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Mr. VITTER. Madam President, I come to the floor to speak about an issue we should all be concerned about, the State of veterans health care in our VA hospitals, our VA clinics, our VA system, and around the country.
I have been concerned about this for some time, working very hard on getting outpatient clinics built in Louisiana--new ones, expanded ones, in particular, in Lafayette and Lake Charles.
I am a member of a bipartisan working group on VA backlog issues, and we have made substantial progress through that bipartisan group. We have also introduced legislation to deal specifically with that VA backlog crisis.
As we work on those things, unfortunately, the news out of the VA gets worse and worse, and the need for real progress on these fronts--including the community-based clinics I am going to talk about in Louisiana and elsewhere--that need gets more and more dire.
Think about the recent reports. CNN and others have reported that in Arizona at least 40 U.S. veterans died--died--waiting for appointments at the Phoenix VA health care system. Many of these were placed on a secret waiting list. The secret list was part of an elaborate scheme designed by the VA managers in Phoenix who were trying to hide the fact that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor.
There is an official list that is shared with officials in Washington. That official list shows that the VA has been providing timely appointments. The problem is, you don't get on that official list, in some cases, until you have waited months and months and months on the secret list that is hidden from Washington, that was hidden from the world, and that was hidden from outsiders until the news media broke the story. So 40 of those veterans died waiting for appointments through this abuse.
In Colorado, USA Today and others reported that clerks at the Department of Veterans Affairs clinic in Fort Collins were instructed last year about how to falsify appointment records so it appeared the small staff of doctors was seeing patients within the agency's goal of 14 days--the exact same abuse, the exact same type of scheme, but different details. Many of the 6,300 veterans treated at the outpatient clinic waited months to be seen, but that was hidden through this scheme.
If the clerical staff had allowed records to reflect that veterans waited longer than 14 days, they were punished by being placed on the bad boy list, the report shows. So, again, it is exactly the same fraud and abuse, the same scheme, designed to hide the real waits that veterans in these places and in many other places around the country are subjected to.
We see these horrible abuses. We see these examples with increasing frequency. It has gotten so bad that the head of the American Legion and the head of the Concerned Veterans for America on Monday called for Secretary Shinseki to resign and called for members of his top leadership to resign with him.
The calls for his resignation came after months of reporting that I have been talking about--U.S. veterans who have actually died waiting for care at VA facilities across the country. It came after these reports about Phoenix. It came after these reports about Colorado.
The heads of these organizations did not rush into a public call for his resignation. They did not take that lightly. That is virtually and perhaps completely unprecedented, but they did that on Monday. They called for the Secretary's resignation. They called for it publicly, and they called for several of his leadership team to resign with him. That is how bad it has gotten.
Yet in the midst of this, rather than responding to this crisis in any way we can, as quickly as we can, we have important matters hung up on pure politics on the Senate floor. Specifically, I am talking about my proposal to move forward with 27 community-based clinics around the country, including the two vital new and expanded community-based clinics that we need to move on, approve, and build in Louisiana, in Lafayette and Lake Charles.
These clinics around the country--and particularly the two in Louisiana, in Lafayette and Lake Charles--have been hung up through one bureaucratic screw up after another. These should have been built by now.
First, in terms of our two Louisiana clinics, the VA messed up how they let out the contract, and that caused them to pull back. It was their mistake, pure and simple. They have admitted that freely, and it cost us 1 year in terms of moving forward with those clinics.
After that mistake was corrected--after the loss of 1 year of waiting--then the CBO decided that they were going to score these clinics in a completely new way, something they had never done before, and that caused a ``scoring'' or ``fiscal issue'' with regard to all 27 of the community-based VA clinics around the country that I am talking about.
That further delayed progress.
Finally, after these two major delays, leaders in the House got together on a bipartisan basis--and I want to commend my Louisiana colleagues in the House, in particular led by Congressman Boustany and others--to fix this scoring issue. They put together a reform bill and they got it approved by the House overwhelmingly, with one dissenting vote. In today's environment, resolutions to honor Mother Teresa don't pass the House of Representatives with only one dissenting vote, but they did that.
So it came over here, and I worked to address some small issues and objections that existed on the Senate side through a perfecting amendment which I have at the desk. I worked very hard for weeks to clear up those objections so we could move forward with this noncontroversial measure. Because of that, we have the unanimous support of the Senate--not one single objection to moving forward with these 27 community-based VA clinics around the
country. There is not one single objection related to the substance of that proposal--not one.
The only objection now has been from the distinguished Senator from Vermont who objects to moving forward with this focused proposal because the Senate does not agree unanimously or near unanimously with his much larger bill that encompasses dozens of VA issues. Again, I have pledged to and I will work with the Senator on those broader issues. I have been working hard on those issues, including these clinics, including being an active member of the bipartisan working group on the VA backlog issue. I will continue to work on that. But the fact remains his larger bill has substantial opposition. There are around 46 Senators--excuse me, around 44 Senators who oppose that larger bill.
In the meantime, I think we should agree on what we can agree on. We should make progress on what we can make progress on, starting with these 27 clinics. Veterans have been dying around the country because of these ridiculous waits and the fraud and abuse involved in hiding these waits. These 27 community-based clinics will directly help address veterans who are waiting for months and months in some cases, waiting for medical treatment. It will directly alleviate that issue in the communities in 18 States where these clinics will be located. There is a significant number of communities in a significant number of States. So let's agree on what we can agree on. Let's make that significant progress. Let's keep talking and working on the rest.
Last November Senator Sanders seemed to agree with that principle and that way of moving forward. In talking about another Veterans' Affairs piece of legislation, he said, on November 19 of last year, ``I'm happy to tell you that I think that was a concern of his.''--talking about another of our colleagues--``We got that UC'ed last night.''--unanimous consent--``So we moved that pretty quickly, and I want to try to do those things. Where we have agreement, let's move it.''
To repeat from that quote: `` ..... I want to try to do those things. Where we have agreement, let's move it.''
That is all I am asking for. We are not going to agree on everything immediately, but we can agree on important things right today, right this hour, right this minute. We do agree on 27 important community-based clinics in 18 States around the country, including 2 in Louisiana--Lafayette and Lake Charles, LA--that Senator Landrieu and I represent.
I want to try to do those things where we have agreement. Let's move it. And that can start right this minute in a productive, positive way with these 27 community-based clinics around the country. So let's agree on what we can agree on. Let's move on this important clinic issue.
Leaders of national groups--American Legion, American Vets, DAV, Paralyzed Veterans of America, and others--think the same. That is why they wrote a letter on June 10 of last year--June 10 of 2013--saying these community-based clinics are important. Let's come together, work together, and move specifically on these community-based clinics. They are important.
I ask unanimous consent to have printed in the Record the letter of June 10 to which I just referred.
There being no objection, the material was ordered to be printed in the Record, as follows:
June 10, 2013.
Hon. Harry Reid,
Senate Majority Leader, Washington, DC.
Hon. John A. Boehner,
Speaker of the House, Washington, DC.
Hon. Mitch McConnell,
Senate Minority Leader, Washington, DC
Hon. Nancy Pelosi,
House Minority Leader, Washington, DC.
DEAR LEADERS OF CONGRESS: We write you, as leaders of Congress, to urge you to work together to prevent a looming problem that over the next several years may harm the health of more than 340,000 wounded, injured and ill veterans in 22 states who will be in need of care provided by the Department of Veterans Affairs (VA). Without your intervention, these veterans are in jeopardy of losing that important health resource.
Since the 1990s, Congress has helped improve VA health care access and patient satisfaction by authorizing and funding nearly 900 VA community-based outpatient clinics. These are important facilities for local, convenient, and cost-effective primary care for millions of veterans. Unfortunately, a policy shift by the Congressional Budget Office (CBO); in 2012 has effectively halted Congressional authorization of leases for such new clinics. Also, as old leases expire and need reauthorization in future years, this CBO decision jeopardizes existing VA-leased health, research and other facilities.
Last year, CBO announced it would redefine 15 VA-proposed leases as ``capital'' leases and would treat them as current-year mandatory obligations, costing more than $1 billion altogether over a 20-year period. In order to advance these leases to approval, House budget rules would have forced an offset to equal the cost of these leases with an unrealistic Fiscal Year (FY) 2013 reduction in mandatory veterans' programs. Since no such accommodation could be made in a single year, and VA had not addressed such an offset in its FY 2013 budget, the proposed lease authorizations were dropped from the authorizing bill. These 15 proposed community facilities are now in limbo, and veterans are not being served.
This unexpected challenge will not resolve itself absent action by House and Senate leadership to ensure Congress continues to authorize leases of local VA community-based outpatient clinics and other VA facilities when such approvals are needed. Also the VA warns that over time numerous existing leases will be expiring. Lack of reauthorization could result in closures of current clinics. Newly proposed clinics without lease authorization cannot be activated. Costs of veterans' VA care will be rising while they face longer travel and more waiting for needed treatment, or they may be forced to go without treatment.
Committee leaders with jurisdiction over the VA have pledged to solve this problem, but no resolution has emerged since CBO's determination, made nine months ago. Without leadership intervention, these promised clinics and more in the future cannot be activated or will be shut down, and wounded, injured and ill veterans in need will be denied VA health care.
The CBO's policy must be reversed or otherwise addressed in consultation with VA and the Office of Management and Budget. We ask that you take action that results in Congressional authorization of the 15 clinics still in limbo since 2012, the additional ones proposed earlier this year in VA's budget for FY 2014, and in general to find the means to allow VA's leased facilities to continue to provide flexible, low-cost VA care to wounded, injured and ill veterans. The current situation is unacceptable and must be remedied.
We appreciate your support for America's veterans and look forward to your response.
Peter S. Gaytan,
Executive Director, The American Legion.
Barry A. Jesinoski,
Executive Director, Washington Headquarters Disabled American Veterans.
Robert E. Wallace,
Executive Director, Veterans of Foreign Wars of the United States.
Stewart M. Hickey,
National Executive Director, AMVETS.
Homer S. Townsend, Jr.,
Executive Director, Paralyzed Veterans of America.
Mr. VITTER. These groups agree with what Senator Sanders said last year and they agree with what I am saying today: Let us come together and move on those things we can agree on, and they specifically wrote the Senate leadership about these community-based clinics.
That leads to my unanimous consent request, which is to adopt this spirit of agreeing where we agree, getting things accomplished whenever and wherever we can, and continuing to work on the rest.
I ask unanimous consent the Veterans' Affairs Committee be discharged from further consideration of H.R. 3521 and the Senate proceed to its immediate consideration; that my amendment, which is at the desk, be agreed to; that the bill, as amended, be read a third time and passed and the motion to reconsider be laid upon the table.
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Mr. VITTER. If I may reclaim the floor and reclaim my time, I would like to respond.
I think it is really unfortunate. As we all agreed to today and in previous appearances on the floor, there is absolutely no objection on the merits of this proposal. The only objection from the distinguished Senator from Vermont is that a far larger bill, which does have significant opposition--around 44 Members, almost half of the Senate--people have concerns about that. So if he can't play the game exactly his way, he is going to take his ball and go home, and he is going to block 27 community-based clinics on which there is no substantive objection, on which the leaders of national veterans organizations have pleaded with leaders of the Senate and House to act in a bipartisan way.
I am particularly concerned that today what I hear is an even higher bar that we are going to have to meet to act on these clinics that are not objected to on their merits.
Previously the Senator from Vermont talked about his far broader bill. Today he talked about all of health care. Apparently I am going to have to agree with Senator Sanders about all of health care reform before we can move forward on these 27 community-based clinics on which there is no substantive objection.
The Senator from Vermont said he will do everything he can to deal with these issues. Well, we can do something right here, right now, to deal with these issues. It is not solving every problem in the world. It is not solving every problem in health care. It is not solving every problem in the VA. But it is doing something real and meaningful and substantial in 27 communities and 18 States. We can move forward with these community-based clinics. We can try to do those things on which we have agreement. Let's move it. We can do that. That is all I am asking. And I think it is really counterproductive to
take the view that until we agree about all of the VA or about all of health care or whatever, we are not going to do any of that. I think that is really sad and counterproductive.
I will keep coming to the floor. I will keep working on this vital issue. I will keep working on other vital issues. I will keep talking to the Senator from Vermont about his broader bill. But I have to say that these scandals in Phoenix and elsewhere don't alleviate my concerns; they only heighten my concerns about a broader bill that is going to push many more patients, overnight, into a system that is obviously broken.
So I will continue working and talking about it all. I will continue working in the bipartisan working group on the VA backlog. But let's do what we can do now. Let's start with one step and then two and then five, and then maybe we can start to jog and then we can start to run. I think that is the productive path forward.
I urge my colleague to reconsider and let us move forward with these important clinics.
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Mr. VITTER. Madam President, just to briefly repeat, I did object on behalf of myself and 43 other Senators about major provisions in this bill. I am happy to talk about it. I am happy to work on it. I am happy to work with Senator Burr, who is the ranking member on the committee, who has been communicating all these concerns to Senator Sanders and his staff. But I think that is very different from objecting to a focused community-based clinic bill that has no objection on the merits.
I just think it is a shame not to try to do those things where we have agreement--let's move forward--not to move forward. That would be moving forward in a substantial way. That would quickly improve the lives of veterans in 27 communities and in 18 States, including Lafayette and Lake Charles--communities that certainly Senator Landrieu and I very much care about and very much want to have their VA issues addressed in this way.
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