Military Construction, Veterans Affairs And Related Agencies Appropriations Act, 2010 - Continued

Floor Speech

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Mr. DURBIN. Mr. President, let me join the Presiding Officer, the Senator from Virginia, Mr. Webb, and Senator Thune in endorsing the concept of this World War I memorial. I am a student--a minor, amateur student of history, and I realize the dramatic impact that war had on the United States. It is amazing to know there is still a surviving veteran from that great conflict.

When I first got involved in politics, I would go to rural counties in Illinois, and there would be a flatbed truck with five or six World War I vets on it. Of course, they are gone. They were a great generation that sacrificed and engaged in a war so far away at such great peril. It is fitting that there be an update of that monument. I have walked by it. In its day, I am sure it was a glorious monument, but it needs attention today for it to be a fitting tribute to the men and women who served our Nation during that great conflict. I heartily support it. I wish to thank Senator Johnson, the chairman of this appropriations subcommittee, for entertaining this as part of his legislation.

I will tell my colleagues we had a press conference today on another issue involving veterans. It is one that means a lot to me, personally, because it involves a family whom I have become very close to. It is the Edmondson family. They live in North Carolina. I met them by chance when Eric Edmondson, who was a veteran of the war in Iraq, was being treated at a hospital in Chicago. Eric was a victim of a traumatic brain injury and in surgery after his injury there was deprivation of oxygen and he has become a quadriplegic and cannot speak. When I first met him 2 years ago, he was 27 years old, a husband and father of a little baby girl. I met his father Ed and his mother Marybeth. They were people who came to a hearing I held on veterans health care. They talked about the journey Eric had made from Iraq to the United States and then to Chicago to the Rehabilitation Institute of Chicago.

They had all but given up on Eric because of his injuries and, at one point, they told his father he would have to be admitted to a nursing home at the age of 27 because there was nothing they could do. It appeared he was headed in that direction until his father said: No, I won't do this to my son.

What followed has been a heroic story--heroism matching, I believe, the courage his son showed in volunteering to serve our country and risk his life--because Eric's father, Ed, started his own personal effort to find the very best place in America for Eric's treatment. He came up with the Rehab Institute of Chicago.

I went to visit Eric at the Rehab Institute, when he was there 2 years ago. When I walked into the room, he was sitting in a wheelchair with a big smile. He cannot speak. We talked a little bit about his treatment there. They invited me to come back. I came back a few weeks later, about 6 weeks later, and they said Eric had a gift for me. I didn't know what they meant by that. His mother and dad each grabbed an elbow, stood him up, and Eric took four steps out of his wheelchair. It was an amazing moment. There wasn't a dry eye in that hospital room that day; that he had made the progress where he could literally take four steps. His father said he would be checking out of the Rehab Institute in Chicago a few weeks after that and invited me to come because, he said: Eric is going to put on his dress uniform and he is going to walk out the front door of this hospital.

I said: I will be there. So was the mayor of Chicago and every other politician who heard about it, and every TV camera in Chicago was there to see Eric make it out the front door, with the help of two attendants by his side. There he was with a big smile on his face in his dress uniform.

Well, Eric returned to North Carolina, and because of the amazing generosity of a lot of local people, they literally built him and his family a home that was wheelchair accessible. Because of that generosity, he had a place to live but still with a very young wife and a baby girl.

His mother and father decided they would quit their jobs and move in with their son and become full-time caregivers to Eric Edmondson, this veteran of the Iraq war, and that is what happened. His father basically cashed in all his savings, sold his home, sold his business, took what he had and dedicated himself to his son--totally dedicated himself to his son.

Over the period of time that Ed and Marybeth were taking care of Eric, they lost their health insurance. But Eric was still being cared for by the veterans system. I went down to visit them in their home. It was clear they spent every minute of every day caring for their son.

Mr. Edmondson asked me to take a look at a bill that Senator Hillary Clinton had introduced called the Caregivers Assistance Act which said the
Veterans' Administration should start off on a demonstration basis to take a look at caregivers, such as the Edmondson family, and give them a helping hand. I asked Senator Clinton as she was leaving the Senate and heading for the State Department if I could take over the bill, and she said I could.

I introduced it in this session of Congress. Senator Danny Akaka, the chairman of the Senate Veterans' Affairs Committee, read the bill and called me and said: I want to move this bill. I want to make it a major piece of legislation to help veterans. That bill was considered by the Veterans' Affairs Committee and was reported out unanimously.

What the bill would do is create a program in the Veterans' Administration for caregivers, such as Ed and Marybeth Edmondson. What it would give them is training so they would know how to take care of their son, a disabled veteran--training in basic first aid and health care.

Second, it would provide them with a monthly stipend which the Veterans' Administration would determine is appropriate so they would have some help in getting by with the expenses of keeping their family together and helping their veteran.

It would also give them a respite for a couple weeks so at least they would be able to have some time off and others would come in and take care of the veteran while they went off and recharged their batteries and came back and dedicated themselves again to the veteran.

It would provide basic health insurance for caregivers as well because that is one of the first things they lose when they give up a job or business to take on this responsibility.

This is just one family's story from our recent war that still goes on. There are others. I met another one in Chicago on Sunday, Aimee Zmysly, who literally married her husband after he came home and became disabled from an operation at a veterans hospital. This 23-year-old woman married this young man who had no family and now is his full-time personal care attendant. Because of it, he can stay home; he is not in a formal facility.

The cost of his care is a fraction of what it would be otherwise, and he has the dignity of being where he wants to be--with someone who loves him very much, who spends every moment of every day helping him.

This is the right thing to do. This caregivers bill is the appropriate thing to do. For at least 6,000 veterans across America, there is a personal family caregiver who makes the difference every day in their lives, a person who will be there for them every second they need them. You cannot buy that kind of help. Even the best medical professionals could not provide the love that comes with that care.

I think the Veterans' Administration, certainly the Senate Veterans' Affairs Committee, recognizes that. That is why this legislation is currently on the calendar of the Senate. It has been here now for over 6 weeks. I had hoped we could pass this before this Veterans Day, tomorrow. But, unfortunately, it is being held by one Senator.

The Senator and I debated it on the floor yesterday. He said he doesn't want us to even consider this bill. We cannot even debate this bill. He would not even offer an amendment to this bill. He wants to stop this bill, he said, because I haven't figured out a way to pay these caregivers.

We reminded him that during the course of this war, we waged this war and paid for it with debt. The former administration did not pay for any of the war expenses. They added them to the debt of the United States. That Senator and others--myself included--voted to continue that war, understanding that it was not being paid for.

Now when it comes to caring for the veterans and the casualties of that war, we have a strict accounting standard, a deficit standard that was not applied to waging a war. Why is it the cost of the war--the bullets and the bombs--does not have to be paid for, but when it comes to the care of our veterans who come home, we have this strict accounting; we cannot consider helping them unless there is some specific way of demonstrating how to pay for it?

I believe we will pay for it, I believe we should have it, and I believe this Senator for veterans in 2009 should lift his hold on this bill and let us consider it on the Senate floor. Let us have this debate. Let us determine who will be covered by it and what kind of coverage they will have.

These caregivers will not quit on us because they will not quit on their veteran. Why should we quit on them? Why should we say we are not going to provide them help when every moment of every day they are helping a man or woman who literally risked their lives for our country and paid a heavy price in doing so?

I also have two other amendments. One of my amendments now pending before the Senate on this appropriations bill is the capstone of a project that I have been working on for a long time.

It seems that right outside of Chicago in Lake County, north of Chicago, is a great veterans hospital known as the North Chicago Veterans Hospital. It is modern. It serves thousands of veterans in the region. It was threatened with closure just a couple years ago, a few years ago now.

Then, coincidentally, not far away, is the Great Lakes Naval Training Center, the training station for all of our new recruits in the U.S. Navy. There is a hospital in the center of the Great Lakes naval training base. It turned out that this hospital needed to be modernized because all of these recruits who once were trained in places such as California and Florida are now coming to the Great Lakes Naval Training Center off Lake Michigan.

I talked with them about combining these two facilities. Can we bring together a Navy hospital and a veterans hospital, put them in one facility and coordinate their activities so they both have the very best?

After years--literally years--of effort, it is going to happen. I thank Senator Carl Levin and so many others for making it a reality. This was a dream that many of us had, and it is on its way to completion.

The amendment I have offered is one that will name this first-of-its-kind medical facility in North Chicago the Captain James Lovell Federal Health Care Center. I think this is a fitting name for this facility.

CAPT James Lovell was one of the first humans to travel in space. From his humble beginnings in Cleveland, OH, he loved flight. In 1944, a 16-year-old Lovell and his friends built a little rocket that shot up 80 feet in the air and exploded. But it hooked him. He wanted to be a pilot.

He went on to graduate from the U.S. Naval Academy in 1952 where he wrote his senior thesis on the feasibility of sending a rocket into space. He married his high school sweetheart, Marilyn Gerlach, the day he graduated. He went on to become a test pilot for the Navy. In 1962, NASA chose him as one of our first astronauts.

He distinguished himself among his space flight colleagues, including Neil Armstrong, Buzz Aldrin, and John Glenn. He will be remembered for launching America into the new age of space. He had success as an astronaut, serving on the early Gemini 7 and Gemini 12 missions. In December 1968, he circled the Moon as a member of the Apollo 8 mission.

Today, the iconic image of the Earth--a world of greens and blues hovering in the vastness of space--is a common sight. But in 1968, the Apollo 8 brought this image of Earth to the people of the world in a way never before seen, in Captain Lovell's own words, ``an oasis in the vastness of space.''

Of all his accomplishments in space, Lovell is best known as the commander of the Apollo 13 mission. In 1970, Lovell and fellow astronauts, Fred Haise and John Swigert, launched what would become one of the most storied flights in NASA history.

The Apollo 13 mission started as the third attempt at a lunar landing by a manned spacecraft. It ended, in the words of author W. David Compton, as ``a brilliant demonstration of the human spirit triumphing under almost unbearable stress.''

The crew's mission started with little difficulty, but a few days into the flight, one of the fuel cells on the Apollo 13 short-circuited, causing a fire that spread to the oxygen tanks.

Lovell radioed back to mission control:

Houston, we've had a problem.

He knew that with the oxygen tanks and the fuel cells compromised, their lunar landing could not be completed.

Apollo 13 had been on a lunar landing course. NASA made a risky decision. It set the spacecraft on a trajectory around the Moon. NASA engineers hoped the Moon's gravitational pull would whip Lovell and his colleagues back toward Earth with the speed they needed to return.

For days the crew suffered from cold, a lack of oxygen, and little nourishment. The world turned its attention to the three American astronauts and to our government's effort to save them and bring them home.

Seventy-two hours after Lovell and his crew had been in space, the Apollo 13 shot around the far side of the Moon and lost contact with mission control. But NASA's bet had paid off and the spacecraft headed home for a successful splash landing in the Pacific.

With the safe return of Apollo 13, Captain Lovell became a great American hero and a great story in American history. He remained with NASA until he retired in 1973. During his 11 years as an astronaut, he spent more than 715 hours in space.

Today, I am proud to say, he lives in my home State in Lake Forest, IL, just a few minutes from this new health care facility.

The story of Apollo 13 has been told so many times as a testament to human ingenuity in harrowing circumstances. Captain Lovell's experience reminds us of our excitement in exploring the final frontier of space.

With this amendment, which I hope the committee will accept, and I hope the Senate will accept, his name will embrace a new effort, not as glamourous and exciting as space travel, but an effort that honors his legacy, providing quality health care for Navy recruits, veterans, and military families.

The second amendment which I have pending is one which will allow rural VA centers to be able to offer incentives for recruitment and retention of medical personnel. A little over 2 years ago, at the VA center in Marion, IL, we had a tragic situation where nine veterans lost their lives in surgery. We found later it was the result of mismanagement and medical malpractice. At that point, they closed down the surgical facilities in the Marion VA and started hiring new people to run the institution.

I am sorry to tell you that it still is not where it needs to be. Progress has been made. A recent hygiene report has given us pause. We realize more has to be done. We still are finding there is a difficulty in attracting the kinds of medical professionals we need at this rural VA facility. This is not the only facility facing it. Many others have as well.

What we are doing is taking existing funds in the VA and allowing them to dedicate a small portion to recruit and retain medical professionals. This is the least we can do to make sure we provide our veterans the very best.

I ask unanimous consent that Senators Rockefeller and Tester be added as cosponsors of my amendment, which I believe is amendment No. 2760.

The PRESIDING OFFICER (Mr. Webb). Without objection, it is so ordered.

Mr. DURBIN. Mr. President, I have learned the hard way how important it is for rural veterans' hospitals to attract good doctors and administrators.

The VA Medical Center in Marion, IL, has had significant problems with quality management and patient safety.

In an effort to help improve quality at this rural medical center, I have spoken with two VA Secretaries, and one acting Secretary, about these challenges and potential responses. I have also corresponded with numerous VA officials, and met with the employees on the frontline of care at Marion.

One thing I have taken away from all these conversations is how important it is to have the best possible providers and administrators in our veterans' medical facilities. And that is easier for Hines Medical Center in Chicago than it is for Marion and other rural health centers throughout this country.

Many rural counties have the highest concentrations of veterans according to the 2000 census. The VA estimates that 37 percent of all veterans reside in rural areas.

In 2007, we were horrified to learn that nine patients at Marion Veterans Affairs Medical Center had died in what turned out to be a terrible lapse in quality management and accountability.

The hospital administrator, the chief surgeon, and others were relieved of their duties, and the hospital stopped offering in-patient surgeries.

Since then, we have been told time and again, that the VA has addressed quality management structures there and has been trying to restart a full continuum of care at Marion.

Last week, we found out that these efforts have not been enough. The VA's IG reported that patient safety and quality management at the Marion VAMC failed again on several measures.

Many are repeats from what was found at Marion 2 years ago. It is clear that Marion VAMC leadership did not right the ship.

Last week, members of the Illinois congressional delegation met with Secretary Shinseki about this most recent report on Marion.

The Secretary talked about how important quality leadership is at the local level and how hard it is to recruit and retain talented, high-performing administrators and doctors to rural facilities.

This is not the first time we have heard this. In fact, the surgical program at the hospital has been shut down for two years because we don't have the personnel to restart it.

Recruitment and retention of healthcare professionals to serve rural populations is a nationwide problem. It is not limited to the VA. And it is not limited to Illinois.

In February, the Director of VA's Office of Rural Health testified that, ``greater travel distances and financial barriers to access can negatively impact care coordination for many rural veterans.''

As far back as 2000, the VA recognized that the large proportion of rural veterans has made it harder for those veterans to access care.

My amendment allows the VA to develop and test a pilot program to attract and retain high quality providers and management to rural facilities across the country. It is one of many efforts to address quality of care for our veterans.

These incentives would only be available to the employee for as long as they were serving in the designated rural areas.

The amendment would allow the VA to spend up to $1.5 million to attract qualified health care providers and another $1.5 million to attract qualified health care administrators to our neediest, most underserved rural VA facilities.

The amendment would also require VA to report back to Congress on the structure of the program, the number of individuals recruited through such incentives, and the prospects for retention of these doctors, nurses, and administrators.

Just last month, the Kansas Health Institute reported that financial incentives are an important part of recruiting and retaining providers to rural areas in the civilian sector.

We need to give the VA similar tools.

Veterans in Marion and Chicago, IL, New York City and Niagara, NY, Dallas and Temple, TX, deserve the same quality of care. As veterans of current wars leave active duty and return to their hometowns, we must be ready to serve them. It is simply the cost of war.

This amendment would give the VA another tool to use as it works to improve its rural health facilities. I encourage my colleagues to support it.

Mr. President, I yield the floor.

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