[Congressional Record (Bound Edition), Volume 146 (2000), Part 12]
[Extensions of Remarks]
[Pages 17447-17448]
[From the U.S. Government Publishing Office, www.gpo.gov]



     INTRODUCTION OF THE COMPREHENSIVE HEPATITIS C HEALTH CARE ACT

                                 ______
                                 

                      HON. RODNEY P. FRELINGHUYSEN

                             of new jersey

                    in the house of representatives

                      Thursday, September 7, 2000

  Mr. FRELINGHUYSEN. Mr. Speaker, I rise today to introduce the 
Comprehensive Hepatitis C Health Care Act. This bill would 
fundamentally change the way the Department of Veterans Affairs is 
addressing the growing Hepatitis C epidemic, and would create a 
national standard for testing and treating veterans for the virus.
  For several years, I and other members of this chamber from across 
the country have been asking the VA to look at the growing problem of 
Hepatitis C among the veterans population, and to dedicate the 
necessary resources to fighting this disease. According to the Centers 
for Disease Control and Prevention (CDC), Hepatitis C is a disease of 
the liver caused by contact with the Hepatitis C virus. It is primarily 
spread by contact with infected blood. The CDC estimates that an 
estimated 1.8 percent of the population is infected with the Hepatitis 
C virus, although that number is much higher among veterans. Vietnam-
era veterans are considered to be at greatest risk, since many may have 
been exposed to Hepatitis C-infected blood as a result of combat-
related surgical care during the Vietnam War.
  Despite all the attention to Hepatitis C, and all that we are 
learning about this disease, the VA still lacks a comprehensive, 
consistent, uniform approach to testing and treating veterans for the 
virus.
  We know this because the VA's handling of Hepatitis C has been raised 
in hearings in the House, both in the VA/HUD Appropriations 
subcommittee, of which I am a member, as well as the House Government 
Reform Subcommittee on National Security, Veterans Affairs and 
International Relations and the Veterans Affairs Subcommittee on 
Benefits.
  In fact, in the VA/HUD Appropriations subcommittee hearing held on 
March 22, 2000, former VA Secretary Togo West claimed that the VA was 
unable to spend all of the Fiscal Year 2000 Hepatitis C funding of $195 
million because the demand was not there. He said, ``if you are hearing 
that we are not using all of say the $199 million that was appropriated 
in 2000 for hepatitis C, it would be because we are not seeing that 
incidence of patients that add up to that much money, essentially.''
  Unfortunately, we are seeing that incidence of patients, most acutely 
in New Jersey and New York, but across the country as well. If the VA 
had properly spent the $195 million allocated in FY2000 on Hepatitis C 
testing and treatment, then there would have been little reason for the 
VA to release $20 million from the National Reserve Account on June 28, 
2000. Based on the VA's own figures, the $20 million allocation was 
half of what the 22 Veterans Integrated Service Networks, or VISNs, had 
spent on Hepatitis C in just the first two quarters of FY2000 alone! 
This money was not even a downpayment toward the Hepatitis C costs 
being incurred by all 22 VISNs.
  Further, only a fraction of the 3.5 million veterans enrolled 
nationally with the VA Health Care System have been tested to date. 
Part of the problem stems from a lack of qualified, full-time medical 
personnel to administer and analyze the tests. Most of the 172 VA 
hospitals in this country have only one doctor, working a half day a 
week, to conduct and analyze all the tests. At this rate, it will take 
years to test the entire enrolled population--years that many of these 
veterans do not have.
  As a result of the VA's inaction, I am introducing the Comprehensive 
Hepatitis C Health Care Act.
  This bill would improve access to Hepatitis C testing and treatment 
for all veterans, ensure that the VA spends all allocated Hepatitis C 
funds on testing and treatment, and set new, national policies for 
Hepatitis C care.
  First, the bill would improve testing and treatment for veterans by 
requiring annual

[[Page 17448]]

screening tests for Vietnam-era veterans enrolled in the VA system, and 
provide annual tests, upon request, to other veterans enrolled in the 
VA system. Further, it would require the VA to treat any enrolled 
veteran who tests positive for the Hepatitis C virus, regardless of 
service-connected disability status or priority group categorization. 
The VA would be required to provide at least one dedicated health care 
professional--a doctor and a nurse--at each VA Hospital for testing and 
treatment of this disease.
  Veterans who request a liver biopsy or Hepatitis C genotype from VA 
would be able to receive those tests under this bill. Under the VA's 
current policy, veterans in some areas of the country have been denied 
access to these critical tests. And, VA staff would be provided with 
increased training options intended to improve the quality of care for 
veterans with Hepatitis C. Finally, the VA is encouraged to provide 
each VA hospital with one staff member, preferably trained in 
psychiatry, psychology or social work, to coordinate treatment options 
and other information with patients.
  This bill would increase the amount of money dedicated to Hepatitis C 
testing and treatment, and would make sure these funds are spent where 
they are needed most. Beginning in FY01, the $340 million in Hepatitis 
C funding would be shifted to the Specific Purpose account under the 
Veterans Health Administration, and will be dedicated solely for the 
purpose of paying for the costs associated with treating veterans with 
the Hepatitis C virus. The bill would allocate these funds to the 22 
VISNs based on each VISN's Hepatitis C incidence rate, or the number of 
veterans infected with the virus. The VISNs will be allowed to use 
other funds to pay for the costs associated with Hepatitis C testing 
and treatment, but the $340 million in the Specific Purpose account 
could be used to pay for the costs related to Hepatitis C care.
  Finally, this bill will end the confusing patchwork of policies 
governing the care of veterans with Hepatitis C in each of the 22 
VISNs. This legislation directs the VA to develop and implement a 
standardized, national Hepatitis C policy for its testing protocol, 
treatment options and education and notification efforts. The bill 
further directs the VA to develop a standard, specific Hepatitis C 
diagnosis code for measurement and treatment purposes. Finally, the VA 
must develop a national ``reminder system'' to alert untested veterans 
to the need and availability of Hepatitis C testing.
  Mr. Speaker, many veterans do not even realize that they may be 
infected with the Hepatitis C virus, and the VA is doing little to 
encourage them to get the critical testing they need. The VA currently 
lacks a comprehensive national strategy for combating this deadly 
disease. With the passage of the Comprehensive Hepatitis C Health Care 
Act, veterans will finally be provided with access to testing and 
treatment that they have more than earned and deserve.
  The VA has known about the problem of Hepatitis C since 1992. They 
have not acted, and they must not be allowed to continue to push this 
disease under the rug. I urge my colleagues to join me in supporting 
this legislation.

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