[Congressional Record Volume 152, Number 52 (Thursday, May 4, 2006)]
[Senate]
[Pages S4057-S4059]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CRAIG (for himself and Mr. Akaka):
  S. 2736. A bill to require the Secretary of Veterans Affairs to 
establish centers to provide enhanced services to veterans with 
amputations and prosthetic devices, and for other purposes; to the 
Committee on Veterans' Affairs.
  Mr. CRAIG. Mr. President, today I seek floor recognition to introduce 
legislation to create a series of Amputation and Prosthetic 
Rehabilitation Centers in the Department of Veterans Affairs.
  As many of you are aware, VA already operates numerous specialty care 
centers for the treatment of veterans with spinal cord injury, 
traumatic brain injury, and visual impairment. However, at this moment, 
VA does not operate any similar centers of care for the treatment of 
veterans with amputations.
  I do not mean to suggest that VA does not provide excellent care and 
services to those veterans who have unfortunately lost a limb or part 
of limb.

[[Page S4058]]

But, there's always room for improvement in the care VA delivers and, 
just as importantly, there is room for improvement in the prosthetic 
services and devices that help those men and women with their physical 
restoration.
  Many of us have spoken personally with service members who are 
recuperating from injuries at Walter Reed Army Medical Center or 
Bethesda Naval Hospital. Today's extraordinary battlefield medicine is 
bringing back to our shores service members from Iraq and Afghanistan 
who would never have lived through their injuries in previous wars. 
Thanks to the best health care facilities the military has to offer and 
the wonders of modern medicine, these brave Americans will eventually 
leave the hospital. Then, most will start the difficult process of 
reintegrating into civilian life. For those whose injuries resulted in 
an amputation, that process is just a little more difficult.
  My hope with this bill is that these centers will be the lynchpin of 
a fully integrated Prosthetic Service Network; similar to those I 
mentioned at the outset of my remarks for the care of spinal cord 
injury, traumatic brain injury, and blindness. They would be fully 
responsible for the system-wide coordination of all of the Physical and 
Occupational Therapy and Prosthetics care provided to this new 
generation of severely wounded veterans. In addition, they will provide 
a new level of service to those who have long lived with amputations 
caused during previous wars or conflicts.
  Further, it is my hope and expectation that these centers will house 
and drive much of the prosthetic and amputee related research and 
development projects conducted by VA. I believe that by gathering under 
one roof specialists, who have dedicated their medical practice to 
caring for and rehabilitating those who have lost limbs, we will drive 
the marketplace of ideas and develop the best treatment in the country. 
There is no limit to what modern technology, American ingenuity, and a 
great cause can accomplish.
  Just the other day, my Committee held a hearing on VA's research 
program. At that meeting, I had the opportunity to speak with a VA 
clinician who, along with many of his colleagues, has created a proto-
type prosthetic for someone who had lost part of a hand, but still had 
wrist control. In just a few moments time, I was able to wire the 
equipment to my own arm and with a little practice pick up a glass of 
water, hold it in the prosthetic hand, and then return it to the table 
and remove the hand from it without spilling a drop. It was nothing 
short of amazing. It was also a small glimpse of where we can go.
  Of course, discoveries and inventions, like that hand, do not just 
remain in the VA vacuum. Once created, tested and approved, the R&D 
will leave the VA world and almost immediately benefit the civilian 
population of amputees. By combining the resources of our government 
and the needs of our veterans, we can improve the American medical 
system for all of our citizens.
  With the right technology, the best health care services, and a 
little personal drive, many of our amputees will return to active 
lives. They will play tennis, basketball, go kayaking, and even climb 
mountains. And while I am not suggesting that these centers will cause 
all of that to happen, I believe they will create the environment in 
which those things can happen.
  I hope all of my colleagues will join me in supporting this bill now. 
And I hope to report it out of my committee and bring it to the floor 
for a vote later this summer.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2736

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. AMPUTATION AND PROSTHETIC REHABILITATION CENTERS 
                   FOR VETERANS.

       (a) Establishment.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     establish not less than five centers to provide 
     rehabilitation services to veterans with amputations or 
     prosthetic devices.
       (2) Purpose.--The purpose of each center established 
     pursuant to paragraph (1) are--
       (A) to provide regional clinical facilities of the 
     Department of Veterans Affairs with special expertise in 
     prosthetics, rehabilitation with the use of prosthetics, 
     treatment, and coordination of care for veterans who have an 
     amputation of any functional part of the body; and
       (B) to provide information and supportive services to all 
     facilities of the Department of Veterans Affairs concerning 
     the care and treatment of veterans with a prosthetic device.
       (3) Designation.--Each center established pursuant to 
     paragraph (1) shall be known as an ``Amputation and 
     Prosthetic Rehabilitation Center'' (in this section referred 
     to as a ``Center'').
       (b) Geographic Distribution.--In identifying appropriate 
     facilities for the location of the Centers established 
     pursuant to subsection (a), the Secretary shall ensure, to 
     the maximum extent practicable, that such Centers are 
     geographically located so as to be accessible to as many 
     veterans as possible in the United States.
       (c) Staff and Resources.--Each Center shall include the 
     following:
       (1) A modern, well-equipped, and appropriately certified 
     laboratory facility capable of providing state-of-the-art and 
     complex prosthetic devices to all veterans with an 
     amputation, including veterans with an amputation incurred in 
     Operation Iraqi Freedom or Operation Enduring Freedom.
       (2) Certified and experienced prosthetists, including 
     prosthetists with certifications in new fabrication 
     techniques.
       (3) An accredited Physical Medicine and Rehabilitation 
     (PM&R) service with staff who are well-trained in current 
     prosthetic services and emerging trends for treatment of 
     amputations.
       (4) A modern gait laboratory, permanently located within 
     such Center.
       (d) No Duplication of Services of Polytrauma Centers.--
       (1) In general.--The Secretary shall, to the extent 
     practicable, ensure that the services provided by the Centers 
     established pursuant to subsection (a) do not duplicate the 
     services provided by the polytrauma centers of the Department 
     of Veterans Affairs designated as Tier I or Tier II 
     Polytrauma centers.
       (2) Construction.--Paragraph (1) shall not be construed to 
     prohibit the location of a Center so as to facilitate the 
     ready support of a polytrauma center, referred to in that 
     paragraph.

  Mr. AKAKA. Mr. President, today I rise with my good friend and 
colleague, Senator Craig from Idaho, to introduce legislation to 
establish at least five Amputation and Prosthetic Rehabilitation 
Centers within the Department of Veterans Affairs (VA). Through 
progressive and specialized expertise in the area of prosthetics and 
rehabilitation, the visible reminders of the sacrifices made by our 
wounded warriors will become less evident and hopefully less of a 
factor in their everyday lives.
  Specialty care for amputees has become an even more pressing concern 
because of the types of injuries our brave soldiers have sustained in 
Operation Iraqi Freedom and Operation Enduring Freedom. Many would 
agree that this is not the same kind of war that other generations of 
veterans have fought. The use of body armor and improvements in 
battlefield medicine have saved more lives, but in many cases have left 
our soldiers with traumatic injuries. Servicemembers in the current 
conflicts have suffered from twice as many amputations as those who 
fought in past wars. Unfortunately, the incidence of multiple 
amputations from bomb blasts is higher in this war.
  The VA health care system has only begun to see the men and women 
from Operation Enduring Freedom and Operation Iraqi Freedom who are in 
need of long-term rehabilitation. Indeed, these veterans are young and 
plan on being active for a long time. VA is well poised to take on this 
challenge. An ongoing study at the Providence VA hospital is looking at 
``biohybrid'' limbs which are implanted into tissue and later become an 
integral part of the patient.
  We cannot, however, forget about the war our current veterans 
continue to fight everyday against time and their health. Veterans 
struggling with diseases such as diabetes are often faced with 
amputation. The establishment of the Amputation and Prosthetic 
Rehabilitation Centers will provide advanced care to those who have 
endured the loss of a limb, which will help them regain full function 
and a better quality of life.
  The centers will provide VA regional clinical facilities with cutting 
edge expertise in prosthetics, rehabilitation with the use of 
prosthetics, treatment, and coordination of care for a veteran with an 
amputation. By placing these centers in locations with the highest 
concentrations of veterans, those in need will truly benefit from these 
specialized services.

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  VA has always been a leader in progressive treatment and care. These 
centers will maintain VA as a leader by providing the tools and staff 
necessary to do so. The legislation requires that the centers must have 
a well-equipped and appropriately certified laboratory facility 
necessary to provide the most state-of-the-art and complex prosthetic 
devices.
  With experienced prosthetists trained and certified in the area of 
new techniques, an accredited Physical Medicine and Rehabilitation 
service with trained staff in the most current prosthetic services, and 
a permanent modern gait laboratory located within each center, veterans 
are sure to receive the most advanced treatment and care.
  A critical part of this legislation is that these centers will serve 
as resources for smaller VA hospitals which may not have all of the 
expertise but will certainly have the patients.
  As Ranking Member of the Committee on Veterans' Affairs, I urge my 
colleagues to join Chairman Craig and myself in support of providing 
treatment to those in need so they can stand on their own.
                                 ______