Rural Veterans Health Care Act of 2006

Mr. President, I have sought recognition in these waning hours of the 109th Congress to provide a summary of the good work accomplished over the last 2 years on behalf of America's veterans, and to comment on comprehensive legislation that is now pending in the Senate. I provide this summary in my capacity as chairman of the Committee on Veterans' Affairs, a title I will soon pass on to my friend, Senator Danny Akaka of Hawaii.

Before the 109th Congress convened, I made a decision to serve as chairman of the Committee on Veterans' Affairs

for two fundamental reasons. The first and most important was that our country was at war and continues to be at war, and a nation at war, with hundreds of thousands of young men and women having spent extensive tours overseas in hostile lands, fighting for our country, deserves the full attention of the Senate. Many have died during the course of combat operations. Others have been seriously wounded. Thousands more will transition out of the military service in the coming years and will attempt to reenter the workforce or go to school under the Montgomery GI bill. There simply was no greater calling than for me to assume the leadership role to ensure our Government was effectively assisting the current generation of America's veterans and their families.

Second, I have always been nonplused, I guess, at the characterization that the Committee on Veterans' Affairs was a ``B'' committee. This characterization exists despite these facts. Mr. President, 24 million Americans have served in the military and are potentially eligible for VA-administered benefits. In addition, VA will soon have a budget over $80 billion, which is one of the largest and fastest growing budgets within Government. And finally, VA has the second largest Federal workforce of any Government agency.

Therefore, it was my goal to elevate the committee's profile and the importance of the veterans' benefits and services by embarking on a course of vigorous oversight and legislative effort and, I believe, accomplishment.

It is my humble opinion that I share the credit with 13 other members of the committee. One of them is here on the floor with me, Senator Kay Bailey Hutchison of Texas, who also served not only on the authorizing committee with me but chairs VA MilCon and has played a critical role in veterans issues. We have been diligent and active participants of the committee, and the business of this committee, in my opinion, has been extremely productive in the last 2 years.

The committee held 52 hearings during the 109th Congress. From the start, our focus was on the combat wounded, the combat deceased, and their families. We held a hearing on the difficulty that surviving spouses have in getting timely and effective, consistent information regarding their benefits following the active-duty death of their loved one.

We held several hearings on whether returned combat veterans are provided with a seamless transition--many of us have heard those words used--from active duty to civilian life. We are still working with DOD on that, to make sure it is truly seamless.

We focused on medical and vocational needs of our severely wounded. We examined the research being done within the VA to advance our understanding of various diseases and disabilities confronting veterans in the hope that advances in medical science and technology could one day improve their lives. And there is clear evidence today that that very thing is happening.

The committee was particularly active in examining VA's budget needs, and no one can argue about the high priority this Congress placed on funding the VA system.

The total VA budget will have increased from approximately $63 billion at the end of fiscal year 2004 to over $80 billion upon enactment of a fiscal year 2007 appropriations bill, an increase of 27 percent.

In addition to resources provided, this Congress has put in place a system of accountability to ensure that the appropriations provided to VA are being used to meet the needs of those who rely on the vital health care provided by VA facilities around the Nation.

By law, VA now submits quarterly reports to the Congress on its budget that contain a comparison between VA's planned expenditures and actual expenditures.

More importantly, VA is required to include quality indicators in this report, such as the percentage of primary care appointments scheduled within 30 days of a patient's desired date.

I am confident that the Congress has the mechanisms in place to know, on short order, if VA's budget needs are outpacing its resources, and is therefore equipped to take swift remedial action if necessary.

On the legislative front, the Senate has continued to do the work expected of it by the men and women we serve and represent. Let me give a quick accounting of the legislative provisions that were enacted into law during this Congress:

First S. 1234 and S. 2562. In both the first and second sessions of the Congress, cost-of-living-adjustment legislation was enacted to increase the rates of disability compensation and survivors' compensation. Benefit rates were increased by 4.1 percent for 2006 and will be increased by 3.3 percent for 2007.

Second, Traumatic Injury Protection under Servicemembers' Group Life Insurance, T-SGLI. In many instances the wives, parents, and other family members of servicemembers who are traumatically injured incur substantial financial obligations in order to spend time with their loved ones during recovery periods at military hospitals.

Under the provisions of Public Law 109-13, those traumatically wounded since the start of OIF and OEF as a result of combat wounds are eligible for financial payments which range from $25,000 to $100,000 for qualifying injuries, depending on severity. To date, more than 2.500 wounded servicemembers have received payments as a direct result of this legislation.

As of December 1, 2005, all servicemembers and Reservists insured under the Servicemembers' Group Life Insurance program are also covered under the T-SGLI benefit. The coverage extends to all qualifying injuries regardless of whether injuries are incurred as a result of combat.

Under the provisions of H.R. 3200, the maximum coverage for members of the Armed Forces and veterans of the Service Members Group Life Insurance and the Veterans Group Life Insurance benefit was increased from $250,000 to $400,000.

The bill, as enacted, also requires that spouses be notified when members insured under T-SGLI elect less than maximum coverage or designate a beneficiary other than the spouse or the children or the child.

In fiscal year 2006, the National Defense Authorization Act, H.R. 1815, under provisions of H.R. 1815 and as a result of veterans committees oversights, the Department of Defense was directed to provide customized integrated information to survivors of those killed on active duty about their future Federal benefits through an Internet Web site.

I was amazed when we started these hearings that we were still dealing with a hodgepodge of approaches of how we dealt with the surviving spouse of a lost one.

DOD was also directed to develop a uniform policy on providing casualty assistance to survivors. I would like to especially thank Senators Warner and Levin for their cooperation on that bill.

Also under H.R. 1815, a provision was adopted to prohibit military funeral honors and burial in VA national cemeteries and in Arlington National Cemetery to any person who is convicted of a Federal or State capital murder for which a sentence of death or life in prison may be imposed

We had an example of a fellow from Maryland who had killed two elderly people and was sentenced to death, died in prison, and was buried at Arlington. This provision was adopted following our committee's oversight and hearing of that double murder that I just expressed. I will speak more to my colleagues about the status of the double murder incident in a moment.

In June of 2006 President Bush signed into law S. 1235, a bill to help severely injured servicemembers in their transition from the military to their civilian lives. It authorizes VA to make grants available--ranging from $2,000 to $14,000--to assist with housing adaptations on a family member's home in which a severely disabled veteran is living.

It allows servicemembers, who have been legally determined 100 percent disabled when they separated from the military, up to 2 years from that date to apply for premium-free Servicemembers' Group Life Insurance coverage. Finally, it enables them to convert their coverage to Veterans' Group Life Insurance, or an individual plan or policy, during the same 2-year period.

As to H.R. 5037, undoubtedly most of my colleagues are aware of the fringe

group which has used its protected free speech rights to deliberately disrupt funerals of our military heroes. That is why the Senate voted unanimously to put reasonable restrictions on demonstrations at VA cemeteries and Arlington National Cemetery.

An amendment was put forward on the floor of the Senate balancing the rights of grieving families to a dignified funeral ceremony; the rights of private property owners who live near cemeteries to be free from overly intrusive Federal laws; and the rights of demonstrators to have their message heard. The amendment was accepted, the bill was passed, and it is now Federal law.

In addition to the bills already enacted into law, the House and Senate Committees on Veterans' Affairs have agreed on a comprehensive substitute amendment to S. 3421, which has cleared the House and awaits Senate action. I urge my colleagues to support this important bill.

S. 3421, the ``Veterans Benefits. Health Care, and Information Technology Act of 2006,'' contains provisions that would: enhance veterans' health, education, memorial affairs, and other benefit programs; improve VA's information technology infrastructure; authorize the construction of needed VA medical facilities; improve services for homeless veterans; remove the remains of a convicted double murderer from Arlington National Cemetery; and, I am proud to say, repeal an outdated and paternalistic law that limits the ability of veterans to hire an attorney to represent them during the VA claims process.

While a fuller accounting of the provisions of S. 3421 can be found in the Joint Explanatory Statement language accompanying the amendment text in the Congressional Record--and I ask unanimous consent that the Joint Explanatory Statement be printed in the Record along with the text of the substitute amendment to S. 3421,--I will make a few remarks about three provisions of note that I have championed.

Mr. President, currently, veterans and other claimants seeking veterans' benefits may not hire an attorney until the VA administrative proceedings have been completed--a process that often takes several years.

That law flows from a Civil War era policy intended to protect veterans from unscrupulous attorneys. That policy arose at a time-- unlike today--when attending law school was not required to become a lawyer and there was no effective professional oversight of lawyers.

In recent months, it has become abundantly clear that many veterans and their survivors want the option of hiring an attorney to help them navigate the increasingly complex VA system. In fact, the prohibition against veterans hiring attorneys is considered to be unfair and outdated by a broad spectrum of individuals and organizations, including veterans' organizations, veterans' advocates, judges, law professors, and bar associations.

For these reasons, I am very pleased that a compromise version of legislation I authored was accepted that would allow veterans to hire attorneys after a veteran files a Notice of Disagreement with VA's initial decision on their claim.

A provision of S. 3421 will enable the spouses of seriously wounded veterans to obtain educational assistance benefits sooner than they have ever been able to before.

The need for the educational assistance provision was brought to my attention by U.S. Army SFC Jeff Mittman, a young man who was blinded after an attack in Iraq and is being treated at Walter Reed Army Medical Center.

Sergeant First Class Mittman's wife would like to begin receiving educational assistance benefits from the VA while her husband undergoes treatment in order to improve her job opportunities once he is officially discharged from service, but is now prevented from doing so by law. If enacted, S. 3421 would remove that barrier.

Finally, S. 3421 would remove the cremated remains of a convicted double murderer from Arlington National Cemetery.

In the summer of 2005, we learned that the remains of a brutal murderer--Russell Wayne Wagner--were placed in the Nation's preeminent military cemetery, Arlington National Cemetery.

I was appalled to discover that the law enacted in 1997 to deny capital offenders from burial in national cemeteries did not apply to Wagner.

This was also quickly brought to my attention by the Senator from Maryland, Barbara Mikulski. We joined together in that effort. The answer was it couldn't happen, it couldn't be removed because of the law.

While we moved swiftly to close the loophole that permitted Wagner's burial in the first place, the question remained: Should his remains continue to be included among the scores of honored dead in Arlington? For me and Senator Mikulski, who joined me in this effort, the answer was ``no.''

That is why I am so pleased that S. 3421 would direct the Secretary of the Army to remove Wagner's remains from Arlington.

As I stated last summer, we must not dishonor the sacrifices made by those memorialized at our Nation's military cemeteries by including among them individuals who, through their own heinous acts, have grievously dishonored themselves because at another time in their life they were veterans.

S. 3421 is an impressive assortment of legislation. It contains the collective work of more than 44 Senators. I want to take some time to single out a few of them.

Senators Burr and Obama for their work on the homeless assistance provisions of the bill; Senators Hutchison, Feinstein, Graham, Landrieu, and Murray for their work on the construction provisions; Senators Thune, Salazar, and Burr for their work on the rural health components of the bill.

And lastly, the committee's ranking member, and a true friend of veterans, Senator Akaka.

I ask my colleagues for their vote. And I thank every Senator on the committee and in the Senate for their support in seeing this, and all of the other veterans' bills, through the Senate.

I also want to thank my House colleagues, in particular Chairman Buyer, Ranking Member Evans, and Acting Ranking Member Filner. We were able to come together in the spirit of compromise in the final hour on some key provisions, and it is a fitting way to end this Congress.

As we head into a new Congress, I want to extend my best wishes to my friend, and soon-to-be chairman, Senator Akaka. It has been a pleasure working with a Senator of his quality, and I pledge that as ranking member I will strive to emulate the kindness, cooperation, and ``aloha'' that he showed me during my time as chairman of this great committee.

I yield the floor.

Mr. Speaker, today I am introducing H.R. 5524, the Rural Veterans Health Care Act of 2006, to strengthen and improve access to health care for rural veterans.

The Memorial Day weekend has recently passed us by. The holiday reminded us all of the great sacrifices made by our Nation's veterans and their families. It is important that we honor our veterans with action and not just words. We must not forget that we have soldiers in harm's way in Iraq and Afghanistan, and they too have earned the support of a grateful nation, just as generations before them.

Meeting the needs of our veterans and their families should be a top priority. While the Department of Veterans Affairs (VA) does a good job in delivering quality medical care, treatment is sometimes harder to access for veterans in rural areas.

Rural communities have always answered their Nation's call to service. Nationwide, more than 44 percent of recent U.S. military recruits come from rural areas. This tradition of service is true in my home State of Maine where approximately one in six residents is a veteran--one of the highest proportions in the country. Across the country, one in five veterans who is enrolled to receive VA health care lives in a rural area.

Veterans who live in rural settings are often older and have more physical and mental health diseases as compared to veterans who live in suburban or urban settings. According to the 2005 Institute of Medicine report, The Future of Rural Health, ``the smaller, poorer, and more isolated a rural community is, the more difficult it is to ensure the availability of high-quality health services.''

It is important that we address the unique challenges that rural veterans face in accessing health care. At my request last summer, the House Veterans' Affairs Subcommittee on Health held a hearing at Eastern Maine Community College in Bangor to raise awareness of this issue and to search for solutions. The field hearing focused on rural veterans' access to primary care and gave the Chairman and me the opportunity to hear directly from veterans and health care providers in Maine.

It was clear to the Chairman and me that if our rural veterans are going to get the care they deserve, the VA needs to have a focused effort to increase access to quality health care for those living in non-urban areas of our country.

My legislation is a result of the findings from the Maine field hearing, an ongoing dialogue between my office and Maine veterans and health care providers, and reports published by the Institute of Medicine that focused on improving health care in rural areas.

Specifically, my bill would help rural communities address the needs of returning veterans who are serving in Iraq and Afghanistan by requiring the VA to conduct an extensive outreach program to these veterans who reside in rural communities. The VA would be required to collaborate with employers, state agencies, community health centers, rural health clinics and the National Guard to conduct this extensive outreach program to ensure that returning troops have access to the benefits they have earned.

The legislation would also build on the strength of the Vet Centers program. Vet Centers are located in the community outside of the larger VA medical facilities, in easily accessible, consumer-oriented facilities. They are highly responsive to the needs of local veterans. In 2005, the 206 Vet Centers saw over 132,853 veterans. For nearly one out of four veterans seen at Vet Centers, these centers are their access to VA programs and benefits. This core group of veteran users primarily received counseling for military-related trauma. My bill would require the VA to expand its presence in rural areas and to establish a pilot program to have mobile Vet Centers that could help reach veterans in the most rural and remote areas.

Consistent with the promise made to veterans in the CARES process, my legislation would hold the VA accountable for improving access for rural veterans through Community Based Outpatient Clinics (CBOCs) and other access points by requiring the VA to develop and implement a plan for improving veterans' access to quality care in rural areas. The May 2004 Secretary's CARES decision identified 156 priority CBOCs and new sites of care nationwide. The VA Secretary would also be required to develop a plan for meeting the long-term care needs of rural veterans, expanding adult day-care and respite care programs for rural veterans, expanding the use of telemedicine to enhance the care of rural veterans, and expand access to mental health care for rural veterans.

The 2005 groundbreaking Institute of Medicine report on The Future of Rural Health recommended that the federal government incorporate a rural focus in planning and developing a national health information infrastructure. The VA has been a leader in developing an electronic medical record system to enhance patient safety and improve quality of care. This legislation recognizes that VA has a leading role and responsibility to help rural veterans and their providers. The bill would establish a health information technology pilot to ensure a continuum of quality of care for veterans that rely on VA provided care, VA fee-basis care and contracted care. The pilot would have the VA partner with a range of providers including community health centers, rural health clinics and critical access hospitals, where appropriate.

Rural veterans, veteran service organizations and other experts need a seat at the table to help the VA consider important program and policy decisions that affect rural veterans. The legislation would establish a Rural Veterans Advisory Committee to harness the knowledge and expertise of representatives from other federal agencies, academic affiliates, veterans and other experts to recommend opportunities to meet the challenges of veterans' rural health care.

This legislation would also put VA in the forefront of researching, developing and evaluating innovative approaches in the delivery of rural health care by establishing four Rural Health Research, Education, and Clinical Care Centers. These centers of rural health care excellence will conduct research on rural health services, allow the VA to pioneer models for furnishing services to treat rural veterans, provide education and training for health care professionals, and develop and implement innovative clinical activities and systems of care. These centers would maximize the investment of federal tax dollars by collaborating with Department of Health and Human Services Rural Research Centers.

Health workforce shortages and recruitment and retention of the health care workers are key challenges to rural veterans' access to care and quality of care. Rural Americans face a unique combination of factors that create disparities in health care not found in urban areas. Only 10 percent of physicians practice in rural areas despite the fact that one-fourth of the U.S. population lives in these areas. State offices of rural health identify access to mental health care and concerns for suicide, stress, depression, and anxiety disorders as major rural health concerns. The 2005 IOM report recommended that the federal government initiate a renewed, vigorous and comprehensive effort to enhance the supply of health professionals working in rural areas.

The VA's involvement in medical and nursing education of future rural providers is essential. Almost 28,000 medical residents and 16,000 medical students receive some of their training in the VA every year. In addition, over 32,000 associated health students, including future nurses, pharmacists, dentists, audiologists, social workers, psychologists, physical therapists, optometrists, respiratory therapists, physician assistants and nurse practitioners, receive training through the VA.

This legislation would place VA at the forefront of enhancing the rural education and training of health professionals. The legislation requires the VA Secretary to institute additional rotations for medical residents in rural areas; establish programs to enhance the education, training, recruitment and retention of nurses in rural areas; and create programs to enhance the education, training, recruitment and retention of allied health professionals in rural areas.

Helping homeless veterans in rural and remote locations recover, rehabilitate and reintegrate into society is complex and challenging. The VA has no specific programs to help community providers who focus on homeless veterans in rural and remote locations. This legislation would authorize special grants to community providers to meet the needs of homeless rural veterans.

Native American, Native Hawaiian and Native Alaskan veterans have unique needs. This legislation would expand VA's health care presence in these rural and remote communities.

Rural America has always answered the call to service. We should do everything we can to ensure that rural veterans have the same reasonable access to the high quality care available through the VA as veterans in suburban and urban areas. I urge my colleagues to support the Rural Veterans Health' Care Act of 2006.

The American Legion,

Washington, DC, June 5, 2006.

Hon. Michael Michaud,

House of Representatives,

Washington, DC.

Dear Representative Michaud: On behalf of the 2.7 million

members of The American Legion, I would like to express our

support for your legislation addressing rural veterans health

care.

The American Legion understands the dire straits that many

veterans who reside in rural and highly rural areas find

themselves. As the Global War on Terror and the ongoing

conflicts in Afghanistan and Iraq continue to escalate, the

need for the nation's Active Duty, National Guard and Reserve

service members to deploy not once, twice, but three times is

becoming the rule and not the exception. The need for the

Department of Veterans Affairs (VA) to reach out to these

veterans, many of them in rural communities, has reached an

unprecedented scale. The time is now for VA to take

responsibility to bring those veterans in and provide them

the services they not only need, but also earned.

Adequate and directed outreach, rural mental health

services, trained medical staff, rural health research and

homeless rural veterans are all key components of your

legislation that address the growing dilemma that is access

to rural health care.

The American Legion believes this legislation will go a

long way in addressing this crucial issue and we thank you

for your continued leadership and support of America's

veterans and their families.

Sincerely,

Steve Robertson,

Director,

National Legislative Commission.

Mr. President, I commend the distinguished chairman of the Committee on Veterans' Affairs. Senator Craig has done an outstanding job of making sure the laws that weren't working, where we were not doing what we should be doing to help our veterans, were changed.

He has worked a long time on the bill now coming to its final passage--finally. He has been working on it for 2 years, that I am aware. He has done a terrific job. There is a lot of authorization that is essential to go forward next year on appropriations.

I appreciate the work of the Senator. He is retiring as chairman of the Committee on Veterans' Affairs and going to ranking member. I know his working relationship with the new chairman is such that we will continue to see progress in this area.

military construction appropriations

I will talk about the continuing resolution being passed by the House in a few hours that will be sent to the Senate. We will send that bill to the President to meet the midnight deadline so Government can continue to function.

I am talking tonight about this bill with very mixed feelings because I am chairman of the Appropriations Subcommittee on Military Construction, Veterans' Affairs and Related Agencies, and I wanted to pass the full bill, the appropriations for military construction, and I wanted to make sure we covered our veterans' needs. It is an important subcommittee, of which I have served as chairman these last 2 years. I have worked with my ranking member, Senator Feinstein, to assure we had the funding we needed. Senator Feinstein and I were ready to go on our bill. It passed in September. It is a bill that passed unanimously in the Senate. I know everyone agreed we had

covered the bases that need to be covered to do what is right for our military--active duty and the veterans--who have served our country in the past.

Unfortunately, our full bill is not going to pass. It is not going to pass because, first, it was held up in the Senate for appointing conferees, held up by a few Senators who thwarted the majority. I was very disappointed we lost those weeks. Our Appropriations Committee chairman Thad Cochran tried, as I, to pry the bill out so we could go to conference and work with the House.

Finally, this week, through the leadership of Senator Frist and Senator Stevens from Alaska, the chairman of the Appropriations Subcommittee on Defense, we were able to alleviate all of the concerns raised and get the bill to conference.

Then, unfortunately, the members of the House committee had determined we did not have enough time to conference the bill. I think we did have enough time. We had the time to do all of the construction that should be started right now. However, that is not going to happen.

I would not have allowed this bill to go forward, and I would be speaking against it right now if we did not have a provision in the House-passed continuing resolution that will give budget transfer authority to the Department of Veterans Affairs so that there will be no medical need, no service need, no payment to any veteran that will not be made before this continuing resolution runs out.

If that provision had not been added in the bill, we would not be passing this bill tonight because I would be talking all night to keep it from passing.

I called the Secretary of Veterans Affairs this afternoon, and I asked him if he could assure me that there would be enough money in the accounts from which they could transfer to assure that all of the medical needs, including surges in medical needs, would be able to be given. The Secretary assured me that is the case. The Secretary said they had enough surplus money, enough rainy day fund money, and enough money in the other accounts that they would not hurt the other accounts and they would be able to transfer. He did say that by the time we got to February 15, if we didn't have a full bill, they would be beginning to run into trouble. He gave me his word--and I know his word is good-- that if they see some shortfall that would start happening before February 15, and if there is no bill, he would call me immediately, and we would begin to work on a supplemental approach.

I am certainly going to trust his word. Secretary Nicholson has been a man of his word throughout these years I have worked with him. He is a veteran himself, a distinguished veteran. He knows the veterans issues. He cares about veterans. He will call, as he did last year when he saw a looming shortfall and he asked for help and we gave him the help to assure the veterans' needs would be met. We are going to cover it, and we are going to do it in a way that will assure that the medical care is given.

I have to say, I am disappointed we are going to adjourn without completing the full bill, without completing the military construction so it can start right away, without completing the appropriations and the priorities that we are putting in the next year for veterans. I know they will not suffer in any way because Secretary Nicholson assured me of that.

I will be watching. I will be staying on top of the VA's financial situation throughout this period that the continuing resolution is going to run, to the middle of February. If a problem arises, I will not stop advocating for the supplemental appropriation that will be necessary to assure we have the funding we need.

We will work together in this Congress to assure that the men and women who are protecting our freedom, as we speak today, get the quality of life they deserve. We will continue to work together to assure that the veterans who have served our country, who have answered the call of our country, are given everything to which they are entitled and which we owe them.

I am going to be the ranking member of this subcommittee next year, having served as chairman for 2 years with a wonderful ranking member, Senator Feinstein. It has been pure joy. She has a wonderful staff. We have never had a disagreement that couldn't be worked out. We have made sure the priorities, which are the same for both of us, have been met. I will be a loyal ranking member, and I hope the new chairman will have the same relationship and the same overall goal for Military Construction and Veterans Affairs that Senator Feinstein and I have had. I believe he will.

I am going to vote for the continuing resolution. However, I could not be more disappointed that we did not pass the full appropriations bill for Military Construction and Veterans Affairs. I know the veterans will be taken care of, and I know the military construction will begin with the new starts a couple of months late. We will get those projects done with that small delay. I am going to make it my priority to assure that happens.

Senator Stevens has come to the Senate. I want to say, in addition to Senator Cochran, Senator Stevens and Senator Inouye have been the advocates for our military throughout the time I have been in the Senate. I am honored to be a member of the Appropriations Subcommittee on Defense. I know those two leaders work together, as Senator Feinstein and I do, and that is with one goal: to make sure the military, who are in harm's way, who are fighting so we may speak freely in this Chamber, who are fighting for our children and grandchildren to have the freedom we enjoy and that has been given to us by generations past, will have the opportunities they deserve, and that is the quality of life that we can give them.

I thank the Senate for coming to the end with this continuing resolution. I will support it.

I yield the floor.

Mr. President, I would just like to clarify, with the Senator from Alaska on this subject, that the Senate did act. The Senate did pass our bill, and we did appoint conferees, and it was a lack of willingness on the part of the House to have conferees meet with the Senate. His disappointment is the same as mine.

I am going to start working on January 4, when we are sworn in to the new Congress. And I hope we can take the bill that has been passed unanimously by the Senate and work through the appropriations process and pass this bill before the continuing resolution is ended on February 15. We do not have to wait until February 15. And once the committee is constituted, and we have a chairman and a ranking member, I will be the ranking member, and I will work with the chairman. And I hope we can pass this bill because it is in very good order and it was unanimously supported by the Senate. And I think we are pretty close to what the House passed. I think, with a strong will, we will be able to come in before February 15 and start those projects about which the Senator from Alaska just spoke.

So I will look forward to working with him in the new year, both for Defense appropriations and for this Military Construction bill and the Veterans Affairs bill and the military quality of life that is in the bill that we passed in the Senate earlier this year.

I thank the Senator.

Mr. President, I wish to take a few minutes. I ask unanimous consent the Senator from Ohio, Mr. DeWine, be permitted to take the floor following my remarks.

Mr. President, we ought to understand what we are talking about now because the bills that are before the Senate now and the CR should have been enacted by October 1. This bill will move that money out to February now and will not be available to the department agencies until sometime in February.

I am concerned about this because prior to this Congress, the quality-of-life money for the members of the Department of Defense was under the Appropriations Subcommittee on Defense that I cochair with my friend from Hawaii, Senator Inouye.

We are disturbed that Congress has not finished its work on the Military Construction and Veterans Affairs appropriations bill. To me, the failure to complete this work is inexplicable.

I am disappointed we are unable to reach an agreement with the House on the matters contained in this bill and to realize the necessity of completing action on the bill in total. We are neglecting our congressional responsibilities by not completing work on this bill. It is unfortunate. We have had a considerable amount of time to do so.

This is not a routine disagreement between Members of the House and the Senate. This is a disagreement that affects our Nation while we are at war. We have hundreds of thousands of service men and women deployed around the world. This sends a message we are not willing to take the time to finish the work necessary to assure they have the money, the funding, the facilities to do the work we have asked them to do. It will have an impact on military life and the morale of our armed services.

The Military Construction appropriations bill not only contains money for military construction and for quality of life, but it also contains the money for our veterans. In total, it provides critical funding for family housing, barracks, mission facilities, implementation of the base closure and realignment process, maintenance of defense and veterans facilities, environment cleanup, the Defense Health Program, and medical care for our veterans.

Now I am told that the CR does now come up to the President's request for

the medical health program, and that really removes part of my objection to proceeding on this bill. Without this bill, the Department of Defense and Veterans Affairs have to contend with this continuing resolution. Most people do not understand it. It means these moneys will be postponed until mid-February, the additional moneys that are necessary to meet the additional demands being placed on our Armed Services before September 30. We are supposed to finish this bill by September 30.

I am told the Department of Defense will not be able to start a single military construction project, although those projects were authorized more than 3 months ago. It means the projects cannot be started until the regular bill is passed. I hope it will be passed in February.

Now, I took the time to go to Italy and look at the new Army base there and the new Air Force base there, as we are redeploying our forces from Germany and other places into Italy. Those projects involve barracks, quality of life facilities, and family housing. That cannot go forward. The money will not be available because it was not covered by the 2006 appropriations bill. It is not covered by this continuing resolution.

I think it is true now, because of what I mentioned, the Veterans' Administration should be able to sustain the medical care for our veterans without disruption. But I can tell the Senate, they will not be able to go much more than mid-February without running into real trouble. So one of the first bills that ought to be considered when we get back is the Veterans appropriations bill.

I am here tonight because I announced to our conference I would oppose this CR unless it contained these bills in it. After consulting, and my staff consulting, with the Department of Defense, the Veterans' Administration, and understanding what the House has done now since that time on the medical portion for the Veterans' Administration, it does not seem possible for me to do that now. All I can do is express my deep reservation about voting for this bill under the circumstances.

We should have had at least the balance of the military money and the veterans money made available by this Congress before we went home. And I am really disappointed it is not possible.

Mr. President, I say to the Senator from Texas, you wish the floor again? The Senator from Ohio would follow me, but you wish to comment?

Mr. President, I thank the Senator from Texas for those comments.

My point is, the Congress as a whole should have finished its job. We should have done this job before this Congress ends, particularly for those bills which impact the men and women in our Armed Services, their families, and the veterans who have served, particularly the new class of veterans now who are coming out of the service, many of whom are wounded. Many of them have readjustment problems. This bill, the bill the Senator from Texas and her subcommittee prepared, would have answered many of those problems. It would have made money available now to deal with them.

I am chagrined that bill is not going to pass. I think it is a failure of this Congress. And we ought to admit it is a failure. But as far as this Senator is concerned, we have done everything we can to try to rectify that. It is just not possible to get the Congress to vote. The House has already voted. I do not think it is possible for us to try to amend this bill now. And I am told the agencies involved have reviewed it and say they will find a way to continue their work until February without it.

That does not answer the question to me though because the things they should start now would be well underway by February, and it will not be possible with postponing this bill. It is a tragedy we are not able to complete our appropriations process, in my opinion.

I yield the floor.

Mr. Speaker, since the founding of our Nation, rural Americans have always answered the call to service in times of war. One in three of the patients seen at the Department of Veterans Affairs lives in a rural community. Veterans who live in rural settings are often older and have more physical and mental health diseases as compared to veterans who live in suburban or urban settings. According to the 2005 Institute of Medicine report, The Future of Rural Health, the smaller, poorer, and more isolated a rural community is, the more difficult it is to ensure the availability of high-quality health services. With some 44 percent of current military recruits coming from rural areas, we must help VA focus on meeting the pressing health care needs of rural veterans.

I have introduced H.R. 5524, the Rural Veterans Health Care Act of 2006, to take a comprehensive and practical approach towards improving care for our rural veterans by increasing community based facilities and outreach, encouraging the training and recruitment of health care professionals, focusing on research to develop innovative solutions to the challenges of delivering rural health care, and developing the information technology infrastructure we need to enhance health care services in rural areas.

Rural America has always answered the call to service. We should do everything we can to ensure that rural veterans have the same reasonable access to the high quality care available through the VA as veterans in suburban and urban areas. I urge my colleagues to support rural veterans and pass H.R. 5524.

Mr. Speaker I would like to include in the Congressional Record a letter of support for H.R. 5524, the Rural Veterans Health Care Act of 2006, from the National Rural Health Association.

National Rural Health Association,

Kansas City, MO, July 17, 2006.

Hon. Michael Michaud,

House of Representatives,

Washington, DC.

Dear Representative Michaud: On behalf of the National

Rural Health Association, I am writing to express our strong

support for H.R 5524, the ``Rural Veterans Health Care Act of

2006.''

The NRHA is a national nonprofit, non partisan, membership

organization with approximately 10,000 members that provides

leadership on rural health issues. The Association's mission

is to improve the health of rural Americans and to provide

leadership on rural health issues through advocacy,

communications, education and research. The NRHA membership

consists of a diverse collection of individuals and

organizations, all of whom share the common bond of an

interest in rural health.

The NRHA members are keenly aware of the disproportionate

rates at which rural people serve in the military and the

issues our rural veterans face in obtaining health and mental

health care in rural communities. We are pleased to see so

many provisions in this legislation to address these

concerns. In particular, the provisions which call for

expansion of and improved quality of services provided by Vet

Centers, Outreach Health Centers, and CBOCs in rural areas.

These services represent approaches that greatly increase

access to quality care for these vets. Vet Centers, as is

their role, will also educate returning rural veterans to

their benefits and the services they have earned.

The bill also addresses the long term care needs of rural

vets, the use of an electronic medical record system to

enhance patient safety and improve quality of care, takes

advantage of the groundbreaking IOM report on the future of

rural health care recommendations, and provides a provision

for the training of health care professionals in rural

facilities serving veterans. All of these provisions are

included in NRHA's support. The NRHA is especially supportive

of the call for a national Advisory Committee on Rural

Veterans, and offer up any assistance we might make in

recommending members for this committee should the

legislation be successful. In addition, we are pleased that

the legislation increases the number of rural rotations for

medical residents training at the VA and takes steps to

enhance the education, training, retention, and recruitment

of health professionals in rural areas. Research has shown

that rural rotations are effective in increasing the number

of medical personnel that choose to practice in rural areas.

The NRHA is supportive and involved in the dissemination of

research and resources developed by the Department of Health

and Human Services (HHS) Rural Research Centers, therefore,

we support the provisions in the bill which would designate

at least four centers as the location for research targeted

at defining rural veteran health and mental health care

needs, and chronic disease management. NRHA is keenly aware

of the limited research on rural veterans and their families,

and this provision will begin to address the dearth of

research in this area.

The NRHA maintains a Minority and Multicultural committee

within our organization and develops many policy statements

regarding the unique needs of rural minority groups and

women. We are pleased to see the specific inclusion of Native

American, Native Hawaiian and Native Alaskan veterans in this

legislation. This legislation would expand VA's health care

presence in these rural and remote communities. The NRHA also

hopes that special consideration will also be given to the

unprecedented number of African American women and all women

serving at the highest rates ever seen in our country and the

special needs that they will bring into the VA system in just

a few short years.

The NRHA developed the first national policy paper as a

non-Veteran Service Organization on rural veterans in 2003-

2004, and we are pleased to see some of the recommendations

called for in our policy paper addressed in this legislation.

For these many reasons, the NRHA strongly supports your

efforts to urge Congress to enact the ``Rural Veterans Health

Care Act of 2006.'' Thank you for your leadership on this

issue.

Sincerely,

William Sexton,

President.