[Congressional Record Volume 161, Number 167 (Tuesday, November 10, 2015)]
[Senate]
[Pages S7878-S7881]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




    MILITARY CONSTRUCTION AND VETERANS AFFAIRS AND RELATED AGENCIES 
                  APPROPRIATIONS ACT, 2016--Continued

  Mr. McCONNELL. Mr. President, what is the pending business?
  The PRESIDING OFFICER. H.R. 2029.


 Amendments Nos. 2774, 2775, 2776, 2779, 2781, 2785, 2786, 2787, 2788, 
            2789, 2795, 2794, and 2798 to Amendment No. 2763

  The PRESIDING OFFICER. Under the previous order, the clerk will 
report the following amendments by number.
  The bill clerk read as follows:


[[Page S7879]]


  

       The Senator from Illinois [Mr. Kirk], for others, proposes 
     amendments numbered 2774, 2785, 2786, 2787, 2788, and 2789 to 
     amendment No. 2763.
       The Senator from Kentucky [Mr. McConnell], for Ms. 
     Murkowski, proposes amendments numbered 2775 and 2776 to 
     amendment No. 2763.
       The Senator from Montana [Mr. Tester], for others, proposes 
     amendments numbered 2779, 2781, 2795, 2794, and 2798 to 
     amendment No. 2763.

  The amendments are as follows:


                           Amendment No. 2774

  (Purpose: To prohibit the use of funds to pay for the transfers or 
relocations of senior executives of the Department of Veterans Affairs)

       At the end of title II, add the following:
       Sec. ___.  None of the amounts appropriated or otherwise 
     made available by title II may be used to carry out the Home 
     Marketing Incentive Program of the Department of Veterans 
     Affairs or to carry out the Appraisal Value Offer Program of 
     the Department with respect to an employee of the Department 
     in a senior executive position (as defined in section 713(g) 
     of title 38, United States Code).


                           Amendment No. 2775

 (Purpose: To require the Comptroller General of the United States to 
   submit to Congress a report evaluating the implementation by the 
 Department of Veterans Affairs of section 101 of the Veterans Access, 
                Choice, and Accountability Act of 2014)

       At the appropriate place, insert the following:
       Sec. __. (a) Not later than one year after the date of the 
     enactment of this Act, the Comptroller General of the United 
     States shall submit to the congressional veterans committees 
     a report evaluating the implementation by the Department of 
     Veterans Affairs of section 101 of the Veterans Access, 
     Choice, and Accountability Act of 2014 (Public Law 113-146; 
     38 U.S.C. 1701 note).
       (b) The report required by subsection (a) shall include, 
     with respect to the implementation of such section 101, an 
     evaluation of the following:
       (1) The effect of such implementation on the reduction in 
     the use of purchased care by the Department, including delays 
     or denials of care and interruptions in courses and 
     continuity of care.
       (2) The ability of health care providers to meet the demand 
     for primary, specialty, and behavioral health care under such 
     section 101 that cannot reasonably be provided in medical 
     facilities of the Department.
       (3) The efforts of the Department to recruit health care 
     providers to provide health care under such section 101.
       (4) The accuracy of the information provided to veterans 
     through call centers regarding the receipt of health care 
     under such section 101.
       (5) The timeliness of referrals of veterans by the 
     Department to health care providers under such section 101.
       (6) Unique issues and difficulties in the implementation of 
     section 101 with respect to veterans residing in rural areas, 
     the States of Alaska and Hawaii and states lacking a full 
     service VA Hospital.
       (7) With respect to rural areas: (A) an identification of 
     the average wait times for veterans in rural areas to receive 
     health care under such section 101, measured from when the 
     veteran first calls the Department or contracted call center 
     to request an appointment; (B) an assessment of utilization 
     rates for health care provided under such section 101 in 
     rural areas (C) an assessment of the accessibility of 
     veterans in rural areas to primary and specialty care at 
     medical centers of the Department and from non-Department 
     health care providers under such section 101; (D) an 
     assessment of the status of any pilot programs created by the 
     Department to provide care under such section 101; (E) an 
     identification of the number of health care providers 
     providing health care under such section 101 to veterans in 
     rural areas, broken out by primary care providers, specialty 
     and subspecialty providers, and behavioral health providers 
     in each Veterans Integrated Service Network.
       (8) Recommendations for such improvements to the provision 
     of health care under such section 101 as the Comptroller 
     General considers appropriate.
       (c) In this section, the term ``congressional veterans 
     committees'' means the Veterans Affairs Committees of the 
     United States Senate and the House of Representatives and the 
     Subcommittee on Military Construction, Veterans Affairs and 
     Related Agencies of the Committees on Appropriations of the 
     United States Senate and the House of Representatives.


                           AMENDMENT NO. 2776

  (Purpose: To require the Secretary of Veterans Affairs to submit to 
Congress a report on the provision of health care to veterans in Alaska 
   through the use of non-Department of Veterans Affairs health care 
                               providers)

       At the appropriate place, insert the following:
       Sec. ___.  Not later than February 1, 2016, the Secretary 
     of Veterans Affairs shall submit to the Committee on 
     Veterans' Affairs of the Senate and the Committee on 
     Veterans' Affairs of the House of Representatives a report 
     that supplements the report required under section 4002(c) of 
     the Surface Transportation and Veterans Health Care Choice 
     Improvement Act of 2015 (Public Law 114-41) and that contains 
     the following:
       (1) A description of the changes in access, if any, of 
     veterans in Alaska to purchased care from the Department of 
     Veterans Affairs that have resulted from implementation of 
     section 101 of the Veterans Access, Choice, and 
     Accountability Act of 2014 (Public Law 113-146), including 
     denials of care and interruptions in the course and 
     continuity of care.
       (2) An assessment of the performance of the Department in 
     providing health care under such section 101 in Alaska, 
     including--
       (A) the performance of call center service provided to 
     veterans;
       (B) the accuracy of call center information provided to 
     veterans and health care providers;
       (C) whether health care providers are agreeing to provide 
     health care under such section 101 in each of the major 
     communities in Alaska;
       (D) gaps in the availability of health care providers, 
     disaggregated by primary, specialty, subspecialty, and 
     behavioral health care;
       (E) impediments to the provision of health care under such 
     section 101; and
       (F) plans to mitigate those impediments.
       (3) An assessment of the status of health care provider 
     vacancies at the VA Alaska Healthcare System as of the date 
     of submittal of the report under this section, including 
     impediments to filling those vacancies and plans to mitigate 
     those impediments.
       (4) A description of the manner in which the Department 
     plans to serve the primary, specialty, and behavioral health 
     care needs of veterans in Alaska if the plan and 
     recommendations set forth in the report submitted under such 
     section 4002(c) are implemented, including a description of 
     specific strategies to be employed by the Department to 
     address gaps in the provision of health care to veterans and 
     the supply and demand of health care providers for veterans, 
     including the roles of tribal health providers and community 
     providers in addressing those gaps.


                           amendment no. 2779

  (Purpose: To require that amounts appropriated to the Department of 
Veterans Affairs for medical and prosthetic research are used to ensure 
the provision of gender appropriate prosthetics and to conduct research 
                       related to toxic exposure)

       On page 31, line 23, strike the period and insert ``: 
     Provided, That such sums are allocated to ensure the 
     provision of gender appropriate prosthetics and to conduct 
     research related to toxic exposure.''


                           amendment no. 2781

  (Purpose: To require that amounts appropriated to the Department of 
Veterans Affairs for medical supplies and equipment are used to procure 
                    gender appropriate prosthetics)

       On page 30, line 6, strike the period and insert ``: 
     Provided further, That the Secretary of Veterans Affairs 
     shall ensure that amounts appropriated to the Department of 
     Veterans Affairs for medical supplies and equipment are 
     allocated to ensure the provision of gender appropriate 
     prosthetics.''


                           amendment no. 2785

 (Purpose: To prohibit the use of funds to carry out Fast Letter 13-10 
     or create or maintain certain patient record-keeping systems)

       At the end of title II, add the following:
       Sec. 247.  None of the amounts appropriated or otherwise 
     made available by this title may be used--
       (1) to carry out the memorandum of the Veterans Benefits 
     Administration known as ``Fast Letter 13-10'', issued on May 
     20, 2013; or
       (2) to create or maintain any patient record-keeping system 
     other than those currently approved by the Department of 
     Veterans Affairs Central Office in Washington, District of 
     Columbia.


                           amendment no. 2786

 (Purpose: To require the Comptroller General of the United States to 
submit to Congress a report on the recruitment and retention of health 
         care providers by the Department of Veterans Affairs)

       At the appropriate place, insert the following:
       Sec. ___. (a) Not later than 180 days after the date of the 
     enactment of this Act, the Comptroller General of the United 
     States shall submit to Congress a report on the recruitment 
     and retention of health care providers by the Department of 
     Veterans Affairs.
       (b) The report required by subsection (a) shall include the 
     following:
       (1) An identification of the ratio of veterans to health 
     care providers of the Department, disaggregated by State.
       (2) An analysis of the workload of primary and specialty 
     care providers of the Department, disaggregated by State.
       (3) An assessment of initiatives carried out by the 
     Veterans Health Administration to recruit and retain health 
     care providers of the Department.
       (4) An assessment of the extent to which the Veterans 
     Health Administration oversees health care providers of the 
     Department.
       (5) Such recommendations for improving the recruitment and 
     retention of health care providers of the Department as the 
     Comptroller General considers appropriate.

[[Page S7880]]

  



                           amendment no. 2787

  (Purpose: To require the Secretary of Veterans Affairs to submit to 
 Congress a report on the implementation by the Department of Veterans 
      Affairs of section 101 of the Veterans Access, Choice, and 
               Accountability Act of 2014 in rural areas)

       At the appropriate place, insert the following:
       Sec. ___. (a) Not later than 180 days after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to Congress a report on the implementation by 
     the Department of Veterans Affairs of section 101 of the 
     Veterans Access, Choice, and Accountability Act of 2014 
     (Public Law 113-146; 38 U.S.C. 1701 note) in rural areas.
       (b) The report required by subsection (a) shall include the 
     following:
       (1) An identification of average wait times for veterans in 
     rural areas to receive health care under such section 101, 
     measured from when the veteran first calls the Department to 
     schedule an appointment.
       (2) An assessment of utilization rates for health care 
     provided under such section 101 in rural areas.
       (3) An assessment of the accessibility of veterans in rural 
     areas to primary and specialty care at medical centers of the 
     Department and from non-Department health care providers 
     under such section 101.
       (4) An identification of the number of health care 
     providers providing health care under such section 101 in 
     each Veterans Integrated Service Network.
       (5) An assessment of the status of any pilot programs 
     created by the Department to provide care under such section 
     101 in rural areas.


                           amendment no. 2788

(Purpose: To require a report on the use of social security numbers by 
 the Department of Veterans Affairs and the plans of the Secretary of 
               Veterans Affairs to discontinue such use)

       At the end of title II, add the following:

     SEC. 247. REPORT ON USE OF SOCIAL SECURITY NUMBERS BY 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) Report Required.--Not later than 120 days after the 
     date of the enactment of this Act, the Secretary of Veterans 
     Affairs shall submit to the appropriate committees of 
     Congress a report on the use of social security numbers by 
     the Department of Veterans Affairs and the plans of the 
     Secretary to discontinue the unnecessary use.
       (b) Contents.--The report required by subsection (a) shall 
     include the following:
       (1) A list of documents and records of the Department of 
     Veterans Affairs that contain social security numbers.
       (2) A list of all government and non-government entities 
     and the numbers of their employees that have access to the 
     social security numbers of veterans that are stored by the 
     Department.
       (3) A description of how the Department, other governmental 
     entities, and persons use social security numbers they obtain 
     from the Department, including a description of any 
     information sharing arrangements that the Secretary may have 
     with the heads of other governmental entities.
       (4) The number of data breaches of Department of Veterans 
     Affairs information systems that involved social security 
     numbers that occurred during the five-year period ending on 
     the date of the enactment of this Act that the Secretary 
     discovered or that were reported to the Secretary, a 
     description and status of the investigations conducted by the 
     Secretary regarding such breaches, and a description of the 
     plans of the Secretary to remediate such breaches.
       (5) The plans of the Secretary, including a timeline, to 
     discontinue the unnecessary use by the Department of social 
     security numbers.
       (c) Appropriate Committees of Congress Defined.--In this 
     section, the term ``appropriate committees of Congress'' 
     means--
       (1) the Committee on Veterans' Affairs and the Committee on 
     Appropriations of the Senate; and
       (2) the Committee on Veterans' Affairs and the Committee on 
     Appropriations of the House of Representatives.


                           amendment no. 2789

  (Purpose: To require the Secretary of Veterans Affairs to submit to 
 Congress a report on wait times for medical appointments at the South 
    Texas Veterans Health Care System of the Department of Veterans 
                                Affairs)

       At the appropriate place, insert the following:
       Sec. ___. (a) Not later than 30 days after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to the appropriate committees of Congress a 
     report that includes, with respect to the South Texas 
     Veterans Health Care System of the Department of Veterans 
     Affairs, the following:
       (1) A description of the nature and scope of any 
     foreseeable increase in wait times for medical appointments.
       (2) An assessment of whether a shortage of health care 
     providers is the primary cause of any such increase in wait 
     times.
       (3) An identification of any other causes of any such 
     increase in wait times.
       (4) A description of any action taken by the Department to 
     correct any such increase in wait times.
       (5) An assessment of any issues relating to access to care.
       (6) A plan for how the Secretary will remedy any such 
     increase in wait times, including a detailed description of 
     steps to be taken and a timeline for completion.
       (b) In this section, the term ``appropriate committees of 
     Congress'' means--
       (1) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the Senate; and
       (2) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the House of Representatives.


                           amendment no. 2795

  (Purpose: To require the Secretary of Veterans Affairs to conduct a 
study on the impact of combat service on suicide rates and other mental 
     health issues among members of the Armed Forces and veterans)

       At the end of title II, add the following:
       Sec. 2__. (a) Not later than 30 days after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall, in consultation with the Secretary of Defense, enter 
     into a contract with an independent third party described in 
     subsection (b) to carry out a study on the impact of 
     participation in combat during service in the Armed Forces on 
     suicides and other mental health issues among members of the 
     Armed Forces and veterans.
       (b) An independent third party described in this subsection 
     is an independent third party that has appropriate 
     credentials to access information in the possession of the 
     Department of Defense and the Department of Veterans Affairs 
     that is necessary to carry out the study required under 
     subsection (a).


                           amendment no. 2794

   (Purpose: To modify the amounts appropriated to the Department of 
   Veterans Affairs for medical services and medical and prosthetic 
                               research)

       At the end of title II, add the following:
       Sec. 2__. (a) The amount appropriated or otherwise made 
     available by this title under the heading ``medical and 
     prosthetic research'' under the heading ``Veterans Health 
     Administration'' is hereby increased by $8,922,462.
       (b) The amount appropriated or otherwise made available by 
     this title for fiscal year 2016 under the heading ``medical 
     services'' under the heading ``Veterans Health 
     Administration'' is hereby reduced by $8,922,462.


                           amendment no. 2798

(Purpose: To make available $5,000,000 for a pilot program on awarding 
 grants to provide furniture, household items, and other assistance to 
       formerly homeless veterans moving into permanent housing)

       At the end of title II, add the following:
       Sec. 247.  Of the amounts appropriated or otherwise made 
     available by this title for ``medical services'', not more 
     than $5,000,000 shall be available to the Secretary of 
     Veterans Affairs to carry out a pilot program to assess the 
     feasibility and advisability of awarding grants to veterans 
     service agencies, veterans service organizations, and 
     nongovernmental organizations to provide furniture, household 
     items, and other assistance to formerly homeless veterans who 
     are moving into permanent housing to facilitate the 
     settlement of such veterans in such housing.

  The PRESIDING OFFICER. Under the previous order, the question is on 
agreeing to the amendments en bloc.
  The amendments (Nos. 2774, 2775, 2776, 2779, 2781, 2785, 2786, 2787, 
2788, 2789, 2795, 2794, and 2798) were agreed to en bloc.
  Mr. McCONNELL. Mr. President, I ask unanimous consent that the Brown 
amendment No. 2801 be called up and agreed to, the Kirk amendment No. 
2764 be withdrawn, and the Senate vote on the Kirk amendment No. 2763, 
as amended; further, that following the disposition of the Kirk 
amendment No. 2763, the bill, as amended, be read a third time and the 
Senate vote on passage of H.R. 2029, as amended.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.


                Amendment No. 2801 to Amendment No. 2763

  The PRESIDING OFFICER. The clerk will report the Brown amendment.
  The senior assistant legislative clerk read as follows:

       The Senator from Montana [Mr. Tester], for Mr. Brown, 
     proposes an amendment numbered 2801 to amendment No. 2763.

  The amendment is as follows:

 (Purpose: To require the Secretary of Veterans Affairs to develop and 
  publish an action plan for improving the vocational rehabilitation 
services and assistance provided by the Department of Veterans Affairs)

       At the end of title II, add the following:

     SEC. 247. DEPARTMENT OF VETERANS AFFAIRS ACTION PLAN TO 
                   IMPROVE VOCATIONAL REHABILITATION AND 
                   EDUCATION.

       (a) In General.--Not later than 270 days after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall develop and publish an action plan for improving the 
     services and assistance provided under chapter 31 of title 
     38, United States Code.

[[Page S7881]]

       (b) Elements.--The plan required by subsection (a) shall 
     include each of the following:
       (1) A comprehensive analysis of, and recommendations and a 
     proposed implementation plan for remedying workload 
     management challenges at regional offices of the Department 
     of Veterans Affairs, including steps to reduce counselor 
     caseloads of veterans participating in a rehabilitation 
     program under such chapter, particularly for counselors who 
     are assisting veterans with traumatic brain injury and post-
     traumatic stress disorder and counselors with educational and 
     vocational counseling workloads.
       (2) A comprehensive analysis of the reasons for the 
     disproportionately low percentage of veterans with service-
     connected disabilities who served in the Armed Forces after 
     September 11, 2001, who opt to participate in a 
     rehabilitation program under such chapter relative to the 
     percentage of such veterans who use their entitlement to 
     educational assistance under chapter 33 of title 38, United 
     States Code, including an analysis of barriers to timely 
     enrollment in rehabilitation programs under chapter 31 of 
     such title and of any barriers to a veteran enrolling in the 
     program of that veteran's choice.
       (3) Recommendations and a proposed implementation plan for 
     encouraging more veterans with service-connected disabilities 
     who served in the Armed Forces after September 11, 2001, to 
     participate in rehabilitation programs under chapter 31 of 
     such title.
       (4) A national staff training program for vocational 
     rehabilitation counselors of the Department that includes the 
     provision of--
       (A) training to assist counselors in understanding the very 
     profound disorientation experienced by veterans with service-
     connected disabilities whose lives and life-plans have been 
     upended and out of their control because of such 
     disabilities;
       (B) training to assist counselors in working in partnership 
     with veterans on individual rehabilitation plans; and
       (C) training on post-traumatic stress disorder and other 
     mental health conditions and on moderate to severe traumatic 
     brain injury that is designed to improve the ability of such 
     counselors to assist veterans with these conditions, 
     including by providing information on the broad spectrum of 
     such conditions and the effect of such conditions on an 
     individual's abilities and functional limitations.

  The PRESIDING OFFICER. Under the previous order, amendment No. 2801 
is agreed to.


                      Amendment No. 2764 Withdrawn

  Under the previous order, amendment No. 2764 is withdrawn.


                     Amendment No. 2763, as Amended

  Under the previous order, the question occurs on the substitute 
amendment, as amended.
  The Senator from Montana.
  Mr. TESTER. Mr. President, if I may have 1 minute, I urge my 
colleagues to vote for this Military Construction-VA appropriations 
bill before us.
  Thank-yous are in order. I thank the chairman, Senator Kirk, and his 
staff, Bob Henke, D'Ann Lettieri, and Patrick Magnuson. I also thank 
Tina Evans and Chad Schulken. By the way, it is Chad's birthday today, 
so make sure you wish him a happy birthday. I also thank Michael Baine, 
Tony McClain, and the other staff who worked on this bill.
  This bill does right by our veterans, and I am proud to have worked 
with our colleagues in this Chamber.
  The PRESIDING OFFICER. The question is on agreeing to the substitute 
amendment, as amended.
  The amendment (No. 2763), as amended, was agreed to.
  The amendment was ordered to be engrossed, and the bill to be read a 
third time.
  The bill was read the third time.
  The PRESIDING OFFICER. The bill having been read the third time, the 
question is, Shall the bill pass?
  Mr. CRAPO. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The senior assistant legislative clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Texas (Mr. Cruz), the Senator from Colorado (Mr. Gardner), 
the Senator from South Carolina (Mr. Graham), the Senator from Nevada 
(Mr. Heller), the Senator from Kentucky (Mr. Paul), the Senator from 
Florida (Mr. Rubio), and the Senator from Louisiana (Mr. Vitter).
  Further, if present and voting, the Senator from Nevada (Mr. Heller) 
would have voted ``yea'' and the Senator from Louisiana (Mr. Vitter) 
would have voted ``yea.''
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 93, nays 0, as follows:

                      [Rollcall Vote No. 302 Leg.]

                                YEAS--93

     Alexander
     Ayotte
     Baldwin
     Barrasso
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Boxer
     Brown
     Burr
     Cantwell
     Capito
     Cardin
     Carper
     Casey
     Cassidy
     Coats
     Cochran
     Collins
     Coons
     Corker
     Cornyn
     Cotton
     Crapo
     Daines
     Donnelly
     Durbin
     Enzi
     Ernst
     Feinstein
     Fischer
     Flake
     Franken
     Gillibrand
     Grassley
     Hatch
     Heinrich
     Heitkamp
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johnson
     Kaine
     King
     Kirk
     Klobuchar
     Lankford
     Leahy
     Lee
     Manchin
     Markey
     McCain
     McCaskill
     McConnell
     Menendez
     Merkley
     Mikulski
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Perdue
     Peters
     Portman
     Reed
     Reid
     Risch
     Roberts
     Rounds
     Sanders
     Sasse
     Schatz
     Schumer
     Scott
     Sessions
     Shaheen
     Shelby
     Stabenow
     Sullivan
     Tester
     Thune
     Tillis
     Toomey
     Udall
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                             NOT VOTING--7

     Cruz
     Gardner
     Graham
     Heller
     Paul
     Rubio
     Vitter
  The bill (H.R. 2029), as amended, was passed.
  The PRESIDING OFFICER. The majority leader.

                          ____________________