[Congressional Record Volume 141, Number 70 (Monday, May 1, 1995)]
[Senate]
[Pages S5918-S5919]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                   VETERANS' COMMUNITY-BASED CARE ACT

 Mr. WELLSTONE. Mr. President, I rise to support S. 725, the 
Veterans' Community-Based Care Act of 1995, introduced by my 
distinguished colleague, Senator Rockefeller. I am honored to be an 
original cosponsor of this bill that I deeply believe is of signal 
importance to veterans and to the future of VA health care.
  The VA currently is planning to revamp its health care system to 
reduce its strong emphasis on inpatient hospital care in order to 
provide more veterans with health care in outpatient and 
noninstitutional settings, including community-based facilities when 
such care is appropriate. This bill will not only support VA's 
restructuring efforts, but also help some of our most vulnerable 
veterans--those with substance abuse problems who require 
rehabilitation services; elderly veterans who are infirm; and homeless 
veterans who suffer from severe mental illnesses or substance abuse 
problems.
  Let me stress that these are proven programs with successful track 
records and this bill will extend existing authorities for these 
worthwhile and innovative programs for about 5 years.
  Mr. President, I would like to briefly describe these programs so 
that my colleagues may more fully appreciate their value to needy 
individual veterans and to the VA health system as a whole:
  One provision would extend VA authority to contract with non-VA half-
way houses for rehabilitation services for veterans with substance 
abuse problems. This worthwhile program was first authorized in 1979, 
and currently operates at 106 medical centers, with 6,300 veterans 
treated in fiscal year 1994. These community half-way houses perform a 
vital function in facilitating a veteran's successful transition from 
inpatient substance abuse treatment and detoxification to independent 
living within the community. The half-way houses provide a supervised, 
substance free environment, and help develop independent living and 
social skills. I strongly and unequivocally supported extension of this 
program in the 103d Congress and I firmly believe it merits further 
extension.
  The bill also would extend VA's authority to provide health and 
health-linked service to veterans who otherwise would need nursing home 
care. It enables veterans to live at home and receive, at less cost to 
VA and the taxpayer, the same type of services that would otherwise be 
provided in a hospital or nursing home. Mr. President, this can be best 
described as a win-win-win program. Veterans would be able to continue 
living at home, costs to the taxpayer would be cut significantly, 
[[Page S5919]] and VA inpatient facilities and nursing homes could be 
reserved for veterans for whom there is no other feasible alternative.
  I am especially pleased that this bill would reauthorize the Homeless 
Chronically Mentally Ill [HCMI] program. This program has been 
effective in serving the most disadvantaged, most needy and often most 
difficult population of vets to reach. It is precisely the kind of 
program that Senator Hubert Humphrey would have approved of in that 
passes his litmus test for judging a society by the way it deals with 
the most vulnerable and needy of its citizens. HCMI authorizes VA 
outreach workers to contact homeless vets, assess and refer vets to 
community services, and place eligible vets in contracted community-
based residential treatment facilities. This program is one of the two 
major VA homeless programs and now operates out of 57 medical centers 
in 31 States and the District of Columbia. I backed extension of this 
program unequivocally in the 103rd Congress, and I am even more 
convinced now that it merits reauthorization.
  Another extraordinarily valuable, effective, and humane program that 
this measure would reauthorize is known as the Compensated Work Therapy 
and Therapeutic Transitional Housing program [CWT/TR]. It is a 
demonstration program authorizing the VA to renovate 50 residences as 
therapeutic transitional houses for chronic substance abusers, many of 
whom are also homeless, jobless, and mentally ill. VA would also be 
authorized to contract with nonprofit corporation which would own and 
operate the transitional residences in conjunction with existing VA 
compensated work therapy programs. Once a residence is fully renovated 
and operational, rent collected from vets in the program usually exceed 
operating costs. A preliminary VA evaluation of the program indicates 
that well over 50 percent of participants complete the program and have 
had substantially better sobriety, employment, and housing status than 
before entering the program. I strongly backed extension of this 
program in the last Congress and have no doubt that there is an urgent 
need to further extend this program that serves those are among the 
most needy of our veterans.
  Finally, Mr. President this bill would extend VA's authority to enter 
into enhanced use leases, which would permit other parties to use VA 
property so long as at least part of the property will provide for an 
activity that furthers the VA mission and enhances use of the property. 
An excellent illustration of how this program would operate is a plan 
to establish at the Minneapolis VA Medical Center [VAMC] a managed care 
clinical research and education center on land owned by the VAMC. An 
HMO would build a facility on VAMC grounds that would be large enough 
for VA personnel to do important clinical research and provide 
additional space for VA personnel to provide patient care to vets. 
Additionally, VA personnel would gain first-hand experience in managed 
care and make the VA more competitive in a managed care environment. 
Finally, the program would ready the Minneapolis VAMC for participation 
in the Minnesota State health care reform program should this become 
feasible.
  In closing I want to thank my colleague, Senator Rockefeller for his 
leadership in preparing this legislation and urge my colleagues to give 
it their full support.


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