[Congressional Record Volume 166, Number 164 (Tuesday, September 22, 2020)]
[House]
[Pages H4680-H4682]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
VA MISSION TELEHEALTH CLARIFICATION ACT
Mr. TAKANO. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 3228) to amend title 38, United States Code, to authorize
health professional trainees to provide treatment via telemedicine, and
for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 3228
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 ``VA Mission Telehealth
Clarification Act''.
SEC. 2. LICENSURE OF HEALTH CARE PROFESSIONALS PROVIDING
TREATMENT VIA TELEMEDICINE.
Section 1730C(b) of title 38, United States Code, is
amended to read as follows:
``(b) Covered Health Care Professionals.--For purposes of
this section, a covered health care professional is any of
the following individuals:
``(1) A health care professional who--
``(A) is an employee of the Department appointed under
section 7306, 7401, 7405, 7406, or 7408 of this title, or
under title 5;
``(B) is authorized by the Secretary to provide health care
under this chapter;
``(C) is required to adhere to all standards for quality
relating to the provision of health care in accordance with
applicable policies of the Department; and
``(D) has--
``(i) an active, current, full, and unrestricted license,
registration, or certification in a State to practice the
health care profession of the health care professional;
``(ii) qualifications prescribed by the Secretary under
section 7402(b) of this title for an appointment to a
position in the Veterans Health Administration; or
``(iii) other authorization from the Secretary to provide
health care.
``(2) A health professions trainee who--
``(A) is appointed under section 7405 or 7406 of this
title; and
``(B) is under the clinical supervision of a health care
professional described in paragraph (1).
[[Page H4681]]
``(3) A health care professional who--
``(A) is appointed to a position described in paragraph (1)
or (3) of section 7401 of this title under--
``(i) section 7401 of this title;
``(ii) section 7405 of this title; or
``(iii) title 5;
``(B) is in the process of obtaining, within a timeframe
prescribed by the Secretary--
``(i) a license, registration, or certification described
in paragraph (1)(D)(i);
``(ii) qualifications described in paragraph (1)(D)(ii); or
``(iii) authorization described in subparagraph (B) or
(D)(iii) of paragraph (1); and
``(C) is under the clinical supervision of a health care
professional described in paragraph (1).''.
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. Mr. Speaker, I ask that all Members may have 5
legislative days in which to revise and extend their remarks and to
insert extraneous material on H.R. 3228, as amended.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 3228, as amended, the VA
Mission Telehealth Clarification Act.
The John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA
Maintaining Internal Systems and Strengthening Integrated Outside
Networks Act of 2018, or the VA MISSION Act, as it is more commonly
known, expanded VA's ability to provide telehealth to veterans across
State lines.
The legislation before us builds on those enhancements by allowing
healthcare professionals in training to provide tele-healthcare to
veterans with clinical supervision.
As we have seen over the course of this pandemic, tele-healthcare is
becoming more and more a staple of Americans' healthcare experience. As
this virus will be with us for some time to come, the value and
reliance on telehealth will continue. It is critical that during this
time, VA has the authorities necessary to keep veterans healthy and
safe in their homes.
This is particularly important for our rural and aging veterans whose
access to in-person care was already a challenge. We need to do
everything possible to ensure veterans' access to safe distant care
whenever it is appropriate.
Mr. Speaker, I thank Congressman Carter for his dogged work to see
veterans have what they need during this time. I encourage all of my
colleagues to support H.R. 3228, as amended.
Mr. Speaker, I reserve the balance of my time.
Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I yield myself such time
as I may consume.
Mr. Speaker, I rise today in support of H.R. 3228, the Department of
Veterans Affairs Mission Telehealth Clarification Act.
The VA healthcare system is our country's largest integrated
healthcare system, with responsibility for delivering care to
approximately 7 million veteran patients. The VA healthcare system is
also the country's largest provider of healthcare education, with
responsibility for supporting the training of approximately 45,000
medical and dental residents and thousands more healthcare professional
trainees every year. I happened to be one of them many years ago.
The VA Mission Telehealth Clarification Act would authorize VA
residents and trainees to provide care to veteran patients virtually
using telehealth, regardless of that resident or trainee's State
licensure, so long as they are working under the clinical supervision
of a VA healthcare professional.
While face-to-face visits between patients and providers are
irreplaceable in many respects, telehealth is an increasingly important
tool in the delivery of modern healthcare. That was true even before
the COVID-19 pandemic created a skyrocketing demand for telehealth
services.
In the MISSION Act passed last Congress, we authorized VA providers
to provide telehealth across State lines in an effort to increase
access to telehealth to veteran patients, particularly those in rural
or remote areas or for those whose travel to a medical facility is
otherwise difficult. However, the law inadvertently exempted VA
residents, trainees, and certain others from that authority. This bill
would fix that oversight.
In doing so, it would further expand veteran access to telehealth,
which has been critical to ensuring continuity of care throughout the
last several months. It would also ensure that the medical education VA
provides to the next generation of healthcare professionals includes
valuable training and needed experience in the delivery of care via
telephone, video, and other virtual modalities.
This bill is sponsored by my good friend, Congressman Buddy Carter
from Georgia. I am grateful to him for recognizing early on the
benefits that a well-rounded medical education will have on access and
quality of care for veterans and all Americans and working so hard to
give aspiring providers and others working within the VA the ability to
practice telehealth across State lines, within appropriate parameters.
Mr. Speaker, I urge all of my colleagues to join me in supporting
this bill, and I reserve the balance of my time.
Mr. TAKANO. Mr. Speaker, I reserve the balance of my time.
Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I yield 4 minutes to the
gentleman from Georgia (Mr. Carter), my good friend.
I have had the privilege of visiting his beautiful district, and I
really appreciate his work on this extremely important issue.
Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for
yielding.
Mr. Speaker, I rise today in support of the VA Mission Telehealth
Clarification Act, which I am proud to have introduced.
H.R. 3228, the VA Mission Telehealth Clarification Act, is a simple
bill that builds on the VA MISSION Act's historic expansion of the
veterans health system.
One of the most significant parts of the VA MISSION Act was the
authorization for the VA to use telehealth and provide care across
State lines. The bill began as the result of a visit I had to a VA
facility before the current pandemic, as they laid out some of the
issues they were trying to overcome. But now with the COVID-
19 pandemic, we are seeing how extremely beneficial these technologies
can be for our veterans.
In fact, the VA Medical Center in Charleston, South Carolina, which
serves part of my district along Georgia's coast, had an over 200
percent increase in telehealth medical services during the pandemic
when we spoke in May.
Even more incredibly, the VA announced it had a 1,000 percent
increase in telehealth video appointments using its VA Video Connect
Program during the first months of the pandemic. This is an extremely
important ability for the VA to have. However, the law did not
authorize trainees within the VA to use telehealth technologies, only
practitioners with a full license.
As telehealth medicine grows in prevalence, we need for interns,
residents, and fellows to gain experience using these services,
especially considering that many of these trainees later go on to work
as doctors at the VA, bringing with them a wealth of experience.
Rather than depending on doctors to learn while on the job, which
could delay the rollout of care, this bill would allow trainees to gain
experience on telehealth systems while properly supervised by
credentialed VA staff.
Mr. Speaker, I am pleased to say that the bill was further improved
through the committee process after input from my colleagues in the VA.
The bill will not only allow for trainees to participate in telehealth,
but it will also expand the ability to practice telemedicine to all
appropriately qualified healthcare professionals at the VA, fixing the
issue once and for all.
While Congress intended for trainees and others to be included from
the beginning, the VA's reading of the law did not include them,
although they have expressed their desire to include them in telehealth
services.
{time} 1415
The VA Mission Telehealth Clarification Act will give VA the
certainty to provide essential telehealth programs
[[Page H4682]]
to our veterans, improving the quality and timeliness of their care.
Again, this is a commonsense bill with bipartisan support and has
received the support from the American Legion, Veterans of Foreign
Wars, AMVETS, and Paralyzed Veterans of America, among others.
Mr. TAKANO. Mr. Speaker, I have no further speakers. I am prepared to
close, and I reserve the balance of my time.
Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I yield myself the
balance of my time.
Mr. Speaker, I want to thank the gentleman from Georgia (Mr. Carter),
my good friend who serves on the Doctors Caucus with me, for bringing
this important piece of legislation up.
Mr. Speaker, this pandemic actually has done one good thing, and that
is to advance telehealth. Just to give you some scope of this, the VA
went from tens of thousands of mental health visits--and we know that
people have been isolated. Certainly, many of our elderly have been
confined; they can't visit people. They have gone from tens of
thousands of mental health visits per month to hundreds of thousands of
visits. So we are able to stay in touch with patients in need.
I know in my own medical practice in Tennessee, it has been extremely
helpful for patients to access their physicians through telehealth. I
think we are going to continue this, and I think the next Congress is
going to have to address how Medicare and Medicaid funds these
telehealth visits outside the VA, it is that important for care.
If you live in a rural area in rural Appalachia like I do, the only
way we are going to get specialty care for our patients in need--and in
many cases, in our cities--is via telehealth, because these specialists
are so hard to find and there are so few of them. And especially in
cases like neurology and pediatrics, these are very difficult people to
see.
So I really am appreciative of this. I appreciate Dr. Carter bringing
it up, and I certainly thank the chairman for putting this on the
agenda.
Mr. Speaker, I encourage all of my colleagues to support this, and I
yield back the balance of my time.
Mr. TAKANO. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I want to thank the ranking member for his comments
about the VA really being a pioneer in this moment, that the expansion
of tele-mental health, especially, has seen a logarithmic increase, and
it has implications for Medicare and Medicaid. I am hearing from the
civilian medical sector about the need to follow the VA's example.
I am very proud of the work the VA has done to respond to this
pandemic moment by making sure that our veterans, no matter where they
live, have access to medical care through telehealth and tele-mental
health, especially.
I want to thank, again, the sponsor of this legislation, and I want
to urge all of my colleagues to join me in passing this important
legislation, H.R. 3228, as amended.
Mr. 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. 3228, 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.
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