[Congressional Record (Bound Edition), Volume 155 (2009), Part 12]
[House]
[Pages 15908-15913]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  1245
               WOMEN VETERANS HEALTH CARE IMPROVEMENT ACT

  Mr. Filner. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1211) to amend title 38, United States Code, to expand and 
improve health care services available to women veterans, especially 
those serving in Operation Enduring Freedom and Operation Iraqi 
Freedom, from the Department of Veterans Affairs, and for other 
purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1211

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Women 
     Veterans Health Care Improvement Act''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.

  TITLE I--STUDIES AND ASSESSMENTS OF DEPARTMENT OF VETERANS AFFAIRS 
                   HEALTH SERVICES FOR WOMEN VETERANS

Sec. 101. Study of barriers for women veterans to health care from the 
              Department of Veterans Affairs.
Sec. 102. Comprehensive assessment of women's health care programs of 
              the Department of Veterans Affairs.

  TITLE II--IMPROVEMENT AND EXPANSION OF HEALTH CARE PROGRAMS OF THE 
           DEPARTMENT OF VETERANS AFFAIRS FOR WOMEN VETERANS

Sec. 201. Medical care for newborn children of women veterans receiving 
              maternity care.
Sec. 202. Training and certification for mental health care providers 
              of the Department of Veterans Affairs on care for 
              veterans suffering from sexual trauma and post-traumatic 
              stress disorder.
Sec. 203. Pilot program for provision of child care assistance to 
              certain veterans receiving certain types of health care 
              services at Department facilities.
Sec. 204. Addition of recently separated women and minority veterans to 
              serve on advisory committees.

[[Page 15909]]



  TITLE I--STUDIES AND ASSESSMENTS OF DEPARTMENT OF VETERANS AFFAIRS 
                   HEALTH SERVICES FOR WOMEN VETERANS

     SEC. 101. STUDY OF BARRIERS FOR WOMEN VETERANS TO HEALTH CARE 
                   FROM THE DEPARTMENT OF VETERANS AFFAIRS.

       (a) Study Required.--The Secretary of Veterans Affairs 
     shall conduct a comprehensive study of the barriers to the 
     provision of comprehensive health care by the Department of 
     Veterans Affairs encountered by women who are veterans. In 
     conducting the study, the Secretary shall--
       (1) survey women veterans who seek or receive hospital care 
     or medical services provided by the Department of Veterans 
     Affairs as well as women veterans who do not seek or receive 
     such care or services;
       (2) build on the work of the study of the Department of 
     Veterans Affairs entitled ``National Survey of Women Veterans 
     in Fiscal Year 2007-2008'';
       (3) administer the survey to a representative sample of 
     women veterans from each Veterans Integrated Service Network; 
     and
       (4) ensure that the sample of women veterans surveyed is of 
     sufficient size for the study results to be statistically 
     significant and is a larger sample than that of the study of 
     the Department of Veterans Affairs entitled ``National Survey 
     of Women Veterans in Fiscal Year 2007-2008''.
       (b) Elements of Study.--In conducting the study required by 
     subsection (a), the Secretary of Veterans Affairs shall 
     conduct research on the effects of the following on the women 
     veterans surveyed in the study:
       (1) The perceived stigma associated with seeking mental 
     health care services.
       (2) The effect of driving distance or availability of other 
     forms of transportation to the nearest medical facility on 
     access to care.
       (3) The availability of child care.
       (4) The acceptability of integrated primary care, women's 
     health clinics, or both.
       (5) The comprehension of eligibility requirements for, and 
     the scope of services available under, hospital care and 
     medical services.
       (6) The perception of the personal safety and comfort of 
     women veterans in inpatient, outpatient, and behavioral 
     health facilities of the Department.
       (7) The gender sensitivity of health care providers and 
     staff to issues that particularly affect women.
       (8) The effectiveness of outreach for health care services 
     available to women veterans.
       (9) The location and operating hours of health care 
     facilities that provide services to women veterans.
       (10) Such other significant barriers as the Secretary of 
     Veterans Affairs may identify.
       (c) Authority To Enter Into Contracts.--The Secretary of 
     Veterans Affairs shall enter into a contract with a qualified 
     independent entity or organization to carry out the studies 
     and research required under this section.
       (d) Mandatory Review of Data by Certain Divisions Within 
     the Department.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     ensure that the head of each division of the Department of 
     Veterans Affairs specified in paragraph (2) reviews the 
     results of the study conducted under this section. The head 
     of each such division shall submit findings with respect to 
     the study to the Under Secretary for Health and to other 
     pertinent program offices within the Department of Veterans 
     Affairs with duties relating to health care services for 
     women veterans.
       (2) Specified divisions of the department.--The divisions 
     of the Department of Veterans Affairs specified in this 
     paragraph are--
       (A) the Center for Women Veterans, established under 
     section 318 of title 38, United States Code; and
       (B) the Advisory Committee on Women Veterans, established 
     under section 542 of title 38, United States Code.
       (e) Reports.--
       (1) Report on implementation.--Not later than 6 months 
     after the date on which the Department of Veterans Affairs 
     publishes a final report on the study entitled ``National 
     Survey of Women Veterans in Fiscal Year 2007-2008'', the 
     Secretary of Veterans Affairs shall submit to Congress a 
     report on the status of the implementation of the section.
       (2) Report on study.--Not later than 30 months after the 
     date on which the Department publishes such final report, the 
     Secretary of Veterans Affairs shall submit to Congress a 
     report on the study required under this section. The report 
     shall include recommendations for such administrative and 
     legislative action as the Secretary of Veterans Affairs 
     determines to be appropriate. The report shall also include 
     the findings of the head of each specified division of the 
     Department and of the Under Secretary for Health.
       (f) Definition of Facility of the Department.--In this 
     section the term ``facility of the Department'' has the 
     meaning given that term in section 1701(3) of title 38, 
     United States Code.
       (g) Authorization of Appropriations.--There is authorized 
     to be appropriated to the Secretary of Veterans Affairs 
     $4,000,000 to carry out this section.

     SEC. 102. COMPREHENSIVE ASSESSMENT OF WOMEN'S HEALTH CARE 
                   PROGRAMS OF THE DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--The Secretary of Veterans Affairs shall 
     conduct a comprehensive assessment of all health care 
     services and programs provided by the Department of Veterans 
     Affairs for the health care needs of women veterans. Such 
     comprehensive assessment shall include assessments of 
     specialized programs for women with post-traumatic stress 
     disorder, for women who are homeless, for women who require 
     care for substance abuse or mental illnesses, and for women 
     who require obstetric and gynecologic care.
       (b) Specific Matters Studied.--
       (1) Identification of programs.--For each medical facility 
     of the Department of Veterans Affairs, the Secretary of 
     Veterans Affairs shall identify each of the following types 
     of programs for women veterans provided by the Department and 
     determine whether effective health care services, including 
     evidenced-based health care services, are readily available 
     to and easily accessed by women veterans:
       (A) Health promotion programs, including reproductive 
     health promotion programs.
       (B) Disease prevention programs.
       (C) Health care programs.
       (2) Identification of relevant issues.--In making such 
     determination, the Secretary of Veterans Affairs shall 
     identify, for each medical facility of the Department of 
     Veterans Affairs--
       (A) the frequency with which such services are available 
     and provided,
       (B) the demographics of the women veterans population,
       (C) the sites where such services are available and 
     provided, and
       (D) whether, and to what extent, waiting lists, geographic 
     distance, and other factors obstruct the receipt of any of 
     such services at any such site.
       (c) Authority To Enter Into a Contract.--The Secretary of 
     Veterans Affairs shall enter into a contract with a qualified 
     independent entity or organization to carry out the studies 
     and research required under this section.
       (d) Development of Plan To Improve Services.--
       (1) Plan required.--After conducting the comprehensive 
     assessment required by subsection (a), the Secretary of 
     Veterans Affairs shall develop a plan to improve the 
     provision of health care services to women veterans and to 
     project the future health care needs, including the mental 
     health care needs of women serving in the combat theaters of 
     Operation Enduring Freedom and Operation Iraqi Freedom.
       (2) List of services.--In developing the plan under this 
     subsection, the Secretary of Veterans Affairs shall list the 
     types of services available for women veterans at each 
     medical center of the Department.
       (e) Report.--Not later than one year after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to Congress a report on the assessment conducted 
     pursuant to subsection (a) and the plan required under 
     subsection (d). The report shall include recommendations for 
     such administrative and legislative action as the Secretary 
     of Veterans Affairs determines to be appropriate.
       (f) GAO Report.--Not later than 6 months after the date on 
     which the Secretary of Veterans Affairs submits the report 
     required under subsection (e), the Comptroller General shall 
     submit to Congress a report containing the findings of the 
     Comptroller General with respect to the report of the 
     Secretary, which may include such recommendations for 
     administrative or legislative actions as the Comptroller 
     General determines to be appropriate.
       (g) Authorization of Appropriations.--There is authorized 
     to be appropriated to the Secretary of Veterans Affairs 
     $5,000,000 to carry out this section.

  TITLE II--IMPROVEMENT AND EXPANSION OF HEALTH CARE PROGRAMS OF THE 
           DEPARTMENT OF VETERANS AFFAIRS FOR WOMEN VETERANS

     SEC. 201. MEDICAL CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS 
                   RECEIVING MATERNITY CARE

       (a) Newborn Care.--Subchapter VIII of chapter 17 of title 
     38, United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 1786. HOSPITAL CARE AND MEDICAL SERVICES FOR NEWBORN 
                   CHILDREN OF WOMEN VETERANS RECEIVING MATERNITY 
                   CARE

       ``In the case of a child of a woman veteran who is 
     receiving hospital care or medical services at a Department 
     facility (or in another facility pursuant to a contract 
     entered into by the Secretary) relating to the birth of that 
     child, the Secretary may furnish hospital care and medical 
     services to that child at that facility during the 7-day 
     period beginning on the date of the birth of the child.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 17 of such title is amended by inserting 
     after the item relating to section 1785 the following new 
     item:

``1786. Hospital care and medical services for newborn children of 
              women veterans receiving maternity care.''.

[[Page 15910]]



     SEC. 202. TRAINING AND CERTIFICATION FOR MENTAL HEALTH CARE 
                   PROVIDERS OF THE DEPARTMENT OF VETERANS AFFAIRS 
                   ON CARE FOR VETERANS SUFFERING FROM SEXUAL 
                   TRAUMA AND POST-TRAUMATIC STRESS DISORDER.

       Section 1720D of title 38, United States Code, is amended--
       (1) by redesignating subsection (d) as subsection (f); and
       (2) by inserting after subsection (c) the following new 
     subsections:
       ``(d) The Secretary shall carry out a program to provide 
     graduate medical education, training, certification, and 
     continuing medical education for mental health professionals 
     who provide counseling, care, and services under subsection 
     (a). In carrying out such program, the Secretary shall ensure 
     that all such mental health professionals have been trained 
     in a consistent manner and that such training includes 
     principles of evidence-based treatment and care for sexual 
     trauma and post-traumatic stress disorder.
       ``(e) The Secretary shall submit to Congress an annual 
     report on the counseling, care, and services provided to 
     veterans pursuant to this section. Each report shall include 
     data for the year covered by the report with respect to each 
     of the following:
       ``(1) The number of mental health professionals, graduate 
     medical education trainees, and primary care providers who 
     have been certified under the program required by subsection 
     (d) and the amount and nature of continuing medical education 
     provided under such program to such professionals, trainees, 
     and providers who are so certified.
       ``(2) The number of women veterans who received counseling 
     and care and services under subsection (a) from professionals 
     and providers who received training under subsection (d).
       ``(3) The number of graduate medical education, training, 
     certification, and continuing medical education courses 
     provided by reason of subsection (d).
       ``(4) The number of trained full-time equivalent employees 
     required in each facility of the Department to meet the needs 
     of veterans requiring treatment and care for sexual trauma 
     and post-traumatic stress disorder.
       ``(5) Any recommended improvements for treating women 
     veterans with sexual trauma and post-traumatic stress 
     disorder.
       ``(6) Such other information as the Secretary determines to 
     be appropriate.''.

     SEC. 203. PILOT PROGRAM FOR PROVISION OF CHILD CARE 
                   ASSISTANCE TO CERTAIN VETERANS RECEIVING 
                   CERTAIN TYPES OF HEALTH CARE SERVICES AT 
                   DEPARTMENT FACILITIES.

       (a) In General.--
       (1) Pilot program required.--Not later than six months 
     after the date of the enactment of this Act, the Secretary of 
     Veterans Affairs shall carry out a two-year pilot program 
     under which, subject to paragraph (2), the Secretary shall 
     provide child care assistance to a qualified veteran child 
     care needed by the veteran during the period of time 
     described in paragraph (3).
       (2) Form of child care assistance.--Child care assistance 
     under this section may include--
       (A) stipends for the payment of child care offered by 
     licensed child care centers (either directly or through a 
     voucher program);
       (B) the development of partnerships with private agencies;
       (C) collaboration with facilities or programs of other 
     Federal departments or agencies; and
       (D) the arrangement of after-school care.
       (3) Period of time.--Child care assistance under the pilot 
     program may only be provided for the period of time that the 
     qualified veteran--
       (A) receives a health care service referred to in paragraph 
     (4) at a facility of the Department; and
       (B) requires to travel to and return from such facility for 
     the receipt of such health care service.
       (4) Qualified veteran defined.--In this section, the term 
     ``qualified veteran'' means a veteran who is the primary 
     caretaker of a child and who is receiving from the Department 
     of Veterans Affairs one or more of the following health care 
     services:
       (A) Regular mental health care services.
       (B) Intensive mental health care services.
       (C) Any other intensive health care services for which the 
     Secretary determines that the provision of child care would 
     improve access by qualified veterans.
       (5) Location of pilot program.--The Secretary shall carry 
     out the pilot program at no fewer than three Veterans 
     Integrated Service Networks.
       (b) Authorization of Appropriations.--There is authorized 
     to be appropriated to the Secretary of Veterans Affairs 
     $1,500,000 for each of fiscal years 2010 and 2011 to carry 
     out the pilot program under this section.
       (c) Report.--Not later than six months after the completion 
     of the pilot program, the Secretary shall submit to Congress 
     a report on the pilot program and shall include 
     recommendations for the continuation or expansion of the 
     pilot program.

     SEC. 204. ADDITION OF RECENTLY SEPARATED WOMEN AND MINORITY 
                   VETERANS TO SERVE ON ADVISORY COMMITTEES.

       (a) Advisory Committee on Women Veterans.--Subsection 
     (a)(2)(A) of section 542 of title 38, United States Code, is 
     amended--
       (1) by striking ``and'' at the end of clause (ii);
       (2) by striking the period at the end of clause (iii) and 
     inserting ``; and''; and
       (3) by inserting after clause (iii) the following new 
     clause:
       ``(iv) women who are recently separated veterans.''.
       (b) Advisory Committee on Minority Veterans.--Subsection 
     (a)(2)(A) of section 544 of title 38, United States Code, is 
     amended--
       (1) by striking ``and'' at the end of clause (iii);
       (2) by striking the period at the end of clause (iv) and 
     inserting ``; and''; and
       (3) by inserting after clause (iv) the following new 
     clause:
       ``(v) recently separated veterans who are minority group 
     members.''.
       (c) Effective Date.--The amendments made by this section 
     shall first apply to appointments made on or after the date 
     of the enactment of this Act.

  The CHAIR. Pursuant to the rule, the gentleman from California (Mr. 
Filner) and the gentleman from Arkansas (Mr. Boozman) each will control 
20 minutes.
  The Chair recognizes the gentleman from California.
  Mr. FILNER. Mr. Speaker, I yield myself such time as I might consume.
  Mr. Speaker, this bill is a critical piece of legislation which 
expands and improves health care services available for women veterans 
through the Department of Veterans Affairs.
  The bill will be explained in greater detail by the chairwoman of the 
Subcommittee on Economic Opportunity, Ms. Herseth Sandlin, as the 
person who introduced the bill and we thank her for her steadfast 
commitment to helping women veterans.
  Mr. Speaker, we had a roundtable at our full committee, where we had 
representatives and women veterans from all around the country. It was 
searing testimony which revealed serious weaknesses in the culture of 
the VA.
  The VA health care system, after all, was built to accommodate the 
war-related illnesses and injuries of male veterans. The increased 
percentage of female veterans that has been occurring, especially with 
the war in Iraq and Afghanistan, has led many women veterans to say 
that we need some changes in the culture of the VA. Women walk through 
the lobbies of VA hospitals and are given catcalls. There are not 
sufficient women doctors available for the women who want them. The 
male doctors don't yet seem to have the respect for the sacrifice of 
women veterans.
  There was one woman who testified who had an amputation of one arm 
from combat. When she showed up at the doctor's office, he just assumed 
that it was lost from something else like cancer. He didn't even think 
that this could be a combat-related injury. And we can go on and on, 
but we need to change the culture and change the resources and change 
behavior, and that's what this bill by Ms. Herseth Sandlin starts to 
do.
  There are about 1.8 million women veterans today, or 7 percent of the 
nearly 24 million veterans that we serve. Assuming that the current 
enrollments remain the same, the number of female veterans who use the 
VA system will double in the next 5 years, making female veterans one 
of the fastest growing subgroups of veterans. In this environment of 
organizational transformation and changing demographics, H.R. 1211 has 
the potential to lay the foundation for improved health care services 
for our women veterans.
  I urge my colleagues to support the legislation.
  I reserve the balance of my time.
  Mr. BOOZMAN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 1211, as amended, a bill to 
amend title 38, United States Code, to expand and improve health care 
services available to women veterans from the Department of Veterans 
Affairs and for other purposes.
  I appreciate the hard work of the gentlelady from South Dakota (Ms. 
Herseth Sandlin) on this bill and in bringing it forward. Throughout 
history, women have played a vital role in supporting our national 
defense. Currently women make up 8 percent, about 8 percent of the 
total veteran population, and VA estimates that by 2020, women veterans 
will comprise about 10 percent of the veteran population.

[[Page 15911]]

  Women are the fastest-growing segment of the veteran population, and 
it's essential to make sure that VA is providing specialized programs 
and services to meet their unique physical and mental health needs.
  I want to thank again my good friend and colleague, the gentlelady 
from South Dakota, for introducing this legislation, and I am pleased 
to have joined with her as an original cosponsor for H.R. 1211.
  This legislation would expand and improve benefits and services for 
our female veterans, especially our newest generation of women veterans 
serving in Iraq and Afghanistan. The VA would be required to conduct 
independent studies to look at the barriers women veterans face in 
obtaining VA health care, assist the services currently being provided, 
and develop a plan to better meet their needs.
  In the past 5 years, there has been a 30 percent increase in the 
number of women veterans of child-bearing age enrolling in the VA 
health care system. H.R. 1211, as amended, would aid this population by 
authorizing VA to provide care to newborns of women veterans receiving 
maternity care through VA. Additionally, the bill would establish a 
pilot program to provide child care assistance for certain qualified 
veterans while they are receiving care at the VA.
  Recognizing that the largest number of women veterans are serving in 
Operation Enduring Freedom and Operation Iraqi Freedom, the bill would 
also ensure that recently separated women veterans have a voice on the 
advisory committee on women veterans and minority veterans.
  I urge my colleagues to support 1211, as amended.
  I reserve the balance of my time.
  Mr. FILNER. I am proud to recognize the gentlelady from South Dakota 
(Ms. Herseth Sandlin) for as much time as she may consume. She is the 
author of this very, very important piece of legislation.
  Ms. HERSETH SANDLIN. Mr. Speaker, I rise today in strong support of 
H.R. 1211, the Women Veterans Health Care Improvement Act, as amended, 
which the Veterans' Affairs Health Subcommittee passed on June 4 and 
the full committee approved on June 10.
  I would like to thank Chairman Filner, Ranking Member Buyer, 
Subcommittee Chairman Mike Michaud and Subcommittee Ranking Member 
Brown for their leadership and support of this bill, as well as my 
colleague on the Subcommittee on Economic Opportunity, the 
distinguished ranking member, Mr. Boozman of Arkansas, for cosponsoring 
this important legislation.
  I would also like to take a moment to give special recognition to 
Chairman Filner for his leadership on this very important issue. He had 
mentioned the roundtable that the full committee hosted, his brainchild 
to bring all of the women who represent different veterans service 
organizations and women veterans themselves to speak to their 
experiences and to better inform and educate committee members about 
the extraordinary circumstances that they have faced time and time 
again as they have sought care in VA medical centers.
  So I was extremely pleased to introduce this important legislation on 
February 26, 2009, proud of the bipartisan support the legislation has 
garnered. And the roundtable discussion hosted by Chairman Filner 
illustrated even further how imperative the passage of this bill is for 
our women veterans.
  Before I discuss the bill in greater detail and the needs of women 
veterans, I would also like to take this opportunity to thank the 
Disabled American Veterans for their continued leadership and the 
effort to address the needs of female veterans and their support for 
this important legislation.
  I also want to thank Cathy Wiblemo and the rest of her team for the 
great work that they have done on the health subcommittee. Cathy and 
her staff did excellent work in assisting with this legislation and 
shepherding it through the legislative process.
  Today women make up approximately 8 percent of veterans in the United 
States, and that percentage will continue to rise as more and more 
women answer the call to duty to serve their country. With an 
increasing number of women seeking access to care for a diverse range 
of medical conditions, the challenge of providing adequate health care 
services for women veterans is one that the VA must meet.
  Unfortunately, services at VA facilities often fall short of properly 
providing for the health care needs of women. There is too much 
fragmentation of care and not enough clinicians with the correct 
training and experience.
  Child care considerations aren't being met adequately for male or 
female veterans, and currently the VA does not cover care for the 
newborn child of an eligible veteran.
  To answer these challenges and others, H.R. 1211 takes a number of 
important steps to help the VA provide the services and care that our 
women veterans need and sets the VA on a path toward providing even 
better care in the future.
  H.R. 1211 authorizes the VA to conduct two important studies. First 
the VA will examine barriers to health care that women veterans 
experience within the VA system. The study will examine the full range 
of barriers, including the lack of comprehensive primary care, the 
sensitivity of VA providers regarding gender-specific issues, the 
stigma of seeking mental health care services, and the availability of 
child care.
  The second study is a comprehensive assessment of the VA's women's 
health program, with the task of developing a strategy to improve 
services at every VA medical center. The bill also works to enhance the 
VA's sexual trauma and post-traumatic stress disorder programs for 
women by requiring the secretary of the VA to ensure that all mental 
health professionals have been properly and consistently trained to 
help women veterans.
  Female veterans who have suffered such attacks have already suffered 
enough. They need to know before they begin treatment that every VA 
mental health professional is prepared to help them, understands the 
best methods and practices, and can make them feel secure in seeking 
treatment.
  Child care concerns also have emerged as a crucial issue for women 
veterans seeking care. Sometimes veterans without access to appropriate 
child care are forced to forego important health care appointments.
  H.R. 1211 begins to address this issue by authorizing a child care 
pilot program for patients and requires the VA to carry out this study 
in at least three veterans service networks. Possible forms of child 
care assistance include stipends for child care centers, the 
development of partnerships with private agencies and collaboration 
with other Federal agencies that have similar programs.
  H.R. 1211 also requires the VA to provide 7 days of medical care for 
the newborn children of women veterans. Currently the VA has no 
provision to provide care for these infants. However, 86 percent of 
Operation Enduring Freedom and Operation Iraqi Freedom women veterans 
are under the age of 40, and this benefit represents an important 
update of VA policy.
  Finally, the bill requires the VA to add recently separated women and 
minority veterans to serve on key advisory committees, such as the 
advisory committee on women veterans. The VA must ensure adequate 
attention is given to women veterans programs so quality health care 
and specialized services are available for both women and men.
  I believe my bill will help the VA better meet these specialized 
needs and develop new systems to better provide for the health care of 
women veterans, especially those who are sexually assaulted, suffer 
from PTSD or who need child care services. Congress must honor our 
Nation's commitment to all of our veterans, and this legislation 
furthers that aim.
  Again, I want to thank Chairman Filner for his outstanding leadership 
on this issue, and I urge all of my colleagues to support H.R. 1211.
  Mr. BOOZMAN. I would also like to thank my colleagues on the Health

[[Page 15912]]

Subcommittee, Chairman Mike Michaud and Ranking Member Henry Brown of 
South Carolina, for their hard work on this bill. I would also like to 
thank Chairman Bob Filner, Ranking Member Steve Buyer, for working 
together to move this bill quickly and get it on this floor.
  I would also like to acknowledge and thank Ms. Herseth Sandlin for 
her leadership and recognizing the problem and then moving forward with 
legislation that hopefully will be of great help to women veterans.
  Mr. Speaker, I urge all of my colleagues to support H.R. 1211, as 
amended.
  I yield back the balance of my time.
  Mr. FILNER. Mr. Speaker, I yield 3 minutes to the gentlelady from 
Illinois (Mrs. Halvorson).
  Mrs. HALVORSON. Mr. Speaker, I rise in support of H.R. 1211, the 
Women Veterans Health Care Improvement Act.
  I want to thank Ms. Herseth Sandlin for her dedication on this issue. 
As more women serve in the military, they are quickly becoming an 
important segment of VA users. Their numbers will double over the next 
2 to 4 years, and many are under the age of 40.
  This presents new challenges to the VA system, which historically was 
designed to serve male veterans. Significant changes to the VA need to 
occur to properly serve all veterans.
  As we heard at the VA committee roundtable on women veteran issues, 
women veterans arrive at the VA with a variety of unique challenges. 
Many women veterans do not identify themselves as veterans and seek 
care outside of the system. Some feel stigmatized and are hesitant to 
speak out. Women who have sought care at VA facilities have complained 
that staff lacks understanding of the role of women in combat.
  The most pressing of these challenges relate to mental health, 
including PTSD, depression, anxiety, and behavioral issues. A 2008 VA 
study reported that 15 percent of women in Iraq and Afghanistan 
experience sexual assault or harassment, and 59 percent of these women 
were at a higher risk for mental health problems.

                              {time}  1300

  These are tragic numbers and we need to act immediately to address 
them. The difficulty women face in accessing the VA system and the lack 
of women-focused health care is unacceptable.
  These women have sacrificed so much for our country. This bill takes 
the first step to meet these challenges and follows up on 
recommendations provided by Veterans Service Organizations by requiring 
the Secretary of the VA to study the barriers women face as they seek 
VA services.
  Similarly, H.R. 1211 improves training and education for VA 
professionals to help treat women veterans. This education will help to 
address the concerns that many women veterans have that the VA doesn't 
understand their needs.
  This is why I support H.R. 1211 and strongly urge my colleagues to 
vote ``yes'' on this important bill.


                             General Leave

  Mr. FILNER. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
include extraneous material on H.R. 1211, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. FILNER. In closing, Mr. Speaker, I was listening to Ms. Herseth 
Sandlin talk about the need for pilot programs for child care. We've 
had testimony that if a woman veteran showed up with her child or 
children, they would be denied their appointment and sent home. I mean 
this is a way that the culture just must change, which this bill is the 
first step toward that change.
  So I would urge my colleagues to support H.R. 1211, as amended.
   Mr. FALEOMAVAEGA. Mr. Speaker, I rise today in strong support of 
House Resolution 1211. This piece of legislation will assist our women 
veterans in obtaining better health care.
  First, I'd like to commend the chief sponsor of this resolution, Ms. 
Stephanie Herseth Sandlin. I would also like to recognize my other 
colleagues for their strong support and co-sponsorship of this piece of 
legislation.
  Currently, there are an approximated 200,000 female troops in our 
Armed Forces serving to help protect our Nation. It is not only an 
important issue but a matter of responsibility that we ensure the fair 
and first-rate treatment of our brave female troops when they return 
and/or retire from the Armed Forces.
  This resolution will benefit our women veterans by providing graduate 
education for them. I believe education is a keystone for every U.S. 
citizen and our government should provide the right to an education for 
our valiant troops returning home. This gives the opportunity for women 
veterans who enlisted right after high school to continue on with their 
education at higher levels.
  This legislation will also train and certify mental health 
professionals so we can aid any of our veterans who are in need of 
help. It is imperative that we service our veterans in the best way we 
can. On a day-to-day basis, thousands of veterans suffer from 
conditions such as sexual trauma and post-traumatic stress disorder. 
The number of female veterans that tested positive for military sexual 
trauma was 8,705 and this was a climb in number. It is crucial that we 
take care of our female troops especially because around 20 percent of 
female veterans test positive for sexual trauma while only 1.8 percent 
of male veterans test positive.
  The resolution is also beneficial to our veterans due to the fact 
that this piece of legislation provides for the study and analysis of 
any current problems that our women veterans face in the current state 
of our system. It will help us make amends and additions to the 
structure of health care for our female veterans.
  Another important piece of this legislation that will help Veterans 
Affairs greatly is including recently discharged women veterans in the 
Advisory Committee on Women Veterans and the Advisory Committee on 
Minority Veterans. This will only add more experience to the current 
committee because having recently discharged troops is important in 
knowing what health care issues recently discharged female military 
personal need.
  Mr. Speaker, it is important that we take care of our veterans. These 
veterans put their life on the line to help protect all of us that live 
in this great Nation. It is of the essence to provide easy access to 
health care and to a better current health care system for our women 
veterans.
  Again, I would like to thank my colleague Congresswoman Stephanie 
Herseth Sandlin for being the chief sponsor of this key resolution in 
aiding our women veterans. I strongly urge my other colleagues to 
support this resolution as well.
  Mr. MICHAUD. Mr. Speaker, I rise in strong support of the Women 
Veterans Health Care Improvement Act.
  This legislation will improve and expand health care for women 
veterans.
  I would like to thank Congresswoman Herseth Sandlin for all of her 
hard work. She is a champion of our nation's veterans. I am honored to 
be a cosponsor of this legislation.
  Women now make up approximately fourteen percent of the active 
military, and in the past recruiting class, they made up twenty 
percent.
  Data released by the VA shows that the amount of women who are 
expected to use the VA health care system is expected to double within 
the next four years.
  As a country, we must ensure that women veterans have a voice and 
that their needs are addressed.
  Passing this bill into law will help identify and break down barriers 
faced by women veterans in accessing VA health care.
  I urge all of my colleagues to support this crucial bill.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise today in strong support 
of H.R. 1211, ``Women Veterans Health Care Improvement Act.'' I would 
like to thank my colleague, Congresswoman Herseth Sandlin, for 
introducing this bill, and providing leadership on this important 
issue.
  In the wake of the recent Democratic Presidential victory, we 
witnessed an historic time in our electoral system. Now is the time to 
address the major ongoing disparities that exist for our minority and 
women. Secretary of State Hillary Rodham Clinton once said, ``There 
cannot be true democracy unless women's voices are heard. There cannot 
be true democracy unless women are given the opportunity to take 
responsibility for their own lives. There cannot be true democracy 
unless all citizens are able to participate fully in the

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lives of their country.'' And today, there cannot be true democracy 
unless women receive the same care and treatment in the military as 
their male counterparts. In addition to the health care reform debate, 
H.R. 1211 ``Women's Veterans Health Care Improvement Act'' will be an 
essential piece to the health care reform bill.
  As the 111th Congress and 44th President of the United States undergo 
swift actions to reform our health care system it's important we get 
reform right! It will be a long-term problem if we don't implement the 
right kind of change now, which needs to include all Americans of every 
race, every gender, and in every condition. Without comprehensive 
reform, our government will have failed to serve our people in a time 
when the people elected for change.
  This legislation will expand and improve health care services 
available to women veterans, especially those serving in Operation 
Enduring Freedom and Operation Iraqi Freedom. Women Veterans Health 
Care Improvement Act requires the Secretary of Veterans Affairs to: (1) 
study barriers encountered by women veterans to the provision by the 
Department of Veterans Affairs (VA) of comprehensive health care; (2) 
assess all health care services and programs provided by the VA for 
women veterans; (3) provide graduate education, training and 
certification for mental health professionals who provide counseling, 
care, and services to women veterans suffering from sexual trauma and 
post-traumatic stress disorder (PTSD); and (4) carry out a pilot 
program of child care for certain women veterans receiving health care 
from VA facilities.
  For 19 out of the past 22 fiscal years, appropriated funds for 
medical care were not provided to the Department of Veterans Affairs 
before the commencement of its new fiscal year, causing the Department 
great challenges in planning and managing care for enrolled veterans.
  By providing the access and care for women in the military, we will 
meet the vital obligation to provide health care to all veterans. 
Congress must take action in ensuring our veterans who return home 
sick, injured, or even healthy will receive the quality health care 
they deserve. As acts in an unprecedented time, I urge my colleagues to 
set aside the bickering and come together on a united front to ensure 
all of our citizen's happiness in a quality health care system. Only 
then can we live out the true meaning of our country, democracy.
  Mr. FILNER. 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. Filner) that the House suspend the rules 
and pass the bill, H.R. 1211, as amended.
  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. BOOZMAN. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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