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Rural Veterans Access to Care Act

Location: Washington, DC

RURAL VETERANS ACCESS TO CARE ACT -- (House of Representatives - September 09, 2008)

Mr. MORAN of Kansas. Mr. Speaker, I rise in obvious support of H.R. 1527, as amended, the Rural Veterans Access to Care Act. This is a piece of legislation that I have worked on for a number of years, and I am pleased that under the leadership of Mr. Filner and Mr. Buyer this bill is now on the House floor, and I am excited about the opportunities that it presents to better care for veterans who live in rural America.

About 39 percent of our veterans enrolled in VA health care live in those rural areas. Many face challenges of accessing VA care because of the distances between where they live and where the facilities are located.

We are making some progress in regard to rural veterans. In the last several years, we have approved an amendment that I have offered for a number of years increasing the veterans' mileage reimbursement rate from 11 cents per mile to 28.5 cents per mile. The fiscal year 2009 Military Construction and Veterans Affairs Appropriations bill that we passed earlier this year, back in July, would increase that from 28.5 cents to 40 cents per mile. So that's one step we have taken to help our rural veterans better access health care.

Recently the VA established an Office of Rural Health and a Rural Health Advisory Committee to develop solutions to the challenges of providing health care to veterans living in rural America, and the VA continues to expand community-based outpatient clinics and will activate an additional 44 new clinics in the next 15 months, bringing the number of those clinics to more than 1,000. The VA has also increased the number of readjustment counseling service centers, the Vet Centers, nationwide with plans to open an additional 39 Vet Centers by the fall of 2009. In my home State of Kansas, we have opened an outpatient clinic this year in Hutchinson and opened a Vet Center in Manhattan, Kansas; so progress is being made.

However, despite all those efforts, the reality is that many veterans live in remote areas of the country beyond the VA's ability to construct medical facilities to care for them. The congressional district that I represent in Kansas is an example of an instance where veterans experience great difficulty in traveling to VA facilities. My congressional district is more than the size of the State of Illinois. It has more hospitals than any other congressional district in the country but not one VA hospital. Some Kansas veterans are forced to travel up to 5 hours to a VA hospital for the care they need; and, unfortunately, more often than it should be, they simply forego that care altogether.

H.R. 1527, as amended, would require the VA to conduct a 3-year demonstration project to allow highly rural veterans living in four VISNs, Veterans Integrated Service Networks, to receive the covered services through non-VA providers.

This pilot will ask the VA to explore in several regions a practical approach when the VA care is not otherwise available close by. It would give those who live the farthest from VA facilities the choice to receive their care closer to home at the local hospital or the local physician's office.

There are criteria by which a veteran must qualify to receive this kind of assistance. A veteran must live at least 60 miles from a VA clinic, 120 miles from a VA hospital, or 240 miles from a VA specialized care facility when they're seeking that kind of health care. To ensure the continuity of care, the legislation requires the VA to develop the functional capabilities to exchange veterans' medical information between the VA and non-VA providers in this pilot, and the VA will be required to report to Congress annually on the cost, upon the quality of care, and upon patient satisfaction.

Forty-four percent of our military recruits are from rural areas, as are many Guards and Reserves that our Nation has increasingly called into service. This means that rural veterans are more likely to increase in number. Allowing the most underserved of these veterans to take advantage of the existing rural health care infrastructure is a commonsense approach. This is good for the veteran. It's good for the community. It's good for the health care provider. In many of the hospitals and clinics that I represent, in the communities that I represent, an additional patient is a very important thing. Hospitals in many instances are like schools. One more student matters to the viability of our school system just as one more patient matters to the viability of the private health care providers. We have approved this concept in our appropriation bill earlier this year. In July the VA military construction spending bill approved an additional $200 million to increase access to fee-based care for veterans in areas where the VA does not offer services. And with the high price of gasoline and its impact upon our rural veterans, it's even more important that this legislation pass.

We must fully consider this practical reform for highly rural veterans living outside the VA's ability to care for them, and I urge my colleagues to support H.R. 1527.

Mr. Speaker, I reserve the balance of my time.


Mr. MORAN of Kansas. Mr. Speaker, first of all, let me thank the gentleman from Texas (Mr. Al Green) for his comments, his ecumenical attitude, and his understanding for the needs for all American veterans, and I am hopeful that that is demonstrated today by all Members of the House as we approve this legislation.

Let me also take this moment to thank all of the employees, the staff, the medical providers within the VA system in Kansas and across the country who work hard on a daily basis to make certain that our veterans are cared for and also for all those who have volunteered their time, their automobiles, their days, and their driving skills, as we have had many veterans who have helped other veterans get to a medical facility, often miles and distance away.

These kinds of volunteer activities have been important and it is a way that some veterans have been able to access health care. But this legislation takes us in a very positive step, one that we have worked on for a long time to achieve, and I am very pleased by the efforts that we see, the culmination of those efforts that we see today.

Finally, let me thank the staff of the Veterans' Committee, both the minority and majority. I appreciate the approach and attitude, the diligence with which we have addressed this legislation. It has had its false starts as recently as a month ago. I am very grateful for the efforts that all made to make certain that this legislation is before us today, and in particular I thank the gentleman from California, Mr. Filner, who gave me his word back in early August that this legislation would be on the House floor this week, and I very much appreciate Mr. Filner's efforts.

With that, Mr. Speaker, I support this legislation and appreciate the consequences that arise from its passage.

Mr. Speaker, I yield back the balance of my time.

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