Mr. Speaker, pursuant to House Resolution 891, I call up the bill (S. 2372) to amend title 38, United States Code, to provide outer burial receptacles for remains buried in National Parks, and for other purposes, and ask for its immediate…
Mr. Speaker, pursuant to House Resolution 891, I call up the bill (S. 2372) to amend title 38, United States Code, to provide outer burial receptacles for remains buried in National Parks, and for other purposes, and ask for its immediate consideration in the House.
Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and insert extraneous material in the Record on S. 2372, as amended.
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of my bill, the John S. McCain III; the Daniel K. Akaka; and with great honor, the Samuel R. Johnson Department of Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018, or the VA MISSION Act.
This bill exemplifies exactly how Congress should work. It is a bipartisan, bicameral compromise agreement between the House and Senate Veterans' Affairs Committees that was crafted over the last year and a half through regular order and in close coordination with stakeholders and advocates in VA, the White House, the military and veterans service organizations, and the broader health community.
It is also aptly named after Senator McCain, late Senator Akaka, and Congressman Sam Johnson, three great Americans whose lives and work exemplify service and statesmanship. The MISSION Act is also aptly named in that it would address and reaffirm Congress' commitment to VA's core and most important mission: caring for, as President Lincoln said, those who have borne the battle.
There are five main components of the MISSION Act. Each of these components on their own would be noteworthy and significant. Together, they are transformational.
The first component of the MISSION Act would consolidate and improve VA's community care programs. VA uses several different methods to refer veterans to community providers today. The most recent and notable method is the Choice Program, which Congress created following the nationwide access and accountability crisis in 2014. All of those methods serve different purposes and employ different business processes, reimbursement rates, and eligibility criteria. That creates a tremendous and increasing amount of confusion and consternation from VA employees, community providers, and VA patients.
The MISSION Act would consolidate all of those methods into a single, streamlined VA community care program that is easier to understand, administer, and deliver to veterans who need it. This would increase access to timely quality care in every community across the country and, in doing so, expand VA's reach and veterans' choice. It would also return all VA community care funding to the discretionary side of the ledger, thereby increasing transparency and accountability for the hard-earned taxpayer dollars that VA receives.
The second component of the MISSION Act would address the pending shortfall in the Choice fund. When Congress created the Choice Program 4 years ago, it also created the Choice fund and stipulated that the program would end when the fund ran dry. Congress has acted time and time again to prevent that from happening in recognition of the millions of veterans who rely on the Choice Program despite its imperfections.
However, Acting VA Secretary Wilkie sent a letter just last week declaring that the remaining funds in the Choice fund will be exhausted as early as May 31, just 2 weeks from today. The consequences of that have the potential to be catastrophic for veterans, with Acting Secretary Wilkie warning that wait times will increase, access to care will decrease, continuity of care will be disrupted, and valuable community partnerships will be damaged.
To prevent that, the MISSION Act would authorize and appropriate $5.2 billion to the Choice fund. This would prevent an access-to-care crisis from occurring in the immediate future and provide sufficient funding to allow the Choice Program to continue serving veteran patients over the next year until the new, consolidated community care program is implemented.
The third component of the MISSION Act would address VA's massive and misaligned physical footprint. VA is one of the largest property- holding entities in the Federal Government with a capital asset portfolio that includes thousands of medical facilities spanning hundreds of millions of square feet.
The average VA medical facility building is more than five times older than the average building in the not-for-profit system in this country, with some VA facilities being much older than that. For example, the VA medical center in my hometown of Johnson City, Tennessee, was built in 1903 to care for Civil War veterans. It is still seeing patients today.
Since being named chairman of the Committee on Veterans' Affairs a year and a half ago, I have made it a priority to travel to VA facilities across the country. While many of them are doing great work, they are operating out of facilities that were designed and built to meet antiquated healthcare needs and delivery models.
Those facilities are increasingly impossible to manage and maintain in accordance with modern standards and the ever-changing shifts in the veteran population, not to mention that demand for care is growing progressively more costly and complex in Tennessee and across the country.
The Asset and Infrastructure Review, or AIR, Act process that the MISSION Act would create is based on a recommendation from the bipartisan Commission on Care that was put together by President Obama. It would create an open, objective, politically insulated process to recommend how VA's massive physical footprint can be realigned and brought up to date. This would transform the VA healthcare system that we know today into one that is stronger, more efficient, and better able to meet the healthcare needs of veterans, now and for generations of veterans to come.
None of us who are lucky enough to have a VA facility in their backyard, as I do, want to contemplate a future where that facility may change or disappear. But without action as bold, brave, and potentially transformative as the AIR Act is, the long-term success and sustainability of the VA healthcare system is in serious question, and veterans will suffer the consequences.
I want to assure those who may still be concerned about AIR that they will have nothing to fear from it. I worked closely with a wide variety of veteran service organizations to ensure that the AIR process takes and includes a high level of veteran, VSO, stakeholder, and community involvement--both locally and nationally--and to make sure no AIR recommendation would occur behind closed doors without an open discussion and a review of all the relevant facts, with every option and opportunity left on the table.
It is my firm belief that AIR will result in a modern, streamlined VA healthcare system but not necessarily a markedly smaller one. VA is going to remain a presence in communities large and small, and no facility that is needed to care for veteran patients or that has a worthy service to provide them will be negatively impacted.
The fourth component of the MISSION Act will be to expand the Family Caregiver Program to the caregivers of pre-9/11 veterans. Congress created the Family Caregiver Program in 2010 to provide services and supports, including a monthly stipend payment and healthcare coverage, if needed, to caregivers of post-9/11 veterans.
Caregivers provide an invaluable service, often at great personal sacrifice, to those veterans who have been seriously injured in the line of duty. Caregivers know no age or era, but for far too long the Family Caregiver Program has been restricted to an inequality based on era of service. The MISSION Act would correct that serious inequity and finally give pre-9/11 caregivers the recognition they deserve.
The fifth and the final component of the MISSION Act would be to enhance the internal capacity of the VA healthcare system to care for veteran patients internally. Opponents of this bill will tell you falsely that it is aimed at eventual privatization of the VA healthcare system. That misconception is based on nothing but fear and rhetoric, I think.
The MISSION Act contains numerous provisions that would make it easier for VA to attract high-quality commissions and other professionals and put them to work in VA medical facilities, just as I have done. It also contains numerous provisions that would make it easier for the providers already working in VA hospitals and clinics to see more veteran patients and to be recognized and rewarded for their great work.
Together, these provisions would fortify the VA healthcare system and make sure it stays strong and able to provide the care that it is meant to provide.
Before closing, I want to take a moment to recognize some people: Chairman Johnny Isakson and Ranking Member Tester of the Senate Committee on Veterans' Affairs. Chairman Isakson and Ranking Member Tester have been steadfast partners over the last year and over the last several weeks, in particular. The MISSION Act would not be a reality without their good-faith efforts to work hand in hand with me and with our veteran service organization partners to overcome our differences and craft a bipartisan, bicameral compromise bill that veterans and their families can be proud of. Mr. Speaker, I want to thank them for their leadership and for their friendship.
I am also grateful for the many members of the committee from both sides of the aisle and both sides of the Capitol, including Ranking Member Walz, and to our VSO partners in the community, the VA, and in the White House who have worked hard over the last year and a half to craft and consider many of the provisions that make up the MISSION Act.
Finally, I want to thank President Trump for his leadership and steadfast commitment to veterans since taking office. This bill would not have been possible without his vocal leadership. This may well be the most impactful vote that any of us will ever take for our Nation's veterans.
And before I finish, I also want to thank the staffs on both sides of the aisle, both in the Senate and in the House, both Republican and Democrat, for their incredible hard work, the many hours behind the scenes that you never see, that the public never sees, that I certainly appreciate and I believe Ranking Member Walz does too, the hard work of our staffs.
A ``yes'' vote is a vote for access, for quality, for choice, for the long-term success and sustainability of the VA healthcare system, for caregivers and for veterans. And for that I would recommend a positive ``yes'' vote.
The MISSION Act is supported by every major military and veteran service organization that rightfully recognizes this as a monumental and historic opportunity to support a bill that will positively impact the daily lives and well-being of millions of veterans and their families and fundamentally shape and improve the second largest agency in the Federal Government.
I urge every single one of my colleagues to stand today with me and
these organizations dedicated to the service of veterans, servicemembers, and their families, and, most importantly, our Nation's veterans, and support the VA MISSION Act.
Mr. Speaker, I include in the Record a letter from the VSO in support of the MISSION Act.
May 7, 2018.
Hon. Phil Roe,
Chairman, House Veterans' Affairs Committee, Washington, DC.
Hon. Johnny Isakson,
Chairman, Senate Veterans Affairs Committee, Washington, DC.
Hon. Tim Walz,
Ranking Member, House Veterans' Affairs Committee,
Washington, DC.
Hon. Jon Tester,
Ranking Member, Senate Veterans' Affairs Committee,
Washington, DC.
Dear Chairman Roe, Ranking Member Walz, Chairman Isakson
and Ranking Member Tester: On behalf of the millions of
veterans, service members and family members we represent and
advocate for, we offer our strong support for the ``VA
Maintaining Internal Systems and Strengthening Integrated
Outside Networks Act of 2018,'' also known as the ``VA
MISSION Act of 2018.'' This historic veterans legislation
would consolidate and reform VA's community care programs;
extend funding for the current Veterans Choice Program for
one year; strengthen VA's ability to recruit, hire and retain
quality medical personnel; review, realign and modernize VA's
health care infrastructure; and extend eligibility to VA's
comprehensive caregiver assistance program to aging and
disabled veterans injured before September 11, 2001.
Our organizations strongly support expanding eligibility
for VA's comprehensive caregiver program to all generations
of seriously disabled veterans, while maintaining the
caregiver benefits that are currently available. Today, this
program provides full comprehensive caregiver assistance only
to veterans injured on or after September 11, 2001, leaving
family caregivers and veterans injured during World War II,
the Korean, Vietnam and Gulf Wars ineligible for this
critical support. The legislation will help to correct this
injustice and we--along with millions of members in our
organizations--applaud you for taking this action and look
forward to working in the future to ensure that both injured
and ill veterans from all eras are eligible for this benefit.
The legislation would consolidate VA's community care
programs and develop integrated networks of VA and community
providers to supplement, not supplant VA health care, so that
all enrolled veterans have timely access to quality medical
care. The bill includes funding to continue the current
Choice Program for an additional year until the new community
care program is implemented as well as important workforce
improvement provisions to strengthen VA's internal capacity
to delivery care. This carefully crafted compromise
represents a balanced approach to ensuring timely access to
care while continuing to strengthen the VA health care system
that millions of veterans choose and rely on.
The legislation also includes a new Asset and
Infrastructure Review (AIR) process intended to design and
implement a comprehensive plan to optimize and modernize VA's
medical care facilities. The AIR process would provide
meaningful stakeholder involvement, transparency and other
safeguards during the review process to help ensure the final
result leads to a stronger and better aligned VA
infrastructure able to deliver care to veterans when and
where they need it.
Since the access and waiting list crisis exploded in 2014,
Congress, VA and veterans leaders have debated how best to
strengthen and reform the delivery of veterans health care to
ensure timely and seamless access for enrolled veterans. The
legislation before the Committee would take a major step
towards that goal by making improvements to and investments
in the VA health care system, creating integrated networks so
that veterans have access to care when and where they need
it, and providing the further recognition and assistance to
family caregivers of severely disabled veterans deserve.
As leaders of the nation's veterans and military service
organizations, we thank you for your steadfast leadership in
crafting this important bipartisan bill and call on all
members of Congress to seize this historic opportunity to
improve the lives of veterans, their families and caregivers
by swiftly passing the ``VA MISSION Act of 2018.'' The men
and women who have served, are serving and will serve in the
future are counting on Congress' support.
Respectfully,
Garry J. Augustine, Washington Executive Director, DAV
(Disabled American Veterans); Verna L Jones, Executive
Director, The American Legion; Joseph R. Chenelly,
Executive Director, AMVETS; Dana T. Atkins, Lieutenant
General, U.S. Air Force (Ret.), President, Military
Officers Association of America; Robert E. Wallace,
Executive Director, Veterans of Foreign Wars of the
United States; Carl Blake, Executive Director,
Paralyzed Veterans of America; Rick Weidman, Executive
Director of Policy, Vietnam Veterans of America; Rene
Bardof, Senior Vice President, Government & Community
Relations, Wounded warrior Project; Paul Rieckhoff,
Founder and CEO, Iraq and Afghanistan Veterans of
America; Joseph C. Bogart MA, Executive Director,
Blinded Veterans Association; Thomas J. Snee, National
Executive Director, Fleet Reserve Association; Kristina
Kaufmann, Executive director, Code of Support
Foundation.
Paul K. Hopper, Colonel, USMC (Ret.), National President,
Marine Corps Reserve Association; James T. (Jim)
Currie, Ph.D., Colonel, USA (Ret.), Executive Director,
Commissioned Officers Association of the U.S. Public
Health Service; Neil Van Ess, National Commander,
Military Order of the Purple Heart; Steve Schwab,
Executive Director, Elizabeth Dole Foundation; Bonnie
Carroll, President and Founder, Tragedy Assistance
Program for Survivors; Jon Ostrowski, Senior Chief
USCGR, Retired, Director, Government Affairs, Non
Commissioned Officers Association; Michael Cowan MD,
VADM USN (Ret), Executive Director, AMSUS; Randy Reid,
Executive Director, U.S. Coast Guard Chief Petty
Officers, Association; Deirdre Park Holleman, Esq.
Washington Executive Director, The Retired Enlisted
Association; John H. Madigan, Jr, Vice President and
Chief Public Policy Officer, American Foundation for
Suicide Prevention; CW4 (Ret.) Jack Du Teil, Executive
Director, United States Army Warrant Officers,
Association; Jim Lorraine, President & CEO, America's
Warrior Partnership.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I yield 4 minutes to the gentleman from Texas (Mr. Sam Johnson), one of my personal heroes. One of the greatest privileges I have had in the 9\1/2\ years I have served in this U.S. Congress is to serve with Sam Johnson.
Mr. Speaker, just for clarification, we have been under cap since 2011. The VA budget has grown exponentially since then. We have always done the right thing for our Nation's heroes and will continue to do that.
Mr. Speaker, it is my privilege to yield 2 minutes to the gentleman from Ohio (Mr. Wenstrup), my good friend. He served until he recently moved to a different committee, as chairman of the Health Subcommittee. He has been an active member of the Veterans' Affairs Committee and has been a very valued member.
Mr. Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Bilirakis), the vice chair of the committee and a tireless worker on the Veterans' Affairs Committee.
Mr. Speaker, it is my great honor to welcome Ms. Kuster back. She has been out for a little bit due to some work, and I am glad to see her back on the floor.
Mr. Speaker, I yield 2 minutes to the gentleman from Maine (Mr. Poliquin), my good friend and a very active member of the Veterans' Affairs Committee.
Mr. Speaker, I yield an additional 15 seconds to the gentleman.
Mr. Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Dunn), my good friend, a U.S. Army veteran, and an active member of the Veterans' Affairs Committee.
Mr. Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Rutherford), a very active member of the Veterans' Affairs Committee.
Mr. Speaker, I yield 3 minutes to the gentleman from Michigan (Mr. Bergman), a lieutenant general and an incredibly valued member of our committee.
Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I want to thank everyone who was involved in this process, beginning with the staff, who have been heavily involved in this. Both the Republican side and Democratic side worked for the last, really, almost 18 months.
I want to thank our Senate colleagues on the other side of this Capitol who worked very hard and the hours that went into this. The real winners here are our Nation's heroes, the veterans.
This VA MISSION Act does a community care where veterans can get high-quality care both inside the VA and out when the VA can't do that. We have heard speakers down here from areas that don't have a VA hospital. They absolutely rely on that.
I was in Oregon a few months ago and realized that some veterans had to drive 5 hours to a VA facility. They need the community care bill in their community. We provide the funding for that bill to bridge us over until the new Secretary implements that.
We have a caregiver. I am a Vietnam-era veteran, and I have seen many catastrophically injured Vietnam veterans whose families struggled for decades. 520-plus Vietnam veterans are dying every day. It is time we implement this bill and get these needed benefits to those World War II and veterans up to 9/11.
We need to rightsize the VA. Healthcare is not provided like it used to be. It has become much more sophisticated and streamlined. And outpatient, the VA needs to get to be able to do that also. That is what the AIR Act is about. We are increasing the internal capacity so we can train and get new clinicians and providers in.
The speaker, Sam Johnson, who spoke a minute ago, said it all. We should be able to look at that hero, who is a true American hero, and listen to his speech, which brought tears to my eyes, and vote for this bill.
Mr. Speaker, I yield back the balance of my time.
Mr. Speaker, I demand a recorded vote.
The Speaker pro tempore. Pursuant to clause 8 of rule XX, further proceedings on this question will be postponed.