Mr. President, I rise today to proudly join my friend and colleague Senator Blanche Lincoln in the introduction of the Servicemembers' Healthcare Benefits and Rehabilitation Enhancement Act of 2007.…
Mr. President, I rise today to proudly join my friend and colleague Senator Blanche Lincoln in the introduction of the Servicemembers' Healthcare Benefits and Rehabilitation Enhancement Act of 2007.
In March, I was able to visit one of Maine's returning soldiers who has been assigned outpatient care at the Walter Reed Army Medical Center. We spoke about the many issues and obstacles faced by our wounded troops as they struggle not only to recover from their injuries, but to prepare themselves for their future. During our meeting, this soldier covered many of the pitfalls faced by troops as they confront the bewildering processes of medical and physical evaluation boards without the benefit of anyone to advocate on their behalf. In fact, he aptly described the process as an ``adversarial'' system that onerously demands wounded soldiers to provide the ``burden of proof '' for their claims.
In response, we have crafted this legislation in order to remedy a variety of flaws that currently plague the military health care system, including: Inequitable disability ratings, a lack of advocacy within military outpatient facilities, inadequate mental health treatment, and inefficient transition from the DOD to the VA.
First off, our bill would address the concerns I have heard from a number of returning troops from my home State of Maine and across this Nation who have gone without the proper advocacy and case management for medical benefits during their stay at military outpatient facilities. It is inexcusable that our returning heroes are often forced to navigate the esoteric physical disability evaluation system, PDES, within an adversarial atmosphere.
The measure we are proposing would require the Secretary of Defense to provide each recovering servicemember in a military medical treatment facility with a medical care manager who will assist him or her with all matters regarding their medical status, along with a caseworker who will assist each servicemember and his or her family in obtaining all the information necessary for transition, recovery, and benefits collection. Further, provisions we included will create a DOD- wide ombudsmen office to provide policy guidance to, and oversight of, ombudsman offices in all military departments and the medical system of the DOD. Only then, will our returning servicemembers recover within an atmosphere that is based upon advocacy.
Additionally, recent news reports and independent analysis have revealed troubling statistics regarding rampant inaccuracies within the military disability ratings system. According to Pentagon data analyzed by the Veterans' Disability Benefits Commission, since 2000, 92.7 percent of all disability ratings handed out by physical evaluation boards, PEBs, have been 20 percent or lower. Under the current policy, those who receive disability ratings under 30 percent and have served less than 20 years of military service are discharged with only a severance check, deprived of full military retirement pay, life insurance, health insurance, and access to military commissaries.
Further evidence of a troubled disability ratings system shows that since America went to war in Afghanistan and Iraq, fewer veterans have received disability ratings of 30 percent or more, inferring that the DOD may have lowered the ratings for injured troops who would have otherwise received a host of lifelong benefits. On top of that, it currently takes an average of 209 days for troops to complete the PDES process by receiving notification of potential discharge and a subsequent disability rating.
As a means of fixing these blatant flaws within the military disability ratings system, this legislation consolidates the physical evaluation system by placing the informal and formal physical evaluation boards under one command, as a method of streamlining and expediting the process. Our troops deserve timely care and efficient treatment upon their return home, and therefore, no recovering servicemember should be forced to endure lengthy delays in a medical hold or holdover status due to bureaucratic inefficiencies.
The bill also requires that physicians preparing each individual medical case for all physical evaluation boards report multiple diagnosed medical impairments that, in concert, may deem a servicemember to be unfit for duty. Under the current system, the U.S. Army, for example, only rates physical impairments that individually, cause a servicemember to be deemed unfit for duty, ultimately dismissing ailments that may significantly hinder a servicemember's ability to continue his or her service in the military or find gainful employment in the civilian sector.
Over the past year, the American public has also become acutely aware of the effects of traumatic brain injury, TBI, which has become the signature injury of the wars in Iraq and Afghanistan, affecting thousands of returning servicemembers. Therefore, it is now more imperative than ever for both the DOD and the VA to implement mental health treatment policies that accurately diagnose and adequately treat debilitating mental health injuries among our injured troops.
Our bill addresses these issues by including a provision that requires all servicemembers who are expected to deploy to a combat theater to receive a mental health assessment that tests their cognitive functioning within 120
days before deployment, a mental health assessment within 60 days after deployment, to include a comprehensive screening for mild, moderate, and severe cases of TBI. Additionally, all servicemembers will receive a third mental health assessment at the time of their predischarge physical.
The measure we are putting forward today also aims to update the current disability ratings system used by the military and the VA to include the effects of TBI and posttraumatic stress disorder, along with any other mental health disorders that may affect our Nation's returning warriors. The Secretary of Veterans Affairs would be required to issue a report to Congress detailing a plan to update the Veteran's Administration Schedule for Ratings Disabilities, VASRD, to align its disability ratings to more closely reflect the effects of mental health disorders, including TBI and PTSD on the modern workforce.
The Servicemembers' Healthcare Benefits and Rehabilitation Enhancement Act of 2007 also calls on the Secretaries of Defense and Veterans Affairs to provide Congress with a report detailing plans to increase the role of eligible private sector rehabilitation providers for assisting the VA in providing comprehensive post acute inpatient and outpatient rehabilitation for TBI and PTSD, if in certain instances, the VA is unable to provide such services.
The Veterans Health Administration is, unequivocally, the foremost expert in providing mental health treatment for our recovering servicemembers, yet in varying circumstances, the VA may require additional health care coverage in remote areas. All of our returning heroes, despite the severity of their mental health ailments, or their location geographically, deserve every available option for rehabilitative services, to ensure that they never go untreated.
Additionally, to help ease the transition from the military health care system to the VA system, both the DOD and the VA must adopt and implement a unified electronic medical database. Interagency database compatibility would not only increase medical efficiency, but it would significantly ease the transition into civilian life for injured or retiring servicemembers who deserve timely and effective health care. Therefore, our legislation establishes and implements a single electronic military and medical record database within the DOD that will be used to track and record the medical status of each member of the Armed Forces in theater and throughout the military health care process, and will be accessible to the VA through the joint patient tracking application, JPTA. This electronic records system will be identical to the VistA system, currently used by the VA, which has served as a model of excellence for electronic medical databases among our Nation's health community.
I have nothing but the utmost respect for those brave Americans who served in uniform with honor, courage, and distinction. The obligation our Nation holds for its servicemembers and veterans is enormous, and it is an obligation that must be fulfilled every day. We must always remain cognizant of the wisdom laid forth by President George Washington, when he stated, ``The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional as to how they perceive the Veterans of earlier wars were treated and appreciated by their country.''
At a time when over 600,000 courageous men and women have returned from combat in both Iraq and Afghanistan, I believe it is now up to Congress to do everything in its power to answer the call of our men and women who have nobly served our Nation in uniform, to ensure that they receive the heroes treatment they rightly earned and rightly deserve. Again, I want to thank my colleague, Senator Lincoln, for her assistance in making this a stronger bill and bringing it before the Senate. I strongly urge my colleagues to support this legislation.
Mr. President, as ranking member of the Senate Committee on Small Business and Entrepreneurship, I rise today to join with Chairman Kerry in introducing the Entrepreneurial Development Act of 2007, a bill to reauthorize and improve the U.S. Small Business Administration's--SBA--Entrepreneurial Development Programs. I have long fought to expand the power and reach of the SBA's entrepreneurial development tools, which are used by millions of aspiring entrepreneurs and small businesses across the United States. These programs demonstrate how Congress can play a positive role in enhancing private- sector financing for start-up companies. We must continue to strengthen these core SBA programs because they have proven invaluable in aiding the efforts and dreams of America's entrepreneurs.
The bill which I am cosponsoring today is the product of the type of bipartisan work the Small Business Committee has come to be known for. The provisions contained in this legislation are a compilation of ideas and initiatives put forward by myself, Chairman Kerry, and other Committee members. Much of the language in the Entrepreneurial Development Act of 2007 was contained in my SBA Reauthorization and Improvements Act passed unanimously by the Small Business Committee during the 109th Congress. Unfortunately, this bipartisan bill never passed the Senate.
Since 1980, Small Business Development Centers--SBDCs--have been essential in the delivery of management and technical counseling assistance and educational programs to prospective and existing small business owners. Since its inception, the SBDC program has served over 11 million clients with new business starts, sustainability programs for struggling firms, and expansion plans for growth firms. For every dollar spent on the SBDC program, approximately $2.66 in tax revenue is generated.
An example of the local value of the SBDC program is found in my home State of Maine, where SBDCs invested more than 10,000 hours in counseling to 3,000 clients in 2005. The economic benefits of these services on the economy in Maine was demonstrated by a recent study of the Maine SBDCs that showed: No. 1, long-term clients of the Maine SBDC generated $44 million in incremental sales and 908 new jobs because of SBDC counseling assistance; and No. 2, the total amount of tax revenue generated as a result of counseling 5 or more hours is approximately $3.0 million in State taxes and $1.58 million in Federal tax revenues.
The Women's Business Center--WBC--program, established by Congress in 1988, promotes the growth of women-owned businesses through business training and technical assistance, and provides access to credit and capital, Federal contracts, and international trade opportunities. The WBC program served more than 144,000 clients across the country last year, providing help with financial management, procurement training, marketing and technical assistance. WBCs also provide specialized programs that include mentoring in various languages, Internet training, issues facing displaced workers, and rural home-based entrepreneurs. According to the SBA's 2008 budget submission, WBCs were responsible for creating or retaining over 6,800 jobs nationwide. I take great pride in the fact that my own State of Maine leads the way for women-owned businesses. Today, there are more than 63,000 women- owned firms in Maine, employing over 75,000 Mainers and generating more than $9 billion in sales. We must all be committed to multiplying that story of success in every State in America.
Service Corps of Retired Executives--SCORE--is a nonprofit association that matches business-management counselors with small business clients. SCORE volunteer counselors share their management and technical expertise with both existing and prospective small business owners. With its 10,500 member volunteer association sponsored by the SBA, and more than 389 service delivery points and a Web site, SCORE provides counseling to small businesses nationwide. The National SCORE organization delivers its services of business and technical assistance through a national network of chapters, an Internet counseling site, partnerships with SBA, the SBDCs and WBCs, and with the public/private sector. In 2006, SCORE counseled and trained over 300,000 clients.
The bill being introduced today builds upon the aforementioned successes of SBA's Entrepreneurial Development programs, which counsels over 1.2 million small businesses and entrepreneurs each year through the expertise of the trained resource partners located across America.
In addition to reauthorizing SBA's Entrepreneurial Development programs and increasing funding levels, this bill also addresses the crisis small businesses face when it comes to securing quality, affordable health insurance. In 4 of the past 5 years, health insurance costs have increased by double-digit percentage levels. This has led to a disturbing trend of fewer and fewer small businesses being able to offer health insurance to their employees. The Kaiser Family Foundation recently reported that only 47 percent of our Nation's smallest businesses--with less than 10 employees--are able to
offer health insurance as a workplace benefit. In stark contrast, health insurance is nearly universally offered at larger businesses.
A key provision in this bill would establish a 4-year, pilot grant program to provide information, counseling, and educational materials to small businesses, through the well-established national framework of SBDCs. Recent research conducted by the non-partisan Healthcare Leadership Council found that with a short educational and counseling session, small businesses were up to 33 percent more likely to offer health insurance to their employees. My proposal is based on the Small Business Health Education and Awareness Act, which I introduced in the 109th Congress with Senator Bennett, and plan to reintroduce this session with Senators Kerry and Bennett.
Most American workers are employed by small and medium sized enterprises. It is these businesses that account for nearly 98 percent of the growth in exporter population--and are among the major beneficiaries when foreign barriers are reduced. Additionally, 97 percent of exporters are small businesses. Over the last decade, the number of exports from small businesses increased by more than 250 percent. Small businesses account for almost $300 billion of yearly export sales--nearly one-third of total U.S. exports.
This bill establishes an Associate Administrator for International Trade, and expands the trade distribution network to include the United States Export Assistance Centers USEACs. In addition, this section ensures that all our Nation's small exporters have access to export financing. This provision establishes a floor of international finance specialists at level SBA had in January 2003. Finally, this provision increases the maximum loan guarantee amount to $2.75 million and specifies that the loan cap for international trade loans--ITLs--is $3.67 million, as well as sets out that working capital is an eligible use for loan proceeds. The bill also makes ITLs consistent with regular SBA 7(a) loans in terms of allowing the same collateral and refinancing terms as with regular 7(a) loans.
The SBA's entrepreneurial development programs provide tremendous value for a relatively small investment. I am committed to ensuring that Americans have the necessary resources to start, grow, and develop a business. I believe that it is our duty to do everything possible to sustain prosperity and job creation throughout the United States. I urge my colleagues to support this vital piece of legislation.