Hearings to examine building a 21st century VA health care system, focusing on assessing the next generation of VA's community care network.
Committee on Veterans' Affairs
2026-02-11
Source: Congress.gov
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Transcript
Good afternoon, everyone. Thank you for your presence. Welcome to this week's hearing. Two weeks ago, we had the opportunity to discuss with Secretary Collins his vision for bringing the organizational and governance structure of the VA's direct care into the 21st century. Today, we're here to discuss how to achieve that same goal for the VA's community care system. Health care is local. And for many veterans in Kansas and across the country, the ability to see a doctor in their community is not a luxury. It's an essential part of their health care and well-being and the ability to use the VA health care benefits they earned through their service. Congress recognized the reality of this circumstance in 2018 with the enactment of the Mission Act. The Mission Act intended to make certain that no veteran would be limited by geography, long wait times, bureaucratic barriers, the need for specific kind of care in seeking care from the VA and that every veteran would have the opportunity for meaningful choice in where and how they receive their care they require. This afternoon, we're here to discuss where the VA has made strides in delivering on that promise and where it's fallen short. We will also discuss where improvements are needed to make the VA's community care program stronger, more sustainable, and more successful by putting the veteran first, expanding meaningful choice, and providing care when and where veterans need it and want it. To that end, I was encouraged to see the VA release a request for proposals in December for the next generation of community care network contract, followed yesterday by a separate request for proposals to establish a national dental community care contract. In many ways, these procurements reflect a welcome focus on innovation, competition, and accountability. They also signal a long overdue long overdue progress toward upholding industry standards, embracing value-based care, strengthening program integrity, and addressing persistent challenges such as timely return of medical documentation that have frustrated veterans, providers, and policymakers alike.
Achieving these lofty goals can't be easy. The contracts must do more than look good on paper. The VA must deliver results for veterans, VA staff, and community care providers. and taxpayers by leading to real measurable improvements in access, choice, outcomes, and costs. I look forward to hearing from the VA witnesses this afternoon about how the department can meet that mission and how this committee can support them. With that, I recognize the ranking member, Senator Blumenthal. Thank you, Mr. Chairman. Thank you to our witnesses for being here today and for your service to our country and to
all the men and women who work with you, veterans among them, and dedicated to the mission of providing gold standard healthcare to all of our veterans. We're here to discuss the VA's next generation of community care contracts, which will total about a trillion dollars to be live, as I understand it, in 2027, which gives us time to assess what the needs are for community care on contracts that will be indefinite delivery and indefinite quantity, which is kind of scary when you think of all the indefinites there. And it emphasizes the need for strong oversight on the part of the Congress and the Inspector General. of the VA. And we can't really talk about community care without talking about its impacts on VA's direct care budget, because for many veterans, care in VA facilities is veterans' care. And what they are seeing now is losses of staff through caps on workforce, the attrition, of many of the skilled and dedicated men and women who have served and the potential for lower quality if we take our eye off the ball of direct patient care through VA facilities. My feeling is that the VA has to prioritize resources for expanding access to direct care by adding and expanding existing facilities, increasing staff to reduce wait times, and supporting the VA's gap services, such as telehealth, emergent and urgent care capabilities.
Community care is a critical component, and a supplement to VA direct care, it is veterans care. Community care is veterans care, no question. But it cannot supplant VA direct care. For all the reasons that everybody here knows well, it is the preference that veterans have to seek care directly at VA facilities, at least for many of them through VA providers. It matches or outperforms the quality of community care in many instances, and it is a more efficient use of taxpayer dollars. So, first and foremost, we need access to information. The chairman and I submitted a letter to the secretary after his appearance here with very specific requests for information that he promised to provide. There has been no response so far. We are hoping, or at least I will speak for myself, that that Information will be forthcoming. It is essential to judgments that will be made about community care as well about direct VA care. would oppose a blank check for community care without real guardrails, and establishing those guardrails depend on getting straight answers from the department that enable us to do basic oversight, including the request that we made on the record. I will just say committee staff have not received a quarterly briefing as yet from the Office of Integrated Veterans Care, the office overseeing VA's community care system.
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