Mr. Speaker, I move to suspend the rules and pass the bill (S. 1963) to amend title 38, United States Code, to provide assistance to caregivers of veterans, to improve the provision of health care to…
Mr. Speaker, I move to suspend the rules and pass the bill (S. 1963) to amend title 38, United States Code, to provide assistance to caregivers of veterans, to improve the provision of health care to veterans, and for other purposes, as amended.
I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous materials on S. 1963, as amended.
I yield myself 4 minutes.
Mr. Speaker, when I became chairman of the Committee on Veterans' Affairs 3 years ago, the VA was strained to the breaking point by years of chronic underfunding. We were a country at war; yet, the Department of Veterans Affairs remained unprepared to care for the hundreds of thousands of new veterans returning from Iraq and Afghanistan.
It is simply our duty as a Nation, no matter where we stand on the war, to put our men and women in harm's way under the care of our Nation when they return. Under the Democratic leadership, Congress has provided almost a 60 percent increase for VA medical care funding over the last 3 years, adding over $20 billion to the VA budget baseline.
S. 1963 demonstrates America's commitment to the dedicated servicemembers who have served in uniform and puts front and center the health care needs of veterans and their families. It is our pledge to them that we have not forgotten the sacrifices they have made in defense of this country. So in this bill, we help caregivers of injured veterans, women veterans, rural veterans, homeless veterans, and veterans with mental health issues.
S. 1963 provides immediate support to the mothers, fathers, husbands, and wives caring for warriors from the current conflicts as well as from previous conflicts. Today we have the opportunity to recognize their tremendous sacrifice and share their heavy burden.
The bill also expands and improves VA services for the 1.8 million women veterans currently receiving VA health care and goes a step further by anticipating the expected increase of women warriors over the next 5 years. This bill seeks to build a VA health care system respectful of the unique medical needs of women veterans.
S. 1963 also advances America's commitment to end veterans' homelessness. Hundreds of thousands of veterans are at risk of homelessness because of poverty and the lack of support from family and friends. An increasing number of veterans of operations in Afghanistan and Iraq are falling into this category, and we must be vigilant in providing support to this population.
We expand the number of places where homeless vets may receive supportive services; and for our veterans struggling without a roof over their heads, this small change in the law will make a big difference in their lives.
The bill also includes key provisions to improve health care provided to our rural veterans by authorizing stronger partnerships with community providers and the Department of Health and Human Services. These collaborations will allow VA to offer health care options to servicemembers living far from the nearest medical facility.
In addition, we address the troubling reality of posttraumatic stress disorder and troubling incidents of suicide amongst the veterans' population. The bill requires a much-needed and long-awaited study on veteran suicide and requires the VA to provide counseling referrals for former members of the Armed Forces who are not otherwise eligible for readjustment counseling.
S. 1963 provides higher priority status for Medal of Honor recipients, establishes a director of physician assistant services, and creates a committee on care of veterans with traumatic brain injury. It requires the VA to provide health care for herbicide-exposed Vietnam veterans and veterans of the Persian Gulf War who have insufficient medical evidence to establish a service-connected disability, and it prohibits the VA from collecting copayments from veterans who are catastrophically disabled.
This bill, Mr. Speaker, demands our immediate attention. We owe our veterans a great debt of gratitude, and this bill represents an understanding that the sacrifices of our veterans are shared amongst all Americans.
I urge all of my colleagues to support passage of S. 1963, as amended, and reserve the balance of my time.
Explanatory Statement Submitted by Mr. Filner, Chairman of the House Committee on Veterans' Affairs, Regarding the Amendment of the House of
Representatives to S. 1963
Caregivers and Veterans Omnibus Health Services Act of 2010
S. 1963, as amended, the ``Caregivers and Veterans Omnibus
Health Services Act of 2010,'' reflects the Compromise
Agreement between the Committees on Veterans' Affairs of the
Senate and the House of Representatives (the Committees) on
health care and related provisions for veterans and their
caregivers. The provisions in the Compromise Agreement are
derived from a number of bills that were introduced and
considered by the House and Senate during the 111th Congress.
These bills include S. 1963, a bill to provide assistance to
caregivers of veterans, to improve the provision of health
care to veterans, and for other purposes, which passed the
Senate on November 19, 2009 (Senate bill); and H.R. 3155, a
bill to provide certain caregivers of veterans with training,
support, and medical care, and for other purposes, which
passed the House on July 27, 2009 (House bill).
In addition, the Compromise Agreement includes provisions
derived from the following bills which were passed by the
House: H.R. 402, a bill to designate the Department of
Veterans Affairs Outpatient Clinic in Knoxville, Tennessee,
as the ``William C. Tallent Department of Veterans Affairs
Outpatient Clinic,'' passed by the House on July 14, 2009;
H.R. 1211, a bill to expand and improve health care services
available to women veterans, especially those serving in
Operation Enduring Freedom and Operation Iraqi Freedom, from
the Department of Veterans Affairs, and for other purposes,
passed by the House on June 23, 2009; H.R. 1293, a bill to
provide for an increase in the amount payable by the
Secretary of Veterans Affairs to veterans for improvements
and structural alterations furnished as part of home health
services, passed by the House on July 28, 2009; H.R. 2770, a
bill to modify and update provisions of law relating to
nonprofit research and education corporations, and for other
purposes, passed by the House on July 27, 2009; H.R. 3157, a
bill to name the Department of Veterans Affairs outpatient
clinic in Alexandria, Minnesota, as the ``Max J. Beilke
Department of Veterans Affairs Outpatient Clinic,'' passed by
the House on November 3, 2009; H.R. 3219, a bill to make
certain improvements in the laws administered by the
Secretary of Veterans Affairs relating to insurance and
health care, and for other purposes, passed by the House on
July 27, 2009; and H.R. 3949, a bill to make certain
improvements in the laws relating to benefits administered by
the Secretary of Veterans Affairs, and for other purposes,
passed by the House on November 3, 2009.
The Compromise Agreement also includes provisions derived
from the following House bills, which were introduced and
referred to the Subcommittee on Health of the House Committee
on Veterans' Affairs: H.R. 919, to enhance the capacity of
the Department of Veterans Affairs to recruit and retain
nurses and other critical health care professionals, and for
other purposes, which was introduced on February 9, 2009;
H.R. 3796, to improve per
diem grant payments for organizations assisting homeless
veterans, which was introduced on October 13, 2009; and H.R.
4166, to make certain improvements in the laws administered
by the Secretary of Veterans Affairs relating to educational
assistance for health professionals, and for other purposes,
which was introduced on December 1, 2009, and was
concurrently referred to the Committee on Energy and
Commerce.
The House and Senate Committees on Veterans' Affairs have
prepared the following explanation of the Compromise
Agreement. Differences between the provisions contained in
the Compromise Agreement and the related provisions in the
bills listed above are noted in this document, except for
clerical corrections and conforming changes, and minor
drafting, technical, and clarifying changes.
Title I--Caregiver Support
Assistance and Support Services for Family Caregivers
(section 101)
The Senate bill contains a provision (section 102) that
would create a new program to help caregivers of eligible
veterans who, together with the veteran, submit a joint
application requesting services under the new program.
Eligible veterans are defined as those who have a serious
injury, including traumatic brain injury, psychological
trauma, or other mental disorder, incurred or aggravated
while on active duty on or after September 11, 2001. Within
two years of program implementation, the Department of
Veterans Affairs (VA) would be required to submit a report on
the feasibility and advisability of extending the program to
veterans of earlier periods of service. Severely injured
veterans are defined as those who need personal care services
because they are unable to perform one or more independent
activities of daily living, require supervision as a result
of neurological or other impairments, or need personal care
services because of other matters specified by the VA. For
accepted caregiver applicants, VA would be required to
provide respite care as well as pay for travel, lodging and
per-diem expenses while the caregiver of an eligible veteran
is undergoing necessary training and education to provide
personal care services. Once a caregiver completes training
and is designated as the primary personal care attendant,
this individual would receive ongoing assistance including
direct technical support, counseling and mental health
services, respite care of no less than 30 days annually,
health care through the Civilian Health and Medical Program
of the Department of Veterans Affairs (CHAMPVA), and a
monthly financial stipend. The provision in the Senate bill
would require VA to carry out oversight of the caregiver by
utilizing the services of home health agencies. A home health
agency would be required to visit the home of a veteran not
less often than once every six months and report its findings
to VA. Based on the findings, VA would have the final
authority to revoke a caregiver's designation as a primary
personal care attendant. The provision also would require an
implementation and evaluation report, and provide for an
effective date 270 days after the date of the enactment of
this Act.
The House bill contains comparable provisions (section 2
and section 4) with some key differences. The provisions in
the House bill would provide educational sessions, access to
a list of comprehensive caregiver support services available
at the county level, information and outreach, respite care,
and counseling and mental health services to family and non-
family caregivers of veterans of any era. For family
caregivers of eligible veterans who served in Operation
Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF),
the House bill would require VA to provide a monthly
financial stipend, health care service through CHAMPVA,
and lodging and subsistence to the caregiver when the
caregiver accompanies the veteran on medical care visits.
Eligible OEF or OIF veterans are defined as those who have
a service-connected disability or illness that is severe;
in need of caregiver services without which the veteran
would be hospitalized, or placed in nursing home care or
other residential institutional care; and are unable to
carry out activities (including instrumental activities)
of daily living.
The Compromise Agreement contains the Senate provision
modified to no longer require VA to enter into relationships
with home health agencies to make home visits every six
months. In addition, the Compromise Agreement follows the
House bill in creating a separate program of general family
caregiver support services for family and non-family
caregivers of veterans of any era. Such support services
would include training and education, counseling and mental
health services, respite care, and information on the support
services available to caregivers through other public,
private, and nonprofit agencies. In the event that sufficient
funding is not available to provide training and education
services, the Secretary would be given the authority to
suspend the provision of such services. The Secretary would
be required to certify to the Committees that there is
insufficient funding 180 days before suspending the provision
of these services. This certification and the resulting
suspension of services would expire at the end of the fiscal
year concerned.
The overall caregiver support program for caregivers of
eligible OEF or OIF veterans would authorize VA to provide
training and supportive services to family members and
certain others who wish to care for a disabled veteran in the
home and to allow veterans to receive the most appropriate
level of care. The newly authorized supportive services would
include training and certification, a living stipend, and
health care--including mental health counseling,
transportation benefits, and respite.
The Compromise Agreement also includes an authorization for
appropriations that is below the estimate furnished by the
Congressional Budget Office. The lower authorization level is
based on information contained in a publication (Economic
Impact on Caregivers of the Seriously Wounded, Ill, and
Injured, April 2009) of the Center for Naval Analyses (CNA).
This study estimated that, annually, 720 post-September 11,
2001 veterans require comprehensive caregiver services. The
Compromise Agreement limits the caregiver program only to
``seriously injured or very seriously injured'' veterans who
were injured or aggravated an injury in the line of duty on
or after September 11, 2001. CNA found that the average
requirement for such caregiver services is 18 months, and
that only 43 percent of veterans require caregiver services
over the long-term. CNA also found that, on average, veterans
need only 21 hours of caregiver services per week. Only 233
family caregivers were referred by VA for training and
certification through existing home health agencies in FY
2008. This represented five percent of all home care
referrals. In FY 2009, only 168 family caregivers were
referred to home care agencies for training and
certification.
Medical Care for Family Caregivers (section 102)
The Senate bill contains a provision (section 102) that
would provide health care through the CHAMPVA program for
individuals designated as the primary care attendant for
eligible OEF or OIF veterans and who have no other insurance
coverage.
The House bill contains a comparable provision (section 5),
with a difference in the target population. Under the House
bill, the target population would include all family
caregivers of eligible OEF or OIF veterans, defined as those
who have a service-connected disability or illness that is
severe; are in need of caregiver services without which
hospitalization, nursing home care, or other residential
institutional care would be required; and, are unable to
carry out activities (including instrumental activities) of
daily living.
The Compromise Agreement contains the Senate provision.
Counseling and Mental Health Services for Family Caregivers
(section 103)
The Senate bill contains a provision (section 102) that
would provide counseling and mental health services for
family caregivers of OEF or OIF veterans.
The House bill contains a comparable provision (section 3),
except that counseling and mental health services would be
available to caregivers of veterans of any era.
The Compromise Agreement contains the House provision.
Lodging and Subsistence for Attendants (section 104)
The Senate bill contains a provision (section 103) that
would allow VA to pay for the lodging and subsistence costs
incurred by any attendant who accompanies an eligible OEF or
OIF veteran seeking VA health care.
The House bill contains a comparable provision (section 6),
with a difference in the target population. Under the House
bill, the target population would include all family
caregivers of eligible OEF or OIF veterans, defined as those
who have a service-connected disability or illness that is
severe; are in need of caregiver services without which
hospitalization, nursing home care, or other residential
institutional care would be required; and, are unable to
carry out activities (including instrumental activities) of
daily living.
The Compromise Agreement contains the Senate provision.
Title II--Women Veterans Health Care Matters
Study of Barriers for Women Veterans to Health Care from the
Department of Veterans Affairs (section 201)
The Senate bill contains a provision (section 201) that
would require VA to report, by June 1, 2010, on barriers
facing women veterans who seek health care at VA, especially
women veterans of OEF or OIF.
H.R. 1211 contains a comparable provision (section 101)
that would require a similar study of health care barriers
for women veterans. The House provision also would define the
parameters of the research study sample; direct VA to build
on the work of an existing study entitled ``National Survey
of Women Veterans in Fiscal Year 2007-2008;'' mandate VA to
share the barriers study data with the Center for Women
Veterans and the Advisory Committee on Women Veterans; and
authorize appropriations of $4 million to conduct the study.
VA would be required to submit to Congress a report on the
implementation of this section within six months of the
publication of the ``National Survey of Women Veterans in
Fiscal Year 2007-2008'', and the final report within 30
months of publication.
The Compromise Agreement contains the House provision.
Training and Certification for Mental Health Care Providers
of the Department of Veterans Affairs on Care for
Veterans Suffering from Sexual Trauma and Post-Traumatic
Stress Disorder (section 202)
The Senate bill contains a provision (section 204) that
would require VA to implement a program for education,
training, certification, and continuing medical education
for mental health professionals, which would include
principles of evidence-based treatment and care for sexual
trauma. VA would also be required to submit an annual report
on the counseling, care, and services provided to veterans
suffering from sexual trauma, and to establish education,
training, certification, and staffing standards for personnel
providing treatment for veterans with sexual trauma.
H.R. 1211 contains a similar provision (section 202),
except it included no provision requiring VA to establish
education, training, certification, and staffing standards
for the mental health professionals caring for veterans with
sexual trauma.
The Compromise Agreement contains the House provision.
Pilot Program on Counseling in Retreat Settings for Women
Veterans Newly Separated from Service in the Armed Forces
(section 203)
The Senate bill contains a provision (section 205) that
would require VA to establish, at a minimum of five
locations, a two-year pilot program in which women veterans
newly separated from the Armed Forces would receive
reintegration and readjustment services in a group retreat
setting. The provision also would require a report detailing
the pilot program findings and providing recommendations on
whether VA should continue or expand the pilot program.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision but
specifies that the program be carried out at a minimum of
three, not five, locations.
Service on Certain Advisory Committees of Women Recently
Separated from Service in the Armed Forces (section 204)
The Senate bill contains a provision (section 207) that
would amend the membership of the Advisory Committee on Women
Veterans and the Advisory Committee on Minority Veterans to
require that such committees include women recently separated
from the Armed Forces and women who are minority group
members and are recently separated from the Armed Forces,
respectively.
H.R. 1211 contains a similar provision (section 204) except
that it would allow either men or women who are members of a
minority group to serve on the Advisory Committee on Minority
Veterans.
The Compromise Agreement contains the Senate provision.
Pilot Program on Subsidies for Child Care for Certain
Veterans Receiving Health Care (section 205)
The Senate bill contains a provision (section 208) that
would require VA to establish a pilot program through which
child care subsidies would be provided to women veterans
receiving regular and intensive mental health care and
intensive health care services. The pilot program would be
carried out in no fewer than three Veterans Integrated
Service Networks (VISNs) for a duration of two years and, at
its conclusion, there would be a requirement for a report to
be submitted within six months detailing findings related to
the program and recommendations on its continuation or
extension. The provision also would direct VA, to the extent
practicable, to model the pilot program after an existing VA
Child Care Subsidy Program.
H.R. 1211 contains a comparable provision (section 203),
but it does not stipulate that the child care program shall
be executed through stipends. Rather, stipends are one option
among several listed, including partnership with private
agencies, collaboration with facilities or program of other
Federal departments or agencies, and the arrangement of
after-school care.
The Compromise Agreement contains the Senate provision,
with a modification to clarify that the child care subsidy
payments shall cover the full cost of child care services. In
addition, the provision expands the definition of veterans
who qualify for the child care subsidy to women veterans who
are in need of regular or intensive mental health care
services but who do not seek such care due to lack of child
care services. Finally, the Compromise Agreement follows the
House provision by allowing for other forms of child care
assistance. In addition to stipends, child care services may
be provided through the direct provision of child care at an
on-site VA facility, payments to private child care
agencies, collaboration with facilities or programs of
other Federal departments or agencies, and other forms as
deemed appropriate by the Secretary.
Care for Newborn Children of Women Veterans Receiving
Maternity Care (section 206)
The Senate bill contains a provision (section 209) that
would authorize VA to provide post-delivery health care
services to a newborn child of a woman veteran receiving
maternity care from VA if the child was delivered in a VA
facility or a non-VA facility pursuant to a VA contract for
delivery. Such care would be authorized for up to seven days.
H.R. 1211 contains a comparable provision (section 201),
but would allow VA to provide care for a set seven-day period
for newborn children of women veterans receiving maternity
care.
The Compromise Agreement contains the Senate provision.
Title III--Rural Health Improvements
Improvements to the Education Debt Reduction Program (section
301)
The Senate bill contains a provision (section 301) that
would eliminate the cap in current law on the total amount of
education debt reduction payments that can be made over five
years so as to permit payments equal to the total amount of
principal and interest owed on eligible loans.
H.R. 4166 contains a provision (section 3), that would
expand the purpose of the Education Debt Reduction Program
(EDRP), set forth in subchapter VII of chapter 76 of title
38, United States Code, to include retention in addition to
recruitment, as well as to modify and expand the eligibility
requirements for participation in the program. In addition,
the provision would increase the total education debt
reduction payments made by VA from $44,000 to $60,000 and
raise the cap on payments to be made during the fourth and
fifth years of the program from $10,000 to $12,000. The
provision would also provide VA with the flexibility to waive
the limitations of the EDRP and pay the full principal and
interest owed by participants who fill hard-to-recruit
positions at VA.
The Compromise Agreement contains the House provision.
Visual Impairment and Orientation and Mobility Professionals
Education Assistance Program (section 302)
The Senate bill contains a provision (section 302) that
would require VA to establish a scholarship program for
students accepted or enrolled in a program of study leading
to certification or a degree in the areas of visual
impairment or orientation and mobility. The student would be
required to agree to maintain an acceptable level of academic
standing as well as join VA as a full-time employee for three
years following their completion of the program. VA would be
required to disseminate information on the scholarship
program throughout educational institutions, with a special
emphasis on those with a high number of Hispanic students and
Historically Black Colleges and Universities.
H.R. 3949 contains the same provision (section 302).
The Compromise Agreement contains this provision.
Demonstration Projects on Alternatives for Expanding Care for
Veterans in Rural Areas (section 303)
The Senate bill contains a provision (section 305) that
would authorize VA to carry out demonstration projects to
expand care to veterans in rural areas through the
Department's Office of Rural Health. Projects could include
VA establishing a partnership with the Centers for Medicare
and Medicaid Services to coordinate care for veterans in
rural areas at critical access hospitals, developing a
partnership with the Department of Health and Human Services
to coordinate care for veterans in rural areas at community
health centers, and the expanding coordination with the
Indian Health Service to enhance care for Native American
veterans.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Program on Readjustment and Mental Health Care Services for
Veterans who Served in Operation Enduring Freedom and
Operation Iraqi Freedom (section 304)
The Senate bill contains a provision (section 306) that
would require VA to establish a program providing OEF and OIF
veterans with mental health services, readjustment counseling
and services, and peer outreach and support. The program
would also provide the immediate families of these veterans
with education, support, counseling, and mental health
services. In areas not adequately served by VA facilities, VA
would be authorized to contract with community mental health
centers and other qualified entities for the provision of
such services, as well as provide training to clinicians and
contract with a national non-profit mental health
organization to train veterans participating in the peer
outreach and support program. The provision would require an
initial implementation report within 45 days after enactment
of the legislation. Additionally, the Secretary would be
required to submit a status report within one year of
enactment of the legislation detailing the number of veterans
participating in the program as well as an evaluation of the
services being provided under the program.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision, but
does not include the reporting requirement and authorizes
rather than requires VA to contract with community mental
health centers and other qualified entities in areas not
adequately served by VA facilities.
Travel Reimbursement for Veterans Receiving Treatment at
Facilities of the Department of Veterans Affairs (section
305)
The Senate bill contains a provision (section 308) that
would authorize VA to increase the mileage reimbursement rate
under section 111 of title 38, United States Code, to 41.5
cents per mile, and, a year after the enactment of this
legislation, allow the Secretary to adjust the newly
specified mileage rate to be equal to the rate paid to
Government employees who use privately owned vehicles on
official business. If such an adjustment would result in a
lower mileage rate, the Secretary would be required to submit
to Congress a justification for the lowered rate. The
provision also would allow the Secretary to reimburse
veterans for the reasonable cost of airfare when that is the
only practical way to reach a VA facility.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Pilot Program on Incentives for Physicians Who Assume
Inpatient Responsibilities at Community Hospitals in
Health Professional Shortage Areas (section 306)
The Senate bill contains a provision (section 313) that
would require VA to establish a pilot program under which VA
physicians caring for veterans admitted to community
hospitals would receive financial incentives, of an amount
deemed appropriate by the Secretary, if they maintain
inpatient privileges at community hospitals in health
professional shortage areas. Participation in the pilot
program would be voluntary. VA would be required to carry out
the pilot program for three years, in not less than five
community hospitals in each of not fewer than two VISNs. In
addition, VA would be authorized to collect third party
payments for care provided by VA physicians to nonveterans
while carrying out their responsibilities at the community
hospital where they are privileged.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Grants for Veterans Service Organizations for Transportation
of Highly Rural Veterans (section 307)
The Senate bill contains a provision (section 315) that
would require VA to establish a grant program to provide
innovative transportation options to veterans in highly rural
areas. Eligible grant recipients would include state veterans
service agencies and veterans service organizations, and
grant awards would not exceed $50,000.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Modifications of Eligibility for Participation in Pilot
Program of Enhanced Contract Care Authority for Health
Care Needs of Certain Veterans (section 308)
The Senate bill contains a provision (section 316) that
would clarify the definition of eligible veterans who are
covered under a pilot program of enhanced contract care
authority for rural veterans, created by section 403(b) of
the Veterans' Mental Health and Other Care Improvements Act
of 2008 (P.L. 110-387, 122 Stat. 4110). Eligible veterans
would be defined to include those living more than 60 minutes
driving distance from the nearest VA facility providing
primary care services, living more than 120 minutes driving
distance from the nearest VA facility providing acute
hospital care, and living more than 240 minutes driving
distance from the nearest VA facility providing tertiary
care.
H.R. 3219 contains the same provision (section 206).
The Compromise Agreement contains this provision.
Title IV--Mental Health Care Matters
Eligibility of Members of the Armed Forces Who Served in
Operation Enduring Freedom or Operation Iraqi Freedom for
Counseling and Services Through Readjustment Counseling
Services (section 401)
The Senate bill contains a provision (section 401) that
would allow any member of the Armed Forces, including members
of the National Guard or Reserve, who served in OEF or OIF to
be eligible for readjustment counseling services at VA
Readjustment Counseling Centers, also known as Vet Centers.
The provision of such services would be limited by the
availability of appropriations so that this new provision
would not adversely affect services provided to the veterans
that Vet Centers are currently serving.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Restoration of Authority of Readjustment Counseling Service
to Provide Referral and Other Assistance upon Request to
Former Members of the Armed Forces Not Authorized
Counseling (section 402)
The Senate bill contains a provision (section 402) that
would require VA to help former members of the Armed Forces
who have been discharged or released from active duty, but
who are not otherwise eligible for readjustment
counseling. VA would be authorized to help these
individuals by providing them with referrals to obtain
counseling and services from sources outside of VA, or by
advising such individuals of their right to apply for a
review of their release or discharge through the
appropriate military branch of service.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Study on Suicides among Veterans (section 403)
The Senate bill contains a provision (section 403) that
would require VA to conduct a study to determine the number
of veterans who committed suicide between January 1, 1999 and
the enactment of the legislation. To conduct this study, VA
would be required to coordinate with the Secretary of
Defense, veterans' service organizations, the Centers for
Disease Control and Prevention, and state public health
offices and veterans agencies.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Title V--Other Health Care Matters
Repeal of Certain Annual Reporting Requirements (section 501)
The Senate bill contains a provision (section 501) that
would eliminate the reporting requirements, set forth in
sections 7451 and 8107 of title 38, United States Code, on
pay adjustments for registered nurses. These reporting
requirements date to a time when VA facility directors had
the discretion to offer annual General Schedule (GS)
comparability increases to nurses. Current law requires VA to
provide GS comparability increases to nurses so that that pay
adjustment report is no longer necessary. The provision would
also eliminate the reporting requirement on VA's long-range
health care planning which included the operations and
construction plans for medical facilities. The information
contained in this report is already submitted in other
reports and plans, in particular the Department's annual
budget request.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Submittal Date of Annual Report on Gulf War Research (section
502)
The Senate bill contains a provision (section 502) that
would amend the due date of the Annual Gulf War Research
Report from March 1 to July 1 of each of the five years with
the first report due in 2010.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Payment for Care Furnished to CHAMPVA Beneficiaries (section
503)
The Senate bill contains a provision (section 503) that
would clarify that payments made by VA to providers who
provide medical care to a beneficiary covered under CHAMPVA
shall constitute payment in full, thereby removing any
liability on the part of the beneficiary.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Disclosure of Patient Treatment Information from Medical
Records of Patients Lacking Decision-making Capacity
(section 504)
The Senate bill contains a provision (section 504) that
would authorize VA health care practitioners to disclose
relevant portions of VA medical records to surrogate
decision-makers who are authorized to make decisions on
behalf of patients lacking decision-making capacity. The
provision would only allow such disclosures where the
information is clinically relevant to the decision that the
surrogate is being asked to make.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Enhancement of Quality Management (section 505)
The Senate bill contains a provision (section 506) that
would create a National Quality Management Officer to act as
the principal officer responsible for the Veteran Health
Administration's quality assurance program. The
provision would require each VISN and medical facility to
appoint a quality management officer, as well as require VA
to carry out a review of policies and procedures for
maintaining health care quality and patient safety.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Pilot Program on Use of Community-Based Organizations and
Local and State Government Entities To Ensure That
Veterans Receive Care and Benefits for Which They are
Eligible (section 506)
The Senate bill contains a provision (section 508) that
would require VA to create a pilot program to study the use
of community organizations and local and State government
entities in providing care and benefits to veterans. The
grantees would be selected for their ability to increase
outreach, enhance the coordination of community, local,
state, and Federal providers of health care, and expand the
availability of care and services to transitioning
servicemembers and their families. The two-year pilot program
would be required to be implemented in five locations and, in
making the site selections, the Secretary would be required
to give special consideration to rural areas, areas with high
proportions of minority groups, areas with high proportions
of individuals who have limited access to health care, and
areas that are not in close proximity to an active duty
military station.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision, but
would give VA 180 days to implement the pilot program.
Specialized Residential Care and Rehabilitation for Certain
Veterans (section 507)
The Senate bill contains a provision (section 509) that
would authorize VA to contract for specialized residential
care and rehabilitation services for certain veterans.
Eligible veterans would be those who served in OEF or OIF,
suffer from a traumatic brain injury (TBI), and possess an
accumulation of deficits in activities of daily living and
instrumental activities of daily living that would otherwise
require admission to a nursing home.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Expanded Study on the Health Impact of Project Shipboard
Hazard and Defense (section 508)
The Senate bill contains a provision (section 510) that
would require VA to contract with the Institute of Medicine
(IOM) to study the health impact of veterans' participation
in Project Shipboard Hazard and Defense (SHAD). The study
would be intended
to cover, to the extent practicable, all veterans who
participated in Project SHAD and may utilize results from the
study included in IOM's report on ``Long-Term Health Effects
of Participation in Project SHAD.''
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Use of Non-Department Facilities for Rehabilitation of
Individuals with Traumatic Brain Injury (section 509)
The Senate bill contains a provision (section 511) that
would clarify when non-VA facilities may be utilized to
provide treatment and rehabilitative services for veterans
and members of the Armed Forces with TBI. Specifically, the
provision would allow non-VA facilities to be used when VA
cannot provide treatment or services at the frequency or
duration required by the individual plan of the veteran or
servicemember with TBI. The provision also would allow the
use of non-VA facilities if VA determines that it is optimal
for the recovery and rehabilitation of the veteran or
servicemember. Such non-VA facility would be required to
maintain standards that have been established by an
independent, peer-reviewed organization that accredits
specialized rehabilitation programs for adults with TBI.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Pilot Program on Provision of Dental Insurance Plans to
Veterans and Survivors and Dependents of Veterans
(section 510)
The Senate bill contains a provision (section 513) that
would require VA to carry out a three-year pilot program to
provide specified dental services through a contract with a
dental insurer. Additionally, the provision would provide
that the pilot program should take place in at least two but
no more than four VISNs and that enrollment would be
voluntary. The program would provide diagnostic services,
preventive services, endodontic and other restorative
services, surgical services, emergency services, and such
other services as VA considers appropriate.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision,
modified to provide that the pilot program may take place in
any number of VISNs the Secretary deems appropriate. The
purpose of providing the Secretary with this authority is to
ensure the capability, should it be required, to maximize the
number of voluntary enrollees insured under the dental
program so as to reduce premium expenditures.
Prohibition on Collection of Copayments from Veterans who are
Catastrophically Disabled (section 511)
The Senate bill contains a provision (section 515) that
would add a new section 1730A in title 38, United States
Code, to prohibit VA from collecting copayments from
catastrophically disabled veterans for medical services
rendered, including prescription drug and nursing home care
copayments.
H.R. 3219 contains the same provision (section 203).
The Compromise Agreement contains this provision.
Higher Priority Status for Certain Veterans who are Medal of
Honor Recipients (section 512)
H.R. 3519 contains a provision (section 201) that would
amend section 1705 of title 38, United States Code, to place
Medal of Honor recipients in priority group 3 for the
purposes of receiving health care through VA. This would
situate Medal of Honor recipients in a priority group with
former prisoners of war and Purple Heart recipients.
The Senate bill contains no comparable provision.
The Compromise Agreement contains the House provision.
Hospital Care, Medical Services, and Nursing Home Care for
Certain Vietnam-Era Veterans Exposed to Herbicide and
Veterans of the Persian Gulf War (section 513)
H.R. 3219 contains a provision (section 202) that would
amend section 1710 of title 38, United States Code, to
provide permanent authorization for the special treatment
authority of Vietnam-era veterans exposed to an herbicide and
Gulf-War era veterans who have insufficient medical evidence
to establish a service-connected disability.
The Senate bill contains no comparable provision.
The Compromise Agreement contains the House provision.
Establishment of Director of Physician Assistant Services in
Veterans Health Administration (section 514)
H.R. 3219 contains a provision (section 204) that would
create the position of Director of Physician Assistant
Services in VA central office who would report directly to
the Under Secretary for Health on all matters related to
education, training, employment, and proper utilization of
physician assistants.
The Senate bill contains no comparable provision.
The Compromise Agreement contains the House provision,
modified to require the Director of Physician Assistant
Services to report directly to the Chief of the Office of
Patient Services instead of to the Under Secretary for
Health.
Committee on Care of Veterans with Traumatic Brain Injury
(section 515)
H.R. 3219 contains a provision (section 205) that would
require VA to establish a Committee on Care of Veterans with
Traumatic Brain Injury. This Committee would be required to
evaluate VA's capacity to meet the treatment and
rehabilitative needs of veterans with TBI, as well as make
recommendations and advise the Under Secretary for Health on
matters relating to this condition. Additionally, VA would be
required to submit to the Committees on Veterans' Affairs of
the Senate and the House of Representatives an annual report
on the Committee's findings and recommendations and the
Department's response.
The Senate bill contains no comparable provision.
The Compromise Agreement contains the House provision.
Increase in Amount Available to Disabled Veterans for
Improvements and Structural Alterations Furnished as Part
of Home Health Services (section 516)
H.R. 1293 contains a provision that would increase, from
$4,100 to $6,800, the amount authorized to be paid to
veterans who have service-connected disabilities rated 50
percent or more disabling for home improvements and
structural alterations. The provision would also increase
from $1,200 to $2,000, the amount authorized to be paid to
veterans with service-connected disabilities rated less than
50 percent disabling.
The Senate bill contains no comparable provision.
The Compromise Agreement contains the House provision.
Extension of Statutorily Defined Copayments for Certain
Veterans for Hospital Care and Nursing Home Care (section
517)
Under current law, VA has the authority to provide hospital
and nursing home care on a space available basis to veterans
who do not otherwise qualify for such care. VA is authorized
to collect from such a veteran an amount equal to $10 for
every day that a veteran receives hospital care, and $5 for
every day a veteran receives nursing home care. This
authority expires on September 30, 2010.
Neither the House nor Senate bills contain a provision to
extend this authority.
The Compromise Agreement contains a provision which would
extend the statutorily defined copayments for certain
veterans for hospital care and nursing home care to September
30, 2012.
Extension of Authority to Recover Cost of Certain Care and
Services from Disabled Veterans with Health-Plan
Contracts (section 518)
Under current law, VA is authorized to recover the costs
associated with medical care provided to a veteran for a non-
service-connected disability if, among other eligibility
criteria, the veteran receives such care before October 1,
2010, the veteran has a service-connected disability, and the
veteran is entitled to benefits for health care under a
health-plan contract.
Neither the House nor Senate bills contain a provision to
extend this authority.
The Compromise Agreement contains a provision which would
extend the authority to recover the cost of such care and
services from disabled veterans with health-plan contracts to
October 1, 2012.
Title VI--Department Personnel Matters
Enhancement of Authorities for Retention of Medical
Professionals (section 601)
The Senate bill contains provisions (section 601) intended
to improve VA's ability to recruit and retain health
professionals. First, VA would be given the authority to
apply the title 38 hybrid employment system to additional
health care occupations to meet the recruitment and retention
needs of VA. Next, the probationary period for full-time and
part-time registered nurses would be set at two years; part-
time registered nurses who served previously on a full-time
basis would not be subject to a probationary period. In
addition, VA would be authorized to waive the salary offset
where the salary of an employee rehired after retirement from
the Veterans Health Administration is reduced according to
the amount of their annuity under a federal government
retirement system.
Section 601 also would provide for a number of new or
expanded pay authorities, including setting the pay for all
senior executives in the Office of the Under Secretary for
Health at Level II or Level III of the Executive Schedule;
authorizing recruitment and retention special incentive pay
for pharmacist executives of up to $40,000; amending the pay
provisions of physicians and dentists by clarifying the
determination of the non-foreign cost of living adjustment,
exempting physicians and dentists in executive leadership
positions from compensation panels, and allowing for a
reduction in market pay for changes in board certification or
a reduction of privileges; modifying the pay cap for
registered nurses and other covered positions to Level IV of
the Executive Schedule; allowing the pay for certified
registered nurse anesthetists to exceed the pay caps for
registered nurses; increasing the limitation on special pay
for nurse executives from $25,000 to $100,000; adding
licensed practical nurses, licensed vocational nurses, and
nursing positions covered by title 5 to the list of
occupations that are exempt from the limitations on increases
in rates of basic pay; and expanding the eligibility for
additional premium pay to part-time nurses. Finally, section
601 would improve VA's locality pay system by requiring VA to
provide education, training, and support to the directors of
VA health care facilities on the use of locality pay system
surveys.
H.R. 919 contains a comparable provision (section 2) which
would not, in contrast to
the Senate bill, restrict VA from applying hybrid title 38
status to positions that are administrative, clerical or
physical plant maintenance and protective services, would
otherwise be included under the authority of section 5332 of
title 5, United States Code; do not provide direct patient
care services, or would otherwise be available to provide
medical care and treatment for veterans. The House provision
also would not place restrictions on the categories of part-
time nurses for whom the probationary period would be waived.
The House section contains an additional provision which
would provide comparability pay up to $100,000 per year to
all individuals appointed by the Under Secretary for Health
under the authority of section 7306 of title 38, United
States Code, who are not physicians or dentists and who would
be compensated at a higher rate in the private sector.
The Compromise Agreement contains the Senate provision,
modified to eliminate the provision of the Senate bill that
would provide VA with the authority to waive salary offsets
for retirees who are reemployed in the Veterans Health
Administration.
Limitations on Overtime Duty, Weekend Duty, and Alternative
Work Schedules for Nurses (section 602)
The Senate bill contains a provision (section 602) that
would prohibit VA from requiring nurses to work more than 40
hours in an administrative work week or more than 8 hours
consecutively, except under unanticipated emergency
conditions in which the nurses' skills are necessary and good
faith efforts to find voluntary replacements have failed. The
provision also would strike subsection 7456(c) of title 38,
United States Code, which provides that nurses on approved
sick or annual leave during a 12-hour work shift shall be
charged at a rate of five hours of leave per three hours of
absence. Finally, for recruitment and retention purposes, VA
would be authorized to consider a nurse who has worked 6
regularly scheduled 12-hour work shifts within a 14-day
period to have worked a full eighty-hour pay period.
H.R. 919 contains the same provision (section 3).
The Compromise Agreement contains this provision.
Reauthorization of Health Professionals Educational
Assistance Scholarship Program (section 603)
H.R. 919 contains a provision (section 4) that would
reinstate the Health Professionals Educational Assistance
Scholarship Program. Section 2 of H.R. 4166 contains a
similar provision which would also direct VA to fully employ
program graduates as soon as possible following their
graduation, require graduates to perform clinical rotations
in assignments or locations determined by VA, and assign a
mentor to graduates in the same facility in which they are
serving.
The Senate bill contains a similar provision but did not
include the requirement to fully employ graduates as soon as
possible.
The Compromise Agreement contains the provision from
section 2 of H.R. 4166.
Loan Repayment Program for Clinical Researchers from
Disadvantaged Backgrounds (section 604)
H.R. 919 (section 4) and H.R. 4166 (section 4) contain
identical provisions that would allow VA to utilize the
authorities available in the Public Health Service Act for
the repayment of the principal and interest of educational
loans of health professionals from disadvantaged
backgrounds in order to employ such professionals in the
Veterans Health Administration to conduct clinical
research.
The Senate bill contains the same provision (section 603).
The Compromise Agreement contains this provision.
Title VII--Homeless Veterans Matters
Per Diem Grant Payments (section 701)
H.R. 3796 contains a provision that would authorize VA to
make per diem payments to organizations assisting homeless
veterans in an amount equal to the greater of the daily cost
of care or $60 per bed, per day. The provision would also
require VA to ensure that 25 percent of the funds available
for per diem payments are distributed to organizations that
meet some but not all of the criteria for the receipt of per
diem payments. These would include (in order of priority)
organizations that meet each of the transitional and
supportive services criteria and serve a population that is
less than 75 percent veterans; organizations that meet at
least one but not all of the transitional and supportive
services criteria, but have a population that is at least 75
percent veterans; or organizations that meet at least one but
not all of the transitional and supportive services criteria
and serve a population that is less than 75 percent veterans.
The Senate bill contains no comparable provision.
The Compromise Agreement contains the House provision, but
does not require the minimum amount of $60 per bed, per day
for the Grant and Per Diem program. In addition, VA would be
authorized but not required to award the per diem grants to
non-profit organizations meeting some but not all of the
criteria for the receipt of such payments.
Title VIII--Nonprofit Research and Education Corporations
General Authorities on Establishment of Corporations (section
801)
H.R. 2770 contains a provision (section 2) that would
authorize Nonprofit Research and Education Corporations
(NPCs) to merge, thereby creating multi-medical center
research corporations.
The Senate bill contains the same provision (section 801).
The Compromise Agreement contains this provision.
Clarification of Purposes of Corporations (section 802)
H.R. 2770 contains a provision (section 3) that would
clarify the purpose of NPCs to include specific reference to
their role as funding mechanisms for approved research and
education, in addition to their role in facilitating research
and education.
The Senate bill contains the same provision (section 802).
The Compromise Agreement contains this provision.
Modification of Requirements for Boards of Directors of
Corporations (section 803)
The Senate bill contains a provision (section 803) that
would require that a minimum of two members of the Board of
Directors of an NPC be other-than-federal employees.
Additionally, the provision would allow for the appointment
of individuals with expertise in legal, financial, or
business matters. The provision also would conform the law
relating to NPCs to other federal conflict of interest
regulations by removing the requirement that members of the
NPC boards have no financial relationship with any entity
that is a source of funding for research or education by VA.
H.R. 2770 contains a comparable provision (section 4), but
provides that the executive director of the corporation may
be a VA employee.
The Compromise Agreement contains the House provision, with
a modification which removes the provision allowing VA
employees to serve as executive directors.
Clarification of Powers of Corporations (section 804)
H.R. 2770 contains a provision (section 5) that would
clarify the NPCs' authority to accept, administer, and
transfer funds for various purposes. NPCs would be allowed to
enter into contracts and set fees for the education and
training facilitated through the corporation.
The Senate bill contains the same provision (section 804).
The Compromise Agreement contains this provision.
Redesignation of Section 7364A of Title 38, United States
Code (section 805)
H.R. 2770 contains a provision (section 6) that would
provide clerical amendments associated with implementing this
legislation concerning Nonprofit Research and Education
Corporations.
The Senate bill contains the same provision (section 805).
The Compromise Agreement contains this provision.
Improved Accountability and Oversight of Corporations
(section 806)
The Senate bill contains a provision (section 806) that
would strengthen VA's oversight of NPCs by requiring those
NPCs with revenues of over $10,000 to obtain an independent
audit once every three years, or with revenues of over
$300,000 to obtain such an audit each year, and to submit
certain Internal Revenue Service forms.
H.R. 2770 contains a comparable provision (section 7), but
would instead raise to $100,000 the threshold for requiring
three-year audits and to $500,000 the revenue threshold that
would require yearly audits. The provision also would revise
conflict of interest policies to apply to the policies
adopted by the corporation.
The Compromise Agreement contains the House provision.
Title IX--Construction and Naming Matters
Authorization of Medical Facility Projects (section 901)
The Senate bill contains a provision (section 901) that
would authorize funds for the following major medical
facility projects in FY 2010: Livermore, California; Walla
Walla, Washington; Louisville, Kentucky; Dallas, Texas; St.
Louis, Missouri; Denver, Colorado and Bay Pines, Florida.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision, but
strikes the authorization for the construction project in
Walla Walla, Washington, since authorization for this
construction project was provided in Public Law 111-98,
enacted on November 11, 2009.
Designation of Merril Lundman Department of Veterans Affairs
Outpatient Clinic, Havre, Montana (section 902)
The Senate bill contains a provision (section 903) that
would name VA outpatient clinic in Havre, Montana, as the
``Merril Lundman Department of Veterans Affairs Outpatient
Clinic.''
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Designation of William C. Tallent Department of Veterans
Affairs Outpatient Clinic, Knoxville, Tennessee (section
903)
In the House, H.R. 402 contains a provision that would name
the VA outpatient clinic in Knoxville, Tennessee as the
``William C. Tallent Department of Veterans Affairs
Outpatient Clinic.''
The Senate bill contains no comparable provision.
The Compromise Agreement contains the House provision.
Designation of Max J. Beilke Department of Veterans Affairs
Outpatient Clinic, Alexandria, Minnesota (section 904)
In the House, H.R. 3157 contains a provision that would
name the VA outpatient clinic in Alexandria, Minnesota as the
``Max J. Beilke Department of Veterans Affairs Outpatient
Clinic.''
The Senate bill contains no comparable provision.
The Compromise Agreement contains the House provision.
Title X--Other Matters
Expansion of Authority for Department of Veterans Affairs
Police Officers (section 1001)
The Senate bill contains a provision (section 1001) that
would provide additional authorities to VA uniformed police
officers, including the authority to carry a VA-issued weapon
in an official capacity when off VA property and in official
travel status, the authority to conduct investigations on and
off VA property of offenses that may have been committed on
VA property, expanded authority to enforce local and State
traffic regulations when such authority has been granted by
local or State law, and to make arrests based upon an arrest
warrant issued by any competent judicial authority.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Uniform Allowance for Department of Veterans Affairs Police
Officers (section 1002)
The Senate bill contains a provision (section 1002) that
would modify VA's authority to pay an allowance to VA police
officers for purchasing uniforms. The provision would provide
a uniform allowance in an amount which is the lesser of the
amount prescribed by the Office of Personnel Management or
the actual or estimated cost as determined by periodic
surveys conducted by VA.
There was no comparable House provision.
The Compromise Agreement contains the Senate provision.
Submission of Reports to Congress by Secretary of Veterans
Affairs in Electronic Form (section 1003)
Under current law, there is no requirement for VA to submit
Congressionally mandated reports in an electronic form.
Neither the House nor Senate bills contained a provision to
change this procedure.
The Compromise Agreement contains a provision which would
create a new section 118 in title 38, United States Code,
which would require VA to submit reports to Congress, or any
Committee thereof, in electronic format. Reports would be
defined to include any certification, notification, or other
communication in writing.
Determination of Budgetary Effects for Purposes of Compliance
with Statutory Pay-As-You-Go-Act of 2010 (section 1004)
Neither the Senate nor House bills contain a provision
relating to compliance with the Statutory Pay-As-You-Go-Act
of 2010, Title I of P.L. 111-139, 124 Stat. 8.
The Compromise Agreement contains a procedural provision to
require the determination of the budgetary effects of
provisions contained in the Compromise Agreement to be based
upon the statement entered into the Congressional Record by
the Chairman of the Committee on the Budget of the House of
Representatives.
Mr. Speaker, the chairman of our Health Subcommittee, Mr. Michaud, and ranking member, Mr. Brown of South Carolina, were the chief hard workers on this bill. We thank them all.
I yield 3\1/2\ minutes to Chairman Michaud.
Mr. Speaker, before I yield to our Speaker, I just want to say with gratitude, on the part of our Nation's veterans, in her 3\1/2\ years as Speaker and her years before that as minority leader, Ms. Pelosi focused like a laser on the needs of our veterans. We would not be here with this landmark bill were it not for our Speaker.
I yield 1 minute to the Speaker of the House, the gentlewoman from California (Ms. Pelosi).
Mr. Speaker, I yield 2 minutes to Ms. Herseth Sandlin of South Dakota, the chair of our Economic Opportunity Subcommittee and the prime mover behind the section of this bill dealing with our women veterans.
Mr. Speaker, the freshman members of our committee have added a new level of commitment and enthusiasm and have played a major part in this bill. I would like to yield 1\1/2\ minutes to one of those great freshmen, Mrs. Halvorson of Illinois.
Mr. Speaker, I yield 1\1/2\ minutes to another one of our great freshmen, Mr. Perriello from Virginia.
Mr. Speaker, Mr. Teague from New Mexico authored an important provision in the bill, and I would yield to him 1\1/2\ minutes to explain that provision.
Mr. Speaker, another valued member of our committee, Mr. Ciro Rodriguez of Texas, authored an important provision in this bill, and I would recognize him for 1\1/2\ minutes.
Mr. Speaker, how much time does each side have remaining?
Mr. Speaker, one of the great provisions of this bill is an incentive program to get doctors in certain specialties into the VA. The author of that scholarship program is Ms. Jackson Lee of Texas, and I would recognize her for 1 minute.
Mr. Speaker, this bill adds an important position to the Department of Veterans Affairs. The author of that legislation is Mr. Hare of Illinois. He was on our committee; I wish we had him back. I yield him 1 minute.
Mr. Speaker, the gentlelady from Texas (Ms. Eddie Bernice Johnson), added an important provision with regard to retention and recruitment of the kind of professionals we need in the VA. I would yield to her 1 minute and thank her for her efforts.
I yield myself the balance of my time, and I want to return the debate to the bill under consideration.
Mr. Speaker, this is a landmark bill. Finally, it gives some help to the caregivers of wounded warriors--family members who have to, perhaps, give up their jobs and spend almost full time with their loved ones. There is the issue of women veterans, which is a rising percentage in what was always a male institution, and we have to change the culture there in the VA. We help our homeless veterans. We help those who are in rural areas, and we provide more money for mental health care for all of our Nation's veterans. This is an important bill, and I urge unanimous approval.
I yield back the balance of my time.
Mr. Speaker, on that I demand the yeas and nays.
