[Congressional Record Volume 167, Number 85 (Monday, May 17, 2021)]
[House]
[Pages H2375-H2378]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         SGT. KETCHUM RURAL VETERANS MENTAL HEALTH ACT OF 2021

  Mr. TAKANO. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 2441) to direct the Secretary of Veterans Affairs to expand 
the Rural Access Network for Growth Enhancement Program of the 
Department of Veterans Affairs, and to direct the Comptroller General 
of the United States to conduct a study to assess certain mental health 
care resources of the Department of Veterans Affairs available to 
veterans who live in rural areas.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2441

       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 ``Sgt. Ketchum Rural Veterans 
     Mental Health Act of 2021''.

     SEC. 2. EXPANSION OF RURAL ACCESS NETWORK FOR GROWTH 
                   ENHANCEMENT PROGRAM OF THE DEPARTMENT OF 
                   VETERANS AFFAIRS.

       (a) Expansion.--The Secretary of Veterans Affairs shall 
     establish and maintain three new centers of the RANGE 
     Program.
       (b) Locations.--The centers established under subsection 
     (a) shall be located in areas determined by the Secretary 
     based on--
       (1) the need for additional mental health care for rural 
     veterans in such areas; and
       (2) interest expressed by personnel at facilities of the 
     Department in such areas.
       (c) Timeline.--The Secretary shall establish the centers 
     under subsection (a) during fiscal year 2022.
       (d) Funding.--There is authorized to be appropriated 
     $1,200,000 for each of fiscal years 2022 through 2024 to 
     carry out this section.

     SEC. 3. GAO STUDY OF MENTAL HEALTH CARE FURNISHED BY THE 
                   SECRETARY OF VETERANS AFFAIRS TO RURAL 
                   VETERANS.

       (a) Study Required.--The Comptroller General of the United 
     States shall conduct a study to assess whether the Department 
     of Veterans Affairs has sufficient resources to serve rural 
     veterans who need covered mental health care. Such study 
     shall include assessments of--
       (1) whether the mental health care furnished by the 
     Secretary (through resources including the RANGE Program, 
     Enhanced RANGE Program, mental health residential 
     rehabilitation treatment programs, inpatient mental health 
     services, and PRR centers) is sufficient to meet the covered 
     mental health care needs of rural veterans;
       (2) how best to expand and to appropriately locate 
     resources described in paragraph (1);
       (3) whether to require the establishment of a PRR center at 
     a medical facility of the Department that serves 1,000 or 
     more veterans on the National Psychosis Registry;
       (4) the demand by rural veterans for mental health 
     resources specified in paragraph (1);
       (5) the average wait time for a rural veteran for mental 
     health resources specified in paragraph (1); and
       (6) how many rural veterans died by suicide or overdose--
       (A) while on a wait list for mental health resources 
     specified in paragraph (1); and

[[Page H2376]]

       (B) during the term of the study.
       (b) Report Required.--Not later than 18 months after the 
     date of the enactment of this Act, the Comptroller General 
     shall submit to the Committees on Veterans' Affairs of the 
     Senate and House of Representatives a report containing the 
     results of the study under this section.

     SEC. 4. DEFINITIONS.

       In this Act:
       (1) The term ``covered mental health care'' means mental 
     health care that is more intensive than traditional 
     outpatient therapy.
       (2) The term ``PRR center'' means a psychosocial 
     rehabilitation and recovery center of the Department of 
     Veterans Affairs.
       (3) The term ``RANGE Program'' means the Rural Access 
     Network for Growth Enhancement Program of the Department of 
     Veterans Affairs.
       (4) The term ``rural veteran'' means a veteran who lives in 
     a rural or highly rural area (including such an area in a 
     Tribal or insular area), as determined through the use of the 
     Rural-Urban Commuting Areas coding system of the Department 
     of Agriculture.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Takano) and the gentleman from Illinois (Mr. Bost) 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 
have 5 legislative days in which to revise and extend their remarks and 
to insert extraneous material on H.R. 2441.
  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 am pleased to speak on H.R. 2441, the Sgt. Ketchum 
Rural Veterans Mental Health Act of 2021, introduced by Congresswoman 
Axne.
  This bill has not only bipartisan support, but also bicameral support 
with the recent introduction of a companion bill from Senate Veterans' 
Affairs Committee Chairman Tester and Ranking Member Moran.
  This bill is named for an Iowa veteran who died by suicide after 
failing to receive intensive treatment for his PTSD. It is designed to 
honor his memory with action and to prevent a similar outcome for his 
fellow veterans.
  Through this legislation, VA will open three new RANGE programs in 
rural locations, including territories and insular areas. VA RANGE 
programs offer intensive outpatient services and case management for 
rural veterans with mental illness, housing and food insecurity, 
financial issues, and problems with daily living. They can be 
absolutely lifesaving for veterans who need this kind of wraparound 
care and safety nets.
  Additionally, this bill calls for a GAO study of how accessible VA's 
continuum of superior mental healthcare services, from outpatient to 
residential and inpatient, really is for rural veterans.
  We all know that even a well-designed system may not reach every 
veteran who needs it. With this legislation, our work to close the gaps 
will be guided by data. I, therefore, ask my colleagues to join me in 
supporting the Sgt. Ketchum Rural Veterans Mental Health Act.
  Madam Speaker, I support this legislation, and I reserve the balance 
of my time.
  Mr. BOST. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, I rise today in support of H.R. 2441, the Sgt. Ketchum 
Rural Veterans Mental Health Act.
  May is Mental Health Awareness Month. I am pleased to commemorate it 
today by passing this bill to expand mental healthcare to veterans in 
rural areas.
  The Sgt. Ketchum Rural Veterans Mental Health Act would expand VA's 
RANGE program. The RANGE program provides veterans who have serious 
mental illness or who are at risk of homelessness with intense case 
management.
  Almost a quarter of our Nation's veterans reside in rural 
communities. I am one of those veterans who does. While I wouldn't have 
it any other way, I know firsthand that living in a rural area can be a 
barrier to care. This bill will help remove that barrier for some of 
our most vulnerable veterans. It will help ensure that they do not fall 
through the cracks. It will help them heal.
  It will also require GAO to assess whether VA has sufficient 
resources to support mental health in rural areas. That will help 
identify any other barriers to care that may exist for these veterans 
so that we can break them down.
  This bill is supported by the entire Iowa delegation, including by my 
friend, fellow veteran, and fellow committee member, Congresswoman 
Mariannette Miller-Meeks.
  It is named after Brandon Ketchum, an Iowa veteran who died by 
suicide in 2016. My heartfelt condolences go out to his family and 
friends. I am honored to support this bill today in Brandon's memory.
  Madam Speaker, I urge all of my colleagues to join me, and I reserve 
the balance of my time.
  Mr. TAKANO. Madam Speaker, I yield 5 minutes to the gentlewoman from 
Iowa (Mrs. Axne), my good friend and the author of H.R. 2441.
  Mrs. AXNE. Madam Speaker, I rise today to honor an Iowan, a Marine, 
and a fallen hero, Brandon Ketchum.
  I am also here to make a promise to his mother, Bev. When I 
introduced this legislation, I told Bev that Brandon's story was one 
that would ensure that other veterans get the mental health help that 
they need. Today, we are here to take that next step in keeping that 
promise.
  Five years ago, retired Sergeant Brandon Ketchum took his own life 
when he was unable to get the mental healthcare he needed. Sergeant 
Ketchum had served two tours in Iraq and another in Afghanistan. In his 
first tour alone, he helped clear 92 roadside bombs in 7 months, 
service that earned him the Combat Action Ribbon.
  His heroic service wasn't his only role, however. He was a loving 
father, son, brother, and friend. But like many veterans, Sergeant 
Ketchum struggled with depression, addiction, and PTSD related to his 
time in uniform.
  After his service, Brandon volunteered and spoke publicly to students 
about his experience with PTSD. But despite receiving therapy and 
addiction treatment after returning from his tours, Brandon had a hard 
time adjusting to civilian life.
  When he sought inpatient hospitalization in 2016 from an Iowa VA, the 
treatment rooms were full, and he was turned down for the care he 
needed. Hours later, Sergeant Ketchum took his own life.
  We all know that veterans do not have enough mental health resources 
across this country. Nearly 17 veterans die by suicide every day, and a 
recent HHS study found that only 50 percent of returning vets who need 
mental health treatment will receive it. And, in particular, these 
mental health services are even harder to find in our Nation's rural 
areas, areas that I and my Iowa colleagues represent here in Congress.
  The truth is sad, but it is pretty simple. We are failing our 
veterans. Brandon asked us for help, but he was turned away because of 
a lack of resources. So, we must make sure, in his memory and for the 
sake of others still serving, that when our soldiers return home, they 
can get the treatment that they need.

  My bill will increase mental health facilities in rural areas by 
establishing three new Rural Access Network for Growth Enhancement 
programs, known by their acronym RANGE. RANGE programs provide rural 
veterans with more mental health resources, including access to a team 
of experts who can provide intensive addiction and mental health 
treatment, helping veterans reintegrate into their communities.
  My bill will also study how the VA is currently meeting the needs of 
rural veterans with mental health issues and what resources may be 
needed to improve their care so that we can actually address the root 
causes of mental health issues in our rural areas and with our 
veterans.
  Not only is this an important cause, but it is a bipartisan one, too. 
As mentioned, all four members of our Iowa delegation have joined 
together and signed on to this. I would like to thank them all for 
doing that, my incredible cosponsors, and, of course, Chairman Takano 
and subcommittee Chairwoman Brownley for their support of this bill, as 
well as their constant dedication to our veterans.

[[Page H2377]]

  Veterans put their lives on the line and serve our Nation with honor. 
When they come home, they should be able to receive the care that they 
need regardless of ZIP Code.
  We can't simply accept that Brandon's death is a tragedy, and that is 
just what it is. We have to use his story to make the changes that are 
long overdue and to ensure that no other veteran falls through the 
cracks.
  We must take action to address the rural health shortages and the 
mental health needs of our Nation's veterans. I urge all of my 
colleagues to honor Sergeant Ketchum's legacy with a ``yes'' vote on 
this bill.
  Mr. BOST. Madam Speaker, I yield 2 minutes to the gentlewoman from 
Iowa (Mrs. Miller-Meeks), from the Second Congressional District.
  Mrs. MILLER-MEEKS. Madam Speaker, I thank my colleague from Illinois 
for yielding me time.
  Madam Speaker, I rise today to speak in support of the bipartisan 
Sgt. Ketchum Rural Veterans Mental Health Act, which I was proud to 
introduce with the Iowa House delegation.
  This legislation was named in honor of the memory and service of 
Sergeant Brandon Ketchum of Davenport, which is in my congressional 
district. Sergeant Ketchum died by suicide in 2016 after being denied 
access to much-needed mental health services for PTSD at the VA 
facility in Iowa City.
  Our legislation would establish new Rural Access Network for Growth 
Enhancement, or RANGE, programs throughout the VA and support 
additional research on rural veteran mental healthcare needs.
  The case of Sergeant Ketchum is tragic and shows us that we must do 
more to serve our veterans. Expanding healthcare services in rural 
America and among our veterans are two of my top priorities in 
Congress, so I am proud to join the entire Iowa delegation in this 
effort. We simply have to do better for our veterans. There is no other 
option.
  I would like to thank my colleagues in the Iowa delegation, 
Congresswoman Axne, Congresswoman Hinson, and Congressman Feenstra, for 
their partnership in this simple legislation to help veterans. I urge 
all of my colleagues to support the bipartisan Sgt. Ketchum Rural 
Veterans Mental Health Act.
  Mr. TAKANO. Madam Speaker, I have no further speakers, and I am 
prepared to close.
  But before I reserve the balance of my time, let me say that I am 
very, very pleased that we are addressing the issue of mental 
healthcare in our rural areas. As we wind down this pandemic, I think 
we are going to see not just veterans but Americans of all stripes who 
live in our rural areas dealing with the need for increased numbers of 
mental healthcare practitioners.
  I congratulate and I thank the work of my colleague, Congresswoman 
Axne, in moving the VA a step forward in this area. But there is far 
more that needs to be done.
  I reserve the balance of my time.
  Mr. BOST. Madam Speaker, I yield 3 minutes to the gentlewoman from 
Iowa (Mrs. Hinson), from the First Congressional District.
  Mrs. HINSON. Madam Speaker, today, I rise in support of H.R. 2441, 
the Sgt. Ketchum Rural Veterans Mental Health Act.
  I want to start off by thanking my colleague, Congresswoman Cindy 
Axne, for introducing this legislation and for her leadership. I was 
proud to join the gentlewoman and our entire Iowa delegation, as has 
already been mentioned, to introduce this very important bipartisan 
bill for our veterans.
  Sergeant Ketchum from Davenport served our country honorably overseas 
in both Iraq and Afghanistan. But let's be real: Not every war wound is 
visible.
  Many veterans struggle when they come home with serious mental health 
challenges. When Sergeant Ketchum returned home from his tours, he 
battled again; this time with post-traumatic stress disorder.
  Sergeant Ketchum sought help at the Iowa City VA hospital but was 
turned away. Shortly after, he did take his own life.
  No veteran should be denied the help and the care that they need 
after dedicating their lives to serving our country. No veteran should 
ever be turned away like Sergeant Ketchum was.
  Unfortunately, veterans who live in rural areas face increased 
challenges and additional barriers to accessing the treatment that they 
need.
  Our legislation, named in honor of Sergeant Ketchum, will improve 
access to mental health services for veterans in rural areas. Our 
veterans put their lives on the line every day to protect our freedoms, 
and we have a duty to ensure that they can receive high-quality 
treatment once they return home from service.
  We have a duty to ensure that our veterans know they aren't alone and 
that we have their backs, regardless of where they live.
  I am proud to work alongside my colleagues in Iowa to improve access 
to mental health services for veterans in rural areas and to help 
ensure that no veteran is denied the care that they deserve.
  I urge all of our colleagues to support the Sgt. Ketchum Rural 
Veterans Mental Health Act. Vote ``yes'' in honor of Sergeant Ketchum 
and the thousands of veterans like him who need and deserve our 
support.

                              {time}  1545

  Mr. TAKANO. Madam Speaker, I reserve the balance of my time.
  Mr. BOST. Madam Speaker, I yield 1 minute to the gentleman from Iowa 
(Mr. Feenstra).
  Mr. FEENSTRA. Madam Speaker, our veterans deserve the best care and 
attention, including when it comes to treating unseen wounds. That is 
why I am honored to be part of this effort to expand mental health 
services to our veterans in rural areas.
  The Sgt. Ketchum Rural Veterans' Mental Health Act is named in honor 
of Sergeant Brandon Ketchum, an Iowan and a Marine Corps veteran who 
served in Iraq and Afghanistan.
  After serving overseas, he suffered from a number of physical and 
mental conditions. Tragically, Sergeant Ketchum took his own life after 
failing to receive the mental healthcare he needed from the VA.
  It is clear, mental healthcare shortcomings for our veterans need to 
be addressed, and that is what this bill does.
  I thank my colleague from Iowa, Congresswoman Axne, for her work on 
this important bill. I also thank my colleagues, Congresswoman Miller-
Meeks and Congresswoman Hinson, for their work as well.
  God bless all those who have fought to protect our country. We owe 
them our help.
  Mr. TAKANO. Madam Speaker, I reserve the balance of my time.
  Mr. BOST. Madam Speaker, I yield myself the balance of my time for 
the purpose of closing.
  Madam Speaker, I just encourage everyone to support this piece of 
legislation. There should be no one that would vote against this.
  Like all of the pieces of legislation that we have worked on this 
afternoon, Madam Speaker, I do want to thank the chairman and his staff 
for the job of working together. This is truly a case where this 
committee has done its bipartisan work the way it should.
  I also want to thank our staff for the hard work that they have put 
in with each one of these bills, as well as each of the Members today 
who have presented these pieces of legislation.
  Madam Speaker, I yield back the balance of my time.
  Mr. TAKANO. Madam Speaker, I yield myself the balance of my time.
  Madam Speaker, I extend my thanks to Ranking Member Bost and the 
Republicans on the committee and all staff from both sides of the aisle 
for putting together this package of 10 bills in advance of Memorial 
Day. It is especially poignant to end today's package of bills with a 
bill named in memory of Sergeant Ketchum.
  As we failed to reach Sergeant Ketchum in a timely and effective way 
in rural America, let's not forget that the VA's mental healthcare has 
improved greatly over the past several years. We need to make sure that 
quality of healthcare gets out into the rural areas.
  We are charged as a Veterans' Affairs Committee to deal with our 
veterans and their healthcare needs. Part of the answer to serving our 
veterans is to make sure that we have robust providers, regardless of 
whether they serve veterans or the general population. We need to look 
at how we are going to do that in rural America, including our 
territories and insular areas.

[[Page H2378]]

  I will use this moment on the floor to plug that cause with all of my 
colleagues who may be listening from their offices. We must, for the 
sake of all the folks that have suffered so long from this pandemic, 
look at how we are going to provide a robust provider network for 
mental healthcare.
  As we head into the Memorial Day weekend, I am so gratified and 
pleased with the work we have done on a bipartisan basis to produce 
this package of bills and that we have preserved the spirit of the 
committee.
  Madam Speaker, I urge my colleagues to pass H.R. 2441, and 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. 2441.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. ROSENDALE. Madam Speaker, on that I demand the yeas and nays.
  The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution 
8, the yeas and nays are ordered.
  Pursuant to clause 8 of rule XX, further proceedings on this motion 
are postponed.

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