[Congressional Record Volume 163, Number 131 (Wednesday, August 2, 2017)]
[Senate]
[Pages S4713-S4714]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                          Veterans Legislation

  Mr. BLUMENTHAL. Mr. President, sometimes bipartisanship and comity do 
work. They have in the last 24 and 48 hours on two measures that are 
critically important to help our Nation's veterans have access to 
benefits and healthcare that they vitally need, that they deserve, and 
that they have earned. Those measures relate to appeals reform and to 
the Choice Program.
  Last night the Senate passed by unanimous consent--which means 
without any objection--H.R. 2288, the Veterans Appeals Improvement and 
Modernization Act of 2017.
  I am proud to have worked on this measure with the chairman of the VA 
Committee, Senator Isakson, when I was the ranking member of that 
committee during the last session. I thank him for his leadership, his 
vision, and his commitment to this very important cause.
  This bipartisan measure now goes to the President. It provides a 
significant step toward securing benefits veterans have earned. Once 
these reforms are fully funded--and they should be--our Nation's 
veterans will no longer be bogged down by a cumbersome, time-consuming, 
irksome, and, in fact, aggravating process that denies them fair and 
full consideration when they appeal their claim's denial. This reform 
will begin--it is only a beginning--a better system involving 
transparency and communication for veterans and their families.
  As ranking member of the Senate Veterans' Affairs Committee, I heard 
testimony that the Department of Veterans Affairs' appeals process 
desperately needs updating and reform. We all in this body have heard 
from our constituents again and again and again about the antiquated 
delay and burdensome process that exists today. The average wait time 
on an appeal today is 5 years. Let me repeat that. The average wait 
time on an appeal is 5 years. Nearly half a million veterans are caught 
in a quagmire--often a quicksand--of repeated consideration, unable to 
claim benefits because of the VA's existing backlog.

  Between fiscal year 2015 and fiscal year 2017, the number of pending 
appeals increased from about 380,000 to 470,000. That is an increase of 
more than 20 percent. The increase in those appeals was the ``bad 
news'' side of improvements in the process to consider the initial 
appeal. There were more appeals because more claims were disposed of, 
but that is no excuse for that kind of delay in appeals.
  We worked with the VA and veterans groups to devise a new appeals 
system that allows veterans to choose an option that is right for them. 
The bill that passed yesterday will create three separate paths. They 
can choose among them for veterans seeking redress from a decision by 
the Veterans Benefits Administration. This reform is vitally important 
because it gives Secretary Shulkin the authority to test the new system 
before its full implementation.
  I know it will take time to implement these changes. It should take 
less time than is predicted because the Veterans Administration owes it 
to our heroes--the men and women who have served and sacrificed for our 
Nation. My constituent caseworkers in Hartford have tried to assist 
many individual veterans with their claims, and these efforts must 
continue around the country in all of our offices even as these new 
reforms are implemented.
  The second area where we joined together in a bipartisan way relates 
to the Choice Program. We have agreed to continue funding by providing 
$2.1 billion and authorizing 28 new leases for medical facilities 
across the country to improve access to the high-quality care provided 
at VA hospitals. Make no mistake, this action is a down payment, not 
the final word. I am going to continue to champion further reforms to

[[Page S4714]]

make sure we improve VA healthcare and enhance access to VA medical 
facilities.
  I am particularly concerned by recent findings made by the VA 
inspector general, Michael Missal, about a troubling lack of health 
information sharing between VA and non-VA providers relating to chronic 
pain treatment. To put it very simply and bluntly, the lack of 
information sharing makes opioid addiction far more likely than it 
should be, especially among veterans who seek care from private 
providers through the Choice system.
  Connecticut was one of the first States in the country to have a 
statewide prescription drug monitoring program. I urged Secretary 
Shulkin at a hearing last year to make sure the VA prescription drug 
monitoring program exchanges information with the State system, which 
has data from private providers. The sharing of information is vital to 
prevent doctor shopping and excessive prescriptions. Without it, 
veterans potentially are susceptible to weaknesses and gaps that enable 
them to seek excessive prescriptions of opioid pain killer treatment 
that can lead to addiction and worse.
  We cannot allow the Veterans Choice Program to exacerbate opioid 
addiction. We must do everything we can to stop the opioid epidemic 
that is ravaging our communities. As Senator Manchin of West Virginia 
and other colleagues have made clear, the VA must close the information 
gap on opioid prescriptions through improved opioid safety initiative 
guidelines and enhanced prescription drug monitoring programs. While we 
work in Congress to reform the Choice Program, I call on the VA to 
immediately take certain commonsense steps, none of them novel or 
original. They have been identified by the inspector general:
  First, require all participating VA Purchased Care providers to 
receive and review evidence-based guidelines for prescribing opioids.
  Second, implement a process to ensure all Purchased Care consults for 
non-VA care include a complete, up-to-date list of medications and 
medical history.
  Third, require non-VA providers to submit opioid prescriptions 
directly to a VA pharmacy for dispensing and recording in the patient's 
VA electronic health record.
  Fourth, ensure that if facility leaders determine that a non-VA 
provider's opioid prescribing practices conflict with the guidelines, 
immediate action is taken to ensure the safety of all veterans 
receiving care from that non-VA provider.
  These are basic protections for our veterans. They are protections 
against overprescribing opioids or negligent misconduct--and worse--on 
the part of non-VA providers and others.
  My hope is that we are beginning on a path to better information 
sharing between those prescription drug monitoring programs at the 
State level for non-VA providers and the VA facilities and providers 
who care for our veterans directly. That information sharing is not a 
luxury or convenience; it is a necessity.
  We must help veterans of every era with their need for prompt appeals 
dispositions and effective healthcare that also protects them from 
opioid addiction. I am hopeful the Senate will quickly pass the Harry 
Walker Colmery Veterans Educational Assistance Act, which has been 
unanimously approved by the House, to make comprehensive improvements 
to the GI bill. I helped to draft this measure and lead it, and I am 
proud the House has approved it.
  We must also help veterans of all eras suffering from toxic exposure 
and make sure we award a Congressional Gold Medal to the American 
Legion and make USERRA protections for our servicemembers meaningful 
and enforceable. These steps are part of an unfinished agenda that we 
owe our veterans. We cannot shirk that duty. We cannot postpone it. It 
is an obligation, not a convenience.
  I look forward to moving forward with these efforts, as we have done 
with Choice and with the appeals reform, and to learning what we know 
already--that we can work together across the aisle when it comes to 
keeping faith with our veterans and making sure that no veteran of any 
era is left behind.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Arkansas.