Veterans to Paramedics Transition Act

Mr. President, I am pleased to follow my friend and colleague from Vermont, Senator Sanders, and I want to begin by thanking him for his leadership, his persistence, and his perseverance in the face of resistance that should not exist. This cause ought to be one that galvanizes the Nation, and perhaps it will, since the Nation has been appalled and astonished by reports of not only cooking the books but covering up that potential criminality--destruction of documents, falsification of records, secret waiting lists, delays that are unacceptable and intolerable for basic, necessary health care our veterans need.

But these issues are longstanding, decades old in this system, and they need to be addressed with system-wide reform.

I am strongly in support, and proudly so, in advocating the Ensuring Veterans Access to Health Care Act that Senator Sanders has just introduced. It is a version of the omnibus bill and

other measures that have been introduced. It has essential features that will provide better health care sooner and more accessibly to our veterans. It is necessary to pass, but these provisions should have passed literally years ago. In fact, the very first piece of legislation I introduced in the Senate, S. 1060, called the Honoring All Veterans Act, included a provision to deal with this shortage of doctors in this system. It included other health care-related measures to expand the availability and accessibility of health care. These problems, far from new, have been existent for some time. And the coverup, the lying, and falsification of records is potentially now criminal and beyond a failure of public policy; it is a failure in integrity.

I am pleased to join Senator Sanders to make sure the 9.3 million of the Nation's 22 million who are enrolled in the VA health care system-- which is up from about 2.5 million at the end of the first gulf war-- have the kind of service they need. This bill will address some basic needs. It provides authority to remove senior executives based on poor job performance and preventing wholesale political firings. The legislation would provide veterans who cannot get timely appointments access to private clinics and the option of going to community health care centers, military hospitals, or private doctors. It would authorize the Veterans' Administration to lease 27 new health facilities in 18 States, including funds for the enhanced lease of the Errera Community Care Center in West Haven, CT, which does profoundly important and excellent work.

The legislation authorizes emergency funding to hire new doctors and nurses and other providers in order to address systemwide health care provider shortages and to take other necessary steps to ensure timely access to care. It addresses the health care primary care shortage for the long term as well by authorizing the National Health Service Corps to award scholarships to medical school students and to forgive college loans for doctors and nurses who work at the VA. These kinds of measures and others in the bill will act to fulfill our basic obligation to our veterans, just as I attempted to do in the Honoring All Veterans Act some years ago, and others have joined since in seeking to do.

My hope is we can reach across the aisle. In fact, I am working with Senator McCain on a bipartisan letter to the Attorney General urging all possible involvement and leadership in a criminal investigation. I hope a similar spirit of bipartisanship will enable us to work with Senators McCain, Burr, and Coburn on their Veterans Choice Act and combine these measures, enlist them in supporting a bipartisan solution and join Senator Sanders in hoping for that bipartisan effort in this measure because there is no question that the VA budget has grown, but simply has failed to keep pace with surging demand, especially in mental health services and primary care. Too many of our veterans are coming home with serious mental health issues, including post-traumatic stress, traumatic brain injury, and need the care we owe them. We need accountability. Part of it will be firing the officials who should be held responsible, but part of it may also be prosecuting them, and that is the reason I have asked the Attorney General to take the lead to assume much more immediate, significant involvement in any criminal investigation that may be necessary.

In fact, there is credible and significant evidence of criminal wrongdoing here. The Department of Justice must be involved and in my view must take a leadership role, and that is the reason Senator McCain and I have joined in a letter that we are seeking support for our colleagues to send that would request the Attorney General to take such steps. Only the Attorney General has the resources, expertise, and authority, along with the FBI, to do a prompt and effective criminal investigation. Only the Department of Justice can convene a grand jury and take other necessary steps. Only the FBI can bring to bear the expertise as well as the resources.

The inspector general of the Veterans' Administration has only 165 investigators for the entire Nation. This investigation now spans more than 40 centers where criminality has been alleged. Of the 216 sites visited by the auditors recently, many were found to have issues of scheduling practice defects and potential integrity problems. So there is a reason for the VA inspector general to not only consult with the Department of Justice but also involve the Department of Justice in an active leadership role here, and for the Acting Secretary of the VA to request that involvement, which I hope he will do. I commend what he has done so far, but now is the time for the Department of Justice to be involved in leading.

The audit of the facilities around the country is to be made public-- not just the overall results which have been delivered to the President in a report last Friday, but all of the results--site-specific results for locations, for example, the two hospitals in Connecticut in West Haven and in Newington as well as the six medical centers in Connecticut. All of those site-specific audits should be made public.

I have written to the Acting Secretary Sloan Gibson, urging that he make those face-to-face audits of the VA medical facilities public, not only for Connecticut but for the whole country. Restoring trust and credibility will be achieved only if there is more transparency. Nondisclosure would be a bad way to begin a new era of leadership at the VA. Full transparency is absolutely vital to help restore trust and confidence, which has been so gravely threatened and, indeed, undermined.

Finally, I have a few words to say about Secretary Shinseki. The immediate challenge is not about replacing one person, it is about fixing a system that is desperately wrong. I deeply respect Secretary Shinseki's decision to resign last week after concluding that his continued service would be a distraction from the urgent and necessary overhaul of the Veterans' Administration. I respect even more his dedicated service to our Nation. He is a decorated combat veteran who led into battle many of the men and women who now use the Veterans' Administration. His mentors and models, as he so eloquently told our committee, now use the Veterans' Administration. In his heart, I believe he is passionately committed to the cause of serving our veterans, and he deserves gratitude and respect from the American people for his service in the U.S. military and his telling truth to power as the President so powerfully observed.

The Nation must recognize it owes our veterans world-class, first- class medical care that is second to none. Putting them at risk in medical facilities after they have put their lives on the line on the battlefield is a disservice to them and our Nation.

It is abhorrent and atrocious that there have been these potentially criminal acts--destruction of documents and falsification of records-- at many of the VA facilities around the country. There is no excuse for it. Whether it is arbitrary deadlines or timelines, there is simply no excuse for that kind of lying. The lying that happened within the VA was not only to General Shinseki, but to the American people. The ones who committed that kind of wrongdoing should be held accountable administratively and criminally.

The wars in Iraq and Afghanistan, and the ongoing global military operations since 9/11, have cast a long shadow on this Nation's history. It involved less than 1 percent of the population, including the families of the brave warriors who have been sent to battle. All of us will live with the consequences, and all of us have an obligation to keep faith with them, leave no veteran behind, and give them prompt and world-class, first-class medical care when they need it right away.

The ``greatest generation'' set a model for them, and they are, indeed, the next greatest generation. We have to do right by them as they have done right by us. No matter what the era, conflict, or war, let us keep faith with all of the veterans and leave no veteran behind.

Mr. President, it has been almost 2 months since allegations that some 40 veterans died while waiting for care at the Phoenix VA were first made public. Since that report, we have learned of similar allegations of gross mismanagement and data manipulation at 42 VA medical facilities across the U.S. More troubling, according to the Office of the Inspector General's preliminary report, 1,700 veterans in the Phoenix VA Health Care System who thought they were about to receive care were never even placed on the VA's Electronic Waiting List and are ``at risk of being forgotten or lost in Phoenix HCS's convoluted scheduling process''. Today, it is clear that delaying medical care and manipulating records to hide those delays in care is systemic through the Department of Veterans' Affairs health system. This has created in our veterans' community a crisis of confidence toward the VA--the very agency that was established to care for them.

Today, I joined Senators Coburn, Burr, and Flake to introduce the Veterans Choice Act of 2014. This bill would, principally, empower veterans with greater flexibility when choosing their medical care and increase transparency and accountability within the VA to ensure that it delivers quality care to our veterans in a timely manner. Specifically, it would give veterans the option to go to a different doctor if the VA can't schedule an appointment within a reasonable time or if the veteran lives too far away from a VA medical facility. Additionally, this bill would prohibit scheduling or wait-time metrics/ goals from being used as factors to determining performance awards or bonuses. It would also require the Secretary of the VA to punish employees who falsify data, including civil penalties, suspension or termination. And, empower the Secretary of the VA to remove any top executive at the VA if the Secretary determines that his performance warrants removal.

Put simply, unlike some other proposals that have been made to reform how the VA delivers care, this bill would squarely address the root causes of the tragic circumstances that have brought us to this point.

For almost all this century, Americans have been fighting in faraway places to make this dangerous world safer for the rest of us. They have been brave. They have sacrificed and suffered. They bear wounds and mourn losses they will never completely recover from--and we can never fully compensate them for. But, we can care for the injuries they incurred on our behalf and provide for their physical and emotional recovery from the battles they fought to protect us. Quality care for our veterans is among the most solemn obligations a nation must pay, and we will be judged by God and history by how well we discharge ours.

Indeed, we must be worthy of the sacrifices made on our behalf How we care for those who risked everything for us is the most important test of a Nation's character. Today, we are failing that test. We must do better tomorrow. Much better.

For the 9 million American veterans who depend on the VA for their health care, and for the families whose tragic stories we have heard over the last two months, who I know are still grieving their losses, it is time to provide our veterans with the care, choice, and accountability that they so rightly deserve. I am pleased to be associated with the bill Senator Burr, Senator Coburn and Senator Flake introduced today, which would help the nation achieve those laudable, necessary goals. I urge my colleagues--on both sides of the aisle--to support it.

Mr. President, as chairman of the Senate Committee on Veterans' Affairs, I rise today to introduce the Ensuring Veterans Access to Care Act of 2014.

I thank the 16 cosponsors of this legislation, and they are Senators Rockefeller, Begich, Shaheen, Kaine, Reed, Merkley, Casey, Whitehouse, Blumenthal, Heinrich, Udall of New Mexico, Schatz, Baldwin, Wyden, Hirono, and Leahy.

It is safe to say there is broad bipartisan agreement among all of us that every veteran in this country who enters the VA health care system deserves high-quality care and deserves that care in a timely manner.

Overall, talking to veterans in Vermont and, in fact, throughout this country, talking to the veterans service organizations who represent their interests and reading independent studies, they all confirm that by and large, once veterans get into the VA health care system, the system is, in fact, quite good.

However, it has become clear--and I think all of us are aware of what has happened in the last month--that while quality is generally good, there are too many veterans throughout this country waiting too long to access this care.

In recent years, the VA has seen a huge increase in its patient load.

In fact, in the last 4 years, 2 million new veterans have come into the system, many of them with very complicated health care cases, including TBI, post-traumatic stress disorder, and many of the needs that older veterans and older people generally have.

Despite this fact, it is still absolutely unacceptable that some veterans are forced onto long waiting lists for care, and it is totally intolerable--it is reprehensible--that any VA employee could be manipulating data in Phoenix or anyplace else to hide how long veterans have been on waiting lists to see doctors. This is an issue that must be dealt with and must be dealt with rapidly and strongly.

These problems are real, and they have to be addressed. But they should not be an excuse to walk away from a system that serves 6.5 million veterans every single year and 230,000 veterans every single day. This is a system we must fix, not a system that we should ditch.

We must focus on the underlying problems and work to transform the