[Congressional Record Volume 153, Number 155 (Monday, October 15, 2007)]
[Senate]
[Pages S12870-S12872]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. AKAKA. (for himself and Mr. Brown):
  S. 2160. A bill to amend title 38, United States Code, to establish a 
pain care initiative in health care facilities of the Department of 
Veterans Affairs, and for other purposes; to the Committee on Veterans' 
Affairs.
  Mr. AKAKA. Mr. President, today I, along with my colleague Senator 
Brown, introduce legislation that would enhance VA's pain management 
program. It is estimated that nearly 30 percent of Americans, that is 
some 86 million people, suffer from chronic or acute pain every year. A 
recent study conducted by VA researchers in Connecticut found that 
nearly 50 percent

[[Page S12871]]

of veteran patients that are seen at VA facilities reported that they 
experience pain regularly.
  While pain increases in severity with age, it is also a growing 
problem among younger veterans who have been injured in the wars in 
Iraq and Afghanistan. Many of these veterans are coming home with 
severe injuries, often traumatic brain injuries, that require intensive 
rehabilitation. In some cases, these younger veterans will have to live 
with the long-term effects of their injuries, of which pain is a large 
and debilitating part.
  Pain management is an area of health care that by many accounts is 
not yet up to par, in both the private and public sectors. The bill we 
are introducing would enhance VA's pain management program on a 
national, system-wide level, by requiring VA to establish a pain care 
initiative at every VA health care facility. Every hospital and clinic 
would be required to employ a professionally recognized pain assessment 
tool or process, and ensure that every patient who is determined to be 
in chronic or acute pain is treated appropriately.
  The profile of a veteran in pain is often times different than that 
of his or her counterpart in the private sector. For example, veterans 
suffering from chronic pain are more likely to be receiving treatment 
for other problems including depression, substance abuse, alcoholism, 
or post traumatic stress disorder. Understanding and treating their 
pain must be a priority, and this bill will help VA enhance the 
department's existing pain management program.
  VA's current pain management efforts are worthwhile, but are 
unfortunately not adequate to meet the all of the needs of veterans. 
Pain management in VA continues to be relatively decentralized and 
unstandardized. Some VA medical centers have adopted successful 
approaches and procedures to deal with pain, while others have been 
less active. Fortunately, VA has begun the work of identifying 
professional talent and developing ideas that provide the groundwork of 
an effective pain management program. This bill would build upon that 
foundation and help ensure that these ideas become practice.
  This bill provides us with an opportunity to help the thousands of 
veterans who are living in pain each and every day. I urge all of my 
colleagues to support this legislation.
  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. 2160

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Veterans Pain Care Act of 
     2007''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Acute and chronic pain are prevalent conditions within 
     the population of veterans.
       (2) Methods of modern warfare, including the use of 
     improvised explosive devices, produce substantial numbers of 
     battlefield casualties with significant damage to both the 
     central and peripheral nervous systems.
       (3) The successes of military health care, both on and off 
     the battlefield, result in high survival rates of severely 
     injured military personnel who will be afflicted with 
     significant pain disorders on either an acute or chronic 
     basis.
       (4) Failure to treat pain appropriately at the time of 
     transition from receipt of care from the Department of 
     Defense to receipt of care from the Department of Veterans 
     Affairs contributes to the development of long-term chronic 
     pain syndromes, in some cases accompanied by long-term mental 
     health and substance use disorders.
       (5) Pain is a leading cause of short-term and long-term 
     disability among veterans.
       (6) The Department of Veterans Affairs has implemented 
     important pain care programs at some facilities and in some 
     areas, but comprehensive pain care is not consistently 
     provided on a uniform basis throughout the health care system 
     of the Department to all patients in need of such care.
       (7) Inconsistent and ineffective pain care provided by the 
     Department of Veterans Affairs leads to pain-related 
     impairments, occupational disability, and medical and mental 
     complications for veterans with acute and chronic pain, with 
     long-term costs for the health care and disability systems of 
     the Department and for society at large.
       (8) Research, diagnosis, treatment, and management of acute 
     and chronic pain for veterans constitute health care 
     priorities of the United States.

     SEC. 3. PAIN CARE INITIATIVE IN DEPARTMENT OF VETERANS 
                   AFFAIRS HEALTH CARE FACILITIES.

       (a) Requirement.--Subchapter II of chapter 17 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 1720F. Pain care

       ``(a) In General.--The Secretary shall carry out at each 
     health care facility of the Department an initiative on pain 
     care.
       ``(b) Elements.--The initiative at each health care 
     facility of the Department shall ensure that each individual 
     receiving treatment in such health care facility receives the 
     following:
       ``(1) An assessment for pain at the time of admission or 
     initial treatment, and periodically thereafter, using a 
     professionally recognized pain assessment tool or process.
       ``(2) Appropriate pain care consistent with recognized 
     means for assessment, diagnosis, treatment, and management of 
     acute and chronic pain, including when appropriate, access to 
     specialty pain management services.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 1720E the following new item:

``1720F. Pain care.''.

       (c) Implementation.--The Secretary of Veterans Affairs 
     shall ensure that the pain care initiatives required by 
     section 1720F of title 38, United States Code, as added by 
     subsection (a), are implemented at all health care facilities 
     of the Department of Veterans affairs by not later than--
       (1) January 1, 2008, in the case of inpatient care; and
       (2) January 1, 2009, in the case of outpatient care.

     SEC. 4. PROGRAM ON RESEARCH AND TRAINING ON PAIN IN 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--Subchapter II of chapter 73 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 7330A. Program of research and training on acute and 
       chronic pain

       ``(a) In General.--The Secretary shall carry out within the 
     Medical and Prosthetic Research Service of the Veterans 
     Health Administration a program of research and training on 
     acute and chronic pain.
       ``(b) Purposes.--The purposes of the program shall include 
     the following:
       ``(1) To identify research priorities most relevant to the 
     treatment of the types of acute and chronic pain suffered by 
     veterans.
       ``(2) To promote, conduct, and coordinate research in 
     accordance with such research priorities--
       ``(A) through the facilities and programs of the 
     Department; and
       ``(B) in cooperation with other agencies, institutions, and 
     organizations, including the Department of Defense.
       ``(3) To educate and train health care personnel of the 
     Department with respect to the assessment, diagnosis, 
     treatment, and management of acute and chronic pain.
       ``(c) Designation of Centers.--(1) The Secretary shall 
     designate an appropriate number of facilities of the 
     Department as cooperative centers for research and education 
     on pain. Each such center shall be designated with a focus on 
     research and training on one or more of the following:
       ``(A) Acute pain.
       ``(B) Chronic pain.
       ``(C) A research priority identified under subsection 
     (b)(1).
       ``(2) The Secretary shall designate at least one of the 
     centers designated under paragraph (1) as a lead center for 
     research on pain attributable to central and peripheral 
     nervous system damage commonly associated with the 
     battlefield injuries characteristic of modern warfare.
       ``(3) The Secretary shall designate one of the centers 
     designated under paragraph (1) as the lead center for 
     coordinating the pain care research activities of the centers 
     designated under this subsection. The functions of such 
     center shall be the following:
       ``(A) To review and evaluate periodically the research of 
     the centers designated under this subsection and to ensure 
     that such research is conducted in accordance with the 
     research priorities identified pursuant to subsection (b)(1).
       ``(B) To collect and disseminate the results of the 
     research of the centers designated under this subsection.
       ``(C) To develop and disseminate educational materials and 
     products--
       ``(i) to enhance the assessment, diagnosis, treatment, and 
     management of acute and chronic pain by the health care 
     professionals and facilities of the Veterans Health 
     Administration; and
       ``(ii) for veterans suffering from acute or chronic pain 
     and their families.
       ``(d) Award of Funding.--Centers designated under 
     subsection (c) may compete for the award of funding from 
     amounts appropriated to the Department each fiscal year for 
     medical and prosthetics research.
       ``(e) National Oversight.--The Under Secretary of Health 
     shall designate an appropriate officer--
       ``(1) to oversee the operation of the centers designated 
     under subsection (c); and
       ``(2) to review and evaluate periodically the performance 
     of such centers.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is

[[Page S12872]]

     amended by inserting after the item relating to section 7330 
     the following new item:

``7330A. Program of research and training on acute and chronic pain.''.
                                 ______