Veterans' Access to Child Care Act
Floor Speech
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Mr. TAKANO. 840.
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Mr. TAKANO. Madam Chair, I yield myself such time as I may consume.
Madam Chair, I rise in strong support of H.R. 840, the Veterans' Access to Child Care Act.
We ask our servicemembers to risk their lives in service of our country, and in return, we promise to provide healthcare and benefits so they can live happy, healthy, and successful lives, and provide for their families.
As our veteran population becomes increasingly diverse, as the number of LGBTQ and minority and women veterans goes up, we must ensure every veteran has the opportunity to access their healthcare and benefits. Addressing underserved veterans is a pillar of my VA 2030 vision, which will drive our work on the Committee on Veterans' Affairs in the 116th Congress.
I proudly chose Congresswoman Brownley's Veterans' Access to Child Care Act as the very first bill our committee would bring to the House floor because it addresses a sometimes overlooked group of veterans: veterans who are parents and caregivers to young children.
Providing cost-free, safe, and convenient healthcare so that veterans can see a mental health provider for treatment of post-traumatic stress, military sexual trauma, cancer resulting from exposure to Agent Orange, spinal cord injury, or even treatment for drug or substance abuse is the least we can do to make their lives easier so they, in turn, can be loving parents and caregivers to the children who depend on them.
Under my leadership of the most diverse and talented Committee on Veterans' Affairs in the history of this Chamber, underserved veterans, especially women veterans, minorities, LGBTQ veterans, and veterans from our tribal communities, homeless veterans, and even deported veterans will be a top priority.
We will work together to shatter the barriers and structural challenges underserved veterans face in this country they selflessly served by first attending to their most basic and essential needs: healthcare.
Ms. Brownley, the chair of the Veterans' Affairs Subcommittee on Health and the head of the Task Force on Women Veterans, has been a tireless advocate for veterans since being elected to Congress. Her bill makes an already successful and popular pilot program permanent, a program that helps mothers, fathers, grandparents, and caregivers who need their VA healthcare, but struggle to find safe and convenient childcare or struggle to afford the high cost of childcare for their children.
A veteran should never be made to choose between caring for their children and their health. This bill will make sure veterans will no longer have to make this terrible choice.
The Caregivers and Veterans Omnibus Health Services Act first authorized the pilot program we are making permanent today. Under the pilot, VA could provide childcare services to eligible veterans seeking mental healthcare, intensive mental healthcare services, and other intensive healthcare services that require veterans to travel to VA hospitals, clinics, or vet centers for regular or frequent appointments.
The first childcare program started at the VA Medical Center in Buffalo, New York, in October of 2011. Within 2 years, VA expanded the program to Northport, New York, and American Lake, Washington, and later brought childcare to Dallas, Texas.
The 2-year pilot program was meant to end in September 2013, but Congress has reauthorized the program for the past 6 years due to its success and popularity.
Since the beginning, over 10,000 children have used the childcare pilot program, and as more veterans and their children use the program, the cost decreased.
Last Congress, the legislation authorizing this program passed unanimously, and now we will have an opportunity to improve this already great bill with amendments we will be considering today and tomorrow. I am optimistic this bill will pass with the same bipartisan, unanimous support.
So I am very excited to work with Dr. Roe, the ranking member of our committee, on this bill and on future bipartisan legislation.
Before I give him a chance to share his thoughts on this bill, I would like to share one of the anecdotes we received from a social worker who helps homeless veterans under the Department of Housing and Urban Development-Veterans Affairs Supportive Housing Program, otherwise known as the HUD-VASH program: ``Just this week a female veteran with a 3-year-old son discussed childcare with me. She was so relieved it was still open, because she scheduled a gynecological appointment that she was going to cancel because she had no one to care for her son.
``This is a veteran who came to us homeless with a newborn and unmanaged diabetes. She is now diligently following her medical regimen and consistently makes appointments. She is stably housed in the community, enjoying being a mother, attending college, and working part-time.
``I do not think we would have been able to stabilize her life without the support of childcare to allow her to get to her appointments and receive the treatment, medication, recommendations, and care that have helped her succeed.''
Now, as chairman of this committee, I look forward to sharing more stories of veterans throughout this country whose lives have been improved because of access to VA healthcare.
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Mr. TAKANO. Madam Chair, I yield myself such time as I may consume.
Madam Chair, I thank the gentleman for his support of the bill. I would say, with regard to the amendments, we would have entertained more amendments. I would have been happy to do so had they been germane, and we would have been glad to entertain them, but they were not.
Before I yield to Ms. Brownley, the sponsor of this legislation, I include in the Record a letter of support from the Easterseals. Easterseals, February 6, 2019. Hon. Julia Brownley, House of Representatives, Washington, DC.
Dear Representative Brownley: Easterseals is pleased to again support your Veterans' Access to Child Care Act legislation to increase the availability of child care for veterans who are receiving services or treatment at a U.S. Department of Veterans Affairs (VA) medical center.
Easterseals is a national network of more than 70 nonprofit organizations who deliver local services to help children and adults with disabilities, veterans, older adults and others to live independently and to fully participate in their communities. Easterseals is a leading provider of inclusive child care and early education and development in the United States, providing thousands of young children with and without disabilities with high-quality child care.
Easterseals understands how important access to high- quality child care is to allow parents, including veterans, to go to work and to meet their own health care needs. That is why we supported the establishment of a pilot program at the VA to provide child care at select VA medical centers around the country that qualified veterans could use while at a medical appointment or while receiving medical services. The program has been particularly helpful for female veterans, nearly 30 percent of whom have children living at home. A recent VA report found that 42 percent of female veterans who use the VA reported that finding child care to attend a medical appointment was hard or very hard. When asked about solutions, more than three of out five female veterans surveyed said on-site childcare would be ``very helpful.''
The Veterans' Access to Child Care Act would expand and make permanent the VA Child Care Pilot Program. The legislation would make available a stipend, to cover the full cost of child care provided by a licensed, on-site or private child care center while the veteran receives services, including travel time back and forth to the facility. The legislation is a common-sense next step toward improving access to VA health care to veterans.
Easterseals is pleased to support the Veterans' Access to Child Care Act. In addition, Easterseals stands ready to partner with the VA to provide child care assistance while they attend to their well-being and medical care. Thank you for your leadership on this important issue. Sincerely, Maynard Friesz, Assistant Vice President, Government Relations, Easterseals.
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Mr. TAKANO. This bill is also supported by the American Legion, the Veterans of Foreign Wars, the Vietnam Veterans of America, and other veterans service organizations. So I am pleased to say that we have heard the VSOs weigh in on Ms. Brownley's legislation.
Madam Chair, I yield 5 minutes to the gentlewoman from California (Ms. Brownley), the author of the bill.
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Mr. TAKANO. Madam Chair, I yield 2 minutes to the gentleman from New York (Mr. Higgins).
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Mr. TAKANO. Madam Chair, I yield myself such time as I may consume.
We have the data to show how access to healthcare services improves and saves lives, but I think it is important that we also hear from the veterans and the providers whose lives have been improved by this program.
I would like to share another story from a childcare staffer in Buffalo, New York.
``Buffalo also has a World War II veteran, now 97 years old, who cares for his great-granddaughter. He heard of the service, stopped in to see the facility and ask questions to verify he felt `safe' in leaving her in their care. As primary caretaker for this child, he is so pleased to be able to attend his appointments at his `elderly age' and keep his family close.''
Let me also add, I want to address the reservation, although the ranking member has stated his general support for the bill, but this reservation about the legislation, H.R. 840, lacking a pay-for that was included in last session's legislation, and the pay-for that they said was necessary this time around.
I want to state that H.R. 840 simply makes permanent a program that we, as a Congress, have reauthorized six times since 2013. For none of those six times was the issue of a pay-for really germane. In fact, the CBO has never required that we do it.
The pay-for that the gentleman keeps speaking of will not pay for this program. It will simply take money from veterans and send it to the Treasury, and the VA, still under discretionary funds, will still have to find the money to pay for it.
Each of the six times we authorized this program, not once did my colleagues insist on a pay-for. Only when we are introducing legislation to make it a permanent program does this suddenly pop up as a concern.
In reality, even if we included the pay-for, the Treasury wouldn't see the funds for nearly a decade.
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Mr. TAKANO. Madam Chair, just in response, the pay-for to which the gentleman from Tennessee is referring is under mandatory spending, which would not actually pay for the program. It would be returned to the Treasury, and the discretionary funds simply--there is no pay-for out of the discretionary funds. It is coming out of the mandatory side. It is a very illusory device.
So I want to reiterate that each time this pilot program was reauthorized under the majority, never was there a demand on their part that there be a pay-for.
Madam Chair, I have no further speakers. I am prepared to close, and
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Mr. TAKANO. Madam Chair, I wholly support Ms. Brownley's bill, H.R. 840. I urge my colleagues to join me in its passage, and I yield back the balance of my time.
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Mr. TAKANO. Madam Chair, I thank the gentleman for yielding, and I support this amendment because, by clarifying that community-based outpatient clinics are covered under the bill, we are ensuring that veterans seeking healthcare services at any VA facility are able to receive no-cost childcare.
Mr. DAVID P. ROE of Tennessee. Madam Chair, I have no further speakers, and I am prepared to close.
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Mr. TAKANO. Madam Chair, I claim the time in opposition to the amendment, even though I am not opposed to the amendment.
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Mr. TAKANO. Madam Chair, I rise in support of this amendment to ensure that our taxpayer dollars are spent according to Congress' intent.
I agree that childcare should only be provided to veterans when they are using the childcare to attend their healthcare appointments.
I thank the gentlewoman for working with me to make this amendment bipartisan and ensure it is clear to the VA that they cannot revoke this benefit from veterans for missing an appointment.
The intent of this amendment is not to be an incentive to access care. It is simply to make it easier for veterans to make it to their appointments. It will be up to us as lawmakers to keep close oversight over this program and many others at the Department of Veterans Affairs.
This committee will keep close watch over the resources we provide and the programs we authorize at the VA. We will hold VA leaders accountable when these programs are not carried out according to congressional intent, or made in a haphazard and uninformed manner, or without the purpose of doing what is best for veterans.
I look forward to working with the gentlewoman and my colleagues on this committee to oversee the successful execution of this childcare program so any eligible veterans who need childcare can get it.
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Mr. TAKANO. Madam Chair, I yield 2 minutes to the gentleman from the Northern Mariana Islands (Mr. Sablan).
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Mr. TAKANO. Madam Chair, I yield the gentleman an additional 30 seconds.
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Mr. TAKANO. Madam Chair, I yield myself the balance of my time.
Let me say for the record that I believe, if a veteran is receiving care at a facility, in this case in Hawaii on travel from Saipan, that the intent of the legislation would provide that childcare for the time necessary for that veteran, and it would be at a VA facility. It would be childcare at a VA facility in Hawaii, in this particular case.
Madam Chair, in closing, I do urge that my colleagues support the amendment by Mrs. Radewagen, and I yield back the balance of my time.
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Mr. TAKANO. Madam Chair, I thank the gentleman for yielding.
I support this amendment because veterans are not immune from the opioid epidemic. They are not immune to alcoholism or substance abuse. When a veteran is also suffering from post-traumatic stress or other serious health conditions that may have caused dependency on a substance, we should do everything we can to make sure that veteran can receive care.
I thank the gentleman for offering this very important amendment, and I urge all my colleagues to support it.
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Mr. TAKANO. Mr. Chair, I rise in opposition to the amendment.
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Mr. TAKANO. Mr. Chairman, I rise in opposition to the amendment, which would prevent additional VA hospitals and clinics from providing onsite childcare to veterans receiving care at VA hospitals and clinics.
VA only has four childcare sites throughout the VA system, and this amendment would prevent further expansion of the program by preventing a VA hospital or clinic from even doing basic things to provide convenient childcare, things like covering electrical sockets to make a facility safe for young children or putting up fencing around the playground so children can play safely.
As our colleague, Ms. Shalala, reminded us during the Rules Committee meeting yesterday, and as many parents of young children quickly learn, most private childcare facilities do not allow children to be temporarily dropped off for just a few hours. Childcare facilities need to know whether children are up to date on their vaccinations, have food allergies or other medical conditions to provide safe care.
This means VA must have the flexibility to determine how best to execute this program at each of its facilities throughout the country. If this means that it makes sense to build an onsite childcare center, VA should not be barred from doing so.
I think this amendment was written without considering its effects, which would limit further the expansion of the program and prevent veterans from being able to access childcare and their healthcare when they need it.
Any of us who have been on this committee long enough know that VA has had trouble managing major construction projects. Admittedly, this is what we know on the committee. And I am just as outraged as my colleagues across the aisle when VA construction projects are mismanaged and money is wasted. However, we are talking about minor construction that, in many cases, will be necessary to expand this program to all eligible veterans who need it.
There are other ways in which we can ensure the money for this program is not mismanaged, and it doesn't need to be something as drastic as preventing construction which will, in effect, prevent the program's expansion.
Now, I hope to work with General Bergman and my other colleagues on this committee to prevent mismanagement of construction projects, procurement of the $16 billion electronic health record, and other contracts and programs at the VA; and I pledge to work with the general to ensure funds for construction of childcare facilities are not wasted.
Mr. Chair, I must say that I have to urge my colleagues to oppose this amendment, and
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Mr. TAKANO. Mr. Chair, I would just wish to point out to the ranking member of the Oversight and Investigations Subcommittee of the Veterans' Affairs Committee, General Bergman, that his amendment would not even allow for the repurposing of existing facility space that may exist at a VA.
It is so rigid that it would be difficult to even put protective electrical sockets in to prevent young children from electrocuting themselves. Even minor construction would be prohibited by this amendment.
I am pleased to know that the general is serving on the Oversight and Investigations Subcommittee, and I do plan to work with the chairman, Mr. Pappas of New Hampshire, and him to make sure that VA money is well spent.
As I said, this amendment would simply prevent reasonable expansion of this program, and that is something that members of this committee and Members of this House would not want to see happen.
Mr. Chair, I yield back the balance of my time.
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Mr. TAKANO. Mr. Chair, I thank the gentlewoman for yielding.
I support this amendment because, by clarifying that vet centers are covered under the bill, we are ensuring that veterans seeking healthcare at any VA facility are allowed access-at-no-cost childcare.
Vet centers are particularly attractive to veterans who are uncomfortable in a more clinical setting, and they should be able to seek childcare while they receive their mental health care at a VA vet center.
Mr. TAKANO. Mr. Chair, I claim the time in opposition to the amendment, even though I am not opposed to it.
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Mr. TAKANO. Mr. Chairman, I rise in support of this amendment offered by the gentleman from Kentucky, a new member on the Committee on Veterans' Affairs, and I believe the co-chair of the Bourbon Caucus.
I agree that it is important to require that VA collect data on the effectiveness of its childcare program so we can determine whether veterans are better able to access their healthcare because of this benefit.
As the veterans population becomes increasingly diverse, the VA of the year 2030 that I envision must be prepared to provide healthcare to women veterans, fathers of young children, stepparents and grandparents, and to make sure veterans are able to access their healthcare while also caring for their children.
Congress and VA need reliable data to inform these decisions and determine whether other barriers to healthcare access exist for veterans who care for young children. If the data from this study demonstrates that veterans are less likely to miss appointments and have better healthcare outcomes, it could be used to inform further VA policy decisions to expand the program.
Mr. Chairman, I wholeheartedly support this bipartisan amendment, and I yield back the balance of my time.
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Mr. TAKANO. Mr. Chairman, I thank the gentleman for yielding.
I support this amendment because it will allow Congress to receive the critical data and information it needs to determine how to expand this program and the feasibility of expanding this program to community-based outpatient clinics and VA centers, VA facilities that are away from the main VA medical center campuses but critical for veterans in rural areas to access their care.
While this bill specifically provides the no-cost childcare benefit to veterans receiving care from the VA doctors, nurses, and VA providers, I would like to work with my colleagues on the committee at a future date on whether it may be feasible to provide no-cost childcare to veterans receiving treatment from community providers, or even look at ways we can provide incentives to community providers to offer no-cost childcare on-site when they contract with the VA to provide care to veterans.
I thank the gentleman for offering this important amendment. I support it wholeheartedly, and I urge all my colleagues to do so as well.
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Mr. TAKANO. Mr. Chair, I thank the gentleman for yielding.
I support this amendment because it provides an important clarification that veterans receiving physical therapy for a service- connected disability will be able to access no-cost childcare.
When 50 percent of the veterans treated in VA facilities suffer from chronic pain, physical therapy is a vital part of their treatment that will reduce their need for prescribing opioids. We are in the midst of an opioid epidemic in this country, and many of our veterans, sadly, suffer from opioid addiction because they were prescribed these powerful drugs to treat pain.
We should encourage other treatments like physical therapy, which can address the root cause of pain, and make it easier for them to access this care, which often requires multiple treatments over time.
I thank the gentleman for this important amendment, and I urge my colleagues to support it.
Mr. DAVID P. ROE of Tennessee. Mr. Chair, caring for service- connected conditions is the reason the VA healthcare system exists. I strongly support Congressman Cisneros' amendment and encourage my colleagues to support it also.
I yield back the balance of my time.
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Mr. TAKANO. Mr. Chairman, I rise in opposition, even though I am not opposed to the amendment.
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Mr. TAKANO. Mr. Chairman, I rise in support of this amendment offered by the gentleman from Illinois, which would ensure either parent to a young child would be considered the primary caretaker for a child and, therefore, eligible to receive the childcare benefit.
This amendment is necessary, especially in instances when a veteran is receiving mental health services with a spouse. In instances like this, a veteran could not rely on the spouse to watch a child if it was important that a spouse participate in the treatment.
This will also relieve a significant administrative burden on VA and the veteran: As long as a veteran is a parent to a child and in need of childcare, that veteran would be eligible.
As lawmakers, we should strive to make sure that programs we authorize are not confusing to VA and conduct oversight to ensure our constituents are not confused when the VA rolls out a program. This amendment will make it more clear to VA and veterans that, in families where one or both parents are veterans, they are eligible for this childcare benefit when receiving services from the VA.
I support this amendment, and I urge my colleagues to do the same.
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Mr. TAKANO. Mr. Chairman, I yield back the balance of my time.
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Mr. TAKANO. Mr. Chair, I thank the gentleman for yielding.
Mr. Chairman, I want to make note that we just have gotten a release that the VA has exceeded 1 million telehealth visits in fiscal year 2018. That one-year achievement represents a 19 percent increase over the previous year. I congratulate the VA for that amazing achievement.
I want to make known my support for my good colleague from the Northern Mariana Islands, Mr. Sablan's, amendment, because as VA expands its footprint--and we have just seen how it has expanded its footprint significantly--and that it remains at the forefront of providing treatment via telemental health services, we need to ensure that the VA has the ability to make those telehealth services as successful as their in-person services.
In districts like Mr. Sablan's where veterans are separated from VA healthcare services by the Pacific Ocean, telemental health is often the only manner in which veterans are able to receive mental healthcare from the VA.
Mr. Chair, I thank the gentleman for offering this very important amendment and I urge my colleagues to support it.
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Mr. TAKANO. Mr. Chairman, I claim the time in opposition to the amendment, even though I am not opposed to the amendment.
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Mr. TAKANO. Mr. Chairman, I rise in support of the amendment offered by the gentleman from Texas.
I think all of us can recount concerns raised by our constituents about VA payment processing and late payments to healthcare providers.
Although I am not aware of any issues with respect to VA stipend payments to childcare providers under VA's pilot program, I do think it is important that VA report to Congress on whether it has experienced problems with making timely payments and ask for the resources to address payment processing.
The more data we collect from VA, the better we are able to determine what solutions and resources are needed to improve VA programs and services.
Mr. Chair, I do thank the gentleman for offering this amendment, and
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Mr. TAKANO. Mr. Chairman, I have no further speakers. I urge support for the gentleman's amendment, and I yield back the balance of my time.
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Mr. TAKANO. Mr. Chairman, I move that the Committee do now rise.
The motion was agreed to.
Accordingly, the Committee rose; and the Speaker pro tempore (Mr. Sean Patrick Maloney of New York) having assumed the chair, Mr. Johnson of Georgia, Acting Chair of the Committee of the Whole House on the state of the Union, reported that that Committee, having had under consideration the bill (H.R. 840) to amend title 38, United States Code, to direct the Secretary of Veterans Affairs to provide child care assistance to veterans receiving certain medical services provided by the Department of Veterans Affairs, had come to no resolution thereon.
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