<DOC> [109th Congress House Hearings] [From the U.S. Government Printing Office via GPO Access] [DOCID: f:26674.wais] THE VA'S FISCAL YEAR 2007 INFORMATION TECHNOLOGY BUDGET THURSDAY, MARCH 2, 2006 U.S. HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS, COMMITTEE ON VETERANS' AFFAIRS, Washington, D.C. The Subcommittee met, pursuant to notice, at 10:00 a.m., in room 340, Cannon House Office Building, Hon. Michael Bilirakis [Chairman of the Subcommittee] presiding. Present: Representatives Bilirakis, Strickland, Reyes, and Buyer. MR. BILIRAKIS. Good morning. Today we will examine the Department of Veterans Affairs (VA) information technology (IT) budget and review VA's IT expenses. It is certainly, as you know, not new to the Committee, nor is it new to the Subcommittee. However, this year we have for the first time a line-item breakdown of the VA's IT budget. Previously we would have to look at over 50 areas of the budget to figure out the Department's IT budget. On November 30 of last year, the President signed fiscal year 2006 Military Quality of Life and Veterans' Affairs Appropriation Act (PL 109-114), which included in the conference report -- which a provision that directed the VA to provide $1.2 billion for VA IT and IT restructuring, and further directed the monies should be set up as a new IT systems account. The law also authorizes the transfer of funds among various accounts, subject to Congressional notification and approval to perfect the accounting structure of the IT systems account. The law further mandated that the VA provide a comprehensive listing of priority projects for fiscal year 2006 not later than 30 days after enactment of the act. At this point, I think it is important to note that the Administration has requested $1.3 billion for IT funding in fiscal year 2007. While IT issues may seem mundane to some, and apparently they must, we make a significant investment in information technology (IT) each year, and I believe it is important that we ensure we are getting the best bang for our buck. Not included in my prepared remarks is the fact that we have -- Mr. Secretary and others of you, we have commended you. We have complimented you in the past, because even though we've been very frustrated and very disappointed in the progress of IT within VA. We do feel that it is probably far ahead from many of the other branches of the government, and we have complimented and commended you. Having said that, of course, that is kind of the good news. Consequently, today's hearing marks over a half-dozen hearings held by the Committee on VA IT issues since 2000. Previous hearings have focused not only on the budget, but also on specific programs and the VA's enterprise architecture, or organization of the Department's IT. While the purpose of the hearing is for the Subcommittee to act in due diligence and conduct oversight on the newly formed VA IT spending account, VA IT reorganization is a major focus of the Full Committee, and part of this evolving process. We are very complimented that the Full Committee Chairman, Mr. Buyer, is here with us this morning. Therefore, we would like to hear how the Department is proceeding with IT reorganization. During the September 14th, 2005 Full Committee hearing, led by Mr. Buyer, Deputy Secretary Mansfield stated that the Department was adopting a federated model for VA's IT infrastructure. Deputy Secretary Mansfield also reiterated VA's plans to move to a federated IT infrastructure model before the Senate Veterans' Affairs Committee in October of last year. However, as of last night, and I understand some things may have taken place this morning, but as of last night, March 1st, VA had yet to approve its IT reorganization implementation plan to move to a federated model. Given the slow pace of the Department's restructuring, the issue of VA IT reorganization funding is of concern to us. In fiscal year (FY) 2006, the VA received $7.7 million for the Department's enterprise architecture, the blueprint for the IT structure of the VA, to assist the Department in its IT reorganization. In this FY 2007, VA has requested $12.6 million, and yet the VA appears to have made little progress towards IT reorganization. The Subcommittee also has some concern regarding some of last year's funding projects. Included in the list of VA IT projects for FY 2006 was $25.9 million in funding for Financial Logistics Integrated Technology Enterprise (FLITE). For FY 2007, VA requested $39.5 million for FLITE. The Subcommittee would like to learn more about FLITE, and whether or not this is associated with Core FLS. I remind you, the Core FLS initiative -- I don't think I have to remind you, but I will anyhow -- the Core FLS initiative in Bay Pines, Florida, bellied up to the tune of $342 million after four years of poor or little project management. Also of concern are six IT projects that are projected to run on the new VistA system once the existing VistA legacy system is re-hosted. For instance, the scheduling replacement project that has been in development for 10 years, and aw we understand is not even close to implementation, as we understand. According to VA's budget, almost all of the costs associated with these programs are for development, with little to no funding for operations and maintenance. The Subcommittee and the Full Committee are extremely concerned that VA risks spending millions of dollars for developing software applications that will not run on the re-hosted program. As a matter of fact, VA has not provided a plan for re-hosting the 25 year-old system, but has gone ahead and started new software applications for the new-but-not-yet-in-place system. Today, we will hear testimony from Deputy Secretary Gordon Mansfield. The fact that the Secretary is the only witness to this hearing is an indication I think of the fact that we place great focus on this subject, and want to spend as much time as we can on this subject with him, and with of course the good people that he has brought with him. He is accompanied by the Honorable Jonathan B. Perlin, Dr. Perlin, Under Secretary for Health; the Honorable Daniel L. Cooper, Under Secretary for Benefits; William F. Tuerk -- Tuerk or Turk? MR. TUERK. Tuerk. Tuerk, Mr. Chairman. MR. BILIRAKIS. Under Secretary for -- I'm Greek Orthodox, so I tend to not use that word, forgive me. MR. TUERK. I understand. MR. BILIRAKIS. I don't know, why did I have to say that? Under Secretary for Memorial Affairs; the Honorable Robert Henke, the Assistant Secretary for Management; and the Honorable Robert McFarland, Assistant Secretary of Information Technology. I, along with the other Members, look forward to hearing your testimony and answers to Members' questions. [The statement of Mr. Bilirakis appears on p. 30] MR. BILIRAKIS. Steve, you don't mind if I recognize Mr. Strickland next, do you? I would now recognized Mr. Strickland, my good friend from Ohio, Ranking Democratic Member. MR. STRICKLAND. Thank you, Mr. Chairman, and to the Chairman of the Full Committee, my statement will be very short. So thank you for allowing me to precede, I appreciate it. MR. STRICKLAND. Thank you, Mr. Chairman. I look forward to hearing the VA's justifications for its fiscal year 2007 information technology systems request of $1.257 billion, an increase of $43 million over the fiscal year 2006 enacted level. This year, in our Democratic views and estimates, we recommended $1.249 billion, an amount lower than the Administration's budget request. We expressed concerns over funding levels for the VA's Financial and Logistics Integrated Technology Enterprise Program, or FLITE, and we recommended a decrease for this program. The majority has also expressed concerns regarding this program, and I know that I speak for all of us here in looking forward to your discussion regarding the FLITE program. My Republican friends, in their views and estimates, went further than we did in recommending additional cuts, eliminating funding for the health data repository, HealtheVet, VistA, pharmacy reengineering, and IT support scheduling replacement, VistA imaging, and VistA laboratory IS systems reengineering programs. They also recommended dramatically reducing funding for the VistA legacy system. Although I believe that we should look to any savings possible in the VA's IT account, I also believe that we should ensure that the VA has the resources to do the job today, and that any cuts that are ultimately made do not jeopardize larger savings that may be achieved down the road. This is especially important when we are dealing with the VA's electronic health record program, which is rightly held up as a model for other health care systems. We must ensure that the actions we take in regards to the VA's IT budget do not ultimately mean veterans not receiving the quality care they deserve. But before any actions are taken, the VA needs to produce a re-hosting plan and a transition plan for these programs. They must make sure that the VA has the resources to meet its essential IT needs, and does not seek funding from other accounts, especially the Medical Services. At the same time, we on this Committee do not want to be throwing good money after bad, which arguably has happened in the IT area before. I would like the VA to explain to us what it is doing in the area of cyber security, an issue all of us on this Subcommittee care about. In a bipartisan manner, we recommended an increase of $20 million for fiscal year 2007. Finally, I am interested in hearing from the VA about its experiences so far this fiscal year in the IT area. The VA is dealing with the new appropriations account structure in relation to IT, as well as explicit requirements mandated in the fiscal year 2006 spending bill. I believe that a separate IT account will afford us a better tool in which to conduct our oversight of the VA's IT efforts, or lack of efforts. I would like to hear from the VA how they are handling this, how it is ready to meet the challenges before it, and address the concerns of this Subcommittee. And I thank the witnesses for being here, and Mr. Chairman, I thank you for your courtesy. MR. BILIRAKIS. And I thank the gentleman. Chairman of the Full Committee, Mr. Buyer. MR. BUYER. I'd like to thank the Chairman, the Ranking Member, and the members of the O&I Subcommittee for your leadership on the issue, and I would only like to make this comment to our friends in the Administration: as you know, Capitol Hill can be a highly volatile place politically. So when there are moments in time when Republicans and Democrats stand together unanimously on a particular issue, it is noteworthy. And that is what has happened here with regard to IT. We have our own thoughts and our own judgments. We recognize our oversight is part of the accountability function with regard to the dollar, and we also embrace counsel and seek the wisdom that other companies throughout the world also seek. And I think the Secretary was right, Secretary Mansfield, when VA sought out Gartner. So you make an investment in Gartner consulting, and they give you their best judgment, and then it is not followed. We then give our recommendations, and we proceed together with the centralized model, take it to the House floor, and it is voted 408 to zero. Now that is a pretty strong vote. I am just letting you know, on matters of substance, very tough issues of substance, 408 to nothing, you can't trump that, you can't throw it away, you can't ignore it. So we look at this one and go, "Okay, the Senate wants to be deferential. We understand the Senate. We understand how they operate." So they want to be deferential, they don't want to micro-manage. You go over to the Senate, you try to operate by consensus sort of the leadership that the secretary has given to you, Secretary Mansfield, so you try to work through this and you come up with the federated model. The federated model then appears to be the political compromise model, but what does it mean, "federated model"? Does it mean that which was delivered to us in testimony by Gartner Consulting last year? Or is it something different? So I don't even know where you are going. I don't know what "federated" means. Is "federated" going to mean that model for which Gartner has advised and gave counsel to us and for which you testified last year before the Senate, about which Larry Craig, the Chairman, then says, "I will hold you accountable," Or are you walking this to the status quo? And if that is what is happening, what will happen here is a very ugly confrontation between the Committee and the Administration, and we don't want that, because we want to be able to bring perfection and efficiencies to this system. And we can be sensitive with regard to Dr. Perlin's counsel about the development, and these crucibles of initiative and creativity, we can be sensitive to all that. But we are losing our patience up here. I just want you to know that. And so let me yield back to the Chairman. MR. BILIRAKIS. Very well said, Mr. Chairman. Mr. Reyes, opening statement, sir? No, all right. Well, that being the case, Mr. Secretary, I'm not even going to turn on the clock or the light. You have the floor, sir. You can certainly bring in any of your people at any point if you would like. I am hoping that even though the -- I suppose you might say the focus of this hearing is supposed to be the breakdown of the budget and that sort of budget areas, but you can see that our frustrations are such that even though you may satisfy what used to be the 50 earmarks and whatnot, what are now 50 earmarks or whatever that figure is, that we are still concerned about progress, and I mean real progress. So hopefully, you will work that into any prepared statement you have. Thank you for being here sir, and for your service to our country. STATEMENT OF GORDON MANSFIELD, DEPUTY SECRETARY, U.S. DEPARTMENT OF VETERANS AFFAIRS, ACCOMPANIED BY JONATHAN B. PERLIN, UNDER SECRETARY FOR HEALTH; DANIEL L. COOPER, UNDER SECRETARY FOR BENEFITS; WILLIAM F. TUERK, UNDER SECRETARY FOR MEMORIAL AFFAIRS; ROBERT HENKE, ASSISTANT SECRETARY FOR MANAGEMENT; AND ROBERT MCFARLAND ASSISTANT SECRETARY FOR INFORMATION AND TECHNOLOGY MR. MANSFIELD. Thank you, Mr. Chairman, and Mr. Chairman, Mr. Strickland, and Mr. Reyes. I appreciate the opportunity to be here to talk about our IT programs. Let me begin then by updating you on the department's ongoing reorganization. I can report that the VA is making steady process in adopting a federated management model that will result in considerable efficiencies. Our federated model separates IT management structure into two domains: operations and maintenance, and development. The CIO is responsible for the operations and maintenance domain, with oversight and accountability over all IT budgets and projects within the VA. Administrations and staff offices will remain responsible for the application development domain, following the policies and framework established for the department. Let me be clear that under the federated model, the budget will be centralized to the Chief Information Officer, as will security. Development will involve the CIO's review and budget approval. On October 19th, the Secretary approved the federated IT management system concept. Under that plan the CIO is charged with developing an interim federated model, and a follow-on implementation plan. And in January, 2006, our management team was briefed on an additional draft of a framework presented to us by Gartner for the federated model. The next step is to flesh out this framework, and adopt the final structure. VA management understands the critical importance of this endeavor, and will remain highly involved in the organizational realignment. We also understand that leadership changes culture, and a culture change has to take place in order for buy-in to occur at all levels, Department-wide. Mr. Chairman, we believe that this is a plan that the VA can and will execute. This federated IT management system will enhance IT operational effectiveness, and provide standardization, and eliminate duplication. We can realize efficiencies through the reorganization and consolidation. For example, consolidating the more than 100 data processing centers that currently operate across the VA into a much smaller number will provide significant efficiencies. As we move forward, it is vital that any reorganization not adversely impact services to veterans, or unnecessarily affect our employees. Our first principle will be to do no harm for the patients in our world-class health care system, and to do no harm to the millions of beneficiaries that depend on checks being dispatched in a timely and accurate manner. We know that there are no simple lightswitch solutions in any model, but we are committed to managing these changes for the good of the department, and most importantly for the benefit of the veterans and their families we are privileged to serve. Mr. Chairman, the president's 2007 budget for VA as you mentioned provides $1.257 billion for non-payroll costs associated with IT projects across the department. Broken down, this is a $43.2 million above our 2006 budget. The 2007 request includes $832 million for medical care program, $55 million for benefits, $4 million for burial, and $366 million for projects managed by our staff offices; most notably, non-payroll costs in the office of information and technology, and the office of management, to support department-wide initiatives and operations. VA's IT programs operate in a tight budget environment in 2006. Challenges will continue into the upcoming fiscal year, as the VA transitions to a new line-item budget, as you mentioned, Mr. Chairman, and continues its infrastructure reorganization. For development and infrastructure realignment, we are in a strategic pause for fiscal year 2006 that will continue somewhat into the proposed fiscal year 2007 budget. I recognize that VA must improve our execution of the business of IT. Establishing the line-item budget for VA's IT program is a step in revamping the way we plan and spending dollars. In the past, IT dollars were spread across the department, and could be moved from one project to cover shortfalls in another. Budgets for information technology projects needed only general estimates. However, we are now operating in an environment requiring a rigorous, disciplined approach, in order to budget accurately. This is a significant change for the VA. This year, 2006, will be a learning year for the department, during which there will be occasions when it may be necessary for the VA to come to Congress to request reprogramming of IT dollars, to make adjustments. The most critical IT project for our medical care program is continued operational improvement to the department's electronic health records system, a presidential priority which has been recognized nationally for increased productivity, quality, and patient safety. Within this overall initiative, we are requesting $51 million for ongoing development implementation of a new system architecture called HealtheVet, which will incorporate new technology, new or re-engineered applications, and data standardization, to continue improving veterans health care. Until HealtheVet is operational we must maintain the VistA legacy system. This system will remain operational as the new applications are developed and implemented. This approach will mitigate transition and migration risks associated with a move to a new architecture. The budget provides 188 million to operate the legacy system. In support of the department education benefits programs for veterans, our 2007 request includes money for non-payroll cost to continue the development of TEES or the -- to operate the education program. VA's 2000 and information technology budget request provides 57.4 million for cyber security. This vital function ensures coordination of the development, deployment, and maintenance of enterprise-wide security controls to better secure our information technology investments in support of all the department's programs. In 2005, VA significantly improved its security posture by completing certification and accreditation activities for 100 percent of the department's operational information technology systems, bringing VA into the Federal Information Security Management Act -- FISMA -- compliance, for the first time. VA also implemented the department-wide security operations center. And finally, we laid the groundwork for implementation of the security configuration management program. This program is essential to eliminating vulnerabilities that expose the VA systems to inappropriate access to information. I would like to address the Committee's proposed reductions to VistA and other programs in the health care arena. These reductions would severely jeopardize our ability to maintain the VA's electronic health record, acknowledged by independent analysts like Gartner, the Rand Corporation, and even Consumer Reports, to be a gold standard for electronic medical records systems. And this is at a time when we are trying to achieve President Bush's vision to have electronic records capability for most Americans by 2014, and to implement the associated executive order. The Committee's proposed reductions seriously hamper efforts focused on replacement of the existing VistA legacy health care infrastructure, what we believe to be the critical foundation for meeting future system requirements. Much like the venerable Boeing 747 that transformed air transportation and served us well for many years, the functionality that VA's VistA legacy system currently provides is without peer. But this system, like the 747, now needs updating. VistA legacy has evolved and grown over the years to meet the challenging VA health care delivery needs. The software has become cumbersome and time-consuming to maintain, and must be replaced so that VA can take full advantage of future health care technologies, and support future care delivery models that will improve service and lower costs. Please understand that there is no other electronic health record that could be deployed throughout the VA to meet patient needs. Let me make a change here, too, and note that if you look at where we are with the enrollment population of 7.6 million, and a unique patient treatment population of about 5.3 million veterans expected, and look what it costs to run this system,it comes out to be about $80 per individual. And I will tell you that if you look at just repeating one test, which this system allows us not to have to do, as the civilian community does, it pays for itself in a sense, in that way. Eighty dollars to maintain a record for an individual veteran for a year is not an excessive cost. Depriving VA of the development funds we will need to replace the underlying architecture could disrupt ongoing maintenance required for safe operation. It would also preclude support for new activities, such as enhanced charge capture, revenue collection, and transition to an architecture that will be interoperable with the DOD's development plans. By making an investment now to transform the legacy system to the new environment, we will be positioned to take advantage of rapidly emerging technology, gene therapy, more effective drugs optimized to the patient, telemedicine, and superior clinical knowledge support, that a modern system structure would provide. If funding cuts are implemented, we will also delay the resolution of our current process inefficiencies, such as clinical scheduling and waiting-time monitoring, potentially for years, and will require additional funding in the future, perhaps significantly more than we are asking for now, to address those inefficiencies. We look at things like the advanced clinic access program that we are running to try and reduce waiting times. That requires more than just the additional space that we are putting on the scene for the doctors and nurses and health care people to use. It also requires this health care record system that they use every time that they see a veteran. Mr. Chairman, I conclude by reaffirming VA's commitment to faithfully serve and support our veterans, and to be good stewards of the taxpayers' money. I would add in here that I don't want confrontation, either. I understand that we have some differences on how this goes forward. The senior management sitting at this table that effectively runs the VA, or manages the VA, has come together under the secretary's direction to agree on a federated model as what we need to go forward. The secretary signed off on that, directed us to proceed, and this senior management will be required to pay attention to it across the implementation phase. So I look forward to future appearances before you to report the continued success of VA's ongoing and future IT programs throughout the department, and that concludes my testimony, and we will attempt to answer the Committee's questions. Thank you very much for this opportunity. [The statement of Mr. Mansfield appears on p. 34] MR. BILIRAKIS. Thank you, Mr. Secretary. I am going to recognize us up here for a 10 minute questioning period. Whether we have a second round or not, I guess we will determine at that point in time. Hopefully, 10 minutes will be at adequate and keep us on the course that we are on. Mr. Buyer, to inquire. MR. BUYER. Well, thank you, my colleagues. Allow me to open with some few questions here. It was a pretty good meeting I had a few weeks back in Bloomington, Indiana, at a hospital that is working with McKesson. And they also wanted to upgrade their IT system, and they wanted to move toward electronic medical records, and were asking "How do we get this done?" So McKesson came in and gave them some advice and some counsel, and this is a small hospital. And the hospital Administrator hires a hotshot CIO, okay? And the medical chief makes the CIO his next best friend. Those guys are standing there together like this, okay? I am not kidding -- I am sorry, Mr. Chairman. I didn't mean to interrupt. And it was fascinating to see how this CIO and the chief medical officer of this Hospital were best buds, and that is the way it is supposed to be, okay? It is supposed to be like that, because they had buy-in. And that medical director understood what the CIO was going to implement was going to increase the quality of his care, and create efficiencies, and he had complete buy-in. And it was wonderful to watch this staff, and the presentation, and hear that. And I sat there sort of in amazement because that is not what I sense and feel from your staff. And that sort of disappointed me, because I can give the same analogy. VA goes out there and they get a hotshot, he is sitting to your right. He is one of the best in our country, and he wants to help transform the VA to set a standard and a model for our country that can be leveraged across our health system. So much so that, as you said in your testimony the president recognized that. Congress recognizes that. And so we are sort of miffed as to why, you know, Mr. McFarland and Dr. Perlin don't exchange Christmas cards. You should. I don't know if you don't. Maybe you think I'm overstating; I am not trying to be cute. We have been pretty tough on your IT budget. Last year, not only us, but from our leadership, and the appropriators took action, the Senate took action, and the trend line is not favorable with you, right? Is that a fair statement? It is not favorable because we don't have a good comfort zone. So you have this 25 year-old VistA model that we invest a lot of money in, and so we have this shack. And we have this shack that is working kind of well, but we are investing a lot of maintenance on shack. And on the development side, you want to continue to build on a sun room, and put in a big swimming pool, plus a four-car garage. Maybe every analogy is imperfect, okay. But you know where we would like to take you? And please, tell me if you think I am crazy, but here is where we would like to take you. We want you to make sure that you have a one architecture. We want to empower your CIO for the one architecture. His job is not to say "No." His job is to make sure that whatever on the business side or the development side fits in the one architecture, okay? And we would like for you to transition out of the VistA and get to a new system. So as you migrate to the new system, we want to make sure that whatever you are working out there on the development side, as you re-host, that it fits. And so in order to make all that happen, to whom do you turn? He is sitting to your right, that from whom you are to seek the counsel, okay? Not the one to your left. Now, if you say, "Steve, you know what? Let me tell you where I disagree with you." Please, we need to know that. So let me turn to you, Mr. Secretary. MR. MANSFIELD. Well, I think the analogy can be the situation that you referred to with your arms around the counsel is a situation where I've got my one arm around this one, and one arm around this one. And this expert -- I agree with you, God bless us for having him, coming back out of retirement to come in and do something positive for the VA and I recognize that -- and he is my expert on IT, the Secretary's expert on IT. But he came into a system where his predecessors have built the system that we have. And it is not just my arms around these two; it is my arms around these two, and 230,000 employees out there, whom we have got to make sure all get the message, and all get it right, and we go forward as mentioned before with doing no harm. And I think we have come a lot further in the period that I've been up here talking to you in an effort to get there and move forward. And again, I would make the point that after reviewing Gartner's report, which we asked them to come in and give us some recommendations, and after talking to, again, the senior leadership of the department and having them go through some intense discussion and debate, and come up with the answer, the Secretary decided that we are going forward on a federated model. And we are going forward on that. And we are making process. The other part of it is I would agree with you that we are under the gun on the dollars. It just so happens that it kind of works serendipitously, because with the re-organization going forward and with this new budgeting requirement with the new line-item budget, and the requirement finally to be able to get down there and figure out where all these dollars go, and then a requirement that we be very careful and come up here and answer to any reprograming requests, we are going through some significant changes in this organization right now. And that strategic pause that has been mentioned allows us to get through it as we get into '07, start making this thing work. MR. BUYER. You use the word "federated." Is that federated, as was described by Larry Craig, or is there a federated -- is there a new federated model? I mean, first of all, you give testimony to Larry Craig, and then you go back to Gartner and say, "Okay, we have made a consensus again on a federated model." Then you seek counsel from them. You have three definitions of the word "federated" right now. MR. MANSFIELD. We asked Gartner to come in with a fleshed-out framework for what they believe a federated model would be. In other words, they talked about the different options. They have come back, the IT director contracted with them, they have come back in with the Gartner model for a framework of what a federated model should be, and we are in the process of reviewing that at the senior level right now, and are getting very, very close to accepting that framework, which then will be the basis that we use to go forward and make -- MR. BUYER. Then let's cut to the chase. Are you going to follow the implementation plan of the Gartner federated model? MR. MANSFIELD. I am listening to a debate that is going on with the senior management about what that model means and how we need to go forward, and basically the answer is we are going forward in an effort to put that framework in place so that we have something to take down to the lower levels and start implementing this plan. MR. BUYER. I don't know how to respond to that, Mr. Secretary. I really don't. MR. MANSFIELD. Mr. Chairman, let me make a point. We went through this last time with the discussion about where we were, when I was up here in September, I think, and the issue is we hired Gartner. They are working for us. We sent them out there to do a job for us, then come back with some recommendations. But they are not running the department. MR. BUYER. I understand. MR. MANSFIELD. They are not running the department. This management group here is responsible for making sure things work, so as we go through -- MR. BUYER. Well, look from our perspective for just a second. Four hundred and eight members of Congress, basically you are saying they are flat- out wrong. MR. MANSFIELD. No, sir. I didn't say that. MR. BUYER. Wait a second. Because you say, "Your centralized approach we are not going to follow in the VA. Even though I spent all this money on Gartner, we are not going to follow that." Then you tell the Senate, "We are going to follow a federated approach." You go back to Gartner and you get their opinion on a federated approach, and then we end up with sort of a "federated light." So instead, you then tell the Senate, "we are going to go here," and then you come back and tell us, "here," -- you are still in a management position over here. We want to get you over here, and we are walking the other direction, because you are trying to get consensus. I am challenged. But can I turn to Mr. McFarland for a second, may I, Mr. Secretary? MR. MANSFIELD. Yes, sir. MR. BUYER. I would like for your opinion. Have you seen what we have submitted in our budget views and estimates to the budget Committee, from this Committee? MR. MCFARLAND. Yes, sir. MR. BUYER. All right. We came in there and we have zeroed out some of these development programs. And we have done that because we are anxious for you to set the architecture in place, to then move to the new system, and be able to re-host development. And we are concerned. So we are in this sort of strategic pause. Now, from a business standpoint, is that the right way to approach it, or the wrong way? Help us out here in your counsel. MR. MCFARLAND. Well, I think it is a good approach from a business perspective. I can't pass on which pieces of the development side are good, bad, otherwise, can't pass on that because I don't have insight into that area. It is not an area that the IT organization has ever managed here. Until we get a chance to dig into each of those, through detailed analysis of the budget and the spend plans, which we are trying to do now, I can't tell you whether those are good pauses, bad pauses, intermediate pauses. I can't answer that. I can certainly answer the areas which my department controls, which is a small amount of the budget, but I can answer those questions. I would have to defer to Dr. Perlin as to whether those are good pauses or bad pauses. Only he can answer that. MR. BUYER. All right. Dr. Perlin? This is my last question. DR. PERLIN. Thank you, Mr. Chairman, for the opportunity to respond. I think they are exceptionally dangerous pauses. I know this Committee would never knowingly do anything to jeopardize the ability of this department to deliver safe, effective, and efficient care. There are two pauses -- MR. BUYER. Wait a second. Let me say this -- you just used a very powerful word. You said, "If we zero this out, that it is dangerous." This is new development. "Dangerous" would be if I did something to your system that would affect ongoing operations. This is new development over here, which sets a different standard. So you have just used the word "dangerous." How can it be dangerous if it deals with a new development, as opposed to affecting your ongoing operation, Dr. Perlin? DR. PERLIN. There are two components in the views estimates. And first, let me reiterate how much we appreciate your great support for VA in the overall budget, and your concern for veterans. The two components, as you know, which are reduced, includes: One, the operation of the current VistA system. The second is the aspect that does provide development for things such as the health data repository. The health data repository is the current relational data set that would allow us to do things like drug error checking. It would increase, as the deputy secretary said, the ability to have data which are interoperable with the Department of Defense, and to allow medical care to be informed by the past experience of the servicemember during military service. The HealtheVet VistA component is not an application, or it is not an application that runs on the new architecture; it is the new architecture. It is what will transcend some of the limitations of the current architecture, which happens to provide very good clinical care. It has been listed by many as the gold standard. Matthew Morgan, Canadian Journal of Health Care Papers listed it as that, and the basis for not only safer and higher-quality care, but also tremendous efficiencies on the larger medical services budget. But the HealtheVet VistA would allow greater maintenance efficiencies to occur, as well. Pharmacy engineering and IT support are an incredibly relevant area to the issue of safety. The new pharmacy package would allow the inclusion of pharmaceuticals that are not prescribed within the VA, will allow the inclusion of over-the-counter herbal supplements that have tremendous interactions with the prescribed pharmaceuticals that a patient might use. Similarly, for VistA imaging, in laboratory, the ability to manage those data timely and effectively has tremendous impact. I would note that we agree fully in VHA of the need to transform, and desire to transform. We concur absolutely that we should be more efficient in the corporate purchasing, in management of generic IT, and we fully support the home for the enterprise architecture, and indeed, the approval of each and every development program, and the control of the budget in the Departmental Office of Information and Technology. Thank you. MR. MANSFIELD. Mr. Chairman, let me just follow up on that, and reiterate that point that Dr. Perlin made with the reference to Mr. McFarland's testimony. In the federated model, the IT, the CIO at the IT office will be in charge of the architecture, and also have oversight over all budgets including development budgets. They will also make sure that standardization operates across the department, not just in operations and management, but also in the development side. And also in addition to that, the CIO will be the overseer of the OMB 300 plans. And then I have decided that any proposed reprogramming issues are going to have to be cleared through the IT's office, since they deal with budget issues. So he will have, in the near feature, the ability to make sure that the architecture is followed, that the budgets are followed, and that we do get what we want here, which is standardization, and that we follow the IT budget. MR. BUYER. Mr. Chairman, in conclusion I think our oversight should only at this moment in time intensify. Because the last thing we could want is, we have legislation that we have passed 408 to nothing, the Senate over there being deferential to the Administration, and what we don't want to happen is, is a continued walking to the status quo, so we end up with a "federated light," and we then get pushed back from the Senate by way of saying, "Well, you know," to the house, "you don't need to do anything legislatively, because they are already taking action," and what we are doing is pushing this down the road even that much further, and we are not even being able to perfect efficiencies. With that, I yield back. MR. BILIRAKIS. Thank you, Mr. Chairman. Mr. Strickland to inquire. MR. STRICKLAND. Mr. Chairman, I defer to you as the Chairman of this Subcommittee, and I will ask my questions when you have finished, if that is okay. MR. BILIRAKIS. I guess it is okay. Some of us have worked for the federal government in another life. I didn't do it all that long. I was an engineer before I went on to law school, and I was with the Federal Power Commission for a while. I know that there is a feeling sometimes of these guys on Capitol Hill being an ivory tower. That they are generally pretty darn educated and hard-working people, and that sort of thing, but they think they know everything about everything, and they really don't know very much about anything. Now I don't know how you perceive us, I know that Dr. Perlin is going to be expert, certainly, when it comes to health care. Mr. McFarland, certainly, when it comes to IT, and the rest of you, as far as your areas of concern. You are not under oath here. I know that in Energy and Commerce, where I also serve, for the Oversight and Investigations Subcommittee, every hearing is under oath and that sort of thing. We haven't done that here, and I don't know that it is necessary to do it. I would like to ask you to be candid with us. Are we wrong? Is Mr. Buyer wrong? He asked you to tell him, Secretary Mansfield, he asked you to tell him if he's crazy. You don't have to use that word, but is he wrong? Am I wrong? Are we wrong here to have heard for a period of years that there is an interest in IT? A real sincere interest in IT: "All we need is additional monies," and "we need to hire an expert," and we hired an expert, and he has given us his opinion," or "they have given us their opinion, and I don't know." I understand Mr. McFarland, who probably has more expertise in this area than any of us do tends to favor, maybe, the opinion of the expert that was hired and an awful lot of money was spent for. I don't know, I have an engineering degree but I'm here to tell you, my wife will tell you, I can't even do the least little thing at the house. So I am not technically minded in spite of the fact that I have that degree. I am not sure that I understand big differences between the centralized model and any other model that you have made up your mind you want to do. I think you probably had already made up your mind on the federated model before we spent millions of dollars on the expert. Anyhow, are we wrong? Are we on the wrong track here? Are we trying to shove something down your throats that you think is a bad thing for purposes of the veterans? Is Mr. Buyer wrong when he talks about Dr. Perlin and Mr. McFarland not sending Christmas cards to each other? Is that the kind of a thing that we have in our VA that we think so very strongly about? Just talk a little bit, talk a little bit on my time, here. Go ahead, Gordon. MR. MANSFIELD. Thank you, Mr. Chairman, and I would preclude my frank comments by a couple of statements. Number one is I have been up here, at this table in fact, in another life, and I don't think my attitudes or my, thoughts changed from there to here. You know, we are all here to do the best thing we can to take care of veterans who have served this country and earned benefits, and deserve those benefits that they have earned. MR. BILIRAKIS. Are we open-minded in the process? Are we turf-conscious, or are we not turf-conscious in the process? The worst word I think in the English language is "turf," not "Turk." Turk is all right, but turf, that is a big problem up here. It is a big problem, we are all concerned about protecting our turf. Is that what we have here? MR. MANSFIELD. That is Bill over there. MR. BILIRAKIS. Bill? A little bit of levity. MR. MANSFIELD. I wanted to make a couple of other comments, too. And make sure that I firmly believe these. We are here because the Constitution of the United States mandates that -- for example, the Congress is the one that takes taxpayers' dollars and allocates them to the executive branches. You are the folks that set up the laws that we are required to follow through on -- MR. BILIRAKIS. You can tell us -- forgive me for interrupting, but you can tell us. Come on, let's be candid here. Let's not bring in the Constitution. You can tell us, are we wrong? Are we on the wrong path here, in terms of what we think should be done, and maybe should have been done long before now? MR. MANSFIELD. You are definitely on the right path in that IT needs to be reformed and made more efficient, and work more effectively, and that the dollars need to get more return for investment. You are definitely right on that. You are right that we sent out and had Gartner come in with the report, but as I said, our belief is we hired them to do a job for us. They came in with more than one recommendation. And we took into consideration our ability and our requirement to manage this department, and then the Secretary's desires, and came up with an answer that was different than yours. I surely am not going to tell the Chairman that he's crazy when he can get a 408 to nothing vote on the floor. That obviously means that he knows what he is doing in this area and this arena, and I don't think that I want to get caught between this side of the Hill and the other side of the Hill. But they both, as I remember, are involved in making final decisions. We believe that this is the way to go. This is the way to go, and a start towards reforming the VA's IT. MR. BILIRAKIS. How many starts have we had? MR. MANSFIELD. This is the first one that I have been involved in, sir. MR. BILIRAKIS. Well, I appreciate that. This past October, you stated that the Secretary has recently made a decision to proceed with implementing the federated model in reorganizing VA IT. That is the federated model, not the 408- to-zero model, but the federated model. I realized that that did not become law, that mandate, but certainly it is a pretty good idea how Congress feels about it. Your comments before the Senate, the whole point of that it was going to take 12 to 18 months to implement the Federated model. This was in October, four months have passed. Could you tell us what specific steps the Department has taken on implementing the Secretary's federated model? MR. MANSFIELD. I just asked the expert how long it would take to implement a centralized model, and he said basically the same time. One thing that I want to put on the record here is that I am operating on some of the lessons I learned from the Core FLS issue. And one of those is to make sure that we have got it right up front, that we do not move forward until we make sure in the management ranks that we have got it right, and we are prepared to roll it out, and we can make sure that the department can follow along with the instructions we are given. That means communication, that means training, that means a lot of things. But rather than step forward a day early, I would rather make sure that we have got it right, so that we know it will work when we put it out there. MR. BILIRAKIS. Is the problem, Gordon, that we keep changing people at the top? Therefore we have lack of stability and consistency and whatnot? You indicated under your watch, so to speak. Is that a problem? MR. MANSFIELD. Well, as I testified I think in September, I came in as Deputy Secretary about the same time Mr. McFarland came in, and the first assignment we had together was to go down to Bay Pines and find out what was going on. And I went down there and got down and talked to be GS-4s, fives and sevens and eights that were trying to make that system work, and I learned some lessons. And I am trying to apply what I learned there to what we are doing here. MR. BILIRAKIS. All right. MR. MANSFIELD. And one of the things is that we have got to get it right before we roll it out, to make sure we will make it work this time. MR. BILIRAKIS. All right, so what we are talking about is we are discarding the, recommended even by the GAO, the centralized model, and we are focusing on the federated model? The decision has been made by VA to go federated, right? MR. MANSFIELD. October 19th, Secretary Nicholson signed a document saying we are going to proceed with the federated model. MR. BILIRAKIS. Okay. MR. MANSFIELD. Those are -- and I will tell you, that is based on this management team's recommendation, discussion with them, where he went around the table and asked each one, "Is this what we need to do, is this what we need to do, are you in agreement with this?" And those are our marching orders from the person that is responsible to give us direction. MR. BILIRAKIS. Would you mind if I ask Mr. McFarland a question, direct question? Do you have any problem with that? MR. MANSFIELD. Sir, you can ask Mr. McFarland any question you want. I understand that that is why these folks were brought up here. But I want to make a point -- well, no, I won't, either. MR. BILIRAKIS. Mr. McFarland, I am sure anybody would agree when it comes to IT, you are more expert than probably all of us put together. Do you buy into the federated model? You are the one who is going to have to do it, aren't you? You are the one who is going to have to implement it, oversee it, et cetera, right? MR. MCFARLAND. Well, I have to oversee the operations and maintenance side of it. The development side of it in a federated model is in the hands of the Administration. So, I have oversight over the budget, as you have given me. But from the operations and maintenance side, that is the side that I would manage in a federated model. MR. BILIRAKIS. Go ahead, Mr. Buyer. MR. BUYER. Your testimony to this Committee and your counsel to us was that you endorsed a centralized approach as presented by Gartner. And that testimony has not changed today. You still believe in the centralized model, as utilized in the business community. I mean, you still believe in a centralized model, but you have had to move toward a consensus with regard to a federated approach which you are prepared to implement under the leadership of the VA; is that a fair? MR. MCFARLAND. That is correct. MR. BUYER. Okay. MR. BILIRAKIS. Okay, that being the case, and we all work for somebody else -- we work for a heck of a lot more people that you do. Well, maybe I guess the same number. The point is, that being the case, your superiors and your colleagues here have all decided to go federated. You can live with that, and you feel that they do can do the job with that as adequately as you would have with the other model, that you preferred? MR. MCFARLAND. Sir, any change from where we are today is a good change. MR. BILIRAKIS. Yes, are you a lawyer? MR. MCFARLAND. No, sir. But in the last two years, I have been learning how to -- MR. BILIRAKIS. You are learning how. MR. MCFARLAND. We would like to clear the record, sir. My wife, Susan, and I did receive a Christmas card from Dr. Perlin and his lovely wife. DR. PERLIN. And for the record, we received one from -- MR. BILIRAKIS. You received one. MR. BUYER. I am going to have to leave, and we want to continue to work with you, and these are matters of policy. It is hard, it is challenging. We are going to the same goal. We embrace the same goal, Mr. Secretary, and to the Under Secretaries, I say we are going to get there. And the more we engage each other, the more we bang it through, and we are going to get a good system. The reality about Capitol Hill is, is even though we would love to move in bold strokes, the reality is we move in increments, and we recognize that. So you are not moving at a pace which we would desire, and we will deal with the Senate's as deferential, but we are going to keep the pressure on, that is the reality. I want to switch to a completely different topic, and I want to bring to your attention a great concern of mine, and I believe of the Committee, and it deals with the tone and tenor of the nation. So Secretary Tuerk, I bring this to your attention. In Indiana, we have an individual who was just killed, Sergeant Ricky Jones, from Kokomo, Indiana. His family home has been vandalized, has been egged. The family have received phone calls that say, quote, "I am glad your son is dead." So I am about as outraged as I can be and must speak against such behavior toward our sacred dead. So what I would like to do is work with you, Secretary Tuerk, and work with the secretary of the VA, to reach out to this family in Indiana. Now, there is something that is occurring in the country called patriot riders. And my sense is, you are about to have a thousand patriot riders show up in Kokomo, Indiana. And the last thing I want is violence, but I just believe that everyone would share the thought that we are equally appalled that something like this would be occurring. But I think we need to have a voice from the VA, and I am going to speak with the family today, and I am going to go to the funeral. I don't know what your plans are but Under Secretary Tuerk, if the Secretary or Gordon Mansfield, I know you have busy schedules, but if you can be there, I would like for you to check your schedule. This is your department. And I would like for you to reach out to this family, and I would like the VA to send out a bold message, because you are responsible for this individual's body, and for how we care for this individual, and make sure that his life, that individual's life is recognized. Let me turn it to you, Secretary Tuerk. MR. TUERK. Mr. Chairman, I don't know whether I can articulate outrage and disgust any better than you just have. You have my solemn commitment that I will work with you to properly honor this servicemember and his loved ones. I cannot think of anything that would take precedence over joining you in Kokomo, Indiana, to help this family get through its hour of need. And I assure you that I cannot anticipate that my boss, Deputy Secretary Gordon Mansfield, would have a priority for my time that is higher, either. So I look forward to traveling with you, and doing right by this family. You have my assurance of that. MR. BUYER. All right. They are not constituents of mine. I am just appalled. If the Secretary can't make it, Gordon, you know, if you can deliver a letter from the Secretary of the VA to the family, or something in person? MR. MANSFIELD. We will bring the president's certificate, and we will check with your folks -- MR. BUYER. Let us have our staffs work together. MR. MANSFIELD. Do everything we can, yes. MR. BUYER. We can stand to send a message to the country that this conduct is pretty outrageous. MR. TUERK. Yes, sir. MR. BUYER. All right, thank you. MR. BILIRAKIS. All right. Thank you, Mr. Buyer. Gordon, I have two questions and I am just going to ask them. One I started to ask, and then I am going to ask you to respond to them within a week in writing, and give you a better opportunity to do that. We are expecting votes at 11:30, and I thought it would be only fair to go through the rest of the members, to give the rest of the members an opportunity here. The one is continuing on what I recently went into, is your testimony in October regarding implementing the Federated model. You said it was going to take 12 to 18 months to implement it. This was in October. So my question is, four months have passed -- MR. MANSFIELD. Excuse me, sir. MR. BILIRAKIS. It is all right, sir. Four months have passed. Could you please tell us what specific steps the Department has taken in implementing the Secretary's federated model, first question. Hopefully, a response in writing within a week. Is a week fair? MR. MANSFIELD. Yes. MR. BILIRAKIS. All right. Second one -- MR. MANSFIELD. You want that in writing? MR. BILIRAKIS. Yes, I want that in writing. In 2006, Congress appropriated roughly $26 million for Core FLS, here we are again. However, in a VA letter to the House Appropriations Committee that listed VA IT-related and the amounts to be spent for FY 2006, it appears that VA reprogrammed monies for Core FLS, and put the monies into a new program called FLITE. You are not surprised that I am bringing all this up -- recently, my staff requested briefings on the FLITE program, formerly Core FLS. According to VA, this is a new program and not a rebranding of Core FLS. Please explain why the VA reprogrammed VA IT monies into a new program which is called the FLITE program, and whether or not Congress was notified of the reprogramming as required by law. I will submit these to you so you can have the question exactly as I asked them. MR. MANSFIELD. You want the second one by -- in writing? MR. BILIRAKIS. Within a week. MR. MANSFIELD. Yes, sir. MR. BILIRAKIS. If you would do that, I would appreciate it. MR. MANSFIELD. Will do, sir. MR. BILIRAKIS. Again, I thank all of you for appearing here, and would now turn the query over to Mr. Reyes. MR. REYES. Thank you, Mr. Chairman, and gentlemen, thank you for being here. The Gartner report recommended that the VA adopt a centralized IT model, or the VA's adoption of what you are terming a "federated model," and it also cited that the poor state of the VA's investment management process was a reason for that recommendation. However, Mr. Secretary, your written testimony states that you are, and I am quoting, "pleased to report that the VA is making steady progress in adopting a federated management model that will result in considerable efficiencies." My question is, how have you improved the poor state of your investment management process? And how certain can this Subcommittee be that the efficiencies that you are promising will in fact be realized? MR. MANSFIELD. Mr. Reyes, those are good questions, and I would make the point that in addition to the reorganization, for the first time ever, in fiscal year 2006 the VA is required, and has an IT line-item. And that means that we have to ensure that we get the programs under that lined up and accounted for. And it also means that we are going to have to be more rigid in our accounting, more accurate in our accounting, and ensure that we do it right. And I would tell you that, sir, I have to unfortunately say that we have not always done it right in the past. The second thing is that in the reorganization as we move forward combining the IT line-item, and the reorganization, the CIO, the Assistant Secretary for Information Technology is now in charge of reviewing the OMB 300 programs, which gives us a better chance up front to figure out exactly what the budgeting and finance requirements are. So that is a starting point. The other point is that no matter which program you went to, centralized or federated, you would still have the opportunity in making sure that the programs that the IT folks are going to be responsible for, management and operations, can be standardized and in many cases consolidated, and that is where we believe we will be able to realize the first savings in this program. MR. REYES. I guess the frustration that I hope you know we are feeling is, let me give you one example, and it deals with this, what in your testimony you referred to are "strategic pauses." And in your testimony, you say that these "strategic pauses" pay for development and infrastructure realignment in fiscal years 2006 and 2007. The frustration deals with trying to understand what, in real terms, the "strategic pause" means. Why, when we know the need, when we spent millions of dollars on a recommendation with the Gartner report, why are we in a "strategic pause?" Can you explain that to me? MR. MANSFIELD. Yes, sir, and still I would make the point again for the record that we are following one of the recommendations of the Gartner report. They came in with a number of recommendations, and as I said, we went through a process within the department to determine how to apply to the department. The senior management team here in conjunction with the Secretary made a decision to go to the federated model. So that is where we are in that sense. And I think the answer to the question is, we just have to, you know, work our way through reorganizing the whole IT function of the department. It isn't just management and operations that is going through a reorganization. I have directed the under Secretaries of the administrations to go through a process to make sure they examine and do a reorganization on their development functions which are still left under their control in the federated model. MR. REYES. But if you accepted the recommendation of a "strategic pause" in the Gartner report for this resetting, of the prioritization of the IT function, why in the world wouldn't you accept the recommendation that it be a centralized, versus what you are calling a federated model? MR. MANSFIELD. Well, the strategic pause is actually applied to the development function, not the management and operations. So the transformation that is going forward in the management operations sense is a big issue for the department. While we are going through that, and while we are doing an effort to conform the requirements that we have on the IT budgeting, another major project that the department has never done before, we are doing it for the first time this year; and as we are looking at making sure that the OMB 300s are reviewed in a timely and accurate manner, that gives us the opportunity, with reduced funding as directed by the Congress to go forward, with a strategic pause, to make sure we can get through the reorganization, to make sure that we can -- and at the same time, reorganize, or refresh the development programs. And that will allow us, then, to move forward, probably towards the end of '07 or '08 with new development programs that we will be recommending in future budgets. MR. REYES. Okay. So, why haven't we seen a detailed plan of what you intend to do? Because the concern that I know I have, and maybe perhaps some of my colleagues, is that when you came in with your budget request, it seeks funding for certain programs that ultimately may not be consistent with your re- hosting efforts. So where are we on having a detailed or comprehensive plan of what you intend to do and what it is going to look like, so that we can have some assurances as the Subcommittee on Oversight, that you are not going to -- that we are not going to be funding programs that will be obsolete once, whatever this plan is, will get implemented? MR. MANSFIELD. And that is exactly what a strategic pause can allow us to do. We won't be going forward with programs until we get the final decision made on what the standards are, and what service level agreements are, and what we exactly have to do to carry forward. So this strategic pause I think, sir, allows us to do what you want us to do, which is make sure we don't spend money where it shouldn't be spent. MR. REYES. What makes the VA so unique that you can't follow the industry standard? I mean, we have got systems that may need maybe a little but of tweaking, but that are industry standards, that are state-of-the-art. From what I can gather from your testimony and what I have read about this effort, you are going to have islands out there that you are going to connect with bridges, instead of one centralized system that everyone will be able to utilize, that everybody will be able to train on, that everybody will be able to depend on for information. And that will ultimately make the VA more effective, more efficient, and give the kind of service that I know all of us want the veterans to receive. MR. MANSFIELD. One of the things that I believe will happen -- I don't believe, I know will happen, is that the IT, the CIO will bring industry standards to bear, as we move forward in this reorganization. But I would make the point, too, that as mentioned earlier, if you are looking for the standard, for example, in electronic health records, it is right here at VA. Even though it is on a 25-year-old platform, it has been redone up- to-date. And again, as I say, that is a electronic health care record that costs us $80 a year per patient to maintain, and I would make the point, too, in an announcement by Representative John Porter, about moving towards electronic records for the federal employees health benefits plan. There's an article here in the Washington Post that talks about Mr. Porter indicating that the VA has been able to do this, and that is the goal they are looking for. So we are in effect the industry-standard in health care records, I believe. And we can take it a little bit further to make sure they are brought into the 21st century. MR. BILIRAKIS. Would the gentleman yield? MR. REYES. Yes, sir. MR. BILIRAKIS. You are, and you can be even more. We talk about this sort of thing should take place, particularly for health care, throughout the entire country so that every provider, every hospital, et cetera, et cetera, et cetera. You could be a model, you can be a model. You are really not a model as yet, even though you are probably ahead of everybody else. We know when the problems took place as a result of the Hurricane Katrina, that when you transferred patients from, was it New Orleans to Houston, that the equipment in Houston was not capable of being able to take what you sent over there to plug it in, that you had to reconfigure. So more work has to be done. MR. MANSFIELD. I agree, sir. You are talking about an ideal system. We are talking about taking a 20-year-old system and bringing it into the position where it can do that. But I would suggest to you that any other health-care system in that area right now is probably digging out their paper records and trying to figure out what they saved -- MR. BILIRAKIS. Amen, but we keep falling back on that. MR. MANSFIELD. Sir, I don't disagree with you, and that is the plan here. And that is why we requested this money to go forward, is we need to bring these records further into the current -- MR. BILIRAKIS. I think Mr. Reyes is trying to -- you were trying to get, I think, to what their decision is going to be, what plan, what model is the one that is going to be used. MR. REYES. Exactly. MR. BILIRAKIS. I understood, you know, February the 7th, you were going to come up with some sort of decision. Then it was deferred to the 15th, that it was deferred to February the 28th. Then we heard, and I don't know how we get this information, but we heard that you all were getting together this morning to come up with some sort of a decision. MR. MANSFIELD. Sir, I made a decision that I am not going to be doing something without, you know, full review and an ability to look at everything on the table, to be able just to come up here and present something to you. MR. BILIRAKIS. All right. MR. MANSFIELD. I think that is part of the problem we have had in the past, for example, lessons learned, that we have forced ourselves to do something so we can present it to you and say, "Hey, we did it." MR. BILIRAKIS. Yes, sure -- MR. MANSFIELD. And I think that is not right, and I am not going to do it. MR. BILIRAKIS. All right. You should not be frightened of us, or forced to do something prematurely or anything of that nature. Back in October you said it would take 12 to 18 months, and I guess you are going to tell us what has taken place during those first, those four months, right? MR. MANSFIELD. As I indicated, we went out to Gartner again, which everybody up there seems to think is the best way to go, and asked them to come back and give us a framework. Not an actuality, but a framework that would allow us to use that to flesh out all the things that we need to do to go forward. And then looking at that framework again, if the first steps are wrong, then the next steps are going to be wrong, and by the time we get down the road, we are going to have another mess on our hands, and I am not going to do that. I want to make sure it is done right up front, and that we can go forward. At some point, I am going to have to step in and say, "Do it this way." MR. BILIRAKIS. Go ahead, Mr. Reyes. I am sorry, I didn't mean to interrupt. MR. REYES. No, you followed up, and that is the very question I wanted to, or reassurance that I wanted to, because you know, we like the programs, health data repository, scheduling replacement, VistA imaging, all of those. We are spending all these millions of dollars on that, and I think what I want is reassurance that those things aren't going to go out the window whenever you reset this plan, whether it is that you are waiting, as I understood, from the recommendation from the Gartner report, or the combination of the Gartner report and the federated plan. Can you give us that assurance? MR. MANSFIELD. In my testimony I think I pointed out that we object to those cuts. We believe each and every one of those programs is important. The health data repository not only helps us; it is going to help us connect the VA and DOD systems in a seamless transition. Some of these programs are set up so that we can increase our efficiency. For example, with the scheduling, the clinical scheduling package will allow us to make sure that the advanced clinic access program, that needs more than, as I said -- MR. REYES. Well, but Mr. -- MR. MANSFIELD. -- so I am committed to making those programs move forward so that they can provide efficiencies in the future. Part of it is though, you know, we have to make sure as we go through, as I said, the strategic pause, that we have the ability to do everything that is required. MR. REYES. Okay. Well, one of the problems is that you are in a "strategic pause" on these programs, yet you are asking us to fund the development of these programs while you are in this pause. So I for one am -- MR. MANSFIELD. I would make the point that we have cut it down to those we do want to go forward with, and the others that are not so important or not critical to operations with VA, DOD, or critical to scheduling, or other efficiencies, are the ones that are in the pause mode. MR. REYES. Okay, but the problem is we still don't have a plan of where you are going with that, and that is why I think there is, at least on my part, a reluctance to move forward. MR. MANSFIELD. Well, sir, I understand your concern and your reluctance. I made the point to the Chairman, to the full Committee Chairman, to the Subcommittee Chairman, and I agree that we haven't done it exactly as we should have done in the past, and unfortunately we suffer because of that. I would just make the commitment that part of what we are trying to do here is make sure that we do do it right. The strategic pause was to allow us to make sure that we got the reorganization and the budgeting issues taken care of, and then the planning issues, which are the OMB 300, to make sure that we got that right. But I would also tell you that those ones that you mentioned are key to us to be able to move forward in efficiencies, in return on investment, and we do want to be able to do that. However, in addition to the reorganization, as I mentioned, the CIO is responsible for ensuring that the management operations backbone of the system, the operating systems, are made efficient. The Under Secretaries are responsible for making sure that the development functions, which remain under their control, that which is left, conform to the standardization that is set by the CIO, conform to the architecture that is set by the CIO, go through a budget review that is done by the CIO, but also are done right. And that is what we are trying to do all at the same time. MR. BILIRAKIS. Is it a good idea to do this, to do all this? We keep talking about it. We keep talking about throwing money at it and that sort of thing, you want additional dollars. Is it good for the veterans? Is it good for the Department to do all these things? MR. MANSFIELD. Yes, sir. Yes. MR. BILIRAKIS. It is good, all right. We have been talking about it now for how many, 10 years or something of that nature? Again, whatever that period of time is, it is something like 10 years. I realize that you are not responsible for your predecessors and things of that nature, Mr. Secretary, but here we are, again. You can't blame us for feeling that there is something happening here, whether it is a culture thing or something of that nature, I don't know. I understand that Gartner gave VA an implementation plan that you have not even adopted as yet. You haven't even made the decision on adopting it. Now I realize I want you to cross all the T's and dot the I's and make sure, so we don't have the problems that we had in the past, and throw good money after bad, et cetera. There has got to be some sort of limitation of time. Hell, I retire at the end of the year. Why should I feel confident that something like this is really on a good path by the time I retire? I don't, I mean what are we doing here? We are having problems with adequate funding for health care of veterans and things of that nature. I really have the feeling we ought to take all this money and divert it into health care, because we don't seem to see things get done. MR. MANSFIELD. This is health care, sir. You couldn't get the health care to 5.3 million patients without the electronic health care record. And we can give it better and more efficiently with more quality, and make no mistakes, if we adopt some of these things we want to do. MR. BILIRAKIS. Then why are we taking so long to do it? Why are we taking so long to do it? It is health care, you are right. MR. MANSFIELD. If I could have it done by midnight, I would have it done by midnight. I am pushing this as hard as I can. The Secretary has made the decision. At senior staff meetings, the Secretary continues to point out to his senior management group that this is a priority of the department, and we need to move forward. We are moving forward appropriately to get this done. But as I said, rather than do something just to do something, we want to do it right the first time. MR. BILIRAKIS. Okay, so you haven't come up with a model as yet, is that right? MR. MANSFIELD. I have the framework. I have a model that will give us a framework, that we can then use to go forward with, and make the final decisions. MR. BILIRAKIS. When can we expect -- MR. MANSFIELD. We can't go out the door and buy something off the shelf to do it. MR. BILIRAKIS. Yes, but Gordon, it has been about 10 years. MR. MANSFIELD. Well, sir, let me back up and make the point. I fully understand and appreciate your concerns about this issue. I fully understand and appreciate the fact that the Committee and Subcommittee are concerned about -- based on history, unfortunately -- whether we can get it done. I am just telling you that the Secretary is committed, I am committed, this management team sitting with me here is committed, and we are moving forward appropriately to get it done. MR. BILIRAKIS. Yes. Is wrong for us to mandate a particular date? I think it is not fair to you, we are not down at that particular level. Yet, here we are, we feel like we are floundering. I hate to use the word, "stonewalling," because I think you are above that. MR. MANSFIELD. Well, as I mentioned in my conclusion, sir, I think I said I look forward to further trips up here to this Subcommittee and Committee to answer questions as we go through this, and I am serious about that. And the other point I would make is we on a regular basis attempt to brief your staffs about where we are, what we are doing, and how we are going forward. You mentioned the FLITE briefing that took place. So we are attempting to convey the information and let you know what we are trying to do, but I fully expect to be at this table with this microphone in front of me, further on in the year. And let me, if I may, say -- you mentioned your departure. Let me say thank you, Mr. Chairman, thank you for the service that you have provided up here. Thank you for the direction that you have given to the Department of Veterans' Affairs. Thank you for all the legislation and the oversight that you have provided to ensure that those veterans that we are here to take care of are getting the benefits and services that they have earned. I really, really we want you to know that I am saying that personally and for the department. We do appreciate all the effort and passion that you obviously are putting into this. MR. BILIRAKIS. Well, thank you for that sir. I have one more question and it would go to Secretary Cooper, but I would ask that it may be submitted in writing. It has to do with the Carnegie Mellon SEI report of September on VETSNET, where it stated that there is no credible evidence that the program will be substantially complete by December 2006. The report further states that the program could lead to a "never-ending program." You are aware, of course, VETSNET has been in development for over 10 years, and at a cost of over $600 million, and the program's development continues to reside within VBA. So the question is, under the Federated model, will VETSNET still be an open-ended application development project? And when is VBA going to develop rules and standards to application development? That is the question. We will hand it to you personally, and please respond to that hopefully within a week, because I don't want to be unfair with, you know, the time line, there. Well, Mr. Reyes, anything further? MR. REYES. No, Mr. Chairman. MR. BILIRAKIS. Well, gentlemen, thank you for coming here now. This is tough on you, but I think it is tougher on us because of the frustration that we have. Now I feel that you are dedicated and you care about the veterans, and it has got to be frustrating to you, too. Somewhere along the line with the time that it has taken here, we just keep on reinventing the wheel. It seems like it is throwing, maybe sometimes, good money -- you know we have thrown some good money after bad over the years. Something has got to take place here. I don't know what the answer is, but you have indicated your willingness to cooperate with the staff. I know that Art, is very much interested in this, and he has been awfully good as far as I am concerned. He is courteous and whatnot. Hopefully, he has been that way in his communications, and relationship with you. We want to see some action for and on behalf of the veteran. The hearing is over. [Whereupon, at 10:54 a.m. the Subcommittee was adjourned.] <GRAPHICS NOT AVAILABLE IN TIFF FORMAT>