Congressional Record, Volume 160 Issue 121 (Wednesday, July 30, 2014)

[Congressional Record Volume 160, Number 121 (Wednesday, July 30, 2014)]
[House]
[Pages H7078-H7085]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

CONFERENCE REPORT ON H.R. 3230, PAY OUR GUARD AND RESERVE ACT

Mr. MILLER of Florida. Mr. Speaker, I move to suspend the rules and
agree to the conference report on the bill (H.R. 3230) making
continuing appropriations during a government shutdown to provide pay
and allowances to members of the reserve components of the Armed Forces
who perform inactive-duty training during such period.
The Clerk read the title of the bill.
(For conference report and statement, see proceedings of the House of
July 28, 2014, at page H6953.)
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Florida (Mr. Miller) and the gentleman from Maine (Mr. Michaud) each
will control 20 minutes.
The Chair recognizes the gentleman from Florida.

General Leave

Mr. MILLER of Florida. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days within which to revise and extend
their remarks.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Florida?
There was no objection.
Mr. MILLER of Florida. Mr. Speaker, I yield myself such time as I may
consume.
I rise today in support of the conference report to accompany H.R.
3230, the Veterans' Access to Care through Choice, Accountability, and
Transparency Act of 2014.
General Omar Bradley, the former administrator of what is now the
Department of Veterans Affairs, once said of our work, ``We are dealing
with veterans, not procedures--with their problems, not ours.''
We have come face-to-face with the problems our veterans routinely
encounter, and they are considerable to say the least. As every
American now knows, congressional oversight and whistleblower
revelations have exposed widespread corruption and systemic delays in
access and failures of accountability across our Nation's second
largest bureaucracy.
Thousands of veterans across this country have been left to wait--
some for years; some in pain; and, most disturbingly, some in caskets
that are draped with American flags; some while chronic or fatal
conditions worsened until little hope was left--for the health care
they earned through their honorable service to our Nation. Meanwhile,
poor-performing VA leaders and employees continued to receive large
bonuses, subject to little accountability for their many inadequacies.
There is no doubt, Mr. Speaker, that the Department of Veterans
Affairs, as we know it today, is in crisis, and as a result, our
veterans are suffering. The conference report we are considering this
afternoon is the first step to alleviating their pain and for paving
the

[[Page H7079]]

way for the failing VA health care system to experience much-needed
structural and cultural reform.
To immediately improve access to care for veteran patients, the
conference report would require the VA to authorize non-VA care to any
eligible veteran who is unable to secure a timely appointment at a VA
facility or who resides more than 40 miles from the nearest VA medical
facility, with certain exceptions.
Eligible veterans would include those who are enrolled in the VA
health care system as of August 1 of 2014 or who are newly-discharged
combat veterans.
It would further require the VA to issue a veterans choice card to
eligible veterans to facilitate care provided by non-VA providers and
provide $10 billion for the newly-established veterans choice fund to
cover the costs of access to non-VA care under this bill.
To lead the way for true reform in the long term, the conference
report would require a comprehensive assessment of VA care by an expert
independent entity or entities and would establish a congressional
commission on care, which would be charged with setting the future
course for access to and quality care throughout the entire VA health
care system.
To improve the VA's internal capacity to provide timely and high-
quality care to our veterans, this report would also provide the
Department with $5 billion to hire physicians and other clinical staff
and would provide for certain critical physical infrastructure
improvements.
The conference report would also extend the VA's rural health care-
focused project, ARCH--a pilot program--for an additional 2 years. It
would extend the pilot program for an additional 3 years to provide
rehabilitation, quality of life, and community integration services to
veterans with traumatic brain injury.
It would authorize 27 medical facility leases across 18 States and
Puerto Rico and make certain improvements to care provided to veterans
who have experienced military sexual trauma and others.
To advance genuine accountability for incompetent or corrupt senior
managers, the conference report would reduce funding for bonuses
available to VA employees by $40 million each year through fiscal year
2024, and it would authorize the Secretary to fire or demote Senior
Executive Service employees and title 38 SES equivalent employees for
poor performance or misconduct. Poor-performing employees who are
disciplined under this authority would be provided an expedited and
limited appeal process, but would be prohibited from receiving their
pay, bonuses, or benefits during the appeal process.
This provision will give the Secretary the tools he needs to
expeditiously hold senior managers accountable for the types of willful
misconduct and possibly criminal negligence we have seen during our
investigations.
The conference report would also require public colleges to provide
instate tuition to veterans and eligible dependents for the school to
remain eligible to receive GI Bill education payments.
This provision closely mirrors the bill that I offered, H.R. 357, the
GI Bill Tuition Fairness Act, which passed the House earlier this year.
The men and women who served this Nation did not just defend the
citizens of their home States; they defended the entire United States
of America.
The conference report would also include approximately $5 billion in
offsets with additional incidental offsets expected to accrue over time
as a result of increased third-party collections for nonservice-
connected conditions and reductions in Medicare payments as a result of
the increased utilization of the newly-created choice program.
Mr. Speaker, the bill before us is one that I am proud of, but more
importantly, it is one that I believe our Nation's veterans can be
proud of. It is not a blank check for a broken system, but it is an
important first step down a long road toward true transformation.
However, our work is far from over. We all know that congressional
oversight was crucial to bringing the failures at the VA to light, and
it will increase in the days and weeks and months ahead after the
passage of this bill.
The passage of this conference report will increase access to care
and improve accountability within a desperately broken bureaucracy.
However, the reform that is necessary to reforming the agency will
require dedication for years to come, and I would ask all of my
colleagues to join me in beginning that effort today.
I reserve the balance of my time.

{time} 1515

Mr. MICHAUD. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in strong support of the conference report
to H.R. 3230, the Veterans Access, Choice, and Accountability Act of
2014.
I would like to thank Chairman Miller, Senator Sanders, Senator Burr,
and the other members of the conference committee for working so
diligently on this legislation.
Even when it looked like an agreement would not be possible to
achieve a compromise and bring it to the House floor today, at the end
of the day, we all worked together to make sure our national commitment
to veterans is there. This compromise agreement can serve as a model on
how Congress should look at serious problems facing our country and how
to address them.
It has been a long road getting here. The House Veterans' Affairs
Committee, under Chairman Miller's leadership, has held over a dozen
oversight hearings in the past couple of months alone. We have heard
from veterans, their families, VA employees, and veterans service
organizations about what is and what isn't working within the
Department of Veterans Affairs.
The measure before us today isn't a long-term solution to all of the
VA's problems, but it is an appropriate and well-crafted response to
the immediate problems of veterans not being able to access quality
health care in a timely fashion.
This bill also takes important steps to begin to address the systemic
problems within the Department of Veterans Affairs that have led to
this crisis: too few doctors, inadequate infrastructure, and a
management culture that is asleep at the wheel. It holds those whom the
Nation has entrusted with our veterans' lives and well-being
responsible for the outcomes.
For the 12 years that I have been on the Veterans' Affairs Committee,
I have fought to ensure that our veterans, especially those who are
living in rural areas, have access to quality health care. I fought for
the needs of veterans returning from the current conflicts, while not
forgetting the sacrifices and the needs of veterans from previous
conflicts.
One of the successes that you heard from Chairman Miller earlier I am
most proud of is the Project ARCH. The Access Received Closer to Home
project expands the opportunity for rural veterans to receive health
care without long drives to a VA facility many miles away. I am pleased
to see that the conference report extends and expands this important
program. It is critical for the thousands of veterans who live in
districts like mine. Many veterans in my district would be forced to
make a nearly 600-mile round trip drive to the nearest VA facility if
it weren't for ARCH.
Another important aspect of this bill not only deals with Senior
Executive Service, but also the title 38 employees, which covers about
80,000 within the VA. It sets metrics and outcomes and accountability
for those employees.
This bill also will address the immediate problem of long waiting
times for health care, while beginning to strengthen the VA, so we are
not facing the same crisis next year or the year after.
But I would also like to remind my colleagues that this bill is only
the first step. After 12 years on the House Veterans' Affairs
Committee, I am more convinced than ever that we must begin to talk
about the innovative solutions that will truly modernize the Department
and better meet the needs of current and future veterans.
Far too often, the good intentions underlying the laws that we passed
are stymied by an organizational structure that has originated back in
the seventies and eighties. Far too often, the good intentions of the
Department of Veterans' Affairs employees meet the wall of bureaucratic
indifference. Far too often, our veterans ask for help and there is no
one there at the other end to answer for that help.

[[Page H7080]]

This is totally unacceptable, and it is why I believe we must begin
the work of radically restructuring the Department of Veterans'
Affairs. We must restructure it to better assist our veterans, to
better live up to the promises we have made to them. We need to look at
the fundamental business model, the processes, the organization, the
technology, the data and information and the workforce capabilities.
Our work today is to pass this conference report and get it to the
President's desk as quickly as possible so that we can fix the current
crisis. The work for tomorrow is the work that I ask each and every one
of my colleagues to continue working on: to make sure that the
Department of Veterans Affairs evolves to a new, more veteran-centered
Department of Veterans Affairs.
It is going to take a lot of work and a lot of oversight, as you
heard the chairman mention earlier. Once again, I would encourage my
colleagues to pass this bill.
Mr. Speaker, I reserve the balance of my time.
Mr. MILLER of Florida. Mr. Speaker, it is my pleasure to yield 2
minutes to the gentleman from Colorado (Mr. Lamborn), a member of the
conference committee.
Mr. LAMBORN. Mr. Speaker, I would like to thank Chairman Jeff Miller
for his continued leadership as we work to provide our veterans with
the care and benefits that they have earned.
Keeping the promises that we have made to our veterans and their
families is of utmost importance to me and all Americans. This piece of
legislation is a major step in the process of restoring veteran trust
in the VA.
This bill will expand access to non-VA care, making wait times
shorter and increase convenience. Although this will ensure veterans
who are currently on a waiting list will get the timely care they
deserve, much more needs to be done.
I am especially pleased that an independent congressional committee
on care will be formed to look at the VA from the ground up. For
lasting change to take place, the corrupt culture shown by some in the
VA must be purged. It must be replaced with an ethos that puts the
veteran first.
By authorizing the Secretary of the VA to fire senior employees that
are guilty of poor performance or misconduct, this bill ensures that
newly confirmed Secretary McDonald will have more tools to hold
individuals accountable for their actions. However, granting this
authority will mean nothing if it isn't combined with the leadership
required to always do the right things for our veterans. Through his
words and actions, Secretary McDonald must make it clear from day one
that individuals will be held accountable, whistleblowers will be
protected, and anyone responsible for poor performance, negligence, or
preventable deaths, even, will be held accountable.
It has been an honor to serve with the chairman during this
conference committee.
I urge my colleagues to join me in supporting the VA conference
report.
Mr. MICHAUD. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman
from Nevada (Ms. Titus).
Ms. TITUS. Mr. Speaker, I thank my friend for yielding.
I thank Mr. Michaud and Chairman Miller for their leadership on this
important bill.
As a member of the House Veterans' Affairs Committee, I have been
working with my colleagues to ensure that veterans have access to the
highest quality care in a timely fashion. This legislation before us
takes important steps towards that goal.

I am especially pleased that the compromise includes three of my
bills, which ensure that: one, all victims of sexual assault in the
military, including those in the National Guard, have access to the
care they need; two, that spouses of those who have died in service to
our country get education benefits; and, three, more residencies are
going to be funded at VA hospitals in areas of the country that are
underserved by doctors in private practice.
Our committee, I know, will continue to work in a bipartisan fashion
with the new Secretary to ensure that all veterans have access to the
benefits and care that they have so bravely earned.
Today, we are acting on behalf of a grateful Nation to provide our
country's heroes the care they need and restore their trust in the VA.
So I urge my colleagues to support this conference report to the
Veterans Access, Choice, and Accountability Act.
Mr. MILLER of Florida. Mr. Speaker, it is a pleasure to yield 2
minutes to the gentleman from Tennessee (Mr. Roe), a veteran, a
physician, and also a member of the conference committee.
Mr. ROE of Tennessee. Mr. Speaker, it is a pleasure to stand before
this body in support of the conference report, the first major step in
providing timely, high-quality health care to the veterans who so
selflessly served this great Nation. As a physician, veteran, and
member of the Veterans' Affairs Committee, it was an honor to have
served on the conference committee.
Mr. Speaker, a corrosive culture has been allowed to exist within the
Veterans Affairs bureaucracy for far too long and to the detriment of
our veterans. The most important thing this bill does is give the
veterans who are experiencing long wait times or live more than 40
miles from the nearest VA facility a choice. These veterans will now be
able to obtain a veterans choice card, which will allow them to seek
care in the private sector. Only by forcing the VA to compete will we
achieve the cultural change that is required in how they serve
veterans.
I have met with many physicians in recent weeks, and the desire to
help our veterans is stronger than ever. Hospitals and physicians,
alike, are ready and willing to care for veterans, helping to address a
crisis created by VA mismanagement.
Moving forward, this report creates a process by which we can make
significant strides toward accountability, by giving the VA Secretary
the ability to fire senior employees who fail to do their jobs and
ensuring that there will be swift, harsh penalties for knowingly
misreporting or falsifying information.
This agreement will also improve educational benefits for veterans
and their dependents.
As the founder and cochair of the House Invisible Wounds Caucus along
with my friend Tim Walz, I am pleased this report includes a provision
to extend an important pilot program intended to help veterans with
traumatic brain injuries for 3 more years.
The negotiations were tough, but I know the final product will have a
very positive impact on the lives of our veterans, and I would like to
thank the House and Senate VA committee staffs for all their late
nights and hard work they put into this toward this worthy goal.
Mr. Speaker, I applaud the chairmen, Miller and Sanders, for their
leadership throughout this process, along with Ranking Member Michaud
and Senator Burr.
I urge all of my colleagues to support this report.
Mr. MICHAUD. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Arizona (Mrs. Kirkpatrick).
Mrs. KIRKPATRICK. Mr. Speaker, I urge all my colleagues to support
H.R. 3230.
As a member of the conference committee, I pushed for negotiations on
this bill to continue because veterans have waited too long for the
care they deserve.
This bill reflects the comprehensive, meaningful reforms that passed
the Senate and that I introduced as the companion bill in the House.
This bill ensures that rural veterans who live too far from a veterans'
medical facility and veterans who have waited too long for an
appointment can see a provider closer to home.
For the tribal veterans in my district, this bill strengthens the
relationship between the Veterans Administration and the Indian Health
Services.
This bill also ensures that the Veterans Administration can quickly
hire more doctors, nurses, and medical professionals, and this bill
gives the Veterans Administration Secretary the authority to hold VA
employees accountable.
Our veterans deserve world-class health care and a VA that puts
veterans first. I believe this bill provides the foundation to do just
that. Again, I urge all my colleagues to vote for this bill so it can
be signed into law without delay.
Mr. MILLER of Florida. Mr. Speaker, it is a pleasure to yield 2
minutes to the gentleman from Michigan (Mr.

[[Page H7081]]

Benishek), a former physician within the VA system.
Mr. BENISHEK. Mr. Speaker, I rise in strong support of the conference
report to the Veterans Access to Care Act.
As a doctor who served at the VA hospital in Iron Mountain, Michigan,
for 20 years, I have seen firsthand how Washington bureaucracy can keep
doctors and nurses from taking care of veterans. On its most basic
level, this is the sacred mission of the VA, and the VA has failed.
Today we take an important step toward reversing that failure. Most
urgently, our bill will allow veterans suffering long waits for care
the option to be seen by a local doctor at a private hospital. I
believe every veteran should have a choice as to where they receive
care, and this bill moves us closer to that goal.
But this triage measure is not the long-term solution. That is why
our bill directs the VA to tap the best health care minds that we have
in this country to go step by step through the system and write us a
blueprint for a lean, smart, 21st century VA.
Our bill is not perfect, and the problems at the VA will not be
solved overnight. However, this landmark effort is the best chance we
have had in years to make fundamental changes to the way the VA
operates.
Make no mistake, our true test comes next. We must continue to keep
the pressure on the VA long after the headlines have faded and the
worst employees have been fired, because our veterans will still be
there and they will still deserve to be at the top of our priority
list.
As the father of a veteran myself, I am committed to refusing to let
this issue go. We will demand results, and we will demand swift and
full implementation of this legislation. Anything short of that is not
worthy of our veterans and is unacceptable.
Mr. Speaker, I urge my colleagues to support the conference report.

{time} 1530

Mr. MICHAUD. Mr. Speaker, I yield 2 minutes and 35 seconds to the
gentlewoman from Florida (Ms. Brown).
Ms. BROWN of Florida. Mr. Speaker, as the most senior member of the
House Veterans' Affairs Committee, I strongly believe that the VA
provides the best care for our Nation's servicemembers returning from
protecting the freedoms we most hold dear, and I am committed to VA
continuing their critical mission of serving our veterans.
VA has served the special needs of our returning veterans for over 75
years and has expertise in their unique health care needs, including
prosthetics, traumatic brain injury, post-traumatic stress disorder,
and a host of other veteran-specific injuries. My focus continues to be
on ensuring that the VA retains the unique responsibility for the
health care our veterans receive, regardless of the provider.
The bill includes critical language that I discussed with Senator
Bernie Sanders of Vermont to ensure the VA has the final authority over
the care that the veterans receive, whether at the VA or at non-VA
providers. We need to continue to work with our veteran stakeholders to
ensure the VA has all the resources it needs to provide superior health
care to our veterans.
I am looking forward to working with the new VA Secretary. And I want
to thank the past Secretaries. I have worked with past Secretaries from
Jesse Brown to the present one.
I know a lot of people will say that we have given the VA everything
they need. But of course many of us don't have institutional memory.
I remember the first time the VA got the real budget they wanted in
2009 under President Barack Obama, when we had a Democratic House and a
Democratic Senate. So a lot of us talk the talk, walk the walk, but
don't really roll the roll.
So we have got to make sure as we move forward that we don't just
talk about providing service, but that we really provide service and we
ensure that the veterans have the service that the first President,
George Washington, promised the veterans.
And I do want to thank our chairperson, Mr. Miller of Florida, for
his leadership and the way he has conducted our meetings, and also our
ranking member.
Mr. MILLER of Florida. Mr. Speaker, it is my pleasure to yield 1
minute and 35 seconds to the gentleman from Colorado (Mr. Coffman), a
United States veteran and another member of the conference committee.
Mr. COFFMAN. Mr. Speaker, I want to start by thanking Chairman Miller
for his dedicated work on behalf of our veterans.
As a Marine Corps combat veteran and chairman of the House Veterans'
Affairs Subcommittee on Oversight and Investigations, I have spent the
past year working side-by-side with the members of my subcommittee and
with Chairman Miller to investigate and uncover the largest scandal in
the history of the Department of Veterans Affairs.
I am proud that Republicans and Democrats were able to put aside
their partisan differences to focus on supporting our Nation's warriors
with choice, accountability, and greater transparency. These reforms
will allow veterans to vote with their feet if they cannot get an
appointment within a reasonable timeframe at a VA facility.
I am also proud that we were able to include much-needed reforms on
the treatment of victims of sexual assault in the military. The scourge
of sexual assault in the military and the corruption of covered-up
waiting lists at VA hospitals are shameful acts, and we must work
together to confront them head on.
Mr. MICHAUD. Mr. Speaker, how much time do I have remaining?
The SPEAKER pro tempore. The gentleman from Maine has 10 minutes
remaining. The gentleman from Florida has 6\1/2\ minutes remaining.
Mr. MICHAUD. Mr. Speaker, at this time, I yield 2 minutes to the
gentleman from Maryland (Mr. Hoyer).
Mr. HOYER. I thank the gentleman for yielding. I congratulate Mr.
Miller, the chairman of the committee, and Mr. Michaud, the ranking
member, for working together to get this done.
Mr. Speaker, this bill is the result of a bipartisan agreement. And
while I have some serious concerns about a number of provisions of
which I will speak, I am supporting it because it assigns resources to
help cut down the waiting times for veterans to get the care they need
and that we owe them. That must be our number one goal.
I remain deeply outraged, as so many of us are, by what transpired in
Phoenix and at other VA facilities, where our wounded warriors were
made to wait weeks, months to get an appointment and receive treatment,
including for serious postdeployment mental health issues. That is not
acceptable. This is more than unacceptable, however. It is
unconscionable.
I think there is wide agreement on both sides of the aisle that any
VA personnel who facilitated this wrongdoing or undermined veterans'
health care must be held accountable.
However, Mr. Speaker, I am concerned with provisions in this bill
regarding the removal of senior executive personnel. While this bill
does improve on the House version by adding a 21-day period for
appeals, it still undermines civil service protections that had been in
place for decades to ensure a merit service, not a politicized,
patronage service.
There are already strict rules in place that facilitate the swift
removal of SES officials who do not perform their jobs responsibly, as
there should be.
Those protections strike the right balance between giving agencies
the authority to remove personnel without trampling on the due process
rights of SES employees, who need to do their job without fear of
political reprisal or arbitrary removal.
Having said that, Mr. Speaker, this bill addresses major challenges
at the VA. It provides resources to ensure that our veterans can access
health care at private facilities if they face a very long wait or live
in rural areas far from VA doctors.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. MICHAUD. I yield the gentleman an additional 30 seconds.
Mr. HOYER. I thank the gentleman.
And it makes health care services more available and accessible to
veterans through additional resources for medical and other VA
personnel.
This, of course, is not a perfect bill. But then again, I don't think
I have ever voted for a perfect bill. But this is a good bill that
moves in the right direction.

[[Page H7082]]

Again, I congratulate Mr. Miller and Mr. Michaud on their work on
this very important piece of legislation.
Mr. MILLER of Florida. Mr. Speaker, at this time, I yield 2 minutes
to the gentlewoman from Indiana (Mrs. Walorski), another member of our
conference committee and an outstanding member of the full committee.
Mrs. WALORSKI. Mr. Speaker, I would like to say to Chairman Miller
and Ranking Member Michaud, on behalf of the 54,000 veterans in my
district and the 20 million around the country, thank you. And to every
conferee that has served on this conference committee, thank you. This
is a huge step forward today, and I am grateful to have been a part of
this process. The need for this legislation and for our conference
committee to have worked together was great, and it has been an
incredible experience.

Let's not forget, in the past decade, nearly 1,000 veterans have died
as a result of substandard treatment from the Department of Veterans
Affairs, and many more cases are under investigation. Mr. Speaker,
50,000 new patients have waited at least 90 days for their first
appointment at VA hospitals. VA staff have admitted to falsifying
medical appointment dates to fit within the agency's wait time
performance goal of 14 days. All these facts have been simply
appalling. All of us in Congress have constituents who have been
directly impacted by this scandal.
The need for the legislation is so timely today. I just came from the
World War II Memorial, and I thanked a veteran from the Chicagoland-
Indiana area. I shook his hand, looked him in the eye, and thanked him
for serving our Nation. He stood up out of his wheelchair, looked me in
the eye, and said: ``Thank you for fighting for us.'' It just simply
shows how important this is. This is an opportunity, as legislators, to
take the first steps toward real change at the VA.
So today we stand together to help our Nation's heroes. We owe it to
our veterans to provide them with nothing but the best. However,
echoing the chairman's comments, simply providing a financial boost to
an agency that has repeatedly demonstrated awful management practices
will not solve the problem.
In the coming weeks and months, we must continue to stand together to
ensure additional improvements are made to the VA. I urge my colleagues
to vote in support of this bill.
Mr. MICHAUD. Mr. Speaker, at this time, I yield 1 minute to the
gentlewoman from Texas (Ms. Jackson Lee).
Ms. JACKSON LEE. Mr. Speaker, I thank the gentlemen very much on
behalf of the State that has one of the largest populations of
veterans, including those in my congressional district. I would like to
say thank you.
To Ranking Member Michaud and Chairman Miller, thank you for allowing
me to sit in on a hearing. Thank you to the conferees. Thank you for
understanding that, when our soldiers put on the uniform, have any of
us ever had them question why? And therefore, we should never question
why are we giving the best service that we can give to our veterans.
I am grateful for the $5 billion that allows this temporary
flexibility, that if you cannot get service, you are, in fact, able to
go to civilian doctors.
The professionals that are going to be added with primary and
specialty doctors are the TMI, housing, PTSD, sexual assault. All of
these are making a difference.
In the name of the World War II veteran that I saw in Normandy, by
the name of Curtis, a veteran in my district who had an appointment in
2013 and never heard back from the veterans hospital, in his name, I
believe that this is the most important opportunity. We should vote for
this and be able to provide our veterans with the promise we have made
to them: You serve, and we will serve you.
God bless America.
Mr. Speaker, as a senior member of the Judiciary and Homeland
Security Committees, I rise in strong support of the Conference Report
to H.R. 3230, ``Veterans Access, Choice, and Accountability Act of
2014.''
We must remember that freedom is not free and pause to recognize the
valor and self-sacrifice of our nation's veterans.
We also need to keep our promises to the nation's more than 2 million
troops and reservists and 23 million veterans.
I support the Conference Report for 6 principle reasons. The
legislation before us:
1. Expands access to health care for veterans;
2. Addresses the shortage of health professionals in the VA;
3. Ensures access to care for rural veterans;
4. Provides funding to establish 27 new VA clinics;
5. Expands access to education for veterans and their families; and
6. Extends a community-based housing program for veterans.
Specifically, the conference report provides that the bulk of the
funding in this agreement--$10 billion in emergency funding--be used to
expand access to non-VA health care options for veterans who have been
left waiting for more than 30 days for an appointment or live more than
40 miles from the nearest VA facility.
Additionally, the bill provides $5 billion to VA to hire more primary
and specialty care physicians and other medical staff and includes
incentives to attract more doctors, nurses and other medical personnel
to the VA, and to increase medical education opportunities to attract
doctors in the future.
Third, the bill extends the ARCH (Access Received Closer to Home)
pilot program for two years. The ARCH program expands VA's ability to
serve veterans who live far from VA facilities in Northern Maine;
Farmville, Virginia; Pratt, Kansas; Flagstaff, Arizona; and Billings,
Montana.
Fourth, the bill expands VA authority to provide counseling, care and
other services to veterans and certain other non-veteran service
members who have experienced military sexual trauma during active or
inactive duty training (including members of the National Guard and
Reserves). The legislation also requires the VA and DOD to conduct an
annual assessment focused on the transition and continuum of care from
DOD to VA for those who have experiences military sexual trauma.
Fifth, the conference report includes $1.5 billion to lease 27 new VA
clinics, including a new research facility in my home city of Houston,
Texas, bringing care closer to where veterans live and increasing
access to specialty care services.
Sixth, the Conference Report permits veterans who are eligible for
education benefits under the Post 9-11 New GI Bill to qualify for in-
state tuition and it expands the Marine Gunnery Sergeant John David Fry
Scholarship to include spouses of members of the Air Force who die in
the line duty while serving in active duty.
Finally, the Conference Report gives the VA Secretary the authority
to immediately fire or demote senior executives based on poor job
performance or misconduct but includes an expedited appeals process for
terminated employees to prevent political firings and protect
whistleblowers from retaliation.
Mr. Speaker, my state of Texas and Houston appreciates the service
and sacrifices of veterans and takes care of them.
The Michael E. DeBakey VA Medical Center, for example, located in
Houston, Texas serves the 32,477 veterans and is the primary healthcare
provider for almost 130,000 veterans in southeast Texas.
Veterans from around the country are referred to the DeBakey VA
Medical Center for specialized diagnostic care, radiation therapy,
surgery, and medical treatment including cardiovascular surgery,
gastrointestinal endoscopy, nuclear medicine, ophthalmology, and
treatment of spinal cord injury and diseases.
DeBakey VA Medical Center provides vital healthcare services to
Veterans in the Houston area and through the nation.
I am proud to support the Conference Report since veterans from
Houston and surrounding regions will benefit with the establishment of
a new facility that will extend access to specialty care services.
Mr. Speaker, in addition to long wait times at VA facilities, many
veterans face a number of other challenges, including homelessness,
coping with PTSD, and finding suitable employment in the civilian job
market.
To address these problems, earlier this year I was successful in
passing amendments to this year's Military Construction and Veterans
Affairs Appropriations Act and the Defense Appropriations Act providing
additional funding and resources targeted to helping homeless veterans
secure housing and treating veterans suffering from PTSD in underserved
urban and rural areas.
I also introduced H.R. 4110, the ``Transitioning Heroes Act of
2014,'' which provides strong tax incentives for employers to hire,
retain, and employ veterans in positions that take maximum advantage of
their skills and experience.
Mr. Speaker, our men and women in the military have fulfilled a
commitment to this nation and to each other that we should imitate in
our actions to work to provide for veterans now that their military
service has ended.
That is why as Members of Congress we need to make sure our veterans
receive the best medical care that modern medicine has to offer to them
and their families.

[[Page H7083]]

That is why I urge my colleagues to join me in supporting the
Conference Report to H.R. 3230, ``Veterans Access, Choice, and
Accountability Act of 2014.''
Mr. MILLER of Florida. Mr. Speaker, I yield 1\1/2\ minutes to the
gentleman from Florida (Mr. Bilirakis), the vice chairman of the full
committee and a member of the conference committee.
Mr. BILIRAKIS. I thank the gentleman for yielding.
Today I rise in support of the VA conference report on H.R. 3230. The
Veterans Access, Choice and Accountability Act of 2014 is a positive
first step toward reforming the VA, which provides, among other things,
relief to veterans who have waited excessively to receive the health
care they have earned at a level of quality they deserve, Mr. Speaker.
This bill also includes real accountability provisions, allowing the
VA Secretary to fire or demote Senior Executive Service employees for
lack of performance and management negligence.
This reform package is focused around ensuring the veteran has timely
access to quality care and includes language to authorize 27 major
medical facility leases, including one in Pasco County, Florida, in my
congressional district.
The veterans in my area will soon have the ability to seek treatments
at a consolidated clinic, thanks to Chairman Miller, as opposed to
having to travel between the main clinic and four other satellite
facilities.
Authorizing these leases will improve the timeliness for veterans to
receive care in Pasco County and in 17 other States throughout the
Nation, as well as Puerto Rico.
Passage of this bill is the beginning, not the end. Obviously much
work needs to be done. However, immediate action needs to be taken to
get veterans off waiting lists and ensure they receive care within the
VA health system or in the private sector, if they so choose. The
veteran should have the choice. We need to get this done for our
veterans.
I urge passage of the bill.
Mr. MICHAUD. Mr. Speaker, at this time, I yield 1 minute to the
gentleman from California (Mr. Takano).
Mr. TAKANO. Mr. Speaker, I rise in support of the conference report.
I want to thank Chairman Miller for the gracious way that he has
conducted the committee hearings, and I thank Ranking Member Michaud
for his hard work.
Principally, I am very pleased that this conference report also
includes 1,500 funded graduate medical school education slots at
veterans facilities around this country. It was a good thing that we
approved access to non-VA care for those servicemembers, those veterans
who have been on waiting lists for far too long. But that would not be
satisfactory to those areas of the country that are experiencing
physician shortages. This is a huge, huge accomplishment for a Congress
that is so partisan to approve these 1,500 funded GMEs.
I urge all my colleagues to support the conference report.
Mr. MILLER of Florida. Mr. Speaker, I yield 1\1/2\ minutes to the
gentleman from Kansas (Mr. Huelskamp).
Mr. HUELSKAMP. Mr. Speaker, I thank the chairman for his work on this
bill.
As a member of the Veterans' Affairs Committee, I want to take a
moment to share a little about what this bill means for my Kansas
veterans.
Since coming to Congress, I have heard dozens of stories from Kansas
veterans about their troubles with the VA. They have shared about how
they are required to travel hundreds of miles for simple medical tests
or to renew their prescriptions, all the while, driving past dozens of
local hospitals and other health care providers with the ability and
desire to meet their needs locally. Many Kansas veterans drive halfway
across the State or to Colorado, Nebraska, or even Texas to get their
simplest health care needs met.
In fact, just yesterday, my office had to step in to help a 94-year-
old World War II veteran. The nearest VA hospital was 240 miles away.
He just had a recent serious surgery, and they said, you have to come
into the hospital to renew your prescriptions.

{time} 1545

Thankfully, I was able to contact the VA and ensure this veteran
could get his care in his local community, but as I tell folks in
Kansas, you shouldn't have to call your Congressman to get the care you
deserve.
With this bill, hundreds of rural Kansas veterans will be able to use
their new veteran choice card or Project ARCH, call their local doctor,
and get their health care needs met. Just like Medicare or TRICARE,
veterans should have the choice to schedule their own appointments,
pick their own doctors in their own communities.
When our veterans come back from serving and defending our country
and return to communities across the United States, most of them don't
ask for much, but I want our veterans to know that I believe you
deserve the best, not just the mediocre, scandal-plagued culture we
have seen at the current VA.
This bill is just plain common sense. It is a big first step towards
giving veterans real choice and real accountability. As this law is
implemented, I remain committed to continuing to ask the hard questions
and working to return the VA to its true mission, to serve our
veterans.
The SPEAKER pro tempore. The gentleman from Maine has 5\1/2\ minutes
remaining. The gentleman from Florida has 2 minutes remaining.
Mr. MICHAUD. Mr. Speaker, I yield 1 minute to the gentleman from West
Virginia (Mr. Rahall).
Mr. RAHALL. Mr. Speaker, I commend Chairman Miller and Ranking Member
Michaud for bringing this Veterans' Access to Care Through Choice,
Accountability, and Transparency Act to us today.
In medically-underserved communities, where health care staffing
shortages have caused delays in appointments, this conference agreement
will help provide critical investments so that the VA can begin hiring
the doctors it needs to serve our veterans.
It will help to reduce the backlog in VA construction and maintenance
projects. It will help to ensure that veterans unable to get a medical
appointment at a VA facility will be able to get the care they need
from a non-VA provider.
This legislation can do a lot of good, but it is only a first step.
The bill must be implemented, regulations issued, and scarce moneys
allocated to ensure that veterans get the care that this legislation
promises.
We must not lose sight of the rural, underserved areas in our Nation
like in southern West Virginia, where veterans are elderly and travel
is costly and burdensome. We must not lose sight of the need for
medical facilities and health providers in those areas.
I urge the VA to remember rural veterans as it implements this bill,
and I certainly aim to help to ensure that it does so. Again, I commend
the chairman and ranking member for bringing this legislation to us
today.
Mr. MILLER of Florida. Mr. Speaker, I yield 1 minute to the gentleman
from Nebraska (Mr. Terry), someone who always has veterans first in his
mind.
Mr. TERRY. Mr. Speaker, this bill is a necessary repair for our vets'
damage that was caused by VA workers who were willing to allow veterans
to die by denying them care, ostensibly to receive a bonus.
Leave no doubt that this is a patch and that the VA requires a
complete overhaul. For example, 7 years ago, the VA hospital in Omaha
was deemed to be in such poor condition it needed to be replaced ASAP.
It was put on the official list, and in those 7 years since, the
project has actually fallen down the list, as few projects have been
completed.
The VA is just not able to manage major projects. The entire Nebraska
delegation wrote then-Secretary Shinseki over a year ago to meet and
discuss the lack of progress and possible alternatives, but he refused
to meet with our delegation, even after repeated requests.
This is evidence of total dysfunction of this VA in Washington, D.C.
My hope is that the new VA Secretary will be more accommodating to
listen to the Nebraska delegation whose sole goal is simply to help our
veterans receive the appropriate care in a building that meets at least
today's standards.
Mr. MICHAUD. Mr. Speaker, I yield 1 minute to the gentleman from
Arizona (Mr. Barber).

[[Page H7084]]

Mr. BARBER. Mr. Speaker, I am proud and honored to rise today in
support of the Veterans' Access to Care Through Choice, Accountability,
and Transparency Act of 2014 and to commend Representative Miller and
Representative Michaud for their leadership in getting this bill to us
and this conference committee report to us today.
As the son of a veteran of World War II, Korea, and Vietnam, I say it
is long overdue that Congress took action to provide the quality of
care that our veterans have earned. I am here today to fight for
veterans in southern Arizona, of which I represent 85,000, and veterans
all across this Nation.
I have been pushing for better access to health care for our veterans
since I came to Congress a little over 2 years ago. This has become
even more urgent given the tragedy, the disgraceful behavior that we
have uncovered in Phoenix and potentially across veterans centers in
our Nation. To play games with our veterans to get bonuses is
despicable, and this bill, I hope, will move us in a direction of
correcting those terrible actions.
One of the first bills I introduced was the veterans' access to
health care bill to ensure that veterans could get health care they
need in their communities, and this bill, I am glad to say, includes
that provision. I commend the leader, the chairman, and the ranking
member for their work, and I urge all my colleagues to vote ``yes'' for
this important bill for our veterans.
Mr. MICHAUD. Mr. Speaker, I yield 1 minute to the gentleman from
Texas (Mr. Gallego).
Mr. GALLEGO. Mr. Speaker, I, too, rise in support of the conference
committee report, asking all of our fellow members to support it, and I
congratulate the chairman with whom I had a rather spirited
conversation on this floor, as well as the ranking member on
accomplishing the first step, I think, and it is the first step, but it
is a significant step.
I am particularly proud that two of the provisions that I came to
this floor to argue for--that being additional facilities, including an
expansion of the facility in San Antonio, as well as additional support
personnel, medical personnel, and health care personnel--are included
in this bill.
This bill includes so much more: a graduate medical education
component and, in addition, educational opportunities for spouses and
families. This is an incredible first step.
I, again, want to underscore my thanks to the chairman, to the
ranking member, to the members of the conference committee, and this is
a great first step at putting us in the right direction towards finally
treating our veterans with the respect that they not only deserve, but
they have earned over the period of their service.
Mr. MICHAUD. Mr. Speaker, how much time is remaining?
The SPEAKER pro tempore. The gentleman from Maine has 2\1/2\ minutes
remaining. The gentleman from Florida has 1 minute remaining.

Mr. MICHAUD. I yield 1 minute to the gentleman from California (Mr.
Peters).
Mr. PETERS of California. Mr. Speaker, I am proud to state my support
for this agreement, the Veterans' Access to Care through Choice,
Accountability, and Transparency Act of 2014, and thank both Chairman
Miller and Ranking Member Michaud for their leadership on bringing this
issue to a resolution.
Last week, I offered a motion to instruct as a way to spur a
bipartisan solution and to ensure that vets on the GI Bill could pay
lower instate college tuition. I am happy that that provision has been
included.
Enacting the measures offered in this plan will go a long way toward
improving veterans health care though, as everyone noted, there is much
more work to be done. The more than 200,000 veterans who live in San
Diego County deserve access to the medical care and benefits America
has promised them and they have earned.
It is my hope that our action today will give new hope to the many
vets who felt despair and disappointment at the way they have been
treated by the VA after all they have sacrificed. Today, we send a
bipartisan message to them: America keeps its promises to our veterans.
Mr. MICHAUD. Mr. Speaker, I have no further speakers, and I am ready
to close.
Mr. Speaker, I would urge my colleagues to support the conference
report to H.R. 3230. This is a very important bill. It is a bill that
we have worked long and hard over the last several months. It is one
that took into consideration a lot of the concerns that Members from
both sides and both bodies had, and we came together with this bill.
I do want to thank Chairman Miller for his hard work and dedication
to our veterans and their families. We would not be here today if it
wasn't his determination in having strong oversight hearings over the
last couple of months within our committee.
I also want to thank staffs on both sides, the majority and minority
staff. I know they have put in thousands of hours for oversight
hearings to work on this conference report to get us where we are
today. We could not have done it without our dedicated staffs on both
sides of the aisle going through this document and making sure that
every Member's concerns were addressed in this document.
With that, I want to once again thank the chairman for your hard work
on this effort and look forward to the vote on this. I encourage all my
colleagues to support this bill.
With that, Mr. Speaker, I yield back the balance of my time.
Mr. MILLER of Florida. Mr. Speaker, I, too, would like to say thank
you to the ranking member of the full House committee, Mr. Michaud, for
his tenacity in what he has done to move this conference report along.
I also want to say thank you to the ranking member, Mr. Burr, in the
Senate and to Senator Sanders because, as we continue to negotiate
through, there never was a willingness to quit by either side.
I am grateful to the 24 other conference committee members who worked
with us, with their input, their ideas, and their willingness to
embrace this compromise. It was brought forth by diligent, focused
effort and a willingness on all sides to put aside differences of
opinion and ideology and focus not on our disagreements, but how best
we can all help our veterans.
While not perfect, this is an example of all the good work we can
accomplish when we work together, and remember, it is the veteran who
is sacred, not the VA.
With that, Mr. Speaker, I yield back the balance of my time.
Mr. BISHOP of Georgia. Mr. Speaker, at this time, there is no Federal
agency more deserving of our attention than the U.S. Department of
Veterans Affairs. The VA has served generations of heroes who have
sacrificed on behalf of our country and we have an obligation to take
care of them when they come home.
Without a doubt, the American people expect and veterans deserve the
best service possible and I firmly believe that it is a duty of all of
us in Congress to ensure that no one betrays the sacred trust owed to
our Veterans.
The failure and mismanagement of care for our veterans that has come
to light through the IG's investigation over the past two months must
never be repeated, and I trust that this bill will go far to help
reverse the failures, and ensure better future treatment of veterans at
the VA.
I think this conference report contains provisions that will help
provide timely care to veterans, hold the management of the Department
of Veterans Affairs accountable, uphold the integrity of the
department, and improve education benefits for veterans and their
dependants--representing a major step in the right direction in meeting
those obligations.
Specific measures to do so include; providing $5 billion to the VA to
hire additional physicians and other medical staff, authorizing a
system for the VA to fire or demote management level employees for poor
performance or misconduct, and increasing access to non-VA care for
those veterans in dire need.
Yesterday, we were greeted with the good news of the Senate
confirmation of the new VA Secretary, Robert McDonald. While the Senate
acted swiftly on the confirmation of McDonald, I was disappointed to
see that the Senate Appropriations Committee Chairwoman was unable to
bring the FY 2015 MilCon/VA Appropriations bill to floor due to
objections from the Senate Minority. If we truly wanted to get the ball
rolling to make the VA better the Senate Minority should allow the bill
to come to the floor.
Nevertheless, I also have full expectation that with the passage of
this conference report it is going to be important that this Congress
hold Secretary McDonald and his subordinates fully accountable moving
forward.

[[Page H7085]]

Many in Congress are concerned about the cost of this bill. One way
to help pay the cost of improved health care for veterans would be to
improve third party collections.
Section 201 of the bill authorizes an independent assessment of a
number of VA activities. Among other provisions, the assessment would
report on ways to increase funds owed to the VA by third parties.
Over the past dozen years, the GAO and the VA/OIG have issued more
than a dozen reports outlining the problems with third party
reimbursement. I hope that the assessment team will not reinvent the
wheel.
We already know that the VA has increased its billings for these
services, but its collection rate has decreased or has remained
stagnant. As a result, in FY13 alone, the VA failed to collect more
than $3 billion in billings. Between FY07 and FY13, the VA left nearly
$23 billion on the table.
The assessment should include specific directives for the improvement
of the entire billings and collections process--from initial billing to
denied claims to appeals of denied claims. The private sector seeks to
maximize reimbursement. The VA should do no less.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Florida (Mr. Miller) that the House suspend the rules
and agree to the conference report on H.R. 3230.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. MILLER of Florida. Mr. Speaker, on that I demand the yeas and
nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further
proceedings on this motion will be postponed.

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