[Congressional Record Volume 165, Number 103 (Wednesday, June 19, 2019)]
[Senate]
[Pages S3824-S3826]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
VA MISSION Act
Ms. ERNST. Mr. President, one of the most sacred promises our Nation
makes is our pledge to care for our men and women in uniform when they
return home.
When it became clear that the VA was falling short of that standard,
I am proud to say that we here in the Senate put politics aside, rolled
up our sleeves, and actually got to work.
The result was the VA MISSION Act, a bipartisan bill that aims to
ensure our veterans are receiving the quality care they have earned and
deserve. I was honored to have been on hand in the Rose Garden
representing Iowa, its veterans, and its military families, as
President Trump signed this bill into law.
This month, the more than 200,000 veterans across Iowa will begin to
see the benefits of those reforms as the VA begins to implement the VA
MISSION Act. That is because one major focus of the bill was to make
sure it would help the VA do a better job of taking care of our
veterans in rural and underserved areas.
Toward that end, one significant reform that is going into effect
this month aims to allow rural or disabled veterans to receive care
from the comfort of their own home by increasing telehealth and
telemedicine services provided by the VA. This was a provision I pushed
for, starting with my VETS Act, and I am so glad it made it into the
final package.
You see, we in Iowa know that rural and disabled vets face an even
harder uphill battle when it comes to getting quality healthcare. This
is because doctors aren't right down the street or a short drive away.
These folks have to drive many miles just to see a caregiver and
sometimes many more for followup treatments or procedures.
The law includes a lot of other great reforms. It expands VA
caregiver benefits to pre-9/11 veterans. It takes steps to modernize VA
facilities, increases resources to hire more providers, and helps
ensure prompt payment to community providers. It is just another
example of how, despite what folks may see on television, the Senate is
passing legislation that is making a positive impact on Americans'
lives.
Our veterans have selflessly sacrificed in defense of our freedom and
our great way of life. They deserve nothing less than the benefits they
were promised and better access to quality care.
With the VA MISSION Act, the Senate has given the VA the tools it
needs to work toward keeping that promise. I am so thankful for the
other Members who will be joining me here today on the floor to talk
through the successes of the implementation of the VA MISSION Act.
Of course, a strong leader who brought this bill over the finish line
is the chairman of the Veterans' Affairs Committee.
I yield to the wonderful Senator from the great State of Georgia,
Johnny Isakson.
(Mr. PERDUE assumed the Chair.)
Mr. ISAKSON. Mr. President, just for the record, a staff sergeant
just addressed a lieutenant colonel. She is beautiful, and she is also
very smart. I am glad to be in the military with her. I am glad to have
served our country and proud of the service she has given our country
and the service she gives to the U.S. Senate and the great State of
Iowa.
As chairman of the Veterans' Affairs Committee, I have had a great
experience the last few years pretty much lined up with what Senator
Ernst said.
When we got here 4 years ago in the Senate and took this committee,
the VA was a mess. Veterans services were not being met. There was
story after story after story of veterans not getting appointments
kept, the wrong tooth being pulled, the wrong leg being set, the wrong
disease being treated. Lots of hospitals had sanitation problems. There
were just a whole lot of things, and I said ``What have I gotten myself
into?'' because I came here to go on the committee and try to help our
veterans get better healthcare. Instead, I thought I was presiding over
the end of healthcare.
So we all set our minds--Senator Ernst and I, Senator Perdue in the
Chair now, and Mr. Scott from the great State of Florida--all of us
rallied and said: We are going to make this right. We are going to go
on a mission. Our mission is to make the VA work and make it work for
our veterans. We are not going to take no for an answer.
On the 6th day of June, a week and a half ago, we all celebrated the
75th anniversary of D-day. But it was the first anniversary of a
renewed VA--a VA on a mission. I am proud to tell you now that on the
first anniversary of the VA MISSION Act, which passed last year, we
have fewer complaints, more compliments, better reserve, and better
outcomes. We are working toward seeing to it that we have the best
possible healthcare we can have for our veterans.
I am glad to join Senator Ernst and the other Senators who will speak
about the promises of the VA system now being met for those who have
sacrificed and risked their lives for us, being sure they are given the
healthcare they want. We are doing it by applying the right types of
principles and the right type of can-do attitude.
Care in the community, which is a major portion of the MISSION Act,
was the most important part. Care in the community is basically all of
the services we put together to make healthcare accessible to our
veterans. We were having a problem with veterans getting appointments
within 30 days of making the appointment. We were having trouble with
veterans who live more than 40 miles from a VA hospital or VA CBOC to
get appointments in time in the system. We have had problems with
certain rare diseases and difficult problems only from the types of
warfare we are in today with IEDs and things like that to get the right
doctors with the right veterans at the right time.
Then, we had the problem of America being a country spread out all
over the place, 48 contiguous States from Montana to Florida. A lot of
doctors have to be utilized to get care to the veteran. It is the same
thing with Hawaii, the same thing with Alaska.
But we put the whole thing together in a care in the community
package, which started during last year and now is in full swing, and I
am proud to tell you--and I am sure I am going to regret saying this--
but we didn't have a complaint in the first week after the inception
last year about the system failing to work.
The access standards have been looked at and improved. We took the
mistakes we made a year ago and put the answers in place, solutions in
place. We did everything we could to make our mission a winner for the
veterans, and we did. I am here today to join my other colleagues who
are going to speak about the MISSION Act and about our veterans. We are
very proud that we took the challenge to see to it that something we
had promised them years ago--our vets--works and worked better for
them, and we will continue to keep that pledge in the years to come.
We owe no greater obligation than we do to those who served our
country in the military. Our obligation is to see to it that what we
promised them when they joined is what they get when they are in the
veteran status. As long as I have the ability to serve in the U.S.
Senate and as chairman of that committee, I will remain committed and
remain on a mission to see to it that we make that a reality for all of
our veterans.
With that said, I suggest the absence of a quorum.
[[Page S3825]]
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. HOEVEN. Mr. President, I ask unanimous consent that the quorum
call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. HOEVEN. Mr. President, I am pleased to come today and join my
colleagues to highlight the VA MISSION Act--legislation we passed to
provide our veterans with access to health and long-term care closer to
home. This month, I had the opportunity to join a Senate delegation in
Normandy for the 75th Anniversary of D-day. We had the honor of meeting
with some of our veterans who landed on the beaches of Normandy, and we
were reminded, once again, of the tremendous sacrifices our Nation's
veterans have made to preserve our way of life and keep our Nation
free.
Given their service and sacrifice, the least that our Nation can do
is uphold its commitment to provide our veterans with the healthcare
they have truly earned. Over the last year, we have been working with
the VA to ensure that the MISSION Act is properly implemented so it
truly benefits our veterans. This bipartisan legislation not only
strengthens the VA's ability to provide care for our veterans, but when
the VA is unable to do so, it gives our veterans more options to seek
care in their home communities. This has been a top priority for
veterans in my home State of North Dakota and across the country.
The VA MISSION Act removed the arbitrary 30-day, 40-mile eligibility
requirement that prevented veterans living within 40 miles of a VA
facility from being eligible for care in their home community. Now,
when a VA Medical Center or community-based outpatient clinic isn't
able to provide the services a veteran needs, our veterans are able to
access healthcare services in their local community.
Additionally, the VA MISSION Act contains provisions from the
veterans access to long-term care and health services legislation I had
introduced, which allows non-VA, long-term care providers--so now long-
term care providers, nursing homes and others--to enter into veterans
care agreements with the VA. These agreements will help cut through the
bureaucratic redtape at the VA and help veterans access nursing home
and other long-term care in their communities, including home-based
care services--again, providing not only healthcare but long-term care
to our veterans closer to home, in their home communities and closer to
their loved ones.
We are continuing to work with the VA and long-term care providers to
ensure that providers that want to treat veterans are able to do so
without unnecessary burdens, meaning without additional inspections,
without additional redtape that in some cases, causes our long-term
care providers--whether it is nursing homes or in-care providers--to
not accept VA reimbursement. This makes sure that they can take VA
reimbursement and that the rules and requirements are the same as if
they are taking Medicaid or Medicare reimbursement. This is very
important for our veterans, but it makes sure that we streamline the
process so those nursing homes or those home-based and community-based
services in a community provide those services to our veterans and take
VA reimbursement to do it.
Our veterans have sacrificed so much for our Nation, which is why we
continue working to implement the VA MISSION Act properly and ensure it
meets our goal--meets our goal of providing veterans access to
healthcare and long-term care closer to home.
With that, I yield the floor.
The PRESIDING OFFICER. The Senator from Indiana.
Mr. YOUNG. Mr. President, having served in the Navy and as a Marine
Corps officer, I am sensitive to the many challenges facing our
veterans. The VA was established almost 90 years ago, so when the VA
MISSION Act was passed, it was time for a wide-scale reform to
modernize and improve the system.
I was proud to support and vote for the VA MISSION Act, which was
signed into law 1 year ago this month. This new program could
dramatically change the way our veterans receive care. For the first
time, veterans can walk into a local urgent care clinic, like most
Americans can--as long as it is in network--and receive care that day,
at no cost to them, up to three visits per year. They can even get a
flu shot now at urgent care rather than having to visit the VA for such
a simple procedure.
The VA MISSION Act is already at work back home in Indiana. In fact,
a Hoosier veteran recently approached me while I was traveling
throughout the State, and he said there was an appointment he could not
get scheduled with the VA until August or September. Now, we had this
conversation some weeks ago, but when the VA MISSION Act went into
effect at the beginning of this month, he tried again, and he was able
to get an appointment right away. So I am sure this is just the first
of many positive stories I am going to be hearing as I travel around
the State in coming days and even years to come.
It is also important that we in Congress listen to those whose
experience with the VA has not improved. If there is a part of this act
that isn't working or isn't being implemented as intended, then we have
to revisit it. We have to work with the VA to get it right--removing
barriers within the system and streamlining access to care. This is
going to help veterans of all eras live happy and healthier lives. So
that is what matters the most.
I will continue to fight for the proper care and treatment of our
veterans because they deserve nothing less.
I yield back.
The PRESIDING OFFICER. The Senator from Arkansas.
Mr. BOOZMAN. Mr. President, I am pleased to join my colleagues today
to show our continued support for improvements to the VA Community Care
Programs. Last year, under the leadership of Senate VA Committee
Chairman Isakson and Ranking Member Tester, we passed the VA MISSION
Act so veterans would have access to healthcare and services in their
own communities.
I was proud to support this landmark legislation that improves how VA
delivers healthcare. Earlier this month, the VA rolled out the Veterans
Community Care Program. The VA MISSION Act offers veterans more options
to better support their needs no matter where they live. This allows a
veteran and his or her doctor to decide where it is best for the
veteran patient to receive care, taking into consideration the
veteran's healthcare needs and the availability and location of both VA
and community care.
For veterans who live in a rural State like Arkansas, this is
especially good news. Arkansas veterans can be proud of the VA
facilities in our State. The VA hospitals in Little Rock and
Fayetteville and those in neighboring States provide quality care and
service for our veteran population. The challenge is, these are located
in more urban areas.
The community-based outpatient clinics, known as CBOCs, make
healthcare more accessible to veterans in rural areas, but if a veteran
needs more advanced care than a CBOC can provide, it can mean a full-
day trip to the nearest VA Hospital. The reforms to community care will
allow more veterans to avoid that extended travel time and enable them
to receive quality care within their own community.
This program expands access to more local doctors and urgent care
within the VA's contracted network. Our Nation's veterans were promised
access to healthcare for their service and sacrifice. The program
continues our work to uphold that pledge.
The VA MISSION Act improves the VA's ability to hire high-quality
healthcare professionals, expands VA caregiver benefits to veterans of
all generations, and creates a process to evaluate and reform VA
facilities so they can best serve veterans.
It is evident that under Secretary Wilkie's leadership, his team has
been focused on executing a complete plan to implement this program and
minimize any negative consequences our veterans might face as we
transition to the new and updated Community Care Program.
The VA has been proactive in educating veterans about the reforms and
eligibility requirements with a variety of sources of information about
criteria for the new community care.
[[Page S3826]]
The Department has provided training to VA employees across the
country on the updated criteria. Its initial outreach included talking
to healthcare providers also about the changes.
There are still parts of the VA MISSION Act that have not yet been
enacted, but so far, I am pleased with the rollout. My colleagues and I
on the Senate VA Committee take our oversight responsibility very
seriously. We will continue to closely follow the implementation and be
ready to fix issues that may arise along the way so we can be sure that
benefits are delivered as they were promised. The responsibility to
ensure funding for community care programs falls to the Appropriations
Subcommittee on Military Construction and Veterans Affairs.
As the chairman, I will continue working to fully fund the expansion
of community care, and I look forward to support from my colleagues to
provide the necessary resources to ensure this program's success.
I yield the floor.
The PRESIDING OFFICER. The Senator from Indiana.
Mr. BRAUN. Mr. President, my hometown of Jasper, IN, sits in the
county with the most veterans per capita in the State. My father was a
tail gunner on a B-17 himself, and I will never forget the lesson he
and my community impressed upon me of honoring those who have served so
effortlessly and selflessly.
Providing for the health and well-being of the men and women who have
sacrificed so much for our country is the least we can do, and it ought
to be one of the things we can all agree on in this Chamber.
When the Trump administration took over, the VA had been in dire
straits for many years. The passage of the MISSION Act represented a
great stride toward improving access to quality healthcare services for
our vets and, especially, a great step for Hoosier veterans.
A few of the valuable provisions for Hoosier veterans in the MISSION
Act include these: replacing the mileage requirement with a drive time
requirement; greatly expanding access to care for Hoosier veterans who
report to VA hospitals in bigger cities like Chicago, Indianapolis,
Louisville, and Cincinnati; reducing the maximum wait times and
reducing the strain on smaller VA facilities that may not have the
resources or specialties available to serve patients in a timely
manner; implementing a new urgent care benefit so veterans can now
utilize urgent care and walk-in facilities from providers in the VA
network without prior authorization; and a big win for access to care
for Hoosier vets, allowing veterans to seek out community care if the
VA medical service line is unable to meet quality standards.
Before this legislation, Hoosier veterans not receiving proper care
would have nowhere else to turn. The MISSION Act offers Hoosier
veterans better choices, better access, and better care.
As we reflect on the sacrifice of our servicemen and servicewomen
this upcoming Fourth of July season, we must also remember our
commitment to them once they return from the field of battle. We have
made great strides in improving access and quality for veteran care in
the last 2 years, and the MISSION Act is a big win for Hoosiers and all
American veterans.
I yield the floor.
The PRESIDING OFFICER. The Senator from Montana.
Mr. DAINES. Mr. President, 1 year ago, we came together not as
Republicans or Democrats but as Americans. We passed a major milestone
for our veterans. The bipartisan VA MISSION Act brought us a step
closer to fulfilling our obligation to care for our men and women who
serve in uniform.
In Montana we have one of the highest veteran per capita populations
in the United States, and the issue of access to veteran healthcare is
one that I hear across every corner of our State.
My dad is a U.S. marine. I am proud we were able to get this
important bill signed into law. The VA MISSION Act will help fix many
of the problems plaguing the VA Choice Program. The veterans across our
rural communities in Montana will have greater and more convenient
access to care. Telemedicine services will be strengthened to
accommodate those who live a long ways away from traditional hospitals
or health clinics. Oversight of opioid prescriptions will be
strengthened. There will be greater accountability in how companies
manage this new program.
It will help fill the VA's medical professional shortage through
scholarship and loan repayment programs for medical and dental students
who commit to serving in the VA. The MISSION Act was an important step
forward, and I am proud to have helped get this bill across the finish
line and onto President Trump's desk.
Now we must hold the VA and the program administrators accountable
for ensuring the MISSION Act works for our veterans. I will be in
constant contact with local VA leaders and veterans themselves to get
firsthand feedback as this is implemented.
As we celebrate this important milestone, we must not slow down our
efforts to continue to improve our veterans' healthcare. I look forward
to continuing to work on behalf of our veterans and build off the good
work that was accomplished here last year. We must ensure that veterans
in Montana and across our Nation receive the care they have earned. I
am honored to fight this fight for the brave men and the brave women
who served in uniform.
Thank you.
I yield the floor.
The PRESIDING OFFICER. The Senator from Oklahoma.