Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2017

Floor Speech

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Mr. KEATING. Mr. Chairman, I thank Chairman Dent and Ranking Member Bishop for their work on this appropriations bill, and for their cooperation with this amendment.

I rise today to offer an amendment that will support a requirement of VA prescribers to complement a continuing medication course in pain management.

Nationally, about 30 percent of Americans have some form of chronic pain. However, the percentage of veterans who report chronic pain is significantly higher. Over 50 percent of elderly veterans report chronic pain as do almost 60 percent of veterans returning from the conflict in the Middle East.

In fact, chronic pain is the most common medical problem experienced by returning combat veterans in the last decade.

Of course, pain is not a stand-alone problem. Pain is something we see as a consequence of physical injury, and sometimes that physical injury leads to co-occurring mental health ailments.

We are increasingly more aware of the mental health consequences stemming from time in combat. Veterans with brain trauma are more likely to report physical pain and, in turn, are more likely to receive prescriptions for opioids.

Recent VA data shows us that roughly 523,000 veterans are receiving prescriptions for opioids, and the number of veterans with opioid use disorders has grown 55 percent over the past 5 years. Veterans are twice as likely to overdose on prescription opioids as the general population.

We are very fortunate to live in a time where quality care can be offered to our military personnel, and it is unparalleled. Now we need to do our part to help these heroes manage their chronic pain in the safest manner possible.

Last month I introduced the Safe Prescribing for Veterans Act, which will help those who provide healthcare services to veterans learn the latest pain management techniques, understand safe prescribing practices, and spot the signs of potential substance use disorders. This act works by directing healthcare providers from the VA to take continuing education courses specific to pain management, opioids, and substance abuse.

VA healthcare providers already need continuing education to maintain their State-issued professional licenses, and my bill makes sure they spend some of the already-required time learning about safe opioid prescribing practices.

The bill does not add to the total number of credits that prescribers already have to take, it just insists that they spend their time on this important issue.

Only 14 States require their physicians to take pain management education credits. My constituents are fortunate in Massachusetts because we are 1 of the 14 States that ask its doctors to complete pain management training.

However, even our neighboring States do not have the mandatory pain management requirements. Veterans in my district, especially those in the South Coast, often find it easy to receive their health care at VA hospitals in Rhode Island. As of now, there is no guarantee that the doctors they see in Providence have taken the same pain management education courses.

I rise before you today in an effort to give our veterans that guarantee.

I urge my colleagues to join me in support of this amendment to ensure our veterans receive the care they deserve.

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Mr. KEATING. Mr. Chairman, I yield back the balance of my time.
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Mr. KEATING. Mr. Chairman, again I would like to thank Chairman Dent and Ranking Member Bishop for their work on this bill and their cooperation on this amendment.

I rise today to offer a straightforward amendment that will improve our understanding of the causes of delays within the Veterans Choice Program. The Veterans Choice Program was implemented to address delays in patient care at the Veterans Administration. However, as of April of this year, data from the VA showed that the number of veterans waiting more than 30 days for an appointment was actually higher than when the Veterans Choice Program was initiated.

The well-intentioned and necessary program was initiated and acknowledged. The fact is the Veterans Choice Program was cobbled together very quickly given the time constraints. This led to excessive privatization and contracting through third parties, which has contributed to frequent delays, and we are seeing these delays even today.

In my district alone, I have spoken with numerous veterans who live a great distance from VA medical facilities, such as the islands of Martha's Vineyard and Nantucket. My constituents rely heavily on accessibility to non-VA doctors the Veterans Choice is intended to provide.

Further, an oft cited problem with Veterans Choice is the lack of clear communications regarding the eligibility requirements of the program to both veterans and non-VA providers. Understanding the obstacles around efficient scheduling of appointments of veterans and swift reimbursement for providers would serve as a crucial first step in resolving some of the issues that the Choice Program faces. Without this understanding, the program itself really isn't beneficial.

That is why I am offering this amendment, to advocate for redirected funding toward finding a solution to the delays and the communication errors plaguing implementation of Veterans Choice.

I have no doubt whatsoever that every Member of Congress here agrees that our veterans deserve the very best possible care in a timely manner. Ultimately, this amendment is meant to assist the VA in identifying why these delays are occurring and to help recommend solutions.

I want to thank the chairman again.

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Mr. KEATING. Again, Mr. Chairman, I thank the chairman and ranking member.

I yield back the balance of my time.

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