[Congressional Record Volume 165, Number 24 (Thursday, February 7, 2019)]
[House]
[Pages H1418-H1431]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   VETERANS' ACCESS TO CHILD CARE ACT


                             General Leave

  Mr. TAKANO. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
to insert extraneous material on H.R. 840.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  The SPEAKER pro tempore. Pursuant to House Resolution 105 and Rule 
XVIII, the Chair declares the House in the Committee of the Whole House 
on the state of the Union for the consideration of the bill, H.R. 840.
  The Chair appoints the gentlewoman from the Virgin Islands (Ms. 
Plaskett) to preside over the Committee of the Whole.

                              {time}  1507


                     In the Committee of the Whole

  Accordingly, the House resolved itself into the Committee of the 
Whole House on the state of the Union for the consideration of the bill 
(H.R. 840) to amend title 38, United States Code, to direct the 
Secretary of Veterans Affairs to provide child care assistance to 
veterans receiving certain medical services provided by the Department 
of Veterans Affairs, with Ms. Plaskett in the chair.
  The Clerk read the title of the bill.
  The CHAIR. Pursuant to the rule, the bill is considered read the 
first time.
  General debate shall not exceed 1 hour equally divided and controlled 
by the chair and ranking minority member of the Committee on Veterans' 
Affairs.
  The gentleman from California (Mr. Takano) and the gentleman from 
Tennessee (Mr. David P. Roe) each will control 30 minutes.
  The Chair recognizes the gentleman from California.
  Mr. TAKANO. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, I rise in strong support of H.R. 840, the Veterans' 
Access to Child Care Act.

[[Page H1419]]

  We ask our servicemembers to risk their lives in service of our 
country, and in return, we promise to provide healthcare and benefits 
so they can live happy, healthy, and successful lives, and provide for 
their families.
  As our veteran population becomes increasingly diverse, as the number 
of LGBTQ and minority and women veterans goes up, we must ensure every 
veteran has the opportunity to access their healthcare and benefits. 
Addressing underserved veterans is a pillar of my VA 2030 vision, which 
will drive our work on the Committee on Veterans' Affairs in the 116th 
Congress.

  I proudly chose Congresswoman Brownley's Veterans' Access to Child 
Care Act as the very first bill our committee would bring to the House 
floor because it addresses a sometimes overlooked group of veterans: 
veterans who are parents and caregivers to young children.
  Providing cost-free, safe, and convenient healthcare so that veterans 
can see a mental health provider for treatment of post-traumatic 
stress, military sexual trauma, cancer resulting from exposure to Agent 
Orange, spinal cord injury, or even treatment for drug or substance 
abuse is the least we can do to make their lives easier so they, in 
turn, can be loving parents and caregivers to the children who depend 
on them.
  Under my leadership of the most diverse and talented Committee on 
Veterans' Affairs in the history of this Chamber, underserved veterans, 
especially women veterans, minorities, LGBTQ veterans, and veterans 
from our tribal communities, homeless veterans, and even deported 
veterans will be a top priority.
  We will work together to shatter the barriers and structural 
challenges underserved veterans face in this country they selflessly 
served by first attending to their most basic and essential needs: 
healthcare.
  Ms. Brownley, the chair of the Veterans' Affairs Subcommittee on 
Health and the head of the Task Force on Women Veterans, has been a 
tireless advocate for veterans since being elected to Congress. Her 
bill makes an already successful and popular pilot program permanent, a 
program that helps mothers, fathers, grandparents, and caregivers who 
need their VA healthcare, but struggle to find safe and convenient 
childcare or struggle to afford the high cost of childcare for their 
children.
  A veteran should never be made to choose between caring for their 
children and their health. This bill will make sure veterans will no 
longer have to make this terrible choice.
  The Caregivers and Veterans Omnibus Health Services Act first 
authorized the pilot program we are making permanent today. Under the 
pilot, VA could provide childcare services to eligible veterans seeking 
mental healthcare, intensive mental healthcare services, and other 
intensive healthcare services that require veterans to travel to VA 
hospitals, clinics, or vet centers for regular or frequent 
appointments.
  The first childcare program started at the VA Medical Center in 
Buffalo, New York, in October of 2011. Within 2 years, VA expanded the 
program to Northport, New York, and American Lake, Washington, and 
later brought childcare to Dallas, Texas.
  The 2-year pilot program was meant to end in September 2013, but 
Congress has reauthorized the program for the past 6 years due to its 
success and popularity.
  Since the beginning, over 10,000 children have used the childcare 
pilot program, and as more veterans and their children use the program, 
the cost decreased.
  Last Congress, the legislation authorizing this program passed 
unanimously, and now we will have an opportunity to improve this 
already great bill with amendments we will be considering today and 
tomorrow. I am optimistic this bill will pass with the same bipartisan, 
unanimous support.
  So I am very excited to work with Dr. Roe, the ranking member of our 
committee, on this bill and on future bipartisan legislation.
  Before I give him a chance to share his thoughts on this bill, I 
would like to share one of the anecdotes we received from a social 
worker who helps homeless veterans under the Department of Housing and 
Urban Development-Veterans Affairs Supportive Housing Program, 
otherwise known as the HUD-VASH program: ``Just this week a female 
veteran with a 3-year-old son discussed childcare with me. She was so 
relieved it was still open, because she scheduled a gynecological 
appointment that she was going to cancel because she had no one to care 
for her son.
  ``This is a veteran who came to us homeless with a newborn and 
unmanaged diabetes. She is now diligently following her medical regimen 
and consistently makes appointments. She is stably housed in the 
community, enjoying being a mother, attending college, and working 
part-time.
  ``I do not think we would have been able to stabilize her life 
without the support of childcare to allow her to get to her 
appointments and receive the treatment, medication, recommendations, 
and care that have helped her succeed.''

                              {time}  1515

  Now, as chairman of this committee, I look forward to sharing more 
stories of veterans throughout this country whose lives have been 
improved because of access to VA healthcare.
  Madam Chair, I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I yield myself as much 
time as I may consume.
  Madam Chair, I rise today in support of H.R. 840, the Veterans' 
Access to Child Care Act, and I acknowledge the gentlewoman from 
California (Ms. Brownley), the chairwoman and sponsor of this 
legislation, for her hard work and leadership on this issue.
  As a father of three and a grandfather of three more, I know 
firsthand how important affordable, accessible, and safe childcare is 
and how difficult it can be for busy parents to find.
  I never want a veteran, particularly one struggling with a mental 
health condition that requires regular ongoing treatment to manage, to 
be unable to get the care they need because of a lack of childcare.
  The Veterans' Access to Child Care Act would prevent that by 
authorizing the Department of Veterans Affairs to provide childcare 
assistance to veterans who are receiving mental health or certain other 
intensive healthcare services.
  Since 2011, VA has been providing childcare assistance to eligible 
veterans in select sites through a pilot program that has been extended 
by Congress on a consistent basis. This bill would permanently 
authorize that program and expand it across the VA healthcare system.
  I was proud to support this bill last Congress as it passed the House 
with unanimous bipartisan support, and I am proud to support it today. 
However, my support is not without some reservations.
  When we passed this bill last Congress, it had been reported out of 
the committee fully offset with a mandatory pay-for that, again, passed 
the House with unanimous bipartisan support.
  An amendment offered by Congressman Gus Bilirakis of Florida that 
would use the same pay-for to offset the cost of this bill, which has 
increased from $96 million 2 years ago to an estimated $120 million 
today, was ruled not in order by the Rules Committee yesterday. That is 
a shame.
  As chairman of the Veterans' Affairs Committee in the previous 
Congress, I entertained frequent objections to other good policies from 
my friends on the other side of the aisle due to concerns about how 
improvements to the VA healthcare system would be accounted for under 
discretionary caps. It appears those concerns have suddenly 
disappeared.
  Yesterday afternoon, Chairman Takano noted that no offset was 
provided for this bill because the House Democrats have no requirement 
for discretionary costs to be offset, and it would be up to the 
appropriators to provide the funding VA needs to implement this 
program.
  The Democrats' lack of a rule promoting fiscal discipline does not 
mean that we should not aspire to be good stewards of taxpayer money. 
The American taxpayer should expect and certainly deserve more from 
their elected officials than literally passing of the buck.
  I also have reservations about this bill because it failed to move 
through

[[Page H1420]]

regular order, which it most certainly would have benefited from.
  I commend my colleagues from both sides of the aisle for offering a 
number of thoughtful amendments to this legislation. I look forward to 
considering a number of those later today.
  That said, we do not know what the Department thinks of them. We do 
not know what veterans service organizations think of them. We are 
blind to the second and third order implications they will undoubtedly 
have on this program and its cost. What is more, not all of the 
thoughtful amendments that were offered to this bill were ruled in 
order or will be up for debate.
  I offered an amendment that would have provided the Asset and 
Infrastructure Review Commission greater flexibility by removing a 
prohibition against the Commission meeting in any calendar year except 
2022 and 2023.
  The AIR Commission is an objective, data-driven, transparent process 
that will consider VA's real property portfolio as a whole and 
determine how it will be realigned and brought into the 21st century to 
continue providing the high-quality care that our veterans require in 
future years.
  The bill we are considering today could result in the repurposing of 
existing space or creation of new space to be used to provide childcare 
services. Decisions about how limited VA medical facility space will be 
used must not be made in a vacuum, especially when Congress has already 
established a process for how those decisions should be made. I fail to 
see how my amendment doesn't apply here, and it is a shame that we 
didn't have an opportunity to have a robust debate on that in committee 
or on the floor.
  Another good government amendment that was, unfortunately, ruled out 
of order was offered by Congressman Jodey Arrington of Texas. 
Congressman Arrington's amendment would have prohibited any employee 
who is hired by VA to provide childcare pursuant to this bill from 
spending their time on taxpayer-funded union activities rather than 
performing the childcare duties they were hired to perform.
  I agree that government employees should be doing the job for which 
they are hired and receive a taxpayer-funded paycheck to do, and do 
nothing else.
  Again, it is a shame we won't be able to discuss or debate that 
amendment. Despite these issues, I do find the underlying bill to be a 
worthy one, and I will be supporting it today.
  I thank Congresswoman Brownley, again, and Chairman Takano for 
bringing this bill to the floor today, and I look forward to working 
with them in the next 2 years on these and other important issues of 
our Nation's veterans.
  Madam Chair, I reserve the balance of my time.
  Mr. TAKANO. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, I thank the gentleman for his support of the bill. I 
would say, with regard to the amendments, we would have entertained 
more amendments. I would have been happy to do so had they been 
germane, and we would have been glad to entertain them, but they were 
not.
  Before I yield to Ms. Brownley, the sponsor of this legislation, I 
include in the Record a letter of support from the Easterseals.

                                                  Easterseals,

                                                 February 6, 2019.
     Hon. Julia Brownley,
     House of Representatives,
     Washington, DC.
       Dear Representative Brownley: Easterseals is pleased to 
     again support your Veterans' Access to Child Care Act 
     legislation to increase the availability of child care for 
     veterans who are receiving services or treatment at a U.S. 
     Department of Veterans Affairs (VA) medical center.
       Easterseals is a national network of more than 70 nonprofit 
     organizations who deliver local services to help children and 
     adults with disabilities, veterans, older adults and others 
     to live independently and to fully participate in their 
     communities. Easterseals is a leading provider of inclusive 
     child care and early education and development in the United 
     States, providing thousands of young children with and 
     without disabilities with high-quality child care.
       Easterseals understands how important access to high-
     quality child care is to allow parents, including veterans, 
     to go to work and to meet their own health care needs. That 
     is why we supported the establishment of a pilot program at 
     the VA to provide child care at select VA medical centers 
     around the country that qualified veterans could use while at 
     a medical appointment or while receiving medical services. 
     The program has been particularly helpful for female 
     veterans, nearly 30 percent of whom have children living at 
     home. A recent VA report found that 42 percent of female 
     veterans who use the VA reported that finding child care to 
     attend a medical appointment was hard or very hard. When 
     asked about solutions, more than three of out five female 
     veterans surveyed said on-site childcare would be ``very 
     helpful.''
       The Veterans' Access to Child Care Act would expand and 
     make permanent the VA Child Care Pilot Program. The 
     legislation would make available a stipend, to cover the full 
     cost of child care provided by a licensed, on-site or private 
     child care center while the veteran receives services, 
     including travel time back and forth to the facility. The 
     legislation is a common-sense next step toward improving 
     access to VA health care to veterans.
       Easterseals is pleased to support the Veterans' Access to 
     Child Care Act. In addition, Easterseals stands ready to 
     partner with the VA to provide child care assistance while 
     they attend to their well-being and medical care. Thank you 
     for your leadership on this important issue.
           Sincerely,

                                               Maynard Friesz,

                                         Assistant Vice President,
                                Government Relations, Easterseals.
  Mr. TAKANO. This bill is also supported by the American Legion, the 
Veterans of Foreign Wars, the Vietnam Veterans of America, and other 
veterans service organizations. So I am pleased to say that we have 
heard the VSOs weigh in on Ms. Brownley's legislation.
  Madam Chair, I yield 5 minutes to the gentlewoman from California 
(Ms. Brownley), the author of the bill.
  Ms. BROWNLEY of California. Madam Chair, I thank the chairman for 
yielding time and for bringing my bill, the Veterans' Access to Child 
Care Act, to the floor for consideration; and I thank Ranking Member 
Roe for his support of the bill.
  As a member of the House Veterans' Affairs Committee, I believe that 
it is critical that veterans have the support they need to ensure they 
are able to access needed healthcare services at the VA.
  For many veterans, the lack of access to childcare is a barrier to 
receiving healthcare, especially mental healthcare and intensive care 
services. Research has shown that women veterans more commonly face 
this barrier, as they are more often responsible for caring for young 
children. That said, we know that the problem is not unique to women 
veterans, as male veterans have also reported lack of available 
childcare as a barrier to making their healthcare appointments as well.
  In 2010, Congress passed legislation directing the VA to start a 
pilot program to provide free childcare at a small number of VA medical 
centers and clinics throughout the country. Since then, this pilot 
program has been successfully implemented and hugely popular at several 
locations across the country.
  In 2015, the VA reported that the pilot program had provided 
childcare assistance to more than 10,000 children, and since then, many 
more veterans have benefited.
  The pilot program has been popular among the veteran community, and 
there has been strong support for its continuation from veterans 
service organizations. That is because we all believe that veterans 
should not be forced to choose between getting necessary healthcare and 
caring for a child.
  My bill, which we are debating today, would make the VA childcare 
pilot program permanent and expand the program to VA facilities all 
across the Nation.
  Like the original pilot program, my bill is narrowly tailored for 
veterans who are full-time caretakers of children and who need 
intensive medical care or mental health treatments and for those 
veterans who might otherwise miss their appointments because of lack of 
available short-term childcare during their appointments.
  For instance, a veteran who is undergoing cancer treatment cannot 
afford to miss these critical and intense medical appointments, and 
they need a safe place to leave their young child while they receive 
chemotherapy or radiation therapy.
  Likewise, veterans who have regular mental health appointments would 
need a place to leave their young children, because it would be 
inappropriate for young children to be present for tough conversations 
with a therapist about military sexual trauma or other battlefield 
trauma.

[[Page H1421]]

  Like the pilot program, my bill also gives VA flexible authority to 
determine how to provide childcare assistance during veterans' medical 
appointments. Options include:
  Providing the benefit through stipend payments directly to veterans 
to pay for their childcare expenses;
  Direct provision of childcare at VA facilities;
  Direct payment to childcare providers;
  Collaboration with other Federal departments and agencies; or
  Other appropriate forms of assistance that the Secretary determines 
are appropriate.
  Passage of this legislation will benefit veterans of all areas who 
are primary caretakers. In fact, many of the caretakers who have used 
the pilot program have been women and older veterans, including 
grandparents who take care of a child during the day and would 
otherwise be unable to make their appointments.
  This bill will guarantee these veterans receive the healthcare they 
need, while ensuring a safe, reliable, and cost-free option for 
childcare during those appointments.
  For our colleagues who are new to this body, I would note that 
similar legislation passed the House in the 115th Congress by voice 
vote. I urge my colleagues to again support this legislation.
  I especially want to thank my colleague Mr. Higgins from New York, 
who has been a tireless advocate for expanding and making permanent the 
childcare pilot program. His partnership has been invaluable in moving 
our bill forward.
  I also want to thank Senator Patty Murray from Washington, who has 
introduced similar legislation in the Senate.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I have no further 
speakers. I reserve the balance of my time.
  Mr. TAKANO. Madam Chair, I yield 2 minutes to the gentleman from New 
York (Mr. Higgins).
  Mr. HIGGINS of New York. Madam Chair, I rise in strong support on 
passage of H.R. 840, the Veterans' Access to Child Care Act, to provide 
childcare assistance to our military families.
  Nearly a decade ago, the Veterans Administration survey found that 
over 1 in 10 veterans have had to cancel their VA medical appointments 
due to the lack of childcare. In response, Congress created the VA 
childcare pilot program. The first in the Nation opened in my hometown 
of Buffalo, New York.
  The program has been a tremendous success. Since its inception, it 
has served countless military families. Last year, more than 1,000 
children visited the Kids Korner, located at the Buffalo VA Center, 
while their parents received much-needed care.
  America's veterans placed their lives on the front lines for our 
freedoms. Many veterans returned to their families from combat with 
injuries and post-traumatic stress disorder that requires regular 
treatment at their VA.
  Madam Chair, we need to remove barriers to care and give our veterans 
certainty. By passing this legislation, Congress will make childcare 
available to veterans who need it, while being cost effective in 
improving health outcomes.
  In closing, I thank Congresswoman Brownley for her tireless work on 
behalf of our Nation's veterans, and I strongly urge my colleagues to 
vote on passage of this important legislation.

                              {time}  1530

  Mr. DAVID P. ROE of Tennessee. Madam Chair, I reserve the balance of 
my time.
  Mr. TAKANO. Madam Chair, I yield myself such time as I may consume.
  We have the data to show how access to healthcare services improves 
and saves lives, but I think it is important that we also hear from the 
veterans and the providers whose lives have been improved by this 
program.
  I would like to share another story from a childcare staffer in 
Buffalo, New York.
  ``Buffalo also has a World War II veteran, now 97 years old, who 
cares for his great-granddaughter. He heard of the service, stopped in 
to see the facility and ask questions to verify he felt `safe' in 
leaving her in their care. As primary caretaker for this child, he is 
so pleased to be able to attend his appointments at his `elderly age' 
and keep his family close.''
  Let me also add, I want to address the reservation, although the 
ranking member has stated his general support for the bill, but this 
reservation about the legislation, H.R. 840, lacking a pay-for that was 
included in last session's legislation, and the pay-for that they said 
was necessary this time around.
  I want to state that H.R. 840 simply makes permanent a program that 
we, as a Congress, have reauthorized six times since 2013. For none of 
those six times was the issue of a pay-for really germane. In fact, the 
CBO has never required that we do it.
  The pay-for that the gentleman keeps speaking of will not pay for 
this program. It will simply take money from veterans and send it to 
the Treasury, and the VA, still under discretionary funds, will still 
have to find the money to pay for it.
  Each of the six times we authorized this program, not once did my 
colleagues insist on a pay-for. Only when we are introducing 
legislation to make it a permanent program does this suddenly pop up as 
a concern.
  In reality, even if we included the pay-for, the Treasury wouldn't 
see the funds for nearly a decade.
  Madam Chair, I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, just to, I guess, retort 
to my friend, the chairman, if a program costs money, the money has to 
come from somewhere. We have programs right now, and the appropriators 
are going to have to decide, if this program costs a lot of money, to 
take it away from some other VA program, whereas, we had the extra 
revenue to pay for this program. That is all we are talking about.
  Every single one of us in this Chamber last Congress agreed to pay 
for it. So now something has changed. I have no further speakers on the 
bill, and I am prepared to close. I reserve the balance of my time.
  Mr. TAKANO. Madam Chair, just in response, the pay-for to which the 
gentleman from Tennessee is referring is under mandatory spending, 
which would not actually pay for the program. It would be returned to 
the Treasury, and the discretionary funds simply--there is no pay-for 
out of the discretionary funds. It is coming out of the mandatory side. 
It is a very illusory device.
  So I want to reiterate that each time this pilot program was 
reauthorized under the majority, never was there a demand on their part 
that there be a pay-for.
  Madam Chair, I have no further speakers. I am prepared to close, and 
I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I yield myself such time 
as I may consume.
  First of all, I thank Ms. Brownley for her leadership on this. I, 
too, have been, at one point in my life, a single parent. I am a 
veteran, and I certainly understand the difficulty in childbearing and 
child-rearing from my previous life as an OB/GYN doctor. I delivered a 
lot of babies and took care of a lot of parents who were single 
parents, who struggled to not only make ends meet, but to get the 
healthcare they need.
  I think this is a great bill. I think it should be supported 
unanimously in this Congress.
  Our American heroes who have served this country can come get the 
care they need. We know that, in this country, 20 veterans commit 
suicide each day, and 14 of them have never gotten into VA care. We 
don't know what the reason for some of those are, but, hopefully, it is 
not a barrier of childcare.
  Madam Chair, I encourage all my colleagues on both sides of the aisle 
to support unanimously H.R. 840, and I yield back the balance of my 
time.
  Mr. TAKANO. Madam Chair, I wholly support Ms. Brownley's bill, H.R. 
840. I urge my colleagues to join me in its passage, and I yield back 
the balance of my time.
  The CHAIR. All time for general debate has expired.
  Pursuant to the rule, the bill shall be considered for amendment 
under the 5-minute rule.
  It shall be in order to consider as an original bill for the purpose 
of amendment under the 5-minute rule the amendment in the nature of a 
substitute consisting of the text of the

[[Page H1422]]

Rules Committee Print 116-3. The amendment in the nature of a 
substitute shall be considered as read.
  The text of the amendment in the nature of a substitute is as 
follows:

                                H.R. 840

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Veterans' Access to Child 
     Care Act''.

     SEC. 2. CHILD CARE ASSISTANCE FOR VETERANS RECEIVING MENTAL 
                   HEALTH CARE AND OTHER INTENSIVE HEALTH CARE 
                   SERVICES PROVIDED BY THE DEPARTMENT OF VETERANS 
                   AFFAIRS.

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

     ``Sec. 1730D. Child care assistance for veterans receiving 
       mental health care and other intensive health care services

       ``(a) In General.--The Secretary shall provide child care 
     assistance to an eligible veteran for any period that the 
     veteran--
       ``(1) receives covered health care services at a facility 
     of the Department; and
       ``(2) is required travel to and return from such facility 
     for the receipt of such health care services.
       ``(b) Child Care Assistance.--(1) Child care assistance 
     provided under this section may include any of the following:
       ``(A) A stipend for the payment of child care offered by a 
     licensed child care center (either directly or through a 
     voucher program) which shall be, to the extent practicable, 
     modeled after the Department of Veterans Affairs Child Care 
     Subsidy Program established pursuant to section 590 of title 
     40.
       ``(B) Direct provision of child care at an on-site facility 
     of the Department.
       ``(C) A payment made directly to a private child care 
     agency.
       ``(D) A collaboration with a facility or program of another 
     Federal department or agency.
       ``(E) Such other form of assistance as the Secretary 
     considers appropriate.
       ``(2) In the case that child care assistance under this 
     section is provided as a stipend under paragraph (1)(A), such 
     stipend shall cover the full cost of such child care.
       ``(c) Definitions.--In this section:
       ``(1) The term `eligible veteran' means a veteran who--
       ``(A) is the primary caretaker of a child or children; and
       ``(B) is--
       ``(i) receiving covered health care services from the 
     Department; or
       ``(ii) in need of covered health care services, and but for 
     lack of child care services, would receive such covered 
     health care services from the Department.
       ``(2) The term `covered health care services' means--
       ``(A) regular mental health care services;
       ``(B) intensive mental health care services; or
       ``(C) such other intensive health care services that the 
     Secretary determines that provision of assistance to the 
     veteran to obtain child care would improve access to such 
     health care services by the veteran.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 1730C the following new item:

``1730D. Child care assistance for veterans receiving mental health 
              care and other intensive health care services.''.

  The CHAIR. No amendment to the amendment in the nature of a 
substitute shall be in order except those printed in House Report 116-
6. Each such amendment may be offered only in the order printed in the 
report, by a Member designated in the report, shall be considered as 
read, shall be debatable for the time specified in the report equally 
divided and controlled by the proponent and an opponent, shall not be 
subject to amendment, and shall not be subject to a demand for division 
of the question.


                Amendment No. 1 Offered by Mr. Brindisi

  The CHAIR. It is now in order to consider amendment No. 1 printed in 
House Report 116-6.
  Mr. BRINDISI. Madam Chair, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 2, line 2, insert ``, such as a community-based 
     outpatient clinic'' after ``Department''.

  The CHAIR. Pursuant to House Resolution 105, the gentleman from New 
York (Mr. Brindisi) and a Member opposed each will control 5 minutes.
  The Chair recognizes the gentleman from New York.
  Mr. BRINDISI. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, I thank the gentlewoman from California, chairwoman of 
the Veterans' Affairs Committee's Health Subcommittee, for introducing 
this important bill, as well as the chairman of the Veterans' Affairs 
Committee, the gentleman from California.
  Veterans should never have to miss a doctor's appointment or medical 
treatment because they don't have access to affordable childcare. This 
bill is a commonsense solution that removes this roadblock and ensures 
our Nation's veterans have access to the care they have earned. I am 
glad to see the House take up this issue.
  My amendment would clarify that community-based outpatient clinics 
are included under the bill's definition of facilities of the 
Department and ensure that veterans who receive their care from CBOCs 
are able to access VA childcare assistance.
  Many veterans who live in rural areas in my district and across the 
country do not have a full-service hospital nearby, and they rely on 
CBOCs to receive primary and mental healthcare. It is important to make 
clear that this childcare benefit would include them, no matter how 
small or large their VA facility is.
  As a new Member of the House Committee on Veterans' Affairs, I will 
continue working to improve access to VA healthcare and benefits for 
veterans, including veterans living in rural communities.
  I urge adoption of my amendment and again thank the gentlewoman from 
California for introducing this bill, and I urge our colleagues on both 
sides of the aisle to pass the underlying legislation.
  Madam Chair, I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I ask unanimous consent 
to claim the time in opposition, though I am not opposed to it.
  The CHAIR. Is there objection to the request of the gentleman from 
Tennessee?
  There was no objection.
  The CHAIR. The gentleman is recognized for 5 minutes.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I yield myself such time 
as I may consume.
  Madam Chair, I rise in support of Congressman Brindisi and former 
member of the committee Congresswoman Kuster's amendment that would 
clarify that veterans receiving intensive mental health or other 
qualifying treatment from community-based outpatient clinics, CBOCs, 
are also eligible for childcare assistance from the VA.
  CBOCs are an important access point for many veterans, and healthcare 
continues to transition away from inpatient hospitals and will form the 
basis of future care. Madam Chair, we have over 800 of these CBOCs in 
the country, so it makes care much more available to our veterans in 
their home communities.
  Childcare burdens are no less a factor for veterans who receive care 
in a CBOC than it is for veterans who seek care in a VA medical center. 
This amendment rightly recognizes that fact and ensures that we don't 
inadvertently create a disparity for veterans with the same conditions 
seeking the same treatments who happen to use different VA medical 
facilities.
  Madam Chair, I urge all my colleagues to join me in supporting this 
amendment, and I thank Congressman Brindisi and Congresswoman Kuster 
for submitting that, and I reserve the balance of my time.
  Mr. BRINDISI. Madam Chair, I yield 1 minute to the gentleman from 
California (Mr. Takano), the chair of the committee.
  Mr. TAKANO. Madam Chair, I thank the gentleman for yielding, and I 
support this amendment because, by clarifying that community-based 
outpatient clinics are covered under the bill, we are ensuring that 
veterans seeking healthcare services at any VA facility are able to 
receive no-cost childcare.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I have no further 
speakers, and I am prepared to close. I reserve the balance of my time.
  Mr. BRINDISI. Madam Chair, I urge adoption of the amendment, and I 
yield back the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I strongly support this 
amendment, and I yield back the balance of my time.
  The CHAIR. The question is on the amendment offered by the gentleman 
from New York (Mr. Brindisi).
  The amendment was agreed to.

[[Page H1423]]

  



               Amendment No. 2 Offered by Mrs. Radewagen

  The CHAIR. It is now in order to consider amendment No. 2 printed in 
House Report 116-6.
  Mrs. RADEWAGEN. Madam Chair, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:
       Page 3, line 4, strike ``The Secretary'' and insert 
     ``Subject to subsection (c), the Secretary''.
       Page 3, after line 24, insert the following:
       ``(c) Condition on Receipt of Assistance.--(1) The 
     Secretary may not provide any child care assistance under 
     this section to an eligible veteran who is receiving covered 
     health care services from the Department unless that eligible 
     veteran actively participates in such services.
       ``(2) For purposes of this subsection, the term `actively 
     participates' means, with respect to covered health care 
     services--
       ``(A) engaging in transit to and from appointments for such 
     services;
       ``(B) attending appointments for such services; and
       ``(C) such other activities as the Secretary determines 
     appropriate.''.
       Page 3, line 25, strike ``(c)'' and insert ``(d)''.

  The CHAIR. Pursuant to House Resolution 105, the gentlewoman from 
American Samoa (Mrs. Radewagen) and a Member opposed each will control 
5 minutes.
  The Chair recognizes the gentlewoman from American Samoa.
  Mrs. RADEWAGEN. Madam Chair, I thank Representative Brownley for 
introducing this legislation to help our veterans and their families.
  Madam Chair, I am offering this amendment to clarify that the 
childcare benefit be made available for veterans while they are 
actively participating in VA healthcare services, i.e., when they are 
traveling to or attending VA appointments, and not at any other time.
  This small clarification will ensure that the childcare assistance is 
reserved for veterans who need it most and that it does not 
accidentally replace more long-term childcare programs.
  If there is a need for an expanded childcare program, I believe it 
should be created separately, and I would be happy to work with my 
colleagues on that.
  Madam Chair, I ask my colleagues to support this amendment, and I 
reserve the balance of my time.
  Mr. TAKANO. Madam Chair, I claim the time in opposition to the 
amendment, even though I am not opposed to the amendment.
  The CHAIR. Without objection, the gentleman from California is 
recognized for 5 minutes.
  There was no objection.
  Mr. TAKANO. Madam Chair, I rise in support of this amendment to 
ensure that our taxpayer dollars are spent according to Congress' 
intent.
  I agree that childcare should only be provided to veterans when they 
are using the childcare to attend their healthcare appointments.
  I thank the gentlewoman for working with me to make this amendment 
bipartisan and ensure it is clear to the VA that they cannot revoke 
this benefit from veterans for missing an appointment.
  The intent of this amendment is not to be an incentive to access 
care. It is simply to make it easier for veterans to make it to their 
appointments. It will be up to us as lawmakers to keep close oversight 
over this program and many others at the Department of Veterans 
Affairs.
  This committee will keep close watch over the resources we provide 
and the programs we authorize at the VA. We will hold VA leaders 
accountable when these programs are not carried out according to 
congressional intent, or made in a haphazard and uninformed manner, or 
without the purpose of doing what is best for veterans.
  I look forward to working with the gentlewoman and my colleagues on 
this committee to oversee the successful execution of this childcare 
program so any eligible veterans who need childcare can get it.
  Madam Chair, I reserve the balance of my time.
  Mrs. RADEWAGEN. Madam Chair, I yield 2 minutes to the gentleman from 
Tennessee (Mr. David P. Roe).
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I thank Mrs. Radewagen, 
who is a tireless advocate for veterans issues, for bringing this up. 
She travels, I guess, about as far as anybody, 24 hours in the air to 
get here, so she is a tireless advocate for our Nation's heroes, and I 
thank her for that.

                              {time}  1545

  Madam Chair, I rise in strong support of this amendment that would 
clarify that childcare assistance is intended for veterans while they 
are attending a VA appointment or traveling to and from a VA 
appointment, but not at any other time.
  This amendment is in line with the intent of the underlying bill, 
which is to provide access to childcare services so that veterans who 
would otherwise be burdened with childcare responsibilities can have 
easier access to the care that they need.
  By clarifying when VA-provided childcare assistance will be provided, 
this amendment will help ensure that this program is sustainable, is 
not unintentionally abused, and will help the greatest number of 
veterans in need.
  Congresswoman Radewagen is a valuable member, as I have stated, of 
the Committee on Veterans' Affairs, and I thank her for bringing this 
commonsense, good-government amendment forward today.
  Madam Chair, I urge my colleagues to join me in supporting it.
  Mrs. RADEWAGEN. Madam Chair, I yield back the balance of my time.
  Mr. TAKANO. Madam Chair, I yield 2 minutes to the gentleman from the 
Northern Mariana Islands (Mr. Sablan).
  Mr. SABLAN. Madam Chair, I rise to enter into a short colloquy with 
the distinguished gentlewoman from American Samoa.
  As it is in your district, it is in my district. Sometimes we have to 
leave our home and travel by airplane to a place where we can receive 
the medical attention we need for VA services for our veterans.
  I would like to discover, which I think I may already know the 
answer, but just for the record, a veteran who lives, say, in Saipan 
going to Tripler or Spark M. Matsunaga VA Medical Center in Hawaii, 
that childcare is provided for that time, including the travel time and 
the time when the veteran is receiving medical attention in Hawaii and 
until that veteran returns home.
  Is that an appropriate or correct interpretation of this legislation?
  Mrs. RADEWAGEN. Will the gentleman yield?
  Mr. SABLAN. I yield to the gentlewoman from American Samoa.
  Mrs. RADEWAGEN. That is a good question, and that is something we are 
going to have to work on.
  Mr. SABLAN. It happens many times that a veteran, again, has to 
leave. For example, in my district, they would have to leave the island 
of Tinian or the island of Rota, fly to Saipan even to have a 
teleconference, a telemedicine video, with their licensed social 
worker, their psychologist, or their psychiatrist, and it takes time. 
Flights are just once a day, for example, or a flight to Guam requires 
an overnight stay.
  So for the time that the veteran leaves home, goes to Guam, for 
example, gets the care and comes back, I was hoping that that 
restriction is appropriate.
  The CHAIR. The time of the gentleman has expired.
  Mr. TAKANO. Madam Chair, I yield the gentleman an additional 30 
seconds.
  Mr. SABLAN. Madam Chair, I would like to engage the gentleman from 
Tennessee in a colloquy.
  Mr. DAVID P. ROE of Tennessee. Will the gentleman yield?
  Mr. SABLAN. I yield to the gentleman.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, Mr. Sablan and I have 
worked together on these unique issues about where he is in American 
Samoa. That is one of the reasons I wish we had had regular order. We 
could have brought this up, because the gentleman does have unique 
circumstances because of long travel distances, and I think that is 
something else we need to look at in the committee.
  I will pledge myself to work with you on this issue as ranking 
member.
  Mr. SABLAN. I thank the ranking member of the committee and my 
distinguished colleague from American Samoa.

[[Page H1424]]

  

  Mr. TAKANO. Madam Chair, I yield myself the balance of my time.
  Let me say for the record that I believe, if a veteran is receiving 
care at a facility, in this case in Hawaii on travel from Saipan, that 
the intent of the legislation would provide that childcare for the time 
necessary for that veteran, and it would be at a VA facility. It would 
be childcare at a VA facility in Hawaii, in this particular case.
  Madam Chair, in closing, I do urge that my colleagues support the 
amendment by Mrs. Radewagen, and I yield back the balance of my time.
  The CHAIR. The question is on the amendment offered by the 
gentlewoman from American Samoa (Mrs. Radewagen).
  The amendment was agreed to.


            Amendment No. 3 Offered by Mr. Rose of New York.

  The CHAIR. It is now in order to consider amendment No. 3 printed in 
House Report 116-6.
  Mr. ROSE of New York. Madam Chair, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 3, line 16, strike ``or'';
       Page 3, after line 16, insert the following:
       ``(C) health care services related to substance or drug 
     abuse counseling; or''.
       Page 3, line 17, strike ``(C)'' and insert ``(D)''.

  The CHAIR. Pursuant to House Resolution 105, the gentleman from New 
York (Mr. Rose) and a Member opposed each will control 5 minutes.
  The Chair recognizes the gentleman from New York.
  Mr. ROSE of New York. Madam Chair, I yield myself such time as I may 
consume.
  Madam Chair, I rise to offer an amendment that would make clear that 
healthcare related to substance and drug abuse counseling is included 
in the covered health services in this bill.
  In addition, Madam Chair, the opioid epidemic has not only affected 
my home district of Staten Island and south Brooklyn--and to be clear, 
it very much has--but this has touched constituents in district after 
district, State after State, and has disproportionately affected our 
Nation's greatest heroes.
  As the fathers, wives, husbands, and children of the veterans 
fighting this disease can attest, combating this addiction is daunting 
and heartbreakingly difficult. Imagine how excruciating it can be when 
a mother has to make the choice between receiving the treatment that 
she so desperately needs and making sure that her own children are 
cared for.
  That is the choice veteran parents need to make time and again. It is 
a disgrace, and on both sides of the aisle, we have not done enough.
  Make no mistake here, if Congress does not act, these barriers to 
treatment will absolutely persist. Whether you are a Republican or a 
Democrat, it is our constituents who are suffering, and we need to act 
now. If we do not address this, this epidemic will continue to wreak 
havoc on our districts, our communities, and our families.
  A national survey from the Substance Abuse and Mental Health Services 
Administration showed that 1 in 15 veterans suffer from a substance 
abuse disorder, but for vets who left Active Duty post-9/11, it was 
nearly one in eight. These veterans are twice as likely to die from an 
accidental overdose as a nonveteran.
  As one of the few post-9/11 combat veterans who is serving right now 
in this body, I have seen the courage of my fellow former soldiers who 
seek the help that they so desperately need. I have seen that substance 
abuse counseling at our VA facilities can really save lives and save 
families. And I have seen what happens when my brothers and sisters who 
serve do not get the treatment they need. I am here to tell my 
colleagues that I refuse to watch that happen again.
  That is why I offer this amendment here today, so that the veteran 
mother who I mentioned, and the fathers who are full-time caregivers of 
their children, are no longer trapped in an impossible choice. They can 
receive treatment for PTSD, for cancer, and for counseling to combat 
life-threatening addiction with the peace of mind that their children 
are safe and cared for.
  That is the very reason Congress directed this pilot program to start 
in the first place. When we put party politics aside and put our 
constituents first, this country really succeeds.
  We can all agree that this country is battling an opioid epidemic. 
Let's show our constituents that we are more than just talk and more 
than just thanking vets for their service and are actually doing 
something about it. We have to stop treating addiction as anything but 
the disease and the public health crisis that it actually is. We need 
to encourage, not punish, those who are taking this fight head on and 
seeking the care that they so desperately need and deserve.
  Madam Chair, I thank Ms. Brownley for sponsoring this legislation and 
commend my colleague, Mr. Norcross from New Jersey, for cosponsoring 
this amendment. I applaud my colleagues, Ms. Sherrill, Mr. Golden, Ms. 
Stefanik, and Mr. Delgado, for offering amendments to strengthen this 
bill.
  Madam Chair, I urge adoption of this amendment, and I reserve the 
balance of my time.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I claim the time in 
opposition, although I am not opposed to the amendment.
  The CHAIR. Without objection, the gentleman is recognized for 5 
minutes.
  There was no objection.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I yield myself such time 
as I may consume.
  Madam Chair, I rise in support of Congressman Rose's amendment to 
include substance abuse or drug abuse counseling under the definition 
of a covered health service, and I thank him for his service to our 
great country.
  Unfortunately, our veterans are not immune to the scourge of 
addiction that has tragically impacted far too many of our communities 
for far too long, particularly in the last few years of the opioid 
crisis. Veterans seeking substance abuse treatment from VA should 
certainly have access to childcare assistance if they require it, and I 
am grateful to Congressman Rose for sponsoring this amendment to make 
sure that they are specifically included in this bill. I hope that I am 
joined by all my colleagues in supporting this needed amendment today.
  Madam Chair, I reserve the balance of my time.
  Mr. ROSE of New York. Madam Chair, I yield 1 minute to the gentleman 
from California (Mr. Takano).
  Mr. TAKANO. Madam Chair, I thank the gentleman for yielding.
  I support this amendment because veterans are not immune from the 
opioid epidemic. They are not immune to alcoholism or substance abuse. 
When a veteran is also suffering from post-traumatic stress or other 
serious health conditions that may have caused dependency on a 
substance, we should do everything we can to make sure that veteran can 
receive care.
  I thank the gentleman for offering this very important amendment, and 
I urge all my colleagues to support it.
  Mr. DAVID P. ROE of Tennessee. Madam Chair, I urge support of 
Congressman Rose's amendment, and I yield back the balance of my time.
  Mr. ROSE of New York. Madam Chair, in closing, I urge support of this 
amendment, and I yield back the balance of my time.
  The CHAIR. The question is on the amendment offered by the gentleman 
from New York (Mr. Rose).
  The amendment was agreed to.

                              {time}  1600


                 Amendment No. 4 Offered by Mr. Bergman

  The CHAIR. It is now in order to consider amendment No. 4 printed in 
House Report 116-6.
  Mr. BERGMAN. Madam Chair, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       At the end, add the following section:

     SEC. 3. PROHIBITION ON USE OF FUNDS FOR CHILD CARE ASSISTANCE 
                   TO CONSTRUCT NEW CHILD CARE FACILITIES.

       The Secretary of Veterans Affairs may not use funds made 
     available for child care assistance provided under section 
     1730D of title 38, United States Code, as added by section 2, 
     to construct any new child care facility.

  The CHAIR. Pursuant to House Resolution 105, the gentleman from 
Michigan (Mr. Bergman) and a Member opposed each will control 5 
minutes.

[[Page H1425]]

  The Chair recognizes the gentleman from Michigan.
  Mr. BERGMAN. Madam Chair, I rise today to offer an amendment to H.R. 
840, the Veterans' Access to Child Care Act.
  My amendment is simple. It prohibits VA from constructing new 
childcare facilities using funds made available by this bill. It does 
not prohibit the VA from using existing facilities.
  While I support the underlying bill and believe something as simple 
as childcare services can greatly improve veterans' access to care, I 
also understand how bloated VA's infrastructure portfolio has become.
  Just last year, Congress passed the VA MISSION Act, which included 
language to establish the Asset and Infrastructure Review Commission. 
This commission is designed to assess areas in which the VA can 
modernize and realign its existing infrastructure portfolio to save 
valuable money and refocus on its core mission of caring for our 
veterans.
  Madam Chair, offering childcare services has the potential to make VA 
benefits more accessible and convenient for all families. H.R. 840 
allows VA to provide childcare services via private centers and through 
collaboration with other Federal agencies, thus utilizing already 
existing facilities.
  Until the asset and infrastructure review is complete, it would be 
irresponsible to allow VA to invest more limited resources in new 
construction when positive, viable alternatives are available.
  I appreciate the work our committee has done to help improve access 
to care, and I look forward to our continued efforts to realign VA's 
priorities and its unused or underutilized assets.
  Mr. Chair, I urge support of this amendment, and I reserve the 
balance of my time.
  Mr. TAKANO. Mr. Chair, I rise in opposition to the amendment.
  The Acting CHAIR (Mr. Johnson of Georgia). The gentleman from 
California is recognized for 5 minutes.
  Mr. TAKANO. Mr. Chairman, I rise in opposition to the amendment, 
which would prevent additional VA hospitals and clinics from providing 
onsite childcare to veterans receiving care at VA hospitals and 
clinics.
  VA only has four childcare sites throughout the VA system, and this 
amendment would prevent further expansion of the program by preventing 
a VA hospital or clinic from even doing basic things to provide 
convenient childcare, things like covering electrical sockets to make a 
facility safe for young children or putting up fencing around the 
playground so children can play safely.
  As our colleague, Ms. Shalala, reminded us during the Rules Committee 
meeting yesterday, and as many parents of young children quickly learn, 
most private childcare facilities do not allow children to be 
temporarily dropped off for just a few hours. Childcare facilities need 
to know whether children are up to date on their vaccinations, have 
food allergies or other medical conditions to provide safe care.
  This means VA must have the flexibility to determine how best to 
execute this program at each of its facilities throughout the country. 
If this means that it makes sense to build an onsite childcare center, 
VA should not be barred from doing so.
  I think this amendment was written without considering its effects, 
which would limit further the expansion of the program and prevent 
veterans from being able to access childcare and their healthcare when 
they need it.
  Any of us who have been on this committee long enough know that VA 
has had trouble managing major construction projects. Admittedly, this 
is what we know on the committee. And I am just as outraged as my 
colleagues across the aisle when VA construction projects are 
mismanaged and money is wasted. However, we are talking about minor 
construction that, in many cases, will be necessary to expand this 
program to all eligible veterans who need it.
  There are other ways in which we can ensure the money for this 
program is not mismanaged, and it doesn't need to be something as 
drastic as preventing construction which will, in effect, prevent the 
program's expansion.
  Now, I hope to work with General Bergman and my other colleagues on 
this committee to prevent mismanagement of construction projects, 
procurement of the $16 billion electronic health record, and other 
contracts and programs at the VA; and I pledge to work with the general 
to ensure funds for construction of childcare facilities are not 
wasted.
  Mr. Chair, I must say that I have to urge my colleagues to oppose 
this amendment, and I reserve the balance of my time.
  Mr. BERGMAN. Mr. Chairman, I yield 1 minute to the gentleman from 
Tennessee (Mr. David P. Roe).
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I rise in strong support of 
this amendment to prohibit VA from constructing new structures to be 
used as childcare centers.
  Mr. Chair, the VA has over 6,000 pieces of property, and 1,100 of 
them are either not utilized or underutilized. We on the committee, 
including the chairman, have just witnessed a $600 million hospital in 
Denver, Colorado, explode into a $2 billion--I didn't say that wrong, 
two thousand million dollars--project.
  Both General Bergman's amendment and mine, which would have provided 
greater flexibility to the Asset and Infrastructure Review Commission, 
recognized that VA's vast and, in most cases, outdated, misaligned, and 
prohibitively-expensive-to-maintain infrastructure must be dealt with 
holistically.
  I regret that my amendment was not made in order today, but I am glad 
that General Bergman's was. Where VA has existing space that is not 
needed for veteran patients, VA could and should consider repurposing 
that space to provide childcare assistance, and where existing space is 
not available, VA should use the authorities provided in this bill to 
provide childcare assistance.

  The Acting CHAIR. The time of the gentleman has expired.
  Mr. BERGMAN. Mr. Chair, I yield an additional 2 minutes to the 
gentleman.
  Mr. DAVID P. ROE of Tennessee. Where existing space is not available, 
VA should use the authorities provided in this bill to provide 
childcare assistance off VA property--either through leases, sharing 
agreements, and other means--rather than investing in costly new 
buildings.
  Mr. Chair, what happens? If we build a childcare facility and the 
demographics change and it is no longer needed, we have got an empty 
building. If we lease that building, which this gives us the authority 
to do, we can let the lease expire, and the VA can go on and use their 
moneys for something else.
  General Bergman is the ranking member of the Subcommittee on 
Oversight and Investigations, and I thank him today, as always, for his 
leadership and vision on behalf of his fellow veterans.
  Mr. Chair, I am pleased to support this amendment today, and I urge 
all of my colleagues to join me in support.
  Mr. BERGMAN. Mr. Chair, I yield back the balance of my time.
  Mr. TAKANO. Mr. Chair, I would just wish to point out to the ranking 
member of the Oversight and Investigations Subcommittee of the 
Veterans' Affairs Committee, General Bergman, that his amendment would 
not even allow for the repurposing of existing facility space that may 
exist at a VA.
  It is so rigid that it would be difficult to even put protective 
electrical sockets in to prevent young children from electrocuting 
themselves. Even minor construction would be prohibited by this 
amendment.
  I am pleased to know that the general is serving on the Oversight and 
Investigations Subcommittee, and I do plan to work with the chairman, 
Mr. Pappas of New Hampshire, and him to make sure that VA money is well 
spent.
  As I said, this amendment would simply prevent reasonable expansion 
of this program, and that is something that members of this committee 
and Members of this House would not want to see happen.
  Mr. Chair, I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentleman from Michigan (Mr. Bergman).
  The question was taken; and the Acting Chair announced that the ayes 
appeared to have it.
  Mr. BERGMAN. Mr. Chair, I demand a recorded vote.

[[Page H1426]]

  The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further 
proceedings on the amendment offered by the gentleman from Michigan 
will be postponed.


             Amendment No. 5 Offered by Mrs. Lee of Nevada

  The Acting CHAIR. It is now in order to consider amendment No. 5 
printed in House Report 116-6.
  Mrs. LEE of Nevada. Mr. Chair, I have an amendment at the desk.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 3, after line 21, insert the following:
       ``(3) The term `facility of the Department' includes any 
     Vet Center.
       ``(4) The term `Vet Center' has the meaning given that term 
     in section 1712A of this title.''.

  The Acting CHAIR. Pursuant to House Resolution 105, the gentlewoman 
from Nevada (Mrs. Lee) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentlewoman from Nevada.
  Mrs. LEE of Nevada. Mr. Chairman, my amendment clarifies that every 
veteran is able to access childcare services guaranteed by the 
underlying bill, regardless of whether they are using the services at a 
VA center, medical center, or a vet center that is not on the campus of 
a VA facility.
  I am pleased to be joined in offering this bipartisan amendment by my 
Republican colleague Congresswoman Lesko from Arizona. I would also 
like to thank Congresswoman Brownley for leading this bill, as well as 
Chairman Takano and Ranking Member Roe for their assistance and 
leadership on this vital issue.
  No veteran should be forced to choose between caring for their 
children or caring for themselves. In several States, including my home 
State of Nevada, veterans use both the VA medical centers and the 
community-based vet centers to access the care they need.
  Vet centers provide a wide array of social and psychological services 
to help veterans readjust to civilian life, and I am very proud of the 
work they do to serve those who served all of us.
  For many of those who do not have access to a local VA medical 
center, vet centers are the only VA facilities they can use. To ensure 
that all veterans and, in particular, women veterans are able to 
receive the care they need, our amendment would clarify that any 
veteran receiving care, whether at a VA facility or an off-VA-campus 
vet center, would be eligible for the childcare authorized under this 
legislation.
  We never want any veteran to choose between receiving the care and 
support they need or caring for their child. Our amendment would 
guarantee that all veterans would be able to access care regardless of 
where and how they seek treatment.
  Mr. Chair, I urge my colleagues to support this amendment, and I 
reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I claim the time in 
opposition to the amendment, although I am not opposed to the 
amendment.
  The Acting CHAIR. Without objection, the gentleman is recognized for 
5 minutes.
  There was no objection.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I rise in support of the 
amendment sponsored by Congresswoman Lee and Congresswoman Lesko to 
provide for childcare assistance to veterans receiving readjustment 
counseling in a vet center.
  The work done in vet centers is critical to veterans who are 
struggling to readjust to civilian life following their military 
service. I am glad that this amendment will make it easier for veterans 
who lack childcare to seek the support they need in vet centers, and I 
will be supporting this amendment.
  That being said, expanding childcare assistance to include the 
hundreds of vet centers across the country is a costly prospect. 
Unfortunately, because the bill did not go through regular order, we do 
not know just how costly this project will be.
  I wish that we could have received reviews and cost estimates on this 
proposal prior to voting on it and hope that, moving forward, bills 
will have the benefit of work in committee before being moved onto the 
floor.
  Mr. Chair, I reserve the balance of my time.
  Mrs. LEE of Nevada. Mr. Chairman, I yield 1 minute to the gentleman 
from California (Mr. Takano).
  Mr. TAKANO. Mr. Chair, I thank the gentlewoman for yielding.
  I support this amendment because, by clarifying that vet centers are 
covered under the bill, we are ensuring that veterans seeking 
healthcare at any VA facility are allowed access-at-no-cost childcare.
  Vet centers are particularly attractive to veterans who are 
uncomfortable in a more clinical setting, and they should be able to 
seek childcare while they receive their mental health care at a VA vet 
center.
  Mr. DAVID P. ROE of Tennessee. Mr. Chairman, I yield 2 minutes to the 
gentlewoman from Arizona (Mrs. Lesko).

                              {time}  1615

  Mrs. LESKO. Mr. Chair, I am proud to come to the floor today to 
discuss an amendment to H.R. 840, the Veterans' Access to Child Care 
Act, that I have cosponsored with my colleague, Representative Susie 
Lee from Nevada.
  The Veterans' Access to Child Care Act will provide veterans who need 
to attend regular or intensive mental healthcare appointments with no-
cost childcare during their appointments. Our amendment will make sure 
these childcare services are covered at our local VA clinics, such as 
the one in my district in Peoria, Arizona, along with the main VA 
facilities.
  No veteran seeking these types of mental health services should be 
left behind. It is our responsibility to ensure that, under this 
legislation, all our eligible veterans who need mental health services 
are able to go to a facility operated by the VA Department, even if it 
is located separately from the VA's general healthcare facility.
  My home State of Arizona is blessed to be home to so many of our 
Nation's veterans. In fact, I have 70,000 veterans in my district 
alone. However, it deeply troubles me that veteran suicide rates are 9 
percentage points higher in Arizona than the national average.
  Expensive childcare should not hinder Arizona's returning veterans 
the ability to access needed mental healthcare or other prolonged 
service-connected disability care needs.
  We need to do everything we can do to help our Nation's greatest 
heroes. They risked it all for us. It is inexcusable for us, after our 
veterans have given so much to defend our freedoms, to permit policies 
that don't give them the best resources to recover and heal. We relied 
on them to protect us; now we must step up and help them.
  I thank Representatives Brownley and Roe for their work on this 
legislation, and Representative Lee for her effort on this much-needed 
amendment.
  I urge all of my colleagues to support this amendment to give 
eligible veterans choice and access.
  Mrs. LEE of Nevada. Mr. Chairman, I have no other speakers, and I am 
prepared to close at this time, if my colleague is as well.
  Mr. Chairman, I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I am prepared to close and 
urge support of this bipartisan amendment, and I yield back the balance 
of my time.
  Mrs. LEE of Nevada. Mr. Chair, I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentlewoman from Nevada (Mrs. Lee).
  The amendment was agreed to.


                  Amendment No. 6 Offered by Mr. Barr

  The Acting CHAIR. It is now in order to consider amendment No. 6 
printed in House Report 116-6.
  Mr. BARR. Mr. Chairman, I have an amendment at the desk.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       At the end, add the following:

     SEC. 3. STUDY ON EFFECTS OF CHILD CARE ASSISTANCE.

       (a) Study Required.--Not later than one year after the date 
     of the enactment of this Act, the Secretary of Veterans 
     Affairs shall conduct a study of the effects of the child 
     care assistance provided under section 2 on access to covered 
     health care services, as that term is defined in that 
     section, and on compliance with treatment protocols.
       (b) Report.--Not later than 18 months after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit a report to Congress regarding the study 
     required under subsection (a).

  The Acting CHAIR. Pursuant to House Resolution 105, the gentleman

[[Page H1427]]

from Kentucky (Mr. Barr) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentleman from Kentucky.
  Mr. BARR. Mr. Chairman, I rise today in support of my amendment to 
H.R. 840, the Veterans' Access to Child Care Act.
  Let me just first say to my good friend, the ranking member of the 
House Veterans' Affairs Committee, I appreciate the opportunity and the 
privilege and the responsibility to serve in this Congress on the House 
Veterans' Affairs Committee so we can continue to advocate for the 
veterans of the Sixth Congressional District of Kentucky and throughout 
the Nation.
  This amendment would require the Secretary of Veterans Affairs to 
conduct a study on the effects of childcare assistance provided in the 
underlying bill on access to healthcare services and compliance with 
treatment protocols. While I certainly support the underlying bill, 
this amendment is a commonsense measure that would improve the 
legislation.
  We should always be willing to evaluate and assess whether or not the 
policies we enact are actually producing their intended result; and 
this amendment, by requiring the Secretary to conduct a study after 1 
year of the effects of the childcare assistance on the actual access to 
the covered healthcare services and the requirement to report the 
findings of that study after 18 months to Congress, will ensure that 
the policies we implement are actually successful in increasing 
veterans' access to care.
  I urge my colleagues to support this amendment.
  Mr. Chair, I yield 1 minute to the gentleman from Tennessee (Mr. 
David P. Roe), the ranking member of the Veterans' Affairs Committee.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I thank the gentleman from 
Kentucky, my next-door neighbor, for doing this. We are really pleased 
to have him on the Veterans' Affairs Committee, Mr. Chair.
  I rise in support of this amendment to require VA to study how the 
provision of childcare assistance impacts access to and compliance with 
care.
  It is important that we closely monitor any taxpayer-funded program 
to ensure that it is meeting its intended objectives, and I am grateful 
for Congressman Barr's foresight in ensuring that we do this for this 
program as well.
  Congressman Barr has long been a strong supporter of our Nation's 
veterans, and I am pleased to welcome him, as stated, to the Veterans' 
Affairs Committee this Congress. I thank him for his leadership on this 
amendment and hope that all of my colleagues will join me in supporting 
this amendment.
  Mr. TAKANO. Mr. Chair, I claim the time in opposition to the 
amendment, even though I am not opposed to it.
  The Acting CHAIR. Without objection, the gentleman from California is 
recognized for 5 minutes.
  There was no objection.
  Mr. TAKANO. Mr. Chairman, I rise in support of this amendment offered 
by the gentleman from Kentucky, a new member on the Committee on 
Veterans' Affairs, and I believe the co-chair of the Bourbon Caucus.
  I agree that it is important to require that VA collect data on the 
effectiveness of its childcare program so we can determine whether 
veterans are better able to access their healthcare because of this 
benefit.
  As the veterans population becomes increasingly diverse, the VA of 
the year 2030 that I envision must be prepared to provide healthcare to 
women veterans, fathers of young children, stepparents and 
grandparents, and to make sure veterans are able to access their 
healthcare while also caring for their children.
  Congress and VA need reliable data to inform these decisions and 
determine whether other barriers to healthcare access exist for 
veterans who care for young children. If the data from this study 
demonstrates that veterans are less likely to miss appointments and 
have better healthcare outcomes, it could be used to inform further VA 
policy decisions to expand the program.
  Mr. Chairman, I wholeheartedly support this bipartisan amendment, and 
I yield back the balance of my time.
  Mr. BARR. Mr. Chair, I appreciate the chairman's kind words, and I 
appreciate the chairman's support of this amendment.
  I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentleman from Kentucky (Mr. Barr).
  The amendment was agreed to.


                Amendment No. 7 Offered by Mr. Cisneros

  The Acting CHAIR. It is now in order to consider amendment No. 7 
printed in House Report 116-6.
  Mr. CISNEROS. Mr. Chair, I have an amendment, No. 7, at the desk made 
in order by the rule.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       At the end of the bill, insert the following:
       (c) Feasibility Study on Child Care for Veterans Receiving 
     Care in Non-Department Facilities.--
       (1) Study required.--The Secretary of Veterans Affairs 
     shall conduct a feasibility study to determine how the 
     Department of Veterans Affairs could provide child care 
     assistance for veterans who receive covered health care 
     services (as such term is defined in section 1730D(c)(2) of 
     title 38, United States Code, as added by subsection (a)) 
     from the Department at non-Department facilities.
       (2) Submission to congress.--Not later than one year after 
     the date of the enactment of this Act, the Secretary shall 
     submit to the Committees on Veterans Affairs of the Senate 
     and House of Representatives a report containing the results 
     of the study required to be conducted under paragraph (1).

  The Acting CHAIR. Pursuant to House Resolution 105, the gentleman 
from California (Mr. Cisneros) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentleman from California.
  Mr. CISNEROS. Mr. Chairman, I sincerely thank my colleague, Ms. 
Brownley, for her steadfast leadership on this critical issue, and Mr. 
Takano for working with me to ensure consideration. Finally, I would 
like to thank the gentleman from Vermont (Mr. Welch) for cosponsoring 
this amendment.
  I rise to offer an amendment, which would require the Secretary of 
Veterans Affairs to study how the VA could provide childcare assistance 
for veterans who receive covered healthcare services furnished by the 
VA at non-Department facilities.
  I am a strong supporter and cosponsor of H.R. 840 because I am 
committed to advancing policies that make it easier for all veterans to 
take advantage of their VA benefits they deserve.
  As a veteran with two young twin boys, I know firsthand that 
rambunctious young kids can often derail the best of plans. Providing 
safe, affordable, and convenient childcare for veterans who are parents 
and grandparents eliminates just one of those many barriers to quality 
care our veterans can face when trying to make health and mental health 
appointments. I rise to offer this amendment to ensure that my 
constituents are not left behind in this noble effort.
  Orange County, California, is home to the largest veteran population 
in the country, approximately 130,000 veterans, without its own VA 
hospital. This leaves many of my constituents without easy access to 
high-quality care our VA system provides.
  My amendment would direct the VA to conduct a feasibility study to 
determine how the Department of Veterans Affairs could provide 
childcare assistance for veterans who receive healthcare services far 
from a VA medical center campus. This includes my constituents seeking 
care at the Anaheim community-based orthopedic clinic.
  I urge my colleagues to join me in support of this amendment to 
ensure we do not overlook veterans who could benefit from childcare 
services.
  Mr. Chair, I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I ask unanimous consent to 
rise in opposition, although I am not opposed to it.
  The Acting CHAIR. Is there objection to the request of the gentleman 
from Tennessee?
  There was no objection.
  The Acting CHAIR. The gentleman is recognized for 5 minutes.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I rise in support of 
Congressman Cisneros' and Congressman Welch's amendment to require VA 
to conduct a study to assess the feasibility of VA-provided childcare 
assistance for veterans receiving community care. This is a critically 
important amendment.

[[Page H1428]]

  For decades, VA has had the authority to refer patients to community 
providers when veterans are unable to get the care they need in VA 
medical facilities for various reasons. Last year, almost 40 percent of 
appointments in the VA healthcare system occurred in the community.
  Clearly, VA cannot meet every need of every veteran patient in every 
community across this country without the assistance of community 
partners. That is not the fault of the VA healthcare system. It is a 
strength.
  Veterans in need of childcare assistance should not be denied such 
assistance when they are referred to a VA community partner rather than 
a VA provider.
  I am disappointed that another amendment offered by Congressman Case, 
that would have simply lifted this barrier to care for those veterans 
who must seek care through community partners, was not accepted. 
However, I am encouraged that the issue will be reexamined through this 
study.
  I urge my colleagues to join me in supporting this amendment today.
  Mr. Chair, I reserve the balance of my time.
  Mr. CISNEROS. Mr. Chairman, I yield 1 minute to the gentleman from 
California (Mr. Takano).
  Mr. TAKANO. Mr. Chairman, I thank the gentleman for yielding.
  I support this amendment because it will allow Congress to receive 
the critical data and information it needs to determine how to expand 
this program and the feasibility of expanding this program to 
community-based outpatient clinics and VA centers, VA facilities that 
are away from the main VA medical center campuses but critical for 
veterans in rural areas to access their care.
  While this bill specifically provides the no-cost childcare benefit 
to veterans receiving care from the VA doctors, nurses, and VA 
providers, I would like to work with my colleagues on the committee at 
a future date on whether it may be feasible to provide no-cost 
childcare to veterans receiving treatment from community providers, or 
even look at ways we can provide incentives to community providers to 
offer no-cost childcare on-site when they contract with the VA to 
provide care to veterans.
  I thank the gentleman for offering this important amendment. I 
support it wholeheartedly, and I urge all my colleagues to do so as 
well.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I strongly support 
Congressman Cisneros' amendment, and I yield back the balance of my 
time.
  Mr. CISNEROS. Mr. Chairman, I just want to reiterate that this is a 
simple amendment to require a study by the VA within 1 year.
  I urge my colleagues to adopt this amendment, and I yield back the 
balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentleman from California (Mr. Takano).
  The amendment was agreed to.

                              {time}  1630


                Amendment No. 8 Offered by Mr. Cisneros

  The Acting CHAIR. It is now in order to consider amendment No. 8 
printed in House Report 116-6.
  Mr. CISNEROS. Mr. Chairman, I have an amendment, No. 8, at the desk 
made in order by the rule.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 3, line 16, strike ``or'';
       Page 3, after line 16, insert the following: S6201
       ``(C) intensive health care services related to physical 
     therapy for a service-connected disability; or''.
       Page 3, line 17, strike ``(C)'' and insert ``(D)''.

  The Acting CHAIR. Pursuant to House Resolution 105, the gentleman 
from California (Mr. Cisneros) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentleman from California.
  Mr. CISNEROS. Mr. Chairman, I want to quickly thank my colleague and 
chair of the House Committee on Veterans' Affairs, Mr. Takano, for 
urging, in his testimony before the House Committee on Rules, that this 
amendment be made in order.
  I rise to offer an amendment which would include ``intensive 
healthcare services related to physical therapy for a service-connected 
disability'' in the definition of ``covered healthcare service.''
  Physical therapy is an important aspect of any human process and is 
often necessary for veterans suffering from sustained pain or 
discomfort from a service-connected disability. This experience can 
often involve lengthy commitments and long commutes to achieve results.
  For my constituents, accessing physical therapy services at VA health 
clinics, receiving regular physical therapy means making a regular 
commitment to be stuck in traffic on the 405 to drive to the Long Beach 
VA hospital.
  My amendment will ensure that veterans in need of physical therapy 
for a service-connected disability are specifically afforded access to 
childcare services.
  VA benefits are not truly benefits if the costs associated with 
childcare during regular appointments place too large a burden on 
veteran caretakers.
  Veterans and their families face many obstacles when transitioning 
back to civilian life, but access to healthcare should not be one of 
them. I urge my colleagues to support this amendment.
  Mr. Chairman, I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Mr. Chairman, I ask unanimous consent 
to rise in opposition to the amendment, although I am not opposed.
  The Acting CHAIR. Is there objection to the request of the gentleman 
from Tennessee?
  There was no objection.
  The Acting CHAIR. The gentleman is recognized for 5 minutes.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I yield myself such time as 
I may consume.
  Mr. Chair, I share the gentleman's concern. I have been on the 405, 
and I certainly understand that trip.
  Mr. Chairman, I rise in support of Congressman Cisneros' amendment to 
include physical therapy for service-connected disabilities under the 
definition of ``covered health service.''
  Caring for service-connected conditions is the reason the VA 
healthcare system exists. Service-connected conditions should always 
take priority. I thank Congressman Cisneros for recognizing this with 
his amendment. I am proud to join him in supporting it.
  Mr. Chair, I reserve the balance of my time.
  Mr. CISNEROS. Mr. Chairman, I yield 1 minute to the gentleman from 
California (Mr. Takano).
  Mr. TAKANO. Mr. Chair, I thank the gentleman for yielding.
  I support this amendment because it provides an important 
clarification that veterans receiving physical therapy for a service-
connected disability will be able to access no-cost childcare.
  When 50 percent of the veterans treated in VA facilities suffer from 
chronic pain, physical therapy is a vital part of their treatment that 
will reduce their need for prescribing opioids. We are in the midst of 
an opioid epidemic in this country, and many of our veterans, sadly, 
suffer from opioid addiction because they were prescribed these 
powerful drugs to treat pain.
  We should encourage other treatments like physical therapy, which can 
address the root cause of pain, and make it easier for them to access 
this care, which often requires multiple treatments over time.
  I thank the gentleman for this important amendment, and I urge my 
colleagues to support it.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, caring for service-
connected conditions is the reason the VA healthcare system exists. I 
strongly support Congressman Cisneros' amendment and encourage my 
colleagues to support it also.
  I yield back the balance of my time.
  Mr. CISNEROS. Mr. Chairman, I just want to reiterate that this is a 
simple, commonsense amendment. I urge my colleagues to adopt this 
amendment.
  I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentleman from California (Mr. Cisneros).
  The amendment was agreed to.


        Amendment No. 9 Offered by Mr. Rodney Davis of Illinois

  The Acting CHAIR. It is now in order to consider amendment No. 9 
printed in House Report 116-6.
  Mr. RODNEY DAVIS of Illinois. Mr. Chairman, I have an amendment at 
the desk.

[[Page H1429]]

  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 3, line 3, strike ``the'' and insert ``a''.

  The Acting CHAIR. Pursuant to House Resolution 105, the gentleman 
from Illinois (Mr. Rodney Davis) and a Member opposed each will control 
5 minutes.
  The Chair recognizes the gentleman from Illinois.
  Mr. RODNEY DAVIS of Illinois. Mr. Chairman, I obviously rise in 
support of our amendment.
  Mr. Chairman, I yield 2 minutes to the gentleman from Tennessee (Mr. 
David P. Roe), the ranking member of the Committee on Veterans' 
Affairs, before I offer my comments.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I want to thank Congressman 
Rodney Davis, first of all, for his commitment to our Nation's heroes.
  I was able and privileged to be in his district last year. I saw his 
commitment to that and the respect that they have for him, and I want 
to thank him for bringing this up. He does a terrific job for our 
Nation's heroes in his district, and it was a privilege to be there.
  I rise in support of Congressman Davis' and Congressman Panetta's 
commonsense amendment. The bill we are considering today defines a 
veteran who is eligible for childcare assistance as a veteran who is 
``the'' primary caretaker of a child or children. However, this 
amendment rightly recognizes that most children have two parents and 
either of them could be considered ``a'' primary caretaker of that 
child.
  I thank Congressman Davis and Congressman Panetta for that 
clarification, and I am happy to support this amendment today.
  Mr. TAKANO. Mr. Chairman, I rise in opposition, even though I am not 
opposed to the amendment.
  The Acting CHAIR. Without objection, the gentleman from California is 
recognized for 5 minutes.
  There was no objection.
  Mr. TAKANO. Mr. Chairman, I rise in support of this amendment offered 
by the gentleman from Illinois, which would ensure either parent to a 
young child would be considered the primary caretaker for a child and, 
therefore, eligible to receive the childcare benefit.
  This amendment is necessary, especially in instances when a veteran 
is receiving mental health services with a spouse. In instances like 
this, a veteran could not rely on the spouse to watch a child if it was 
important that a spouse participate in the treatment.
  This will also relieve a significant administrative burden on VA and 
the veteran: As long as a veteran is a parent to a child and in need of 
childcare, that veteran would be eligible.
  As lawmakers, we should strive to make sure that programs we 
authorize are not confusing to VA and conduct oversight to ensure our 
constituents are not confused when the VA rolls out a program. This 
amendment will make it more clear to VA and veterans that, in families 
where one or both parents are veterans, they are eligible for this 
childcare benefit when receiving services from the VA.
  I support this amendment, and I urge my colleagues to do the same.
  I reserve the balance of my time.
  Mr. RODNEY DAVIS of Illinois. Mr. Chairman, in my short time here in 
this institution, I have found that, when you offer an amendment to a 
bill that has jurisdiction of a committee that you don't sit on, it is 
always good to have the chairman and ranking member be in support of 
your amendment. So I want to thank Chairman Takano and Ranking Member 
Roe for their help--and their team's help--in helping us craft this 
commonsense solution.
  And I really want to thank my good friend and colleague Jimmy 
Panetta, who is a main cosponsor of this amendment. Jimmy and I have 
worked together on a wide variety of issues, but not many more 
important than making sure that our families, our heroes, get access to 
the childcare and the services that they need.
  This Veterans' Access to Child Care Act, also, Mr. Chairman, builds 
upon a successful pilot program and is finally going to provide some 
certainty and better access to mental and intensive healthcare services 
for our heroes, our veterans, through increased access to childcare 
while our veterans attend the appointments that they need to attend to.
  The intention of this amendment, as you heard from the chairman and 
the ranking member, is to make sure that the VA does not determine that 
this bill is meant that there is only one primary caretaker in the 
family and then, arbitrarily, have a bureaucrat at the VA decide who 
that caretaker is.
  Without this change, some veterans this bill is intended to help 
would not be able to access childcare over a technicality. Our 
amendment, as you heard, clarifies this language to help eliminate 
barriers to mental health services for our veterans with families.
  When our veterans face a mental health crisis, I want to ensure that 
they are not alone, and that we are doing everything we can to properly 
support them and their families.
  While we have been successful in passing legislation that prevents 
many veterans from having to drive long distances to access care, it is 
possible that, in some cases, a veteran in my district could have to 
drive 4 hours to the nearest VA hospital, and ensured access to 
childcare will encourage them to get the services that they need.
  I don't want a technicality to get in the way of our heroes. I want 
to make sure they get access to the services they need. That is why I 
urge my colleagues to support this bipartisan amendment.
  I urge all Members to support our amendment to H.R. 840, and I yield 
back the balance of my time.
  Mr. TAKANO. Mr. Chairman, I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentleman from Illinois (Mr. Rodney Davis).
  The amendment was agreed to.


                 Amendment No. 10 Offered by Mr. Sablan

  The Acting CHAIR. It is now in order to consider amendment No. 10 
printed in House Report 116-6.
  Mr. SABLAN. Mr. Chairman, I have an amendment at the desk.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 3, line 14, insert ``, including telemental health 
     services furnished by the Department'' after ``services''.
       Page 3, line 15, insert ``, including telemental health 
     services furnished by the Department'' after ``services''.

  The Acting CHAIR. Pursuant to House Resolution 105, the gentleman 
from the Northern Mariana Islands (Mr. Sablan) and a Member opposed 
each will control 5 minutes.
  The Chair recognizes the gentleman from the Northern Mariana Islands.
  Mr. SABLAN. Mr. Chairman, I rise today to offer an amendment 
clarifying that telemental health services furnished by the VA are 
included in the list of covered healthcare services under H.R. 840.
  Making it easier for veterans to get mental healthcare services by 
providing childcare while they are receiving treatment just makes 
sense. Most parents are not going to use the mental health services the 
VA provides if it means leaving their kids at home alone. Worrying 
about their children will only worsen the mental stress for veterans in 
need of care.
  So I support H.R. 840, but I want to make sure the childcare the bill 
offers will be available to veterans in my district who can only 
receive mental health service by videoconference.
  We do not have a VA psychologist in the Marianas. For that matter, we 
do not have a community-based outpatient clinic or a vet center or a 
VBA specialist, services that veterans in the rest of America can take 
for granted. So my vets must sit in front of a video monitor to get 
mental health counseling--not exactly the best arrangement, in my 
opinion.
  So let us at least try and make sure that veterans in the Marianas--
or anywhere else in the Nation--or anywhere else the VA only offers 
telemedicine instead of real person-to-person care, that those veterans 
do not have to worry about the safety and well-being of their children. 
Let us be sure there is no ambiguity in H.R. 840.
  I ask my colleagues for their support of my amendment, backed by the 
Veterans of Foreign Wars, so we can be sure that even vets receiving 
mental health services by video can have the cost of childcare covered.
  I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I ask unanimous consent to 
rise

[[Page H1430]]

in opposition, although I am not opposed.
  The Acting CHAIR. Is there objection to the request of the gentleman 
from Tennessee?
  There was no objection.
  The Acting CHAIR. The gentleman is recognized for 5 minutes.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I yield myself such time as 
I may consume.
  Mr. Chair, I rise in support of Congressman Sablan's amendment to 
include mental healthcare provided via telemedicine under the 
definition of a ``covered health service.''
  The VA healthcare system is an industry leader in telemedicine and 
should be commended in using it to increase access to care for veterans 
who would otherwise have to travel great distances on a regular basis 
to receive the care they need.
  I want to thank my good friend, Congressman Sablan, who is a tireless 
advocate in the Marianas. He has been an amazing supporter of the 
veterans there who really have very limited services. I thank him for 
introducing this amendment to make sure that veterans accessing tele-
healthcare are also eligible for childcare assistance, if needed.
  I am pleased to join him in supporting this.
  Mr. Chair, I yield back the balance of my time.

                              {time}  1645

  Mr. SABLAN. Mr. Chair, I very much thank the chairman of the 
committee, the gentleman from California, and the ranking member, the 
gentleman from Tennessee, for their leadership on the House Veterans' 
Affairs Committee.
  Mr. Chair, I would like to thank my colleague, Ms. Brownley, for 
introducing this bill.
  Mr. Chair, I yield as much time as he may consume to the gentleman 
from California (Mr. Takano), the chairman of the House Veterans' 
Affairs Committee.
  Mr. TAKANO. Mr. Chair, I thank the gentleman for yielding.
  Mr. Chairman, I want to make note that we just have gotten a release 
that the VA has exceeded 1 million telehealth visits in fiscal year 
2018. That one-year achievement represents a 19 percent increase over 
the previous year. I congratulate the VA for that amazing achievement.
  I want to make known my support for my good colleague from the 
Northern Mariana Islands, Mr. Sablan's, amendment, because as VA 
expands its footprint--and we have just seen how it has expanded its 
footprint significantly--and that it remains at the forefront of 
providing treatment via telemental health services, we need to ensure 
that the VA has the ability to make those telehealth services as 
successful as their in-person services.
  In districts like Mr. Sablan's where veterans are separated from VA 
healthcare services by the Pacific Ocean, telemental health is often 
the only manner in which veterans are able to receive mental healthcare 
from the VA.
  Mr. Chair, I thank the gentleman for offering this very important 
amendment and I urge my colleagues to support it.
  Mr. SABLAN. Mr. Chair, I have no further speakers. I ask for support 
for H.R. 840, and I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentleman from the Northern Mariana Islands (Mr. Sablan).
  The amendment was agreed to.


                 Amendment No. 11 Offered by Mr. Cloud

  The Acting CHAIR. It is now in order to consider amendment No. 11 
printed in House Report 116-6.
  Mr. CLOUD. Mr. Chair, I have an amendment at the desk.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 2, after line 24, insert the following:
       ``(c) Annual Report.--
       ``(1) In general.--The Secretary shall submit to Congress 
     an annual report on the provision of child care assistance 
     under this section. Each such report shall include, for the 
     year covered by the report, each of the following for each of 
     the categories of child care assistance specified in 
     paragraph (2):
       ``(A) The average amount of time required by the Department 
     to provide a payment for child care assistance.
       ``(B) The average cost of child care assistance.
       ``(C) The extent to which the Department has a backlog of 
     unprocessed claims for child care assistance.
       ``(D) The number of Department employees who worked on the 
     processing of claims for child care assistance.
       ``(E) The average amount of time required by such an 
     employee to process such a claim.
       ``(F) The number of improper or duplicative payments of 
     child care assistance made.
       ``(G) The recommendations of the Secretary for improving 
     the processing of claims for child care assistance.
       ``(2) Categories of child care assistance.--The categories 
     of child care assistance specified in this paragraph are each 
     of the following:
       ``(A) Direct stipends.
       ``(B) Payments made directly to a child care agencies.
       ``(C) Stipends provided through a voucher program.''.
       Page 2, line 25, strike ``(c)'' and insert ``(d)''.

  The Acting CHAIR. Pursuant to House Resolution 105, the gentleman 
from Texas (Mr. Cloud) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentleman from Texas.
  Mr. CLOUD. Mr. Chair, I rise in support of my amendment to H.R. 840, 
the Veterans' Access to Child Care Act.
  In 2017, the Congressional Budget Office estimated that under similar 
legislation to what we are considering today, the VA each year would 
need to process about 665,000 claims for reimbursement of childcare 
each year.
  The VA has a history filled with delays and difficulty in processing 
claims for veterans.
  As my staff and I have worked with veterans in our Texas 27th 
District, we too often hear from veterans about the trouble they have 
encountered with the VA. From delays in processing benefit claims, to 
wait times in scheduling appointments; veterans have often waited 
months, sometimes years from hearing back from the VA on their request 
or receiving reimbursement for payments due them.
  Should this bill pass, the VA will have to process a considerable 
amount of childcare claims each year; therefore, we must ensure that 
there is oversight in the VA's progress in paying veterans and private 
care providers for childcare.
  My amendment would inject accountability into this program by 
requiring the VA to submit an annual report to Congress on how the 
processing of claims is going.
  Specifically, the report would include data on the number of 
childcare claims filed each year, the number of staffers required to 
process a claim, the average cost of each claim, and how long it takes 
the VA to process a claim.
  If there is a backlog of unprocessed claims, the VA must report on 
the backlog and how it is working to resolve the needs of the affected 
veterans.
  Finally, the VA must report on any improper or duplicative payments 
made for this program.
  Ultimately, my amendment would close the gap in this legislation by 
giving the House Veterans' Affairs Committee and the VSOs important 
data they otherwise wouldn't have.
  Mr. Chair, I reserve the balance of my time.
  Mr. TAKANO. Mr. Chairman, I claim the time in opposition to the 
amendment, even though I am not opposed to the amendment.
  The Acting CHAIR. Without objection, the gentleman from California is 
recognized for 5 minutes.
  There was no objection.
  Mr. TAKANO. Mr. Chairman, I rise in support of the amendment offered 
by the gentleman from Texas.
  I think all of us can recount concerns raised by our constituents 
about VA payment processing and late payments to healthcare providers.
  Although I am not aware of any issues with respect to VA stipend 
payments to childcare providers under VA's pilot program, I do think it 
is important that VA report to Congress on whether it has experienced 
problems with making timely payments and ask for the resources to 
address payment processing.
  The more data we collect from VA, the better we are able to determine 
what solutions and resources are needed to improve VA programs and 
services.
  Mr. Chair, I do thank the gentleman for offering this amendment, and 
I reserve the balance of my time.
  Mr. CLOUD. Mr. Chair, I thank the chairman for his support.

[[Page H1431]]

  Mr. Chair, I yield 1 minute to the gentleman from Tennessee (Mr. 
David P. Roe), the ranking member.
  Mr. DAVID P. ROE of Tennessee. Mr. Chair, I rise in support of this 
amendment to require an annual report on the processing of claims for 
childcare assistance.
  VA has made improvements in recent years in the speed at which 
community providers are being reimbursed for the services they provide 
to veteran patients, however, claims processing remains an area where 
VA struggles; to be kind to them, struggles.
  We must take steps to ensure that veterans and childcare providers 
who are awaiting reimbursement pursuant to this bill are not left 
waiting like many veterans and community providers have been 
previously.
  Mr. Chair, I am grateful to Congressman Cloud for his leadership and 
sponsoring this amendment and I look forward to joining him in its 
support.
  Mr. CLOUD. Mr. Chair, I urge the passage of this amendment, and I 
yield back the balance of my time.
  Mr. TAKANO. Mr. Chairman, I have no further speakers. I urge support 
for the gentleman's amendment, and I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentleman from Texas (Mr. Cloud).
  The amendment was agreed to.
  Mr. TAKANO. Mr. Chairman, I move that the Committee do now rise.
  The motion was agreed to.
  Accordingly, the Committee rose; and the Speaker pro tempore (Mr. 
Sean Patrick Maloney of New York) having assumed the chair, Mr. Johnson 
of Georgia, Acting Chair of the Committee of the Whole House on the 
state of the Union, reported that that Committee, having had under 
consideration the bill (H.R. 840) to amend title 38, United States 
Code, to direct the Secretary of Veterans Affairs to provide child care 
assistance to veterans receiving certain medical services provided by 
the Department of Veterans Affairs, had come to no resolution thereon.

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