[Congressional Record (Bound Edition), Volume 157 (2011), Part 11]
[House]
[Pages 15121-15126]
[From the U.S. Government Publishing Office, www.gpo.gov]




   VETERANS SEXUAL ASSAULT PREVENTION AND HEALTH CARE ENHANCEMENT ACT

  Mr. MILLER of Florida. Madam Speaker, I move to suspend the rules and 
pass the bill (H.R. 2074) to amend title 38, United States Code, to 
require a comprehensive policy on reporting and tracking sexual assault 
incidents and other safety incidents that occur at medical facilities 
of the Department of Veterans Affairs, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2074

       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 ``Veterans Sexual Assault 
     Prevention and Health Care Enhancement Act''.

     SEC. 2. COMPREHENSIVE POLICY ON REPORTING AND TRACKING SEXUAL 
                   ASSAULT INCIDENTS AND OTHER SAFETY INCIDENTS.

       (a) Policy.--Subchapter I of chapter 17 of title 38, United 
     States Code, is amended by adding at the end the following:

     ``Sec. 1709. Comprehensive policy on reporting and tracking 
       sexual assault incidents and other safety incidents

       ``(a) Policy Required.--Not later than March 1, 2012, the 
     Secretary of Veterans Affairs shall develop and implement a 
     centralized and comprehensive policy on the reporting and 
     tracking of sexual assault incidents and other safety 
     incidents that occur at each medical facility of the 
     Department, including--
       ``(1) suspected, alleged, attempted, or confirmed cases of 
     sexual assault, regardless of whether such assaults lead to 
     prosecution or conviction;
       ``(2) criminal and purposefully unsafe acts;
       ``(3) alcohol or substance abuse related acts (including by 
     employees of the Department); and
       ``(4) any kind of event involving alleged or suspected 
     abuse of a patient.
       ``(b) Scope.--The policy required by subsection (a) shall 
     cover each of the following:
       ``(1) For purposes of reporting and tracking sexual assault 
     incidents and other safety incidents, definitions of the 
     terms--
       ``(A) `safety incident';
       ``(B) `sexual assault'; and
       ``(C) `sexual assault incident'.
       ``(2) The development and use of specific risk-assessment 
     tools to examine any risks related to sexual assault that a 
     veteran may pose while being treated at a medical facility of 
     the Department, including clear and consistent guidance on 
     the collection of information related to--
       ``(A) the legal history of the veteran; and
       ``(B) the medical record of the veteran.
       ``(3) The mandatory training of employees of the Department 
     on security issues, including awareness, preparedness, 
     precautions, and police assistance.
       ``(4) The mandatory implementation, use, and regular 
     testing of appropriate physical security precautions and 
     equipment, including surveillance camera systems, computer-
     based panic alarm systems, stationary panic alarms, and 
     electronic portable personal panic alarms.
       ``(5) Clear, consistent, and comprehensive criteria and 
     guidance with respect to an employee of the Department 
     communicating and reporting sexual assault incidents and 
     other safety incidents to--
       ``(A) supervisory personnel of the employee at--
       ``(i) a medical facility of the Department;
       ``(ii) an office of a Veterans Integrated Service Network; 
     and
       ``(iii) the central office of the Veterans Health 
     Administration; and
       ``(B) a law enforcement official of the Department.
       ``(6) Clear and consistent criteria and guidelines with 
     respect to an employee of the Department referring and 
     reporting to the Office of Inspector General of the 
     Department sexual assault incidents and other safety 
     incidents that meet the regulatory criminal threshold in 
     accordance with section 1.201 and 1.204 of title 38, Code of 
     Federal Regulations.
       ``(7) An accountable oversight system within the Veterans 
     Health Administration that includes--
       ``(A) systematic information sharing of reported sexual 
     assault incidents and other safety incidents among officials 
     of the Administration who have programmatic responsibility; 
     and
       ``(B) a centralized reporting, tracking, and monitoring 
     system for such incidents.
       ``(8) Consistent procedures and systems for law enforcement 
     officials of the Department with respect to investigating, 
     tracking, and closing reported sexual assault incidents and 
     other safety incidents.
       ``(9) Clear and consistent guidance for the clinical 
     management of the treatment of sexual assaults that are 
     reported more than 72 hours after the assault.
       ``(c) Updates to Policy.--The Secretary shall review and 
     revise the policy required by subsection (a) on a periodic 
     basis as the Secretary considers appropriate and in 
     accordance with best practices.
       ``(d) Annual Report.--(1) Not later than 60 days after the 
     date on which the Secretary develops the policy required by 
     subsection (a), and by not later than October 1 of each year 
     thereafter, the Secretary shall submit to the Committee on 
     Veterans' Affairs of the House of Representatives and the 
     Committee on Veterans' Affairs of the Senate a report on the 
     implementation of the policy.
       ``(2) The report under paragraph (1) shall include--
       ``(A) the number and type of sexual assault incidents and 
     other safety incidents reported by each medical facility of 
     the Department;
       ``(B) a detailed description of the implementation of the 
     policy required by subsection (a), including any revisions 
     made to such policy from the previous year; and
       ``(C) the effectiveness of such policy on improving the 
     safety and security of the medical facilities of the 
     Department, including the performance measures used to 
     evaluate such effectiveness.
       ``(e) Regulations.--The Secretary shall prescribe 
     regulations to carry out this section.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by adding after the item 
     relating to section 1708 the following:

``1709. Comprehensive policy on reporting and tracking sexual assault 
              incidents and other safety incidents.''.

       (c) Interim Report.--Not later than 30 days after the date 
     of the enactment of this Act, the Secretary of Veterans 
     Affairs shall submit to the Committee on Veterans' Affairs of 
     the House of Representatives and the Committee on Veterans' 
     Affairs of the Senate a report on the development of the 
     performance measures described in section 1709(d)(2)(C) of 
     title 38, United States Code, as added by subsection (a).

     SEC. 3. INCREASED FLEXIBILITY IN ESTABLISHING PAYMENT RATES 
                   FOR NURSING HOME CARE PROVIDED BY STATE HOMES.

       (a) In General.--
       (1) Contracts and agreements for nursing home care.--
     Section 1745(a) of title 38, United States Code, is amended--
       (A) in paragraph (1), by striking ``The Secretary shall pay 
     each State home for nursing home care at the rate determined 
     under paragraph (2)'' and inserting ``The Secretary shall 
     enter into a contract (or agreement under section 1720(c)(1) 
     of this title) with each State home for payment by the 
     Secretary for nursing home care provided in the home''; and
       (B) by striking paragraph (2) and inserting the following 
     new paragraph (2):
       ``(2) Payment under each contract (or agreement) between 
     the Secretary and a State home under paragraph (1) shall be 
     based on a methodology, developed by the Secretary in 
     consultation with the State home, to adequately reimburse the 
     State home for the care provided by the State home under the 
     contract (or agreement).''.
       (2) State nursing homes.--Section 1720(c)(1)(A) of such 
     title is amended--
       (A) in clause (i), by striking ``; and'' and inserting a 
     semicolon;
       (B) in clause (ii), by striking the period at the end and 
     inserting ``; and''; and
       (C) by adding at the end the following new clause:
       ``(iii) a provider of services eligible to enter into a 
     contract pursuant to section 1745(a) of this title who is not 
     otherwise described in clause (i) or (ii).''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to care provided on or after January 1, 2012.

     SEC. 4. REHABILITATIVE SERVICES FOR VETERANS WITH TRAUMATIC 
                   BRAIN INJURY.

       (a) Rehabilitation Plans and Services.--Section 1710C of 
     title 38, United States Code, is amended--
       (1) in subsection (a)(1), by inserting before the semicolon 
     the following: ``with the goal

[[Page 15122]]

     of maximizing the individual's independence'';
       (2) in subsection (b)--
       (A) in paragraph (1)--
       (i) by inserting ``(and sustaining improvement in)'' after 
     ``improving'';
       (ii) by inserting ``behavioral,'' after ``cognitive'';
       (B) in paragraph (2), by inserting ``rehabilitative 
     services and'' before ``rehabilitative components''; and
       (C) in paragraph (3)--
       (i) by striking ``treatments'' the first place it appears 
     and inserting ``services''; and
       (ii) by striking ``treatments and'' the second place it 
     appears; and
       (3) by adding at the end the following new subsection:
       ``(h) Rehabilitative Services Defined.--For purposes of 
     this section, and sections 1710D and 1710E of this title, the 
     term `rehabilitative services' includes--
       ``(1) rehabilitative services, as defined in section 1701 
     of this title;
       ``(2) treatment and services (which may be of ongoing 
     duration) to sustain, and prevent loss of, functional gains 
     that have been achieved; and
       ``(3) any other rehabilitative services or supports that 
     may contribute to maximizing an individual's independence.''
       (b) Rehabilitation Services in Comprehensive Program for 
     Long-term Rehabilitation.--Section 1710D(a) of title 38, 
     United States Code, is amended--
       (1) by inserting ``and rehabilitative services (as defined 
     in section 1710C of this title)'' after ``long-term care''; 
     and
       (2) by striking ``treatment''.
       (c) Rehabilitation Services in Authority for Cooperative 
     Agreements for Use of Non-Department Facilities for 
     Rehabilitation.--Section 1710E(a) of title 38, United States 
     Code, is amended by inserting ``, including rehabilitative 
     services (as defined in section 1710C of this title),'' after 
     ``medical services''.
       (d) Technical Amendment.--Section 1710C(c)(2)(S) of title 
     38, United States Code, is amended by striking 
     ``opthamologist'' and inserting ``ophthalmologist''.

     SEC. 5. USE OF SERVICE DOGS ON PROPERTY OF THE DEPARTMENT OF 
                   VETERANS AFFAIRS.

       Section 901 of title 38, United States Code, is amended by 
     adding at the end the following new subsection:
       ``(f) The Secretary may not prohibit the use of service 
     dogs in any facility or on any property of the Department or 
     in any facility or on any property that receives funding from 
     the Secretary.''.

     SEC. 6. DEPARTMENT OF VETERANS AFFAIRS PILOT PROGRAM ON DOG 
                   TRAINING THERAPY.

       (a) In General.--Commencing not later than 120 days after 
     the date of the enactment of this Act, the Secretary of 
     Veterans Affairs shall implement a three-year pilot program 
     for the purpose of assessing the effectiveness of using dog 
     training activities as a component of integrated post-
     deployment mental health and post-traumatic stress disorder 
     rehabilitation programs at Department of Veterans Affairs 
     medical centers to positively affect veterans with post-
     deployment mental health conditions and post-traumatic stress 
     disorder symptoms and, through such activities, to produce 
     specially trained dogs that meet criteria for becoming 
     service dogs for veterans with disabilities.
       (b) Location of Pilot Program.--The pilot program shall be 
     carried out at one Department of Veterans Affairs medical 
     center selected by the Secretary for such purpose at a 
     location other than in the Department of Veterans Affairs 
     Palo Alto health care system in Palo Alto, California. In 
     selecting a medical center for the pilot program, the 
     Secretary shall--
       (1) ensure that the medical center selected--
       (A) has an established mental health rehabilitation program 
     that includes a clinical focus on rehabilitation treatment of 
     post-deployment mental health conditions and post-traumatic 
     stress disorder; and
       (B) has a demonstrated capability and capacity to 
     incorporate service dog training activities into the 
     rehabilitation program; and
       (2) shall review and consider using recommendations 
     published by Assistance Dogs International, International 
     Guide Dog Federation, or comparably recognized experts in the 
     art and science of basic dog training with regard to space, 
     equipments, and methodologies.
       (c) Design of Pilot Program.--In carrying out the pilot 
     program, the Secretary shall--
       (1) administer the program through the Department of 
     Veterans Affairs Patient Care Services Office as a 
     collaborative effort between the Rehabilitation Office and 
     the Office of Mental Health Services;
       (2) ensure that the national pilot program lead of the 
     Patient Care Services Office has sufficient administrative 
     experience to oversee the pilot program;
       (3) establish partnerships through memorandums of 
     understanding with Assistance Dogs International 
     organizations, International Guide Dog Federation 
     organizations, academic affiliates, or organizations with 
     equivalent credentials with experience in teaching others to 
     train service dogs for the purpose of advising the Department 
     of Veterans Affairs regarding the design, development, and 
     implementation of pilot program;
       (4) ensure that the pilot program site has a service dog 
     training instructor;
       (5) ensure that dogs selected for use in the program meet 
     all health clearance, age, and temperament criteria as 
     outlined by Assistance Dogs International, International 
     Guide Dog Federation, or an organization with equivalent 
     credentials and the Centers for Disease Control and 
     Prevention;
       (6) consider dogs residing in animal shelters or foster 
     homes for participation in the program if such dogs meet the 
     selection criteria under this subsection; and
       (7) ensure that each dog selected for the program is taught 
     all basic commands and behaviors essential to being accepted 
     by an accredited service dog training organization to be 
     partnered with a disabled veteran for final individualized 
     service dog training tailored to meet the needs of the 
     veteran.
       (d) Veteran Participation.--A veteran who is enrolled in 
     the health care system established under section 1705(a) of 
     title 38, United States Code, and is diagnosed with post-
     traumatic stress disorder or another post-deployment mental 
     health condition may volunteer to participate in the pilot 
     program required by subsection (a) of this section and may 
     participate in the program if the Secretary determines that 
     adequate program resources are available for such veteran to 
     participate at the pilot program site.
       (e) Hiring Preference.--In hiring service dog training 
     instructors for the pilot program required by subsection (a), 
     the Secretary shall give a preference to veterans in 
     accordance with section 2108 and 3309 of title 5, United 
     States Code.
       (f) Collection of Data.--The Secretary shall collect data 
     on the pilot program required by subsection (a) to determine 
     the effectiveness of the program in positively affecting 
     veterans with post-traumatic stress disorder or other post-
     deployment mental health condition symptoms and the potential 
     for expanding the program to additional Department of 
     Veterans Affairs medical centers. Such data shall be 
     collected and analyzed using valid and reliable methodologies 
     and instruments.
       (g) Reports to Congress.--
       (1) Annual reports.--Not later than one year after the date 
     of the commencement of the pilot program, and annually 
     thereafter for the duration of the pilot program, the 
     Secretary shall submit to Congress a report on the pilot 
     program. Each such report shall include--
       (A) the number of veterans participating in the pilot 
     program;
       (B) a description of the services carried out by the 
     Secretary under the pilot program; and
       (C) the effects that participating in the pilot program has 
     on veterans with post-traumatic stress disorder and post-
     deployment mental health conditions.
       (2) Final report.--At the conclusion of pilot program, the 
     Secretary shall submit to Congress a final report that 
     includes recommendations with respect to the extension or 
     expansion of the pilot program.
       (h) Definition.--For the purposes of this section, the term 
     ``service dog training instructor'' means an instructor 
     recognized by an accredited dog organization training program 
     who provides hands-on training in the art and science of 
     service dog training and handling.

     SEC. 7. ELIMINATION OF ANNUAL REPORT ON STAFFING FOR NURSE 
                   POSITIONS.

       Section 7451(e) of title 38, United States Code, is 
     amended--
       (1) by striking paragraph (5); and
       (2) by redesignating paragraph (6) as paragraph (5).

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Miller) and the gentleman from California (Mr. Filner) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Florida.
  Mr. MILLER of Florida. Madam Speaker, I yield myself such time as I 
may consume.
  I rise in strong support of H.R. 2074, as amended, the Veterans 
Sexual Assault Prevention and Health Care Enhancement Act. The bill 
before us is, in fact, a bipartisan product of many months worth of 
oversight on behalf of our Health Subcommittee. It's derived from 
numerous proposals championed by Members from both sides of the aisle 
to improve the care and the services provided to our veterans by the 
Department of Veterans Affairs.
  Of special note is a provision introduced by our Health Subcommittee 
chairwoman, Ms. Ann Marie Buerkle, and myself. This provision would 
address the findings of a Government Accountability Office report 
detailing the high prevalence of sexual assault incidents at VA medical 
facilities and the very serious failures in accountability on the part 
of VA leadership.

[[Page 15123]]

  As I've said before, just one assault, just one assault of this 
nature, one sexual predator or one veteran's rights being violated 
within the VA is one too many.
  I am grateful to my good friend, the ranking member, Mr. Filner, and 
the Health Subcommittee Chairwoman, Ann Marie Buerkle and Ranking 
Member Mike Michaud for the leadership that they have shown in bringing 
this legislation forward to strengthen the VA health care system for 
our veteran heroes.
  I now yield such time as she may consume to my good friend and 
colleague from New York, Chairwoman Buerkle, to further discuss the 
provisions of H.R. 2074, as amended.
  Ms. BUERKLE. I thank the chairman.
  Madam Speaker, I rise in strong support of H.R. 2074, as amended, the 
Veterans Sexual Assault Prevention and Health Care Enhancement Act. 
H.R. 2074, as amended, includes several worthy legislative proposals 
brought forth by the Members from both sides reflecting the 
subcommittee's oversight and activities to date.
  This bill would create a safer Department of Veterans Affairs health 
care system, allow for greater flexibility in VA payments to State 
Veterans homes, break down barriers to care for veterans with traumatic 
brain injury, clarify access rights of service dogs on VA property, and 
expand an innovative therapeutic option for veterans struggling with 
post-traumatic stress.
  Section 2 of the bill would require the VA to develop a comprehensive 
policy on the prevention, monitoring, reporting, and tracking of sexual 
assaults and other safety instances at VA facilities. I, along with the 
chairman, introduced this measure in response to a disturbing report 
issued by the Government Accountability Office in early June of this 
year regarding the prevalence of sexual assaults and other safety 
instances on VA property and the very serious safety vulnerabilities, 
security problems, and oversight failures by VA leadership.
  Abusive behavior like the kind documented by GAO is unacceptable in 
any form, but for it to be found in what should be an environment of 
caring for our honored veterans is simply intolerable.
  As a registered nurse and domestic violence counselor, I am all too 
familiar with the corrosive and harmful effects sexual and physical 
violence can have on the lives of its victims. It is an experience I 
wish on no one, much less one of our Nation's heroes or hardworking 
medical professionals.
  Madam Speaker, it is critically important that we take every 
available step to protect the personal safety and well-being of our 
veterans who seek care through the VA and all of the hardworking 
employees who strive to provide that care on a daily basis.
  The provisions included in this bill would require VA to develop 
clear and comprehensive criteria with respect to the reporting of 
instances for both clinical and law enforcement personnel, a 
comprehensive policy on reporting and tracking, risk assessment tools, 
a mandatory safety awareness and preparedness training program for 
employees, appropriate physical security precautions, and a centralized 
and accountable oversight system.
  Madam Speaker, I'm confident that these requirements will resolve the 
many wrongs uncovered by the GAO and ensure that the VA health care 
system remains a safe haven of healing for our honored veterans.
  Madam Speaker, section 3 of the bill would allow for increased 
flexibility in establishing rates for reimbursement to State homes for 
nursing home care provided to veterans with a service-connected 
disability rated at 70 percent or greater, or in need of such care due 
to a service-connected condition.
  State veterans homes have a long history of providing high quality 
care to some of our Nation's most vulnerable veterans. By requiring the 
VA to enter into a contract or agreement separately with each State 
home based on the particular needs of that veteran, this bill would 
correct an unintended consequence in law that has negatively impacted 
certain State homes and, consequently, the veterans under their care.
  This proposal was spearheaded by my friend and colleague, the ranking 
member from Maine, Mr. Mike Michaud. I would like to thank him for his 
advocacy and his hard work in advancing this proposal and recognizing 
the great service that our State homes provide.
  Madam Speaker, section 4 of the bill would improve the provision of 
rehabilitative care to veterans with traumatic brain injury by 
including the goal of maximizing independence and improving behavioral 
and mental health functioning within individual rehabilitation and 
reintegration programs.
  It would also require that rehabilitative services be included within 
any comprehensive long-term care services for veterans with traumatic 
brain injury. Many concerns have been raised by veterans and veterans 
service organizations that current law is being inappropriately 
interpreted to limit rehabilitative care for veterans with TBI to only 
those services that restore function.
  Madam Speaker, it is vital that we ensure that the recovery process 
for our veterans, especially those facing a lifetime of cognitive and 
neurological impairment, is ongoing, unburdened by institutional 
barriers, and extends beyond a strictly medical model to include 
services that allow those struggling to advance functional gains and 
reintegrate successfully into their home communities.
  Madam Speaker, this provision was introduced by Mr. Tim Walz of 
Minnesota, a veteran and valuable member of our Subcommittee on Health, 
and I would like to extend my personal gratitude to him for his service 
and for this proposal.
  Section 5 of the bill would clarify the access rights of service dogs 
on VA property and in VA facilities. This provision, introduced by Mr. 
John Carter of Texas, would amend an outdated VA policy that has left 
some disabled veterans and service dogs they need to function out in 
the cold.
  Unlike guide dogs for visually impaired veterans, service dogs are 
not guaranteed entry at VA facilities under Federal law. Recognizing 
the immense therapeutic value service dogs can have in promoting 
functionality and independence for our veterans, this provision would 
require that service dogs do have access to VA facilities consistent 
with the same terms and conditions and subject to the same regulations 
as generally govern the admittance of guide dogs on VA property.
  Madam Speaker, section 6 of this bill would direct VA to carry out a 
3-year pilot program to assess the effectiveness of addressing post-
deployment mental health and post-traumatic stress disorder, PTSD 
symptoms, through service dog training therapy.
  This legislation would allow for the expansion of promising and 
successful service dog training therapy programs currently in use at 
the VA Medical Center in Palo Alto, California, and the National 
Intrepid Center of Excellence in Bethesda, Maryland. Veterans 
participating in these programs have demonstrated improved emotional 
regulation, social integration, sleep patterns, and a sense of purpose 
and personal safety.
  The prevalence, Madam Speaker, of post-deployment mental health 
issues and post-traumatic stress disorder is rising among our veteran 
population, with over 190,000 veterans of Iraq and Afghanistan having 
sought treatment in VA for post-traumatic stress disorder.

                              {time}  1450

  Veterans who struggle with mental health issues need and deserve the 
very best we can provide in care and treatment. Providing them with 
every tool necessary to reintegrate healthfully back into their 
families and home communities and achieve maximum health and wellness 
is one of my and my subcommittee's top priorities.
  We must continue to explore new and innovative therapeutic options to 
alleviate the symptoms of post-traumatic stress; and I thank my friend 
and fellow New Yorker, Mr. Michael Grimm, for his previous service to 
our country in the Marine Corps and for his very strong commitment to 
moving this initiative forward to assist his fellow veterans.

[[Page 15124]]

  Finally, Madam Speaker, section 7 of the bill would eliminate the 
requirement for the VA to provide Congress with an annual report on 
staffing for nurses and nurse anesthetists. This cumbersome and costly 
report was enacted almost 11 years ago. It is estimated to cost 
approximately $113,000 per year to produce. The report's intended 
purpose was to keep Congress apprised of recruitment and retention 
issues facing certain nursing positions within the VA. However, 
following that, Congress enacted Public Law 107-135, the Veterans 
Affairs Health Care Programs Enhancement Act, which fundamentally 
strengthened VA's ability to recruit and retain qualified nursing 
professionals through additional employee benefits and incentives.
  Reporting requirements included in this law, as well as a variety of 
other ways and means in which Congress can obtain such data, render 
this report unnecessary. Further, for the last several years, the 
report has concluded that nurse staffing remain stable within the 
Veterans Affairs Department. Additionally, eliminating the burdensome 
reporting requirement does not in any way reduce other existing 
requirements for VA to gather information on nurse staffing facility 
leadership, ensuring that such data continues to be readily available 
to Congress and other stakeholders.
  Madam Speaker, it has been an honor for me to work with my colleagues 
in a truly bipartisan manner to move H.R. 2074, as amended, forward; 
and I would like to thank each of them, particularly Chairman Jeff 
Miller and Ranking Member Bob Filner, and Health Subcommittee ranking 
member, Mike Michaud, for their tireless support on behalf of our 
honored veterans.
  Madam Speaker, I urge all of my colleagues to join me in supporting 
this important legislation.
  Mr. FILNER. Madam Speaker, I yield myself such time as I may consume.
  Obviously, nothing is more important than the safety of our veterans; 
and this bill, H.R. 2074, contains many provisions to help improve the 
safety and health care of our veterans.
  Because of a report I requested as chair, the GAO presenter ``VA 
Health Care: Actions Needed to Prevent Sexual Assaults and Other Safety 
Incidents.'' That report found that veterans and employees were exposed 
to personal dangers, including sexual assaults, in the very facilities 
that should be protecting them.
  And, Madam Speaker, I think we ought to be more outraged given the 
findings of that report. That report found that there were not just 
dozens of alleged sexual assaults that went unreported, not even scores 
of such assaults, but hundreds of them--hundreds of sexual assaults 
alleged but not reported by those who had the obligation and 
responsibility to report them.
  How are our veterans protected when they can't even have a report of 
an alleged assault? What message does that give to people that the 
military & the VA care about what's going on here and what's going on 
with their safety? That's who we should be going after here, by the 
way. It's very clear who has the responsibility about reporting such 
assaults, and yet they were not reported in the hundreds of cases, and 
that was only, by the way, at some selected study places. Who knows 
what we would have found in the whole institution?
  I don't know that the VA has ever reprimanded any of those people. I 
don't know that the VA has ever said to the Veterans Administration 
that this will not be tolerated, that not only are we going to report 
on them, but investigate them and bring people to justice. I don't know 
that any of that has happened. That's what this bill should be trying 
to focus on. What happens to those people who don't report them? What 
happens to the cover-ups? What happens to those who protect each other 
as people are assaulted?
  I'm not sure that we have come to grips with this issue. This report 
was outrageous. This report was incredibly, incredibly tragic. And all 
I find is we are going to do some process changes in here--and I 
support those, and we'll vote for the bill. But we're sending a message 
here to the entire 250,000 working people of this VA that we're not 
really concerned about them, we're not reporting them, we're not 
getting to those people covering up, we're not getting at those people 
who protect each other, we're not getting at those who have violated 
the law by not reporting such incidents.
  Let's go after them. Let's give our veterans some comfort that their 
safety is protected.
  I reserve the balance of my time.
  Mr. MILLER of Florida. Madam Speaker, I associate myself with the 
comments of my colleague. It is egregious that there have been so many 
sexual assaults that have, in fact, gone unreported by the VA. I would 
encourage my good friend and his colleagues to work with us and provide 
amendments in any way that they see important to help bills like this 
strengthen the reporting requirements and to help us in an oversight 
and investigative response of this Congress, which is trying to do more 
on the oversight and investigative side. The last Congress did very 
little, and even those under Republican administrations did very 
little.
  We're trying to reengage the oversight and investigation side, and I 
think that it is very important that we work together; and I do commend 
my good friend for his outrage on this particular report that came out, 
and I will work with him in any way possible.
  With that, I yield such time as he may consume to my good friend from 
the Staten Island area of New York, the 13th Congressional District, 
Congressman Grimm.
  Mr. GRIMM. Thank you, Chairman Miller.
  I rise today in strong support of H.R. 2074, which includes the text 
of H.R. 198, the Veterans Dog Training Therapy Act. That's a bill that 
I introduced along with our lead cosponsor, House Veterans' Affairs 
Health Subcommittee Ranking Member Michaud. A special thank you to the 
ranking member. As a marine combat veteran, it's a unique honor for me 
to see this bill considered today by the full House.
  Over the past 9 months, I've had the honor to meet with our Nation's 
veterans who are now faced with the challenges of coping with PTSD and 
physical disabilities resulting from their service in Iraq and 
Afghanistan. Their stories are not for the weak of heart, and they're 
truly moving, with these personal accounts of their recovery, both 
physical and mental, and the important role therapy and service dogs 
played that inspired this legislation.
  The Veterans Dog Training Therapy Act would require the Department of 
Veterans Affairs to conduct a pilot program in VA medical centers 
assessing the effectiveness of addressing post-deployment mental health 
and PTSD through the therapeutic medium of training service dogs for 
veterans with disabilities. These trained service dogs are then given 
to physically disabled veterans to help them with their daily 
activities.
  Simply put, this program treats veterans suffering from PTSD while at 
the same time aiding those suffering from physical disabilities. Since 
it was introduced, this legislation has gained the bipartisan support 
of 96 cosponsors. With veteran suicide rates at all-time highs and more 
and more servicemen and -women being diagnosed with PTSD, this bill 
meets a crucial need for additional treatment methods. I believe that 
by caring for our Nation's veterans, while at the same time providing 
assistance dogs to those with physical disabilities, we create a win-
win scenario for everyone. This is a goal we can all be proud to 
accomplish.
  Just as an added bonus, we provide these wonderful animals with a 
loving and safe environment. And that's why I strongly urge all of my 
colleagues to join me in support of H.R. 2074.

                                                       AMVETS,

                                     Lanham, MD, October 11, 2011.
     Hon. Michael Grimm,
     House of Representatives, Cannon House Office Building, 
         Washington, DC.
       Dear Congressman Grimm: On behalf of AMVETS (American 
     Veterans), I am writing to express our support of H.R. 198, 
     the ``Veterans Dog Training Therapy Act.'' AMVETS supports 
     the updated language of H.R. 198 that is now an amendment in 
     H.R. 2074. We believe the current language in H.R. 2074 will 
     ensure this bill provides our veterans the highest quality 
     care, while at the same time

[[Page 15125]]

     maintaining our commitment to fiscal responsibility.
       As you may know, AMVETS has partnered with the Assistance 
     Dogs International (ADI) accredited Assistance Dog agency 
     Paws With A Cause for over 30 years, in an effort to help 
     provide disabled veterans Service Dogs. Through our 
     experiences we have seen what an immeasurable asset these 
     dogs have proven to be to both the trainers and recipients. 
     This has included, but is not limited to, improvements in 
     both physical and mental health, quality of life and the 
     independence these dogs afford disabled veterans.
       Furthermore, AMVETS believes H.R. 198, as an amendment in 
     H.R. 2074, will prove to be both beneficial to veterans and 
     to the Department of Veterans Affairs in the development of 
     stronger policies and procedures regarding Service Dogs 
     within the VA health care system, as well as being fiscally 
     responsible through the partnering of VA facilities with 
     private sector industry expert ADI agencies for this study.
       AMVETS lends our support to H.R. 198, as an amendment in 
     H.R. 2074 and again applauds your dedication to our veteran 
     community.
           Sincerely,
                                                Christina M. Roof,
                             National Deputy Legislative Director.

                              {time}  1500

  Mr. FILNER. I yield such time as he may consume to the ranking member 
of our Health Subcommittee, someone who has served for 4 years as the 
chair and who has done so much good for our veterans throughout the 
Nation, the gentleman from Maine (Mr. Michaud).
  Mr. MICHAUD. I thank Ranking Member Filner for yielding.
  As my colleagues have stated, our veterans' safety should be one of 
our top priorities, and the Veterans Sexual Assault Prevention and 
Health Care Enhancement Act does just that.
  I would like to thank Chairman Miller and Ranking Member Bob Filner, 
the chair of the subcommittee, as well as all of my colleagues on the 
House Veterans Affairs' Committee, for working in such a bipartisan 
manner to get this very important health care bill to the floor.
  Within H.R. 2074, I would like to highlight two important provisions, 
and you heard the chairwoman explain the bill very eloquently.
  The first provision I would like to highlight is section 2, which was 
offered by the chair of the Subcommittee on Health, Ms. Buerkle. The 
provision will correct the troubling findings in a GAO report. The 
report essentially found that veterans and employees were exposed to 
personal dangers, including sexual assault. This is simply 
unacceptable, and I want to thank the subcommittee chair for offering 
this bill to us.
  The second provision I would like to highlight is in section 3, my 
provision of the bill. Section 3 would provide much needed flexibility 
in the way the State veterans' homes get reimbursed for the care they 
provide to veterans who need that care for a service-connected 
condition or a service-connected condition of 70 percent or greater. 
This will ensure that these veterans are not put out on the streets.
  The Subcommittee on Health has been working on this bill for well 
over 2 years, and now I am finally pleased to see that this bill is 
moving forward. Hopefully, my colleagues on both sides of the aisle 
will support this very important piece of legislation as we have to do 
all that we can to help our veterans and their families. This bill is 
one that takes a different approach to dealing with our veterans and 
their problems.
  Mr. MILLER of Florida. Madam Speaker, I yield 2 minutes to the 
gentleman from the 31st District of Texas (Mr. Carter).
  Mr. CARTER. I thank the chairman for yielding.
  I want to thank the chairman and chairwoman for adopting H.R. 2074 to 
include H.R. 1154, the Veterans Equal Treatment for Service Dogs--the 
vet dogs--bill.
  This ensures that veterans with service dogs have equal access to VA 
facilities. It amends title 38 of the U.S.C. to ensure that the VA 
allows medical service dogs in addition to seeing eye and guide dogs in 
VA facilities. This is sort of a no-brainer. A medical service dog's 
usage has been expanded to deal with all types of brain injury, hearing 
loss, seizures, vets who have lost limbs--for assistance mobility--and 
there are many other important areas in which these service dogs are 
making our veterans better.
  Both the ADA and the Rehabilitation Act support this bill. The VA 
issued a directive recently to allow service dogs into their 
facilities, a directive good for 5 years. I applaud the VA in that 
effort, but this bill makes this directive permanent.
  This is important for these veterans. If you see them with their 
dogs, you'll know that the friendship and the love and the affection 
and assistance that these dogs provide is invaluable to our injured 
veterans.
  Harry Truman once made the statement, If you want a friend in 
Washington, D.C., get a dog. I am just trying to make sure by this 
bill--and we are trying to make sure--that our veterans don't have to 
leave their friends outside the door.
  Mr. FILNER. I have no further requests for time and would be prepared 
to close once the chairman has no further speakers.
  Mr. MILLER of Florida. I have no further requests for time.
  Mr. FILNER. I yield myself such time as I may consume.
  As I said earlier, this is a bill that has a lot of good things in 
it, and I wish we had gone further.
  I met with the GAO this morning. They said they could follow up 
reports such as this with an investigation of personnel actions, for 
example, and could report back to us in terms that don't violate any 
civil service protections that they would provide a third party kind of 
review of the personnel actions that may have resulted from their 
recommendations.
  You don't have to answer now, but I would be prepared to work with 
the chair to request such an investigation, because what we have done 
here is, in response to the report that said reporting requirements 
were not met in hundreds of cases at some few selected sites that they 
examined, merely add new reporting requirements. They didn't follow the 
first ones, so what good are more reporting requirements going to do?
  There have to be some actions on the part of the Veterans 
Administration that say to our employees, that say to our veterans that 
there shall be no sexual assaults on our sites. Yet what we're saying 
here is, oh, we'll add a few more reporting requirements. That doesn't 
send a message, because we already had the reporting requirements.
  Let's try to find a way--and I'll work with the chair to do this--to 
send a message to our agency, not that we're going to pass another few 
rules, but that we're going to take this seriously, that we're going to 
demand that the employees who did not follow what is clearly stated in 
rules and law about reporting alleged cases of sexual assault be 
terminated. In my opinion, they ought to have been terminated. This is 
so serious, and it would have sent such a good message to those who 
might either perpetrate assault or to those who are victims of such 
assault.
  They should have been terminated. I doubt that they were. I doubt 
that they were removed from their jobs. I would hope the VA might 
contradict me, but I doubt that there was anything more than a note 
saying they should do better in the future. I hope I'm wrong, but I 
will tell you that the history of personnel actions in response to acts 
such as these has not been one that gives confidence to me that we have 
sent the right message.
  So I will work with the chair to do whatever we can to send the right 
message from this Congress and from the American people that these acts 
will not be tolerated.
  I yield back the balance of my time.
  Mr. MILLER of Florida. Madam Speaker, I commit to working with the 
ranking member on the further reporting of these incidents. I would add 
that this particular piece of legislation does, in fact, incorporate 
every single recommendation that the GAO gave to this committee in 
their report.


                             General Leave

  Mr. MILLER of Florida. I ask unanimous consent that all Members have 
5 legislative days to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?

[[Page 15126]]

  There was no objection.
  Ms. JACKSON LEE of Texas. Madam Speaker, I rise today in support of 
H.R. 2074, ``the Veterans Sexual Assault Prevention and Healthcare 
Enhancement Act of 2011.'' This legislation requires the Veterans' 
Administration, VA, to report and track sexual assaults and other 
safety related incidents at its medical facilities. Further, it 
requires: a payment of nursing home care for veterans with service-
connected disabilities, requires individualized care for traumatic 
brain injuries (TBI), allows service dogs on VA properties, and 
establishes a three year pilot program to assess the effectiveness of 
mental health and post traumatic stress disorder (PTSD) treatments of 
veterans who are utilizing dog training therapy.
  Throughout my tenure in Congress, I have remained committed to 
meeting the needs of veterans. They have kept their promise to serve 
our nation and have willingly risked their lives to protect the country 
we all love. We must now ensure that we keep our promises to our 
veterans. It is only prudent to require the VA to take steps to ensure 
that our veterans are safe while in their care.
  In the State of Texas, we have nearly 1.7 million veterans, and 18th 
District is home to 32,000 of them. The veterans I represent are aware 
of the services provided by the Veterans' Administration. When they 
return home, the least we can do is to ensure that while they are 
receiving care their physical safety concerns are being addressed.
  The Veterans' Administration is charged with providing for the 
healthcare needs of our nation's veterans. Part of this care includes 
providing for their safety. Although the majority of the men and women 
who have served our country are upright and law abiding citizens there 
are always a few bad actors. The veterans must be protected against bad 
actors in the same way that they have helped to protect the United 
States against our enemies.
  The Department of Defense estimates that in 2010 alone, there were 
over 19,000 sexual assaults in the military, which amounts to nearly 52 
sexual assaults per day. It is not unreasonable to imagine that those 
tens of thousands of survivors and their perpetrators vanish after they 
are discharged from the military. There are substantial numbers of 
veterans who are survivors of sexual trauma, survivors utilizing the VA 
services. According to a VA report in FY 2010 68,379 patients had at 
least one outpatient visit to a VHA facility that was for the treatment 
of a condition related to military sexual trauma: 61 percent, or 
41,475, of those patients were women; 39 percent, or 26,904, were men.
  We must remember that the Veterans' Administration does serve tens of 
thousands of veterans every year. This number will continue to grow as 
more of our troops return home. As with any institution that meets the 
needs of so many the VA must ensure the safety of the patients under 
their care. To do so the VA must train members of their staff on sexual 
harassment and sexual assault responses, and educate patients on the 
process to file a sexual assault allegation.
  According to the Government Accountability Office, GAO, there were 
nearly 300 sexual assault incidents reported to the VA police from 
January 2007 through July 2010--including alleged incidents that 
involved rape, inappropriate touching, forceful medical examinations, 
forced or inappropriate oral sex, and other types of sexual assault 
incidents. Many of these sexual assault incidents were not reported to 
officials within the management reporting stream which is a direct 
violation of VA policy and Federal Regulations.
  H.R. 2074 addresses some of the factors identified by the GAO, namely 
that the VA did not have a consistent sexual assault definition that 
could be utilized for reporting purposes. The VA also did not have 
clear expectations for incident reporting across VA medical facilities. 
In addition, the VA does not have the ability or mechanisms in place to 
monitor sexual assault incidents reported through the management 
reporting stream. H.R. 2074 would require the VA to establish a 
comprehensive policy to report and track all incidents of sexual 
assault and other safety concerns.
  It is important that the men and women receiving care at VA medical 
facilities are adequately protected from harm. It is unfathomable that 
this issue has not been addressed sooner. We must remember that 
although sexual assault is often considered an issue only affecting 
women, in fact, both men and women have suffered sexual assaults. 
Further, victims may be assaulted by predators of the same or the 
opposite sex. Like other types of trauma, sexual trauma can leave 
lasting scars upon the physical and mental health of its victims. 
Veterans who are already receiving care for their wounds should not be 
left to defend themselves against aggressors.
  In addition, the GAO determined that five VA medical facilities 
visited, had poorly monitored surveillance cameras, alarm system 
malfunctions, and the failure of alarms to alert both VA police and 
clinical staff when triggered. Inadequate system configuration and 
testing procedures contributed to these weaknesses. Further, facility 
officials at most of the locations GAO visited said the VA police were 
understaffed. These issues could have dire consequences, as it could 
lead to delayed response time to incidents and seriously erode the VA's 
efforts to prevent or mitigate sexual assaults and other safety 
incidents. This is simply outrageous.
  H.R. 2074 requires the VA to take this matter seriously. As it stands 
this bill requires the VA to have clear accountability goals for VA 
staff. Every VA medical facility is required to have a military sexual 
trauma coordinator; considering the volume of patients who are coping 
with this condition that should not be a surprise. What is surprising 
is that at most VA facilities this position is not a full time job. 
These employees are often given additional duties and obligations not 
related to military sexual trauma. This legislation should be a wakeup 
call. Protecting the safety of our veterans while they are in our care 
is a top priority.
  In addition, this legislation opens the possibility of meeting the 
health needs of veterans who reside in nursing homes, are receiving 
treatment for PTSD and other mental health services. It is important to 
note that when a solider returns from the battlefield he or she brings 
with them both physical and mental wounds. It is our duty to ensure 
that each and every one of those veterans who survive the fields of 
combat are able to receive the care they need when they make it home.
  I urge my colleagues to join me in supporting H.R. 2074, the Veterans 
Sexual Assault Prevention and Healthcare Enhancement Act.
  Mr. MILLER of Florida. I encourage all Members to support this 
legislation, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Florida (Mr. Miller) that the House suspend the rules 
and pass the bill, H.R. 2074, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  The title was amended so as to read: ``A bill to amend title 38, 
United States Code, to require a comprehensive policy on reporting and 
tracking sexual assault incidents and other safety incidents that occur 
at medical facilities of the Department of Veterans Affairs, to improve 
rehabilitative services for veterans with traumatic brain injury, and 
for other purposes.''.
  A motion to reconsider was laid on the table.

                          ____________________