[Congressional Record Volume 165, Number 85 (Tuesday, May 21, 2019)]
[House]
[Pages H4043-H4045]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                VETERANS' CARE QUALITY TRANSPARENCY ACT

  Mr. TAKANO. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 2372) to direct the Comptroller General of the United States 
to conduct an assessment of all memoranda of understanding and 
memoranda of agreement between Under Secretary of Health and non-
Department of Veterans Affairs entities relating to suicide prevention 
and mental health services, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2372

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Veterans' Care Quality 
     Transparency Act''.

     SEC. 2. COMPTROLLER GENERAL ASSESSMENT OF MEMORANDA OF 
                   UNDERSTANDING AND MEMORANDA OF AGREEMENT 
                   BETWEEN UNDER SECRETARY OF HEALTH AND NON-
                   DEPARTMENT OF VETERANS AFFAIRS ENTITIES 
                   RELATING TO SUICIDE PREVENTION AND MENTAL 
                   HEALTH SERVICES.

       (a) Assessment.--Not later than 270 days after the date of 
     the enactment of this Act, the Comptroller General of the 
     United States shall conduct an assessment of the 
     effectiveness of all memoranda of understanding and memoranda 
     of agreement entered into by the Under Secretary of Veterans 
     Affairs for Health and a non-Department of Veterans Affairs 
     entity relating to--
       (1) suicide prevention activities and outreach; and
       (2) the provision or coordination of mental health services 
     during the five-year period preceding the date of the 
     enactment of this Act.
       (b) Contents of Assessment.--The assessment required by 
     subsection (a) shall include an assessment of--
       (1) the size of the catchment area of each such entity;
       (2) the staffing structures of such entities;
       (3) any accreditation or licensure any such entity has 
     obtained in relation to the services the entity provides;
       (4) any variances in the subpopulations of veterans served 
     by such entities;
       (5) any limitations any such entity may face in carrying 
     out its obligations under the memorandum of understanding or 
     memorandum of agreement;

[[Page H4044]]

       (6) the extent to which the Under Secretary provides 
     oversight and tracks outcomes of such entities;
       (7) any variations in the structure or requirements of the 
     memoranda of understanding and memoranda of agreement;
       (8) a breakdown of the percentage of such entities that 
     serve--
       (A) women veterans;
       (B) minority veterans;
       (C) veterans who are over the age of 55;
       (D) veterans between the ages of 18 and 34;
       (E) veterans who reside in United States insular areas; and
       (F) veterans' families; and
       (9) any measures taken to ensure the secure exchange of 
     data and information between such entities and the Department 
     of Veterans Affairs.
       (c) Report to Congress.--Not later than 270 days after the 
     completion of the assessment under subsection (a), the 
     Comptroller General shall submit to the Committees on 
     Veterans' Affairs of the Senate and House of Representatives 
     a report on the results of the assessment.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Takano) and the gentleman from Tennessee (Mr. David P. 
Roe) each will control 20 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. TAKANO. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on H.R. 2372, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. TAKANO. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, to meet the needs of veterans, VA has long relied on 
community partners to provide outreach and services, particularly to 
address mental health needs and suicide prevention.
  The number of mental health- and suicide prevention-related 
agreements between VA and these organizations has increased 
exponentially since 2014. It is anticipated that these relationships 
will continue to grow in the months following the signing of Executive 
Order No. 13861 on March 5, 2019.
  Now, this executive order seeks to establish grants to local 
communities to better collaborate and integrate service delivery and 
resources for veterans. As reliance on outside groups grows, Congress 
must better understand the effectiveness of the programs and mental 
health services these private organizations offer. VA must also ensure 
such partnered organizations are able to provide quality, culturally 
competent, evidence-based services to veterans.
  Congresswoman Underwood's legislation, H.R. 2372, as amended, would 
require the Government Accountability Office to study the effectiveness 
of these partnerships between VA and organizations providing services 
related to suicide prevention and mental healthcare.
  When complete, GAO would report their findings to the House and 
Senate Veterans' Affairs Committees. As part of the assessment, GAO is 
required to look at several factors, such as the staffing structure of 
the organization, its accreditations or licensures, the level of 
oversight and tracking of outcomes by VA, and the secure exchange of 
data and information.
  The GAO would also be required to study the ability of these 
organizations to serve unique subsets of the veteran population, 
including, women, minorities, older and younger veteran cohorts, 
families, and veterans who reside in U.S. insular areas.
  I thank Ms. Underwood for introducing this legislation because it 
will ensure VA is responsibly leveraging its community partnerships to 
reduce veteran suicide and support VA in its transformation to a public 
health approach to suicide prevention. This public health approach 
focuses on prevention and intervention before veterans are in crisis.
  As I previously mentioned, a two-pronged strategy is necessary to 
address the national crisis of veteran suicide. These Federal, State, 
and local partnerships are integral to the first prong of the strategy 
of prevention and early intervention.
  It is critical that we develop these partnerships as part of an 
infrastructure to support veterans. This legislation will ensure we are 
using taxpayer funds effectively to partner with those organizations 
providing quality, evidence-based programs.
  Madam Speaker, I am proud to support this legislation, and I 
encourage all my colleagues to vote ``yes'' on H.R. 2372, as amended.
  Madam Speaker, I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Madam Speaker, I yield myself such 
time as I may consume.
  Madam Speaker, I rise today in support of H.R. 2372, as amended, the 
Veterans' Care Quality Transparency Act.
  This bill is sponsored by Congresswoman Lauren Underwood of Illinois, 
and I thank her for her efforts to bring it to the House floor today.
  This bill would require the Government Accountability Office to 
conduct an assessment of the effectiveness of all memoranda of 
understanding and memoranda of agreement entered into by the Department 
of Veterans Affairs and other governmental or private-sector entities 
regarding suicide prevention activities and outreach, as well as the 
coordination of mental health services, during the 5-year period 
preceding the date of enactment.
  For the last two decades, approximately 20 of our Nation's 
servicemembers and veterans have died by suicide on a daily basis.
  Suicide is, unquestionably, a tragedy that impacts all Americans and 
is a crisis that VA cannot combat alone. In light of that, VA has 
become increasingly mindful of the need to collaborate with partners in 
both the public and private sectors to connect with servicemembers, 
veterans, and their families wherever they reside and with whatever 
they may be struggling.
  This bill would ensure that Congress has insight into those 
collaborations and whether or not they are working as intended to 
reduce incidents of suicide among those who have served our country.
  Madam Speaker, I encourage all Members to support this bill today, 
and I reserve the balance of my time.
  Mr. TAKANO. Madam Speaker, I yield 3 minutes to the gentlewoman from 
Illinois (Ms. Underwood), my good friend, member of the Disability 
Assistance and Memorial Affairs Subcommittee, and author of H.R. 2372.
  Ms. UNDERWOOD. Madam Speaker, I rise today in support of my bill, the 
Veterans' Care Quality Transparency Act.
  With Memorial Day just around the corner, I am humbled to see these 
bipartisan efforts to bring forward legislation that will help all 
veterans receive the care that they have earned through their service 
to our Nation.
  I am so pleased to see the chairman's focus on ensuring access to 
healthcare for veterans, particularly women veterans, who face unique 
challenges navigating a VA system originally designed to serve men.
  I am committed to working to make needed improvements to the VA by 
working with my colleagues on the Servicewomen and Women Veterans 
Congressional Caucus and on the Women Veterans Task Force.
  I am also pleased to see this bipartisan, wide-ranging focus on 
veterans' mental health and suicide prevention.
  Our work, however, has just begun. We have an urgent responsibility 
to continue to fight for the highest standards of care on behalf of 
veterans.
  Despite much good work by the VA and significant Federal investment, 
the veteran suicide rate hasn't gone down. We must empower the VA to 
find innovative, effective ways to end this crisis. That is why I have 
introduced this bill, which will address a vital but overlooked part of 
veteran suicide prevention.
  The bill directs the GAO to evaluate the effectiveness of agreements 
that the Department of Veterans Affairs has with outside providers for 
mental healthcare and suicide prevention services.
  Expanding access to care for veterans struggling with mental health 
or with thoughts of suicide is an essential part of reducing veteran 
suicide rates, and partnering with providers outside the VA is just one 
way to do that. But there just isn't enough data on the ability of 
these outside providers to meet the high standards of care we expect 
from the VA.
  All veterans deserve access to convenient and high-quality 
healthcare, and it is unacceptable that outside providers are not 
currently held to the same high standards as the VA.

[[Page H4045]]

  The mission of the VA is undermined each time a veteran receives 
substandard care. My bill would help ensure outside providers are held 
to the standard of providing high-quality mental healthcare and suicide 
prevention services.
  Our efforts to stop veteran suicide need to focus on wider, better 
informed, and data-driven paths to tangible results so that we can save 
lives. This bill is about increasing transparency so that we can ensure 
that those who have served our Nation are not left behind when they 
return home.
  I am grateful to my colleagues on the Committee on Veterans' Affairs 
who have reaffirmed their commitment to this issue and who have acted 
so quickly to respond to the veteran suicide crisis with the focus and 
resources it deserves.
  Madam Speaker, I urge my colleagues on both sides of the aisle to 
support this bill.
  Mr. DAVID P. ROE of Tennessee. Madam Speaker, I have no further 
speakers, and I am prepared to close.
  Madam Speaker, I want to thank Congresswoman Underwood for submitting 
this legislation today. I think it is much needed. I have thought it 
all along. Let's find out what works and what doesn't work. I 
appreciate her doing this, and I feel like it will be supported by the 
entire body.
  I encourage all Members of the body to support this legislation, and 
I yield back the balance of my time.

                              {time}  1700

  Mr. TAKANO. Madam Speaker, I yield myself the balance of my time.
  I want to thank Congresswoman Underwood for introducing H.R. 2372, 
and the tremendous, tremendous professional background she brings to 
her role in Congress, and for introducing legislation that will ensure 
that we hold private organizations to the same standard of care that we 
impose internally on the VA.
  So I do urge all of my colleagues to join me in passing H.R. 2372, as 
amended.
  Madam Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Takano) that the House suspend the rules 
and pass the bill, H.R. 2372, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________