To amend title 38, United States Code, to establish the position of Director of Physician Assistant Services within the office of the Under Secretary of Veterans Affairs for Health.

Madam Speaker, I rise today to talk about some important legislation that honors the sacrifice and courage of our women who have served and are currently serving in our armed forces.

The Veteran's legislation we considered today provides an opportunity for each of us, regardless of political views, religion, ethnicity, gender, or background to come together, and to recognize and honor our Nation's heroes.

We gather here today, in the midst of ongoing conflict and warfare, to celebrate the dedication of our men and women in uniform. Though we may be divided by our positions on the war in Iraq, we stand together to support our veterans. Our Nation has a proud legacy of appreciation and commitment to the men and women who have worn the uniform in defense of this country. We must be united in seeing that every soldier, sailor, airman, and marine is welcomed back with all the care and compassion this grateful Nation can bestow.

All too many of our veterans are left without the help and support they need to transition from the horrors they bravely face on the front lines of battle to successful civilian life. According to the Veterans Affairs Department, as of 2006, on any given night, 196,000 veterans of all ages were homeless.

The V.A. also reports 400 veterans of the wars in Iraq and Afghanistan alone have already become homeless, and this figure only takes into account those who have sought services from V.A.-sponsored programs. Experts have predicted that the trauma resulting from the extreme horrors of these modern wars could lead to a surge in homeless veterans in the coming years.

I chose to celebrate one of our heroic daughters of Texas, Specialist Monica L. Brown of the United States Army with House Concurrent Resolution 320 for her efforts earlier this year.

Spec. Brown was the first woman in Afghanistan and only the second female soldier since World War II to receive the Silver Star, the Nation's third-highest medal for valor. This solider from Lake Jackson, Texas is only 19 years old.

On April 25, 2007, Specialist Brown was part of a four-vehicle convoy patrolling near

Jani Kheil in the eastern province of Paktia on April 25, 2007, when a bomb struck one of the Humvees.

When Spec. Brown saw her fellow soldiers were injured, she grabbed her aid bag and started running toward the burning vehicle as insurgents opened fire. All five wounded soldiers from her platoon scrambled out. Under this commotion, she assessed her patients and moved them to a safer location because they were still receiving incoming fire.

The Pentagon's official policy is to prohibit women from serving in front-line combat roles in the infantry, armor or artillery, but the nature of the wars in Afghanistan and Iraq, with no real front lines, has seen women soldiers take part in close-quarters combat more than previous conflicts.

According to the army four Army nurses in World War II were the first women to receive the Silver Star, though three nurses serving in World War I were awarded the medal posthumously in 2007. Sgt. Leigh Ann Hester, of Nashville, Tenn., was the first to receive the Silver Star in 2005 along with two fellow male soldiers for her gallantry during an insurgent ambush on a convoy in Iraq.

The Army has stated that Spec. Brown's ``bravery, unselfish actions and medical aid rendered under fire saved the lives of her comrades and represents the finest traditions of heroism in combat.''

Though I have opposed the war in Iraq from its inception, I remain absolutely committed to ensuring that we recognize, celebrate, and honor the service of our sons and daughters returning from Iraq and Afghanistan. Our troops in Iraq did everything we asked them to do, and I firmly believe that we must commend the men and women of our military for their exemplary performance and success in Iraq.

I am proud to be a cosponsor on H. Res. 1054--Honoring the service and achievements of women in the Armed Forces and female veterans (Representative Davis (CA)--Armed Services) and H.R. 3819--Veterans Emergency Care Fairness Act of 2007 (Representative Space--Veterans' Affairs).

We are providing for our Veterans with legislation such as:

H.R. 6081--The Heroes Earnings Assistance and Relief Tax Act of 2008 (Representative Rangel--Ways and Means).

H. Res. 986--Recognizing the courage and sacrifice of those members of the United States Armed Forces who were held as prisoners of war during the Vietnam conflict and calling for a full accounting of the 1,729 members of the Armed Forces who remain unaccounted for from the Vietnam conflict (Representative Boehner--Armed Services)--Recorded Vote

H.R. 2790--To establish the position of Director of Physician Assistant Services within the office of the Under Secretary of Veterans Affairs for Health as amended (Representative Hare--Veterans' Affairs).

H.R. 3681--Veterans Benefits Awareness Act of 2007 (Representative Boozman--Veterans' Affairs).

H.R. 3889--To require the Secretary of Veterans Affairs to conduct a longitudinal study of the vocational rehabilitation programs administered by the Secretary (Representative Boozman--Veterans' Affairs)--Passed

H.R. 5554--Veterans Substance Use Disorders Prevention and Treatment Act of 2008 (Representative Michaud--Veterans' Affairs)--Passed

H.R. 5664--To direct the Secretary of Veterans Affairs to update at least once every six years the plans and specifications for specially adapted housing furnished to veterans by the Secretary (Representative Rodriguez--Veterans' Affairs).

H.R. 5826--Veterans' Compensation Cost-of-Living Adjustment Act of 2008 (Representative Rodriguez--Veterans' Affairs)--Recorded Vote

H.R. 5856--Department of Veterans Affairs Medical Facility Authorization and Lease Act of 2008 (Representative Michaud--Veterans' Affairs).

H.R. 6048--To amend the Service members Civil Relief Act to provide for the protection of child custody arrangements for parents who are members of the Armed Forces deployed in support of a contingency operation (Representative Turner--Veterans' Affairs).

I firmly believe that we should celebrate our veterans after every conflict, and I remain committed, as a Member of Congress, to both meeting the needs of veterans of previous wars, and to provide a fitting welcome home to those who are now serving. Veterans have kept their promise to serve our Nation; they have willingly risked their lives to protect the country we all love. We must now ensure that we keep our promises to our veterans.

Currently, there are over 25 million veterans in the United States. There are more than 1,633,000 veterans living in Texas and more than 32,000 veterans living in my congressional district alone. I hope we will all take the time to show appreciation to those who have answered the call to duty. As Winston Churchill famously stated, ``Never in the field of human conflict was so much owed by so many to so few.''

Madam Speaker, I encourage my colleagues to join me in supporting our troops of yesteryear and our troops of today.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 2790) to amend title 38, United States Code, to establish the position of Director of Physician Assistant Services within the office of the Under

Secretary of Veterans Affairs for Health, as amended.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I am pleased that the House today is considering H.R. 2790, a bill I authored to elevate the current position of Physician Assistant Advisor to a full-time Director of Physician Assistant Services in the VA Central Office.

I would like to thank my good friend Representative Jerry Moran for leading the effort with me, as well as Chairman Filner and Ranking Member Buyer for their cosponsorship of this legislation. I'd also like to acknowledge all of my colleagues on the Veterans' Affairs Committee who joined as cosponsors and the American Academy of Physician Assistants for their tireless work on this bill.

Mr. Speaker, there are currently 1,600 physician assistants serving the Veterans' Health Administration, including many veterans, National Guard, and Reservists. PAs are a critical component of the health care delivery system and are responsible for roughly one-quarter of all primary care patients seen in the VHA.

The change from the current role of PA Advisor, who works part time and is based in the field, to a full-time Director is necessary in order to ensure that PAs are being appropriately and effectively utilized throughout the VHA. Right now the PA Advisor is being left out of strategic planning discussions and long-term staffing narratives, leaving PAs with no voice and no advocate. Additionally, there is a severe disparity throughout the VA facilities in how PAs are being used, what medical services they can perform, and even whether facilities can hire physician assistants. Most importantly, the unnecessary restrictions and widespread confusion are causing the VA to miss a clear opportunity to improve the quality of health care for our veterans.

One of the biggest challenges facing current and future PAs in the VA system is their exclusion from any recruitment and retention efforts or benefits. The VA designates certain positions, such as physicians and nurses, as critical occupations, which are given priority in loan repayment and scholarship programs. Since PAs are not designated as a critical occupation, they are excluded from these moneys, despite the fact that the VA has determined that physician assistants and nurse practitioners are functionally interchangeable and equal in the work that they perform. The underutilization, the lack of recruitment and retention efforts, and pay disparity are all leading PAs to not consider the VHA as a viable employment option.

Physician assistants are very important for veterans living in rural areas, like a large portion of my congressional district. Veterans that live in underserved areas made the same sacrifices as their urban and suburban counterparts. With a disproportionate number of these brave men and women being cared for by PAs, it is critical that we establish a system that will best serve their needs so as not to compromise care to our veterans. Considering the fact that nearly 40 percent of all VA PAs are projected to retire in the next 5 years, the VA is in danger of losing its physician assistants workforce unless some attention is paid to this critical group.

This bill will allow the Director of Physician Assistant Services to become an integral component within the VA system to proactively solve the many issues facing PAs and give PAs a fair and long overdue voice.

Mr. Speaker, this commonsense legislation promotes quality medical care for our veterans. I urge my colleagues to support it.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I would like to recognize my friend from New Hampshire (Ms. Shea-Porter) for such time as she may consume.

Mr. Speaker, I urge my colleagues to unanimously support H.R. 2790, as amended.

Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

General Leave

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material on H.R. 2790, as amended.

Mr. Speaker, I'd like to take this opportunity to thank the sponsor of this legislation, the gentleman from Illinois, Phil Hare, who's a leader and a tireless advocate for veterans.

This Memorial Day we honor the memory of so many who have served this Nation. In honor of their memory, it's fitting that we consider legislation today that will help deliver the benefits that were promised to our veterans and which they earned by their selfless service to our Nation.

The bill before us, H.R. 2790, will create the position of Director of Physician Assistant Services in the VA to manage the education, training, and utilization of physician assistants within the Veterans Health Administration.

PAs play an important part in the health care of our veterans, providing a whole range of diagnostic and therapeutic services, administering physicals, taking patient histories, diagnosing and treating patients. The first PAs were former corpsmen who had served in Vietnam. Their extensive medical training made them ideal candidates for further medical education and the perfect fit for the continuing medical care of their fellow veterans. Since the PA Advisor position was created in the VA in 2000, their ranks have grown, and today almost 1,600 PAs serve in the VA.

PAs go through a very vigorous 2-year-long certification program, and by creating a Director of Physician Assistant Services in the VA, we can help

ensure that their expertise is properly utilized and that our veterans receive the care they deserve. Their utilization may also mean in rural States like mine that veterans have greater access to health care.

It's appropriate that we will pass this legislation today in honor of the veterans who have served our country so bravely. As a proud wife of a veteran myself, working to improve the care veterans were promised and have earned is a top priority for me, and I enthusiastically support this legislation. I urge my colleagues to support this also.

Mr. Speaker, I yield myself such time as I may consume.

As Memorial Day approaches, it's appropriate that we take time this week to consider the next 10 bills that are on the suspension calendar. In doing so, we must be mindful of the heavy sacrifices made by the men and the women of our Armed Forces. It is their sacrifices that allow us to enjoy our American way of life and time-honored traditions like Memorial Day.

For many of us, Memorial Day will be marked with a solemn commemoration at a veterans' cemetery or a befitting memorial. I appreciate Chairman Filner's expediting these bills through the committee process to bring them to the floor in a timely fashion.

Mr. Speaker, I rise this afternoon in support of H.R. 2790, as amended, a bill to establish the position of Director or Physician Assistant Services within the office of the Under Secretary of Veterans Affairs for Health. I commend my colleagues Mr. Hare and Mr. Moran for introducing this bill.

There is a strong relationship between military service and the physician assistant profession. In 1965 Duke University established the first PA education program to capture the knowledge of military medical corpsmen that served in Vietnam and transition their experience into the civilian health care system. Today the VA is the largest employer of physician assistants, and they play a central role in enhancing veterans' access to health care, and it's important for VA to continue to advance the utilization of these health care providers.

Establishing this office would be beneficial to veterans. A full-time Director would ensure PAs are used appropriately to provide veterans the health care that they deserve. I urge my colleagues to support this bill.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mr. Speaker, I want to thank Congressman Hare for his leadership on passage of this bill and my colleagues and staff on the House Veterans Affairs Committee for their support. I joined Congressman Hare as an original cosponsor of H.R. 2790. This bill creates a full-time Director of PA Services within the Department of Veterans Affairs. This legislation is beneficial in improving patient care for our Nation's veterans, ensuring that the 1,600 PAs employed by the VA are fully utilized to provide veterans medical care.

As a Member of Congress who represents one of the most rural districts in the country, I know that physician assistants are a key to providing medical care in underserved areas. Often, they are the only health care professional available. PAs help ensure those who live in our communities receive timely access to quality health care.

I want to be certain that PAs are appropriately utilized by the VA to serve our veterans. Like our armed forces that have full-time directors of PA services, this legislation will establish a dedicated expert in the VA Central Office. This PA Director will work to fully integrate the profession into VA health care, ensuring PAs have a stronger voice in the VA so they can better serve our veterans and their patients.