[Congressional Record Volume 153, Number 155 (Monday, October 15, 2007)]
[Senate]
[Pages S12870-S12874]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
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.''.
______
By Mr. AKAKA:
S. 2162. a Bill to improve the treatment and services provided by the
Department of Veterans Affairs to veterans with post-traumatic stress
disorder and substance use disorders, and for other purposes; to the
Committee on Veterans' Affairs.
Mr. AKAKA. Mr. President, today I introduce comprehensive legislation
to improve the capacity of the Department of Veterans Affairs to care
for veterans with invisible wounds.
For too many veterans, returning home from battle will not bring an
end to conflict. They will return home, but the war will follow them in
their hearts and minds. Just as we support our troops as they fight in
Iraq and Afghanistan, we must support them when they return from war
marked by their service. Invisible wounds are complicated and wide-
ranging, and our solutions must rise to the challenge.
What do we know about the scope of the problem? A March 2007 study
published in the Archives of Internal Medicine reported that more than
one-third of war veterans who have served in either Iraq or Afghanistan
are suffering from various mental ailments, including post-traumatic
stress disorder, anxiety, depression, substance use disorder and other
problems. According to the study, a disproportionate number of young
soldiers suffer mental health problems.
There is no question that action is needed. One in five Iraq War
veterans are likely to develop PTSD, as studies have estimated, and
this is but one aspect of the mental health challenges faced by
veterans.
We also know that veterans suffering from physical and mental wounds
use drugs and alcohol to assuage their pain. Experts believe that
stress is the number one cause of drug abuse, and of relapse to drug
abuse. Mr. President, 60 to 80 percent of Vietnam veterans who have
sought PTSD treatment have alcohol use disorders. VA has been dealing
with substance abuse issues for decades, but much remains to be done.
On April 25, 2007, I chaired a Committee on Veterans' Affairs hearing
on veterans' mental health concerns and on VA's response. We heard
heart-wrenching testimony from the witnesses. Randall Omvig spoke of
his son's suicide upon returning from Iraq. Tony Bailey spoke of his
son's struggle with substance abuse, and of his death. Patrick Campbell
shared his own experience with PTSD and the experiences of his close
friends. Witnesses urged us to learn, and they urged us to act.
The provisions of this bill are a direct outgrowth of that hearing
and the testimony given by those who have suffered with mental health
issues, and by their family members.
This bill addresses the immediate needs of veterans by ensuring high
quality mental health services at VA facilities and in their
communities. The bill also looks to the future. Our legislation has
eleven core provisions. I will highlight some of them:
First, VA medical centers would be required to offer a minimum range
of services for veterans in need of help to overcome their substance
use disorders. It would require programs to prevent relapse and to
provide medical treatments to reduce cravings for alcohol and drugs,
among others. Many VA facilities have some of these programs but there
is no universal minimum.
We know that there are large numbers of veterans suffering with a
terrible confluence of substance use disorders and other mental health
disorders. The bill would require that both issues be treated by a
well-qualified team of health professionals who would treat the
disorders concurrently.
To ensure that innovative mental health services are tailored to
individual communities, the legislation would create grants to enhance
programs and fill holes. VA facilities would compete for grants for
various purposes, from increasing weekend and evening hours to creating
programs which encourage urgent care physicians, who are often gateways
for new patients, to quickly refer those whom they believe may have a
mental health disorder.
Veterans with debilitating mental health issues, including substance
use disorder and PTSD, may need inpatient care. VA has moved rapidly to
reduce their inpatient mental health capacity, but there is no doubt
that inpatient stays are necessary for many veterans. This legislation
would require the VA Secretary to designate six inpatient facilities to
provide recovery services for veterans with comorbid PTSD and substance
use disorders.
The legislation would also require a comprehensive review of VA's
residential mental health facilities. This provision stems directly
from the hearing testimony of Tony Bailey, whose son suffered from PTSD
and substance abuse. Tony's son, Justin, died while in a VA
domiciliary. He overdosed on medications provided to him by VA.
Residential facilities are a necessary part of VA's effort to treat
mental health problems and they must be up to par.
It has been made clear to me, by mental health experts and veterans
experiencing mental health problems, that families need to be much more
involved in the care of their loved ones. Families are suffering in
much the same way that veterans themselves are suffering. They must
have access to care which will aid in the effective treatment and
rehabilitation of a veteran. An existing provision of law allows such
care for family members. Our legislation simply restates this law and
clarifies the type of services to which family members should have
access.
Finally, our goal is to define the best possible treatments for
veterans now and in the future. To that end, this legislation sets up a
mental health research program based on the successful pediatric
oncology model. We are proposing a network of sites with adequate
patient flow and clinical and research expertise. The goal is to
promote rapid progress from research to therapeutic advancement and
effective treatments for PTSD and PTSD in the presence of a substance
use disorder.
An aggressive mental health agenda for veterans begins by providing
VA with financial support. Our comprehensive legislation authorizes the
creation of new programs and expansion of existing ones. While these
changes amount to significant new funding, every dollar was included in
our Committee's Views and Estimates Letter to the Budget Committee. The
Committee on Veterans' Affairs requested a $700 million dollar increase
in fiscal year 2008 for mental health programs, and the full Senate
supported this level in the final budget resolution. A similar level of
funding was supported by the full Senate in the VA appropriation bill.
I urge all of my colleagues to support this innovative and
comprehensive legislation, which will bring hope and progress to many
veterans suffering from invisible wounds.
______
By Mr. INHOFE (for himself and Mr. Cochran):
S. 2164. A bill to establish a Science and Technology Scholarship
Program to award scholarships to recruit and prepare students for
careers in the National Weather Service and in National Oceanic and
Atmospheric Administration marine research, atmospheric research, and
satellite programs and for other purposes; to the Committee on
Commerce, Science, and Transportation.
Mr. INHOFE. Mr. President, today I introduce the NOAA Scholarship Act
of 2007 with my colleague from Mississippi, Senator Cochran. This bill
provides a scholarship program for promising students who seek to
pursue an education in a relevant field of study and commit to work for
a branch of the National Oceanic Atmospheric Administration, NOAA,
including the National Weather Service, upon graduation.
Few can contend with the fact that there is a shortage of American
students devoting themselves to the study of science, math and
engineering. However, the demand for trained individuals in these
professions is rising. In order to achieve their missions, Federal
organizations like NOAA require a cadre of young talent to enter the
workforce with training in fields like meteorology, hydrology, and
oceanography.
In my great State of Oklahoma, we know the importance of NOAA, and
particularly the study of meteorology. Two weeks ago, I met with a
group of Fire Marshalls who informed me that there are more declared
natural disasters per capita in Oklahoma than in
[[Page S12873]]
any other State in the Union. In May of each year, we experience an
average of twenty tornadoes. In fact, the fastest wind speed ever
recorded was in one of the May tornadoes to hit Oklahoma in 1999. As
Oklahomans, we know that having accurate and timely reporting of
atmospheric changes can mean the difference between life and death.
It is no surprise, then, that the University of Oklahoma, OU, has
developed an exceptional program for the study of meteorology. The OU
School of Meteorology is the largest meteorology program in the nation,
with over 320 undergraduate students and 80 graduate students. It ranks
first in the Nation in severe storms and mesoscale research and is
among the top seven meteorology programs in the country. OU President
David Boren, my predecessor in the Senate, targets the OU School of
Meteorology to become the leading radar meteorology program in the
world.
The OU School of Meteorology is fortunate to have a state of the art
facility in the recently constructed National Weather Center. In this
244,000 square foot structure, federal, state, and OU organizations
partner together to better understand weather events occurring in the
atmosphere. The research that occurs in this center is truly
groundbreaking. The scientists who work at NWC, many of them working
with NOAA, have expertise in severe weather, local and regional
climate, numerical modeling, hydrology, and radar meteorology. Their
work is both abstract and tangible, using theory and advanced
scientific research to improve the lives of individuals in Oklahoma and
around the world.
The National Weather Center is the home of many notable achievements.
NWC scientists were able to demonstrate that the Doppler weather radar
can be useful in detecting tornadoes, hail, and other severe weather
events. Using the Doppler radar, they have developed numerical
forecasting models for government and industry applications.
The scientists at NWC are also known for taking risks to discover new
and improved ways of collecting data and making observations; for
example, they can be credited with showing the effectiveness of rapidly
deployable, truck-mounted radars that they drive into the middle of
fierce storms.
It is with the first-hand knowledge of the important work of the
National Weather Service and the National Oceanic Atmospheric
Administration's research in marine research, atmospheric research, and
satellite programs that I introduce this bill. The NOAA Scholarship Act
of 2007 will establish a scholarship program for promising students who
desire to pursue an education in a relevant field of study and then
serve as full-time employees of NOAA at the completion of their
degrees. The students will be required to work for NOAA for 24 months
in return for each academic year that a scholarship is given. This
program will provide an opportunity and an incentive for students to
develop scientific expertise that will continue to enable NOAA, at
facilities like the National Weather Center in Norman, Oklahoma and
elsewhere, to attain its mission.
On September 17, 2007, the House of Representatives passed identical
legislation, H.R. 1657, by a vote of 360-16. I request that the Senate
move quickly on this bill.
Mr. President, 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. 2164
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 ``NOAA Scholarship Act of
2007''.
SEC. 2. SCIENCE AND TECHNOLOGY SCHOLARSHIP PROGRAM.
(a) Establishment of Program.--
(1) In general.--The Administrator is authorized to
establish a Science and Technology Scholarship Program to
award scholarships to individuals to recruit and prepare
students for careers in the National Weather Service and in
Administration marine research, atmospheric research, and
satellite programs.
(2) Competitive process.--Individuals shall be selected to
receive scholarships under the scholarship program through a
competitive process primarily on the basis of academic merit,
with consideration given to financial need and the goal of
promoting the participation of individuals described in
section 33 or 34 of the Science and Engineering Equal
Opportunities Act (42 U.S.C. 1885a or 1885b) in the
scholarship program.
(3) Service agreements.--To carry out the scholarship
program, the Administrator shall enter into contractual
agreements with individuals selected under paragraph (2)
under which the individuals agree to serve as full-time
employees of the Administration, for the period described in
subsection (f)(1), in positions needed by the Administration
in fields described in paragraph (1) and for which the
individuals are qualified, in exchange for receiving a
scholarship.
(b) Scholarship Eligibility.--In order to be eligible to
participate in the scholarship program, an individual shall--
(1) be enrolled or accepted for enrollment as a full-time
student at an institution of higher education in an academic
program or field of study described in the list made
available under subsection (d);
(2) be a citizen or permanent resident of the United
States; and
(3) at the time of the initial scholarship award, not be an
employee (as that term is defined in section 2105 of title 5,
United States Code) of the United States.
(c) Application Required.--An individual seeking a
scholarship under the scholarship program shall submit an
application to the Administrator at such time, in such
manner, and containing such information, agreements, or
assurances as the Administrator may require to carry out this
section.
(d) Eligible Academic Programs.--The Administrator shall
make publicly available a list of academic programs and
fields of study for which scholarships may be utilized in
fields described in subsection (a)(1), and shall update the
list as necessary.
(e) Scholarship Requirement.--
(1) In general.--The Administrator may provide a
scholarship under the scholarship program for an academic
year if the individual applying for the scholarship has
submitted to the Administrator, as part of the application
required under subsection (c), a proposed academic program
leading to a degree in a program or field of study on the
list made available under subsection (d).
(2) Duration of eligibility.--An individual may not receive
a scholarship under the scholarship program for more than 4
academic years, unless the Administrator grants a waiver.
(3) Scholarship amount.--The dollar amount of a scholarship
under the scholarship program for an academic year shall be
determined under regulations issued by the Administrator, but
may not exceed the cost of attendance, as described in
paragraph (4).
(4) Authorized uses.--A scholarship provided under the
scholarship program may be expended for tuition, fees, and
other authorized expenses as established by the Administrator
by regulation.
(5) Contracts regarding direct payments to institutions.--
The Administrator may enter into a contractual agreement with
an institution of higher education under which the amounts
provided for a scholarship under this section for tuition,
fees, and other authorized expenses are paid directly to the
institution with respect to which the scholarship is
provided.
(f) Period of Obligated Service.--
(1) Duration of service.--Except as provided in subsection
(h)(2), the period of service for which an individual shall
be obligated to serve as an employee of the Administration
shall be 24 months for each academic year for which a
scholarship under the scholarship program is provided.
(2) Schedule for service.--
(A) In general.--Except as provided in subparagraph (B),
obligated service under paragraph (1) shall begin not later
than 60 days after the individual obtains the educational
degree for which the scholarship was provided.
(B) Deferral.--The Administrator may defer the obligation
of an individual to provide a period of service under
paragraph (1) if the Administrator determines that such a
deferral is appropriate. The Administrator shall prescribe
the terms and conditions under which a service obligation may
be deferred through regulation.
(g) Penalties for Breach of Scholarship Agreement.--
(1) Failure to complete academic training.--Scholarship
recipients who fail to maintain a high level of academic
standing, as defined by the Administrator by regulation, who
are dismissed from their educational institutions for
disciplinary reasons, or who voluntarily terminate academic
training before graduation from the educational program for
which the scholarship was awarded, shall be in breach of
their contractual agreement and, in lieu of any service
obligation arising under such agreement, shall be liable to
the United States for repayment not later than 1 year after
the date of default of all scholarship funds paid to them and
to the institution of higher education on their behalf under
the agreement, except as provided in subsection (h)(2). The
repayment period may be extended by the Administrator when
determined to be necessary, as established by regulation.
(2) Failure to begin or complete the service obligation or
meet the terms and conditions of deferment.--Except as
provided in subsection (h), an individual who receives a
scholarship under the scholarship program and who, for any
reason, fails to begin or complete a service obligation under
this section after completion of academic
[[Page S12874]]
training, or fails to comply with the terms and conditions of
deferment established by the Administrator pursuant to
subsection (f)(2)(B), shall be in breach of the contractual
agreement. Such an individual shall be liable to the United
States for an amount equal to--
(A) the total amount received by the individual under the
scholarship program; plus
(B) the amount of interest that would have been earned on
such amount, at the maximum legal prevailing rate as
determined by the Treasurer of the United States, during the
period between the date the amount was awarded to the
individual and the date of the breach of the agreement.
(h) Waiver or Suspension of Obligation.--
(1) Death of individual.--Any obligation of an individual
incurred under the scholarship program (or a contractual
agreement thereunder) for service or payment shall be
canceled upon the death of the individual.
(2) Impossibility or extreme hardship.--The Administrator
shall by regulation provide for the partial or total waiver
or suspension of any obligation of service or payment
incurred by an individual under the scholarship program (or a
contractual agreement thereunder) whenever compliance by the
individual is impossible or would involve extreme hardship to
the individual, or if enforcement of such obligation with
respect to the individual would be contrary to the best
interests of the United States.
SEC. 3. DEFINITIONS.
In this Act:
(a) Administration.--The term ``Administration'' means the
National Oceanic and Atmospheric Administration.
(b) Administrator.--The term ``Administrator'' means the
Under Secretary for Oceans and Atmosphere of the Department
of Commerce.
(c) Cost of Attendance.--The term ``cost of attendance''
has the meaning given that term in section 472 of the Higher
Education Act of 1965 (20 U.S.C. 1087ll).
(d) Institution of Higher Education.--The term
``institution of higher education'' has the meaning given
that term in section 101(a) of the Higher Education Act of
1965 (20 U.S.C. 1001(a)).
(e) Scholarship Program.--The term ``scholarship program''
means the Science and Technology Scholarship Program
established under section 2(a).
____________________