[Congressional Record Volume 153, Number 62 (Wednesday, April 18, 2007)]
[Senate]
[Pages S4692-S4693]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SALAZAR (for himself, Mr. Thune, Mr. Tester, Mr. Burr, 
        Mrs. Murray, Mr. Grassley, Mr. Wyden, Ms. Collins, Mr. Pryor, 
        Mr. Enzi, Mrs. Lincoln, Ms. Snowe, Mr. Kerry, Mr. Bingaman, Mr. 
        Smith, Mr. Baucus, and Mr. Dorgan):
  S. 1146. A bill to amend title 38, United States Code, to improve 
health care for veterans who live in rural areas, and for other 
purposes; to the Committee on Veterans' Affairs.
  Mr. SALAZAR. Mr. President, today I am introducing the Rural Veterans 
Healthcare Improvement Act of 2007, with my colleague from South 
Dakota, Senator Thune, and my colleague from Montana, Senator Tester. 
We are pleased to be joined by Senators Burr, Murray, Grassley, Wyden, 
Collins, Pryor, Enzi, Lincoln, Snowe, Kerry, Bingaman, Smith, Baucus, 
and Dorgan.
  Over the last two years my colleagues have heard me speak repeatedly 
about the challenges that are facing rural America. In the America 
where I grew up--the America of farmers, ranchers, small business 
owners, and generations of close-knit families--it is getting more 
difficult to make a living, to access affordable healthcare, and to 
provide opportunities for kids to learn and grow.
  The challenges facing veterans in rural communities are particularly 
grave. For generations, men and women from rural America have devoted 
themselves to the cause of freedom without hesitation and in numbers 
greatly beyond their proportion of the U.S. population. Yet we 
consistently overlook the unique challenges these men and women face 
after they return home to their families and friends in the heartland 
of America. When it comes to the VA healthcare system, we fail our 
Nation's rural veterans by not doing more to ensure they can access the 
high-quality health care they have earned. We owe them much better.
  Over and over, I hear from veterans in my state about obstacles to 
care. In northwest Colorado, veterans must brave three and four hour 
drives on winding mountain roads to reach the VA hospital in Grand 
Junction.
  In northeast Colorado I have heard from a veteran who must travel 500 
miles round trip just to get a simple blood test at a VA hospital. I 
think most of my colleagues would agree with me that this is ludicrous.
  I wish I could say these are isolated circumstances. Unfortunately, 
they are not. Because of gaps in the network of VA hospitals and 
clinics, we hear stories like this all the time.
  Every day, veterans from rural communities throughout the country are 
forced to put off crucial treatment because they live too far from VA 
facilities and can't get the care they need. As a result, rural 
veterans die younger and suffer from more debilitating illnesses--all 
because our system is not equipped to address their needs and provide 
care accordingly. A 2004 study of over 750,000 veterans conducted by 
Dr. Jonathan Perlin, the Under Secretary for Health at the VA, 
consistently found that veterans living in rural areas are in poorer 
health than their urban counterparts.
  Last year, we took an important first step in improving care for 
rural veterans. Thanks to the bipartisan efforts of my colleagues on 
the Veterans' Affairs Committee, we were able to create the Office of 
Rural Health within the VA. The Office of Rural Health is charged with 
working to reduce the wide disparities between care for rural and non-
rural veterans by developing and refining policies and programs to 
improve care and services for rural veterans. Because nearly one in 
every four veterans is from a rural area, the creation of this Office 
of Rural Health is crucial if we are to live up to our promise to 
provide all of our Nation's veterans with high-quality services.
  The bill we are introducing today, the Rural Veterans Healthcare and 
Improvement Act of 2007, builds on last year's work by giving direction 
and resources to the Office of Rural Health and by making healthcare 
more accessible to veterans in rural areas.
  The bill tasks the Office of Rural Health with developing 
demonstration projects that would expand care in rural areas through 
partnerships between the VA, Centers for Medicare and Medicaid 
Services, and the Department of Health and Human Services at critical 
access hospitals and community health centers. The bill also instructs 
the Director of the Office of Rural Health to carry out demonstration 
projects in partnership with the Indian Health Service to improve 
healthcare for Native American veterans.
  In addition, the Rural Veterans Healthcare Improvement Act of 2007 
establishes centers of excellence to research ways to improve care for 
rural veterans. The centers would be based at VA medical centers with 
strong academic connections. The Office of Rural Health would establish 
between one and five centers across the country with the advice of an 
advisory panel.
  The Rural Veterans Healthcare Improvement Act includes two key 
provisions that will help veterans in rural areas reach healthcare 
facilities.
  First, the bill establishes the VetsRide grant program to provide 
innovative transportation options to veterans in remote rural areas. 
The bill tasks the Director of the Office of Rural Health to create a 
program that would provide grants of up to $50,000 to veterans' service 
organizations and State veterans' service officers to assist veterans 
with travel to VA medical

[[Page S4693]]

centers and to improve healthcare access in remote rural areas. The 
bill authorizes $3 million per year for the grant program through 2012.
  Secondly, the bill increases the reimbursement rates for veterans for 
their travel expenses related to VA medical care so that they are 
compensated at the same rate paid to federal employees.
  Finally, our bill requires the VA to report to Congress on the 
assessment it is conducting of its fee-based healthcare policies. We 
need to improve the VA's fee-based healthcare policies to be more 
equitable and efficient in helping veterans in rural areas get the care 
they deserve.
  With almost one-quarter of our Nation's veterans living in rural 
communities, and with the obstacles they face in accessing high-quality 
care, it is evident that we need to do a better job of making sure they 
receive the care they deserve. The creation of the Office of Rural 
Veterans Healthcare was a first step, and this legislation will move us 
further down the path toward improved care.
  I want to again thank my colleague from South Dakota, Senator Thune, 
and my colleague from Montana, Senator Tester, for their efforts on 
this bill. We have a strong group of 17 Senators from both sides of the 
aisle behind this bill so far.
  I know that each and every one of my colleagues deals with veterans' 
issues and feels a deep sense of gratitude towards the brave men and 
women who have fought for our freedom. I hope we can join together to 
move this legislation through Congress and send it to the President for 
his signature.
  Mr. President, I yield the floor.
                                 ______