Mr. SKELTON. Mr. Chairman, I move that the Committee do now rise.
The motion was agreed to.
Accordingly, the Committee rose; and the Speaker pro tempore (Ms. Hooley) having assumed the chair, Mr. Ross, Acting Chairman of the Committee of the Whole House on the state of the Union, reported that that Committee, having had under consideration the bill (H.R. 1538) to amend title 10, United States Code, to improve the management of medical care, personnel actions, and quality of life issues for members of the Armed Forces who are receiving medical care in an outpatient
status, and for other purposes, had come to no resolution thereon.
Mr. HUNTER. Mr. Chairman, I want to add my voice to the eloquent voice of the chairman, Mr. Skelton. I want to thank him, and thank also Dr. SNYDER and JOHN MCHUGH, the chairman and ranking member of Personnel, for their hard work on this bill. And for all the other Members who worked on this, I know Mr. Filner and Mr. Buyer were also architects of this bill. But especially our chairman, who has a heart [Page: H3207]
military and perhaps is the most adept custodian of the history of military personnel matters in the Armed Services Committee; a guy with a great eye and ear for history and for the sense of tradition that kind of brings us together on the Armed Services Committee to find common ground on important issues to the folks that wear the uniform. This is one of those issues, Mr. Chairman.
Mr. Chairman, young people right now are serving this country in far away places like Ramadi and Fallujah and Mosul and Kabul, and many other places around the world where the war against terror brings them face to face with danger every day. Some of those, the great members of the U.S. military, give their last full measure of devotion. Some of them are wounded and come back through Landstuhl and then to Bethesda and Walter Reed.
And, Mr. Chairman, I am reminded of Ronald Reagan's speech in 1981, when he stood on the west steps of the Capitol and he gestured out to the west and he said, There's the Washington Monument, dedicated to the Father of our Country, and beyond that, the Lincoln Memorial, dedicated to the man who saved the Union. But beyond those monuments are thousands of monuments with crosses and Stars of David, dedicated to Americans who gave that full measure of devotion to the same degree that the Founding
Fathers did, and that's Arlington Cemetery.
And he mentioned that under one of those markers lies a man named Martin Trepto, who was killed in World War I. He had gone to fight with the Rainbow Division in France, and after a few months or a few weeks in country, he was killed. When his friends found his body, they found that he kept a diary, and he had written these words, and I am paraphrasing: I must fight this war as if the success or failure of America depends on me alone.
I can tell you, Mr. Chairman, in going out to the warfighting theaters, that standard is the same standard that is carried by the young men and women of America's Armed Forces. And because of that, it is all the more compelling that we do everything possible to make sure that they have good care when they come home, and when they are wounded and when their families similarly are wounded by their wounds; and to make sure that we have a government which is friendly to them.
A lot of this problem at Walter Reed and Bethesda and the rest of our medical care apparatus is this; we need to have a system that is friendly, friendly to that 22-year-old marine wife who drives a couple hundred miles, maybe leaves the kids with the mother-in-law while she goes with her husband to undertake therapy at one of our hospitals. To be able to get in and get out without having to get bogged down in a mass of bureaucracy. It is toward those ends that we dedicated this bill.
And again, I think the chairman has done a great job, as have Mr. McHugh and Mr. Snyder. And let me tell you a couple of the highlights here.
I like the idea that you have got a limitation on 17 cases per case manager. That means that each case manager is going to have a lot of time to spend with each case, with each individual. And you also have the family advocate who will help with housing and transportation and all those things. That is almost as important as the case manager, because that helps a family to be with their loved one while they are undertaking their treatment.
I also like this handoff between the VA and DoD. We now have a physical meeting where you don't have the bureaucracy finally telling us after 3, 4 or 5 months that the records have been lost, that they have been misplaced or that there are some missing. And lastly, when we do the evaluation, to have experts who will assist the servicemember in making sure that his or her file is complete when they go for disability. That means if you've got that frag wound in your left leg, you make sure that
you've got a record of that in that disability packet when you go before the board.
Now, there are lots of other good language in this bill and good provisions in this bill that will accrue to the benefit of the servicemember and their family, but I think those are especially important.
Lastly, I think the hotline is important, Mr. Chairman, where people can call in and let the system know that it's messed up and that it's not serving them well. And I know that the wonderful men and women who serve our U.S. military will respond to that and will make things right.
Thank you, Mr. Chairman, for letting me speak for a couple of minutes about this bill.
Mr. Chairman, I reserve the balance of my time.
Mr. SKELTON. Mr. Chairman, I think our country was shocked at the revelation as to what the conditions were at that certain part of Walter Reed Hospital, and I am pleased that we, on a very bipartisan basis, have addressed this through the Armed Services Committee.
Mr. Chairman, at this time, I yield 2 minutes to my friend, my colleague, the gentleman from Connecticut (Mr. Courtney).
Mr. COURTNEY. Mr. Chairman, it was Presidents' Day weekend when The Washington Post story broke with the appalling and embarrassing story about the conditions under which our soldiers were living within the military health care system. I think as Americans, nothing could be more shocking and embarrassing than the notion that our own soldiers were isolated within the outpatient services of the military health care systems, in conditions with rotted walls, holes in the ceiling, mold growing. And
I would give Mr. Skelton and the ranking member of the Armed Services Committee all the credit because on March 8 the Armed Services Committee held a hearing, looked at the flaws that existed in the system and have come out with this legislation, which will do a lot to make sure that people will not be alone and isolated, with more case managers, with advocates that will be there, and a 1-800 emergency hotline to make sure they won't be, again, alone and isolated.
I do think, as Mr. Hunter indicated, probably the biggest problem that is facing returning soldiers right now is the transition from the Department of Defense to the Department of Veterans Affairs. In the State of Connecticut today, the waiting period is over 600 days for over 2,500 veterans in the State of Connecticut trying to get their claims processed. And in section 10 of this bill, which will require a physical transfer of the files, the medical records of people leaving the Department
of Defense system into the VA system will make sure that we are going to make a dent in reducing the length of time, which literally is threatening people's mortgage payments, their credit rating, and it is inexcusable that people who have served this country are being treated this poorly.
There was an amendment offered by myself on the Armed Services Committee which will also include State Veterans Affairs departments in that handoff because we have many benefits, property tax benefits, educational programs, preferential hiring within our State, like many other States, which returning veterans should be included and informed of immediately. I want to thank the chairman for including that language in the bill and strongly urge its passage.
Mr. GINGREY. Mr. Chairman, I rise today in strong support of H.R. 1538, the Wounded Warrior Assistance Act.
This bipartisan bill was reported unanimously by the Armed Services Committee, and I am a proud, proud cosponsor, along with my friend, distinguished chairman, Mr. Skelton, and my good friend, ranking member, Mr. Hunter.
Mr. Chairman, we are debating this bill today because all of us here, Democrats and Republicans, want to ensure our soldiers are receiving the high quality care for which our military is known.
Indeed, Mr. Chairman, as a physician, I can tell you that access to care is critical to the health and well-being of our military, active, reserve and veteran. While it was a condition of some housing facilities at Walter Reed that led us to examine our military health care system, the fundamental problems with military medical care cannot be fixed with paint, putty and plaster.
I am relieved to know the run-down rooms have been refurbished, but I am proud that this bill starts addressing the system's fundamental problem of [Page: H3208]
overcrowding, delayed paperwork and a shortage of human capital to oversee soldiers' continuing health care and quality of life needs.
Soldiers I met on a recent visit to Walter Reed were frustrated with lost medical records, dupes to forms, paperwork that took a week to make it from one office to another. This system greatly delays our soldiers' ability to meet with their doctors and to eventually, Mr. Chairman, be discharged.
In fact, the average stay at Walter Reed is 350 days, and many of those days are spent as an outpatient assigned to the medical hold unit waiting for the paper trail to catch up with patient care.
This legislation starts addressing these problems by giving soldiers a louder voice in their medical care. It increases the personnel assigned to each servicemember and his or her family so that our soldiers have advocates helping them set appointments and understand the prescribed course of their care. As a physician, I know that caseload greatly affects the personal attention delivered to each patient. More staff means more time for each soldier and their individual needs.
Mr. Chairman, another problem facing our military health system is the difficulty personnel face when they are transitioning from active duty to the retired status, and I am pleased that this legislation includes a pilot program to examine this critical need. A fully electronic and integrated records system would allow the Department of Defense and the VA to share information in a timely fashion.
I would also encourage the Department of Defense to automate all in-patient health records. We know that in the private sector switching from paper files to electronic medical records cuts down on medical errors, saves time, and saves money. Our military should fully realize these benefits as well.
Mr. Chairman, I think it is important to recognize that the Wounded Warrior Act fixes a process that isn't serving the best interest of our warfighters or our military medical personnel. Our military doctors and nurses are an invaluable resource for their expertise, bravery, and dedication. We want to make sure that the system benefits these heroes as well.
The Wounded Warrior Assistance Act represents a significant step toward ensuring our soldiers and veterans are treated with the dignity and respect that they have earned and fully deserve, and I hope all my colleagues will join me in supporting this great piece of legislation.
Mr. SKELTON. Mr. Chairman, I am very, very pleased that this bill will directly address the transition between the Department of Defense and the Veterans Administration with the actual physical hand-off that is provided and required in this.
I yield now 2 minutes to my friend, my colleague, the gentleman from Maryland (Mr. Cummings).
(Mr. CUMMINGS asked and was given permission to revise and extend his remarks.)
Mr. CUMMINGS. I thank the gentleman for yielding.
Mr. Chairman, today we have the opportunity to pass a bipartisan piece of legislation that will assist in correcting many of the wrongs that are rampant throughout our armed services health care system, as most recently illustrated in the reports and investigations surrounding Walter Reed.
I am pleased to join my colleagues in supporting this very vital piece of legislation that is an initial step, and I emphasize that, initial step in tearing down the bureaucratic red tape that can hold wounded service men and women in limbo for months and even years after they return home with injuries from the battlefield.
H.R. 1538, the Wounded Warrior Assistance Act, ensures better access to health care, better conditions in outpatient and inpatient treatment, a better means to report substandard conditions and, finally, better oversight.
H.R. 1538 responds to concerns raised by the men and women of our armed services and does the following things that are so important: Providing them with an assigned medical care case manager and limiting their caseload in order to prevent extensive backlogs; providing medical advocates to stand with soldiers before medical evaluations boards; and I think this is so important, providing a toll-free hotline that soldiers and their families can use to report inadequacies in care; and establishing
a pilot program to ensure that our servicemembers have a seamless transition from Armed Forces to the Veterans Affairs agency.
Finally, let me say this, Mr. Chairman. I am pleased that our chairman, Mr. Skelton, who has done an outstanding job, and Mr. Hunter, our ranking member, were very significant, along with Mr. Filner, in seeing that an amendment that I put forth was passed, and that was to give the head of Veterans Affairs two appointments to the Oversight Committee. So I urge my colleagues to vote in favor of this very outstanding piece of legislation.
Mr. HUNTER. Mr. Chairman, I would like to yield to the gentleman from New York (Mr. McHugh) as much time as he desires. And I would just note that Mr. McHugh, along with Dr. SNYDER, are chief architects of this legislation; and Mr. McHugh is the guy I like to refer to as the guy from the 10th Mountain Division in New York, a guy with enormous dedication to the men and women who wear the uniform.
Mr. McHUGH. I thank the gentleman both for yielding and for his very, very gracious comments, and I thank Mr. Chairman.
I want to begin by giving thanks where thanks are certainly due. I want to express my particular appreciation to my chairman on the Personnel Subcommittee, a fellow I had the opportunity to work with when he was ranking member for a number of years when I had the opportunity to Chair that subcommittee, Dr. SNYDER; as well as and equally so with the chairman of the full committee, Mr. Skelton; and, of course, my dear friend and such a great leader from the great State of California
(Mr. Hunter), for their leadership for recognizing the need to react to this, not in a bipartisan, not in a political way, but in a way that embodies the spirit of the Armed Services Committee.
One reason I am so proud and have been for now going on 15 years to serve on it and that is in the interest of those incredibly brave and unselfish men and women who don the uniform of the United States of America. We owe our thanks as well, as the gentleman from Maryland suggested, to the VA Committee, Mr. Filner and Mr. Buyer, for their willingness to work together in addressing what we all recognize is a very, very serious problem.
This is not a perfect bill. It does not meet the entire range of challenges and problems that we know exist, the entire range and need of problems that, frankly, have been known to many of us for many, many years, particularly the disconnect between two very well-meaning systems, that of the Department of Defense, who cares for our wounded, and later, after retirement and disability ratings, the VA department, who cares for those who follow through.
Both of them tried to do the job, and they tried to do it in very distinct ways, and what we have understood now and what was demonstrated at least in part at Walter Reed is the challenges of helping those two well-meaning, independent agencies work better together.
But while it is not, Mr. Chairman, a perfect bill, it is a very, very good bill, an excellent first step, a place where we can put into effect mechanisms to better ensure the quality of service and, equally important, provide a continuum of care for the brave men and women who risk their lives in defense of our freedoms, of America's freedoms. And I think we can all agree as well we owe that to them. We owe it to their families. We owe them nothing less than the best that we can possibly provide,
the absolute best; and this bill takes an important step towards effecting that kind of necessary change.
There will have to be things that follow. Once we hear from the recommendations of the Dole-Shalala Commission and from the DOD and Military Services' reviews and analysis, we will be in an even better position to take whatever additional actions are necessary to bring it together.
But you have heard my colleagues here on the floor today speak about the important components of this bill. We have looked at the problems, we have looked at the challenges that these folks have faced, and we have tried to [Page: H3209]
respond to them. Everything from hotlines to actual human hand-offs between the two systems, more case managers, more personal face-to-face responsiveness to the problems they may encounter, this bill provides it, with more to follow.
I also want to add, Mr. Chairman, that without the hard work of the staff on both sides of the Armed Services Committee we would not have had this legislation. Our particular thanks to Mike Higgins, Debra Wada, John Chapla, and Jeanette James, amongst others, who took our concerns, who took our feedback and made them into the bill that we receive here today; and we owe them as well.
Before I yield back, on a last note, Mr. Chairman, I would be remiss if I didn't once again add my words of deep appreciation to those incredible military medical professionals who through their hard work, who through their dedication are solely responsible for the best quality care. We are experiencing survival rates today coming out of Afghanistan and Iraq that we have never experienced in any theater of war in the history of this Nation, in fact, in the history of mankind, and that is because
of the wonderful job that they do.
This challenge has never been about them, and I want them most importantly to recognize we understand the differences of the system and, in fact, two systems that need correcting and better oversight from their valiant efforts. We all owe them our deepest appreciation.
So I am proud to be associated with this bill, a bill that will take a quantitative and qualitative step forward in providing the best possible care to our wounded and fallen warriors.
Mr. ANDREWS. Mr. Chairman, I thank you; and I thank the chairman for yielding.
Chairman Skelton and Chairman Snyder, Ranking Member Hunter, Ranking Member McHugh have shown great leadership on this bill; and I thank them for their efforts and salute them for their work. They led because they listened.
First of all, as my friend Mr. McHugh just said, it is important to note that the drafters of this bill listened to the good work that was being done by the many, many men and women in the military health care system, in the veterans health care system.
The system has been beleaguered lately with terrible news reports of intolerable treatment of the wounded warriors of this country. We deplore those reports. We deplore the facts that gave rise to those reports.
But we do want to commend the vast majority of people who work in each of these systems for the great work that they do and acknowledge the contribution they make to our country.
The leaders of this bill listened, and I think they have come up with a great work product that will help. They have listened to the family of the warrior who has sat for too long on a bed unattended, who has languished for too long in a bureaucracy, forgotten about, whose care and whose future situation has not been given the attention it deserves. And by requiring a medical case manager and an advocate for each one of those persons, I think we will find that fewer people will be forgotten about
and more people will get top-quality care.
This bill shows that its drafters have listened to those who have experienced the gaps in care and the frustration where there has not been a continuity of care when they were in the military health care system and then moved over to the VA health care system; that the care they are receiving, the diagnosis, the treatment is not consistent of someone who has had a good quality of care for a period of time, finds that interrupted and finds that to be inappropriate. This bill will establish means
by which we can merge the best qualities of both systems and address the needs of that wounded warrior.
Finally, this bill deals with the outrageous inconsistency that so many people have experienced in the disability system, where the same injury under the same circumstances is treated one way in one system and another way in the other and where it takes months or even years to find out what your final resolution is going to be. So this is a bill that shows that we can listen to those concerns and address them.
As Mr. McHugh says, the bill is not perfect, but the bill is sound, because it listens to the very real concerns of the wounded warriors. It addresses them in a way that puts aside politics. I am proud to support this bill, and I thank the authors for this opportunity.
Mr. SKELTON. Mr. Chairman, as the gentleman from New Jersey (Mr. Andrews) stated about the disparity between the treatment regarding the disability ratings made by the Department of Defense on the one hand, and the Veterans Administration on the other, we hope that disparity will be done away with by the legislation that we pass today.
I yield 1 minute to the gentlewoman from New York (Mrs. McCarthy).
Mrs. McCARTHY of New York. Mr. Chairman, I would like to thank Chairman Skelton for his leadership on this issue, as well as the ranking member, Mr. Hunter.
If you look back at what happened at Walter Reed, and it is on the outside of the care, not the inside care of the hospital that we are talking about, the Wounded Warriors Act certainly is a good first step.
One of the things that I want to address, I want to say thank you to Chairman Murtha for the commitment he has made to our military as far as making sure the money is in there so that we can implement what we need to do.
As we all know, head trauma has become the focus of a lot of these veterans that are coming home. With the IEDs in Iraq, traumatic brain injury has become the signature wound of this conflict. Our soldiers receive outstanding acute medical care; but people have to understand, it used to be thought that after 6 months of treatment, someone with a head injury would be fine and they would just kind of let them go. That is not true.
Back in 1993, my son was shot in the head and he certainly sustained very traumatic head injury. It takes a long time, and we know that we can give treatment for years after. It is 13 years since my son's head treatment, and he is still receiving therapy. So this is a good first start, and I hope we continue with it.
Mr. HARE. Mr. Chairman, I rise today in support of H.R. 1538, the Wounded Warrior Assistance Act of 2007.
As a member of the House Veterans' Affairs Committee, I am deeply concerned about the lack of a seamless transition for our servicemembers into the VA health care system.
This bill changes that broken system by creating a pilot program within the Department of Defense requiring a more efficient movement of medical records and a better process for our separated or retiring troops.
It also provides soldiers and their families with a toll-free hotline for reporting problems. Complaints called into the hotline must be investigated and a plan to remedy them must be in place within 96 hours.
Additionally, the bill requires the Department of Defense and the Veterans' Administration to work together to improve their disability evaluation systems ending a lot of backlog.
Finally, this bill authorizes $50 million for wounded soldiers' support programs, ensuring that these soldiers don't fall through the cracks without any financial support. Our soldiers have fought bravely on the battlefield, and they shouldn't have to fight for the care they need and deserve. I urge my colleagues to support this bill.
Mr. WICKER. Mr. Chairman, I rise today in support of this and other efforts to correct deficiencies in our military health care system and to ensure that the men and women of our Armed Forces get the attention and quality they deserve. This is not a partisan issue; as a matter of fact, this is a bipartisan effort, and I am glad to be a part of it as ranking member of the Subcommittee on Military Construction and Veterans Affairs in the Appropriations Committee.
The Wounded Warrior Assistance Act is an important first step in improving the delivery of medical care and quality of life for our injured military personnel and their families. I say a first step, Mr. Chairman, because I hope it is the first of several to focus the necessary resources and enhance the facilities for overall delivery of service.
I am particularly interested in simplifying and speeding the paperwork process associated with both the initial care of these heroes and their transition to the programs administered through the Department of Veterans Affairs.
Our wounded warriors, their families and the dedicated health care professionals committed to serving their needs should not have to face bureaucratic stumbling blocks that prevent the timely administration of care and the processing of claims to help these heroes get back on their feet. I support provisions in this legislation that will provide more resources to address the problem, especially the medical evaluation delays. As the bill moves forward, I will say to the leadership of the full
committee, I encourage the authors of this legislation to consider adding additional judge advocates to assist the medical evaluation process.
In conversations with soldiers at Walter Reed, I learned of a shortfall of properly trained full-time attorneys to assist and represent patients during the formal evaluations. This occurs during the process leading up to the board and during the board. In many instances, the backlog was so long that soldiers retained outside counsel for hearings at their own cost. Those who could not afford to do this were forced to wait. In fact, the March 12 inspector general report highlighted this problem
and recommended an increase in trained attorneys.
I am grateful for the full committee leadership of the Appropriations Committee for accommodating me in my amendment in this regard. While we await the full Army Tiger Team report in May, I hope my colleagues will recognize the need and right of our wounded soldiers to proper representation.
I participated in hearings on this issue as ranking member of the MILCON VA Appropriations Subcommittee, and as a member of the Defense Subcommittee. I have visited Walter Reed Army Hospital and talked to soldiers receiving treatment there and elsewhere in our military and VA systems. While the recent problems have stained our military health care system, I have been encouraged by the bipartisan manner in which we have approached this issue. I have also been encouraged to hear very positive reviews
also with regard to our VA health care system, and I know it can be improved on, but certainly we get very, very positive reviews from the constituents who actually use these facilities.
These oversight activities have been very helpful in identifying steps we can take immediately to put the focus back on caring for our wounded soldiers. I look forward to working with the chairman and others of my colleagues to advance this legislation as it moves through the process.
Mr. SKELTON. Mr. Chairman, it is my pleasure to yield 3 minutes to the gentleman from Texas (Mr. Ortiz), the chairman of the Readiness Subcommittee of the Committee on Armed Services.
(Mr. ORTIZ asked and was given permission to revise and extend his remarks.)
Mr. ORTIZ. Mr. Chairman, today we begin the process of keeping our promise, our unique moral responsibility to the troops returning home to their families' arms.
Many of those warfighters are deeply wounded in body, mind and soul, and it is our responsibility to care for them, to treat their bodies and their minds.
I want to thank Chairman Skelton for his work in marking this bill with great speed, also the ranking member, Mr. Hunter, and the House leadership for moving this bipartisan bill so quickly.
This legislation provides more funding for caregivers at military hospitals along with training and oversight to guarantee that America's wounded troops will also receive committed quality care.
When we marked this bill in the Committee on Armed Services, I added an amendment which places a 1-year moratorium on all unannounced public-private competitions for work performed at medical facilities. It also requires a report from DOD on each competition still underway to allow Congress to understand the actual cost savings, and the effects of contracting on the quality of work and the workforce personnel before allowing the contracting to go forward.
Like many of my colleagues, I am a frequent visitor not only to Walter Reed, but to Bethesda as well. In the aftermath of the investigative series about the substandard services and housing at Walter Reed, it turns out that the mismanagement of the health care of our troops had much to do with a flawed contracting process.
This bill imposes a 1-year moratorium on future A-76 competitions at the Department of Defense for work at medical facilities. The problems we discovered with the contract at Walter Reed Army Medical Center are only the tip of the iceberg. At the moment Walter Reed should have been ramping up to care for the increased number of wounded warriors, they were single-sourcing a maintenance contract and watching some of their best talent walk out the door as they were caring for a large and growing
number of patients.
In a September 2006 memo, the garrison commander admitted that he had difficulties in retaining and hiring skilled personnel.
This came about for several reasons: DOD wanted to contract out the maintenance work; the proposed firings of former workers; and, of course, BRAC.
We need to step back and review whether contracting is the right way to find cost savings and efficiencies for military medical facilities. And we must make certain that we have not sacrificed service or performance of the health care mission for our wounded fighters.
I urge my colleagues to pass this bill to reform the administrative process and restore the confidence in the integrity and efficiency of the disability evaluation system and begin a better transition of servicemembers to the Department of Veterans' Affairs programs. [Page: H3211]
Mr. SKELTON. As soon as the gentleman from California and I finish our allotted time, is it not correct that the Veterans' Affairs Committee chairman and ranking member will assume leadership on this bill?
Mr. SKELTON. Thank you.
Mr. Chairman, I yield myself such time as I may consume.
The sad situation of Walter Reed hospital regarding the outpatients has alarmed all of us, whether we be in Congress or not, and this bill has some excellent provisions. It is truly a bipartisan effort. I thank Mr. Hunter and Dr. SNYDER, our chairman of our Subcommittee on Personnel, JOHN MCHUGH from New York. All have done superb work on this bill.
It makes some improvements to the medical and dental care for members in an outpatient status.
It establishes a toll-free hotline for reporting deficiencies in medical-related support facilities.
It requires Members of Congress to be notified of combat-wounded servicemembers who have been hospitalized.
It creates an independent medical advocate for members undergoing a medical evaluation board.
It improves the training and reduces the workload for Physical Evaluation Board Liaison Officers.
It standardizes the training program and curriculum for the Department of Defense Disability Evaluation System.
It enhances the training for health care professionals.
It would improve the transition for servicemembers between the Department of Defense and the Department of Veterans Affairs.
It provides a $50 million fund to support programs and activities related to medical treatment and care.
It would create an Oversight Board for Wounded Warriors.
It requires an annual report of the state of military medical facilities.
It requires an evaluation and report on the Department of Defense and the Department of Veterans Affairs Disability Evaluation Systems.
It requires a study of the support services available for families of recovering servicemembers.
And at the behest of Mr. Ortiz, it places a 1-year moratorium on A-76 studies at any military medical facility.
It is clear, Mr. Chairman, that the continued and persistent problems that were highlighted at the Walter Reed Hospital require closer inspection and may demand a significant and comprehensive overhaul of the process.
Mr. Chairman, I reserve the balance of my time.
Mr. HUNTER. Mr. Chairman, I yield as much time as he might consume to the gentleman from South Carolina (Mr. Wilson), who has done an excellent job on this bill.
Mr. WILSON of South Carolina. Mr. Chairman, I thank Congressman Hunter. I appreciate your service here in Congress, and I appreciate you being the parent of a veteran who has served in Iraq.
Mr. Chairman, I rise today in support of H.R. 1538, the Wounded Warrior Assistance Act of 2007, a bipartisan bill authored by Chairman IKE SKELTON.
Our men and women in the U.S. Armed Forces deserve the best medical care we can provide. As a 31-year veteran of the South Carolina Army National Guard, with four sons currently serving in the military, I was greatly concerned when learning of the inadequate living conditions our Nation's wounded veterans have been made to endure at Walter Reed Medical Center.
My eldest son served for a year in Iraq and came under enemy fire twice. Had he been injured, I would have expected him to receive top-notch health care which should be provided to every soldier.
While Walter Reed is renowned as a world-class facility, recent management neglected to provide adequate care. We have the best military medicine in world history, saving more lives than ever before and providing for the maximum recovery for patients.
I know firsthand from Major David Rozelle of the successes at Walter Reed Army Hospital for our amputees, where dedicated staff members are so caringly effective helping our troops recover. In fact, Major Rozelle wrote an excellent book, ``Back in Action,'' the inspiring true story of the first amputee to return to active command in Iraq. [Page: H3212]
I am pleased Congress is coming together to improve the paperwork complications and ensure our military medical system remains the best there is. I urge all of my colleagues to support this bill and provide America's brave, injured warriors the care they so deserve.
In conclusion, God bless our troops, and we will never forget September 11.
Mr. HUNTER. Mr. Chairman, I would yield the balance of my time to any other Members that would like to speak on the majority side, and if there are not, Mr. Chairman, give the chairman of the Veterans' Affairs Committee the option of us simply yielding back our time or if he would like to have some of our time, giving that to him.
Mr. SKELTON. On our time, I have no more speakers, and I would judge that any further speakers would be on the time of the Veterans' Affairs Committee.
Mr. FILNER. Mr. Chairman, as the chairman of the Veterans Affairs Committee, I rise in strong support of the Wounded Warrior Assistance Act; and I yield to myself what time I might consume.
I want to thank Congressman Skelton and Congressman HUNTER. This is a great bill. As a Nation and as a Congress, we were faced with a test, a real challenge, whether we can respond to the conditions of our Nation and of our veterans and our active duty troops. The revelations of what happened at Walter Reed presented us that challenge, gave us that test, and I say with confidence that this Congress is meeting that test.
This is step two in meeting that test. Step one was to make sure we had sufficient resources in the budget of this Nation to meet the needs not only of our existing veterans who have more and more need, whether they are from World War II or Vietnam or the first Persian Gulf war or the great influx of veterans that we are going to have from Iraq and Afghanistan. We already have over 700,000 returning troops who are now veterans, and we are going to get hundreds of thousands more.
In the so-called continuing resolution that was passed by this Congress a few weeks ago, the Veterans Administration was the only agency that got a significant increase from last year's budget; and this Congress added $3.6 billion to veterans in that one continuing resolution.
The supplemental for war that passed this House last week, led by Speaker Pelosi, Chairman Skelton, Chairman Obey, and Chairman Edwards, we said that the supplemental for war has to also have a supplemental for the warrior--for the health care of our returning veterans. Both in the Defense Department and the VA, we put in almost $3.5 billion; and in the budget resolution that we will be considering today and voting on tomorrow, the Democrats have put in $6.6
billion above the 2007 levels. That, in 90 days, is over $13.5 billion added to last year's budget for the care of our veterans.
George Washington said it very clearly, that the morale of our active duty troops is dependent on the sense of how they are going to be treated when they come home.
The first step of infusion of money, the second step of the Wounded Warrior Assistance bill, says that we are going to meet the challenge, that we understand that the costs of caring for our veterans is part of the cost of war, and that no matter what we think about the war in Iraq, we are united in this Congress and in this Nation that every returning young man and woman gets all the care and love and respect and honor that this Nation can deliver. That is what this bill says, that we are all
committed to making sure that the care of these veterans is first in our consciousness.
Both the Defense health care system and the VA system is stretched to its limits. We have underfunded it over the years. We are asking from very dedicated professionals in the VA system to do more and more with less and less resources.
The strain is evident wherever you look. The strain is evident at Walter Reed. The strain is evident when a young Marine shows up at a VA hospital in Minnesota and says, I think I have PTSD and I am having thoughts of suicide, and he was told that you are 28th on the waiting list, come back in a few weeks or a few months, and he went home and he committed suicide. The strain on our system is shown by events like that, and we are committed to making sure that they do not continue.
So we have to live up to our responsibilities, both for the returning Iraqi and Afghanistan veterans and to those who have served our Nation going back to World War II.
In many instances, the problems are exacerbated because of jurisdictional and procedure roadblocks between the Defense and the Veterans Administration. So we have to remove those roadblocks; and, as chairman of the Veterans Affairs Committee, I have worked closely with other members of our committee who will speak today, with Chairman Skelton and Ranking Member Hunter of the Committee on Armed Services, to make sure we are working off the same page.
This legislation takes important steps in making the servicemember's transition from the Department of Defense to the VA a seamless transition. We have been using that word for a long time, but we still have great cracks in that system. It is not seamless, but this bill would mandate the Department of Defense to provide disabled servicemembers who are being separated or returned from the Armed Forces with a written transition plan, a road map pointing the way to programs and benefits offered
to them as veterans.
It would institute a formal process for transmitting reports and other information to the Veterans Administration from the active duty situation.
It would require both the Department of Defense and the Veterans Administration to establish a joint separation and evaluation physical.
Physicals now are done by two different agencies and with two different standards and with two different bureaucracies. It is sometimes a hellish situation for returning active duty troops. We have to have a fully interoperable medical information system so that two agencies can speak to one another, so that the veteran coming home will have on his record in the VA all the things that occurred to him when he was on active duty in the military.
If we are going to make the handoff in the continuum of care successful, if we are going to make sure there is a seamless transition, if we want to make sure that we don't fumble information that puts at risk the returning servicemembers, we have to take these steps. These steps have are not newly invented. They were first expressed in earlier reports, the President's Task Force, for example, to Improve Health care for our Nation's Veterans, talked about this transition. I hope we are providing
both departments with the resources and the tools they need to get that transition right.
Mr. Chairman, our concern is for the health of our fighting men and women when they come home that they get that health care taken care of, both in the Defense Department hospitals and in the VA system. Let's work seamlessly. I urge support for H.R. 1538.
Mr. Chairman, I reserve the balance of my time.
Mr. BUYER. Mr. Chairman, I yield myself 5 minutes.
I rise in favor of this bill, the Wounded Warrior Assistance Act. For over 15 years, whether it was on the House Armed Services Committee or chairman of the personnel responsible for the military health delivery system or now at the VA, issues on seamless transition have been around. It appears that we can only measure success incrementally. For that, it is also unfortunate, because we deal with bureaucracies with both of these very large Departments and their subagencies.
Mr. Skelton had some challenges in front of him because his leadership rushed him to get this bill to the floor. He also then convinced Chairman Filner to waive the jurisdiction of the VA Committee so that this bill could get here. [Page: H3213]
I want to thank Chairman Filner for complementing the amendment that I had offered in the Armed Services Committee, and I also want to thank Chairman Skelton. I want to thank Duncan Hunter. I want to thank Dr. VIC SNYDER and JOHN MCHUGH for working with me on the amendment that was offered at the Armed Services Committee that profoundly enhances the seamless transition.
In its original form, the bill required a year-long pilot position on transition. Pilot programs can be useful in exploring new ground. But when it comes to seamless transition, and especially during a war, this is not new ground, and we need to proceed.
Back in 1982, is when Congress directed VA and DOD to work collaboratively together on health care. That was 25 years ago. I believe this collaboration is still being stymied by bureaucrats protecting their respective rice bowls. My amendment replaced the pilot project with system changes. It required a written transition plan for wounded servicemembers.
The bill would require an interoperable electronic exchange of critical medical information between the Departments and the use of the electronic DD Form 214, which DOD would provide to the VA. That allows VA real-time access to veterans' medical history.
There are countless examples of veterans seeking care at a VA facility, only to discover that their paper and military health records are not available. The lack of prior DOD health services is especially critical for badly wounded warriors returning from Iraq and Afghanistan. The ability to transmit data between DOD and VA will speed the recovery of these warriors by avoiding duplication of unnecessary treatment or, more importantly, failing to provide lifesaving procedures.
Electronic exchange of critical medical information might also prevent bureaucratic intransigence on the part of VA. For example, I recently heard from a former Indiana National Guard member who was wounded in the neck and shoulder by an improvised explosive device. When he eventually filed a disability claim, the VA said the documentation in his military medical record was not sufficient to prove the injury was service connected.
Hopefully this rapid exchange of information will put an end to such bureaucratic injustices. Further, H.R. 1538, as amended, would require the use of a uniformed separation and evaluation of physical by DOD and the VA, but the VA could use more disability ratings. This cornerstone seamless transition eliminates the frustrating requirement for a servicemember to have two physicals, one at the military and one at VA.
I associate my comments with Mr. Filner. Too often, recently discharged veterans filing VA disability claims must undergo a VA physical because their discharge physical failed to address issues affecting the veteran's claim for benefits.
Corporal Murphy, for example, in a hypothetical, gets his discharge physical from Fort Hood, Texas, on June 3. A week later he files a disability claim to the VA for his bad knee. Meanwhile, 90 days later, his physical records at the National Records Center in St. Louis arrive. During that period of time, his medical records are not available to process his claim, and our corporal has already lost 3 months. This is foolishness.
The result is not only costly but also delays the processing of a veteran's claim and possibly entry into life-changing programs, like the VA's vocational rehab program. Finally, the amended wounded warriors bill would collocate VA benefit teams at military treatment facilities and other agreed upon sites to facilitate the transition of recovering servicemembers. Why should a wounded warrior undergo a lengthy period of convalescence and be required to seek out VA benefits counselors at VA offices
that are usually far away from the MTF where the veteran is living.
Instead of making Airman Mendez, for example, go to the VA, it is time to mandate the VA to be present where the airman is undergoing treatment. This will give him timely access to VA counselors and benefits that process needed benefits.
These teams would provide preseparation counseling for recovering servicemembers, and records would be transmitted electronically from DOD to VA before the date of separation or retirement, thereby reducing delays, which now bedevil the system. Access to these teams would enable most veterans to leave the treatment facility with their VA benefit in hand.
My own personal experience over the past decade validates the importance of these reforms.
Mr. Chairman, I reserve the balance of my time.
Mr. FILNER. Mr. Chairman, I would ask unanimous consent to use 10 minutes that were yielded back from the Armed Services time to be split evenly between the majority and minority.
Mr. FILNER. A point of order, Mr. Chairman, I had understood that they had yielded the time that they had left back to the Veterans' Affairs Committee for use if we needed it, and we do need it. I think Mr. Buyer needs some time, and I do also.
If I could yield to Mr. Hunter for that.
Mr. HUNTER. Mr. Chairman, if we could ask unanimous consent that on Armed Services we could reclaim our time that we yielded back, we would like to yield it to the Veterans' Affairs Committee.
Mr. BUYER. So we have 20 minutes. So as of right now we are still operating under the Veterans Affairs Committee time, not Mr. Hunter's time, would that be correct?
Mr. WALZ of Minnesota. Mr. Chairman, I rise today in support of H.R. 1538, the Wounded Warriors Assistance Act of 2007.
First of all, I would like to thank the chairman from California. I would like to thank the ranking member from Indiana for his leadership and colleagues on both sides of the aisle for introducing this timely bill that responds to the needs of our soldiers. Their leadership on both sides of the aisle is a testament to the 110th Congress' commitment to caring for this Nation's active duty forces and veterans. The commitment to veterans can show no political ideology.
As a 24-year veteran of the Army National Guard of this Nation, and the highest ranking enlisted soldier to ever serve in this Congress, I know that taking care of active duty forces and our veterans is one of the most important issues facing this country and this Congress. I, as all Americans, was outraged and saddened when we read reports of substandard care and unacceptable conditions at Walter Reed. Our Armed Forces and their families sacrificed too much to receive poor active duty care and
difficulties in transitioning to veterans care. H.R. 1538 will fix these problems.
It will be done in a bipartisan manner and this piece of legislation has the possibility of starting to heal some of the divisions amongst this Nation, as we all agree, on the care of our veterans as a priority. This bill will provide more staff to work with outpatient servicemembers. It will improve training for medical staff. It will [Page: H3214]
find ways to better transition from active duty to veterans care, and it will create an oversight board for wounded
warriors that they will properly investigate the quality of care our veterans are receiving in a timely manner.
I urge all my colleagues on both sides of the aisle, regardless of political ideology, to support this bill. We must give our brave servicemen and -women the care they deserve, while serving our Nation. We must continue to address the need for their ongoing care once they hang up their uniforms, that they have performed their service to this Nation with honor, pride and dignity.
Now this Congress must do its job, provide the tools, the funding and the oversight necessary to ensure quality care for every soldier that serves this Nation.
Mr. SKELTON. Mr. Chairman, may I confirm the fact that when I yielded back a few moments ago, that I have 8 minutes remaining?
Ms. GIFFORDS. Mr. Chairman, we have before us today an excellent piece of legislation, the Wounded Warriors Assistance Act, that I believe will help untangle problems in military health care such as the ones that we recently saw at the Walter Reed Hospital. This legislation came before us in the Armed Services Committee recently, and I am convinced that the provisions will dramatically improve the treatment for our brave, wounded servicemembers and their families by the Department of Defense
health care system.
One issue of particular importance that was addressed in this bill is the mental health services and screenings that we will provide to our troops. I want to thank Members for supporting my amendment, that directly impacts mental health treatment for our men and women in uniform.
Ongoing military operations in Iraq and Afghanistan are creating a brand-new generation of veterans, many have seen extreme stresses of war. According to the VA, post-traumatic stress syndrome rates are starting to appear about 20 percent. You look back during the Vietnam War era, those rates were close to 30 percent. So, I believe we are just beginning to see the tip of the iceberg.
PTSD is an issue that will face thousands of American combat veterans for years into the future. This legislation will help ensure that these soldiers don't face this problem alone.
I am proud to vote with my colleagues from the Armed Services Committee to report this bill favorably to the House. I will be very pleased to vote for this outstanding piece of legislation when it appears here on the House floor. I want to thank Chairman Skelton and Ranking Member Hunter, for bringing this piece of legislation forward, and, of course, the staff of the Armed Services Committee for their dedication to this issue.
In closing, not every American signs up to put on the uniform. Not every American puts their life on the line for our principles and our values. But for those Americans that do, we owe it to be there with them when they need help.
Mr. MORAN of Kansas. I thank the gentleman from Indiana for yielding time to me. I express my appreciation to the Chair for recognizing me.
Mr. Chairman, I am here today in support of this legislation, but I think this legislation could be significantly improved. I come today to advocate on behalf of veterans who live in rural America, as well as servicemen and -women on leave from active duty.
I failed to have the opportunity to attempt to amend this bill in the Veterans' Affairs Committee because of the waiver of its jurisdiction. I appeared yesterday before the Rules Committee seeking the opportunity to offer an amendment today on the House floor. That authorization for offering that amendment was not allowed, was denied.
And I am concerned that as we look at veterans and our military retirees, as we look at those actively engaged in the military today and we try to address the needs that they face, there is a large area of veterans, there is a significant veteran and military active military population that are disadvantaged. That is those who live in rural America.
I represent a district, a congressional district the size of the State of Illinois, and yet, although we have more hospitals, private community hospitals than any congressional district in the country, there is no VA Hospital. There is no military hospital. And so you can be distanced from that access to care by hours, by 3, 4, 5 and 6 hours.
Legislation that I have introduced would try diligently to address that issue, to allow access to the private sector health care providers. If you live further away from a VA Hospital or an outpatient clinic, that you can take your VA card, you can take your active military benefits and see your hometown physician.
Examples from my own constituents. A veteran in the community of Hoxie was told he couldn't see the local optometrist, despite the fact that the optometrist is down the street. But, no, he has to go to Wichita, 4 hours away, in order to have his glasses adjusted.
Another veteran, who is incapable of travel, was told that, no, the local physician can't refill his prescription. He has got to travel to the VA Hospital in order to do that.
This legislation would correct that by allowing, in those circumstances where distances are so great, that the VA can enter into contracts with the private sector to meet the needs of those veterans and that a physician, a private physician, could fill a prescription.
So, Mr. Chairman, I regret that, although this bill brings to the forefront and addresses many issues that our servicemen and women face, it fails in, at least in my belief, to address the needs that we see from rural veterans.
I was pleased that Mr. Barrow, the gentleman from Georgia, who I have joined with in past efforts to try to increase the reimbursement rate for mileage for rural veterans as they travel to a VA Hospital, his amendment was made in order. And I am pleased and will support that, would love to have the opportunity again to speak in favor of it.
But these are the kind of issues that we cannot let this Congress ignore. We are not a one-size-solution fits all. And those of us who have concerns for those who choose to live in rural America, we believe we can make this legislation better. So, Mr. Chairman, I appreciate the time to speak in favor.
Mr. FILNER. Mr. Skelton and Mr. Hunter, your committee, working with the Veterans Committee, has produced an outstanding piece of legislation; and I hope that that cooperation, I know that cooperation will continue, because we have other things to do.
The gentleman from Kansas expressed what is on the minds of many of our colleagues, and that is to make sure that our rural veterans are served, also. We will do that; and I know my ranking member, Mr. Buyer, joins me in that commitment.
As I said earlier, Mr. Chairman, we have a test as a Nation. Are we going to make sure that every returning young man and woman from Iraq and Afghanistan has the best facilities, the best health care, the best treatment, the best love, the best commitment that we, as a Nation, can offer? And are we going to make sure that their predecessors, from World War II to the present, are also given that same care and commitment? [Page: H3215]
There are 200,000 homeless vets on the street tonight, mainly from the Vietnam era. We cannot allow that to continue.
We have a 600,000 claim backlog for disability payments. We cannot allow that to continue.
We have facilities that need to be repaired and rebuilt. We have needs for Agent Orange veterans and atomic veterans. We, as a Nation, must take up this challenge and must meet it.
We had significant new resources provided in the budget matters that have come before us in the last 60 days. This Wounded Warrior Assistance Act is the next step as we try to make sure that those who faced danger and life-threatening situations in Iraq do not have to face a bureaucracy which threatens to kill them off. This is a step to change that. We are going to have a seamless transition, and I thank the Chair for his commitment.
Mr. BUYER. Mr. Chairman, I yield myself such time as I may consume.
In the 1990s, Mr. Skelton, you can remember well that we drew down the size of the military. We cut all the divisions and the wings and the squadrons; and then we had to figure out how we could maintain all those military hospitals and the medical treatment facilities, all the forts and bases. And we found out, with limited dollars, we really couldn't do all of that to the level which we wanted, so we created three centers of excellence, at Brooke and at Bethesda and at Walter Reed.
And I do not want this debate today, for anyone who is working at Walter Reed, to feel as though this Congress is not proud of the level of respect and the enduring appreciation that we have of the doctors and the nurses and the technicians that provide the health care at Walter Reed, Bethesda, Brooke or any other medical facility, from the battlefield throughout the entire process.
We are very disappointed that we had single soldiers that were wounded, convalescing, being held in an unhealthy building. But for that to then be interpreted as though bad care was being delivered at Walter Reed is not a factual basis.
It is a curious thing, though, that one of our centers of excellence ended up on the BRAC; and that is an issue, Mr. Skelton, we are going to have to address.
I do want to also extend though a compliment to Mr. Hunter and Mr. Skelton, because you saw this one coming in 2004, because in the 2005 Defense bill you then created the Disability Claims Commission. It has been extended now and will not report until September of this year. So I want to thank you for seeing this one coming; and I wish that we could have gotten to those results much, much sooner.
Mr. HUNTER. Mr. Chairman, I yield myself such time as I may consume.
I just want to mention that in 2005, and working with Mr. Buyer and working with Mr. Skelton and other Members of the Armed Services Committee and Veterans' Affairs Committee, we put together this Disability Claims Commission with an eye toward trying to make the evaluations that are arrived at in DOD and the VA system consistent. In this bill that we are passing today, we are directing DOD and VA to go back and, as this commission meets and continues to work, to focus on their
work product and what they are doing; and, hopefully, we can have some value added as a result of their focusing on the commission that currently is in place.
Mr. BUYER. What this means, Mr. Chairman, is we still have work to do. And I didn't want to be overcritical about the pressure the leadership gave you to get this bill to the floor. I think you and I both would have liked to have done something more comprehensive. But with this Disability Claims Commission sitting out there, and they have given 2 years now of labor, we are going to have to come back at this one in earnest. And I am most hopeful that you will continue your work with the Veterans'
Affairs Committee as we work in this endeavor of a seamless transition.
Mr. HUNTER. Mr. Chairman, if I have got a couple of minutes left, if any member of the Veterans' Affairs or the Armed Services Committee would like to use the rest of the time, I would be happy to yield to them.
Appearing that there isn't anybody, I yield back at this point, Mr. Chairman.
Mr. SKELTON. Mr. Chairman, I yield myself such time as I may consume.
I wish to mention Mr. Buyer and I have had this discussion about there is more work to do. We will do it. We will do our very best I know in the Armed Services Committee as well as in the Veterans' Affairs Committee; and I appreciate your mentioning the fact that this is a step, although in my opinion, it is a major step. We still have a great deal of work to do regarding the wounded warriors.
Now, Mr. Chairman, I have mentioned the positive work done by DUNCAN HUNTER, by VIC SNYDER, by JOHN MCHUGH, by BOB FILNER, by STEVE BUYER, but I would be remiss if I didn't brag on and thank the wonderful staff that we have on our Armed Services Committee and also in the Veterans' Affairs Committee. They have worked long and very efficiently, and the product before us is a work of art by the members of our staff, and I certainly thank them for their tremendous