[Congressional Record (Bound Edition), Volume 152 (2006), Part 9]
[Senate]
[Pages 12664-12665]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        RURAL VETERANS CARE ACT

  Mr. SALAZAR. Mr. President, I rise today to discuss a critical issue 
facing thousands of Americans. Many of my colleagues have heard me talk 
about the importance of rural America. As I have said before, in many 
ways, the very fabric of rural America is fraying, thread by thread. 
The America where I grew up--the America of farmers, ranchers, small 
business owners, and generations of close-knit families--is slowly 
slipping away. And the Federal Government is simply not doing enough to 
reverse this troubling trend. This America--rural America--has sadly 
become the ``Forgotten America.''
  As we approach the Fourth of July recess, I want to talk about the 
challenges facing a community within the Forgotten America: rural 
veterans. In rural communities across the country, men and women have 
devoted themselves to the cause of freedom without hesitation and in 
numbers greatly beyond their proportion to the U.S. population. Yet we 
consistently overlook the unique challenges these men and women face 
after they return home to their families and friends in the heartland 
of America. When it comes to the VA health care system, we fail our 
Nation's rural veterans by not doing more to ensure they can access the 
high-quality health care they have earned. We owe them much better.
  Over and over, I hear from veterans in my State about obstacles to 
care. I recently met with a veteran from northeast Colorado who told me 
he had to travel 500 miles roundtrip just to get a simple blood test at 
a VA hospital. I think most of my colleagues would agree with me that 
this is ludicrous.
  I wish I could say this represents an isolated incident. 
Unfortunately, it does not. Because of gaps in the network of VA 
hospitals and clinics, and because the VA health care system is not 
equipped to fill these gaps, we hear stories like this all the time.
  Every day, veterans from rural communities throughout the country are 
forced to put off crucial treatment because they live too far from VA 
facilities and can't get the care they need. As a result, rural 
veterans die younger and suffer from more debilitating illnesses--all 
because our system is not equipped to address their needs and provide 
care accordingly. A 2004 study of over 750,000 veterans conducted by 
Dr. Jonathan Perlin, the Under Secretary for Health at the VA, 
consistently found that veterans living in

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rural areas are in poorer health than their urban counterparts. Still, 
despite the fact that 23 percent of the Nation's veterans live in rural 
areas, the VA does not have a high-level office responsible for 
coordinating care to this vital constituency.
  This is simply unacceptable. We need policies that address the plight 
of our rural veterans, and we need them now.
  With that objective in mind, Senator Thune and I recently introduced 
legislation that would significantly enhance our approach to rural 
veterans' health care. Thanks to the support of the 12 cosponsors of 
this legislation and to the bipartisan efforts of my colleagues on the 
Veterans' Affairs Committee who worked to ensure its fair, insightful, 
and constructive review, we were able to include many of this 
legislation's provisions as part of S. 2694, a broader legislative 
package that passed out of committee last week.
  In keeping with the objectives of our original Rural Veterans Care 
Act, this legislation would create an Office of Rural Health within the 
Veterans Health Administration. The new office would be responsible for 
taking a number of steps aimed at improving the way we provide care to 
rural veterans. Specifically, the Office of Rural Health would be 
charged with conducting, promoting, and disseminating research into 
issues affecting rural veterans, and developing and refining policies 
and programs to improve care and services for rural veterans. Because 
nearly one in every four veterans is from a rural area, the creation of 
this Office of Rural Health is crucial if we are to live up to our 
promise to provide all of our Nation's veterans with high-quality 
services.
  Through specifically designated officials in each of the country's 23 
Veterans Integrated Service Networks, this office will have a real and 
effective presence in rural veterans communities. These individuals 
will serve as regional officers responsible for consulting on and 
coordinating research and policies in their respective service 
networks. Their insight into how to provide rural veterans in their 
areas with the best health care possible will be incredibly useful and 
will help expand the reach of the new office outside the beltway, and 
to all corners of the country.
  The Office of Rural Health will also be required to conduct a study 
on the feasibility of expanding the use of fee-basis care, whereby the 
VA contracts its services out on a limited basis to third party 
providers. I continue to believe we should carefully explore every 
available option when it comes to improving access to care for veterans 
living in rural areas, and I am happy that this legislation will 
provide a way to do just that.
  With almost one-quarter of our Nation's veterans living in rural 
communities, and with the obstacles they face with respect to accessing 
high-quality care so pronounced, it is obvious we need to do better. I 
am pleased that the Veterans' Affairs Committee has taken an important 
first step toward that goal, and I am committed to working with my 
colleagues in the Senate, with the VA, and with veterans across the 
country to build on this momentum. This legislation may not be the 
whole answer, but it is a start, and the dialogue we have helped to 
start on this critical issue is long overdue.
  I want to thank Senators Thune, Akaka, Burr, Murray, Baucus, Burns, 
Conrad, Dorgan, Pryor, Lincoln, Murkowski, Thomas, and Enzi for 
cosponsoring the Rural Veterans' Care Act. I also want to thank 
Chairman Craig and his staff for working with me and the rest of the 
bill's sponsors to include a provision creating a new Office of Rural 
Health as part of S. 2694.
  I know that each and every one of my colleagues deals with veterans 
issues and feels a deep sense of gratitude toward the brave men and 
women who have fought for our freedom. I hope we can join together in 
support of our rural veterans. We owe it to them to make sure our 
actions match our rhetoric when it comes to expressing our gratitude 
and fulfilling the promises we have made. Toward that end, I look 
forward to seeing this legislation passed by Congress and sent to the 
President for his signature.

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