[Congressional Record Volume 153, Number 34 (Wednesday, February 28, 2007)]
[Senate]
[Pages S2363-S2365]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. OBAMA. (for himself, Mrs. McCaskill, Mr. Baucus, Mr. Bayh, 
        Mr. Biden, Mr. Bingaman, Mr. Bond, Mrs. Boxer, Mr. Brown, Ms. 
        Cantwell, Mr. Dorgan, Mr. Durbin, Mr. Feingold, Mr. Kerry, Ms. 
        Klobuchar, Ms. Landrieu, Ms. Mikulski, Ms. Murkowski, Mr. 
        Pryor, Mr. Rockefeller, Mr. Sanders, Ms. Snowe, and Mr. 
        Conrad):
  S. 713. A bill to ensure dignity in care for members of the Armed 
Forces recovering from injuries; to the Committee on Armed Services.
  Mr. OBAMA. Mr. President, I rise today to speak about the ``Dignity 
for Wounded Warriors Act,'' which I am proud to introduce with Senator 
McCaskill.
  Last week, the Nation learned of the serious problems at Walter Reed 
Army Medical Center including decaying, cockroach-infested facilities 
and an overwhelmed patient-care bureaucracy. As described in a series 
of articles in the Washington Post by Dana Priest and Anne Hull, 
wounded soldiers are returning home from the battle in Iraq only to 
face a new battle to get the care and benefits they have earned.
  These stories should not have come as a complete surprise to those 
who have followed the issue closely. We have long known that troops 
returning from battle face numerous bureaucratic hurdles when they get 
home. That's why I introduced legislation last year to smooth the 
transition from active duty to civilian life. The Lane Evans Bill 
expands and improves electronic medical records, face-to-face physical 
exams, better tracking of veterans, and other approaches to make life 
easier for returning veterans.
  However, the stories out of Walter Reed last week did shock my 
conscience because, like many Senators, I have made the half-hour trek 
from the Capitol to visit Walter Reed. And I saw what the Army wanted 
the world to see: a shining world-class facility where the wounded can 
heal with state-of-the-art care. I never saw mold growing on the walls, 
or broken elevators, or the lack of adequate support for soldiers and 
their families. Walter Reed was supposed to be the flagship of military 
health care. Instead it has become an emblem of much that is wrong with 
the system, and a harbinger of more severe problems that may be hiding 
at other military hospitals and facilities that are not in the 
spotlight.
  The problems at Walter Reed stem from complex causes, the most 
important of which is that the military and VA have not yet prepared 
for the growing flood of casualties from the Iraq war. Our injured 
troops did not hesitate to fight for us on the battlefield--we 
shouldn't make them fight again at home in order to receive the care 
they deserve. That is why Senator McCaskill and I are introducing the 
bipartisan Dignity for Wounded Warriors Act today. The bill will fix 
the problems at Walter Reed and improve care at our military hospitals 
and facilities.
  Our bill would fix deplorable conditions at outpatient residence 
facilities by setting high standards and increasing accountability. 
Under this bipartisan measure, the standards will be clear. First, 
recovering soldiers' rooms will be as good or better as the best 
standard rooms for active-duty troops. Second, our injured heroes will 
not have to wait more than two weeks for maintenance problems to be 
repaired. Third, we will have zero tolerance for pest infestations. And 
finally, emergency medical personnel and crisis counselors will be 
available to recovering troops 24 hours a day.

[[Page S2364]]

  The bill also tackles accountability problems. In the days following 
the Post stories, the Army vice chief of staff, and the Assistant 
Secretary of Defense for Health Affairs both said they were surprised 
by conditions at Walter Reed and directed blame on lower-ranking 
officers and noncommissioned officers. I also read in the Army Times 
that soldiers at Walter Reed have been warned not to talk to the media. 
Under our bill, we won't have to rely on the media to inform the 
Congress and the American people of the conditions at military 
hospitals. It requires that the Inspector General inspect facilities 
twice a year and report conditions to high-level officials and the 
public. Under our bill, military leaders will no longer be able to use 
the excuse that they didn't know conditions on the ground.
  When injured servicemembers return home, they along with their family 
members face a mountain of paperwork and bureaucracy. From the moment a 
doctor determines a soldier may be unable to return to duty, it takes 
an average of 209 days for the military to figure out what to do with 
the soldier. The system is broken, and soldiers and their families are 
the ones who pay the price. Our bill addresses this problem by bringing 
the far flung parts of the military's Physical Disability Evaluation 
System (PDES) under one roof in each branch of the military. It also 
puts much of the system online so that caseworkers and servicemembers 
can manage their documents electronically. Today, students can apply to 
go to law school or business school online, without ever having to 
touch a piece of paper. Navigating the Pentagon bureaucracy should be 
that easy.
  Our bill also calls for injury-specific procedures so that the most 
severely injured servicemembers can skip unnecessary steps. There's no 
reason why a soldier with a gunshot injury to the spine should face the 
same procedural hurdles in order to prove his injury was service-
related as a soldier with less severe injuries. At the same time, 
nothing in our bill will prevent those servicemembers who wish to stay 
in the military from appealing decisions. Our bill also helps soldiers 
and their families navigate the PDES system with new hotlines, manuals, 
and an ombudsman to help answer questions.
  Another problem at Walter Reed is casework. The caseworkers are doing 
amazing work helping soldiers schedule medical appointments, prepare 
paperwork, and obtain their everyday needs. However, the caseworkers 
are overwhelmed. Some have to care for 50 or more recovering soldiers 
at a time, more than double the ideal ratio. The Dignity for Wounded 
Warriors Act fixes this problem by forcing the Pentagon to work with 
each military hospital to set the ideal ratio of caseworkers to 
patients based on the particular needs of that facility. In the 
interim, our bill requires a temporary ratio of 1 caseworker for every 
20 recovering servicemembers. This will push the Pentagon to begin 
hiring and training caseworkers right away.
  This legislation also provides important new support for family 
members who often have to endure economic and emotional hardship to 
accompany their loved one through the recovery process and the 
currently flawed PDES process. It clarifies that non-medical attendees 
and family members on invitational orders may receive medical care and 
mental health counseling while caring for injured loved ones at 
military facilities. It extends employment and job placement training 
services to family members. And most important, this bipartisan 
legislation provides federal protections against a family member on 
invitational orders being fired. I think we can all agree that a mother 
should never have to choose between caring for a wounded son or 
daughter and keeping her job.
  Secretary Gates promised a thorough investigation by outside experts 
and accountability for those responsible. Our bill builds on that model 
by establishing an Oversight Board of outside experts to review the 
Pentagon's progress in implementing this bill. The Board would be 
appointed by Congress and the executive branch and be made up of 
veterans, wounded soldiers, family members and experts on military 
medicine. The Oversight Board will be an important check to make sure 
the Defense Department is following through to care for recovering 
troops.
  We cannot move fast enough to make sure our wounded troops are 
getting the care they need. No cost is too great. We must pass the 
Dignity for Wounded Warriors Act quickly and follow up with the 
adequate resources to ensure the men and women recovering at military 
hospitals across the world get the best care we can offer.
  Mrs. McCASKILL. Mr. President, it is my honor to join my 
distinguished colleague from Illinois, Senator Obama, today in 
introducing the Dignity for Wounded Warriors Act, a bill that serves to 
better the experience so many recovering military servicemembers and 
their families have in dealing with the military healthcare system and 
its bureaucracy.
  It is not often that you read something in the paper that makes you 
sick, but this is precisely the feeling I had just over a week ago as I 
read a Washington Post article that spoke of awful living conditions 
and an interminable bureaucracy being experienced by our war wounded 
who are receiving outpatient care at Walter Reed Army Medical Center.
  I will not stand aside as those who have fought for our country come 
home to fight new battles against a crippling bureaucracy just to get 
the compensation they have more than earned. They shouldn't have to 
live in substandard conditions while they are recovering from their 
injuries.
  Our legislation directly tackles these problems. The principle is 
simple: our wounded and recovering servicemembers must receive the best 
treatment. They can't live in substandard housing as they recover. And 
they must have a user-friendly system to help them apply for the 
appropriate disability and benefits compensation. It's the least we can 
do for all they have done for us.
  For example, each military department has a standard for their 
dormitories and barracks. I know that not every dormitory or barracks 
meets the highest standard that the service sets, but that each service 
is steadily working to reach this standard across their facilities. It 
is my belief, and this bill serves to establish, that the lowest 
standard acceptable for a returning wounded servicemember should be the 
highest existing standard in each military service. Facing the daunting 
challenge of recovering from war wounds--both psychological and 
physical--our returning servicemembers should not be living among 
vermin and mold. They should not be placed in temporary, cramped, 
makeshift, ancient or transient quarters. We're not demanding the Taj 
Mahal. We are demanding decent living conditions to help these injured 
men and women.
  Further, when problems exist in the living quarters of our recovering 
servicemembers, they should be identified and repaired quickly. This 
bill establishes strict measures to facilitate reporting of 
unsatisfactory living conditions and to mandate timely repair. It also 
establishes measures to ensure that independent parties are inspecting 
living quarters in order to prevent any syndrome whereby those closely 
engaged in dealing with these facilities are overly focused on 
completing the mission with what they have as opposed to what they 
should have.
  I was also appalled to learn of the extensive, confusing bureaucracy 
that greeted our recovering servicemembers in the outpatient care 
process. With numerous commands, organizations, advocates, doctors, 
commanders and any number of others involved in the process, recovering 
servicemembers found themselves navigating a complicated process and 
often without a map. They also have to fill out numerous forms, request 
records, check off bureaucratic blocks, get the right language in their 
doctor's evaluations, document their illnesses, capture the symptoms 
they are experiencing and more. It is safe to say that the process 
poses a daunting challenge to even a fully healthy individual--but 
imagine the challenge for someone far from home and facing the 
realities of the wounds of war.
  Complicating the challenges, those tasked to provide these 
servicemembers and their families with assistance have been faced with 
large caseloads and insufficient resources. This legislation requires 
responsible caseloads for military leaders and caseworkers--and it 
requires that those providing this assistance not just have

[[Page S2365]]

a caseload that guarantees a recovering servicemember the attention 
they need and deserve, but that these caseworkers are well trained.
  I also learned that those who come to military treatment facilities 
like Walter Reed to help their loved ones often face uphill battles. I 
am proud that this legislation reaches out to protect those loved ones 
who risk their livelihood to care for our recovering servicemembers by 
providing them medical care as well as protections to secure the jobs 
they leave behind.
  Today, I visited Walter Reed, talked with our recovering 
servicemembers, toured the facilities and discussed these issues with 
Walter Reed's leaders. I can confidently say that those treating our 
servicemembers are with me--they want the very best for our recovering 
servicemembers and for their families. I know that the quality of care 
being provided at Walter Reed and at many other military hospitals is 
exceptional and I applaud the caregivers.
  But I also know that we have all failed to provide the best service 
and support to many during the outpatient care process. Their living 
quarters were not the best. The Physical Disability Evaluation System 
they experience is too bureaucratic. It is time to deliver the best. 
This legislation seeks to provide it.
  This is fair legislation. It balances requiring immediate changes 
with letting the Department of Defense study what is necessary and to 
subsequently implement incremental change. It empowers our physicians 
by not requiring random timelines for medical processing or medical 
care, but it requires that care and processing happen with manageable, 
understandable and streamlined procedures that equally empowers the 
servicemember. And this bill requires that trained, professional and 
caring providers be available to recovering servicemembers and their 
families in sufficient numbers and in the appropriate places throughout 
the care process.
  In closing, I want to thank Senator Obama for his efforts in teaming 
with me to produce this important legislation. But mostly I want to 
thank all those serving our nation in uniform today. Their sense of 
duty is remarkable. Their sacrifice is great. Their heroism unmatched. 
They have given their best to our country and our country is committed 
to giving them the best in return.
                                 ______