Floor Statements

Mr. President, as chairman of the Committee on Veterans' Affairs, I am pleased to speak in support of the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012.

I thank my colleagues from the Veterans' Committee for their continuous support of our Nation's veterans--especially my ranking member Senator

Burr of North Carolina, for his steadfast advocacy of the government's responsibility to provide health care for the veterans and family members stationed at Camp Lejeune.

In addition, I thank Representatives Jeff Miller and Bob Filner, the chairman and ranking Member of the House Committee on Veterans' Affairs, for their hard work in developing this bipartisan, bicameral, and fully paid-for legislation.

With the passage of the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012, military families affected by contaminated water at Camp Lejeune, NC, would have the health care they need.

These families have waited for decades to get the assistance they need, and they should not be forced to wait any longer.

The legislation would also allow the VA to continue a number of programs that are so critical to helping veterans who have no place to call home.

Currently, the VA can only provide emergency shelter to veterans who are diagnosed with a serious mental illness. But we all know not all homeless veterans are mentally ill. Yet the VA is currently prevented from offering these critical services to all our veterans.

The Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012 would also make much needed improvements to the VA's housing programs by expanding the eligibility for the VA's specially adapted housing assistance grants.

These are some of the most disabled veterans in our Nation, and they deserve to be able to move about in their homes freely and safely.

This bill will also help more veterans use telehealth and telemedicine and allow veterans to receive travel assistance for visits to our vet centers. These provisions will especially help our veterans in rural and highly rural areas to access care from the VA.

It will also improve the way the VA reimburses State veterans homes for the care of elderly, seriously disabled veterans.

I know every Member of the Senate has at least one State veterans home in their State. Without this change, some of these homes may have to lay off staffers or be unable to accept more veterans, so it is a very important provision of the bill.

This legislation will also require important policy changes to protect veterans from sexual assault and other threats in the VA's inpatient mental health units and homeless programs.

Finally, we all know veterans continue to find themselves waiting entirely too long for a decision on their claims. This legislation will address the claims backlog by providing the VA with the ability to process appeals much more quickly and by supporting the VA's transformation to a paperless system. It will also make other needed improvements to the claims system, such as ensuring surviving spouses receive proper and timely benefit payments.

Above all, this bill fulfill's the responsibility this Nation has to provide care and service to our veterans and their families. In the case of those families who spent time at Camp Lejeune, this bill gives sick veterans and their families the benefit of the doubt their illness or condition was caused by the water at Camp Lejeune so they can finally get the health care they need.

This is something Congress has done before. When an illness or condition comes about after a veteran's service and any relationship between the veteran's current illness and their service is not readily apparent, the burden of proving the illness is a result of one's service can be insurmountable. In such circumstances, we have presumed a veteran's exposure caused their current condition and got them the help they needed. We have lived up to the responsibility we owed them, which is in the core of this bill.

Many veterans and their families are waiting for the passage of this bill. Our House colleagues are ready and willing to move this forward quickly as well. We did have one concern from the Senator from South Carolina, Mr. DeMint. We had a very productive conversation, and we now have that language resolved and have had a gentleman's agreement to move the bill forward today.

I wish to thank the Senator from South Carolina for his work and effort to get this bill passed. I know our veterans and families across the Nation are waiting.

I thank all our colleagues who have worked so hard on this very critical piece of legislation.

I ask unanimous consent to have printed in the Record the Joint Explanatory Statement in relation to this bill.

Mr. President, I come to the floor today to speak in strong support of the DISCLOSE Act, which will help put an end to secretive campaign spending and close the glaring campaign finance loopholes that have been opened up by the Citizens United ruling. I thank the Senator from Rhode Island for his tremendous leadership on this critical issue and all his work which has gotten us to this point today on this very important bill.

This Supreme Court ruling was truly a step backwards for our democracy. It overturned decades of campaign finance law and policy, and it allowed corporations and special interest groups to spend unlimited amounts of their money influencing our democracy. The Citizens United ruling has given special interest groups a megaphone that they can use to drown out the voices of citizens in my home State of Washington and across the country. The DISCLOSE Act would return transparency to this process. It would return accountability to this process. It would be a major step to returning citizens' voices to the important election decisions we make in our country.

This is a very personal issue for me. When I first ran for the Senate back in 1992, I was a long-shot candidate without a lot of money or wealthy corporate backers. But what I did have was amazing and passionate volunteers who were at my side. They cared deeply about making sure the voices of Washington State's families were represented. They made phone calls, they went door to door with us, they talked to families across our State who wanted more from their government.

We ended up winning that grassroots campaign because the people's voices were heard loudly and clearly. To be honest, I don't think it would have been possible if corporations and special interests had been able to drown out their voices with this unlimited barrage of negative ads against candidates who did not support their interests. That is why I support this DISCLOSE Act. I want to make sure no force is greater in our elections than the power of voters across our cities and towns, and no voice is louder than citizens who care about making their State and country a better place to live.

The DISCLOSE Act of 2012 should not be contentious. It simply does what a majority of American people view as a no-brainer. It requires outside groups to divulge their campaign-related fundraising and spending, plain and simple.

It does this by shining a very bright spotlight on the entire process and by strengthening the overall disclosure requirements on groups who are attempting to sway our elections.

Too often corporations and special interest groups are able to hide their spending behind a mask of front organizations because they know voters would be less likely to believe ads if they knew the motives behind their sponsors. For instance, an indication of who is funding many of these shell organizations can be seen in the delayed disclosures of the so-called super PACs. In fact, a Forbes article recently reported that 30 billionaires now are backing Romney's super PAC. It is unknown how much these same billionaires or their corporate interests are already providing to other organizations with even less scrutiny.

The DISCLOSE Act ends all that. Specifically, the act requires any of these front organizations who spend $10,000 or more on a campaign to file a disclosure report with the Federal Election Commission within 24 hours and file a new report for each additional $10,000 or more that is spent. This is a major step in pulling back the curtain on the outlandish and unfair spending practices that are corrupting our Nation's political process. It is a major step toward the kind of open and honest government the American people demand and deserve.

The DISCLOSE Act brings transparency to these shady spending practices and makes sure voters have the information they need so they know who they can trust. It is a commonsense bill. It should not be controversial, and anyone who thinks voters should have a louder voice than special interest groups should be supporting our bill.

This bill aims to protect the very core of our Federal election process. It protects the process by which our citizens fairly assess the people they believe will best come here and be their voice and represent their communities. It exposes the hidden hand of special interests, and it creates an open process for who gets to stand before them as representatives.

I am proud to support this bill and proud of the efforts by Senator Whitehouse and so many others in the Senate. I urge all our colleagues to vote for this bill. Let's move it forward. Let's do what is right for America.

Mr. President, I wish to congratulate Northwest Kidney Centers on its 50th anniversary and to commemorate the organization's service and dedication to kidney patients in my home State of Washington.

In 1960, Dr. Belding Scribner, a University of Washington researcher, created the Teflon shunt, a medical device that allowed patients suffering from kidney disease access to ongoing dialysis treatments. This invention paved the way for the creation of the Northwest Kidney Centers, the first out-of-hospital dialysis organization in the world.

Since opening its doors on January 8, 1962, the Northwest Kidney Centers has grown into a national leader in the field of patient care, education, research, and prevention. It is now the largest community- based, nonprofit dialysis provider in the country--providing approximately 25 percent of Washington State's dialysis patients in 14 centers and 12 local hospitals in King and Clallam Counties. Last year Northwest Kidney Centers served nearly 1,500 patients and trained and supervised 200 patients in self-treatment at

home. All together, the organization provided 226,000 dialysis treatments in our home State.

The organization regularly outperforms the Nation in clinical quality, with higher survival rates, more kidney transplants, and lower hospitalization rates. Moreover, Northwest Kidney Centers founded and still operates the Nation's first nonhospital retail pharmacy specializing in medications for kidney patients. The organization also manages unique special care units for very frail patients, thus avoiding hospitalizations and reducing costs.

Northwest Kidney Centers is a shining example of what it means to be a community-based organization. Each year Northwest Kidney Centers invests millions of dollars in the community with a variety of programs: charity care and uncompensated dialysis; training of kidney physicians; and services for predialysis patients and transplant recipients.

Finally, as we celebrate this historic 50-year milestone, I would like to recognize the entire Northwest Kidney Centers community-- patients, staff, donors, supporters, and volunteers--for their dedication and commitment to improving the lives of kidney patients in our State. I salute them for their remarkable achievements and successes and look forward to the next 50 years of outstanding service and patient care.

Mr. President, I am honored to join my colleagues today in recognizing the Department of Veterans Affairs' National Center for Post-Traumatic Stress Disorder, PTSD, as their month-long PTSD awareness campaign comes to a close and in reflecting on our participation in the third annual National PTSD Awareness Day. I thank Senator Conrad for introducing the resolution to honor Army National Guard SSG Joe Biel who suffered from PTSD and tragically took his own life in April 2007 after returning from his second tour in Iraq.

All this month, we draw attention to PTSD which affects millions of Americans at some point in their lives. As chairman of the Senate Veterans' Affairs Committee, I am especially concerned with the impact that PTSD has had on our Nation's servicemembers and veterans. The number of veterans treated by the Department of Veterans Affairs, VA, for PTSD or related symptoms has reached 475,000 and there are likely more cases that go unreported, undiagnosed, or untreated each year. In fact, as the drawdown of Afghanistan troops continues, we can only expect those numbers to follow the steady rise previously reported. VA and the Department of Defense, DoD, need to be ready now.

This unpreparedness is a tragedy. Whether the wounds they return home with are visible or invisible, no veteran should be left to face their injuries alone, and I am committed to seeing that they never have to.

Already, we have seen a change in how VA and the DoD treat PTSD. Earlier this year, we learned that hundreds of servicemembers and veterans had their PTSD diagnoses reversed over the course of 5 years at Madigan Army Medical Center in my home State of Washington. In the wake of this shocking discovery, Secretary of the Army John McHugh ordered a comprehensive, Army-wide review of medical files from the past decade to uncover any other problems with misdiagnoses. Two weeks ago, Secretary Panetta announced that he would be ordering a similar review across all of the armed services. I applaud these actions taken by Secretary Panetta and Secretary McHugh, but we are a long way from winning the battle on mental and behavioral health conditions.

That is why earlier this week I introduced the Mental Health ACCESS Act of 2012. This bill will require VA and DoD to offer a range of supplemental mental and behavioral health services to ensure that veterans, servicemembers, and their families are receiving the care that they need and deserve. The Mental Health ACCESS Act of 2012 provides for comprehensive standardized suicide prevention programs, expanded eligibility to families for support services, improved training for healthcare providers, new peer-to-peer counseling opportunities, and reliable measures for mental health services.

Finally, we must overcome the stigma that surrounds PTSD. As VA's National Center for PTSD has demonstrated, once diagnosed, PTSD and its symptoms can be treated and those who suffer from it can resume healthy and productive lives. Efforts like National PTSD Awareness Day and PTSD Awareness Month are critical to combating some of the most damaging misperceptions about PTSD.

In closing, as we look back on our efforts to raise awareness of PTSD throughout the month, we must also reaffirm our commitment to those veterans, servicemembers, and families affected by PTSD. Our veterans and servicemembers have made tremendous sacrifices for us and our country and we owe them the support and care that they deserve.

Madam President, I ask unanimous consent that following my remarks, the Senator from Ohio, Mr. Brown, be recognized, and following that, Senator Whitehouse be recognized.

Madam President, last February, in my office in Seattle, I sat down with an Iraq and Afghanistan war veteran named Stephen Davis and his wife Kim. Stephen and Kim were there to talk to me about their experiences since he returned home and about the invisible wounds of war they were struggling with together every single day.

At the meeting Kim did most of the talking. She told me about the nightmares. She told me about the lack of sleep. She talked about the confusion and the anxiety that was now a constant in their lives. But it was the way she summed up her experience since Stephen returned home that struck me hardest.

She said her husband still hadn't returned home. She said the husband she had been married to for nearly two decades--although he was sitting directly next to her--was still not back from the war.

Do you know what. Despite the fact that we often refer to these wounds as invisible, you could see it. When it came time for Stephen to describe to me his experiences, he shook as he explained how difficult the transition

home has been for him, his wife, and for their family.

The Davis family's story is no different than what thousands of other families have faced. But their story does have a tragic and frustrating twist. You see, Sergeant Davis knew when he returned home that he had a problem with post-traumatic stress, and he was courageous enough to reach out for help. He sought care and he was diagnosed with PTSD.

But just a few months later, after a visit to Madigan Army Medical Base in my State of Washington, he was told something that shocked and appalled him and his wife. After just a 10-minute meeting and a written questionnaire, Sergeant Davis was told he was exaggerating his symptoms and he didn't have PTSD. He was told, in effect, that despite serving in two war zones, despite being involved in three separate IED incidents, and despite his repeated deployments, he was making it all up.

He was then sent home with a diagnosis of adjustment disorder and told his disability rating would be lowered and that the benefits he and his family would receive would ultimately be diminished. If this sounds like an isolated, shocking incident, here is something you will find even more shocking. Sergeant Davis was one of literally hundreds of patients at that Army hospital who were told the exact same thing.

Soldiers who had been diagnosed with PTSD--not just once but several times--had their diagnosis taken away. In many instances these soldiers were told they were embellishing or even outright lying about their symptoms. In fact, so many soldiers were being accused of making up symptoms by doctors at that hospital I began to get letters and phone calls from them to my office.

Soon after that, documents came to light showing that the doctors diagnosing these soldiers were being encouraged to consider not just the best diagnosis for their patients but also the cost of care. These revelations have led to a series of internal investigations that are still underway today. Even more important, they have led to these soldiers now, thankfully, being reevaluated, and today hundreds of these soldiers, including Sergeant Davis, have had their proper PTSD diagnosis restored.

This, too, could be viewed as an isolated incident. In fact, when I first raised concerns, the problems we saw at Madigan could be happening at other bases across the country, that is exactly what I was told--it was an isolated incident at one base, at one hospital. But I knew better.

I remembered back to this Salon article that ran a few years ago. In that article, a doctor from Fort Carson in Colorado talked about how he was ``under a lot of pressure to not diagnose PTSD.''

It went on to quote a former Army psychologist named David Rudd, who said:

Each diagnosis is an acknowledgement that psychiatric

casualties are a huge price tag of this war. It is easiest to

dismiss these casualties because you can't see the wounds. If

they change the diagnosis, they can dismiss you at a

substantially decreased rate.

Madam President, I also had my own staff launch an investigation into how the military and the VA were diagnosing mental health conditions at other bases across our country, and I was very troubled by what I found.

It became clear that there were other cases where doctors accused soldiers of exaggerating symptoms without any documentation of appropriate interview techniques. They encountered inadequate VA medical examinations, especially in relation to traumatic brain injury. They found that many VA rating decisions contained errors, which in some cases complicated the level of benefits that veterans should have received.

Now, to their credit, the Army did not run and hide as the questions about other bases continued to mount. In fact, they have now taken two important steps. First, in April, they issued a new policy for diagnosing PTSD that criticized the methods being used at Madigan and pointed out to health officials throughout the entire system that it was unlikely that soldiers were faking these symptoms. Then, in May, the Army went further and announced they would review all mental health diagnoses across the country dating back to 2001. That, in turn, has led Secretary Panetta to announce just last week that all branches of the military are now going to undergo a similar review.

Without question, these are historic steps in our efforts to right a decade of inconsistencies in how the invisible wounds of war have been evaluated. Servicemembers, veterans, and their families should never have to wade through an unending bureaucratic process. Because of this outcry from veterans and servicemembers alike, the Pentagon now has an extraordinary opportunity to go back and correct the mistakes of the past.

We have to make sure these mistakes are never repeated. We still need to fundamentally change a system that Secretary Panetta admitted to me last week has ``huge gaps'' in it.

That is why I am here this evening. Today, I am introducing the Mental Health ACCESS Act of 2012. It is a bill that seeks to make improvements to make sure that those who have served have access to consistent, quality behavioral health care.

It is a bill that strengthens oversight of military mental health care and improves the integrated disability evaluation system on which we rely. As anyone who understands these issues knows well, this is not an easy task. The mental health care, suicide prevention, and counseling programs we provide our servicemembers are spread throughout this entire Department of Defense and the VA. Too often they are entangled in a web of bureaucracy and, frankly, too often this makes them difficult to address in legislation.

In crafting this bill I identified critical changes that need to be made at both the Department of Defense and the VA, and I set up a checklist of legislative changes needed to do just that. Some provisions in the bill will likely be addressed in my Veterans Committee. Others will need to be addressed through Defense bills and work with the chairs of those committees. But all of these provisions are critical, and today I want to share with you some of the most important ones.

High atop the list of changes this bill makes is addressing military suicides which, as we all know, is an epidemic that now outpaces combat deaths in this country. My bill will require the Pentagon to create comprehensive standardized suicide prevention programs. It would also require the Department to better oversee mental health services for servicemembers.

It will expand eligibility for a variety of VA mental health services to family members so we can help families and spouses to cope with the stress of deployment and strengthen the support network that is critical to servicemembers who are returning from deployment.

Third, my bill will improve training and education for our health care providers. Oftentimes our servicemembers seek out help from chaplains, medics, or others who may be unprepared to offer counseling. This bill will help prepare them through continuing education programs.

Fourth, my bill will create more peer-to-peer counseling opportunities. It would do it by requiring VA to offer peer support services at all medical centers and by supporting opportunities to train vets to provide peer services.

Finally, this bill will require VA to establish accurate and reliable measures for mental health services. This will help ensure that the VA understands the problems they face so that veterans can get into the care we know they can provide.

All of these are critical steps at a pivotal time, because the truth is, right now the Department of Defense and the VA are losing the battle against the mental and behavioral wounds of these wars.

To see that, you don't need to look any farther than the tragic fact that already this year over 150 active-duty servicemembers have taken their own lives or the fact that one veteran commits suicide in this country every 80 minutes. And while we all know there are a number of factors that contribute to suicide--repeated deployments, lack of employment security, isolation in their communities, and difficulty transitioning back to their families--not having access to quality and timely mental health care is vital.

When our veterans cannot get the care they need, they often self- medicate. When they wait endlessly for a proper diagnosis, they lose hope. Last year at this time, I held a hearing in my veterans committee on the mental health disability system this bill seeks to strengthen, and I heard two stories that illustrate that despair.

Andrea Sawyer, the wife of Army SGT Lloyd Sawyer, testified about her husband, who is an Iraq veteran and spent years searching for care. Together, they hit barriers and they hit redtape so often that at one point, she said, he held a knife to his throat in front of both her and an Army psychiatrist before being talked out of it.

Later, in that very same hearing, Daniel Williams, an Iraq combat veteran, testified about how his struggle to find care led him to stick the gun in his mouth while his wife begged him to stop, only to see his gun misfire.

Those are the stories that define this problem. These are men and women we must be there for. They have served and sacrificed and done everything this country has asked of them. They have left their families, left their homes. They have served multiple times and protected our Nation's interests at home and abroad. This bill will make a difference for them, but we have to make these changes now.

Today I am asking Members of the Senate from both sides of the aisle to please join me in this effort. We owe our veterans a medical evaluation system that treats them fairly, that gives them the proper diagnosis, and that provides access to the mental health care they have earned and they deserve. We need to join together to get this legislation passed, and I ask every Member of the Senate to help me get this through. It is critical, as thousands of men and women come home today and thousands of them are waiting on care.

Madam President, I yield the floor.

Madam President, last February, in my office in Seattle, I sat down with an Iraq and Afghanistan war veteran named Stephen Davis and his wife Kim. Stephen and Kim were there to talk to me about their experiences since he returned home and about the invisible wounds of war they were struggling with together every single day.

At the meeting Kim did most of the talking. She told me about the nightmares. She told me about the lack of sleep. She talked about the confusion and the anxiety that was now a constant in their lives. But it was the way she summed up her experience since Stephen returned home that struck me hardest.

She said her husband still hadn't returned home. She said the husband she had been married to for nearly two decades--although he was sitting directly next to her--was still not back from the war.

Do you know what. Despite the fact that we often refer to these wounds as invisible, you could see it. When it came time for Stephen to describe to me his experiences, he shook as he explained how difficult the transition

home has been for him, his wife, and for their family.

The Davis family's story is no different than what thousands of other families have faced. But their story does have a tragic and frustrating twist. You see, Sergeant Davis knew when he returned home that he had a problem with post-traumatic stress, and he was courageous enough to reach out for help. He sought care and he was diagnosed with PTSD.

But just a few months later, after a visit to Madigan Army Medical Base in my State of Washington, he was told something that shocked and appalled him and his wife. After just a 10-minute meeting and a written questionnaire, Sergeant Davis was told he was exaggerating his symptoms and he didn't have PTSD. He was told, in effect, that despite serving in two war zones, despite being involved in three separate IED incidents, and despite his repeated deployments, he was making it all up.

He was then sent home with a diagnosis of adjustment disorder and told his disability rating would be lowered and that the benefits he and his family would receive would ultimately be diminished. If this sounds like an isolated, shocking incident, here is something you will find even more shocking. Sergeant Davis was one of literally hundreds of patients at that Army hospital who were told the exact same thing.

Soldiers who had been diagnosed with PTSD--not just once but several times--had their diagnosis taken away. In many instances these soldiers were told they were embellishing or even outright lying about their symptoms. In fact, so many soldiers were being accused of making up symptoms by doctors at that hospital I began to get letters and phone calls from them to my office.

Soon after that, documents came to light showing that the doctors diagnosing these soldiers were being encouraged to consider not just the best diagnosis for their patients but also the cost of care. These revelations have led to a series of internal investigations that are still underway today. Even more important, they have led to these soldiers now, thankfully, being reevaluated, and today hundreds of these soldiers, including Sergeant Davis, have had their proper PTSD diagnosis restored.

This, too, could be viewed as an isolated incident. In fact, when I first raised concerns, the problems we saw at Madigan could be happening at other bases across the country, that is exactly what I was told--it was an isolated incident at one base, at one hospital. But I knew better.

I remembered back to this Salon article that ran a few years ago. In that article, a doctor from Fort Carson in Colorado talked about how he was ``under a lot of pressure to not diagnose PTSD.''

It went on to quote a former Army psychologist named David Rudd, who said:

Each diagnosis is an acknowledgement that psychiatric

casualties are a huge price tag of this war. It is easiest to

dismiss these casualties because you can't see the wounds. If

they change the diagnosis, they can dismiss you at a

substantially decreased rate.

Madam President, I also had my own staff launch an investigation into how the military and the VA were diagnosing mental health conditions at other bases across our country, and I was very troubled by what I found.

It became clear that there were other cases where doctors accused soldiers of exaggerating symptoms without any documentation of appropriate interview techniques. They encountered inadequate VA medical examinations, especially in relation to traumatic brain injury. They found that many VA rating decisions contained errors, which in some cases complicated the level of benefits that veterans should have received.

Now, to their credit, the Army did not run and hide as the questions about other bases continued to mount. In fact, they have now taken two important steps. First, in April, they issued a new policy for diagnosing PTSD that criticized the methods being used at Madigan and pointed out to health officials throughout the entire system that it was unlikely that soldiers were faking these symptoms. Then, in May, the Army went further and announced they would review all mental health diagnoses across the country dating back to 2001. That, in turn, has led Secretary Panetta to announce just last week that all branches of the military are now going to undergo a similar review.

Without question, these are historic steps in our efforts to right a decade of inconsistencies in how the invisible wounds of war have been evaluated. Servicemembers, veterans, and their families should never have to wade through an unending bureaucratic process. Because of this outcry from veterans and servicemembers alike, the Pentagon now has an extraordinary opportunity to go back and correct the mistakes of the past.

We have to make sure these mistakes are never repeated. We still need to fundamentally change a system that Secretary Panetta admitted to me last week has ``huge gaps'' in it.

That is why I am here this evening. Today, I am introducing the Mental Health ACCESS Act of 2012. It is a bill that seeks to make improvements to make sure that those who have served have access to consistent, quality behavioral health care.

It is a bill that strengthens oversight of military mental health care and improves the integrated disability evaluation system on which we rely. As anyone who understands these issues knows well, this is not an easy task. The mental health care, suicide prevention, and counseling programs we provide our servicemembers are spread throughout this entire Department of Defense and the VA. Too often they are entangled in a web of bureaucracy and, frankly, too often this makes them difficult to address in legislation.

In crafting this bill I identified critical changes that need to be made at both the Department of Defense and the VA, and I set up a checklist of legislative changes needed to do just that. Some provisions in the bill will likely be addressed in my Veterans Committee. Others will need to be addressed through Defense bills and work with the chairs of those committees. But all of these provisions are critical, and today I want to share with you some of the most important ones.

High atop the list of changes this bill makes is addressing military suicides which, as we all know, is an epidemic that now outpaces combat deaths in this country. My bill will require the Pentagon to create comprehensive standardized suicide prevention programs. It would also require the Department to better oversee mental health services for servicemembers.

It will expand eligibility for a variety of VA mental health services to family members so we can help families and spouses to cope with the stress of deployment and strengthen the support network that is critical to servicemembers who are returning from deployment.

Third, my bill will improve training and education for our health care providers. Oftentimes our servicemembers seek out help from chaplains, medics, or others who may be unprepared to offer counseling. This bill will help prepare them through continuing education programs.

Fourth, my bill will create more peer-to-peer counseling opportunities. It would do it by requiring VA to offer peer support services at all medical centers and by supporting opportunities to train vets to provide peer services.

Finally, this bill will require VA to establish accurate and reliable measures for mental health services. This will help ensure that the VA understands the problems they face so that veterans can get into the care we know they can provide.

All of these are critical steps at a pivotal time, because the truth is, right now the Department of Defense and the VA are losing the battle against the mental and behavioral wounds of these wars.

To see that, you don't need to look any farther than the tragic fact that already this year over 150 active-duty servicemembers have taken their own lives or the fact that one veteran commits suicide in this country every 80 minutes. And while we all know there are a number of factors that contribute to suicide--repeated deployments, lack of employment security, isolation in their communities, and difficulty transitioning back to their families--not having access to quality and timely mental health care is vital.

When our veterans cannot get the care they need, they often self- medicate. When they wait endlessly for a proper diagnosis, they lose hope. Last year at this time, I held a hearing in my veterans committee on the mental health disability system this bill seeks to strengthen, and I heard two stories that illustrate that despair.

Andrea Sawyer, the wife of Army SGT Lloyd Sawyer, testified about her husband, who is an Iraq veteran and spent years searching for care. Together, they hit barriers and they hit redtape so often that at one point, she said, he held a knife to his throat in front of both her and an Army psychiatrist before being talked out of it.

Later, in that very same hearing, Daniel Williams, an Iraq combat veteran, testified about how his struggle to find care led him to stick the gun in his mouth while his wife begged him to stop, only to see his gun misfire.

Those are the stories that define this problem. These are men and women we must be there for. They have served and sacrificed and done everything this country has asked of them. They have left their families, left their homes. They have served multiple times and protected our Nation's interests at home and abroad. This bill will make a difference for them, but we have to make these changes now.

Today I am asking Members of the Senate from both sides of the aisle to please join me in this effort. We owe our veterans a medical evaluation system that treats them fairly, that gives them the proper diagnosis, and that provides access to the mental health care they have earned and they deserve. We need to join together to get this legislation passed, and I ask every Member of the Senate to help me get this through. It is critical, as thousands of men and women come home today and thousands of them are waiting on care.

Madam President, I yield the floor.

Madam President, I call up my amendment No. 2455 and ask that it be modified with the changes at the desk.

Madam President, I ask unanimous consent that the 60- affirmative threshold be waived, since it is my understanding that we will adopt this by voice vote.

Madam President, the amendment we are going to vote on is bipartisan, fair, and it will make sure Congress gets a report on the impact of all aspects of the scheduled automatic cuts. We all agree the bipartisan sequestration agreed to in the Budget Control Act is a terrible way to cut spending. It was included as a trigger in order to bring both sides to the table ready to compromise.

I am hopeful we can get together and get the bipartisan deal required to replace these automatic cuts responsibly and fairly. But as we work toward that we all should know exactly how the administration would enact sequestration if we don't get a deal.

I was very proud to work with Senators McCain, Levin, and Thune to come together on a bipartisan compromise to make sure Congress has the information we all need on sequestration from the painful cuts to the Defense Department, border security, food safety, education, and programs for middle-class families, on which the most vulnerable Americans depend.

So I thank all my colleagues for working with me on this bipartisan compromise, and I thank the families and advocates who called and wrote letters urging us to examine all aspects of sequestration.

Madam President, it is my understanding that Senator McCain will not speak at this time, so I urge a ``yes'' vote on this voice vote.

Mr. President, I move to reconsider the vote.

I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Mr. President, as chairman of the Senate Committee on Veterans' Affairs, I would like to take a moment to recognize the Department of Veterans Affairs and the American Heart Association for their work to raise awareness about the dangers of cardiovascular disease amongst our Nation's women veterans and service members.

VA's dedicated work on cardiovascular disease has successfully decreased the gaps between men and women veterans in heart disease prevention outcomes. However, as cardiovascular disease remains the No. 1 killer of women, I applaud VA and the American Heart Association's ``Go Red for Women'' campaign for partnering under the First Lady's Joining Forces Initiative to raise awareness and promote prevention amongst our Nation's female veterans. I am pleased to see VA focus its efforts on educating women veterans through an online fitness and nutrition program and an online support network to connect women with other women who share similar experiences.

Today, women serve in every branch of the military. Women represent 15 percent of our Nation's Active-Duty military, and they are the fastest growing population within the veteran community. The number of women veterans is expected to increase to 2 million in 2020 and with this projected increase it is critical that VA remain responsive to the unique needs of women.

Nearly one in two women, 44.4 percent, will die of heart disease and stroke. We must ensure that women receive equal access to VA health care benefits and services. This partnership between VA and the American Heart Association is a great step toward ensuring that women are educated on the dangers of cardiovascular disease and provided with the resources necessary to prevent it.

Mr. President, I applaud the collaboration between VA and the American Heart Association to raise awareness and increase prevention efforts on an issue that affects so many of our Nation's women veterans and civilian women throughout our country.

Mr. President today, as Chairman of the Senate Committee on Veterans' Affairs, I introduce the Women Veterans and Other Health Care Improvement Act of 2012. I am incredibly proud of the women and men who have served or are serving our nation in uniform, and I strongly believe we must do all that we can to honor them.

That is why I introduced legislation, which was signed into law as part of the Caregivers and Veterans Omnibus Health Services Act of 2010, which helped to transform the way that the Department of Veterans Affairs, VA, addresses the needs of women veterans. Among other things, this law required the VA to provide neonatal care, train mental health professionals to provide mental health services for sexual trauma, and develop a child care pilot program. VA has an obligation to provide veterans with quality care and we have an obligation to make sure that VA does so. The legislation I am introducing today builds upon that effort to make additional improvements to VA's services for women veterans and veterans with families.

The nature of the current conflict and increasing use of improvised explosive devices leaves servicemembers, both male and female, at increased risk for blast injuries including spinal cord injury and trauma to the reproductive and urinary tracts. Army data shows that between 2003 and 2011 more than 600 women and men experienced these life-changing battle injuries while serving in Iraq or Afghanistan.

As they return from the battlefield, the VA system must be equipped to help injured veterans step back into their lives as parents, spouses, and citizens. These veterans have served honorably and have made the ultimate sacrifice for our great nation. They deserve the opportunity to pursue their goals and dreams, whether that includes pursuing higher education, finding gainful employment, purchasing their first house, or starting their own family. VA has many programs that help veterans pursue the educational, career, or homeownership dreams and goals that they deferred in service to this country, yet it falls short when it comes to helping severely wounded veterans who want to start a family. These veterans often need far more advanced services in order to conceive a child.

The Department of Defense and the Tricare program are already able to provide advanced fertility treatments, including assisted reproductive technology, to servicemembers with complex injuries. However; not all injured servicemembers are well situated to have a child at the time they are eligible for that coverage, and some are no longer eligible for Tricare by the time they are ready.

VA's fertility counseling and treatment options are limited and do not meet the complex needs of severely injured veterans. I have heard from severely injured veterans whose injuries have made it impossible for them to conceive children naturally. While the details of these stories vary, the common thread that runs through them all is that these veterans were unable to obtain the type of assistance they need. Some have spent tens of thousands of dollars in the private sector to get the advanced reproductive treatments they need to start a family. Others have watched their marriage dissolve because the stress of infertility, in combination with the stresses of readjusting to life after severe injury, drove their relationship to a breaking point. Any servicemember who sustains this type of serious injury deserves so much more. It is our responsibility to give VA the tools it needs to serve them, and the Women Veterans and Other Health Care Improvement Act is a start at doing that.

This legislation also requires VA to build upon existing research framework to gain a better understanding of the long-term reproductive health care needs of veterans, from those who experience severe reproductive and urinary tract trauma to those who experience gender- specific infections in the battlefield. A recent Army Task Force Report found that women in the battlefield experience high rates of urinary tract infections and other women's health conditions. After a decade at war, many women servicemembers are still at increased risk for women's health difficulties due to deployment conditions and a lack of predeployment women's health information, compounded by privacy and safety concerns. Little is known about the impact that these issues and injuries have on the long-term health care needs of veterans. Additional research will provide critical information to help VA improve services for veterans.

VA has come a long way in addressing the unique health needs and challenges that women face. Yet for all of its recent progress, VA can and must do more to ensure that women veterans are receiving the care that they need and deserve. Work remains to make VA a friendly environment for women veterans and veterans with families. Many women veterans are single mothers, making it difficult for them to take full advantage of the services that VA offers. The Women Veterans and Other Health Care Improvement Act creates a pilot program that provides child care to veterans seeking readjustment counseling at VA's Vet Centers. It also helps VA ensure that women veterans can get the information that they need in order to access VA health care and benefits.

This is not a section by section review of all the provisions within this legislation. However, I have provided an appropriate overview of the major benefits of this legislation and how it would improve the lives of our veterans and their families. The promise that we make to our veterans is sacred and knows no gender. To honor our veterans, we must honor this promise for each and every one of them.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President today, as Chairman of the Senate Committee on Veterans' Affairs, I introduce the Women Veterans and Other Health Care Improvement Act of 2012. I am incredibly proud of the women and men who have served or are serving our nation in uniform, and I strongly believe we must do all that we can to honor them.

That is why I introduced legislation, which was signed into law as part of the Caregivers and Veterans Omnibus Health Services Act of 2010, which helped to transform the way that the Department of Veterans Affairs, VA, addresses the needs of women veterans. Among other things, this law required the VA to provide neonatal care, train mental health professionals to provide mental health services for sexual trauma, and develop a child care pilot program. VA has an obligation to provide veterans with quality care and we have an obligation to make sure that VA does so. The legislation I am introducing today builds upon that effort to make additional improvements to VA's services for women veterans and veterans with families.

The nature of the current conflict and increasing use of improvised explosive devices leaves servicemembers, both male and female, at increased risk for blast injuries including spinal cord injury and trauma to the reproductive and urinary tracts. Army data shows that between 2003 and 2011 more than 600 women and men experienced these life-changing battle injuries while serving in Iraq or Afghanistan.

As they return from the battlefield, the VA system must be equipped to help injured veterans step back into their lives as parents, spouses, and citizens. These veterans have served honorably and have made the ultimate sacrifice for our great nation. They deserve the opportunity to pursue their goals and dreams, whether that includes pursuing higher education, finding gainful employment, purchasing their first house, or starting their own family. VA has many programs that help veterans pursue the educational, career, or homeownership dreams and goals that they deferred in service to this country, yet it falls short when it comes to helping severely wounded veterans who want to start a family. These veterans often need far more advanced services in order to conceive a child.

The Department of Defense and the Tricare program are already able to provide advanced fertility treatments, including assisted reproductive technology, to servicemembers with complex injuries. However; not all injured servicemembers are well situated to have a child at the time they are eligible for that coverage, and some are no longer eligible for Tricare by the time they are ready.

VA's fertility counseling and treatment options are limited and do not meet the complex needs of severely injured veterans. I have heard from severely injured veterans whose injuries have made it impossible for them to conceive children naturally. While the details of these stories vary, the common thread that runs through them all is that these veterans were unable to obtain the type of assistance they need. Some have spent tens of thousands of dollars in the private sector to get the advanced reproductive treatments they need to start a family. Others have watched their marriage dissolve because the stress of infertility, in combination with the stresses of readjusting to life after severe injury, drove their relationship to a breaking point. Any servicemember who sustains this type of serious injury deserves so much more. It is our responsibility to give VA the tools it needs to serve them, and the Women Veterans and Other Health Care Improvement Act is a start at doing that.

This legislation also requires VA to build upon existing research framework to gain a better understanding of the long-term reproductive health care needs of veterans, from those who experience severe reproductive and urinary tract trauma to those who experience gender- specific infections in the battlefield. A recent Army Task Force Report found that women in the battlefield experience high rates of urinary tract infections and other women's health conditions. After a decade at war, many women servicemembers are still at increased risk for women's health difficulties due to deployment conditions and a lack of predeployment women's health information, compounded by privacy and safety concerns. Little is known about the impact that these issues and injuries have on the long-term health care needs of veterans. Additional research will provide critical information to help VA improve services for veterans.

VA has come a long way in addressing the unique health needs and challenges that women face. Yet for all of its recent progress, VA can and must do more to ensure that women veterans are receiving the care that they need and deserve. Work remains to make VA a friendly environment for women veterans and veterans with families. Many women veterans are single mothers, making it difficult for them to take full advantage of the services that VA offers. The Women Veterans and Other Health Care Improvement Act creates a pilot program that provides child care to veterans seeking readjustment counseling at VA's Vet Centers. It also helps VA ensure that women veterans can get the information that they need in order to access VA health care and benefits.

This is not a section by section review of all the provisions within this legislation. However, I have provided an appropriate overview of the major benefits of this legislation and how it would improve the lives of our veterans and their families. The promise that we make to our veterans is sacred and knows no gender. To honor our veterans, we must honor this promise for each and every one of them.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, today, as Chairman of the Senate Committee on Veterans' Affairs, I am pleased to introduce the Homeless Veterans Assistance Improvement Act of 2012. No one who has made sacrifices to serve our Nation should ever be homeless, and this problem should never be ignored. The bill I am introducing today would allow the Department of Veterans Affairs, VA, to continue the important work of ending veteran homelessness.

The administration reported that on any given night in January 2011, an estimated 67,500 veterans were homeless. I want to commend the VA for its efforts to reduce the number of veterans sleeping in the streets. Between 2010 and 2011 the number of homeless veterans decreased by 12 percent, but the number of homeless women veterans has continued to increase. We are making great progress, in large part due to interagency collaborations, but there is still more work to be done.

In light of recent reports from VA's Office of Inspector General and the Government Accountability Office, VA must do more to make its homeless veterans programs more welcoming to women and veterans with families. The reports highlighted limitations in available housing options for women veterans with children. Additionally, infrastructure needs such as private and secure rooms and showering facilities are often lacking placing women veterans in uncomfortable and potentially unsafe situations. We can and should do better.

The Homeless Veterans Assistance Improvement Act of 2012 helps achieve this goal by allowing VA to provide

transitional housing services to the children of homeless veterans, where it is appropriate to do so. It also requires grantees who receive funding for transitional housing to meet the privacy, safety, and security needs of women veterans and veterans with families. No veteran should have to choose between housing and their safety or between housing and remaining with their family.

Other provisions in this legislation help VA to meet the self- identified, unmet needs of homeless veterans. VA conducts an annual assessment of homeless veterans, homeless programs staff, and grantees that ranks the top ten unmet needs of homeless veterans. The most recent report, which was from fiscal year 2010, highlights the fact that many homeless veterans ranked legal assistance among their top ten unmet needs for the last several years. Among the top-ranked needs for the last several years have been legal services and dental care. My legislation makes veterans in the HUD-VASH program eligible to participate in the Homeless Veterans Dental Program. It also ensures that a percentage of the funding available for homelessness prevention and rapid re-housing will be used for legal services to remove some of the barriers to obtaining or maintaining stable housing for homeless veterans.

This is not a full summary of all the provisions within this legislation. However, I hope that I have provided an appropriate overview of the major benefits this legislation would provide.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, today, as Chairman of the Senate Committee on Veterans' Affairs, I am pleased to introduce the Homeless Veterans Assistance Improvement Act of 2012. No one who has made sacrifices to serve our Nation should ever be homeless, and this problem should never be ignored. The bill I am introducing today would allow the Department of Veterans Affairs, VA, to continue the important work of ending veteran homelessness.

The administration reported that on any given night in January 2011, an estimated 67,500 veterans were homeless. I want to commend the VA for its efforts to reduce the number of veterans sleeping in the streets. Between 2010 and 2011 the number of homeless veterans decreased by 12 percent, but the number of homeless women veterans has continued to increase. We are making great progress, in large part due to interagency collaborations, but there is still more work to be done.

In light of recent reports from VA's Office of Inspector General and the Government Accountability Office, VA must do more to make its homeless veterans programs more welcoming to women and veterans with families. The reports highlighted limitations in available housing options for women veterans with children. Additionally, infrastructure needs such as private and secure rooms and showering facilities are often lacking placing women veterans in uncomfortable and potentially unsafe situations. We can and should do better.

The Homeless Veterans Assistance Improvement Act of 2012 helps achieve this goal by allowing VA to provide

transitional housing services to the children of homeless veterans, where it is appropriate to do so. It also requires grantees who receive funding for transitional housing to meet the privacy, safety, and security needs of women veterans and veterans with families. No veteran should have to choose between housing and their safety or between housing and remaining with their family.

Other provisions in this legislation help VA to meet the self- identified, unmet needs of homeless veterans. VA conducts an annual assessment of homeless veterans, homeless programs staff, and grantees that ranks the top ten unmet needs of homeless veterans. The most recent report, which was from fiscal year 2010, highlights the fact that many homeless veterans ranked legal assistance among their top ten unmet needs for the last several years. Among the top-ranked needs for the last several years have been legal services and dental care. My legislation makes veterans in the HUD-VASH program eligible to participate in the Homeless Veterans Dental Program. It also ensures that a percentage of the funding available for homelessness prevention and rapid re-housing will be used for legal services to remove some of the barriers to obtaining or maintaining stable housing for homeless veterans.

This is not a full summary of all the provisions within this legislation. However, I hope that I have provided an appropriate overview of the major benefits this legislation would provide.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Madam President, I come today to talk--as my colleagues have discussed--about the fact that Republicans in the House of Representatives seem ready to pack it in for the year.

Led by their majority leader and by the ``my way or the highway'' philosophy they have stuck to all year, they have signaled that they have given up on the work of the American people.

From our yearly responsibility to pass appropriations bills, to legislation that would create thousands of good-paying construction jobs, to efforts to stop an impending student loan hike, to a bill that would protect vulnerable American women from violence, House Republicans have now indicated they would rather kick the can down the road.

It is unfortunate that this is their attitude--not just for our college students or construction workers looking for jobs or women at risk, but it is statements such as the one the House majority leader made that make every American shake their head. That is because as American families come together around their kitchen table to make tough decisions about their mortgage or how to make tuition payments or even about how they are going to afford groceries, they want to see us coming together to make similarly tough decisions.

But as Leader Reid and my other colleagues have made clear: It is tough to legislate from only one side of Capitol Hill. It is tough to address the issues affecting everyday Americans when House Republicans are more interested in drawing dividing lines than coming to the middle. It is pretty tough to create jobs and help our economy rebound when House Republicans are more focused on next year than on the bills that are stuck in their Chamber today. And it is impossible to do anything about the looming fiscal cliff we face when House Republicans continue to show they do not get that it will take a balanced approach to fix.

The bottom line is we need a partner in legislating, and it appears from comments such as those that were made this week that hope is quickly fading.

What is particularly concerning about House Republicans wanting to shutter their Chamber for the year is the fact that bipartisan, commonsense Senate legislation is languishing there. Bills that have gotten support from overwhelming majorities, and that were carefully crafted over months of negotiations, are in limbo for no good reason.

In fact, what I would like to do today is highlight two important numbers to illustrate what I mean. The first number is 68. Madam President, 68--that is the number of Senators who voted to pass a bipartisan, inclusive bill to reauthorize the Violence Against Women Act. It is a total that includes 15 Republican Senators who, like the vast majority of Americans, agreed with us that we not only need to reaffirm our commitment to protect those at risk from domestic violence but that we also need to improve and expand protections. Those are 68 Senators who came together to say that our commitment to saving the lives of victims of domestic violence should be above politics; 68 Senators who said we cannot allow partisan considerations to decide which victims we help and which we ignore; 68 Senators who sent a strong bipartisan message to the House that we can come together to strengthen protections for all victims, regardless of where they live or their race or their religion or gender or sexual orientation. Unfortunately, it is a message that Republicans in the House have ignored. True to form, instead of taking up our bipartisan bill, Republicans have passed a bill that leaves out both the additional protections for vulnerable women and the delicate compromises we achieved.

Men and women across our country see the headlines that Leader Reid pointed out earlier. They know their protections are at risk, and they are at risk not because the Senate cannot come together but because House Republicans refuse to join us.

The second number I wanted to highlight today is 74. That is the number of Senators who came together to send a bipartisan transportation jobs bill to the House; 74 Senators who voted for a bill that will create or save millions of jobs in the country today; 74 Senators

who said that politics should not get in the way of our economic recovery or the need to fix our crumbling infrastructure; 74 Senators who got behind a bill that was the product of intense and long negotiation between Senators we know often did not see eye to eye but who did come together to pass a bill that could truly be called a compromise.

Yet here we are, months after this bill was passed with overwhelming bipartisan support, and it, too, is now the subject of political games in the House. Another bill that should never be considered political has become part of their grandstanding routine. It does not have to be this way. If Republicans can set aside politics and stand up to their tea party base, we can protect victims of domestic violence. We can pass a transportation bill. We can stop those tuition hikes. We can pass our appropriations bills.

In fact, we can even come together on the big issues that House Republicans have indicated they believe can only be resolved after an election. If Republicans are ready to admit it will take a balanced and bipartisan deal to avoid that fiscal cliff, we can make a deal tomorrow. But on this issue, Republicans have not just refused to meet us in the middle. They will not even come out of their corner.

We all know a bipartisan deal is going to be required to include new revenue along with spending cuts. Unfortunately, Republicans are singularly focused on protecting the wealthiest Americans from paying a penny more in taxes. Democrats are ready. We are willing to compromise. We know it is difficult, but we have to have a partner to do that.

Republicans need to understand that the fiscal cliff is not simply going to disappear if they close their eyes and wish hard enough. We are going to have to act, and Republicans should not let politics stop them from working with us now on a balanced and bipartisan deal which middle-class families expect and deserve.

Statements such as the one made by the House majority leader only reaffirm what American families fear the most, that at a time when they deserve a government at their backs, they are being abandoned. In the Senate, we have shown we can come together around bipartisan solutions. But we cannot do it alone. House Republicans need to send the American people a clear message they are willing to be a partner in compromise.

It is time for them to take up our bipartisan legislation to protect women and put workers back on the job. It is time to work with us in the appropriations process and help our Nation too. It is time to realize that a solution to the impending fiscal cliff will require a balance. It is certainly not time to give up.

I yield the floor.