, and addressing
the needs in and around the Hot Springs facility, in as much as
it is such a critical piece of the delivery capability, not only in
South Dakota, but as you say, in Nebraska, Montana, Wyoming.
Senator ROUNDS. The MISSION Act, which is what we operate
under now for our health care, is an item that I did not vote for.
I did not vote for it because it took away guarantees of a veteran
to be able to find a physician of their own choice if they could not
get an appointment within 30 days or if they were more than 40
miles away from a health care facility that the VA sponsored. I
thought they were making promises in the MISSION Act that we
might not be able to keep.
I think you step into the administration of this facility, of this
agency, this administration, in which you are being asked to do a
lot of things and you are going to get pulled in a lot of different
directions. I do not expect you to be able to see the detail of this
chart, but this is a chart of the VA and what it has. You are ex-
pected to provide educational opportunities, you are expected to
provide housing, you are expected to provide final expenses, a final
resting place, and you are also expected to provide health care to
VAs across the entire country.
If you look at this, you can go down 13 levels before you actually
get to where a real doctor is at, where a hospital is at in the chart.
And for me, that says a lot about the challenge that you face. I do
not think that is something that a lot of people realize, when they
talk about the VA and what happens. When you promise every-
thing to everybody and lay it within an administration like this,
whether it is a Republican or a Democrat administration, the chal-
lenges of handling a bureaucracy are huge. You walk into a bu-
reaucracy with perhaps as many as 380,000 individuals, some of
which are providing direct care, others of which are trying to find
reasons why the care can’t be provided.
Specifically, what my concern is, is this. Right now, in the ap-
proval process, when we ask for someone to participate in the care
for the community, it is not veteran-friendly. Too many of the ap-
provals are made by people who work to make sure that the vet-
eran stays within the VA system, regardless of whether or not it
is good for the veteran or not. While the flow chart says that the
veteran’s decision is the veteran’s decision, as Senator Moran sug-
gested it always come back to the VA for approval. In my opinion,
it is tailored for an urban veteran with easy access to tertiary serv-
ices and not the rural veteran who may have to drive well over 50
miles for access to see a primary care provider.
22
If confirmed, what will you do to afford veterans their choices as
to where they receive their health care?
Mr. MCDONOUGH. Thank you, Senator, and I really appreciated
our conversation before on these questions as well. Any credible
strategy as it relates to rural care for our vets has to have at least
three components. One, community care, and community care has
to ensure that more timely payment of bills. It also has to ensure
a more vibrant network of providers, providers who want to be part
of that network. And I think in both of those cases a more active,
or a higher set of expectations for the third-party administration,
for example, is probably wise.
The second thing is using access to new platforms. We had a very
useful conversation, I thought, about telehealth, as I did with sev-
eral other members of the Committee. Consolidating those gains
and growing those.
And then third is getting more aggressive about using the au-
thorities that you have given the Department to recruit and to fill
the vacancies in the facilities that VA already has.
And so, among those three prongs of a strategy I think are the
answers to ensure that the best medical outcome for the vet, which
as I read the statute is what you all have demanded, ends up being
the deciding variable in the equation.
Senator ROUNDS. My time has more than expired, Mr. Chairman.
Thank you for your thoughts, and particularly the one about timely
payments for those providers.
Mr. MCDONOUGH. Thank you.
Senator ROUNDS. Thank you, sir.
Chairman TESTER. Thank you, Senator Rounds. Senator
Blumenthal.
SENATOR RICHARD BLUMENTHAL
Senator BLUMENTHAL. Thanks, Mr. Chairman. Thank you for
having the hearing. Thank you, Mr. McDonough, for your service,
your very extensive service, your commitment to veterans, your
conversation with me about your dedication to them, and your tes-
timony here today, which has been excellent. I have been following
it from afar, and apologize I was not here before now.
I want to first of all followup on part of a conversation we had
about the VA facility in West Haven, where there were two deaths.
It is an aging, in fact, aged facility that is badly in need of recon-
struction Like many facilities across the country, it was built in an-
other century, literally, and we owe it to our veterans to rebuild
that infrastructure. There are several critical construction projects
in the design phase at the West Haven VA, including a new sterile
processing service building and surgical and clinical space tower,
but what is really needed is a reconstruction of the entire facility,
which does great care for our veterans. The doctors, nurses, admin-
istrative staff are superlative, and they are really dedicated patri-
ots, but they are working a structure of bricks and mortar that
fails to keep faith with our veterans.
So I would like your commitment to work with this Committee
and ensure that the VA prioritizes infrastructure, rebuilding, and
most especially, obviously, for the interests of our Connecticut vet-
erans, the facility in West Haven.
23
Mr. MCDONOUGH. Thank you, Senator, and my commitment—my
recommitment now, as it was in our earlier conversation, is to real-
ly dig in on these questions upon confirmation, to keep a very close
collaborative relationship with you on it, to ensure that it is pro-
ceeding consistent with the needs of our vets and consistent with
the two principles that I have laid out, which is increasing access
for vets and improving outcome for vets.
Senator BLUMENTHAL. And I would like to invite you to West
Haven, as I did privately, to come visit. They are doing a great job
there, by the way, on vaccines. I have visited the clinic where they
are administering vaccinations. They are increasing the number.
I would like to know from you how you will ensure that there is
adequate access to vaccinations by minority veterans, communities
of black and brown veterans, and staff members in that category.
Mr. MCDONOUGH. So, I thank you very much, Senator. The
President has made clear that equity will be a fundamental consid-
eration across the pandemic preparedness and response, and it
would be my expectation, if confirmed, that I will assume my seat
at that table, in those deliberations, and I will be a fierce, staunch
advocate for all vets to have access to care and treatment and vac-
cines, consistent with the improved access and the improved out-
comes that will drive any decision I make as Secretary, if con-
firmed.
Senator BLUMENTHAL. You are familiar, no doubt, with the re-
ports about the numbers of veterans who were involved in the as-
sault on the Capitol, which reflects a phenomenon that probably is
no news to a lot of folks, that white supremacists, extremists ide-
ology often find fertile ground among veterans, just as they do in
the general population, regretfully, tragically, and unnecessarily.
So I wonder if you could tell us a little bit about how, under your
leadership, you will take steps to educate veterans about online
disinformation and coordinate with other agencies like the Depart-
ment of Defense in this effort.
Mr. MCDONOUGH. Thank you, Senator. I would just say I was
struck by the activity, the actions that you and your colleagues
took the evening of January 6th, reconvening to continue the demo-
cratic process. I thought that was a very strong Statement. I am
also struck that both throughout that day and in the days hence
there were remarkable stories of veterans associated with the
Washington D.C. police force, Capitol police force, veterans who are
members themselves, all taking valiant action to defend democracy,
a continuation, as we have said throughout the day, of how vet-
erans continue to serve outside of uniform.
On the question of the threat of mis-and disinformation, it is as
important an assignment to protect our democracy as any. I could
see a variety of opportunities for the VA to be an important actor
in those efforts, to protect vets, to highlight the threats of online
activity, trying to provide or insert disinformation. And it would be
my intention to work with my interagency colleagues, the NSC and
others, to make sure that is receiving appropriate consideration.
Senator BLUMENTHAL. Thank you. My time has expired but I
want to congratulate and thank you again, and I will very enthu-
siastically support your nomination on the condition that you come
to Connecticut and visit us there.
24
Mr. MCDONOUGH. I would be happy to go to Connecticut. Thank
you, Senator.
Senator BLUMENTHAL. Thank you.
Chairman TESTER. Thank you, Senator Blumenthal. Senator
Tillis.
SENATOR THOM TILLIS
Senator TILLIS. Thank you, Mr. Chairman. Mr. McDonough, con-
gratulations to you and your family and thank you for years of
service, including a lot up here on Capitol Hill.
First I want to apologize for our not being able to talk before the
hearing. I think you did have an opportunity to speak with every-
one else, and I would like to get your commitment between now
and the time we report you out of Committee to go in, maybe to
have a discussion——
Mr. MCDONOUGH. Happy to.
Senator TILLIS [continuing]. so that we could drill down on some
issues that cannot be covered in 5 minutes. So thank you.
I think in your testimony you made reference to rebuilding trust
in the VA, and I think always we take steps forward, we take steps
back, and we have always got to make sure that we have the trust
for our veterans.
I just wanted to note that I think we are at about 80 percent in
trust at the VA overall and about 90 percent on outpatient health
care, so it seems like we are doing something right. One of the
things I would be curious, if you are confirmed, is if the metrics
that we are using right now to measure our progress are appro-
priate, and then if you deem them appropriate then continue to
commit to reporting back so that we can see the trend lines moving
the right direction. If you do not think they are appropriate then
make suggestions on things that we can better tailor to make sure
that we are doing the best for our veterans.
So I suspect that when you get into this role, and some questions
have already been asked, the question of your not being a vet-
eran—I am not a veteran; I think there are some here who have
not also served. But can you talk a little bit about the experience
that you bring and why you think it makes you well-suited to take
on the role of Secretary of the VA?
Mr. MCDONOUGH. Yes, thank you very much, Senator. One, I am
fighter and I am relentless. I think anybody you talk to who has
worked with me will affirm that. Those attributes will serve me
well to fulfill the fundamental assignment the President asked me
to carry out, which is to be a fierce and stanch advocate for our vet-
erans.
Two, I know and understand the Federal Government, from both
ends of Pennsylvania Avenue. I can unstick problems inside agen-
cies and across agencies, and especially an agency as large as VA,
that is an important skill, and in fact, I have spent a lot of time
working with many members of this Committee on doing just that.
And then there is something more. Going back to those attacks
on 9/11, for 20 years I have been afforded, in my public service,
something relatively few Americans are granted, which is to see up
close the excellence, the execution, the talent of Armed Forces. And
I have been deeply moved by that. And I have also seen, in trips
25
into the field, in Iraq and Afghanistan, on a very regular basis, the
impact of our troops and the impact of long deployments on them
and their families. And I have made it a point to visit at Walter
Reed, and to even be at Dover on the final arrival home for some
of our heroes.
And I am not telling you that I am a vet, but I am telling you
that I have come to understand the massive sacrifices that they
have made, and I have come to witness the amazing skill with
which they have done it. And there is no higher calling than to use
my skills to ensure that we make good on our promises to them,
to serve them as well as they have served us.
Senator TILLIS. Well, thank you. I am going to try to keep to
time for my other colleagues who have yet to speak.
But I actually wanted to thank the Chairman. For the past, I do
not know, Jon, going back four years, with Chairman Isakson’s ap-
proval, he and I met with two Secretaries to track on some of the
transformation efforts, the electronic health record system, which
is something I want to continue to be focused on. I am hoping the
Chair, now that you are in that lofty role of Chair you may want
to have somebody else on the Committee meet with them. But to
meet with you all on a regular basis. I really believe in the elec-
tronic health record implementation. I think the integration with
the DoD, as I think some other member may have alluded to it, is
critical to provide that seamless transition. There are some other
transformation projects that I am very interested in. Also, when we
have a follow-up discussion, I want to talk about the concept of re-
balancing Community Care, what that would really mean. And I
look forward to setting up a phone call or in-person visit over the
next few days.
Thank you all. Again, congratulations to your family. Did you say
you came from a family of 10 kids?
Mr. MCDONOUGH. Yes, 11. So I have 10 brothers and sister.
Senator TILLIS. Were you an altar boy?
Mr. MCDONOUGH. I was.
Senator TILLIS. One of the best jobs I ever head.
Mr. MCDONOUGH. Yes. There is a nice honoraria every once in
a while.
Senator TILLIS. Yes. Thank you.
Chairman TESTER. Thank you, Senator Tillis, and we will con-
tinue to work on EHR. Thank you.
Next we have up Senator Bernie Sanders, remotely.
SENATOR BERNIE SANDERS
Senator SANDERS. Mr. Chairman, thank you very much, and
Denis, great to see you again.
Mr. MCDONOUGH. Nice to see you, sir.
Senator SANDERS. I am sorry we did not have a chance to chat
before the hearing, but I am more than aware of your years of pub-
lic service, and I have absolute confidence that your knowledge of
the bureaucracy is exactly what we need to head up the VA and
make that important institution as efficient and useful to our vet-
erans as it can be. So I look forward to working with you. And if
it’s Okay with you, let’s see if we can chat a little bit in the next
couple of days. Is that something we can do?
26
Mr. MCDONOUGH. Very much. Yes, I would very much appreciate
that.
Senator SANDERS. Okay. I would also love to welcome you to
come to Vermont and chat with some of the folks at our very good
hospital in White River Junction. They would love to meet with you
and have you learn a little bit about the problems facing veterans’
care in rural America. Is that something you might be interested
in?
Mr. MCDONOUGH. I would be happy to do that. I would be happy
to do that, absolutely.
Senator SANDERS. Okay. A couple of issues that I wanted to
touch on—and I apologize, I was in another meeting—is the trend
that we have seen in recent years toward privatization. In talking
to veterans in Vermont, and as former Chair of the VA Committee,
talking to veterans all across this country, I find that veterans, by
and large, with exception, feel that the quality of care that they are
getting at the VA is very good, and they very much appreciate the
level of staffing and people who often come from their backgrounds,
and many of them veterans themselves, who understand the par-
ticular problems that veterans face.
Can you say a word about trying to maybe reverse the efforts to-
ward privatization and adequately fund the VA so that veterans
can get the quality care in a timely manner that they deserve?
Mr. MCDONOUGH. Thank you, Senator. I have indicated that
every decision that I make will flow from two principles, which is
does the decision increase access for veterans and does it improve
outcomes for veterans. And that, at the end of the day, has got to
be the defining set of principles on every decision.
I think, as I have discussed with many members of the Com-
mittee, I do not support privatization. I do recognize that Commu-
nity Care will continue to be a part of how the VA provides care
to veterans, so we have to ensure that Community Care, that VA
is being a good partner in Community Care, timely paying of bills,
maintaining an effective, vibrant network.
At the same time, we have to ensure that this integrated health
model continues to draw on the success and the excellence that is
obvious throughout its work force. So that is how I see this, Sen-
ator.
Senator SANDERS. And I would agree with you. I just wanted to
touch on an issue which is of concern in Vermont, and I think na-
tionally. When I look at health care, Dennis, I see dental care as
an integral part of health care, and yet dental care is not available
to the average veteran except when there is—when it is associated
with an injury, a service-related injury. Would you work with me
in trying, perhaps, to expand dental care as a basic benefit for our
veterans?
Mr. MCDONOUGH. Thank you, Senator. I will absolutely dig into
this question, if confirmed, and continue to work with you and
other members of the Committee in a consultative, collaborative
way to try to address these concerns, absolutely.
Senator SANDERS. Okay. Well, Mr. Chairman, that is all that I
have. I think we are looking at somebody who stands the chance
of being a really, really great VA Secretary, and I certainly look
27
forward to working with him in the future. So thank you very
much, Denis, and I look forward to chatting with you shortly.
Mr. MCDONOUGH. Thank you so much, Senator.
Chairman TESTER. Yes, thank you, Senator Sanders. Next we
have Senator Sullivan.
SENATOR DAN SULLIVAN
Senator SULLIVAN. Thank you, Mr. Chairman, and Mr.
McDonough, thanks for your conversation and meeting yesterday.
As I mentioned, I am proudly serving the State with more vets per
capita than any State in the country—Joe, it is true, sorry. West
Virginia is close, patriotic communities, both of ours. And I reached
out to a number of our veterans for questions that they can ask
you, and I got a lot, of course. And I would say that you could boil
them down to a couple things. They want a Secretary who under-
stands what it means to serve, who will vigorously tackle the ben-
efit and health care challenges facing them, and who listens, who
does not prioritize the needs of, say, a veteran in Los Angeles or
a big city over the needs of those in rural communities like
Utqiagvik or Kotzebue, who works with Congress on finding solu-
tions, not politicizing.
And in the spirit of a great Marine, former constituent of mine,
unfortunately we lost him last year, Marine Gunnery Sargent
‘‘Cajun Bob’’ Thoms from Wasilla, Alaska, six Purple hearts, on the
cover of Life magazine, for his Silver Star of valiant heroic for his
tour in Vietnam, in the confirmation of Secretary Shulkin, he had
asked the question of saying he simply wants a VA Secretary who
‘‘will kick ass and take names.’’
So what do you say to my veterans on these issues, and can you
take a minute—I know you did with Senator Tillis—to speak di-
rectly to the legitimate concerns that Alaska veterans have raised
who feel as though military experience is the prerequisite for the
VA Secretary, to understand and have a baseline understanding of
their needs, their service, their experience.
So if you can address all those I would appreciate it.
Mr. MCDONOUGH. Thank you, Senator, and I appreciate the
question, and I appreciate the concern at the heart of the question
about who is best prepared to be VA Secretary.
I am not a gunnery sergeant, but I am a fighter and I am relent-
less. Anybody who has worked with me knows that. Two, I know
how the government works, and importantly, I know when and
how it does not work. And I will fight relentlessly to ensure that
it works for our vets.
Senator SULLIVAN. So I think my constituents, my veterans, their
families, they want to know, will you have their back?
Mr. MCDONOUGH. I have spent the last 20 years involved in deci-
sions about when and where—as a staff person I am not going to
over state my role, but as a staff person, when and where our men
and women go to fight. And I have gone and seen and met and wit-
nessed what they are doing, and I have gone to visit them when
they are injured, here at home. And I have seen and internalized
their excellence, and I know that the basic requirement of VA Sec-
retary is to have their back, to ensure that I will fight like hell to
take as good a care of them as they have taken of us.
28
Senator SULLIVAN. So in the immortal words of Cajun Bob, you
will——
Mr. MCDONOUGH. Kick ass and take names.
Senator SULLIVAN [continuing]. kick ass and take names on be-
half of our veterans?
Mr. MCDONOUGH. Yes, sir.
Senator SULLIVAN. That is important. They need to know it.
Mr. MCDONOUGH. Yes, sir.
Senator SULLIVAN. I also want to get your commitment, first year
of your tenure, to get up to Alaska and meet with my veterans, see
our State, see the challenges. Can I get your commitment on that?
Mr. MCDONOUGH. You have got that commitment.
Senator SULLIVAN. Can I get your commitment—you know, if
confirmed you are going to be running a big bureaucracy—can I get
your commitment to kind of do a VFR direct with all of us on this
Committee, when we have issues, we can go directly to you and not
through the 18 layers of bureaucracy?
Mr. MCDONOUGH. Yes, you have that commitment.
Senator SULLIVAN. Let me ask one final question. Again, these
were concerns from my veterans. You served in the Obama Admin-
istration. My first 2 years in the Senate were the last 2 years of
the Obama Administration. A lot of the issues I was dealing with
were some of the big VA problems. The Choice program, which, in
my State, the implementation was an utter disaster. It actually col-
lapsed the system in Alaska. I mean, total disaster. The Phoenix
wait time scandal. What did you learn from these, and do you
think that experience is going to help you? Is that a liability, give
your background? And can you assure my veterans that we are not
going to go back to those days, which I do not think anyone on this
Committee thinks were good days for our veterans. We have made
a lot of progress since that, we have made a lot of progress back
home in Alaska, particularly as it relates to putting together an
Alaska plan that got us out of the hole the Choice program put us
in.
Mr. MCDONOUGH. Thank you, Senator. The lifeblood of a well-
run, well-functioning organization or agency is timely, accurate in-
formation. That was not the case in Phoenix. The lifeblood of a
well-run organization is accountability. Accountability happened in
Phoenix, but it was slow. You all have subsequently changed the
statute to make that easier, and it will not ever happen again.
At the end of the day, the principle that will inform my leader-
ship of the VA, if I am confirmed, is whether any decision increases
access and improves outcomes for our vets. That is what we owe
the vets. That is what my commitment to you, to the VSOs, and
to them, and to the President, is that I will deliver, if confirmed
as Secretary.
Senator SULLIVAN. Thank you. Thank you, Mr. Chairman.
Chairman TESTER. Thank you, Senator Sullivan. Senator Joe
Manchin III. Hallelujah.
SENATOR JOE MANCHIN
Senator MANCHIN. Thank you, Mr. Chairman, and congratula-
tions on your lofty position. First of all, Mr. McDonough, thank you
very much, and if I may say, Denis, we have known each other for
29
a while, and I am glad my colleagues brought up about, you know,
sometimes they think we need to be veterans, and I never had the
honor and the pleasure of being able to be a veteran. I think that
is a void in my life. I think back—I was an altar boy for 12 years.
I was a Boy Scout for a long time. I never made it to the military,
and that is something I really think there is a void, and I think
it is a special opportunity. But we know that it takes a person who
cares and has the experience to do the job, and that is where you
come in. And I think, Denis, that says everything.
Let me tell you a little bit of what you are facing and what I
have faced in the 5-years I have been on this Committee. I came
on this Committee in the 114th Congress in 2015. Since then, they
talked about the wait time scandals. That led to the VA Choice Act.
It led to the MISSION Act, which needs a lot of repairs, as you
know. The veterans’ unemployment and hiring after the financial
crisis, we had more veterans unemployed. It took longer to get
them back employed, and we started I Hire a Vet, a campaign all
over the country.
Toxic exposure, Agent Orange, burn pits—I know you are very
much aware of those and it is really wreaking havoc today. The
veteran suicide and mental health that we deal with on a daily
basis. Veteran homelessness is something that I cannot com-
prehend at all how we can have any veterans that we would not
have better care for.
The women veteran health care access. Women think they have
been left out or are not a high priority, and they are an integral
part of our military and our defense today. The hiring backlog, over
40,000 vacancies in the VA. Veterans Affairs IT infrastructure
delay. At Clarksburg VA, murders. If anything I have ever experi-
enced in my life is knowing that we could have veterans who were
murdered in a veteran’s hospital, and we have eight confirmed, a
woman that will be serving many life sentences over and over. And
there might be as many as three more. We have had sexual abuse,
just found it in another Beckley VA hospital, four veterans we
know of and probably 40 more over a 25-year span.
There is a breakdown somewhere, sir, and we are just going to
need someone like you who can dig into that, because to me it
would be vetting. We are not vetting people properly. We are not
having strict rules adhered to.
But more importantly, we passed, in 2017, the Accountability
and Whistleblower Protection Act. We wanted to make sure that
we could basically get rid of the people that were not doing their
job. I do not think that has been exercised much since then, and
I will give you a perfect example. The people that I hold respon-
sible for the VA hospital deaths in Clarksburg have been moved to
other places in the VA system. Unheard of. And I knew way back
when this happened, in a meeting with them, that someone was ei-
ther lying to me or totally incompetent. And now when I found out,
we brought new leadership in, they were moved somewhere. I can-
not find them. And I would like to know on that, if we could bring
that to the highest priority.
I think to put the credibility back in the VA, the care and the
desire for the care that they deserve, I would ask you, as one of
your first visits, to come to Clarksburg VA and set down what your
30
mission would be. And I think, sir, that could set the tone for the
entire VA system all over the country. It is just unbelievable, to-
tally unbelievable. And now families—I have families calling me
daily. Did my father or grandfather lose their life because someone
murdered them when they were there, still not knowing for sure.
These are all the things that we are dealing with today. You can
help ease that pain, I think.
But, Denis, I look forward to you. We need someone of your abil-
ity more now than ever, and like I said, I am in awe today of every
person I see in uniform, all the people you see out here guarding
this great republic of ours, and anybody who has served, to give
them the greatest care.
So with that I know the challenges are great. If you would like
to comment on any of that, I know you have probably been fol-
lowing some of this, but I do not know to what extent on that.
Mr. MCDONOUGH. Well, I thank you very much, Senator, and I
have been following it, and we had a very good conversation, which
I appreciated.
Senator MANCHIN. Thank you for that.
Mr. MCDONOUGH. And my commitment is, as I assured you be-
fore, which is to work in close consultation and collaboratively with
you and with the rest of the members of the Committee on these
question.
Senator MANCHIN. I think you are going to find a committee that
has worked in—I am just about finished—a committee that has
worked in a most bipartisan way. And I have said this before, and
I mean this with all my heart. Men and women in uniform are the
glue of this country. They keep us together. They keep us talking.
They keep us finding ways to work together, to make sure that we
are taking care of those who are taking care of us. So you have got
it in your hands now, the cradle, basically, of the people who have
made the country what we are today, and we owe it to them.
So with that being said, you are going to find all the support. If
we do not have a piece of legislation that allows you to reorganize,
that allows you to basically get rid of the dead wood and the people
who do not care—my grandmother always said, ‘‘People don’t care
how much you know until they know how much you care.’’ I know
how much you care. Now you have to show the rest of the world.
Mr. MCDONOUGH. Thank you.
Senator MANCHIN. Thank you, sir. I look forward to voting for
you too.
Mr. MCDONOUGH. Thank you.
Senator MANCHIN. Count me in. Put me in again, Coach.
Chairman TESTER. You have got it, big boy. Thank you, Senator
Manchin. Remotely we have Senator Blackburn.
SENATOR MARSHA BLACKBURN
Senator BLACKBURN. Yes, thank you. I appreciate that, and Mr.
McDonough, thank you so much for the time this week. It was
wonderful to visit with you by phone. Let me just—and I appre-
ciate your commitment. You have talked some about your passion
and that relentless commitment to doing the job and to public serv-
ice. So very quickly, what would uniquely qualify you to lead the
VA, with a budget that is nearly a quarter of a trillion dollars and
31
400,000 employees, and it serves 9 million enrolled veterans? So
kind of following on to Senator Manchin’s question, what is your
unique qualification?
Mr. MCDONOUGH. Thank you, Senator. As you have indicated, I
am a fighter and I am relentless, and that means I will fight to
get our vets’ backs, and I will ensure, relentlessly, that the re-
sources that you have authorized and appropriated for the Com-
mittee are invested wisely and with the veteran at the center of
those investments.
I also understand how the government works, from both ends of
Pennsylvania Avenue. That means demanding excellence. That
means enforcing accountability. That means being in close collabo-
ration and consultation with you and other members of this Com-
mittee, to ensure that we are using all the available power of the
U.S. Government to get our vets’ backs.
Lastly, for 20 years now I have been involved in these decisions
about when and where to send our men and women to war, not as
a decider—I am not trying to over state my role-—but as a staff
person. And I have also seen the excellence of our military and I
have seen the challenges of long deployments, and I have seen the
sacrifices, but I have seen the resilience. And there is no higher
calling than to be able to use my skills and my experience to repay
and to ensure that we live up to the promises we have made to our
vets.
Senator BLACKBURN. Yes. Let me jump in there, because Senator
Moran and others have talked about Community Care, and you
and I talked a little bit about this. You have got Choice. You have
got MISSION. We have got, as part of repaying these veterans,
many that want to get care in their communities. You talked about
the right balance of care, and I would like for you to bring just a
little bit of clarity to that. What do you see as the right balance
of care, and would you commit that you are not going to roll back
on standards and reverse the intent of a veteran-centric care and
addressing the whole health of the veteran?
Mr. MCDONOUGH. Thank you, Senator. Community Care will
continue to be a fundamental way that the Department provides
care to our veterans, one. Two, the statute is clear on this. It says
that best medical outcome for the veteran is the objective, and that
will continue to be my priority, if confirmed as Secretary.
Third, every decision I make as Secretary will come back to this
principle, which is, is it increasing access for veterans and is it im-
proving outcomes for veterans? If the answer to those questions are
no then we will not do it.
Senator BLACKBURN. Okay. Well, and you and I discussed the
health records, the electronic health records.
Mr. MCDONOUGH. Yes, ma’am.
Senator BLACKBURN. And others have brought that up today.
And, you know, my frustration with a $4 billion IT budget and they
cannot seem to get it right, indeed Senator Tester and I had legis-
lation this year that would have improved the management of that.
And for the record, we are about out of time. I will send you a QFR
on the management of those programs, and then you and I also dis-
cussed purchasing, and for the record I will send you a question
delving a little bit more into that purchasing.
32
But thank you for the time today. Thank you for your commit-
ment. And, Mr. Chairman, I will send the time back to you.
Chairman TESTER. Thank you, Senator Blackburn. Next we have,
remotely, Senator Sinema.
SENATOR KYRSTEN SINEMA
Senator SINEMA. Thank you, Mr. Chairman. I appreciate Mr.
McDonough joining us today. My office is increasingly hearing from
Arizona veterans asking for clarification on how to receive the
COVID vaccine from the VA and when they will be able to receive
it. My staff has been working locally to make sure information is
getting out to the community, and this highlights the importance
of having Senate-confirmed leadership at the Department of Vet-
erans Affairs as quickly as possible.
I have introduced, with Senator Tillis, the Ensuring Survivor
Benefits During COVID legislation to address concerns that sur-
vivors of veterans who died from COVID may not be granted their
earned benefits if the death certificate only identifies COVID–19 as
the cause of death, without considering the impact of other service-
connected illnesses.
If confirmed, will you work with me to ensure that processes are
in place to address these concerns?
Mr. MCDONOUGH. Yes, Senator, I will.
Senator SINEMA. Thank you. Over the last year, my office has
worked with the VA, American Legion, and Philips North America
to bring an Atlas site to Arizona. We hope to provide more details
about that site in the coming weeks. The Atlas, or the Accessing
Telehealth through Local Area Stations program, is part of VA’s
Anywhere to Anywhere telehealth initiative to bring a VA tele-
health access point to underserved communities. In Arizona, there
may be many rural and tribal communities that could benefit from
this and other telehealth initiatives.
If confirmed, will you continue to work with our office to expand
telehealth opportunities to rural and tribal communities?
Mr. MCDONOUGH. Yes, I will.
Senator SINEMA. As we consider expansion, we have to acknowl-
edge the challenges of access to broadband in these communities.
As the VA continues to expand its telehealth initiatives, what role
do you feel the VA should play in addressing broadband access?
Mr. MCDONOUGH. Thank you, Senator. I think the VA has a key
role to play in coordinating with other Federal agencies and with
the FCC to ensure that the kinds of access questions that VA can
lead on, including on telehealth, can be expanded by better
broadband access more universally available. So I think there is a
critical role to play within the interagency, and that, if confirmed,
would be precisely what I intend to do.
Senator SINEMA. Thank you. You know, in Arizona the Navajo
Nation has been hit particularly hard by COVID. The CDC notes
that Native Americans are at a disproportionate risk for complica-
tions from COVID due to health and socioeconomic disparities in
these communities. They also experience other inequities such as
high instances of homelessness and challenges accessing clean
drinking water and sanitation.
33
If confirmed, what steps will you take to ensure the VA is best
serving Native American veterans?
Mr. MCDONOUGH. This would be a fundamental priority, con-
sistent with the President’s Stated priorities on equity and con-
sistent with what I have said throughout the day today, which is
how are we increasing access and improving outcomes for all vets.
And third, consistent with the direction to me from the President
to ensure that VA is welcoming of all veterans, including, obvi-
ously, Navajo and other Native American veterans.
So, there is a fundamental role for us, for the VA to play there,
and if confirmed I would intend to play that role.
Senator SINEMA. I appreciate that. Thank you.
Information technology modernization has been and continues to
be a central focus for the VA. If confirmed, you will be responsible
for overseeing these major modernization efforts. As cybersecurity
threats continue to increase across the U.S., what steps will you
take to ensure that VA is equipped to protect against cyber threats
and is practicing good cyber hygiene?
Mr. MCDONOUGH. Thank you, Senator. Obviously, the range of
cyber threats that we confront as a country is only growing. Having
cybersecurity, cyber hygiene front and center, not only for the
major programmatic efforts at the Department but also for individ-
uals in the work force at the Department will have to be a funda-
mental priority for the next Secretary, and if that is me I would
intend to make cybersecurity a key priority.
Senator SINEMA. Thanks. You know, the VA still has a number
of legacy systems it is supporting. These cannot only be costly but
also generally do not follow or accommodate today’s security best
practices.
Mr. MCDONOUGH. Right.
Senator SINEMA. What would be your approach to addressing leg-
acy systems, if confirmed as VA Secretary?
Mr. MCDONOUGH. Thank you, Senator. Obviously there has to be
a fundamental focus on cybersecurity and cyber hygiene across the
enterprise, one, and then two is effectively performing on the mod-
ernization efforts will allow VA to not only increase security and
increase performance and outcomes for vets but will also reduce
costs over time of these legacy systems. So executing on the mod-
ernization has to be a key priority.
Senator SINEMA. And I see that my time has expired. With your
indulgence, Mr. Chair, I will submit the rest of my questions for
our nominee, and I want to thank him for joining us here today.
Chairman TESTER. Thank you, Senator Sinema, and in that re-
gard the questions need to be in by tomorrow at 5 p.m.
Last but certainly not least, and I have been in your position be-
fore, Senator Cramer. Senator Cramer.
SENATOR KEVIN CRAMER
Senator CRAMER. Thank you, Mr. Chairman. Thank you, Mr.
McDonough, and I do not mind, frankly. It means that I do not
have to ask Denis about rural veterans, Native American veterans,
telehealth, COVID–19, MISSION Act or Community Care Network.
So we can get right down to the business of Clemens Stadium,
34
Johnnies football, and Jake Christiansen Stadium versus the Cob-
bers. How about that?
Mr. MCDONOUGH. I like that.
Senator CRAMER. All right. Well, we will get to that on your way
to Alaska, when you stop in Fargo. Okay? But you and I did have
a wonderful discussion. I want to tell you how much I appreciated
the meeting we had earlier this week. We did drill down on a num-
ber of these issues, as well as one of my most important issues,
that is probably a little more unique to me, and that is, of course,
the use of alternative forms of therapies, treatments, particularly
hyperbaric oxygen treatment.
And the reason I am such a proponent of hyperbaric oxygen
treatment and therapies for veterans is because I have seen it work
so well. A number of veterans that I know have really had their
lives changed, and in some cases saved, by this important therapy,
as well as others, who have had injuries that come from sports,
particularly head trauma, traumatic brain injuries.
And so I am a strong proponent of it, and by the way, I very
much appreciated your dialog with Senator Moran, because he was
getting to the heart of an issue that I think a lot of us, as you could
probably tell, are challenged by, and that is just how large the bu-
reaucracy is and how difficult it can be to maneuver it, and how
often we will actually pass legislation that is signed into law only
to have it sort of either slow walked, whether intentionally or unin-
tentionally, and I happen to believe that most of the time it is with
good intentions.
But with regard to HBOT, I was able to get language in the John
Scott legislation, that you are very familiar with, that would au-
thorize the Secretary of the VA to enter into public-private partner-
ships to research the effectiveness of hyperbaric oxygen therapy.
And it would require—and I stress require—the VA to use an ob-
jective test to measure the effectiveness of hyperbaric oxygen ther-
apy, and it would commission a comprehensive review and study
of HBOT, both within the VA, and I think importantly, with out-
side organizations as well, because there is just a lot of experience
out there that, to this point, has not been brought, in my view, into
a good peer-reviewed objective study. But it would be completed
with a recommendation then from the VA about the effectiveness
of HBOT.
I stress that because that is language in the bill that makes it
law, and I believe there are, as I said, real benefits to this innova-
tive therapy, and by the way, other innovative therapies. And I
think you and I talked about the important role the VA has played,
the leadership role it has played in some very effective alternatives
to traditional medicine or in addition to traditional medicine.
And really want to just, I guess again, thank you for listening
and get a reaffirmation of your commitment to fulfill both the letter
of that law and then the spirit of it, and then accept my invitation
to Fargo on your way to Alaska to see Dan Sullivan.
Mr. MCDONOUGH. Any time I can go to Fargo I will take it, one.
Two is I would be happy to recommit to making sure that we dig
into the analysis of the therapy, consistent with the intent in the
statute, and consistent with getting to the brass tack here, to find
35
out what is the best way and best vehicle to deliver the kind of
care to our vets that they have earned.
Senator CRAMER. I appreciate that. I have written down a num-
ber of the things you have said, in quotes. I will not repeat all of
them, but one thing you have said a couple of times in response
to the question about your cred, if you will, your street cred for this
job—and I love when you say ‘‘I know how government works.’’ I
think that is oftentimes an underappreciated skill set and gift and
experience. So I believe you when you say that. You have every
reason to know how government works. As you have said, you have
seen it from both ends of Pennsylvania Avenue. And count me as
an affirmative vote——
Mr. MCDONOUGH. Thank you.
Senator CRAMER [continuing]. and someone who looks forward to
working with you once you are confirmed.
Mr. MCDONOUGH. Thank you, Senator.
Senator CRAMER. And with that I yield the rest of my time, Mr.
Chairman.
Mr. MCDONOUGH. Thank you.
Chairman TESTER. Yes, thank you, Senator Cramer. Before I
have my closing remarks I will turn it over to the Ranking Mem-
ber, Senator Moran.
Senator MORAN. Chairman Tester, thank you very much. It was
tolerable to have you in the chair today, and it is not exactly what
I wanted but it is not a bad deal either, so thank you for working
with me and my colleagues on this side of the aisle as we commit
to do to you and your colleagues.
Mr. McDonough, before I ask you a question I wanted to point
out to the Committee that we have a new staff director, now on the
minority side, who came from the House minority side but was in
both the minority and majority staff world in the Senate, and is re-
turning now to the Senate. This is his first meeting since his ar-
rival, and John Towers is behind me, and we look forward to hav-
ing him and his help. And we make him available to you, Mr.
McDonough, should you be confirmed.
Mr. MCDONOUGH. Thank you.
Senator MORAN. Mr. McDonough, would you commit to me that
you are a fan of the Chiefs?
[Laughter.]
Mr. MCDONOUGH. Senator Moran, I am a big fan of Patrick
Mahomes, but I am a Vikings fan, and I hate to admit that I am
kind of old school that way.
Senator MORAN. Well, you could have answered the question in
a worse way.
Mr. McDonough, I thank you for your interest in serving as the
Secretary of the Department of Veterans Affairs. I thank you for
your testimony today. I just wanted you to know, based upon what
you have said and what I have learned about you that I will vote
for your confirmation.
Mr. MCDONOUGH. Thank you.
Senator MORAN. And I will ask my Republican colleagues to do
the same. And I look forward to working with you, and your com-
mitment is evident to me, and I think we can accomplish a lot on
behalf of those who served our Nation, working together.
36
So best wishes to you and your family, and I thank them. I know
your wife, in particular, is involved in veterans’ services, and I
would express my gratitude, as I did personally to her, but here
publicly, for her efforts. And so as a family we wish you all well
in this new endeavor——
Mr. MCDONOUGH. Thank you very much.
Senator MORAN [continuing]. and I am grateful for your service.
Thank you.
Mr. MCDONOUGH. Thank you so much, Senator.
Chairman TESTER. Senator Moran, Mr. McDonough, I do not
know if Moran had that question that he asked you and knew the
real impact of it, but not only is Jerry Moran a Chiefs fan but my
Committee director is also a Chiefs fan. So, you know, I mean, I
guess it does not matter if you are a Vikings fan as long as you
root for the Chiefs in the Super Bowl. So, Okay.
I also want to welcome John Towers. John is somebody that both
Jerry and I had the opportunity to work with when he was in the
House. And as you well know, Denis, oftentimes a relationship be-
tween the principles is important, but the relationship between the
staff is more important.
Mr. MCDONOUGH. Hear, hear.
Chairman TESTER. And so I want to welcome you on board, John.
And I also want to thank your wife and your family that have
sat attentively behind you, nodding their heads and paying atten-
tion. I cannot see their eyes so I do not think they nodded off, very
often anyway.
But the truth is, as we all know, that the power and the ability
for any of us to serve in any of these positions, whether it is elected
or staffed, really relies with the family and how important they are
to our ability to do our job. And I want to thank our Committee
today for their thoughtful questions and their belief and the way
they put across the fact that veterans are No. 1 in this Committee,
and that is why we work on this Committee so well.
You know, I looked at the FBI report the day before yesterday,
and I think Senator Moran is going to do it tomorrow, and I do not
think I am out of school by saying that it was pretty darn stellar.
In fact, I told the lady that brought it in I would have to pay a
lot of money to get this many recommendations of what a fine fel-
low I am. And so you are a highly qualified candidate, and I believe
that you will work with this Committee to ensure that we keep the
promises to the men and women who have served their country,
and their families too, by the way.
And Senator Moran visited, and we have an agreement that we
plan to meet again on Tuesday to vote on Denis McDonough’s nom-
ination to be Secretary of the Veterans Affairs, as well the Com-
mittee rules and the budget. And that is what we are going to do.
I think the fact that you had not met with Senator Tillis or Senator
Sanders yet, and the fact that the Ranking Member had not seen
the FBI report requires us to do it then. Otherwise, I would have
tried to move it up, but I am not going to, based on that.
I would ask, as I pointed out to Senator Sinema, that any post-
hearing questions be sent to the clerk by tomorrow at 5 p.m. And
then we will need those responses back from you before we vote on
Tuesday.
37
With that once again I want to thank you and your family for
being here. Always a pleasure to work with Senator Moran. This
hearing is adjourned.
Mr. MCDONOUGH. Thank you.
[Whereupon, at 5:08 p.m., the Committee was adjourned.]
APPENDIX
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RESPONSE: Yes. If confirmed, I commit to look into this program to assure that it is being resourcedand
prioritized to meet Congress’ intent.
Post-Hearing Questions for the Record
Senate Veterans’ Affairs Committee
Hearing to Consider Pending Nomination of Denis R. McDonough
January 27, 2021
From Senator Thom Tillis
Vaccine Prioritization
Background:
On December 19th, 2020, a number of veteran organizations sent the attached letter to the
CDC’s Advisory Committee on Immunization Protocols (ACIP) raising the concern that the
Veterans Health Administration would be unnecessarily limited in classifying various
disabled veterans as “high-risk” if they do not fit into one of the high-risk conditions
identified in the ACIP recommendations. In response, members of the ACIP specifically
encouraged local communities delivering the vaccines (which VA effectively is for the patients
they serve) to not consider the ACIP list as exhaustive, but specifically to considerhigh-risk
conditions with smaller populations which wouldn’t otherwise cover a population large
enough to warrant ACIP identification.
During a January 14th, 2021 conference call between VHA and veteran organizations about
vaccine distribution, VHA staff reported that the Department was compiling data about
specific conditions which may not fit the ACIP categories, but which are just as high risk and
prevalent among VHA’s population. VHA staff indicated they were looking at that veteran
specific data to possibly add more high-risk conditions.
Unfortunately, we are now receiving reports from the field that VHA leadership directed
VHA patients only be given the vaccine under priority 1-C if they have one of the specific
ACIP high-risk conditions, and no others.
Sent via email to ACIP@cdc.gov
Submitted via www.regulations.gov
RE: Docket CDC-2020-0124
Dr. José R. Romero, MD, FAAP
Chair, Advisory Committee on Immunization Practices
Centers for Disease Control and Prevention
1600 Clifton Road, NE
Atlanta, GA 30329-4027
Dear Chairman Romero and Members of the Advisory Committee:
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