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Office of Public and Intergovernmental Affairs

Remarks by Secretary Denis R. McDonough

Senate Veterans Affairs Committee Hearing on Wait Times and Access
Washington, DC
September 21, 2022


Chairman Tester, Ranking Member Moran, distinguished Committee Members—thank you for your unwavering support of Veterans and for this opportunity to testify.

At VA, we come to work every day to ensure access to timely, world-class care for America’s Veterans—ensuring they receive the best possible care wherever they access that care--at VA, or in the community.

I’m talking about Veterans like Amanda Barbosa.

I first met Amanda at the U.S. Capitol early last month—one of those tough Vets who spent nights on the steps of the Capitol until the PACT Act passed.

Amanda’s been through a lot. At what she remembers as the lowest point in her life, she came to the VA clinic at Fort Benning, Georgia.

And she’s said, “VA saved my life, and turned it around, completely.”

Today, Amanda’s thriving—and she’s devoted herself to saving other Veterans’ lives.

Veterans like her husband, Rafael, a Marine Vet and an Army Vet exposed to toxins during three deployments to Afghanistan, Iraq, and Kuwait.

Just two years after he was honorably discharged, he was diagnosed with cancer—and Amanda started caring for him and helped file his VA claim.

Three weeks later, they had a decision—100% service connection.

Amanda says that experience made her a stronger, better advocate for others. As Amanda sees it, it’s her great privilege to stand with other Vets and their families, to help save lives.

And that’s what we want to do at VA—stand with all Vets, be their advocates, and ensure they have access to the care and benefits that they, their families, caregivers, and survivors have earned.

And I know that’s what this committee also wants.

Since President Biden took office, VA has delivered more care to more Veterans than any time in our nation’s history.  

And when it comes to providing world-class healthcare to Veterans and their families, study after study shows that we’re delivering better health outcomes for Veterans than the private sector which is why Veteran trust scores for outpatient VA care have averaged over 90% during the past year.

Notably, in 2021 we had a record 33 million completed community care appointments. We are not where we need to be on timely scheduling those referrals—but as we have seen this record volume, we are making steady progress in reducing wait times.

We have needed to fix the way we measure and publish wait times for Veterans since before I arrived at VA.

So, in July, after working with VSOs, with you and your staffs, and having listened to the IG and GAO, we updated the website so that average wait times better align with what Veterans experience when they make their own appointments—and give Veterans localized information that allows them to choose the care that’s best for them.

We also recently, and finally, completed the comprehensive, Congressionally Mandated Report (CMR) on Access to Care Standards.

At the end of my last appearance here, I said to Senator Moran that I was considering changing the criteria for access standards for community care—but on reflection, and after consultation with our new Undersecretary for Health, Dr. Shereef Elnahal, I have reconsidered.

VA is proposing no immediate changes to the current designated access standards. However, we are planning to propose incorporating VA telehealth availability into determinations regarding eligibility.

I know this will require careful consideration and that is why we will welcome public and Congressional input on this proposal when we make it.

Telehealth is part of the evolving ways in which care is delivered, and improves our ability to provide care. 

Ensuring Veterans receive timely access to world-class care—including each of those 33 million appointments in the community—is influenced by many factors in addition to access standards, including:

  • The enduring impact of COVID and the pandemic on how healthcare is delivered.
  • The state of VA infrastructure—which I learned from our leaders in Des Moines last week too often impacts whether a Veteran can receive care at a VA facility.
  • Our sometimes too slow internal handling of referrals to the community.
  • And the healthcare employee shortages that plague not just VA but all of health care and thus, impact what care is available in the community and the VA direct care system.

We’re overcoming all of these challenges, often with your help, including through passage of the PACT Act, to advance one of our top priorities—getting more Veterans into VA care because study after study shows Vets in VA care do better. 

So, with your help, we are going to continue delivering for Veterans like Amanda and Rafael Barbosa and millions of others.

And giving them the very best, because they deserve nothing less.

Again, thanks for this opportunity to testify. I look forward to your questions.