Executive Session
Floor Speech
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Mr. HOEVEN. Madam President, I rise to speak in support of the VA MISSION Act. I want to begin by thanking the chairman of the Veterans' Affairs Committee who has shown incredible leadership on behalf of our veterans for many years, and this bill fits right in that mold.
This is a very important bill for a number of reasons. Obviously, it is an important bill because it supports our veterans, but it really has important provisions in it that will make a difference for our veterans. I want to thank the chairman of the VA Committee. I want to thank him not only for the quality of the work in this bill but for building the bipartisan coalition necessary to pass it because it really does make a difference for our veterans, to whom we owe so much.
I would like to go through not all but some of the provisions that I think are really important, some I worked on and some I think really do make a difference for our great veterans.
As I said, I speak in support of the VA MISSION Act. It is bipartisan legislation that will help ensure veterans receive the care they so very much deserve.
This piece of legislation not only strengthens the VA's ability to care for our veterans, but when the VA is unable to provide that care, it gives our veterans a choice to seek care in their home communities and to do it on a basis that is convenient, that works for them, and then to make sure those healthcare facilities will provide that service to our veterans because they know they will be compensated for it by the VA.
That is a huge issue because it is not just about making sure there is care out there for our veterans but making sure it is quality care and that it is available to them.
We owe our veterans more than we can ever repay for their incredibly dedicated service. Expanding veterans' access to healthcare options closer to home is just one of the ways we can show our deep appreciation for their service to our country.
Providing this kind of care has proven to be particularly challenging for our veterans residing in rural areas. I live in a rural State, and to get that access to quality service in these rural areas is a challenge. It is a challenge we have to address and a challenge we address directly in this legislation, which is why I am so deeply appreciative that we are working to pass this legislation.
In 2014, the Veterans Choice Program was enacted to alleviate unacceptable waiting times for care at the VA. However, the Veterans Choice Program has been in need of improvement.
In 2016, I worked to secure and implement the Veterans Care Coordination Initiative at our Fargo VA health center. The Fargo VA health center serves all of North Dakota, and it serves half or more of Minnesota as well. The initiative we worked to put in place at the Fargo VA--and the Fargo VA does a tremendous job. We have some VA health centers around the country that obviously need improvement, but the Fargo VA health center does a top-quality job.
This initiative is an initiative we put together as part of the Veterans Choice Program. It has allowed veterans seeking community care to coordinate all of their healthcare through the Fargo VA health center rather than the third-party contractors that were set up under Veterans Choice, and obviously we had some challenges with those contractors. So this allowed the VA health center to provide that service directly, both if the veteran came into VA for institutional care at the healthcare center or at one of its CBOCs or if they wanted to get Veterans Choice care from a private provider in their local community. The initiative has been very successful and has significantly reduced wait times for community care appointments.
The VA MISSION Act builds on that very effort. It builds on that effort by requiring the VA to schedule medical appointments in a timely manner. When the veterans need healthcare, they have to be able to get in and get that care in a timely way.
The MISSION Act improves community care initiatives at the VA, including the Veterans Choice Program, by streamlining it into a single veterans community care program that will be able to provide better care for our veterans. That is the bottom line--better care for our veterans.
Today I want to highlight three priorities we worked to include in the MISSION Act to provide veterans in North Dakota and across the country with better care closer to home.
First, the long-term care piece. When we are talking about care, it is not just medical care; it is long-term care. It is in-home care. It is nursing home care. It is that whole continuum of care that is so important. The VA MISSION Act includes key pieces of legislation I introduced as a stand-alone act. That bill was the Veterans Access to Long Term Care and Health Services Act, and it focused on that long- term care piece, making sure veterans could get the VA to reimburse nursing homes and that nursing homes would take that VA reimbursement and take veterans.
That is why I introduced the legislation, along with some of my other colleagues, to increase veterans' access to long-term care options in their communities.
For example, currently, in our State, only about 20 percent of the nursing homes contract with the VA due to difficult regulations and reporting requirements. That is not dissimilar from across the country. That is what we are seeing across the country, only a percentage-- ultimately, a small percentage--of nursing homes that will take that VA reimbursement because of the redtape and difficulty contracting with the VA in order to get that reimbursement. A veteran should not have to relocate across the State because they can't go into a nursing home in their community because of that reimbursement issue. That is what this legislation addresses.
Think how important that is. You want your veteran to be able to go in and get long-term care in their community, close to their home, close to their family, right? That is what this is all about. Our legislation will allow non-VA long-term care providers, including nursing homes, to enter into provider agreements with the VA. These agreements will cut through the bureaucratic redtape at the VA that has prevented our veterans from receiving long-term care services closer to home. This means veterans can access nursing homes and other long-term care in their communities closer to home and closer to their loved ones.
The MISSION Act also expands caregiver benefits to veteran caregivers of all eras. Again, this is a very important provision. The VA's program of comprehensive assistance for family caregivers includes a monthly tax-free stipend, healthcare coverage under the VA Civilian Health and Medical Program--if the caregiver is not eligible for coverage under another health plan--counseling and mental health services, up to 30 days of respite care services, reimbursement for travel-related expenses required for an eligible veteran's examination, treatment, or episode of care, and travel for caregiver training is also reimbursed.
Currently, these benefits are only available to caregivers of post-9/ 11 veterans. The inclusion of this provision will help support pre-9/11 veterans and the family and the friends who take care of them.
The other provision I want to mention again is really important for our rural areas and for our veterans in the rural areas. This is a very important provision. This priority, this provision, removes the Veterans Choice Program's 30-day, 40-mile eligibility requirement. So it removes that 30-day wait, that 40-mile eligibility requirement. Instead, the bill allows veterans to receive care in their local community when services are not available through the VA or if the veteran and his VA medical team determine that receiving community care would be in the best interest of the veteran--again, what is best for our veterans.
This is a priority we have been working on for veterans in my home State and really States across the country, particularly our rural States.
As I mentioned, for example, North Dakota's only health center is in Fargo. We have CBOCs around the State, but the only health center, the full-scope health center, is in Fargo. As I said, it covers all of North Dakota and, frankly, most of Minnesota. We have these community- based clinics out there. While they provide some services, they aren't always equipped to provide the care necessary for our veterans. So what does that mean? That means the veteran has to travel in some cases a long distance.
Under the Veterans Choice Program's 30-day, 40-mile eligibility requirement, a veteran living within 40 miles of a CBOC meant they either had to go to that CBOC or travel a long distance to a VA health center. So they weren't eligible for that community care, as I say, forcing many veterans to travel long distances, often in inclement weather, in order to receive VA reimbursed care. This legislation, the MISSION Act, removes that requirement. So now, when a VA medical center or CBOC can't provide the service a veteran needs, then those veterans will be able to access healthcare services in their local community.
So we have veterans traveling hundreds of miles now, round trip, inconvenienced, making it very difficult for them and their families. No more. Under this legislation, that 40-mile requirement and the 30- day limit is taken away. If it is most convenient for a veteran to access care from a private provider in their community, they can do it. That is a huge step in making the Choice Program work for our veterans.
Just a few days from now, our Nation will set aside a day to honor those who made the ultimate sacrifice. It is because of their sacrifice that we can experience the freedoms we enjoy as Americans. Sending this legislation to the President's desk is one way we can show our gratitude for their actions.
I wish to congratulate again the great Senator from the State of Georgia and thank the Senate VA Committee staff for their leadership, perseverance, and hard work to get to this point. I am pleased that both sides of the aisle have come together to support this legislation and to support our veterans. I am proud to support the VA MISSION Act. Again, I urge my colleagues to support its passage.
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