Mr. Chair, I thank the gentleman for yielding. Mr. Chairman, in 2017, the VTP program transported a total of 557,331 veterans, of which 103,704 were disabled veterans. The VTP office is the authoritative source for all veteran-related…
Mr. Chair, I thank the gentleman for yielding.
Mr. Chairman, in 2017, the VTP program transported a total of 557,331 veterans, of which 103,704 were disabled veterans.
The VTP office is the authoritative source for all veteran-related travel initiatives. Its core mission is to assist in the improvements of access to care and assist veterans in overcoming transportation barriers to accessing VHA services.
VTS has established a network of transportation options for veterans through joint efforts with VA's Office of Rural Health and veterans service organizations.
This is a valuable program that has clearly been recognized and highlighted by the gentleman from California, that helps veterans who are visually impaired, elderly, or immobilized due to disease or disability, and particularly those living in remote and rural areas, to get to their medical appointments.
At a time with the VA where we are struggling to make sure both in terms of time that veterans have to wait to get an appointment and the difficulty in getting through a long distance to get that service, this is an important amendment.
Mr. Chair, I appreciate the gentleman from California's contribution and I strongly support it.
Mr. Chair, I thank the gentleman for yielding.
I support the efforts by the gentleman from Massachusetts to combat opioid abuse, which really has been a scourge in every region of this country and has left almost no region in this Nation untouched.
The rates of prescription opioid misuse and overdose continue to increase sharply, and prescription opioids are now a leading cause of death in the United States. In fact, Mr. Chairman, we are about to reach the third year in a row that life expectancy in the United States will have gone down. That is the first time that has happened since all the way back to World War I, and it can be directly attributed to opioid abuse and the resulting deaths that has caused.
So I agree with my friend from Massachusetts that the VA should have a toolkit similar to the mental health toolkit and that it could save lives. I support the amendment.
Will the gentleman yield?
Mr. Chairman, pain management education for the prescription of opioids in the VA could help with opioid abuse; that is clear. The VA already has guidelines regarding the management of opioid therapy for chronic pain and provides clear and comprehensive, evidence-based recommendations incorporating current information and practices for practitioners throughout the DOD and the VA healthcare systems.
Mr. Chairman, these guidelines are provided to minimize harm and increase patient safety in patients who require opioid therapy, but these guidelines only work if the prescriber is adequately trained. And that is why the gentleman from Massachusetts' amendment would be so helpful, because we all know that the key to making sure that we can reach people and maximize the effectiveness of the program is to ensure that the appropriate and significant training is done so that we can achieve those goals. So I support this amendment.
Mr. Chairman, I claim the time in opposition, even though I am not opposed to the amendment.
Mr. Chairman, the gentlewoman from Texas has identified a very important issue, one that was brought to my attention in sharp relief by my own hospital association just yesterday.
In Florida, we are now the third-largest State in the Union, and the hospitals in my home State are owed at least $134 million in payments that have not been paid by the VA.
I mean, I don't care how big your operation is, that is a tremendous amount of money, and prompt payment is a critical issue because we need to make sure that the resources that are appropriated to our healthcare system and the revenue that we need generated to contribute to our economy and the care that we need provided is done so promptly.
What we don't want to have happen is healthcare providers deciding not to provide services outside the VA to VA patients. And my discussion with them yesterday was that there are healthcare providers in our State that are starting to decide not to take VA patients anymore, and that would be a travesty.
The gentlewoman is absolutely correct. Waiting 2 or 3 years for payment--that is the kind of length of time we are talking about here-- can have a devastating impact, particularly on small business.
It is not a new issue at the VA. For example, former Secretary David Shulkin started rapid response teams whose goal was to settle the most substantial outstanding bills as quickly as possible.
Mr. Chairman, the issue of prompt payments must be addressed as more veterans seek services outside of the VA. It is a tremendous problem, and I am really pleased that the gentlewoman has brought it to our attention, raised the issue, because we need to know the full scope of VA delinquent payments. So I support this amendment, and I yield back the balance of my time.
Mr. Chair, I claim the time in opposition, even though I am not in opposition to the amendment.
Mr. Chairman, you just can't make this stuff up. The committee members have been to the D.C. VA Medical Center, and they put on a nice show when I first became ranking member. They leave a good impression. But the documented issues at the D.C. VA Medical Center are well known, and I want to just walk our colleagues through a few of them because this is how egregious it is. The gentleman's suggestion through this amendment to make sure that the IG takes a very close look at what is going on at this medical center is critical.
The D.C. VA Medical Center was found to have paid exorbitant amounts for supplies and equipment, including $300 per speculum, which could have been purchased for $122 each, and $900 each for a special needle that was available for $250. In one case, the medical center rented in- home hospital beds for three patients for 3 years at a total cost of $877,000. The medical center could have bought the three beds for $21,000.
A review of 124 veteran patient records found problems with supplies or instruments in 74 of the cases between 2014 and 2017.
One surgery was canceled after the patient was already under anesthesia because a retractor was unavailable because it had not been sterilized since its previous use a week earlier.
A surgeon had to improvise when a tool used to prepare a skin graft was broken and the graft failed. A surgical staff member had to run to a private sector hospital across the street to borrow mesh to repair a hernia midprocedure.
Investigators received more than 1,300 boxes of unsecured records from two warehouses, the hospital basement, and a large trash dumpster in April 2017. Of those records, 81 percent contained confidential patient information, including medical scans and records dating back to the 1970s. This facility is failing the veterans in the Metro D.C. area who deserve better.
This is an important amendment, and making sure that the VA takes care of its patients and is not negligent or derelict in its duties at every single place that those veterans are serviced is critical.
Mr. Chair, I reserve the balance of my time.
Mr. Chair, the gentleman deserves credit for bringing this to the House's attention. The outrage at this medical center speaks for itself, and I look forward to making sure that the IG has the resources that are needed to be able to get to the bottom to help fix this problem.
Mr. Chair, I yield back the balance of my time.
Mr. Chairman, I claim the time in opposition, although I do not oppose the amendment.
Mr. Chairman, the committee opposed the Department's tentative decision last fall to convert almost a billion dollars of funding for homeless programs from special purpose funding to general purpose funding.
This action would have been a fundamental change to the manner in which medical care funding is allocated to the field, and I support giving more local flexibility to Veterans Integrated Service Networks and medical center directors.
However, I strongly support transparency when it comes to changing the levels that Congress sets for VA programs.
We are the appropriations institution. We are the ones that make those decisions. The proposed realignment by VA would have potentially risked funding for essential programs such as the Supportive Services for Veteran Families Program.
Thankfully, after numerous discussions with the committee and public outrage, the Department decided not to move forward with its proposal in FY18. We fully expect for the VA to comply with the levels that we set for programs; and if the levels need to be adjusted, then the VA must consult with Congress before making changes.
I thank the gentleman from California for his amendment, and I believe it sends a strong message to the Department that it must respect congressional priorities.
I urge all Members to support the gentleman's amendment, and I yield back the balance of my time.
Mr. Chair, I claim the time in opposition to the amendment.
Mr. Chair, I do oppose this amendment. I, like many Members, have concerns and share the gentleman's concerns about another round of BRAC. I realize that this is a complex issue for all Members of Congress, especially those with military facilities in their district.
I know that previous rounds of BRAC have ended up being far more expensive and expansive than we were initially led to believe. However, I have concerns about maintaining the infrastructure that the Department of Defense doesn't need. For example, the estimate of excess capacity for the Army is 22 percent. The Air Force's estimate of excess capacity is roughly 30 percent.
I can tell you that, since I became the ranking member of this subcommittee, when I have traveled around the world, almost to a person, when we have spoken to a leader on a military base, they raise the issue of needing to go through another round of BRAC. Both the Army and the Air Force are strong supporters of another BRAC round.
While this amendment has no real effect, it does send a message that Congress is unwilling to tackle a tough issue. This amendment is an abdication of our duties as Members of this House to ensure taxpayer resources are being used in a wise and fiscally responsible way. Therefore, I urge my colleagues to oppose this amendment and have a serious conversation about another BRAC round.
While I am not suggesting that we support another BRAC round, we should not be tying our hands by taking it off the table.
Mr. Chair, I urge Members to oppose the amendment, and I reserve the balance of my time.
Mr. Chair, just to reiterate, we shouldn't be taking any method that gives us an opportunity to be fiscally responsible and save money off the table.
Our friends on the other side of the aisle consistently talk a good game about being fiscally responsible, blow holes in the deficit by passing massive tax scam legislation of a $1.5 trillion deficit expansion, and include amendments like this one that prevent the military, who have asked repeatedly to be able to at least engage in a discussion about another BRAC round, to save millions of dollars and close facilities that are no longer needed. Yet, the last several years, the majority has refused to make the tough decisions and at least have a discussion about this.
It is not responsible. Certainly not fiscally responsible. Mr. Chair, I urge my colleagues to oppose the amendment, and I yield back the balance of my time.
Mr. Chair, as the designee of Ranking Member Lowey, I move to strike the last word.
Mr. Chairman, I want to thank the chairman of the full committee and our ranking member, Mrs. Lowey, for the incredible work that they have done to get us to this point.
While in the minority we have had some concerns about the process, the opportunity to work closely side by side with our colleagues, the opportunity that I had to work with Chairman Dent and looking forward to working with Chairman Carter, is really an example of how we should be working together throughout the entire legislative process.
I want to thank our staff for doing a remarkable job on this work product, and I look forward to continuing to conference.
Mr. Chair, I yield back the balance of my time.