 Well good afternoon. Today I am here with disabled American Veterans Executive Director Randy Rees to talk about VA's response to the COVID-19 pandemic and how we can care for our veterans throughout this crisis. I want to thank the DAV and your auxiliary members. We're grateful to have you with us even though it's just virtually. So be better if it was in person but you know circumstances warrant that we remain safe. I want to give you a brief update that on Tuesday President Trump signed HR 6322 my bipartisan Student Veteran Coronavirus Response Act of 2020 into law. That was a big win for our student veterans and I'm grateful for the DAV support of that legislation. Currently we're getting daily slide decks from the VA with facility level data on the number of veterans and employees who have been tested. How many of those are positive and what the better occupancy rates are? What the supply of PPE is? And sadly the number of veterans and VA staff who have died as a result of COVID-19. I just got a report yesterday from my own local Loma Linda VA that an employee who was I think 64 years of age passed away after having been tested positive some two or three weeks ago. We've also had weekly calls with both the Secretary and Dr. Stone related to the department's response to COVID-19. As I'm sure you're aware Randy we're pressing for more transparency throughout the crisis. What is most important now is that we know what VA needs to keep their staff and veteran patients safe. And that's why I wanted to talk with you today to see how it is we can help and see how things are going. First off you're doing okay? So far so good. Definitely different to make the transformation to teleworking from home and the whole DAV team is teleworking from home but we're all engaged and we're still taking care of business, taking veteran calls and dealing with them online to include the entire claims process and appeals. That's wonderful to hear. Your team is okay for the most part. I've kept both my Washington staff, my district staff they're teleworking as well and we started that fairly early but your team is okay too? Team is doing great and I got to tell you a great compliment to the initiative taken by your staff and especially the first teleconference we had and now doing this virtually along with some of your virtual round table that you had about homeless veterans. Kudos to everybody on the House Veterans Affairs Committee. Well thank you brother. I appreciate that. I really do. But it was the first one you know. I was just on one the day. We're kind of proud of the fact that we were the first out of the gate and leave it to the Veterans Affairs Committee with its tradition of bipartisanship that we got both sides to participate. So we appreciate that feedback. So what are you hearing from your membership? What seems to be their top concerns at this point? Well top concerns as you can imagine with 20% or 1 in 5 of the deaths so far reported being from the veterans population is health. A lot of veterans have a lot of chronic underlying illnesses, concerns and just being able to engage in daily activities is a great concern. And then of course behind that is the increased stress and financial resilience as to whether they'll be able to recover after the disaster is over. Yeah you know our Dr. Stone who is the executive in charge of the Veterans Health Administration you know talked about that our veteran population that we serve in the VA trends older precisely in that most vulnerable age and they have a lot of chronic conditions. A lot of you know they're whether you're talking about age and orange or you're talking about any number of complications that veterans have. They're older, they trend male and you know they have those complex underlying conditions which make them extra vulnerable to infection and its complications. And I was just talking with the PVA before I was talking to you today but they noted that VA has had a success in terms of having a very low rate of infection at the community living centers and at the the spinal injury centers that they have and I know that the VA put a lot of attention on that early they shut down visitations they more recently I think they've done more intensive testing at those sites and it only goes to show that we need that ramping up of testing generally. I'd love to know that we can frequently test all of our employees and that we could do that with the veteran population. All of America really we I think we could use that from use that. Anything else come to mind you're hearing from your members beyond those things that you mentioned so far? Well I think mental health is a significant challenge when we talk about health care sometimes we we categorize that as chronic elements and mental health has a significance within the veterans population on any given day but then you add the constraints of being isolated financial distress it really wears hope down very quickly so mental health is probably at the pinnacle of concern for DAV and our members. I'll probably mention this again but let's take a moment now to plug the veterans crisis line which is open 24 hours a day seven days a week that number is 1-800-273-8255 that's 1-800-273-8255 select option one or you can text 838-255 that's 838-255 I mentioned that because what you just said that veterans are are feeling extra stress I know that the VA has been doing more outreach to those veterans they think are at risk but they may not mind everybody so and so you want to say something about that that they have the you've you've you've noticed that that outreach from the VA? They absolutely have as a as a user of the VA system myself I get text messages quite frequently and some of those text messages about resources from mental health in addition to that you know they've actually done a great job of following up and reaching out just to make sure that the social interaction if you want to call it a buddy check is going on they're even doing peer groups through telemedicine so anytime that you can have a group therapy going on I don't think that VA in the world of mental health in as fast as we've moved in the last six weeks going from face to face to telemedicine they haven't missed a beat so very very proud of the resilience of the VA and being able to keep pace yeah you know the VA takes so many hits and my job as a chairman is to is to be a watchdog and oversight but you know I also want to make sure that we never give the misimpression that the VA is broken uh that it offers great care and especially mental health care and so it's important while we want to be critics and we want them to be better that we give them a pat on the back when they get things right and so I'm hearing that they've been doing the outreach on a mental health basis and I am you know proud of the fact that the of the long-term community living centers a long-term care facility is where we have impatient no resident we have impatient care and a lot of those folks are probably your members that that they've been able to keep them for the most part safe from the virus they've tried to keep them sequestered from other parts of the hospital that they've been instituting internal policies we have seen state veterans homes not be so lucky and the VA does not directly run those they fund them but they don't directly run them and in a few couple of states we've had some tragic collapses in care and and we have a lot of veterans that are staying in private nursing homes and so I know the VA has been reaching out to many of the governors the many states out there to find out where our veterans are in these private nursing homes and under the fourth mission they're even like using they're being proactive they're trying to go out and find nursing homes which may be under collapse they're going to say well you have a veteran there we'll offer to come test them take him to our facility if we need to but we can also since we are since the VA is an expert in taking care of older people they have a lot of advice to give and expertise to give to these private nursing homes that are overwhelmed they've just been overwhelmed absolutely you know I think the last report that the secretary gave this last Wednesday indicated that they had taken the initiative in 33 states to engage with the governors and local municipalities to go and check on veterans and those nursing homes and sometimes you know they're sending in a strike team to give an actual helping hand other times it's given them PPE but certainly exceeding the expectations of the average bear when it comes down to those nursing homes and VA has probably set the standard if you want to call it if we after this is overdue and after action review the new rule book could be we take care of not only the the CLC's of the Department of Veterans Affairs but we get a little more proactive with the state and those other municipalities that has veteran homes yeah um yeah you know the after we don't want to get I don't want to make this but after action but um let's flag that for I know you're going to flag it uh Dr. Stone has mentioned to me uh and you wasn't trying to be critical of FEMA because FEMA has to do its you know things aren't going to run smooth and we're putting together the government's trying to get its act together in real time uh but the VA made that may need to have its own stockpile uh and we're going to have to think about that stockpile not just for our first mission but we're going to have to think about that stockpile for our fourth mission which would include veterans and state homes uh and we're going to have to think about how VA fits into a national pandemic response but we're definitely going to need to be masters of our own fate in terms of having our own stockpile of PPE and other vital supplies um this isn't new concern after 9-11 the IB the VFW of Paralyzed Veterans of American DAB in our independent budget we put out you know some critical concerns that the necessary fourth mission preparations wasn't being quite up to par and unfortunately even under these circumstances while it's a once in a hundred year predicament we could be at war too and have a fourth mission back up to an ongoing war scenario simultaneous with the pandemic and so while we look at this as a worst case scenario it could actually be much worse yes well we we were down in Puerto Rico uh in the aftermath of Hurricane Maria and um we I don't think anybody anticipated that an entire island that the entire island would be out of commission and out of commission for longer than we thought so we were talking way back in August of last year about the need to rethink our caches to supply and disaster preparedness not just in terms of what's driven the fourth mission but what is concerns that driven the fourth mission in history initially nuclear attack anthrax you know terrorism uh but that we were encouraging the VA to take seriously um national disasters and I it's pretty clear that we have not we weren't really thinking in terms of pandemic how VA would fit and it's it goes beyond the VA so um uh and I was aware that there was a revisiting after 9-11 uh and that quite a bit of law was changed uh apparently the whole national stockpile idea kind of began with President Clinton reading a thriller novel uh and it was he got so concerned and scared by what he read in this book he said we got to create a national stockpile and then uh 9-11 happens and then there was rethinking then and um so Dr. Stone has mentioned that we we need to go back and think about how VA fits into the fourth mission and I think we are going to redefine the fourth mission uh going forward uh to include you know uh natural disasters hurricanes and whatnot but also extreme weather events like we've seen in Puerto Rico but certainly pandemics are going to have to re uh we have to revision everything um you know in regards to VA one of the things that mission really puts into places you got to maintain that strong VA presence because the surge capacity the excess capacity in the private sector truly isn't there and we see that now that as quick as the pandemic hit the resources in the community quickly withdrew and VA had to centralize those resources you know case by case analysis to who could and couldn't get that care and ultimately VA is the caretaker for all the veterans even if on a routine basis they get local community care the surge capacity isn't there in the private sector VA is responsible so it's got to stay strong we're going to have to surge capacity or excess capacity whatever you call it we're going to have to rethink in terms of infrastructure uh asset review um and I'm really pleased to see the secretary is uh aggressive about using his national emergency authority uh to onboard more staff uh he tells me we he's he's brought on 10,000 more people of course I think you and I uh and all of the VSOs have been concerned about the 40 to 50,000 person vacancies and and I I I know that we are going to chime together uh to get to make sure that the secretary continues to hire more people uh we have a chance to hire very high quality people at the moment and I want to make sure we put in place the policies that are going to make those people want to stay uh make make it a career at the VA uh and that we don't stop at 10,000 we really try to step pva was telling me about the the the 1000 nurses that were determined to be needed at the spinal uh the spinal injury centers that they have uh and I'm sure you your organization uh has a bead on where we need more staff absolutely when we talk about mental health care need more staff women veterans need more staff not only more staff but talented staff that have the skill sets to take care of our women's veteran cohort there's lots of need out there yeah um you know um uh how are your members uh who rely on caregivers or home services doing what are you hearing uh from caregivers uh caregivers are already you know struggling with enormous responsibilities and feelings of isolation what support or services are available for them during this time well you know caregivers is a sensitive issue for for DAV because it was a big piece of the mission act and those pieces never expanded which means a whole generation from world war two all the way up to the vietnam war aren't getting the services today that they should have if everything would have gone well and they would have expanded in october 2019 but having said that for those who receive caregiver services um the actual personal protective equipment seems to be the largest challenge that we hear that some of the routine daily maintenance activities is still a challenge and if they've got third parties who access the home in order to provide those services some of those challenges because of COVID-19 as well we've made sure that the under secretary for health is aware or the executive in charge if you will and um i think that's been a topic of every wednesday's vso call with the secretary that there's ongoing challenges whether it be retired military or whether it be the caregivers themselves ppe is a significant challenge for caregivers right now um do your members tend to use like the aid and attendance um like pva folks do um and so um i'm i'm trying to work on some language in the next we could talk about this when i talk about what you would like to see in the next carers package but um it seems that one solution is that we need to raise the uh aid and attendance allowances uh so that your members are able to hire uh and contract out with people who now have the added costs of ppe uh that are going up and i realize this issue predated the pandemic uh about having adequate um adequate resources to be able to contract out with the people you need to help take care of you take you know take care of your members um uh we've learned some um uh early what you know what are some of the lessons that we've learned from this crisis uh that the VA caregiver support program must consider as they move forward with expansion well i think probably the biggest piece when you when you think of caregivers because these are first of all we got to put it in context these are our most severely disabled veterans and then to future uh you know thankfully the regulations that are forthcoming are going to also include illnesses in that regard but this is the most vulnerable population being veterans one in five of those who are dying due to COVID-19 this is the most vulnerable of the most vulnerable population they all have serious underlying chronic health conditions and it's the equivalent of being in a nursing home in every one of their houses so we really have to make sure that we put them in the correct context that if we're going to take care of those who are in the community living centers at VA the nursing home the next step is to make sure everybody that's getting those community care resources uh are retracted back in and everybody getting the home caregiver services are all contained in that same bubble of protection that's a really good point you're making there i i can totally get that the way you said it um the people uh that are being taken care of at home and they're a caregiver program uh they're we ought to think of them as sort of many community living centers and that what we do for the community living centers we ought to be having that same mindset for these folks at home that was you're good at this you're good at the advocacy i like that uh made it real clear for me uh for your members who rely on the community care network the ccn's out there what are you hearing about their experiences since the crisis and lockdowns begin how does the role of community care need to modify in terms of national emergencies well i don't think any of this was predictable um so in in large measure we're seeing the same reaction across the country that if there was actual capacity that's there of course they're still doing the business of VA in where there wasn't for those doctors who are doing a VA community care as a part of a network they're following those network rules and those services have all been turned off except for emergency and urgent care again VA being the fallback and they've retracted all care back to VA okay um i i want to take this moment where we're talking about ccn's and uh that veterans who um are not enrolled in the VA during the time of this crisis if you test positive for COVID-19 uh and you start getting complications you can receive health care on a humanitarian basis at the VA so regardless of your income regardless of your eligibility for VA care uh the VA is going to take care of you if you are a veteran uh at you know it's 170 plus medical centers across the country what you need to do is call 1-844-698-2311 that's 844 or six or six i think i lost your volume volume went out okay let's see you're back back okay press three to be connected so i want to give that number again 844-698-2311 also want to add that uh you could be just have been discharged with other than honorable discharge also you're eligible during this national emergency um randy i wanted to thank you for coming to the women's veterans task force with your suggestions for contraception access and addressing intimate partner violence during this time and for women veterans assessing gender specific care from VA was already a challenge but now because of this public health emergency any kind of preventative or routine care is more is now more difficult um how do you see these disruptions to non-covid care impacting women veterans in a long term well you know it's very difficult to to save when it's going to end um so while we've had some short-term disruption the long-term consequences will be more significant not only from the actual physical care walk-in services clinics that's available to all veterans but for women veterans in particular unfortunately they they had some challenges in order to get the care and then mental health overlays that go along with it they have a comorbid risk factors for both mental health care as well as some of the risk of being homeless so women veterans is going to be a significant challenge that we have to monitor it as long as this crisis goes on and when the crisis actually lifts we got to make sure that we don't leave them behind when we start to reopening just because they're a minority of those serve wonderful um well you know we're we have pending before us this uh the cares to package we pass cares one we pass the cares 1.5 to get more money to small businesses um as we start to work on the negotiations for our next coronavirus package that's known as cares two what are the priorities for gav uh that you want to see in that package lost you sound um we can hear me they're hearing now so we have three uh priorities that we'd like to just uh touch on and and bring to your attention the first of course is you know when it comes down to uh veterans and those with issues with finances we'd like to see a part of that package be a mandate that management automatically under national emergency circumstances be suspended so no debt collection occurs for that period of time plus 60 days and there's a bill out there hr 6590 right now that for the most part puts us on the table uh we'd like to see that move forward in the next package in addition under uh champ va uh unlike the under the affordable care act where healthcare is automatically conveyed to the age of 26 under that program you have to be a full-time student so where there's interruptions of student status they may have actually lost full-time student status we don't want people to be temporarily kicked out or permanently kicked out of the champ va program so we'd like for it to coincide with the affordable care act and if you've got champ va that carries through to age 26 your healthcare purpose okay last under national emergency uh circumstances as a temporary but an ongoing protocol you know for comprehensive health coverage of veterans regardless of where they may be we'd like to have va automatically become the first party primary payer for healthcare and that would include emergency care urgent care and for ambulance services during that national emergency so there's no quibbling or debating or trying to work out for a year or two after the fact who's paying the bill for veterans care that's really interesting i just want to check with daniel did you get everything he said because uh on my end the sound went out a little bit when he was talking yeah i was able to pick up pick it up okay great um well anything else that you want to add to that well i think that as these packages come through um you know there's a lot of debate and deliberation about dollars and cents and sometimes i think that veterans themselves they get deflated a bit because it doesn't appear that they were a priority i'll just give you an example when the impact payments came out there was a lot of automatic built-in legislative mandates of who got those payments automatically posited and it seemed like it was a protracted delay in order to get the administration on board to get automatic payments to va beneficiaries uh it'd be nice to have an emergency provision since we've got some lessons learned now so that we don't repeat that in the future if we need to have an automatic payment of any kind from the federal government they should use the protocols and lessons learned here so that veterans are included in that package that's really good so there's when we're in a we're in a situation we're slapping things together that we somehow preserve what happened here i mean you know people without veterans who don't file for their taxes um how are they going to get that automatic payment and we still have an issue with uh veterans that um five uh the five hundred dollar per dependent is an issue so um um i i need to um uh bring this to a close i wish we could i think we've lost your volume again we've had work that we've been able to do um uh together on veterans issues and i want to thank um all of your members for the leadership i know that they're exerting in their own communities uh to help the country get through this moment they know what sacrifice is uh they know what it means to obey orders they don't especially like but they know uh that you know in the spirit of getting the job done we've got to get through this together so uh i know they're bringing a tremendous resource to the country which is themselves so thank you for uh you and all your what your staff does on behalf of veterans and um it's just an honor to work with y'all thank you chairman to kind of you know da v we've been doing this this year's our 100th anniversary um bad time to have your centennial anniversary but we're in this together we'll be okay together and if veterans need help they can reach out to da v let's go to da v dot org we'll get by my hand all right all right thank you have a good day thank you chairman to kind of take care