Videos & Speeches

Veterans Health Care

Mr. President, thank you very much for recognizing me to take the opportunity to address something I hope can readily and easily be solved. If common sense prevails--and we know it doesn't often enough here in our nation's capital--one, the Department of Veterans Affairs certainly, in my view, can solve this problem. If common sense doesn't prevail there, then surely the Senate, the House of Representatives, and the President could agree upon a legislative fix that is really nothing more than common sense. I am talking about a veterans issue--one that is certainly prevalent in a rural state such as mine. My guess is it is a problem that occurs in a state such as the Presiding Officer's as well.

I was very pleased. I came to the Senate floor and talked about the importance of passing and approving the CHOICE Act. We remember the scandal of last year in which it became clear the Department of Veterans Affairs had significant problems across the country. The VA hospital in Phoenix was a poster child for bad behavior that resulted in potentially the death of veterans. One of the things we did to try to help the Department of Veterans Affairs better take care of America's veterans was to pass the CHOICE Act. We did that in August of last year. It was signed into law, and it is now being implemented by the Department of Veterans Affairs.

There are many issues that are associated with the implementation of this bill, but let me raise one. The crux of that legislation is this. If you are a veteran and you live more than 40 miles from a VA facility or if you can't get the Department of Veterans Affairs to provide the services within 30 days or the timeframe in which you need those services, then the Department of Veterans Affairs is required by law to provide those services, if you choose, at a place of your choice, presumably your hometown.

This is about service to our veterans in their hometowns across Kansas and across states around the country. The theory is that the Department of Veterans Affairs is incapable of providing those services perhaps for a number of reasons, including lack of the necessary professionals. Therefore, let's take advantage of the professionals we have at home in our hometowns. Let the veterans see his or her hometown physician. Let the veteran be admitted to his or her hometown hospital. It is a pretty commonsense kind of reaction to the inability of the Department of Veterans Affairs to meet the needs of veterans across our country--provide another option. If that is the choice of the veteran, that veteran wants to have care at home, give them that option.

As a Senator from a state such as Kansas, this makes sense to me even in the circumstance in which the Department of Veterans Affairs can provide the service. For 14 years I represented a congressional district in Kansas, the western three-fourths of our state. The congressional district is larger than the state of Illinois and has no VA hospital.

We pushed for a number of years and were successful in opening outpatient clinics so veterans could get that care closer to home than the VA hospital, and those outpatient clinics provide--or at least intended to provide--routine care. Here is the problem today. The law says if you live more than 40 miles from a VA facility, then the VA must provide the services at home if you choose. The Department of Veterans Affairs is defining facility as any facility, including the hospital or the outpatient clinic. That doesn't seem too troublesome to me until you take it to the next step, which is, even if the VA hospital or the outpatient clinic doesn't provide the service that the veteran needs, they still consider it a facility within 40 miles.

In my hometown, where I grew up, we have had an ongoing dialogue with one of our honored veterans. He needs a colonoscopy. My hometown is nearly 300 miles--250 miles from the VA hospital in Wichita. There is an outpatient clinic, a CBOC, in Hays, 25 miles away. But guess what? The outpatient clinic in Hays doesn't provide the service of colonoscopies.

One would think the veteran in my hometown could go to the local physician or the local hospital and have the colonoscopy performed and the Department of Veterans Affairs provide and pay for the services. But no, because there is an outpatient clinic within 40 miles, even though it doesn't provide the colonoscopy, our veteran is directed to drive to Wichita. Incidentally, we have calculated the mileage expense of the veteran doing it. It does not make sense economically, either. But regardless of that, it certainly doesn't make sense for that veteran.

I have said this many times over the years as we have tried to bring services closer to home to veterans. If you are a 92-year-old World War II veteran and you live in Atwood, KS, up on the Nebraska border, how do you get to the VA hospital in Wichita or in Denver?

Our initial attempt was to put an outpatient clinic closer. The problem with that--we now have an outpatient clinic in Burlington, CO, and an outpatient clinic in Hays, KS. But that is still 2.5 hours from Atwood, KS. If you are a 92-year-old World War II veteran in Atwood, KS, how do you get to Hays or Burlington, CO? The answer is you probably don't.

Our veterans are not being served. We attempted to address this issue. Let me say it differently. We addressed this issue in the CHOICE Act and said that if you are 40 miles from a facility, then the VA provides the services at home. The VA is interpreting that facility--the word facility--just to mean any facility there regardless of what service it provides.

In many instances--I take Liberal, KS, where there is a CBOC. They haven't had a permanent physician in their CBOC in almost 4 years. But yet Liberal--the CBOC in Liberal--counts as a facility even though there is no physician who is regularly in attendance at the clinic. These issues ought to be resolved in favor of whom? The veteran. Whom, of all people, would we expect to provide the best service to? In any capable way we can, whom would we expect to get the best health care in our nation? I would put at the top of the list those who served our country.

The committee that passed this legislation, the CHOICE Act--it says in the language--the conferees recognized the issues I just described and added report language that allows veterans to secure health care services that are either unavailable or not cost-effective to provide at a VA facility, which was intentionally included to give the VA flexibility to provide veterans access to non-VA care when a VA facility, no matter what size or location, cannot provide the care the veteran is seeking.

Yesterday I introduced S. 207. I would ask my colleagues to join me. Again, I guess my first request is, could the Department of Veterans Affairs fix this problem on their own? If not, I would ask that my colleagues join me in fixing this legislatively with one more directive to the Department of Veterans Affairs saying, if they cannot provide the service at the CBOC, then it does not count as a facility within the 40 miles.

This is a problem across our states. I had my staff at a meeting in the VISN in which they were describing how they were going to implement the CHOICE Act. They put up a chart in which they show how they are going to have a mobile van work its way through the area of our state and Missouri and talked about how that will then satisfy the 40-mile requirement.

Why is the VA bending over backward to avoid--let my say it differently. Why is the VA not bending over backward to take care of the veteran, instead of bending over backward to make sure it is the most difficult circumstance for a veteran to get the health care they need at home?

We ought to always err on the side of what is best for veterans, not what is best for the Department of Veterans Affairs--if you could ever make the case that providing services someplace far away from the veteran is good for the VA.