Emergency Supplemental Appropriations Act, 2005
EMERGENCY SUPPLEMENTAL APPROPRIATIONS ACT, 2005 -- (Senate - April 12, 2005)
Mrs. MURRAY. Mr. President, today in Iraq and in Afghanistan, our men and women in uniform are making great sacrifices to serve our country. Last month I had the opportunity to meet with some of them in Baghdad and in Kuwait and all of us can be very proud of their service. Every person I met with was a dedicated professional who was putting their duty above their personal well-being.
Today, I am very concerned that when all of these new veterans come home and need medical care, they are going to be pushed into a veterans health care system that does not have the medical staff, the facilities, or the funding to take care of them.
There is a train wreck coming in veterans health care. I am offering an amendment to deal with this emergency now before it turns into a crisis. The VA health care system is overcrowded. It is underfunded. It is understaffed. It is struggling to deal with existing veterans. I fear what will happen when tens of thousands of our new veterans are added to this already strained system.
As Americans, we make a promise to those who join our military that we will take care of them when they come home. It is a promise all of us have to work together to keep, and that is why I am on the Senate floor today. This is not a Democratic issue. It is not a Republican issue. This is an American issue. I am willing to work with anyone to make sure all of our veterans get the health care they are promised.
I appreciate the leadership of many Senators, especially Senator Craig who chairs the Senate Veterans' Affairs Committee on which I serve. I thank Senator Hutchison of Texas who chairs the committee that funds veterans health care. I truly appreciate their commitment to our veterans. I look forward to working with them, and I will work with many others to make sure we are doing everything we need to do to prepare for the influx of many new veterans.
With Senator Akaka and others, I am offering a veterans health care amendment to this emergency supplemental. Our amendment recognizes that caring for our veterans is part of the cost of war. This is being offered on the emergency supplemental because our amendment recognizes that caring for our veterans is a part of the cost of war.
Our amendment does three things: First, it makes sure all soldiers who need health care when they return home from Operation Enduring Freedom and Operation Iraqi Freedom can get that health care. To do that, this amendment provides $610 million. Second, it provides funding for mental health care for our newest veterans. Specifically, it provides $525 million for expanded mental health services, including $150 million to treat post-traumatic stress disorder for counseling, as well as family therapy. Third, the amendment helps address the shortfalls that are crippling our regional VA networks. It provides $40 million to each and every VISN, Veterans' Integrated Service Network.
This chart shows the 21 regional health networks. For each region, our amendment provides $40 million to spend on their priorities. For some areas it is going to mean erasing big deficits. For others it will help them hire more medical staff. In other parts of the country they will use it to buy medical equipment. That flexible funding that each VISN gets will allow each region to prepare their staff and facilities for our newest veterans. It will put a total of $840 million where these local communities need it the most.
In short, this amendment will ensure that we can handle the health care needs of all the veterans who will seek care after serving our country in Operation Iraqi Freedom and Operation Enduring Freedom.
The total cost of the amendment is $1.98 billion. Let me explain how we arrived at that figure. First, we looked at the number of new veterans who will return to the VA for care. We multiplied that by the average cost per patient and added the cost of reversing the deficits that are today facing our VA hospitals and the cost of meeting increased mental health care needs that everyone assures us we are facing.
Some Senators may wonder if this is the appropriate vehicle to fund veterans health care, so let me talk about that for a minute.
I would have preferred to fund this critical need in the regular budget process. I tried to do it several times last month in the Budget Committee and on the floor with Senator Akaka. Unfortunately, our amendments were voted down. But the need is not going away. The shortfalls are only going to get worse. So if we are not going to take care of our veterans from Iraq in the regular budget, then we have to take care of them in the bill that funds our war efforts. This is the appropriate bill because the veterans health care train wreck is an emergency, and because caring for our veterans is part of the cost of war.
As I have been talking about this amendment and discussing it with our veterans, I have been pleased by the support it has received. This amendment is supported by the Veterans of Foreign Wars, AMVETS, Disabled American Veterans, Paralyzed Veterans of America, and it is supported by the VA workers who care for our veterans, represented by the American Federation of Government Employees, AFL-CIO. I thank all of these organizations and their members for supporting my amendment and reaching out to their Senators to call for its passage.
Before I go any further, I want to note that veterans health care is a very personal issue for me. My father was a disabled World War II veteran. I grew up knowing the sacrifices that our veterans make. When I was in college, I interned in our VA hospital in Seattle during the Vietnam war, and I saw how important the services were to our soldiers who were returning. I became the first woman to serve on the Senate Veterans Affairs Committee. I know what the costs are and I know what the challenges are.
The VA provides some of the best care, research, and treatment anywhere. Our VA employees have a unique understanding of the challenges that our veterans face when they return, and their dedication is unmatched. Like them, I want to make sure this system works for every veteran of every war and every generation.
I will share some specific examples from throughout our country that illustrate the emergency in veterans health care today. These examples didn't come from me. They came from people who know our VA facilities firsthand. A couple days ago, I posted a form on my Web site, murray.senate.gov, where veterans and their advocates can share their stories and examples with me. I have been heartened with the things people have shared. I invite other veterans to share their stories with me and with their own Senators.
For anyone who thinks this is not an emergency or it doesn't merit emergency funding, I invite you to listen very closely. I am going to talk about different places, but the overall problem is the same everywhere.
For years, VA funding has not kept up with the growing demand for care and with the rising costs of health care. So VA networks around our country have held off making improvements. When a doctor or nurse left, they were not replaced. When equipment needed to be purchased, it was put on hold. When a clinic needed to be opened, it was held in limbo. When there wasn't enough money in the operating budget, they started taking money from their capital budget.
Now all those years of chronic underfunding are coming back to roost at the worst possible time, as we are about to have a major influx of new veterans, men and women serving honorably in Iraq and Afghanistan today, when they are returning, our VA facilities across the country are facing deficits, staff shortages, and inadequate facilities.
Let me give a couple of examples that have been shared with me.
In Alaska, as of yesterday, they are starting a waiting list for nonemergency care for all new priority 7 veterans who are not enrolled in VA primary care. That means those people cannot get an appointment to even see a doctor.
In Colorado, the Eastern Colorado Health Care System is $7.25 million short this year.
In California, last year, the VA hospital there in Los Angeles closed its psychiatric emergency room.
In Florida, the VISN 8 facilities were facing a $150 million deficit earlier this year. West Palm Beach Medical Center has a deficit alone of $6 million.
In Idaho, at the VA in Boise, they are resorting to hiring freezes when we have soldiers coming home.
In Kentucky, veterans at the Louisville hospital, who are having a type of bladder examination, have to lie on a broken table because there is no money to replace that broken equipment.
In Maine, the Togus VA has a $12 million deficit.
In Minnesota, at the Minneapolis VA, they have a $7 million shortfall. They have one of the VA's four sites for dealing with veterans with complex, multiple injuries but they are not hiring anymore staff for that specialized center because of the deficit.
All of us who have visited our returning soldiers at Walter Reed or Bethesda know many of them are returning with these kinds of injuries that need to be treated at hospitals such as the one in Minneapolis.
In Missouri, at the Kansas City VA Medical Center, they have a $10 million operating deficit. I am also told that in Missouri there are not enough doctors and providers to see all the veterans. If a veteran is less than 50-percent service-connected disabled, he or she is put on a waiting list.
In South Dakota, they are expecting to be $7 million in the red by the end of this fiscal year. The VA is proposing to save $2 million by not filling staff vacancies. I am told, in fact, they need 58 new beds, and that some of the bedframes in that facility are held together with duct tape and wire. So because of the deficits they cannot even buy new beds. That is unacceptable for our veterans who have served this country.
I am also told that the Black Hills Health Care System is $3 million in the hole. They have had to use the capital budget to pay staff and other expenses.
In Texas, at the Temple, Texas, VA, nurses in inpatient care are working 16-hour days several times a week because there is not enough staff. We know that nurses providing direct care should only be working 12-hour days, because longer shifts lead to medical errors and unsafe care. This is not a way to treat our veterans who are returning.
In Virginia, as of January 1, I understand that Virginia had a budget shortfall of $14.5 million.
In my home State of Washington, we have problems, too. In Tacoma, at the American Lake VA, you can only get an appointment if you are 50-percent or more service-connected disabled. That is not the promise we made to the men and women who serve our country.
In Puget Sound, as of January, there was an $11 million deficit. At the Seattle and American Lake VA they are leaving vacant positions unfilled. There are about 16 new vacancies every month and those positions are remaining empty. They hope to reduce the workforce by 160 full-time equivalents by the end of this fiscal year.
This is having a huge impact on our patients. As of this month, the next appointment at the Seattle VA urology clinic is not available until August. I can tell you that conditions like these are breaking the hearts of our VA personnel who work day in and day out with the men and women who have served this country. They are frustrated at seeing so many veterans not get the care they have earned. Why? Because Congress is not providing the money.
I share these examples not to criticize or cast blame. We have problems such as this in my State as well, as I have talked about. I share these examples because we have to look at what is happening and realize that our VA system is not prepared to handle a new generation of veterans. All of these examples, from more than a dozen States, point to one conclusion: The VA is having trouble taking care of the patients it has today. It is certainly not prepared to handle a new influx of veterans from Iraq and Afghanistan.
Many of these VA centers are in the hole for millions of dollars. They are not in a position today to begin expanding care to meet the growing need. They cannot do it alone. We have to step in and help them.
Before I close, I want to talk about one claim we made here during this debate. Some Senators have suggested that the VA doesn't need any additional funding because it has some kind of reserve for $500 million. I was troubled by the idea that the VA has extra money it is not using while so many communities are struggling, so at a hearing last week of the Senate Veterans' Affairs Committee I got to the bottom of it. I wanted to share this chart with colleagues.
At our hearing on April 7, I asked Acting Under Secretary for Veterans Health Care Dr. Jonathan Perlin:
Is there a $500 million reserve?
Dr. Perlin's reply was:
No ..... I don't know where that might have been suggested, but there is no $500 million reserve that is sitting there for future projects.
I share that with my colleagues to set the record straight. The VA is not sitting on any type of reserve it can use for medical care. That comes straight from the man who runs the program nationwide. We have VA centers that are struggling in every part of our country. They cannot deal with the caseload they have today. How in the world are they going to deal with all of the new veterans who are coming home from Iraq and Afghanistan?
We cannot kick this down the road any longer. It is an emergency today and if we do not deal with it now, it is going to be a crisis tomorrow. This is not a partisan issue; it is an American issue. It is about whether we keep the promise to the men and women we send to serve us overseas.
I am willing to work with anyone who wants to make sure our country is prepared to care for all of the veterans who will be coming home soon. They were there for us. We need to be there for them now. I urge my colleagues to support this veterans health amendment. If you are concerned about this--perhaps I mentioned your State or you have heard from your own veterans--let's talk about it and find a way to make it work.
No matter what party you are in, we are all Americans first. We all have an obligation, as President Lincoln said, ``to care for him who shall have borne the battle, and for his widow, and for his orphan.''
We need to pass a veterans health amendment and keep this promise to America's veterans. This amendment is the last opportunity we will have to make sure our veterans--the men and women serving us--are taken care of when they return home.
BREAK IN TRANSCRIPT
Mrs. MURRAY. Mr. President, let me make a couple of comments. I thank the Senators from Idaho and Texas for working with us on this critical issue. I know both of them have worked very long and hard on veterans issues and care deeply about making sure the men and women who serve are taken care of when they return home, as we promised.
Let me remind everyone, of the 240,000 men and women separated from our services since the beginning of the war in Iraq, 50,000 have already asked the VA for services. Many more of them will continue to do that as they come home and as they get back into their homes and look for services, especially mental health services, as all know who have worked with veterans for a long time.
This is an emergency. If any Members work with veterans in our States, talk to our directors at home, and talk with soldiers who have returned home, we will realize the long lines they are waiting in, the clinics that were promised that have not been opened, the tremendous services that are not being provided.
As I discussed in my opening statement, beds are held together by duct tape in our facilities. This is not how we should be treating our veterans. It is an emergency because more veterans return in higher numbers with the care not available for them.
I am willing to work with the Senators from Idaho and the Senators from Texas over the next several hours, or whatever it takes to come up with a number. If they believe $1.98 billion is too high, I would like to talk to them about that. We can work together. I know both care about this issue, and we want to find a way to make sure our veterans are taken care of.
I remind everyone when we send our men and women overseas, one of the promises we make to them is we will have the care available when they return. When we have veterans who are in beds that are held together by duct tape, when we have veterans who have to endure long waiting lines for simple services, that is an emergency.
I clarify, the money in this bill will be used until it is expended. It does not have to be expended this year. It will be used until expended, allowing our veterans and our veteran services to put in place facilities they need for our men and women coming home.
I close at this time, and I will work with Senators from Idaho and Texas and the chairman of the Appropriations Committee because I believe this is an emergency. I believe we have a responsibility. I will make sure our veterans get the care they need.
I yield the floor.
BREAK IN TRANSCRIPT
http://thomas.loc.gov