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“MILITARY CONSTRUCTION, THE DEPARTMENT OF VETERANS AFFAIRS, AND RELATED AGENCIES APPROPRIATIONS ACT, 2016--MOTION TO PROCEED” mentioning the U.S. Dept of Labor was published in the Senate section on pages S7062-S7065 on Oct. 1, 2015.
The publication is reproduced in full below:
MILITARY CONSTRUCTION, THE DEPARTMENT OF VETERANS AFFAIRS, AND RELATED
AGENCIES APPROPRIATIONS ACT, 2016--MOTION TO PROCEED
The PRESIDING OFFICER. Under the previous order, the Senate will resume consideration of the motion to proceed to H.R. 2029, which the clerk will report.
The legislative clerk read as follows:
Motion to proceed to Calendar No. 98, H.R. 2029, a bill making appropriations for military construction, the Department of Veterans Affairs, and related agencies for the fiscal year ending September 30, 2016, and for other purposes.
The PRESIDING OFFICER. The Senator from Alaska.
Ms. MURKOWSKI. Madam President, I am here this morning to speak about the issue that is before this body, the motion to proceed to H.R. 2029, or what we refer to as the MILCON-VA appropriations bill.
I certainly intend to support closing off debate on this and moving to take up this important appropriations measure. This is important for a host of different reasons, not the least of which is that we need to get to the substance of this issue. We need to get back to a regular order process in order to advance the appropriations bills that we on the Appropriations Committee have spent a considerable amount of time and effort drafting.
Over these past many months, we have worked to make sure that the bills were ready for floor consideration. We didn't want to find ourselves in a situation where, at the end of this year, we scramble to piece together an omnibus measure that has not had the considered debate and opportunity for amendment that I believe we all seek as lawmakers. It is important that we consider the Military Construction-
VA bill in regular order and do it now--not stick it on the back end of another measure, not incorporate it into an omnibus bill or into some fashion of a CR omnibus right before Christmas.
I serve on the Appropriations Committee. I had input into this bill at the subcommittee level and again at the full committee markup, which is a lot more than can be said of many of my colleagues in this body who don't have that opportunity since they are not on the Appropriations Committee. But even after having the input that I have had, it is extraordinarily important that I have another opportunity to influence the bill, and I will illustrate why.
I am going to speak about one very specific issue today that has garnered the attention, concern, and passion of Alaskans and veterans around the State, and that is the issue surrounding the Veterans Choice Card.
In the view of many Alaskans, the Veterans Choice Card is an unmitigated disaster in our State, and there are many reasons that is the case. We don't host a stand-alone VA hospital in Alaska. So the VA has issued a Choice Card to every veteran in the State who is enrolled for health care. In order to use the Choice Card, you have to identify a provider that is willing to accept the card, qualifies under the very onerous Choice Card standards, and is also willing to put up with the bureaucratic strings that are attached to determining which care is approved by the VA over what period of time and for what price.
In Alaska, we have a demand for health care providers that far outstrips the supply, and I have been on the floor many times speaking on that subject. We have many Alaskans that have private health insurance which pays the providers better, and it is certainly more efficient than the government-sponsored programs.
Structurally, the way the Veterans Choice Card Program is currently designed, it does not provide Alaska's veterans with the choices that it promises. It is just as simple as that, and those are just the structural problems we are talking about. Many of our colleagues know that TriWest has encountered difficulties with implementing the program, and the VA has had trouble coordinating TriWest's work with the work of the local VA facilities. Unfortunately, these problems have led to some dangerous near-misses.
We had one situation with a veteran who was scheduled for a fee-basis neurosurgery. He was going to receive this care from a community provider in the State. Then he was told by the VA that the VA had changed its mind. They were not going to sign off on paying for the care. The vet was told to call TriWest. The TriWest call center operator gave the veteran a list of behavioral health providers who had signed up to accept the Choice Card. The call center operator didn't know that neurosurgery is not the same as behavioral health. By the time the VA had reversed itself, the neurosurgery that the veteran had initially scheduled was no longer available. The vet had to wait for one to become available.
What happened in the interim? They gave the veteran pain medicine.
In another case, we had a veteran sent to Seattle for a course of radiation therapy, and in the middle of this course of radiation therapy the vet was told to return home because his authorization had expired. He was told: The authorization has expired. Go home.
It is not as if he could just get in a car and drive 20 minutes back to his house. He had been sent to Seattle from a rural community in Southeast Alaska for the care--for the radiation therapy. They said: Go home. Your authorization has expired.
So there was a whole series of exchanges with TriWest and then with the VA itself. The vet began, basically, calling family members to tell them he was coming home to die and to start making funeral preparations. This is not how we treat our veterans.
Now the Veterans Choice legislation provided that the Choice Card program does not displace any of the existing VA purchased care programs. It explicitly supplemented those programs, which for us in Alaska would be a good thing. In Alaska, the VA--and this was under Secretary Shinseki's leadership--established two purchased care programs to address gaps in VA capacity in Alaska. One of the programs provided for partnerships with our tribal health system to care for our vets in more remote areas of the State where the VA simply doesn't have a presence. It was innovative. It was innovative at the time, and these partnerships worked. They really did help to facilitate the care. The other program called ``Care Closer to Home'' enabled the VA to purchase care from community providers in the State who performed medical services that the VA didn't offer--services such as neurosurgery and specialized forms of radiation therapy.
Before this program was implemented, the VA forced veterans to fly to Seattle or other parts of the country for services that we would consider pretty routine. You have a 1,000-mile-plus flight to Seattle for an orthopedic appointment or for a neurosurgery appointment. This is what we are putting our veterans through. Imagine you are 70 years old, 80 years old, and you are told to go take a flight for 3\1/2\ hours to Seattle--get yourself to the hospital just for an orthopedic appointment. By the time the veteran is at this place and needs that appointment, you are not feeling well in the first place.
I have talked and written before about a veteran on the Kenai Peninsula who died while fighting with the VA over urology care. He couldn't travel to Anchorage, which is about a 3-hour drive, much less to Seattle where the VA wanted to send him because he was in very frail condition, but the VA refused to purchase his care on the Kenai Peninsula where there are facilities that could have helped him. I think we would all agree that when our elderly veterans are in perhaps their final months of life, they have got a lot better things to do than fight with the VA and the bureaucracy.
When the VA came to the hearings before the appropriations subcommittee, I asked them pointblank whether the implementation of the Veterans Choice Card would adversely affect the existing purchased care programs in Alaska, whether it is through IHS or further specialized care, and the answer was clear. There was no nuance; there was no doubt. The answer was no, it is not going to impact negatively the purchased care program. When the Senate Appropriations Committee marked up the MILCON-VA bill on May 21, the VA hadn't changed its answer. It is not going to negatively impact, they said.
Then a week later, on May 28, I happened to be visiting the VA facility in Anchorage, and I learned there that the VA had spent all of its fiscal year 2015 purchased care money and was planning to suspend its relationships with community providers and the Alaska tribal health system.
I had gone to the VA center to get an update, to check in with the new docs who were there and to see how things were going. It was basically a checkup with the folks at VA, and they laid this bombshell. They weren't trying to be coy with me or hide the ball. They had just learned themselves. I don't know who was in greater shock, me or the folks there at the VA and their military partners.
We were also in a situation where there were a lot of rumors that the VA was going to pull out of the Joint Venture Hospital that it shares with the Air Force on the Joint Base Elmendorf-Richardson. Again, this was a bombshell of news. Now we know that the VA was not just out of purchased care money, it was out of money to operate its health care system, and without the emergency infusion of money we provided from the Choice Act fund before August recess, the VA would have run out of money before we had come back from the August recess.
It was a situation that was a mess. We fixed the mess for 2015 but did nothing for 2016.
What does the VA's failure to properly project the cost of purchased care in 2015 mean for its fiscal year 2016 appropriations? After asking the VA on several occasions, I am left with the impression that the VA once again will run out of money for purchased care and then will remedy this situation by shoving veterans who are seeking care under the Choice Card whether the care is meaningfully available or not. So we have been pushing the VA on this, and to Secretary McDonald's credit, he came to Alaska this summer. The Undersecretary for Health, Dr. Shulkin, visited Alaska. They weren't sheltered from the anger that our vets were feeling.
My colleague Senator Sullivan conducted an incredible field hearing to create a record of how the VA, TriWest, and the Choice Card Program were individually and collectively failing Alaska's veterans. But here's the problem. We don't have a fiscal year 2016 solution locked down, and we may not have an acceptable solution locked down by Veterans Day, either.
Without an opportunity to debate the fiscal year 2016 appropriations bill on the floor, I have limited opportunity to press this point, to demand that the GAO investigate what actually is going on and try to amend the bill to ensure that the VA has adequate purchased care money available so that it doesn't drop these veterans through the cracks when it can't serve their critical care issues, and neither can the Choice Card program. Without the opportunity to debate in regular order, I can't do what the people of Alaska have asked me to do in representing them the way I know that we need to in order to deal with this.
I hear what the Democratic leader is saying, that the Budget Control Act needs to be addressed, but I don't agree with the tradeoff that we cannot consider appropriations bills in regular order while conversations are ongoing to address the bigger, broader question. Failing to consider these bills in regular order corrodes the influence of this body; it corrodes the ability of Members to fulfill the responsibilities that we have to the people that we work for. These are issues.
Again, I chose to focus my comments this morning on one area within the MILCON-VA, on that implementation of the Choice Card in Alaska, and how it has so basically failed our veterans. But there is so much more. Again, if we don't have that opportunity to bring it up, to offer our amendments, to do our best to serve the needs of our veterans, we fail them. We fail the system.
I do hope we will have the opportunity this afternoon to advance to these important measures. Remember, this is just the first of 12. It is very important work that we have in front of us.
Madam President, I know my colleague from Connecticut has arrived on the floor, but before I yield the floor to him, I want to briefly mention a meeting that I had this morning in my office.
Welcoming Members of The Anchorage Fire Department Honor Guard
Madam President, I was able to welcome members of the Anchorage Fire Department Honor Guard to my office. They are making their way to Emmitsburg, MD, to be part of a ceremony at the National Fallen Firefighters Memorial, where they will pay tribute to and honor the firefighters who have given their lives in the line of duty during the year 2014.
Remembering Jeff Bayless
The firefighter whom Alaska is recognizing and honoring is a gentleman by the name of Jeff Bayless. He died at the age of 51 on March 7, 2014, during a strenuous training exercise in Anchorage.
How Jeff Bayless lived his life as a fourth-generation Alaskan, and as one who had not only a love for the outdoors but a love and care for people, is something that we want to pay tribute to, and we want to honor and recognize him.
This weekend, on the campus of the National Fire Academy in Emmitsburg, MD, the name of fallen Anchorage firefighter Jeffery Edward Bayless will be inscribed on the National Fallen Firefighters Memorial. A total of 87 firefighters will be honored, and 84 of those firefighters, including Jeff, gave their lives in the line of duty during 2014. Three died in previous years. This week, I welcome members of the Anchorage Fire Department Honor Guard to my office, as they make their way to Emmitsburg to celebrate Jeff's life and his contributions to the fire service.
I wanted to reflect for a moment on the life of fire hero Jeff Bayless. Jeff died at age 51 on March 7, 2014, during a strenuous training exercise in Anchorage. Heroes are remembered for the way they lived their lives and this is how we should remember Jeff Bayless.
Jeff was a fourth generation Alaskan. He grew up in Copper Center, attended Alaska Bible College in Glennallen, and then became a paramedic through the Oregon Health Sciences University training program. Jeff was also trained as a Registered Nurse. After serving as a paramedic in Oregon, he returned to Alaska to work as a first responder in Matanuska-Susitna Borough. Ultimately he found his home at the Anchorage Fire Department, first as a paramedic and then as a firefighter. He excelled in both roles. Working his way up the ranks, Jeff was a Senior Captain at the time of his passing.
As would be expected of a fourth generation Alaskan, Jeff had a love for the out of doors. From an early age, Jeff put his mastery of the outdoors to work in the service of lifesaving. As an older teenager, Jeff and his buddy happened upon a flash flood in the Yukon that swept vehicles off the road. Using their wilderness savvy, they roped up and rescued every person.
Later in life, as a member of the Anchorage Fire Department's whitewater rescue team, he plucked several victims from dangerous waters. One of these rescues was particularly memorable. On September 16, 2012, Jeff's Station 11 was called out to rescue a kayaker on the Eagle River who was lodged against a tree after his kayak overturned. The kayaker was in the water for about 90 minutes when a bystander called for emergency assistance. First the tree had to be cut, then the kayaker plucked from the water by his lifejacket. The kayaker was hypothermic by this point. While a number of units from the Anchorage Fire Department responded, Jeff was senior on the three-man jet boat team that plucked the victim out of the water. Jeff's team won the American Red Cross of Alaska Wilderness Rescue Heroes award. Jeff characterized the rescue as one of the most challenging successful rescues his team had ever been involved with. The team was well trained to perform the rescue and in spite of the dangers ``everyone went home,'' including the victim.
I cannot characterize Jeff's life in words more touching than on his National Fallen Firefighters Foundation official biography. He spent his life simply doing what he loved, completely engaged, lost in the moment. Without any consciousness of the impact his own life was having, he left behind a great legacy of life, encouragement, accomplishments, and friendship.
That, my colleagues, is the definition of a fire hero.
He would say he was one of the guys who was just doing his job, but as one of those men who was just doing his job, he needs to know that we view him as one of our heroes.
Our thoughts and our prayers are with his family and all of his brother and sister firefighters as they gather this weekend in Emmitsburg.
Madam President, I yield the floor.
The PRESIDING OFFICER. The Senator from Connecticut.
Zadroga 9/11 Bill
Mr. BLUMENTHAL. Madam President, I thank my colleague from Alaska for yielding and giving me this opportunity to discuss two measures that ought to be beyond debate or discussion on this floor as well as in America--two issues where Americans ought to unite and be together without controversy or contention.
The first relates to the emergency responders who rushed to the rubble of the World Trade Center in New York in the wake of that horrific attack on America on September 11. I want to join and thank my colleague from New York, Senator Schumer, who just spoke on the floor, and associate myself completely with his very eloquent and powerful explanation for why this Nation must meet its obligation to provide critical health care for those emergency responders, firemen, police, and medical personnel who went to that site, even as it continued to smolder with poisonous chemicals and fumes, risking their lives in the face of peril that they little understood and could not know. They never asked whether that place was dangerous, but, in fact, as we now know, it has caused countless cancers, blood diseases, and lung problems, which have manifested themselves in the years after.
Yet at midnight last night, the beginning of this day, the programs designed to provide critical medical care and compensation to the victims were permitted to expire. That is unconscionable and unacceptable.
I join my colleagues from New York and New Jersey as a leading cosponsor in urging this Congress to act--and to act immediately and urgently--to make sure that we do what is right for those emergency responders who served and sacrificed in the wake of 9/11. Failure to do so is absolutely outrageous. The fund still has some money, and it will continue to function. But this Congress should act to pass the Zadroga 9/11 bill immediately.
Madam President, the second area where I think we ought to be all agreeing relates to doing what is right for our veterans, and that means restoring the $857 million that has been deleted from the President's request for veterans in the Military Construction, the Department of Veterans Affairs, and Related Agencies Appropriations Act, 2016. This bill essentially shortchanges our veterans and straitjackets the Veterans' Administration.
Madam President, I ask unanimous consent to have printed in the Record a letter from the American Legion.
There being no objection, the material was ordered to be printed in the Record, as follows:
The American Legion,
Office of the National Commander,
Washington, DC, September 30, 2015.Hon. Mitch McConnell,Majority Leader, U.S. Senate,The Capitol, Washington, DC.
Dear Majority Leader McConnell: Last May then-National Commander Michael D. Helm called on Congress to pass a budget for the Military Construction-Veterans Affairs Appropriations bill that won't shortchange the Department of Veterans Affairs (VA). On April 30 the House of Representatives had passed a funding bill which unfortunately underfunds VA's medical care, major construction and Information Technology accounts by more than $1.5 billion below the Administration's request.
We were pleased when the Senate Appropriations Committee remedied that shortfall somewhat, but because they were tasked with making an unworkable allocation workable, the Senate version of the bill still underfunds veterans by approximately $857 million. This comes at a time when the VA is faced with an unprecedented demand for services, in terms of both numbers and complexity.
We need your help to ensure that VA is fully funded so it can provide the care and services veterans have earned and need. An inadequate VA budget will have a negative effect on the timeliness and quality of care that veterans will receive. Fully funding VA must be a very high priority for Congress.
The American Legion is the largest veteran service organization in the nation and we take our responsibility to analyze and evaluate veterans' healthcare options very seriously. As VA, Congress and The American Legion move forward together we must ensure that America's veterans are provided with the healthcare and services they have earned and were guaranteed.
Respectfully,
Dale Barnett,
National Commander.
Mr. BLUMENTHAL. This letter emphasizes the challenges that the VA faces in meeting the unprecedented and increasing demand for services that our veterans need and deserve. This obligation for our country is not a matter of discretion or convenience, it is a promise that we have made and we must fulfill to provide medical care, skills training, job opportunity, and, most especially, the mental health care that our veterans need so that we can stop the 22 suicides every day in this country--the greatest, strongest, country in history of our world, where 22 of our Nation's heroes commit suicide every day.
They suffer from the invisible wounds of war, post-traumatic stress and traumatic brain injury. Many of our veterans suffer the more visible wounds, and they need care as well. Many of our veterans in increasing numbers will be coming out of the service needing jobs and skills training, not only through the VA but the Department of Labor. Just yesterday, the nominee for the Veterans Employment and Training Services position in the Department of Labor testified before the Veterans' Affairs Committee as to the importance of services provided by the Department of Labor, and yet they too will be shortchanged by this budget.
So I urge my colleagues to provide sufficient funding to restore that
$857 million and to make sure that we meet those needs of our veterans. Failing to do so is as unacceptable as failing to meet the needs of the emergency responders who went to the 9/11 site. This bill underfunds the VA's medical facilities by $100 million, reducing the VA's ability to keep pace with the need for critical facility maintenance. This is upkeep that is vital for basic repair and maintenance. Facilities will decay and downgrade without that funding. It is an investment in basic infrastructure.
We ought to be investing in the personnel of the VA--the doctors and nurses and other professionals--so that we recruit and retain the men and women who will really do the work on the ground in the trenches to make sure that the VA provides the best care possible--world-class care to our veterans. They deserve no less. Fully funding the VA honors the service and sacrifice of men and women who have risked their lives to keep our great Nation free. Freedom is never free, and this Nation ought to be keeping its promise to those veterans, which, unfortunately, sadly, reprehensibly, this measure fails to do.
I yield the floor.
The PRESIDING OFFICER. The Senator from Arizona.
Mr. FLAKE. Madam President, I ask unanimous consent to enter into a colloquy with the Senator from Wisconsin.
The PRESIDING OFFICER. Without objection, it is so ordered.
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