Congressional Record, Volume 165 Issue 24 (Thursday, February 7, 2019)

[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).

[[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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