3:34 PM EDT

Eddie Bernice Johnson, D-TX 30th

Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Chairman, this amendment proposes text changes to section 107 of the bill, the section that deals with improved training for health care professionals, medical care case managers and servicemember advocates on particular conditions of recovering servicemembers.

As of March 1 of this year, over 24,000 servicemembers have been wounded in action since the onset of Operation Enduring Freedom and Operation Iraqi Freedom, according to the Department of Defense. The Government Accountability Office has found that servicemembers injured in combat face an array of medical and financial challenges as they begin their recovery process in the health care systems of the Department of Defense and the Department of Veteran Affairs. A GAO report was recently released

on March 5 and entitled ``DoD and Va Health Care, Challenges Encountered By Injured Service Members During Their Recovery Process.''

According to the report, Mr. Chairman, the Department of Defense screens servicemembers for post-traumatic stress disorder, but it does not ensure that further mental health evaluations occur.

DoD health care providers review questionnaires, interview servicemembers, and use clinical judgment in determining the need for further mental health evaluation. Sadly, DoD found that only 22 percent of the service members who may have been at risk for developing post-traumatic stress syndrome were actually referred by the Defense Department health care providers for further evaluation. In addition, the Defense Department never identified the factors as health care actually used to determine

which servicemembers needed the referrals.

Although our wounded warriors may obtain mental health evaluations for treatment for post-traumatic stress through the VA, and the VA may face a challenge in meeting the demand for these services, VA officials estimated that follow-ups for veterans to get treatment for this stress syndrome may be delayed up to 90 days.

Now, Mr. Chairman, I spent my professional career as a psychiatric nurse with the Veterans Administration. I can tell you that we could save time and money if we had the proper people in place to diagnose early, or at least get a referral. We miss a lot of early symptoms that later causes long-term unemployment, long-term financial stress and long-term hospitalization simply because we have not put the well-trained people in place, professional social workers, professional nurses that would diagnose

and know that something needs to be done to prevent further deterioration, and that is my reason for bringing this.

My 15 years of hands-on inpatient program care were specialized in mental health. And I have my credentials to show that. And my amendment strengthens this section because I feel that more emphasis needs to be made on adequate training by health care professionals to recognize these signs, including suicidal tendencies, so that the early intervention can come, and it will shorten the recovery period.

I urge my colleagues to support this amendment.

Mr. Chairman, I reserve the balance of my time.

3:38 PM EDT

Tim Murphy, R-PA 18th

Mr. TIM MURPHY of Pennsylvania. Mr. Chairman, I ask to claim the time allotted for debate of the amendment offered by Ms. Johnson, although I do not oppose the amendment.

3:38 PM EDT

Tim Murphy, R-PA 18th

Mr. TIM MURPHY of Pennsylvania. Mr. Chairman, I certainly support this and so many other amendments on this bill which are so very, very important not only to our veterans, but it serves as a model, as do so many veterans programs, of something we could be doing for other Americans.

Let me speak first to the point of what these do when we manage and coordinate patient care. We had an issue recently in the Energy and Commerce Committee which I serve on doing this, another aspect, and it was a very lively discussion. But recognize that someone who is wounded, as well as someone who has other medical illnesses, a single diagnosis is usually not something that stands loan. For example, a person with diabetes may have several other endocrine problems, problems with their kidneys,

with their diet, their circulation, their limbs, their mobility, and of course there are emotions, too, all of which can be very, very complex to deal with.

When the University of Pittsburgh Medical Center did a study on coordinating the care of people with diabetes, for example, they found when they assign people to work on these cases, they reduce rehospitalization by 75 percent. Washington Hospital in Washington, Pennsylvania reduced rehospitalization of folks with heart disease by 50 percent. These are extremely important aspects. And we have to look upon these as things that not only save money, but they save lives and they save a lot of care.

Let me also point to an amendment offered by my dear friend, Mr. Kennedy of Rhode Island, when he talked about mental illness. When we are talking about the wounds of war or the wounds of life, not all of these wounds are visible. They are not necessarily scars one can see, they are not something you can put a bandage on, but they are very real. The psychological wounds of war are such that they can break up a family, keep someone from holding a job, perhaps lead someone to try to self-medicate

their problems away with drugs or alcohol, all too common problems among our veterans.

And then when they are not dealt with, we find people who become more dependent upon others, that with difficulties with their families, with their [Page: H3230]

children, perhaps become hopeless, have trouble holding a job. And all of those continued effects of wounds of war go on.

It is extremely important that we recognize in Mr. Kennedy's amendment, as well as Ms. Johnson's amendment and other aspects of this whole bill that what is vitally important is we treat the whole person.

The time is long past due in this country where we look at medical symptoms and medical disease as something that shows up on an x-ray or a blood test or some other sophisticated test. Indeed, the wounds of war are not always visible, nor are they things that appear soon after the battle. Post traumatic stress disorder, other anxiety disorders can remain latent for years and suddenly reappear. I remember meeting a veteran at a VA hospital who ended up with some problems after 20 or 30 years after

the Vietnam War. He had recently had a liver transplant.

Under the medications and other aspects, he suddenly began having nightmares that he never had before. He had all this psychological trauma that was never showing up before.

What is so important is that we work to train people to understand these issues, which the gentlelady's amendment talks about, that we work to deal with the mental illness issues, which Mr. Kennedy's amendment talks about, and we work as a unit, as a whole, as a Congress, as a Nation to recognize that many times the illnesses and wounds of war are things that may not be there now, may not be visible, but are aspects we have to treat in the long run.

I call on all of my colleagues to enthusiastically support these amendments.

Mr. Chairman, I yield back the balance of my time.