Va Accountability First and Appeals Modernization Act of 2016

Floor Speech

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Mr. KEATING. Mr. Chairman, I would like to thank Chairman Miller of Florida for his assistance with this amendment, as well as the gentleman from California (Mr. Takano).

I rise to offer an amendment to H.R. 5620 that would direct healthcare providers with VA affiliation to take continuing education courses specific to pain management, opioids, and substance abuse.

Nationally, about 30 percent of Americans have some type of chronic pain that they report. However, for veterans--and our elderly veterans--that number escalates dramatically, with 50 percent reporting chronic pain. And it is even more--almost double that--as 60 percent of veterans returning from the current conflict in the Middle East report some type of chronic pain that needs administration. In fact, this type of malady is the most common medical problem experienced by returning combat veterans in the entire last decade. So it is the number one reported problem that our veterans returning home from combat have to endure.

According to VA data, over half a million veterans are receiving prescriptions for opioids. The number of veterans with opioid use disorders has grown 55 percent over the last 5 years alone. Additionally, the American Public Health Association found that veterans are twice as likely to overdose on prescription opioids as are members of the general population.

Of course, pain management isn't just a stand-alone problem for our veterans. The injury leads to co-occurring mental health disorders like brain trauma or post-traumatic stress disorder. Approximately one out of every three veterans seeking treatment for substance use disorders also have brain trauma or PTSD.

The amendment incorporates language that I have introduced earlier in the year, the Safe Prescribing for Veterans Act. It will help those who provide healthcare services to veterans learn the latest in pain management techniques, understand safe prescription practices, and spot the signs of potential substance use disorders.

In our country, some of the States have moved ahead already with what this amendment does. There are 14 States in the country that require continuing education so that their physicians are schooled and kept up to speed with the most modern techniques in dealing with opioid abuse disorders. Even though there are 14, that number decreases in some of those States for the people administering these drugs, including nurse practitioners, physician assistants, dentists, and others. So this is a problem that some States are addressing, but we are not addressing as a country to help our veterans.

In those States that have this, they have that requirement for continuing education as part of treating those people who are seeking treatment. But in the remaining States, even if they have some kind of recommendations, there is no guarantee. And for our veterans nationwide, there is no guarantee.

So this is something, I think, that is essential and that we do the most we can do to help the veterans and the heroes that have served us so well as they come back dealing with some of the effects and aftereffects of their combat, to be able to help them and be there for them the way that they were there for us.

This Congress has already acted, in terms of the appropriations process, for the implementation of the costs attendant to this kind of support. This bill will be a corollary bill that deals with guaranteeing that that occurs.

In my own area, just to show you the conflicts of treatment and the diversity of treatment, the Commonwealth of Massachusetts is one of those 14 States that requires all medical personnel, all doctors, to able to have this continuing education requirement. That includes those doctors that serve the Veterans Administration.

However, in my district in the southeast portion of Massachusetts, most of the veterans in my area go to Providence, Rhode Island, for their treatment, which does not have that guarantee. Just to show an example, they have recommendations of what to do, but they don't have that guarantee.

So in my own State, one portion of the State and the veterans served mostly in that portion has that requirement to make sure that is the case. The other doesn't.

I want to thank Mr. Rothfus of Pennsylvania for joining me as a cosponsor of this amendment. I want to thank my colleagues for this.

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

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