[Congressional Record Volume 166, Number 7 (Monday, January 13, 2020)]
[House]
[Pages H185-H186]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  APPROVING REQUEST OF SECRETARY OF VETERANS AFFAIRS FOR WAIVER UNDER 
            SECTION 1703E(f) OF TITLE 38, UNITED STATES CODE

  Mr. TAKANO. Madam Speaker, I move to suspend the rules and pass the 
joint resolution (H.J. Res. 80) approving the request of the Secretary 
of Veterans Affairs for a waiver under section 1703E(f) of title 38, 
United States Code.
  The Clerk read the title of the joint resolution.
  The text of the joint resolution is as follows:

                              H.J. Res. 80

       Resolved by the Senate and House of Representatives of the 
     United States of America in Congress assembled, That Congress 
     approves the request for a waiver under section 1703E(f) of 
     title 38, United States Code, as submitted by the Secretary 
     on December 6, 2019.

  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 to insert extraneous material on H.J. Res. 80.
  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, I rise in support of H.J. Res. 80 introduced by 
Representative Roe of Tennessee, the ranking member of the Committee on 
Veterans' Affairs.
  This resolution would grant VA limited authority to conduct a dental 
health access pilot, which VA has proposed under section 152 of the VA 
MISSION Act of 2018.
  Under section 152, VA can pilot healthcare payment and service 
delivery models through its Center for Innovation for Care and Payment.
  On December 6, 2019, VA submitted a section 152 report to Congress 
proposing the Care Coordination for Dental Benefits program.
  Through this pilot, VA would refer veterans who are ineligible for 
dental benefits to private providers or community programs that offer 
pro bono or discounted dental services. VA will not pay private 
providers for the cost of these services under the pilot. To carry out 
this dental referral service, the section 152 report contained a 
request that Congress narrowly exempt or ``waive'' VA's authorizing 
statute.
  When a section 152 report contains a request from VA to ``waive'' its 
authorizing statute, Congress must pass a joint resolution to approve a 
waiver so VA can proceed with a pilot program. By passing this joint 
resolution, we are approving VA's waiver request so it can pilot the 
referral of veterans for free or low-cost dental care.
  Madam Speaker, currently VA provides dental services for only about 8 
percent of veterans who are enrolled in the VA healthcare system. 
Generally, to receive dental care at VA's expense, veterans must have a 
dental condition that is related to a service-connected disability, be 
a former prisoner of war, be rated as 100 percent permanently and 
totally disabled, or need dental services in preparation for a hospital 
admission.
  Under this pilot, VA will be able to coordinate dental care for the 
remaining 92 percent of veterans ineligible for dental care. 
Specifically, VA will provide administrative support potentially 
through a call center and online self-service portal to educate and 
assist these veterans in accessing community programs and providers 
that offer pro bono or discounted dental services. According to VA, 
community dental programs are available through federally qualified 
health centers, community health centers, and the American Dental 
Association.
  Through this pilot, VA staff will be able to assist veterans in 
scheduling appointments with dentists that participate in these 
programs. VA staff will be authorized to obtain records from the dental 
visits and provide them to veterans' VA primary care providers.
  I support granting VA this limited waiver because it will not permit 
VA to outsource more healthcare to private providers beyond its current 
authority, and it will not drain precious resources from VA hospitals 
and clinics.
  I support this pilot because it has the potential to improve 
veterans' access to dental care, and to improve the timeliness of that 
care. Neglecting oral health can have serious medical consequences. For 
example, clinical researchers have identified links between poor oral 
health and other medical conditions such as heart disease, bacterial 
pneumonia, and stroke.
  VA estimates this pilot will be cost neutral, as there will be cost 
savings from reducing emergency department visits associated with 
delayed treatment or nontreatment of oral health issues.
  I urge all of my colleagues to join me in supporting H.J. Res. 80.
  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.J. Res. 80, approving the 
request of the Secretary of Veterans Affairs for a waiver under the law 
established by the VA MISSION Act of 2018.
  Specifically, this bill would approve VA's first request for a waiver 
under section 152, as the chairman mentioned, the authority for the 
Department of Veterans Affairs Center for Innovation for Care and 
Payment contained within the VA MISSION Act of 2018.
  The MISSION Act is one of the most transformative pieces of 
legislation passed in recent history. Over the next several years, 
given the authorities provided in the MISSION Act, the VA healthcare 
system that we know today will evolve into one that is stronger, more 
efficient, and better able to meet the healthcare needs of veterans now 
and for generations of veterans to come.
  In addition to streamlining numerous community care programs, 
establishing a process to review and modernize VA assets and 
infrastructure, expanding the caregiver program, and enhancing the 
internal capacity of the VA healthcare, the MISSION Act created a 
Center for Innovation for Care and Payment.
  The Innovation Center is charged with establishing pilot programs 
designed to test potential payment and service delivery models, models 
currently not in VA's authority to pursue without a waiver, with the 
goal of reducing expenditures while preserving or enhancing the quality 
and access to care furnished by VA.
  Under the terms of the MISSION Act, the joint resolution we are 
considering today meets the requirements set forth in law with regard 
to approving waivers. The substance of this waiver is very modest. It 
will allow VA to expand its role in assisting veterans who aren't 
eligible for VA-provided dental care by establishing a pilot program to 
connect veterans with community-based discounted or pro bono dentists.

  The objective of the pilot is to improve the overall health of 
currently enrolled veterans who are ineligible for VA dental services. 
The waiver specifically allows VA administrative staff to coordinate 
community-provided care while also educating veterans on the dental 
care options available to them within the community.
  This proposed pilot is a commonsense approach to improving the 
wellness of veterans. Research has shown that poor oral health can have 
a significant impact on overall health with numerous connections 
between gum disease and other illnesses. Poor oral health is also 
correlated with potentially avoidable and costly emergency department 
visits.
  Additionally, the approval of this waiver holds open the opportunity 
for VA to pursue other ideas that can enhance the care and services 
provided to veterans while also respecting the resources provided by 
the American taxpayer.
  I look forward to working with the VA through the Center of 
Innovation

[[Page H186]]

in identifying additional out-of-the-box approaches that could 
potentially transform the VA even further for the future.
  I thank Chairman Takano for working with me to get this joint 
resolution to the House floor in a timely manner.
  I urge all of my colleagues to support H.J. Res. 80, and I reserve 
the balance of my time.
  Mr. TAKANO. Madam Speaker, I have no further speakers, and I am 
prepared to close.
  I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Madam Speaker, I yield 3 minutes to 
the gentleman from Florida (Mr. Bilirakis), my good friend and a great 
friend of the Veterans' Affairs Committee. There has been no more 
consistent member of that committee, who has numerous advocates, and I 
really appreciate his support of this joint resolution.
  Mr. BILIRAKIS. Madam Speaker, I thank the gentleman for yielding. It 
has been a great experience to work with Representatives Roe and Takano 
to improve the lives of our heroes.
  Madam Speaker, I rise today in support of H.J. Res. 80, which will 
approve the VA secretary's request for a waiver under the MISSION Act, 
allowing for innovative collaborations to expand dental care for 
veterans.
  As a member of the Veterans' Affairs Committee, I was proud to be a 
strong advocate in support of the VA MISSION Act last Congress. One of 
the provisions of this new law established the VA Center for Innovation 
for Care and Payment, allowing the VA to create pilot programs that 
test innovative approaches to payment and service delivery models to 
improve the quality of care at the VA subject to congressional 
approval.
  Many studies suggest that regular dental care, as the good doctor 
said, equates to lower overall healthcare cost and better health 
outcomes. Earlier this year I introduced H.R. 2628, the VET CARE Act, 
designed to determine the potential health benefits to veterans and 
potential cost savings to the VA associated with periodontal care. One 
provision specifically authorizes the VA to provide administrative 
support to local providers who agree to furnish dental care at low to 
no cost, including information about the VA Dental Insurance Program, 
which provides a discounted low-cost insurance plan provided by private 
insurers. At a legislative hearing on my bill, the VA testified its 
strong support for this particular section.
  Currently, the VA only provides outpatient dental services to a 
limited number of the disabled veteran population. Some may be eligible 
to sign up for the VADIP, but I believe we can do more to move this 
issue forward and I am glad to see that the VA agrees with me on this 
particular issue.
  Last month, the VA finalized a rule requesting congressional approval 
to allow coordination of care between veterans and dental providers in 
the community.
  I applaud VA for recognizing the need to increase access and 
coordination of care to dental providers and educate veterans on the 
potential opportunities available to them in the local community.
  I thank Dr. Roe for sponsoring this joint resolution, and I urge the 
Senate to take this up as soon as possible so that the VA can get to 
implementing this pilot program and better providing access to much-
needed dental care our veterans have earned and deserve.
  Madam Speaker, I urge my colleagues to support this joint resolution.
  Mr. DAVID P. ROE of Tennessee. Madam Speaker, I yield myself the 
balance of my time.
  Madam Speaker, this is a very simple resolution. I urge all of my 
colleagues to support H.J. Res. 80, and I yield back the balance of my 
time.
  Mr. TAKANO. Madam Speaker, I yield myself such time as I may consume.
  As we welcome the new year and a new decade, I also want to take a 
moment to recognize my colleague and ranking member of the Committee on 
Veterans' Affairs, Dr. Phil Roe, who has announced he will be retiring 
at the end of this Congress.
  I salute my friend as a Vietnam veteran, as a doctor, and as a 
tireless advocate for veterans across the country. I have served with 
Dr. Roe since I was first elected to the House of Representatives in 
2013, and I am proud of the bipartisan work we have done since then to 
ensure we honor our Nation's commitment to our veterans.
  Madam Speaker, this Congress alone, we have passed 40 bills out of 
this committee with 36 passed out of the House and five signed into 
law. Despite the political rancor, which takes up much of the oxygen in 
Washington, D.C., this committee has set the standard for 
bipartisanship in this body.
  In 2015, though I was still fairly new to this committee, then-
Chairman Roe invited several Members to join him on a congressional 
delegation to Afghanistan to meet with servicemembers over the 
Thanksgiving holiday. He set a great example, and I have worked to 
replicate that example during my time as chairman. This past 
Thanksgiving, we did just that. I took freshmen Members to spend the 
holidays with those away from their families in service to our country.

                              {time}  1645

  During Dr. Roe's tenure as chairman of this committee, he was 
gracious in approving travel to the border so I could better understand 
the issues facing deported veterans. Following that trip, I, along with 
fellow members Ranking Member Tim Walz and Representatives Vargas and 
Coffman, requested additional information from the Department of 
Homeland Security on this veteran population.
  As a result, we learned that ICE did not know how many veterans it 
had deported and failed to follow policies already in place that could 
have shielded veterans from deportation.
  Dr. Roe also has built on the hard work of former Ranking Member Walz 
and helped lay the groundwork for our success in finally passing the 
Blue Water Navy Vietnam Veterans Act of 2019. He helped me bring this 
long-overdue legislation across the finish line, and I trust that he 
will continue to work with me to ensure our true intent of the law is 
implemented.
  Madam Speaker, we have always worked to find common areas of 
agreement. Because of his agreement to include key protections for 
whistleblowers in the last Congress' VA Accountability and 
Whistleblower Protection Act of 2017, I reluctantly supported that 
legislation, but it is clear today that these protections are nowhere 
near as strong as they should be. I hope Dr. Roe will join me in 
pressing this administration to implement these to their true intent 
and help ensure whistleblowers can come forward when they need to, free 
from retaliation.
  Madam Speaker, I thank Dr. Roe for supporting this committee's 
bipartisan work to preserve the power of veterans' voices and combat 
online disinformation campaigns perpetrated by foreign trolls and 
internet actors. I look forward to working with him to continue to 
speak with a unified voice and help prevent the targeting of veterans 
and servicemembers.
  Madam Speaker, I congratulate Ranking Member Roe on more than 11 
years of hard work for the people of Tennessee and decades of service 
to our country.
  It is my hope that, despite it being an election year, we can 
continue to come together and finish our work for our Nation's 
veterans.
  Madam Speaker, I ask that all of my colleagues join me in honoring 
Dr. Roe for his many years of service but also in passing H.J. Res. 80.
  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 joint resolution, H.J. Res. 80.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the joint resolution was passed.
  A motion to reconsider was laid on the table.

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