[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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