Congressional Record, Volume 153 Issue 54 (Wednesday, March 28, 2007)

[Congressional Record Volume 153, Number 54 (Wednesday, March 28, 2007)]
[House]
[Pages H3228-H3236]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

WOUNDED WARRIOR ASSISTANCE ACT OF 2007

The SPEAKER pro tempore. Pursuant to House Resolution 274 and rule
XVIII, the Chair declares the House in the Committee of the Whole House
on the state of the Union for the further consideration of the bill,
H.R. 1538.

{time} 1532

In the Committee of the Whole

Accordingly, the House resolved itself into the Committee of the
Whole House on the state of the Union for the further consideration of
the bill (H.R. 1538) to amend title 10, United States Code, to improve
the management of medical care, personnel actions, and quality of life
issues for members of the Armed Forces who are receiving medical care
in an outpatient status, and for other purposes, with Mr. Ross (Acting
Chairman) in the chair.

[[Page H3229]]

The Clerk read the title of the bill.
The Acting CHAIRMAN. When the Committee of the Whole rose earlier
today, amendment No. 7 printed in House Report 110-78 by the gentleman
from Pennsylvania (Mr. Sestak) had been disposed of.
Pursuant to the order of the House of today, amendments may be
considered in any sequence.

Amendment No. 6 Offered by Ms. Eddie Bernice Johnson of Texas

The Acting CHAIRMAN. It is now in order to consider amendment No. 6
printed in House Report 110-78.
Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Chairman, I offer an
amendment.
The Acting CHAIRMAN. The Clerk will designate the amendment.
The text of the amendment is as follows:

Amendment No. 6 offered by Ms. Eddie Bernice Johnson of
Texas:
In section 107(a), in the first sentence, strike
``modification of the training'' and insert ``improvement of
the training''.
In section 107(a), strike the second sentence and insert
the following: ``The recommendations shall include, at a
minimum, specific recommendations to ensure that such health
care professionals, medical care case managers, and service
member advocates are adequately trained and able to detect
early warning signs of post-traumatic stress disorder (PTSD),
suicidal tendencies, and other mental health conditions among
recovering service members.''.

Amendment No. 6, As Modified, Offered by Ms. Eddie Bernice Johnson of
Texas

Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Chairman, I ask unanimous
consent that my amendment be modified with the text that I have at the
desk that proposes text changes in section 107 of the bill.
The Acting CHAIRMAN. The Clerk will report the modification.
The Clerk read as follows:
Modification to amendment No. 6 offered by Ms. Eddie Bernice Johnson
of Texas:

The amendment, as modified, is as follows:
In section 107(a), in the first sentence, strike
``modification of the training'' and insert ``improvement of
the training''.

In section 107(a), strike the second sentence and insert
the following: ``The recommendations shall include, at a
minimum, specific recommendations to ensure that such health
care professionals, medical care case managers, and service
member advocates are adequately trained and able to detect
early warning signs of post-traumatic stress disorder (PTSD),
suicidal tendencies, and other mental health conditions among
recovering service members and make prompt notification to
the appropriate health care professionals.''.

The Acting CHAIRMAN. Without objection, the amendment is modified.
There was no objection.
The Acting CHAIRMAN. Pursuant to House Resolution 274, the
gentlewoman from Texas (Ms. Eddie Bernice Johnson) and a Member opposed
each will control 5 minutes.
The Chair recognizes the gentlewoman from Texas.
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.
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.
The Acting CHAIRMAN. Without objection, the gentleman from
Pennsylvania is recognized for 5 minutes.
There was no objection.
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.
Ms. EDDIE BERNICE JOHNSON of Texas. I yield 1 minute to Mr. Andrews
from New Jersey.
Mr. ANDREWS. I thank my friend. With the authority of the chairman of
the full committee, I would like to indicate the committee
enthusiastically supports this well-thought-out amendment and thanks
the gentlelady for offering it.
Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Chairman, I have no further
requests for speakers. I want to thank both sides for their support,
and I urge adoption.
The Acting CHAIRMAN. The question is on the amendment offered by the
gentlewoman from Texas (Ms. Eddie Bernice Johnson), as modified.
The amendment, as modified, was agreed to.

Amendment No. 8 Offered by Ms. Hooley

The Acting CHAIRMAN. It is now in order to consider amendment No. 8
printed in House Report 110-78.
Ms. HOOLEY. Mr. Chairman, I offer an amendment.
The Acting CHAIRMAN. The Clerk will designate the amendment.
The text of the amendment is as follows:

Amendment No. 8 offered by Ms. Hooley:
At the end of title I, add the following new section (and
conform the table of contents accordingly):

SEC. 113. OPTION FOR MEMBERS OF RESERVE COMPONENTS TO USE
MILITARY MEDICAL TREATMENT FACILITIES CLOSEST
TO HOME FOR CERTAIN INJURIES.

The Secretary of Defense shall provide that, in the case of
members of the reserve components returning from a combat
theater, if a member requires treatment on an outpatient
basis for injuries or wounds sustained in theater, the member
may be provided treatment at the military medical treatment
facility closest to the member's home rather than closest to
the base from which the member was deployed.

The Acting CHAIRMAN. Pursuant to House Resolution 274, the
gentlewoman from Oregon (Ms. Hooley) and a Member opposed each will
control 5 minutes.
The Chair recognizes the gentlewoman from Oregon.
Ms. HOOLEY. Mr. Chairman, with four in 10 members of the military in
Iraq and Afghanistan serving in the Reserve component, it is clear that
our National Guard is no longer a strategic reserve, but an operational
reserve. And as such, we must change the way we treat the Guard if we
want to maintain recruitment and retention because it is the right and
fair thing to do.
After 5 years of mobilization, both involuntary and voluntary, our
National Guardsmen are still navigating the system that was intended
for use by the active duty rather than our current nearly even blend of
Reserve and active components.
My amendment to H.R. 1538, the Wounded Warriors Act, is simple. It
allows members of the National Guard and Reserve who are returning from
theater with minor injuries or other outpatient care needs the option
to seek treatment at the military medical treatment facility closest to
the member's home rather than closest to the base from which the member
was deployed.

{time} 1545

When an active duty soldier with certain injuries comes back to the
United States, he gets treated at the medical facility closest at his
home base where his family lives. But for Oregon Guardsmen and
Reservists and soldiers from about a dozen other States that have no
bases, our troops must remain for weeks at the base they deployed from
for follow-up care. These can be hundreds or even thousands of miles
away from home and family.
In 2004, I spoke with Monica Davey of the New York Times about the
problem as she covered the issues in a series of front-page news
stories. She quoted one spouse as saying, ``Having him in Iraq was hard
enough. When he got hurt, I said, `Well, at least he can come home now
and get better here with us.' But it is a strange thing. He came home,
but he is not home at all.''
This problem is old news and no longer on the front page, but it
still goes on. Here are a couple examples of what happens when these
Guard troops request treatment upon demobilization:
An Oregon Guardsman who returned months ago is still on the east
coast base with medical issues. He and his wife have several young
children; and, as can happen with lengthy deployments, the separation
has strained their relationship to the breaking point. He has seen his
family only once in the last 3 months. That soldier should have the
option of seeking treatment at Fort Lewis in Washington State, much
closer to his home.
Another story involves an enlisted man with a wife and young children
who has seen his young family stateside only three times in the last 3
months, once because the Army sent him home for convalescent leave, and
the other two times over the holidays because his wife drove their
children out to the east coast military treatment facility where he was
awaiting care because they couldn't afford to fly.
These stories are heartbreaking; and, despite years of work on trying
to get the problem fixed, little progress has been made. Since the
start of the Iraq war in 2003, tens of thousands of Reservists and
Guardsmen have been placed on medical hold.
As the New York Times reporter Ms. Davey aptly put it 3 years ago,
``Unlike the most gravely injured soldiers receiving around-the-clock
treatment at the finest military hospitals, these are ordinary soldiers
with more ordinary wounds. The loneliest and the impatient can elect to
go home even if they still need medical attention, but that could be a
very expensive trade-off. Military rules dictate that they lose their
active duty salaries, even though they may still be too injured or ill
to return to their civilian jobs.''
Today, four out of 10 soldiers in Iraq and Afghanistan are Guard or
Reserve, and it is long past time for the DOD to adjust their policies
and make improvements to the demobilization process for Guard members
in States like mine that have no military treatment facilities. I ask
for your support of this amendment so we can finally give soldiers from
the Reserve component the flexibility to be treated for certain
injuries at military medical treatment facilities nearest their homes
and families just like the active component.
I yield to the gentleman from New Jersey.
Mr. ANDREWS. Very briefly on behalf of the committee, we thank the
gentlelady for offering this well-thought-out amendment and, on behalf
of the chairman, indicate our strong support for the amendment.
Mr. HUNTER. Mr. Chairman, I just want to say we support the
gentlewoman's amendment and have no opposition to it here on our side.
Ms. HOOLEY. Mr. Chairman, I yield back the balance of my time.

[[Page H3231]]

The Acting CHAIRMAN. The question is on the amendment offered by the
gentlewoman from Oregon (Ms. Hooley).
The amendment was agreed to.

Demand for Recorded Vote on Amendment No. 7 Offered by Mr. Sestak

Mr. KENNEDY. Mr. Chairman, I ask unanimous consent that I may be
permitted to request a recorded vote on amendment No. 7 at this point,
notwithstanding the passage of time since its adoption by voice vote.
The Acting CHAIRMAN. Is there objection to the request of the
gentleman from Rhode Island?
There was no objection.
The Acting CHAIRMAN. A recorded vote is requested. Pursuant to clause
6 of rule XVIII, further proceedings on the amendment numbered 7
offered by the gentleman from Pennsylvania will be postponed.

Amendment No. 9 Offered by Mr. Hensarling

The Acting CHAIRMAN (Mr. Altmire). It is now in order to consider
amendment No. 9 printed in House Report 110-78.
Mr. HENSARLING. Mr. Chairman, I offer an amendment.
The Acting CHAIRMAN. The Clerk will designate the amendment.
The text of the amendment is as follows:

Amendment No. 9 offered by Mr. Hensarling:
At the end of title II, add the following new section (and
conform the table of contents accordingly):

SEC. 207. STUDY AND REPORT ON WAITING PERIODS FOR
APPOINTMENTS AT DEPARTMENT OF VETERANS AFFAIRS
MEDICAL FACILITIES.

(a) Study Required.--The Secretary of Veterans Affairs
shall conduct a study on the average length of time between
the desired date for which a veteran seeks to schedule an
appointment for health care at a Department of Veterans
Affairs medical facility and the date on which such
appointment is completed.
(b) Focus of Study.--In conducting the study under
subsection (a), the Secretary shall focus on appointments
scheduled and completed at Department medical facilities
located in both rural and urban areas.
(c) Report.--Not later than 180 days after the date of the
enactment of this Act, the Secretary shall submit a report to
Congress containing the findings of the study under
subsection (a) and recommendations for decreasing the waiting
time between the desired date of an appointment and the
completion of the appointment to a maximum of 15 days.

The Acting CHAIRMAN. Pursuant to House Resolution 274, the gentleman
from Texas (Mr. Hensarling) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentleman from Texas.
Mr. HENSARLING. Mr. Chairman, I yield myself as much time as I may
consume.
Mr. Chairman, first, I want to thank the chairman of the committee,
and I want to thank all those who contributed to this underlying
legislation. I thank them for their good work on behalf of our Nation's
veterans.
I myself am not a veteran. I did not serve my Nation in uniform. My
grandfather did. He served during World War II. My father did. He
served during Korea. My brother did. He served during the Cold War. So
I have the highest respect for the men and women who serve our Nation
in uniform.
Mr. Chairman, as we approach the annual debate on our budget, one
thing that I think that we hold in common, although there are many
differences in our parties, is that we all believe that our veterans
and especially our veterans health care ought to be one of the most
important priorities that we have as a Nation. And as we continue to
fight this war on terror, we know we are creating more veterans with
more health care needs.
During the last congressional recess, I spent a lot of time visiting
with the veterans of the Fifth Congressional District in Texas that I
have the honor and pleasure of representing. I heard many good
comments, frankly, about VA health care and some complaints. And I
suppose, Mr. Chairman, that one of the most important complaints I
heard was the complaint on the waiting time in order to actually get
the appointment that the veteran has requested.
Now, I know that great strides have been made in reducing these
waiting times. I know that the veterans health care system is serving
entire new populations that they didn't serve years ago. And this is a
good thing. But I still would hope that, number one, we could
understand exactly the challenges that our veterans are facing and see
if there are not some commonsense solutions, as earlier the gentlelady
from Texas, my colleague, said, that essentially we can save time and
save money and still help our veterans.
This amendment is a very simple amendment. I hope it is a very
noncontroversial amendment. It simply directs the Secretary of Veterans
Affairs to study the average length of time between the desired date
for which a veteran seeks a scheduled medical appointment and the date
in which the appointment is actually completed.
Now, I know that the vast majority of appointments are completed
within this 30-day window, but I don't believe this body knows if that
means the bulk of them happened on day 29 or the bulk of them may
happen on day six. This is important information we ought to have.
I represent a district that is urban, suburban, and rural; and this
study would not just concentrate on our urban areas but our rural areas
as well, where a number of our veterans go to retire.
Additionally, this amendment would ask for the Secretary's
recommendations on what we might do to shorten the length of time to 15
days and provide recommendations to our body to do that. Not only
veterans in the Fifth Congressional District of Texas, but if you look
at the independent budget supported by numerous of our veterans service
organizations, they speak to the need to see what we can do to reduce,
in many cases, excess waiting times, something they flagged as a strong
concern.
So I know the VA has made great strides, but there is still work that
we can do to serve these people who serve us and protect freedom, the
greatest commodity that we have in our land. And by supporting this
amendment, Congress can make just one more small step in the direction
of supporting our veterans.
Mr. Chairman, I reserve the balance of my time.
Mr. ANDREWS. Mr. Chairman, I ask unanimous consent that I may claim
the time in opposition, although I do not, in fact, oppose the
amendment.
The Acting CHAIRMAN. Without objection, the gentleman from New Jersey
is recognized for 5 minutes.
There was no objection.
Mr. ANDREWS. Mr. Chairman, on behalf of the chairman of the
committee, we thank the gentleman from Texas for offering this well-
thought-out amendment. We support his efforts to try to reduce waiting
time for our deserving veterans, and the majority will support the
amendment.
Mr. Chairman, I yield back the balance of my time.
Mr. HENSARLING. Mr. Chairman, I want to thank the gentleman for his
support. I know when to take ``yes'' for an answer.
Mr. Chairman, I yield back the balance of my time.
The Acting CHAIRMAN. The question is on the amendment offered by the
gentleman from Texas (Mr. Hensarling).
The amendment was agreed to.

Amendment No. 10 Offered by Mr. Bilirakis

The Acting CHAIRMAN. It is now in order to consider amendment No. 10
printed in House Report 110-78.
Mr. BILIRAKIS. Mr. Chairman, I offer an amendment.
The Acting CHAIRMAN. The Clerk will designate the amendment.
The text of the amendment is as follows:

Amendment No. 10 offered by Mr. Bilirakis:
After section 101, insert the following new section (and
conform the table of contents accordingly):

SEC. 102. ESTABLISHMENT OF A DEPARTMENT OF DEFENSE-WIDE
OMBUDSMAN OFFICE.

(a) Establishment.--The Secretary of Defense shall
establish a Department of Defense-wide Ombudsman Office (in
this section referred to as the ``Ombudsman Office'') within
the Office of the Secretary of Defense.
(b) Functions.--
(1) In general.--The functions of the Ombudsman Office are
to provide policy guidance to, and oversight of, the
ombudsman offices in the military departments.
(2) Policy guidance.--The Ombudsman Office shall develop
policy guidance with respect to the following:
(A) Providing assistance to and answering questions from
recovering service members and their families regarding--

[[Page H3232]]

(i) administrative processes, financial matters, and non-
military related services available to the members and their
families throughout the member's evaluation, treatment, and
recovery;
(ii) transfer to the care of the Veterans Administration;
and
(iii) support services available upon the member's return
home.
(B) Accountability standards, including--
(i) creating and maintaining case files for individual
specific questions received, and initiating inquiries and
tracking responses for all such questions;
(ii) setting standards for timeliness of responses; and
(iii) setting standards for accountability to recovering
service members and their families, including requirements
for daily updates to the members and their families about
steps being taken to alleviate problems and concerns until
problems are addressed
(c) Status Reports.--The ombudsman office in each military
department shall submit status reports of actions taken to
address individual concerns to the Ombudsman Office, at such
times as the Ombudsman Office considers appropriate.
(d) Responses From Other Offices.--The Secretary of Defense
shall ensure that all other offices within the Department of
Defense and the military departments respond in a timely
manner to resolve questions and requests from the Ombudsman
Office on behalf of recovering service members and their
families, including offices responsible for medical matters
(including medical holdover processes), financial and
accounting matters, legal matters, human resources matters,
reserve component matters, installation and management
matters, and physical disability matters.
(e) Staff of the Office.--The staff of the Ombudsman Office
shall include representatives from each military department,
including persons with experience in medical holdover
processes and other medical matters.

The Acting CHAIRMAN. Pursuant to House Resolution 274, the gentleman
from Florida (Mr. Bilirakis) and the gentleman from New Jersey (Mr.
Andrews) each will control 5 minutes.
The Chair recognizes the gentleman from Florida.
Mr. BILIRAKIS. Mr. Chairman, I yield myself as much time as I may
consume.
Like all of my colleagues, I was greatly disturbed by the conditions
at the Walter Reed Army Medical Center which were depicted in The
Washington Post. Last week, I introduced H.R. 1580, the Wounded
Warriors Joint Health Care Ombudsman Act. My legislation is intended to
create a single point of reference for recovering servicemembers and
their families to ensure they are receiving prompt responses and
information to their questions.
The amendment that I am offering today is a modified version of my
legislation, and it creates a Department of Defense-wide ombudsman
office within the Office of the Secretary of Defense. The functions of
the office are to provide policy guidance and oversight to each
military department. Specifically, the office would develop policy
guidance with respect to providing assistance to and answering
questions from recovering servicemembers and their families on a
variety of important issues.
The policy guidance developed by the ombudsman office should allow
recovering servicemembers to get information on administrative
processes, financial assistance, the transition to care from the
Department of Veterans Affairs and the support services available upon
the member's return home. Very important.
The office would also establish accountability standards for the
military departments. These standards would cover issues such as
creating and maintaining case files for specific questions received, as
well as tracking the response for all such questions. The office would
also set timeliness standards for responses.
Under my amendment, the office can also require each military
department to submit status reports of actions taken to address
individual concerns raised by the recovering servicemembers and their
families.
In closing, Mr. Chairman, everyone agrees that our military
servicemembers should receive the highest quality of care and services
possible. As they recover from their injuries, our wounded warriors
should not have to battle bureaucracy to get the care and benefits they
have earned. It is important that the ombudsman office be an advocate
for servicemembers during every phase of treatment and the evaluation
process as well.
I urge my colleagues to support this important amendment. I would
also like to thank Chairman Skelton and Ranking Member Duncan Hunter
for their assistance.

{time} 1600

Mr. ANDREWS. Mr. Chairman, will the gentleman yield?
Mr. BILIRAKIS. I yield to the gentleman from New Jersey.
Mr. ANDREWS. On behalf of the chairman, we thank the gentleman for
his carefully crafted amendment. We think it is important that there be
a department-wide ombudsman as well as in the services. The majority
will support the amendment.
Mr. HUNTER. Would the gentleman yield?
Mr. BILIRAKIS. I yield to the gentleman from California.
Mr. HUNTER. I want to join in thanking the gentleman for an excellent
amendment, and thank him for his very thoughtful addition to this
important bill.
The Acting CHAIRMAN. The question is on the amendment offered by the
gentleman from Florida (Mr. Bilirakis).
The amendment was agreed to.

Amendment No. 11 Offered by Mr. Buchanan

The Acting CHAIRMAN. It is now in order to consider amendment No. 11
printed in House Report 110-78.
Mr. BUCHANAN. Mr. Chairman, I offer an amendment.
The Acting CHAIRMAN. The Clerk will designate the amendment.
The text of the amendment is as follows:

Amendment No. 11 offered by Mr. Buchanan:
At the end of title II, add the following new section:

SEC. 207. STUDY AND REPORT ON STANDARD SOLDIER PATIENT
TRACKING SYSTEM.

(a) Study Required.--The Secretary of Defense shall conduct
a study on the feasibility of developing a joint soldier
tracking system for recovering service members.
(b) Matters Covered.--The study under subsection (a) shall
include the following:
(1) Review of the feasibility of allowing each recovering
service member, each family member of such a member, each
commander of a military installation retaining medical
holdover patients, each patient navigator, and ombudsman
office personnel, at all times, to be able to locate and
understand exactly where a recovering service member is in
the medical holdover process.
(2) A determination of whether the tracking system can be
designed to ensure that--
(A) the commander of each military medical facility where
recovering service members are located is able to track
appointments of such members to ensure they are meeting
timeliness and other standards that serve the member; and
(B) each recovering service member is able to know when his
appointments and other medical evaluation board or physical
evaluation board deadlines will be and that they have been
scheduled in a timely and accurate manner.
(3) Any other information needed to conduct oversight of
care of the member through out the medical holdover process.
(c) Report.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Defense shall submit
to the Committees on Armed Services of the Senate and the
House of Representatives a report on the results of the
study, with such findings and recommendations as the
Secretary considers appropriate.

The Acting CHAIRMAN. Pursuant to House Resolution 274, the gentleman
from Florida (Mr. Buchanan) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentleman from Florida.
Mr. BUCHANAN. Mr. Chairman, I yield myself such time as I may
consume.
Mr. Chairman, my amendment is a simple one. It requires the Secretary
of Defense to submit to Congress a report on the feasibility of a
soldier patient tracking system to improve the medical holdover
process.
In the aftermath of the Walter Reed scandal, we heard criticism about
the medical hold and holdover process, which requires injured soldiers
to stay in certain facilities until evaluated and treated.
We heard the story of U.S. Army Staff Sergeant John Shannon who
testified before the House National Security and Foreign Affairs
Subcommittee and he said, ``I had been given a couple of weeks'
appointments and some other paperwork upon leaving ward 58, and I went
to all of my appointments during that time. After these appointments, I
sat in my room for another couple of weeks wondering when someone would
contact me.''
The Buchanan amendment would require the Department of Defense to

[[Page H3233]]

identify and report to Congress ways of making the medical holdover
system more responsive and effective for military personnel like Staff
Sergeant Shannon.
I believe every servicemember should have complete, on-demand
information with respect to his or her status as a medical holdover. No
soldier should sit in their room for weeks wondering about their
treatment and when their next appointment might be. The Department of
Defense must closely examine ways to give servicemembers real-time
information regarding the key milestones in their physical and medical
evaluation process.
By requiring a report to Congress, my amendment would make certain
that we are knowledgeable in considering all available options when it
comes to improving the medical holdover process for troops and their
families. I urge my colleagues to support the Buchanan amendment.
Mr. Chairman, I reserve the balance of my time.
Mr. SKELTON. Mr. Chairman, I accept and I thank the gentleman from
Florida for the amendment.
Mr. HUNTER. I want to support the gentleman's amendment, and thank
him for his valuable contribution to this process.
Mr. BUCHANAN. I thank the chairman and the ranking member and the
House Committee on Armed Services and their staff.
Mr. Chairman, I yield back the balance of my time.
The Acting CHAIRMAN. The question is on the amendment offered by the
gentleman from Florida (Mr. Buchanan).
The amendment was agreed to.

Amendment No. 12 Offered by Mr. Welch of Vermont

The Acting CHAIRMAN. It is now in order to consider amendment No. 12
printed in House Report 110-78.
Mr. WELCH of Vermont. Mr. Chairman, I offer an amendment.
The Acting CHAIRMAN. The Clerk will designate the amendment.
The text of the amendment is as follows:

Amendment No. 12 offered by Mr. Welch of Vermont:
Insert at the end of section 1074l(a) of title 10, United
States Code, as proposed to be added by section 101 of the
bill, the following new paragraph:
``(6) The Secretary concerned shall ensure that medical
care case managers have the resources necessary to ensure
that they expeditiously carry out the responsibilities and
duties of their position.''
Insert at the end of section 1074l(b) of title 10, United
States Code, as proposed to be added by section 101 of the
bill, the following new paragraph:
``(7) The Secretary concerned shall ensure that service
member advocates have the resources necessary to ensure that
they expeditiously carry out the responsibilities and duties
of their position.''
Insert after subsection (b) of section 1074l of title 10,
United States Code, as proposed to be added by section 101 of
the bill, the following new subsection (and redesignate
subsections (c) and (d) of such section as subsections (d)
and (e), respectively):
``(c) Outreach.--The Secretary of Defense shall make
available to each member in an outpatient status at a
military medical treatment facility, and to the family
members of all such members, information on the availability
of services provided by the medical care case managers and
service member advocates, including information on how to
contact such managers and advocates and how to use their
services.''

The Acting CHAIRMAN. Pursuant to House Resolution 274, the gentleman
from Vermont (Mr. Welch) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentleman from Vermont.
Mr. WELCH of Vermont. Mr. Chairman, I yield myself such time as I may
consume.
Mr. Chairman, first, I want to thank the Committee on Armed Services
for this bipartisan legislation that all of us here in Congress are
eager to support. Mr. Skelton has spent virtually his entire career in
Congress making certain that the military is prepared and has the
equipment it needs and it has the services they require when they come
home; and his colleague who has worked very carefully with him, the
gentleman from California (Mr. Hunter). I thank you for bringing this
legislation to Congress.
The underlying bill does two things, as you know. It creates, one, a
medical case manager. Number two, it creates a servicemember advocate.
The point of those two positions is to guarantee that what happened at
Walter Reed won't happen again.
My amendment is intended to strengthen and intensify the ability of
those two positions to be effective on the part of the men and women
who need medical services, and it does it in two ways. One, it makes it
clear to the Secretary that these two positions must be empowered to do
whatever is required to work through the bureaucracy and see to it that
folks get the care they need.
Secondly, it requires the Secretary to advertise the availability of
these services to our veterans, but also to their families. As we saw
at Walter Reed, it was the families who often were the best
spokesperson for the veterans and our soldiers who were in need of
service. So the amendment builds on what the committee has done by
empowering and advertising.
Mr. Chairman, I want to close by thanking the members of the
Committee on Armed Services and their staff for working so closely with
me to help write this amendment in a way that was consistent with the
underlying objectives of the bill.
Mr. Chairman, I yield to the gentleman from Missouri (Mr. Skelton).
Mr. SKELTON. Let me support this amendment of my friend and
colleague, Mr. Welch. The gentleman from Vermont has done a service in
bringing this thoughtful amendment forward.
In doing so, it specifies the training and reporting requirements for
medical care case managers and servicemember advocates. More
importantly, it ensures they have the resources they need to get the
job done. I will repeat that. That they have the resources to get the
job done. I appreciate his contribution and thank him for his efforts
in this regard to make this good bill even better.
Mr. HUNTER. Would the gentleman yield?
Mr. WELCH of Vermont. Yes, I yield.
Mr. HUNTER. I also want to thank the gentleman for his very
thoughtful amendment.
Since this is the last amendment, I thought I would take this
opportunity to thank my great friend, Ike Skelton, for bringing our
team to the floor and moving this very important legislation very
effectively. I thank both gentlemen.
Mr. SKELTON. Would the gentleman yield?
Mr. WELCH of Vermont. I yield to Chairman Skelton.
Mr. SKELTON. I must say, it is a thrill to be able to work with my
friend, Duncan Hunter, in bringing a piece of legislation like this
forward in a bipartisan manner, and thank him for his cooperation as
well as all on both sides of the aisle.
Again, I will mention our wonderful staff that works so well in a
bipartisan manner. So Mr. Hunter, thank you very much for your solid
efforts in this regard.
Mr. WELCH of Vermont. Mr. Chairman, apparently I have the last word,
and I think I will say what any of us would say if they were here, and
that is thank you to the chairman and thank you to the ranking member.
You have embodied in this legislation a principle we all know, and that
is that the cost of the war has to include the cost of caring for the
warrior. So I know I speak on behalf of all of us in thanking you for
your excellent work.
Mr. Chairman, I yield back the balance of my time.
The Acting CHAIRMAN. The question is on the amendment offered by the
gentleman from Vermont (Mr. Welch).
The amendment was agreed to.

Amendment No. 7 offered by Mr. Sestak

The Acting CHAIRMAN. Pursuant to clause 6 of rule XVIII, the
unfinished business is the request for a recorded vote on amendment No.
7 offered by the gentleman from Pennsylvania (Mr. Sestak) on which
further proceedings were postponed and on which the ayes prevailed by
voice vote.
The Clerk will redesignate the amendment.
The Clerk redesignated the amendment.

Recorded Vote

The Acting CHAIRMAN. A recorded vote has been demanded.
A recorded vote was ordered.
The vote was taken by electronic device, and there were--ayes 434,
noes 0, not voting 4, as follows:

[[Page H3234]]

[Roll No. 206]

AYES--434

Abercrombie
Ackerman
Aderholt
Akin
Alexander
Allen
Altmire
Andrews
Arcuri
Baca
Bachmann
Bachus
Baird
Baker
Baldwin
Barrett (SC)
Barrow
Bartlett (MD)
Barton (TX)
Bean
Becerra
Berkley
Berman
Berry
Biggert
Bilbray
Bilirakis
Bishop (GA)
Bishop (NY)
Bishop (UT)
Blackburn
Blumenauer
Blunt
Boehner
Bonner
Bono
Boozman
Bordallo
Boren
Boswell
Boucher
Boustany
Boyd (FL)
Boyda (KS)
Brady (PA)
Brady (TX)
Braley (IA)
Brown (SC)
Brown, Corrine
Brown-Waite, Ginny
Buchanan
Burgess
Burton (IN)
Butterfield
Buyer
Calvert
Camp (MI)
Campbell (CA)
Cannon
Cantor
Capito
Capps
Capuano
Cardoza
Carnahan
Carney
Carson
Carter
Castle
Castor
Chabot
Chandler
Christensen
Clarke
Clay
Cleaver
Clyburn
Coble
Cohen
Cole (OK)
Conaway
Conyers
Cooper
Costa
Costello
Courtney
Cramer
Crenshaw
Crowley
Cubin
Cuellar
Culberson
Cummings
Davis (AL)
Davis (CA)
Davis (IL)
Davis (KY)
Davis, David
Davis, Lincoln
Davis, Tom
Deal (GA)
DeFazio
DeGette
Delahunt
DeLauro
Dent
Diaz-Balart, L.
Diaz-Balart, M.
Dicks
Dingell
Doggett
Donnelly
Doolittle
Doyle
Drake
Dreier
Duncan
Edwards
Ehlers
Ellison
Ellsworth
Emanuel
Emerson
Engel
English (PA)
Eshoo
Etheridge
Everett
Faleomavaega
Fallin
Farr
Fattah
Feeney
Ferguson
Filner
Flake
Forbes
Fortenberry
Fortuno
Fossella
Foxx
Frank (MA)
Franks (AZ)
Frelinghuysen
Gallegly
Garrett (NJ)
Gerlach
Giffords
Gilchrest
Gillibrand
Gillmor
Gingrey
Gohmert
Gonzalez
Goode
Goodlatte
Gordon
Granger
Graves
Green, Al
Green, Gene
Grijalva
Gutierrez
Hall (NY)
Hall (TX)
Hare
Harman
Hastert
Hastings (FL)
Hastings (WA)
Hayes
Heller
Hensarling
Herger
Herseth
Higgins
Hill
Hinchey
Hinojosa
Hirono
Hobson
Hodes
Hoekstra
Holden
Holt
Honda
Hooley
Hoyer
Hulshof
Hunter
Inglis (SC)
Inslee
Israel
Issa
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Jindal
Johnson (GA)
Johnson (IL)
Johnson, E. B.
Johnson, Sam
Jones (NC)
Jones (OH)
Jordan
Kagen
Kaptur
Keller
Kennedy
Kildee
Kilpatrick
Kind
King (IA)
King (NY)
Kingston
Kirk
Klein (FL)
Kline (MN)
Knollenberg
Kucinich
Kuhl (NY)
LaHood
Lamborn
Langevin
Lantos
Larsen (WA)
Larson (CT)
Latham
LaTourette
Lee
Levin
Lewis (CA)
Lewis (GA)
Lewis (KY)
Linder
Lipinski
LoBiondo
Loebsack
Lofgren, Zoe
Lowey
Lucas
Lungren, Daniel E.
Lynch
Mack
Mahoney (FL)
Maloney (NY)
Manzullo
Marchant
Markey
Marshall
Matheson
Matsui
McCarthy (CA)
McCarthy (NY)
McCaul (TX)
McCollum (MN)
McCotter
McCrery
McDermott
McGovern
McHenry
McHugh
McIntyre
McKeon
McMorris Rodgers
McNerney
McNulty
Meehan
Meek (FL)
Meeks (NY)
Melancon
Mica
Michaud
Miller (FL)
Miller (MI)
Miller (NC)
Miller, Gary
Miller, George
Mitchell
Mollohan
Moore (KS)
Moore (WI)
Moran (KS)
Moran (VA)
Murphy (CT)
Murphy, Patrick
Murphy, Tim
Murtha
Musgrave
Myrick
Nadler
Napolitano
Neal (MA)
Neugebauer
Norton
Nunes
Oberstar
Obey
Olver
Ortiz
Pallone
Pascrell
Pastor
Paul
Payne
Pearce
Pence
Perlmutter
Peterson (MN)
Peterson (PA)
Petri
Pickering
Pitts
Platts
Poe
Pomeroy
Porter
Price (GA)
Price (NC)
Pryce (OH)
Putnam
Radanovich
Rahall
Ramstad
Rangel
Regula
Rehberg
Reichert
Renzi
Reyes
Reynolds
Rodriguez
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
Ros-Lehtinen
Roskam
Ross
Rothman
Roybal-Allard
Royce
Ruppersberger
Rush
Ryan (OH)
Ryan (WI)
Salazar
Sali
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Saxton
Schakowsky
Schiff
Schmidt
Schwartz
Scott (GA)
Scott (VA)
Sensenbrenner
Serrano
Sessions
Sestak
Shadegg
Shays
Shea-Porter
Sherman
Shimkus
Shuler
Shuster
Simpson
Sires
Skelton
Slaughter
Smith (NE)
Smith (NJ)
Smith (TX)
Smith (WA)
Snyder
Solis
Souder
Space
Spratt
Stark
Stearns
Stupak
Sullivan
Sutton
Tancredo
Tanner
Tauscher
Taylor
Terry
Thompson (CA)
Thompson (MS)
Thornberry
Tiahrt
Tiberi
Tierney
Towns
Turner
Udall (CO)
Udall (NM)
Upton
Van Hollen
Velazquez
Visclosky
Walberg
Walden (OR)
Walsh (NY)
Walz (MN)
Wamp
Wasserman Schultz
Waters
Watson
Watt
Waxman
Weiner
Welch (VT)
Weldon (FL)
Weller
Westmoreland
Wexler
Whitfield
Wicker
Wilson (NM)
Wilson (OH)
Wilson (SC)
Wolf
Woolsey
Wu
Wynn
Yarmuth
Young (AK)
Young (FL)

NOT VOTING--4

Davis, Jo Ann
Kanjorski
Lampson
Millender-McDonald

{time} 1635

So the amendment was agreed to.
The result of the vote was announced as above recorded.
The Acting CHAIRMAN. There being no further amendments, the question
is on the committee amendment in the nature of a substitute, as
amended.
The committee amendment in the nature of a substitute, as amended,was
agreed to.
The Acting CHAIRMAN. Under the rule, the Committee rises.
Accordingly, the Committee rose; and the Speaker pro tempore (Mr.
Weiner) having assumed the chair, Mr. Altmire, Acting Chairman of the
Committee of the Whole House on the state of the Union, reported that
that Committee, having had under consideration the bill (H.R. 1538) to
amend title 10, United States Code, to improve the management of
medical care, personnel actions, and quality of life issues for members
of the Armed Forces who are receiving medical care in an outpatient
status, and for other purposes, pursuant to House Resolution 274, he
reported the bill back to the House with an amendment adopted by the
Committee of the Whole.
The SPEAKER pro tempore. Under the rule, the previous question is
ordered.
Is a separate vote demanded on any amendment to the amendment in the
nature of a substitute reported from the Committee of the Whole?
Mr. PRICE of Georgia. Mr. Speaker, I demand a re-vote on the Sestak-
Kennedy amendment.
The SPEAKER pro tempore. Is a separate vote demanded on any other
amendment to the amendment in the nature of a substitute?
The Clerk will redesignate the amendment on which a separate vote has
been demanded.
The text of the amendment is as follows:

Amendment No. 7 offered by Mr. Sestak:
At the end of title I, add the following new. section (and
conform the table of contents accordingly):

SEC. 113. PLANS AND RESEARCH FOR REDUCING POST TRAUMATIC
STRESS DISORDER.

(a) Plans for Reducing Post Traumatic Stress Disorder.--
(1) Plan for prevention--
(A) In general.--The Secretary of Defense shall develop a
plan to incorporate evidence-based preventive and early-
intervention measures, practices, or procedures that reduce
the likelihood that personnel in combat will develop post-
traumatic stress disorder or other stress-related
psychopathologies (including substance use conditions) into--
(i) basic and pre-deployment training for enlisted members
of the Armed Forces, noncommissioned officers, and officers;
(ii) combat theater operations; and
(iii) post-deployment service.
(B) Updates.--The Secretary of Defense shall update the
plan under subparagraph (A) periodically to incorporate, as
the Secretary considers appropriate, the results of relevant
research, including research conducted pursuant to subsection
(b).
(2) Research.--Subject to subsection (b), the Secretary of
Defense shall develop a plan, in consultation with the
Department of Veterans Affairs, the National Institutes of
Health, and the National Academy of Sciences, to conduct such
research as is necessary to develop the plan described in
paragraph (1).
(b) Evidence-Based Research and Training.--
(1) Working group.--The Secretary of Defense shall conduct
a study, in coordination with the Department of Veterans
Affairs, the National Institutes of Health, and the National
Academy of Sciences' Institute of Medicine, to determine the
feasibility of establishing a working group tasked with
researching and developing evidence-based measures,
practices, or procedures that reduce the likelihood that
personnel in combat will develop post-traumatic stress
disorder or other stress-related psychological pathologies
(including substance use conditions). The working group shall
include personnel with experience in a combat theater, and
behavioral health personnel who have experience providing
treatment to individuals with experience in a combat theater.
(2) Peer-reviewed research program.--Not later than 180
days after the date of the enactment of this Act, the
Secretary of Defense shall submit to Congress a plan for a
peer-reviewed research program within the Defense Health
Program's research and development function to research and
develop evidence-based preventive and early intervention
measures, practices, or procedures that reduce the likelihood
that personnel in combat will develop post-traumatic stress
disorder or other stress-related

[[Page H3235]]

psychopathologies (including substance use conditions).
(c) Report.--The Secretary of Defense shall submit to
Congress annually a report on the plans and studies required
under this section.

The SPEAKER pro tempore. The question is on the amendment.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. PRICE of Georgia. Mr. Speaker, on that, I demand the yeas and
nays.
The yeas and nays were ordered.
The vote was taken by electronic device, and there were--yeas 426,
nays 0, not voting 7, as follows:

[Roll No. 207]

YEAS--426

Abercrombie
Ackerman
Aderholt
Akin
Alexander
Allen
Altmire
Andrews
Arcuri
Baca
Bachmann
Bachus
Baird
Baker
Baldwin
Barrett (SC)
Barrow
Barton (TX)
Bean
Becerra
Berkley
Berman
Berry
Biggert
Bilbray
Bilirakis
Bishop (GA)
Bishop (NY)
Bishop (UT)
Blackburn
Blumenauer
Blunt
Boehner
Bonner
Bono
Boozman
Boren
Boswell
Boucher
Boustany
Boyd (FL)
Boyda (KS)
Brady (PA)
Brady (TX)
Braley (IA)
Brown (SC)
Brown, Corrine
Brown-Waite, Ginny
Buchanan
Burgess
Burton (IN)
Butterfield
Buyer
Calvert
Camp (MI)
Campbell (CA)
Cannon
Cantor
Capito
Capps
Capuano
Cardoza
Carnahan
Carney
Carson
Carter
Castle
Castor
Chabot
Chandler
Clarke
Clay
Cleaver
Clyburn
Coble
Cohen
Cole (OK)
Conaway
Conyers
Cooper
Costa
Costello
Courtney
Cramer
Crenshaw
Crowley
Cubin
Cuellar
Culberson
Cummings
Davis (AL)
Davis (CA)
Davis (IL)
Davis (KY)
Davis, David
Davis, Lincoln
Davis, Tom
Deal (GA)
DeFazio
DeGette
Delahunt
DeLauro
Dent
Diaz-Balart, L.
Diaz-Balart, M.
Dicks
Dingell
Doggett
Donnelly
Doolittle
Doyle
Drake
Dreier
Duncan
Edwards
Ehlers
Ellison
Ellsworth
Emanuel
Emerson
Engel
English (PA)
Eshoo
Etheridge
Everett
Fallin
Farr
Fattah
Feeney
Ferguson
Filner
Flake
Forbes
Fortenberry
Fossella
Foxx
Frank (MA)
Franks (AZ)
Frelinghuysen
Gallegly
Garrett (NJ)
Gerlach
Giffords
Gilchrest
Gillibrand
Gillmor
Gingrey
Gohmert
Gonzalez
Goode
Goodlatte
Gordon
Granger
Graves
Green, Al
Green, Gene
Grijalva
Gutierrez
Hall (NY)
Hall (TX)
Hare
Harman
Hastert
Hastings (FL)
Hastings (WA)
Heller
Hensarling
Herger
Herseth
Higgins
Hill
Hinchey
Hinojosa
Hirono
Hobson
Hodes
Hoekstra
Holden
Holt
Honda
Hooley
Hoyer
Hulshof
Hunter
Inglis (SC)
Inslee
Israel
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Jindal
Johnson (GA)
Johnson (IL)
Johnson, E. B.
Johnson, Sam
Jones (NC)
Jones (OH)
Jordan
Kagen
Kaptur
Keller
Kennedy
Kildee
Kilpatrick
Kind
King (IA)
King (NY)
Kingston
Kirk
Klein (FL)
Kline (MN)
Knollenberg
Kucinich
Kuhl (NY)
LaHood
Lamborn
Langevin
Lantos
Larsen (WA)
Larson (CT)
Latham
LaTourette
Lee
Levin
Lewis (CA)
Lewis (GA)
Lewis (KY)
Linder
Lipinski
LoBiondo
Loebsack
Lofgren, Zoe
Lowey
Lucas
Lungren, Daniel E.
Lynch
Mack
Mahoney (FL)
Maloney (NY)
Manzullo
Marchant
Markey
Marshall
Matheson
Matsui
McCarthy (CA)
McCarthy (NY)
McCaul (TX)
McCollum (MN)
McCotter
McCrery
McDermott
McGovern
McHenry
McHugh
McIntyre
McKeon
McMorris Rodgers
McNerney
McNulty
Meehan
Meek (FL)
Meeks (NY)
Melancon
Mica
Michaud
Miller (FL)
Miller (MI)
Miller (NC)
Miller, Gary
Miller, George
Mitchell
Mollohan
Moore (KS)
Moore (WI)
Moran (KS)
Moran (VA)
Murphy (CT)
Murphy, Patrick
Murphy, Tim
Murtha
Musgrave
Myrick
Nadler
Napolitano
Neal (MA)
Neugebauer
Nunes
Oberstar
Obey
Olver
Ortiz
Pallone
Pascrell
Pastor
Paul
Payne
Pearce
Pence
Perlmutter
Peterson (MN)
Peterson (PA)
Petri
Pickering
Pitts
Platts
Poe
Pomeroy
Porter
Price (GA)
Price (NC)
Pryce (OH)
Putnam
Radanovich
Rahall
Ramstad
Rangel
Regula
Rehberg
Reichert
Renzi
Reyes
Reynolds
Rodriguez
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
Ros-Lehtinen
Roskam
Ross
Rothman
Roybal-Allard
Royce
Ruppersberger
Rush
Ryan (OH)
Ryan (WI)
Salazar
Sali
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Saxton
Schakowsky
Schiff
Schmidt
Schwartz
Scott (GA)
Scott (VA)
Sensenbrenner
Serrano
Sessions
Sestak
Shadegg
Shays
Shea-Porter
Sherman
Shimkus
Shuler
Shuster
Simpson
Sires
Skelton
Slaughter
Smith (NE)
Smith (NJ)
Smith (TX)
Smith (WA)
Snyder
Solis
Souder
Space
Spratt
Stark
Stearns
Stupak
Sullivan
Sutton
Tancredo
Tanner
Tauscher
Taylor
Terry
Thompson (CA)
Thompson (MS)
Thornberry
Tiahrt
Tiberi
Tierney
Towns
Turner
Udall (CO)
Udall (NM)
Upton
Van Hollen
Velazquez
Visclosky
Walberg
Walden (OR)
Walsh (NY)
Walz (MN)
Wamp
Wasserman Schultz
Waters
Watson
Watt
Waxman
Weiner
Welch (VT)
Weldon (FL)
Weller
Westmoreland
Wexler
Whitfield
Wicker
Wilson (NM)
Wilson (OH)
Wilson (SC)
Wolf
Woolsey
Wu
Wynn
Yarmuth
Young (AK)
Young (FL)

NOT VOTING--7

Bartlett (MD)
Davis, Jo Ann
Hayes
Issa
Kanjorski
Lampson
Millender-McDonald

Announcement by the Speaker Pro Tempore

The SPEAKER pro tempore (Mr. Weiner) (during the vote). Members are
advised that there are 2 minutes remaining in this vote.

{time} 1654

So the amendment was agreed to.
The result of the vote was announced as above recorded.
The SPEAKER pro tempore. The question is on adoption of the committee
amendment, as amended.
The amendment was agreed to.
The SPEAKER pro tempore. The question is on engrossment and third
reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.
The SPEAKER pro tempore. The question is on the passage of the bill.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. ANDREWS. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The vote was taken by electronic device, and there were--yeas 426,
nays 0, not voting 7, as follows:

[Roll No. 208]

YEAS--426

[[Page H3236]]

Markey
Marshall
Matheson
Matsui
McCarthy (CA)
McCarthy (NY)
McCaul (TX)
McCollum (MN)
McCotter
McCrery
McDermott
McGovern
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Melancon
Mica
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Miller (FL)
Miller (MI)
Miller (NC)
Miller, Gary
Miller, George
Mitchell
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Moore (KS)
Moore (WI)
Moran (KS)
Moran (VA)
Murphy (CT)
Murphy, Patrick
Murphy, Tim
Murtha
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Paul
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Sanchez, Loretta
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Schwartz
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Wolf
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Young (FL)

NOT VOTING--7

Davis, Jo Ann
Fattah
Kanjorski
Lampson
Meek (FL)
Millender-McDonald
Rangel

Announcement by the Speaker Pro Tempore

The SPEAKER pro tempore (Mr. Weiner) (during the vote). Members are
advised that 2 minutes remain in this vote.

{time} 1711

So the bill was passed.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.

____________________