[Congressional Record (Bound Edition), Volume 160 (2014), Part 10]
[House]
[Pages 13654-13661]
[From the U.S. Government Publishing Office, www.gpo.gov]




     CONFERENCE REPORT ON H.R. 3230, PAY OUR GUARD AND RESERVE ACT

  Mr. MILLER of Florida. Mr. Speaker, I move to suspend the rules and 
agree to the conference report on the bill (H.R. 3230) making 
continuing appropriations during a government shutdown to provide pay 
and allowances to members of the reserve components of the Armed Forces 
who perform inactive-duty training during such period.
  The Clerk read the title of the bill.
  (For conference report and statement, see proceedings of the House of 
July 28, 2014, at page 13342.)
  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Miller) and the gentleman from Maine (Mr. Michaud) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Florida.


                             General Leave

  Mr. MILLER of Florida. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days within which to revise and extend 
their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. MILLER of Florida. Mr. Speaker, I yield myself such time as I may 
consume.
  I rise today in support of the conference report to accompany H.R. 
3230, the Veterans' Access to Care through Choice, Accountability, and 
Transparency Act of 2014.
  General Omar Bradley, the former administrator of what is now the 
Department of Veterans Affairs, once said of our work, ``We are dealing 
with veterans, not procedures--with their problems, not ours.''
  We have come face-to-face with the problems our veterans routinely 
encounter, and they are considerable to say the least. As every 
American now knows, congressional oversight and whistleblower 
revelations have exposed widespread corruption and systemic delays in 
access and failures of accountability across our Nation's second 
largest bureaucracy.
  Thousands of veterans across this country have been left to wait--
some for years; some in pain; and, most disturbingly, some in caskets 
that are draped with American flags; some while chronic or fatal 
conditions worsened until little hope was left--for the health care 
they earned through their honorable service to our Nation. Meanwhile, 
poor-performing VA leaders and employees continued to receive large 
bonuses, subject to little accountability for their many inadequacies.
  There is no doubt, Mr. Speaker, that the Department of Veterans 
Affairs, as we know it today, is in crisis, and as a result, our 
veterans are suffering. The conference report we are considering this 
afternoon is the first step to alleviating their pain and for paving 
the way for the failing VA health care system to experience much-needed 
structural and cultural reform.
  To immediately improve access to care for veteran patients, the 
conference report would require the VA to authorize non-VA care to any 
eligible veteran who is unable to secure a timely appointment at a VA 
facility or who resides more than 40 miles from the nearest VA medical 
facility, with certain exceptions.
  Eligible veterans would include those who are enrolled in the VA 
health care system as of August 1 of 2014 or who are newly-discharged 
combat veterans.
  It would further require the VA to issue a veterans choice card to 
eligible veterans to facilitate care provided by non-VA providers and 
provide $10 billion for the newly-established veterans choice fund to 
cover the costs of access to non-VA care under this bill.
  To lead the way for true reform in the long term, the conference 
report would require a comprehensive assessment of VA care by an expert 
independent entity or entities and would establish a congressional 
commission on care, which would be charged with setting the future 
course for access to and quality care throughout the entire VA health 
care system.
  To improve the VA's internal capacity to provide timely and high-
quality care to our veterans, this report would also provide the 
Department with $5 billion to hire physicians and other clinical staff 
and would provide for certain critical physical infrastructure 
improvements.
  The conference report would also extend the VA's rural health care-
focused project, ARCH--a pilot program--for an additional 2 years. It 
would extend the pilot program for an additional 3 years to provide 
rehabilitation, quality of life, and community integration services to 
veterans with traumatic brain injury.
  It would authorize 27 medical facility leases across 18 States and 
Puerto Rico and make certain improvements to care provided to veterans 
who have experienced military sexual trauma and others.
  To advance genuine accountability for incompetent or corrupt senior 
managers, the conference report would reduce funding for bonuses 
available to VA employees by $40 million each year through fiscal year 
2024, and it would authorize the Secretary to fire or demote Senior 
Executive Service employees and title 38 SES equivalent employees for 
poor performance or misconduct. Poor-performing employees who are 
disciplined under this authority would be provided an expedited and 
limited appeal process, but would be prohibited from receiving their 
pay, bonuses, or benefits during the appeal process.
  This provision will give the Secretary the tools he needs to 
expeditiously hold senior managers accountable for the types of willful 
misconduct and possibly criminal negligence we have seen during our 
investigations.
  The conference report would also require public colleges to provide 
instate tuition to veterans and eligible dependents for the school to 
remain eligible to receive GI Bill education payments.
  This provision closely mirrors the bill that I offered, H.R. 357, the 
GI Bill Tuition Fairness Act, which passed the House earlier this year. 
The men and women who served this Nation did not just defend the 
citizens of their home States; they defended the entire United States 
of America.
  The conference report would also include approximately $5 billion in 
offsets with additional incidental offsets expected to accrue over time 
as a result of increased third-party collections for nonservice-
connected conditions and reductions in Medicare payments as a result of 
the increased utilization of the newly-created choice program.
  Mr. Speaker, the bill before us is one that I am proud of, but more 
importantly, it is one that I believe our Nation's veterans can be 
proud of. It is not a blank check for a broken system, but it is an 
important first step down a long road toward true transformation.
  However, our work is far from over. We all know that congressional 
oversight was crucial to bringing the failures at the VA to light, and 
it will increase in the days and weeks and months ahead after the 
passage of this bill.
  The passage of this conference report will increase access to care 
and improve accountability within a desperately broken bureaucracy. 
However, the reform that is necessary to reforming the agency will 
require dedication for years to come, and I would ask all of my 
colleagues to join me in beginning that effort today.
  I reserve the balance of my time.

                              {time}  1515

  Mr. MICHAUD. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in strong support of the conference report 
to H.R. 3230, the Veterans Access, Choice, and Accountability Act of 
2014.
  I would like to thank Chairman Miller, Senator Sanders, Senator Burr, 
and the other members of the conference committee for working so 
diligently on this legislation.
  Even when it looked like an agreement would not be possible to 
achieve

[[Page 13655]]

a compromise and bring it to the House floor today, at the end of the 
day, we all worked together to make sure our national commitment to 
veterans is there. This compromise agreement can serve as a model on 
how Congress should look at serious problems facing our country and how 
to address them.
  It has been a long road getting here. The House Veterans' Affairs 
Committee, under Chairman Miller's leadership, has held over a dozen 
oversight hearings in the past couple of months alone. We have heard 
from veterans, their families, VA employees, and veterans service 
organizations about what is and what isn't working within the 
Department of Veterans Affairs.
  The measure before us today isn't a long-term solution to all of the 
VA's problems, but it is an appropriate and well-crafted response to 
the immediate problems of veterans not being able to access quality 
health care in a timely fashion.
  This bill also takes important steps to begin to address the systemic 
problems within the Department of Veterans Affairs that have led to 
this crisis: too few doctors, inadequate infrastructure, and a 
management culture that is asleep at the wheel. It holds those whom the 
Nation has entrusted with our veterans' lives and well-being 
responsible for the outcomes.
  For the 12 years that I have been on the Veterans' Affairs Committee, 
I have fought to ensure that our veterans, especially those who are 
living in rural areas, have access to quality health care. I fought for 
the needs of veterans returning from the current conflicts, while not 
forgetting the sacrifices and the needs of veterans from previous 
conflicts.
  One of the successes that you heard from Chairman Miller earlier I am 
most proud of is the Project ARCH. The Access Received Closer to Home 
project expands the opportunity for rural veterans to receive health 
care without long drives to a VA facility many miles away. I am pleased 
to see that the conference report extends and expands this important 
program. It is critical for the thousands of veterans who live in 
districts like mine. Many veterans in my district would be forced to 
make a nearly 600-mile round trip drive to the nearest VA facility if 
it weren't for ARCH.
  Another important aspect of this bill not only deals with Senior 
Executive Service, but also the title 38 employees, which covers about 
80,000 within the VA. It sets metrics and outcomes and accountability 
for those employees.
  This bill also will address the immediate problem of long waiting 
times for health care, while beginning to strengthen the VA, so we are 
not facing the same crisis next year or the year after.
  But I would also like to remind my colleagues that this bill is only 
the first step. After 12 years on the House Veterans' Affairs 
Committee, I am more convinced than ever that we must begin to talk 
about the innovative solutions that will truly modernize the Department 
and better meet the needs of current and future veterans.
  Far too often, the good intentions underlying the laws that we passed 
are stymied by an organizational structure that has originated back in 
the seventies and eighties. Far too often, the good intentions of the 
Department of Veterans' Affairs employees meet the wall of bureaucratic 
indifference. Far too often, our veterans ask for help and there is no 
one there at the other end to answer for that help.
  This is totally unacceptable, and it is why I believe we must begin 
the work of radically restructuring the Department of Veterans' 
Affairs. We must restructure it to better assist our veterans, to 
better live up to the promises we have made to them. We need to look at 
the fundamental business model, the processes, the organization, the 
technology, the data and information and the workforce capabilities.
  Our work today is to pass this conference report and get it to the 
President's desk as quickly as possible so that we can fix the current 
crisis. The work for tomorrow is the work that I ask each and every one 
of my colleagues to continue working on: to make sure that the 
Department of Veterans Affairs evolves to a new, more veteran-centered 
Department of Veterans Affairs.
  It is going to take a lot of work and a lot of oversight, as you 
heard the chairman mention earlier. Once again, I would encourage my 
colleagues to pass this bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. MILLER of Florida. Mr. Speaker, it is my pleasure to yield 2 
minutes to the gentleman from Colorado (Mr. Lamborn), a member of the 
conference committee.
  Mr. LAMBORN. Mr. Speaker, I would like to thank Chairman Jeff Miller 
for his continued leadership as we work to provide our veterans with 
the care and benefits that they have earned.
  Keeping the promises that we have made to our veterans and their 
families is of utmost importance to me and all Americans. This piece of 
legislation is a major step in the process of restoring veteran trust 
in the VA.
  This bill will expand access to non-VA care, making wait times 
shorter and increase convenience. Although this will ensure veterans 
who are currently on a waiting list will get the timely care they 
deserve, much more needs to be done.
  I am especially pleased that an independent congressional committee 
on care will be formed to look at the VA from the ground up. For 
lasting change to take place, the corrupt culture shown by some in the 
VA must be purged. It must be replaced with an ethos that puts the 
veteran first.
  By authorizing the Secretary of the VA to fire senior employees that 
are guilty of poor performance or misconduct, this bill ensures that 
newly confirmed Secretary McDonald will have more tools to hold 
individuals accountable for their actions. However, granting this 
authority will mean nothing if it isn't combined with the leadership 
required to always do the right things for our veterans. Through his 
words and actions, Secretary McDonald must make it clear from day one 
that individuals will be held accountable, whistleblowers will be 
protected, and anyone responsible for poor performance, negligence, or 
preventable deaths, even, will be held accountable.
  It has been an honor to serve with the chairman during this 
conference committee.
  I urge my colleagues to join me in supporting the VA conference 
report.
  Mr. MICHAUD. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman 
from Nevada (Ms. Titus).
  Ms. TITUS. Mr. Speaker, I thank my friend for yielding.
  I thank Mr. Michaud and Chairman Miller for their leadership on this 
important bill.
  As a member of the House Veterans' Affairs Committee, I have been 
working with my colleagues to ensure that veterans have access to the 
highest quality care in a timely fashion. This legislation before us 
takes important steps towards that goal.
  I am especially pleased that the compromise includes three of my 
bills, which ensure that: one, all victims of sexual assault in the 
military, including those in the National Guard, have access to the 
care they need; two, that spouses of those who have died in service to 
our country get education benefits; and, three, more residencies are 
going to be funded at VA hospitals in areas of the country that are 
underserved by doctors in private practice.
  Our committee, I know, will continue to work in a bipartisan fashion 
with the new Secretary to ensure that all veterans have access to the 
benefits and care that they have so bravely earned.
  Today, we are acting on behalf of a grateful Nation to provide our 
country's heroes the care they need and restore their trust in the VA. 
So I urge my colleagues to support this conference report to the 
Veterans Access, Choice, and Accountability Act.
  Mr. MILLER of Florida. Mr. Speaker, it is a pleasure to yield 2 
minutes to the gentleman from Tennessee (Mr. Roe), a veteran, a 
physician, and also a member of the conference committee.
  Mr. ROE of Tennessee. Mr. Speaker, it is a pleasure to stand before 
this body in support of the conference report, the first major step in 
providing

[[Page 13656]]

timely, high-quality health care to the veterans who so selflessly 
served this great Nation. As a physician, veteran, and member of the 
Veterans' Affairs Committee, it was an honor to have served on the 
conference committee.
  Mr. Speaker, a corrosive culture has been allowed to exist within the 
Veterans Affairs bureaucracy for far too long and to the detriment of 
our veterans. The most important thing this bill does is give the 
veterans who are experiencing long wait times or live more than 40 
miles from the nearest VA facility a choice. These veterans will now be 
able to obtain a veterans choice card, which will allow them to seek 
care in the private sector. Only by forcing the VA to compete will we 
achieve the cultural change that is required in how they serve 
veterans.
  I have met with many physicians in recent weeks, and the desire to 
help our veterans is stronger than ever. Hospitals and physicians, 
alike, are ready and willing to care for veterans, helping to address a 
crisis created by VA mismanagement.
  Moving forward, this report creates a process by which we can make 
significant strides toward accountability, by giving the VA Secretary 
the ability to fire senior employees who fail to do their jobs and 
ensuring that there will be swift, harsh penalties for knowingly 
misreporting or falsifying information.
  This agreement will also improve educational benefits for veterans 
and their dependents.
  As the founder and cochair of the House Invisible Wounds Caucus along 
with my friend Tim Walz, I am pleased this report includes a provision 
to extend an important pilot program intended to help veterans with 
traumatic brain injuries for 3 more years.
  The negotiations were tough, but I know the final product will have a 
very positive impact on the lives of our veterans, and I would like to 
thank the House and Senate VA committee staffs for all their late 
nights and hard work they put into this toward this worthy goal.
  Mr. Speaker, I applaud the chairmen, Miller and Sanders, for their 
leadership throughout this process, along with Ranking Member Michaud 
and Senator Burr.
  I urge all of my colleagues to support this report.
  Mr. MICHAUD. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Arizona (Mrs. Kirkpatrick).
  Mrs. KIRKPATRICK. Mr. Speaker, I urge all my colleagues to support 
H.R. 3230.
  As a member of the conference committee, I pushed for negotiations on 
this bill to continue because veterans have waited too long for the 
care they deserve.
  This bill reflects the comprehensive, meaningful reforms that passed 
the Senate and that I introduced as the companion bill in the House. 
This bill ensures that rural veterans who live too far from a veterans' 
medical facility and veterans who have waited too long for an 
appointment can see a provider closer to home.
  For the tribal veterans in my district, this bill strengthens the 
relationship between the Veterans Administration and the Indian Health 
Services.
  This bill also ensures that the Veterans Administration can quickly 
hire more doctors, nurses, and medical professionals, and this bill 
gives the Veterans Administration Secretary the authority to hold VA 
employees accountable.
  Our veterans deserve world-class health care and a VA that puts 
veterans first. I believe this bill provides the foundation to do just 
that. Again, I urge all my colleagues to vote for this bill so it can 
be signed into law without delay.
  Mr. MILLER of Florida. Mr. Speaker, it is a pleasure to yield 2 
minutes to the gentleman from Michigan (Mr. Benishek), a former 
physician within the VA system.
  Mr. BENISHEK. Mr. Speaker, I rise in strong support of the conference 
report to the Veterans Access to Care Act.
  As a doctor who served at the VA hospital in Iron Mountain, Michigan, 
for 20 years, I have seen firsthand how Washington bureaucracy can keep 
doctors and nurses from taking care of veterans. On its most basic 
level, this is the sacred mission of the VA, and the VA has failed.
  Today we take an important step toward reversing that failure. Most 
urgently, our bill will allow veterans suffering long waits for care 
the option to be seen by a local doctor at a private hospital. I 
believe every veteran should have a choice as to where they receive 
care, and this bill moves us closer to that goal.
  But this triage measure is not the long-term solution. That is why 
our bill directs the VA to tap the best health care minds that we have 
in this country to go step by step through the system and write us a 
blueprint for a lean, smart, 21st century VA.
  Our bill is not perfect, and the problems at the VA will not be 
solved overnight. However, this landmark effort is the best chance we 
have had in years to make fundamental changes to the way the VA 
operates.
  Make no mistake, our true test comes next. We must continue to keep 
the pressure on the VA long after the headlines have faded and the 
worst employees have been fired, because our veterans will still be 
there and they will still deserve to be at the top of our priority 
list.
  As the father of a veteran myself, I am committed to refusing to let 
this issue go. We will demand results, and we will demand swift and 
full implementation of this legislation. Anything short of that is not 
worthy of our veterans and is unacceptable.
  Mr. Speaker, I urge my colleagues to support the conference report.

                              {time}  1530

  Mr. MICHAUD. Mr. Speaker, I yield 2 minutes and 35 seconds to the 
gentlewoman from Florida (Ms. Brown).
  Ms. BROWN of Florida. Mr. Speaker, as the most senior member of the 
House Veterans' Affairs Committee, I strongly believe that the VA 
provides the best care for our Nation's servicemembers returning from 
protecting the freedoms we most hold dear, and I am committed to VA 
continuing their critical mission of serving our veterans.
  VA has served the special needs of our returning veterans for over 75 
years and has expertise in their unique health care needs, including 
prosthetics, traumatic brain injury, post-traumatic stress disorder, 
and a host of other veteran-specific injuries. My focus continues to be 
on ensuring that the VA retains the unique responsibility for the 
health care our veterans receive, regardless of the provider.
  The bill includes critical language that I discussed with Senator 
Bernie Sanders of Vermont to ensure the VA has the final authority over 
the care that the veterans receive, whether at the VA or at non-VA 
providers. We need to continue to work with our veteran stakeholders to 
ensure the VA has all the resources it needs to provide superior health 
care to our veterans.
  I am looking forward to working with the new VA Secretary. And I want 
to thank the past Secretaries. I have worked with past Secretaries from 
Jesse Brown to the present one.
  I know a lot of people will say that we have given the VA everything 
they need. But of course many of us don't have institutional memory.
  I remember the first time the VA got the real budget they wanted in 
2009 under President Barack Obama, when we had a Democratic House and a 
Democratic Senate. So a lot of us talk the talk, walk the walk, but 
don't really roll the roll.
  So we have got to make sure as we move forward that we don't just 
talk about providing service, but that we really provide service and we 
ensure that the veterans have the service that the first President, 
George Washington, promised the veterans.
  And I do want to thank our chairperson, Mr. Miller of Florida, for 
his leadership and the way he has conducted our meetings, and also our 
ranking member.
  Mr. MILLER of Florida. Mr. Speaker, it is my pleasure to yield 1 
minute and 35 seconds to the gentleman from Colorado (Mr. Coffman), a 
United States veteran and another member of the conference committee.
  Mr. COFFMAN. Mr. Speaker, I want to start by thanking Chairman Miller

[[Page 13657]]

for his dedicated work on behalf of our veterans.
  As a Marine Corps combat veteran and chairman of the House Veterans' 
Affairs Subcommittee on Oversight and Investigations, I have spent the 
past year working side-by-side with the members of my subcommittee and 
with Chairman Miller to investigate and uncover the largest scandal in 
the history of the Department of Veterans Affairs.
  I am proud that Republicans and Democrats were able to put aside 
their partisan differences to focus on supporting our Nation's warriors 
with choice, accountability, and greater transparency. These reforms 
will allow veterans to vote with their feet if they cannot get an 
appointment within a reasonable timeframe at a VA facility.
  I am also proud that we were able to include much-needed reforms on 
the treatment of victims of sexual assault in the military. The scourge 
of sexual assault in the military and the corruption of covered-up 
waiting lists at VA hospitals are shameful acts, and we must work 
together to confront them head on.
  Mr. MICHAUD. Mr. Speaker, how much time do I have remaining?
  The SPEAKER pro tempore. The gentleman from Maine has 10 minutes 
remaining. The gentleman from Florida has 6\1/2\ minutes remaining.
  Mr. MICHAUD. Mr. Speaker, at this time, I yield 2 minutes to the 
gentleman from Maryland (Mr. Hoyer).
  Mr. HOYER. I thank the gentleman for yielding. I congratulate Mr. 
Miller, the chairman of the committee, and Mr. Michaud, the ranking 
member, for working together to get this done.
  Mr. Speaker, this bill is the result of a bipartisan agreement. And 
while I have some serious concerns about a number of provisions of 
which I will speak, I am supporting it because it assigns resources to 
help cut down the waiting times for veterans to get the care they need 
and that we owe them. That must be our number one goal.
  I remain deeply outraged, as so many of us are, by what transpired in 
Phoenix and at other VA facilities, where our wounded warriors were 
made to wait weeks, months to get an appointment and receive treatment, 
including for serious postdeployment mental health issues. That is not 
acceptable. This is more than unacceptable, however. It is 
unconscionable.
  I think there is wide agreement on both sides of the aisle that any 
VA personnel who facilitated this wrongdoing or undermined veterans' 
health care must be held accountable.
  However, Mr. Speaker, I am concerned with provisions in this bill 
regarding the removal of senior executive personnel. While this bill 
does improve on the House version by adding a 21-day period for 
appeals, it still undermines civil service protections that had been in 
place for decades to ensure a merit service, not a politicized, 
patronage service.
  There are already strict rules in place that facilitate the swift 
removal of SES officials who do not perform their jobs responsibly, as 
there should be.
  Those protections strike the right balance between giving agencies 
the authority to remove personnel without trampling on the due process 
rights of SES employees, who need to do their job without fear of 
political reprisal or arbitrary removal.
  Having said that, Mr. Speaker, this bill addresses major challenges 
at the VA. It provides resources to ensure that our veterans can access 
health care at private facilities if they face a very long wait or live 
in rural areas far from VA doctors.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. MICHAUD. I yield the gentleman an additional 30 seconds.
  Mr. HOYER. I thank the gentleman.
  And it makes health care services more available and accessible to 
veterans through additional resources for medical and other VA 
personnel.
  This, of course, is not a perfect bill. But then again, I don't think 
I have ever voted for a perfect bill. But this is a good bill that 
moves in the right direction.
  Again, I congratulate Mr. Miller and Mr. Michaud on their work on 
this very important piece of legislation.
  Mr. MILLER of Florida. Mr. Speaker, at this time, I yield 2 minutes 
to the gentlewoman from Indiana (Mrs. Walorski), another member of our 
conference committee and an outstanding member of the full committee.
  Mrs. WALORSKI. Mr. Speaker, I would like to say to Chairman Miller 
and Ranking Member Michaud, on behalf of the 54,000 veterans in my 
district and the 20 million around the country, thank you. And to every 
conferee that has served on this conference committee, thank you. This 
is a huge step forward today, and I am grateful to have been a part of 
this process. The need for this legislation and for our conference 
committee to have worked together was great, and it has been an 
incredible experience.
  Let's not forget, in the past decade, nearly 1,000 veterans have died 
as a result of substandard treatment from the Department of Veterans 
Affairs, and many more cases are under investigation. Mr. Speaker, 
50,000 new patients have waited at least 90 days for their first 
appointment at VA hospitals. VA staff have admitted to falsifying 
medical appointment dates to fit within the agency's wait time 
performance goal of 14 days. All these facts have been simply 
appalling. All of us in Congress have constituents who have been 
directly impacted by this scandal.
  The need for the legislation is so timely today. I just came from the 
World War II Memorial, and I thanked a veteran from the Chicagoland-
Indiana area. I shook his hand, looked him in the eye, and thanked him 
for serving our Nation. He stood up out of his wheelchair, looked me in 
the eye, and said: ``Thank you for fighting for us.'' It just simply 
shows how important this is. This is an opportunity, as legislators, to 
take the first steps toward real change at the VA.
  So today we stand together to help our Nation's heroes. We owe it to 
our veterans to provide them with nothing but the best. However, 
echoing the chairman's comments, simply providing a financial boost to 
an agency that has repeatedly demonstrated awful management practices 
will not solve the problem.
  In the coming weeks and months, we must continue to stand together to 
ensure additional improvements are made to the VA. I urge my colleagues 
to vote in support of this bill.
  Mr. MICHAUD. Mr. Speaker, at this time, I yield 1 minute to the 
gentlewoman from Texas (Ms. Jackson Lee).
  Ms. JACKSON LEE. Mr. Speaker, I thank the gentlemen very much on 
behalf of the State that has one of the largest populations of 
veterans, including those in my congressional district. I would like to 
say thank you.
  To Ranking Member Michaud and Chairman Miller, thank you for allowing 
me to sit in on a hearing. Thank you to the conferees. Thank you for 
understanding that, when our soldiers put on the uniform, have any of 
us ever had them question why? And therefore, we should never question 
why are we giving the best service that we can give to our veterans.
  I am grateful for the $5 billion that allows this temporary 
flexibility, that if you cannot get service, you are, in fact, able to 
go to civilian doctors.
  The professionals that are going to be added with primary and 
specialty doctors are the TMI, housing, PTSD, sexual assault. All of 
these are making a difference.
  In the name of the World War II veteran that I saw in Normandy, by 
the name of Curtis, a veteran in my district who had an appointment in 
2013 and never heard back from the veterans hospital, in his name, I 
believe that this is the most important opportunity. We should vote for 
this and be able to provide our veterans with the promise we have made 
to them: You serve, and we will serve you.
  God bless America.
  Mr. Speaker, as a senior member of the Judiciary and Homeland 
Security Committees, I rise in strong support of the Conference Report 
to H.R. 3230, ``Veterans Access, Choice, and Accountability Act of 
2014.''
  We must remember that freedom is not free and pause to recognize the 
valor and self-sacrifice of our nation's veterans.
  We also need to keep our promises to the nation's more than 2 million 
troops and reservists and 23 million veterans.

[[Page 13658]]

  I support the Conference Report for 6 principle reasons. The 
legislation before us:
  1. Expands access to health care for veterans;
  2. Addresses the shortage of health professionals in the VA;
  3. Ensures access to care for rural veterans;
  4. Provides funding to establish 27 new VA clinics;
  5. Expands access to education for veterans and their families; and
  6. Extends a community-based housing program for veterans.
  Specifically, the conference report provides that the bulk of the 
funding in this agreement--$10 billion in emergency funding--be used to 
expand access to non-VA health care options for veterans who have been 
left waiting for more than 30 days for an appointment or live more than 
40 miles from the nearest VA facility.
  Additionally, the bill provides $5 billion to VA to hire more primary 
and specialty care physicians and other medical staff and includes 
incentives to attract more doctors, nurses and other medical personnel 
to the VA, and to increase medical education opportunities to attract 
doctors in the future.
  Third, the bill extends the ARCH (Access Received Closer to Home) 
pilot program for two years. The ARCH program expands VA's ability to 
serve veterans who live far from VA facilities in Northern Maine; 
Farmville, Virginia; Pratt, Kansas; Flagstaff, Arizona; and Billings, 
Montana.
  Fourth, the bill expands VA authority to provide counseling, care and 
other services to veterans and certain other non-veteran service 
members who have experienced military sexual trauma during active or 
inactive duty training (including members of the National Guard and 
Reserves). The legislation also requires the VA and DOD to conduct an 
annual assessment focused on the transition and continuum of care from 
DOD to VA for those who have experiences military sexual trauma.
  Fifth, the conference report includes $1.5 billion to lease 27 new VA 
clinics, including a new research facility in my home city of Houston, 
Texas, bringing care closer to where veterans live and increasing 
access to specialty care services.
  Sixth, the Conference Report permits veterans who are eligible for 
education benefits under the post-9/11 New GI Bill to qualify for in-
state tuition and it expands the Marine Gunnery Sergeant John David Fry 
Scholarship to include spouses of members of the Air Force who die in 
the line duty while serving in active duty.
  Finally, the Conference Report gives the VA Secretary the authority 
to immediately fire or demote senior executives based on poor job 
performance or misconduct but includes an expedited appeals process for 
terminated employees to prevent political firings and protect 
whistleblowers from retaliation.
  Mr. Speaker, my state of Texas and Houston appreciates the service 
and sacrifices of veterans and takes care of them.
  The Michael E. DeBakey VA Medical Center, for example, located in 
Houston, Texas serves the 32,477 veterans and is the primary healthcare 
provider for almost 130,000 veterans in southeast Texas.
  Veterans from around the country are referred to the DeBakey VA 
Medical Center for specialized diagnostic care, radiation therapy, 
surgery, and medical treatment including cardiovascular surgery, 
gastrointestinal endoscopy, nuclear medicine, ophthalmology, and 
treatment of spinal cord injury and diseases.
  DeBakey VA Medical Center provides vital healthcare services to 
Veterans in the Houston area and through the nation.
  I am proud to support the Conference Report since veterans from 
Houston and surrounding regions will benefit with the establishment of 
a new facility that will extend access to specialty care services.
  Mr. Speaker, in addition to long wait times at VA facilities, many 
veterans face a number of other challenges, including homelessness, 
coping with PTSD, and finding suitable employment in the civilian job 
market.
  To address these problems, earlier this year I was successful in 
passing amendments to this year's Military Construction and Veterans 
Affairs Appropriations Act and the Defense Appropriations Act providing 
additional funding and resources targeted to helping homeless veterans 
secure housing and treating veterans suffering from PTSD in underserved 
urban and rural areas.
  I also introduced H.R. 4110, the ``Transitioning Heroes Act of 
2014,'' which provides strong tax incentives for employers to hire, 
retain, and employ veterans in positions that take maximum advantage of 
their skills and experience.
  Mr. Speaker, our men and women in the military have fulfilled a 
commitment to this nation and to each other that we should imitate in 
our actions to work to provide for veterans now that their military 
service has ended.
  That is why as Members of Congress we need to make sure our veterans 
receive the best medical care that modern medicine has to offer to them 
and their families.
  That is why I urge my colleagues to join me in supporting the 
Conference Report to H.R. 3230, ``Veterans Access, Choice, and 
Accountability Act of 2014.''
  Mr. MILLER of Florida. Mr. Speaker, I yield 1\1/2\ minutes to the 
gentleman from Florida (Mr. Bilirakis), the vice chairman of the full 
committee and a member of the conference committee.
  Mr. BILIRAKIS. I thank the gentleman for yielding.
  Today I rise in support of the VA conference report on H.R. 3230. The 
Veterans Access, Choice and Accountability Act of 2014 is a positive 
first step toward reforming the VA, which provides, among other things, 
relief to veterans who have waited excessively to receive the health 
care they have earned at a level of quality they deserve, Mr. Speaker.
  This bill also includes real accountability provisions, allowing the 
VA Secretary to fire or demote Senior Executive Service employees for 
lack of performance and management negligence.
  This reform package is focused around ensuring the veteran has timely 
access to quality care and includes language to authorize 27 major 
medical facility leases, including one in Pasco County, Florida, in my 
congressional district.
  The veterans in my area will soon have the ability to seek treatments 
at a consolidated clinic, thanks to Chairman Miller, as opposed to 
having to travel between the main clinic and four other satellite 
facilities.
  Authorizing these leases will improve the timeliness for veterans to 
receive care in Pasco County and in 17 other States throughout the 
Nation, as well as Puerto Rico.
  Passage of this bill is the beginning, not the end. Obviously much 
work needs to be done. However, immediate action needs to be taken to 
get veterans off waiting lists and ensure they receive care within the 
VA health system or in the private sector, if they so choose. The 
veteran should have the choice. We need to get this done for our 
veterans.
  I urge passage of the bill.
  Mr. MICHAUD. Mr. Speaker, at this time, I yield 1 minute to the 
gentleman from California (Mr. Takano).
  Mr. TAKANO. Mr. Speaker, I rise in support of the conference report. 
I want to thank Chairman Miller for the gracious way that he has 
conducted the committee hearings, and I thank Ranking Member Michaud 
for his hard work.
  Principally, I am very pleased that this conference report also 
includes 1,500 funded graduate medical school education slots at 
veterans facilities around this country. It was a good thing that we 
approved access to non-VA care for those servicemembers, those veterans 
who have been on waiting lists for far too long. But that would not be 
satisfactory to those areas of the country that are experiencing 
physician shortages. This is a huge, huge accomplishment for a Congress 
that is so partisan to approve these 1,500 funded GMEs.
  I urge all my colleagues to support the conference report.
  Mr. MILLER of Florida. Mr. Speaker, I yield 1\1/2\ minutes to the 
gentleman from Kansas (Mr. Huelskamp).
  Mr. HUELSKAMP. Mr. Speaker, I thank the chairman for his work on this 
bill.
  As a member of the Veterans' Affairs Committee, I want to take a 
moment to share a little about what this bill means for my Kansas 
veterans.
  Since coming to Congress, I have heard dozens of stories from Kansas 
veterans about their troubles with the VA. They have shared about how 
they are required to travel hundreds of miles for simple medical tests 
or to renew their prescriptions, all the while, driving past dozens of 
local hospitals and other health care providers with the ability and 
desire to meet their needs locally. Many Kansas veterans drive halfway 
across the State or to Colorado, Nebraska, or even Texas to

[[Page 13659]]

get their simplest health care needs met.
  In fact, just yesterday, my office had to step in to help a 94-year-
old World War II veteran. The nearest VA hospital was 240 miles away. 
He just had a recent serious surgery, and they said, you have to come 
into the hospital to renew your prescriptions.

                              {time}  1545

  Thankfully, I was able to contact the VA and ensure this veteran 
could get his care in his local community, but as I tell folks in 
Kansas, you shouldn't have to call your Congressman to get the care you 
deserve.
  With this bill, hundreds of rural Kansas veterans will be able to use 
their new veteran choice card or Project ARCH, call their local doctor, 
and get their health care needs met. Just like Medicare or TRICARE, 
veterans should have the choice to schedule their own appointments, 
pick their own doctors in their own communities.
  When our veterans come back from serving and defending our country 
and return to communities across the United States, most of them don't 
ask for much, but I want our veterans to know that I believe you 
deserve the best, not just the mediocre, scandal-plagued culture we 
have seen at the current VA.
  This bill is just plain common sense. It is a big first step towards 
giving veterans real choice and real accountability. As this law is 
implemented, I remain committed to continuing to ask the hard questions 
and working to return the VA to its true mission, to serve our 
veterans.
  The SPEAKER pro tempore. The gentleman from Maine has 5\1/2\ minutes 
remaining. The gentleman from Florida has 2 minutes remaining.
  Mr. MICHAUD. Mr. Speaker, I yield 1 minute to the gentleman from West 
Virginia (Mr. Rahall).
  Mr. RAHALL. Mr. Speaker, I commend Chairman Miller and Ranking Member 
Michaud for bringing this Veterans' Access to Care Through Choice, 
Accountability, and Transparency Act to us today.
  In medically-underserved communities, where health care staffing 
shortages have caused delays in appointments, this conference agreement 
will help provide critical investments so that the VA can begin hiring 
the doctors it needs to serve our veterans.
  It will help to reduce the backlog in VA construction and maintenance 
projects. It will help to ensure that veterans unable to get a medical 
appointment at a VA facility will be able to get the care they need 
from a non-VA provider.
  This legislation can do a lot of good, but it is only a first step. 
The bill must be implemented, regulations issued, and scarce moneys 
allocated to ensure that veterans get the care that this legislation 
promises.
  We must not lose sight of the rural, underserved areas in our Nation 
like in southern West Virginia, where veterans are elderly and travel 
is costly and burdensome. We must not lose sight of the need for 
medical facilities and health providers in those areas.
  I urge the VA to remember rural veterans as it implements this bill, 
and I certainly aim to help to ensure that it does so. Again, I commend 
the chairman and ranking member for bringing this legislation to us 
today.
  Mr. MILLER of Florida. Mr. Speaker, I yield 1 minute to the gentleman 
from Nebraska (Mr. Terry), someone who always has veterans first in his 
mind.
  Mr. TERRY. Mr. Speaker, this bill is a necessary repair for our vets' 
damage that was caused by VA workers who were willing to allow veterans 
to die by denying them care, ostensibly to receive a bonus.
  Leave no doubt that this is a patch and that the VA requires a 
complete overhaul. For example, 7 years ago, the VA hospital in Omaha 
was deemed to be in such poor condition it needed to be replaced ASAP. 
It was put on the official list, and in those 7 years since, the 
project has actually fallen down the list, as few projects have been 
completed.
  The VA is just not able to manage major projects. The entire Nebraska 
delegation wrote then-Secretary Shinseki over a year ago to meet and 
discuss the lack of progress and possible alternatives, but he refused 
to meet with our delegation, even after repeated requests.
  This is evidence of total dysfunction of this VA in Washington, D.C. 
My hope is that the new VA Secretary will be more accommodating to 
listen to the Nebraska delegation whose sole goal is simply to help our 
veterans receive the appropriate care in a building that meets at least 
today's standards.
  Mr. MICHAUD. Mr. Speaker, I yield 1 minute to the gentleman from 
Arizona (Mr. Barber).
  Mr. BARBER. Mr. Speaker, I am proud and honored to rise today in 
support of the Veterans' Access to Care Through Choice, Accountability, 
and Transparency Act of 2014 and to commend Representative Miller and 
Representative Michaud for their leadership in getting this bill to us 
and this conference committee report to us today.
  As the son of a veteran of World War II, Korea, and Vietnam, I say it 
is long overdue that Congress took action to provide the quality of 
care that our veterans have earned. I am here today to fight for 
veterans in southern Arizona, of which I represent 85,000, and veterans 
all across this Nation.
  I have been pushing for better access to health care for our veterans 
since I came to Congress a little over 2 years ago. This has become 
even more urgent given the tragedy, the disgraceful behavior that we 
have uncovered in Phoenix and potentially across veterans centers in 
our Nation. To play games with our veterans to get bonuses is 
despicable, and this bill, I hope, will move us in a direction of 
correcting those terrible actions.
  One of the first bills I introduced was the veterans' access to 
health care bill to ensure that veterans could get health care they 
need in their communities, and this bill, I am glad to say, includes 
that provision. I commend the leader, the chairman, and the ranking 
member for their work, and I urge all my colleagues to vote ``yes'' for 
this important bill for our veterans.
  Mr. MICHAUD. Mr. Speaker, I yield 1 minute to the gentleman from 
Texas (Mr. Gallego).
  Mr. GALLEGO. Mr. Speaker, I, too, rise in support of the conference 
committee report, asking all of our fellow members to support it, and I 
congratulate the chairman with whom I had a rather spirited 
conversation on this floor, as well as the ranking member on 
accomplishing the first step, I think, and it is the first step, but it 
is a significant step.
  I am particularly proud that two of the provisions that I came to 
this floor to argue for--that being additional facilities, including an 
expansion of the facility in San Antonio, as well as additional support 
personnel, medical personnel, and health care personnel--are included 
in this bill.
  This bill includes so much more: a graduate medical education 
component and, in addition, educational opportunities for spouses and 
families. This is an incredible first step.
  I, again, want to underscore my thanks to the chairman, to the 
ranking member, to the members of the conference committee, and this is 
a great first step at putting us in the right direction towards finally 
treating our veterans with the respect that they not only deserve, but 
they have earned over the period of their service.
  Mr. MICHAUD. Mr. Speaker, how much time is remaining?
  The SPEAKER pro tempore. The gentleman from Maine has 2\1/2\ minutes 
remaining. The gentleman from Florida has 1 minute remaining.
  Mr. MICHAUD. I yield 1 minute to the gentleman from California (Mr. 
Peters).
  Mr. PETERS of California. Mr. Speaker, I am proud to state my support 
for this agreement, the Veterans' Access to Care through Choice, 
Accountability, and Transparency Act of 2014, and thank both Chairman 
Miller and Ranking Member Michaud for their leadership on bringing this 
issue to a resolution.
  Last week, I offered a motion to instruct as a way to spur a 
bipartisan solution and to ensure that vets on the GI Bill could pay 
lower instate college tuition. I am happy that that provision has been 
included.

[[Page 13660]]

  Enacting the measures offered in this plan will go a long way toward 
improving veterans health care though, as everyone noted, there is much 
more work to be done. The more than 200,000 veterans who live in San 
Diego County deserve access to the medical care and benefits America 
has promised them and they have earned.
  It is my hope that our action today will give new hope to the many 
vets who felt despair and disappointment at the way they have been 
treated by the VA after all they have sacrificed. Today, we send a 
bipartisan message to them: America keeps its promises to our veterans.
  Mr. MICHAUD. Mr. Speaker, I have no further speakers, and I am ready 
to close.
  Mr. Speaker, I would urge my colleagues to support the conference 
report to H.R. 3230. This is a very important bill. It is a bill that 
we have worked long and hard over the last several months. It is one 
that took into consideration a lot of the concerns that Members from 
both sides and both bodies had, and we came together with this bill.
  I do want to thank Chairman Miller for his hard work and dedication 
to our veterans and their families. We would not be here today if it 
wasn't his determination in having strong oversight hearings over the 
last couple of months within our committee.
  I also want to thank staffs on both sides, the majority and minority 
staff. I know they have put in thousands of hours for oversight 
hearings to work on this conference report to get us where we are 
today. We could not have done it without our dedicated staffs on both 
sides of the aisle going through this document and making sure that 
every Member's concerns were addressed in this document.
  With that, I want to once again thank the chairman for your hard work 
on this effort and look forward to the vote on this. I encourage all my 
colleagues to support this bill.
  With that, Mr. Speaker, I yield back the balance of my time.
  Mr. MILLER of Florida. Mr. Speaker, I, too, would like to say thank 
you to the ranking member of the full House committee, Mr. Michaud, for 
his tenacity in what he has done to move this conference report along.
  I also want to say thank you to the ranking member, Mr. Burr, in the 
Senate and to Senator Sanders because, as we continue to negotiate 
through, there never was a willingness to quit by either side.
  I am grateful to the 24 other conference committee members who worked 
with us, with their input, their ideas, and their willingness to 
embrace this compromise. It was brought forth by diligent, focused 
effort and a willingness on all sides to put aside differences of 
opinion and ideology and focus not on our disagreements, but how best 
we can all help our veterans.
  While not perfect, this is an example of all the good work we can 
accomplish when we work together, and remember, it is the veteran who 
is sacred, not the VA.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BISHOP of Georgia. Mr. Speaker, at this time, there is no Federal 
agency more deserving of our attention than the U.S. Department of 
Veterans Affairs. The VA has served generations of heroes who have 
sacrificed on behalf of our country and we have an obligation to take 
care of them when they come home.
  Without a doubt, the American people expect and veterans deserve the 
best service possible and I firmly believe that it is a duty of all of 
us in Congress to ensure that no one betrays the sacred trust owed to 
our Veterans.
  The failure and mismanagement of care for our veterans that has come 
to light through the IG's investigation over the past two months must 
never be repeated, and I trust that this bill will go far to help 
reverse the failures, and ensure better future treatment of veterans at 
the VA.
  I think this conference report contains provisions that will help 
provide timely care to veterans, hold the management of the Department 
of Veterans Affairs accountable, uphold the integrity of the 
department, and improve education benefits for veterans and their 
dependants--representing a major step in the right direction in meeting 
those obligations.
  Specific measures to do so include; providing $5 billion to the VA to 
hire additional physicians and other medical staff, authorizing a 
system for the VA to fire or demote management level employees for poor 
performance or misconduct, and increasing access to non-VA care for 
those veterans in dire need.
  Yesterday, we were greeted with the good news of the Senate 
confirmation of the new VA Secretary, Robert McDonald. While the Senate 
acted swiftly on the confirmation of McDonald, I was disappointed to 
see that the Senate Appropriations Committee Chairwoman was unable to 
bring the FY 2015 MilCon/VA Appropriations bill to floor due to 
objections from the Senate Minority. If we truly wanted to get the ball 
rolling to make the VA better the Senate Minority should allow the bill 
to come to the floor.
  Nevertheless, I also have full expectation that with the passage of 
this conference report it is going to be important that this Congress 
hold Secretary McDonald and his subordinates fully accountable moving 
forward.
  Many in Congress are concerned about the cost of this bill. One way 
to help pay the cost of improved health care for veterans would be to 
improve third party collections.
  Section 201 of the bill authorizes an independent assessment of a 
number of VA activities. Among other provisions, the assessment would 
report on ways to increase funds owed to the VA by third parties.
  Over the past dozen years, the GAO and the VA/OIG have issued more 
than a dozen reports outlining the problems with third party 
reimbursement. I hope that the assessment team will not reinvent the 
wheel.
  We already know that the VA has increased its billings for these 
services, but its collection rate has decreased or has remained 
stagnant. As a result, in FY13 alone, the VA failed to collect more 
than $3 billion in billings. Between FY07 and FY13, the VA left nearly 
$23 billion on the table.
  The assessment should include specific directives for the improvement 
of the entire billings and collections process--from initial billing to 
denied claims to appeals of denied claims. The private sector seeks to 
maximize reimbursement. The VA should do no less.
  Mr. VAN HOLLEN. Mr. Speaker, I rise today in support of the 
Conference Report on H.R. 3230, the Veterans' Access to Care through 
Choice, Accountability, and Transparency Act of 2014. I also want to 
commend Chairman Sanders, Chairman Miller, Ranking Member Burr, and 
Ranking Member Michaud for their work on crafting a bipartisan bill 
that not only provides for our veterans but addresses many of the 
systemic problems within the Veteran Health Administration.
  The final conference agreement provides over $17 billion in funding 
for the Department of Veteran Affairs. This includes $10 billion in 
funding to allow veterans who live more than 40 miles away from a VA 
facility, or who have waited more than 30 days for an appointment at a 
VA medical center, to seek care with an outside provider. In addition, 
it provides the VA with $6.5 billion in funding to address its critical 
shortage of doctors and nurses and to allow the VA to enter into 27 new 
medical facility leases. By expanding access to care, increasing 
staffing needs, and authorizing new clinics, this bill is a great first 
step in tackling many of the ongoing problems that have surfaced at the 
VA in recent years.
  The Conference Report strengthens a number of other programs to help 
support our veterans and their families. It expands eligibility and 
provides veterans who experienced military sexual trauma while on 
inactive duty the opportunity to seek sexual trauma counseling. It also 
modifies the post-9/11 GI Bill and allows veterans to receive in-state 
tuition rates at any public university, if they decide to relocate. 
Finally, today's legislation extends an important program set to expire 
later this year to provide housing for veterans struggling with 
traumatic brain injuries.
  I do, however, have reservations about a provision in this bill which 
gives the VA Secretary broad authority to fire Senior Executive Service 
(SES) employees even though the VA already has tools to remove SES 
employees who are rated unsatisfactory. However, I am encouraged that--
unlike legislation that passed the House earlier this year--the 
conference agreement does provide SES employees with an expedited 
appeals process through a Merit Systems Protection Board.
  Mr. Speaker, there is nothing more important than providing for those 
who have sacrificed so much for our country. I encourage my colleagues 
to join me in support of this bill.
  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 agree to the conference report on H.R. 3230.
  The question was taken.

[[Page 13661]]

  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. MILLER of Florida. 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, further 
proceedings on this motion will be postponed.

                          ____________________