Infectious Disease Reporting Act

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 357) to amend title 38, United States Code, to require courses of education provided by public institutions of higher education that are approved for purposes of the educational assistance programs administered by the Secretary of Veterans Affairs to charge veterans tuition and fees at the in-State tuition rate, as amended.

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

H.R. 357, as amended, is a bipartisan package of legislation that relates to improving employment and training opportunities for America's veterans. While there are many worthwhile provisions in this bill, I want to focus on section 4 primarily, which deals with instate tuition for veterans, and section 14, which ensures privacy of veterans who are being treated at a VA medical facility.

Mr. Speaker, our Nation's veterans have always been a source of strength for America's economy. The post-9/11 GI Bill has given thousands of our veterans the opportunity to attend college or receive other types of vocational training at little to no cost to the veteran themselves.

Every dollar that we provide in education and training benefits to veterans under the GI Bill goes right back into our economy when these veterans graduate and enter the workforce. I think we can all call that a great investment.

However, there are many veterans, through no fault of their own, who are forced to pay exorbitant tuition rates to schools simply because of the transit nature of their military service, and that precludes them from meeting some of the burdensome State residency requirements.

Mr. Speaker, as most American families know, the difference between instate versus out-of-state tuition at most public schools is immense. According to the College Board, the average instate tuition and fees at public institutions is now $8,655 a year. Out-of-state students pay an average of $21,706 per year.

Since the post-9/11 GI Bill will only pay for tuition and fees at the instate rates at public schools, out-of-state student veterans could incur significant debt to make up that difference. I believe that this practice has got to end.

The men and women who served this Nation did not just defend the citizens of their own home States, but the citizens of all 50 States. The educational

benefits they receive from the taxpayers should reflect the same reality.

Mr. Speaker, many States are out in front on this issue, including my home State of Florida, and I applaud the 22 States that currently offer some form of instate tuition to veterans, regardless of their residency.

Other State legislatures again, as I said, including my home State of Florida, are currently reviewing legislation to provide this benefit. It is my hope that the House passes this bill, and it will encourage those States to move forward.

To that end, section 4 of the bill would require that, in order for public colleges and universities to be eligible to receive payments from a veteran's GI Bill benefits, they must enroll these veterans at instate tuition and fee rates.

There are important limitations to this requirement. First, States would be permitted to require that student veterans show intent to become full-time residents of the State in which they are attending school.

Secondly, the instate requirement would only apply to veterans who are attending college within 3 years of their discharge from Active Duty. These limitations will ensure that this policy not only targets the population of veterans that are most adversely affected by residency requirements following their military separation, but also fairly recognizes States' legitimate interest in subsidizing public education for its taxpaying citizens.

Mr. Speaker, I also want to highlight section 14 of the bill, which incorporates the text of a bill that I introduced called the Veterans' Privacy Act.

In June of 2012, a covert camera disguised as a smoke detector was installed in the room of a brain-damaged veteran who was being treated at the James A. Haley Veterans' Hospital in Tampa. Upon discovering the hidden camera, the veteran's family was understandably outraged. When the veteran's family asked about the camera, VA officials first stated that the camera did not exist. Then they changed their story and admitted that the ``smoke detector'' was actually a video camera.

When further asked if the camera was recording, the VA told the family that the camera was only monitoring the patient; it was not recording. Only after inquiries by local media and the Veterans' Affairs Committee did VA admit that the camera was, in fact, recording the patient. VA then removed the camera from the patient's room.

In the wake of this incident, I sent a letter to VA asking for its legal authority to place a camera in a patient's room without their consent. The VA replied that the hidden camera did not violate the law.

I am deeply disturbed at VA's actions and response to the privacy interests of this veteran and can't help but wonder whether similar incidents are occurring across the country. That is why I authored this section, which should direct VA to prescribe regulations ensuring that when veterans receive care from VA, their privacy will not be violated by unauthorized video surveillance.

Mr. Speaker, as I said, there are many other worthwhile provisions in this bill, and I defer to my colleagues on the floor this afternoon to highlight other remaining provisions.

I thank my good friends and the ranking member of the committee, the gentleman from California (Mr. Takano), and everybody who is here today who are cosponsors of this bill and helping us to move forward.

I am also grateful to Leader Cantor and Speaker Boehner for their help in bringing this legislation to the floor.

With that, I urge all of my colleagues to join me in supporting H.R. 357, as amended.

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

Mr. Speaker, I am proud to yield 2 minutes to the gentleman from Florida, Gus Bilirakis, the vice chairman of the full committee and sponsor for veterans not only in his community but around this country.

Mr. Speaker, I am pleased to yield 2 minutes to the gentleman from Colorado (Mr. Coffman), the chairman of the Subcommittee on Oversight & Investigations.

I yield the gentleman an additional 30 seconds.

Mr. Speaker, I also want to thank my good friend from Pennsylvania (Mr. Doyle) for being in the forefront on this particular issue.

At this time, I yield 1\1/2\ minutes to the gentleman from the 12th District of Pennsylvania (Mr. Rothfus).

Mr. Speaker, at this time, I yield 3 minutes to the gentleman from the 18th District of Pennsylvania, Dr. Murphy, a Navy Reservist himself.

Mr. Speaker, I have one more speaker at this time.

Mr. Speaker, I yield 1 minute to the gentleman from the Third District of the State of Pennsylvania, Mike Kelly, who is a stalwart supporter of the veterans in the State of Pennsylvania and also the United States.

Mr. Speaker, I ask unanimous consent that all Members would have 5 legislative days with which to revise and extend their remarks and add any extraneous materials that they may have on this legislation.

Thank you to all the Members who have come to the floor today to support this bill. I encourage all Members to support this legislation, and I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

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

As one of Riverside County's Representatives, a county that has the eighth-largest veterans' population in the Nation, I proudly rise today in support of H.R. 357, as amended. This bill is a far-ranging bill that seeks to improve the lives of our veterans.

H.R. 357 includes a number of measures that were considered by the Subcommittee on Economic Opportunity and was reported favorably out of the Veterans' Affairs Committee last June.

I want to thank Chairman Miller of the full committee, and Chairman Flores of the Subcommittee on Economic Opportunity, for their leadership. I especially enjoyed holding several field hearings last year with Chairman Flores in our respective districts.

The Veterans' Affairs Committee has traditionally been a bipartisan committee, and I am pleased to see that cooperation continue as both leaders helped bring this bill to the floor today.

In the area of education, H.R. 357 would require all public colleges and universities using the GI Bill to provide all veterans with instate tuition rates. Currently, veterans who have not established residency at the school of their choice must pay out-of-state tuition rates.

In order to fulfill their military obligations, servicemembers must uproot their families and periodically move around the country. This makes it difficult to establish residency for purposes of instate tuition rates when veterans seek to use their GI Bill benefits. By providing all veterans with instate tuition rates, H.R. 357 will make it easier for veterans to choose the educational institution that best serves their needs.

The new Transition Assistance Program includes a mandatory 5-day core program of instruction that all separating servicemembers are required to take. The education portion is an optional track available to all members but is not required. Some separating servicemembers may not have additional time to take an optional course.

H.R. 357 would move the education track to the mandatory portion for veterans seeking to use their GI Bill benefits, which will ensure that these veterans can make better choices regarding their education and assist them in making the most of their GI Bill benefits.

In addition, H.R. 357 also extends the Veterans Retraining Assistance Program for 2 months to better align the program with the traditional academic semester.

Now, in addition to these provisions, Mr. Speaker, I would like to highlight two sections which I have sponsored and which are included in H.R. 357. I believe these sections will also assist our veterans in terms of their education and in finding work after their separation from the military.

Section 6 is from the first bill I introduced, H.R. 844, the VetSuccess Enhancement Act. This provision would extend from 12 years to 17 years the eligibility period that veterans with service-connected disabilities have to enroll in VA vocational rehabilitation and employment programs.

Veterans with traumatic brain injury or spinal cord injury often require years to complete rehabilitation and adjust to the new realities of day-to-day living. Only then can these veterans consider returning to work. This provision will provide these veterans with the additional time they need to seek vocational rehabilitative services.

Section 7 is from another bill I introduced, H.R. 1453, the Work- Study for Student Veterans Act. This section provides for a 5-year extension of the Veterans Work-Study program at the VA.

As an educator, I know how important these programs are to students to enable them to fit some part-time work into their academic term. The VA program pays veterans to perform a variety of tasks, including assisting other transitioning veterans by helping them with outreach.

By providing support in the college Office of Veterans' Affairs, these students help other veterans to navigate the VA system. It is an important program to veteran students in my district and to thousands of others in schools across the country.

The last provision that tackles transition issues would codify the major duties of the directors and assistant directors from the Department of Labor's Veterans' Employment and Training Services.

At present, there is no standardization of the requirements and duties of these positions. H.R. 357 will provide more consistency in the services provided veterans by standardizing the responsibilities of these officials. In addition, codifying their duties will enable us to better track their funding, review their performance and hold everyone accountable to the same standard.

These are important changes to the educational benefits and transition services for our veterans and will better assist veterans in serving our communities and our Nation after they leave service.

Finally, in terms of fighting veteran homelessness and improving VA medical care, H.R. 357 would clarify that veterans who are homeless and participating in the HUD-VASH voucher program, and those who are transitioning from incarceration, are eligible for services under the Homeless Veteran Reintegration Program, or the HVRP. I am sure that all these veterans will find these services very beneficial as they look to begin the next chapter in their lives.

H.R. 357 would require the VA to more consistently report infectious diseases diagnosed at VA medical facilities to State authorities to increase the likelihood that infectious disease outbreaks that may occur are addressed sooner and more comprehensively.

Although we have expressed concerns over the enforcement mechanism included in this provision, we all can support the importance of comprehensive notification.

H.R. 357 also includes a provision that would protect a veteran's personal privacy by directing the VA to ensure that any visual recording made of a patient during treatment is carried out only with the full and informed consent of that patient.

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

Mr. Speaker, at this time, I yield 3 minutes to the gentlewoman from Nevada (Ms. Titus), who is also the ranking member of the Veterans' Affairs Subcommittee on Disability Assistance and Memorial Affairs.

Mr. Speaker, at this time, I am pleased to yield 2 minutes to the gentleman from Pennsylvania (Mr. Doyle), a great champion of veterans and former member of this committee.

Does the gentleman from Florida have additional speakers?

Mr. Speaker, in closing, H.R. 357 makes important changes to the benefits and services we provide veterans and to the manner in which we provide them. I urge my colleagues to support H.R. 357, as amended.

I have no further speakers, and I yield back the balance of my time.

General Leave

Mr. Speaker, ``Sonny'' Calcagno, age 85; John Ciarolla, age 83; Clark Compston, age 74; John McChesney, age 63; William Nicklas, age 87; and ``Mitch'' Wanstreet, age 65 are the victims of the Legionnaires' disease outbreak at the Pittsburgh VA health care system in 2011 and 2012. We can never really heal the emotional scars that these families have suffered and the 21 additional families who had a family member with a case of Legionnaires', but we can work to make sure something like this doesn't happen again.

Today's legislation fixes one of the flaws uncovered during this investigation; and under this bill, VA hospitals will soon follow the same reporting requirements for infectious diseases as other medical facilities. This way, public health authorities will know when a disease outbreak occurs and can take immediate action.

Thanks to the dogged determination and diligence of Chairman Miller, Congressman Coffman, the House Veterans' Affairs Committee, the ranking member, and my colleagues, Messrs. Doyle, Rothfus, and Kelly, we now know the Legionnaires' outbreak was entirely preventable except for the gross mismanagement and negligence of a few key officials at the Pittsburgh VA.

The inspector general's report revealed some troubling findings. The VA lacked proper documentation and maintenance of the water system, and was lax in properly informing and testing patients. Further, the VA did not communicate properly with the hospital system in the detection of Legionella. That is why this bill is necessary, because timely reporting and transparency requires adherence to the strongest standards, followed by quick action.

But with this, our work is not yet done. It has been more than 2 months since I last asked VA Secretary General Shinseki to tell Congress what has been done to hold accountable those who are responsible for this outbreak, and his agency has promised to do so. But Congress is still waiting for an answer.

Transparency and accountability are essential for the Secretary to rebuild the trust in the VA. We are grateful to our veterans for their service and grateful to the hard workers of the VA hospital system. The Pittsburgh VA has been a leader in infection control work and should be commended for that, but, in this case, the failures of some are simply unacceptable.

My hope is that through this bill requiring reporting of infection cases we will be able to restore the trust that the VA has with its veterans and their families. It is so critically needed in order to make these essential changes.

I ask for my colleagues to vote in support of this bill.

Mr. Speaker, I rise today in support of H.R. 357, the GI Bill

Tuition Fairness Act. This legislation contains a number of important changes in VA programs that provide our veterans with education, training, rehabilitation, disability benefits, and housing; and it deserves our support.

I want to focus my remarks today on the disease reporting provisions in the bill because I have been deeply involved with that issue over the last year or so.

In November of 2012, the VA announced that there had been an outbreak of Legionnaires' disease at a VA hospital in Pittsburgh, which I represent. Shortly thereafter, I joined other members of the regional congressional delegation in requesting investigations into the outbreak. In response, the House Committee on Veterans' Affairs and the VA Inspector General's Office examined the outbreak and the events leading up to it at length. The Centers for Disease Control also looked into the outbreak and determined that it had resulted in several deaths and more than two dozen illnesses.

I want to personally express my gratitude to my good friend Veterans' Affairs Committee Chairman Jeff Miller, Oversight Subcommittee Chairman Coffman, and Ranking Member Michaud for being so responsive to our requests for investigations and investigating the outbreak and holding hearings on it last year.

In the end, the hearings and investigations identified a number of shortcomings in the way the outbreak was handled and the need to be addressed. One of the concerns raised, as we learned more about the outbreak, was that for some time after the local VA facility knew it had Legionella bacteria in its water supply and that VA patients had been sickened by it, it had not notified State or local health agencies about the outbreak. Under current law, VA is not required to make such reports, which are required of all other hospitals.

Chairman Miller, Subcommittee Chairman Coffman, Senator Casey, and Congressmen Murphy, Rothfus, and I all agree that in the future the VA should be required to report outbreaks of potentially deadly diseases to public health authorities, just like other hospitals already do.

The language in this bill is the result of our discussions over a number of months. I believe that the need for this reporting requirement is obvious. I urge my colleagues to support this bill which will make this important change.

Mr. Speaker, I rise in support of H.R. 357 and, in particular, section 13, which encompasses my legislation, the Infectious Disease Reporting Act.

Section 13 imposes necessary requirements on the Department of Veterans Affairs to report infectious disease outbreaks at their medical facilities. These requirements are a response to infectious disease problems at VA facilities that were uncovered by my subcommittee's investigations last year. The investigations highlighted a deadly outbreak of Legionnaires' disease at the Pittsburgh VA from February 2011 to November 2012 which tragically caused the deaths of at least five veterans and afflicted as many as 22 others.

According to medical experts, timely disease surveillance is critical to infectious disease control; and delayed, incomplete, or inconsistent disease reporting can compromise an effective public health response and result in further infectious disease outbreaks.

Although it has become clear that these deaths could have been prevented with proper procedures, the VA failed to act appropriately within widely accepted medical practices. Surprisingly, the VA is not required by current law to report the incidence of infectious diseases at their facilities to State and local public health officials.

As one of the Nation's largest health care providers, VA should set the standard for infectious disease reporting. However, they do not even participate in infectious disease reporting like all other medical facilities within a particular State, creating a public health risk to those localities with VA facilities.

In response, section 13 requires the VA to report each case of an infectious disease in accordance with the laws of the State in which the facility is located.

And failure to report will subject the VA facility to State penalties. These penalties are vital to ensure the VA will comply with and improve their reporting requirements.

Given the VA's recent inadequate responses to infectious disease outbreaks, it is imperative that Congress and our veterans demand improvements. Therefore, I urge full support of section 13 of H.R. 357, as well as the passage of the entire bill.