[Congressional Record Volume 145, Number 166 (Monday, November 22, 1999)]
[Extensions of Remarks]
[Pages E2531-E2532]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  CONFERENCE REPORT ON H.R. 2116, VETERANS MILLENNIUM HEALTH CARE AND 
                              BENEFITS ACT

                                 ______
                                 

                               speech of

                       HON. CHRISTOPHER H. SMITH

                             of new jersey

                    in the house of representatives

                       Tuesday, November 16, 1999

  Mr. SMITH of New Jersey. Mr. Speaker, I rise today in support of H.R. 
2116, the Veterans Millennium Health Care Act of 1996. As a conferee on 
this legislation, I am grateful the Senate accepted one particular 
provision, my proposal to add bronchiolo alveolar carcinoma to the 
Department of Veterans Affairs presumption list for radiogenic cancers.
  For the last ten years, I have worked to add this lung cancer to the 
VA's presumption list for service-connected veterans. During the 104th 
and 105th Congresses, the House passed my legislation to add this 
cancer to the VA's presumption list. This year, we have convinced our 
Senate colleagues of the need to put this provision into law because of 
the VA's continual denial of most claims by atomic veterans and their 
survivors.
  Bronchiolo alveolar carcinoma is not considered a smoker`s cancer. 
During a recent class action lawsuit in the state of Florida, the jury 
specifically excluded bronchiolo alveolar carcinoma from the list of 
lung cancers compensable due to smoking. Furthermore, the National 
Research Council cited Department of Energy studies in the BEIR V 
report stating that ``bronchiolo alveolar carcinoma is the most common 
cause of delayed death from inhaled plutonium 239.''
  I know of this firsthand because I have been working with Joan 
McCarthy, a New Jersey resident, who lost her husband, Tom, to 
bronchiolo alveolar carcinoma in 1981. Tom had served as the navigator 
on the U.S.S. McKinley which participated in Operation Wigwam, an 
underwater atomic test in the Pacific that produced a surge of mist 
which Tom inhaled. Twenty-five years later, Tom died of lung cancer, a 
father and husband who was only in his early forties. Passage of the 
Veterans Millennium Health Care Act today will add this cancer to the 
VA's presumption list and thus ensure that Joan McCarthy and other 
veterans and their widows receive the compensation which they need and 
deserve.
  I am also proud of this bill's long-term care provisions for our 
nation's veterans. It reflects the months of heavy lifting that the 
House Veterans' Affairs Committee has done on this issue as America's 
veterans community gets older and consequently needs quality health 
care.
  Another provision which I authored as free standing legislation and 
is now in the conference report is a respite care provision. For the 
first time, we are giving the VA the ability to contract out for 
respite care services. Until now, if a veteran's care giver, be it his 
spouse or adult child, needed a short break, their only recourse was to 
wait for a bed to be made available at either a VA or state nursing 
home. The extra burden of transporting the veterans almost makes this 
self-defeating and it is witnessed by the fact that only 232 cases of 
respite care were provided by the VA during the 1998 fiscal year.
  The need for respite care cannot be underestimated. A few years ago, 
my wife, Marie,

[[Page E2532]]

was the primary care giver for my mother who was dying of brain cancer. 
We chose to take care of her in our home and my wife was the one who 
saw to her needs. Consequently, I know how important it is for the care 
giver, as well as the veteran, to be provided with the occasional day 
off so that they might attend to their own lives for a few hours or a 
few days. In the long run, this will significantly improve the quality 
of life and care of our veterans and unquestionably save the VA money 
in the long run. Most Americans want to remain in their own homes or 
with their families for as long as possible.
  The benefits of respite care cannot be understated. According to the 
Caregiver Assistance Network, family and volunteer caregivers provide 
85% of all home care given in the United States. However, our veterans' 
caregivers need our help. In a California statewide survey taken by the 
Family Caregiver Alliance, 58% of the caregivers showed signs of 
clinical depression. When asked, they responded that their two greatest 
needs were emotional support and respite care. On average, they are 
providing 10.5 hours of care per day. Providing the VA with the ability 
to contract with the nearest nursing home, adult day care center or 
sending someone to the veterans' home will make a real difference in 
the day to day quality of life for a veteran and his or her family.
  The Veterans Millennium Health Care Act also requires the VA to 
provide needed nursing home care for veterans who are 70% service-
connected or in need of such care for a service-connected condition. It 
also lifts the VA's six month limit on adult day health care and it 
allows the VA to expand the scope of the state home program to 
encompass all extended care services such as respite care, adult day 
health care, domiciliary care, and other alternatives to institutional 
care. It also guarantees emergency care for uninsured veterans and 
reinstates preferential eligibility for recipients of the Purple Heart. 
It also requires the VA to establish a policy regarding chiropractic 
treatment, a provision which I first introduced as legislation during 
my first term in Congress. And finally, it authorizes payments to the 
surviving spouses of former POWs who were rated totally disabled due to 
any service-connected cause for a period of one or more years 
immediately prior to death.
  I urge my colleagues to join me in passing the Veterans Millennium 
Health Care Act.

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