will now come to order but before i go into my opening statement i would like to welcome to the hearing today a distinguished group of law students who are spending the summer with the board of veterans appeals many fine law schools are represented and there are veterans members of the national guard and a marine was among the group so again welcome to the hearing today if you'd like to see and i would like to welcome you if anybody is here in the audience today thank you thank you for being with us today i would like to thank everyone for coming and today's legislative hearing actually before i started my opening remark i want to tell the audience that we are scheduled for a vote somewhere between ten fifteen and ten thirty and it's not like it's one or two votes it's going to be about twenty seven of them so what we don't get done i'm going to ask all the panelists to submit their testimony for the record anybody any questions that  but this is an important part of the legislative process so i welcome open discussions from all parties that this legislation would have we have eleven bills before us today and obviously we will probably be submitting most of them for  the amount available for grants and the home improvement structural alteration program the program provides grants as part of the health services to make home improvements that are necessary to continue  the veterans home veterans with service connected nonce or risk connected disabilities are eligible to receive this benefit ninety three would raise the authorized grant amount from forty one hundred dollars to six hundred dollars for service connected veterans and from twelve hundred dollars to two thousand dollars for non service connected veterans it is a good bipartisan bill and i support it in closing fastest growing profession in the country yet the v a is simply not competitive with the private sector for new graduates and is missing an opportunity to improve the quality of veterans health care one of the biggest challenges facing current  afghanistan a rand corporation study estimates that up to three hundred twenty thousand troops who served in these conflicts suffer from brain trauma mild forms of can result  milder forms can result in cognitive problems such as headaches difficulty in thinking memory problems normal speech or language and limited functioning of arms and legs as effects on veterans and their families can be devastating i've met personally with several veterans in my district who suffer from severe brain injury in iraq one is doing well in my home town with a four year scholarship from the sense of freedom i just had lunch with him a couple weeks ago and very pleased to see how well he's adjusted unfortunately many wounded veterans face an even more path to recovery the brain is probably the most adaptable organ of the body but any time there's an injury or section of the brain is damaged it takes time to adjust and compensate when a soldier's wounded first transported to a trauma center to treat brain swelling brain swelling is the biggest and most immediate risk from a brain injury after being stabilized soldiers may face invasive surgical procedures and painful cooling best blasts from improvised explosive devices have become one of the most common cause of injury for troops currently serving in combat zones and recent studies show that fifty nine percent of  hose patients at walter reed have been found to have some form of an april two thousand and seven the veterans administration began screening veterans who served in iraq and afghanistan physical injury which sometimes takes place when a person is within the vicinity of a powerful detonation and these instances signs and symptoms such as the ones i mentioned earlier not readily recognize according to the department of defense and the veterans administration mental health experts can also produce behavioral symptoms similar to post traumatic stress disorder or other mental health conditions and almost always cause post traumatic stress the relationship between post traumatic stress can further compl complicate diagnosis and treatment as a result further research must be conducted to examine the long term effects of these injuries which are not yet fully understood and the best treatment models to address  collect data to ensure that the women veterans the same quality of care as their male counterparts and i am committed to working on this committee to assist in that endeavor when a soldier is transitioning in life it is imperative that we have a system in place that is able to properly evaluate and assess the risks and challenges if any and their families given that for addressing treatment and long term care research into t b i particularly important for understanding post traumatic stress because it often occurs as a result  of the challenges of post traumatic stress treatment studies have shown that in the absence of factual recall individuals may have delusional or reconstruct memories of trauma these individuals imperative that it addresses the twenty first century injuries such as t v i appreciate the testimony comments expressed by all groups of the panel today that i am grateful for their service to this great country i thank i thank you for the opportunity to testify here today mr  yes madam chairwoman how listen thank you ranking member and fellow subcommittee members thank you for allowing me the opportunity to speak on behalf of h r twenty seven thirty eight it was monor and pleasure to introduce this bill and i believe that this legislation will provide some needed relief for the families who care for our nation's veterans twenty seven thirty i would allow family caregivers to give some of their travel expenses paid for when they are accompanied veterans to medical treatment facilities this bill would provide lodging payments a common cost that a veterans family incurs when they are trying to ensure that their loved ones are receiving the care that they me the bill also provides for some flexibility on the defamation of character givers realizing that in this day and a veteran may not have immediate family members caring for them this bill also recognizes not only them each family caregivers that reside with the veteran but also extended family members and stepchildren that may not reside with the veteran missed chairwoman i don't need to tell anyone in this room or in this congress that access to health care is not as easy as they should be or in my district and in many other districts that are real it's even harder while my district is roughly the same geographic size as the state of pennsylvania there is no veterans house take them to the states only be a hospital in albuquerque while this legislation does not create new hospitals it helps to like travel easier for all of our veterans living in rural areas they can make a trip to the v a facility and have their family assist them with that journey and not have the added worry of wondering how they will apply for such a trip during these difficult financial times if an examination at the hospital takes a bit longer than usual they don't have to rush back home late at night we can now give them some peace of mind with this madam chairwoman i believe that this is the least we can do for our nation's veterans after they have given so much in defense of our country i don't think th forcing a veteran to take money out of his pocket or her pocket while they are accessing benefits that they have aren't and i don't think it's the right thing to do we shouldn't make it more difficult for our veterans to get to v a facilities we should take steps to make it easier on them i think that all of my colleagues would agree with me on that statement and i hope that i can have their support on this bill madam chairwoman and writing member i thank you for the time that you've given me to speak on behalf of this building i would also like to thank the staff of the health committee for their assistance expertise and sat on this matter this concludes my testimony and i'm and also my two bills are thirteen thirty five which would prevent the collection of co payments and other fees from catastrophic lee disabled veterans who receive medical or nursing home care from the department of veterans affairs  right now some catastrophic lee disabled veterans are thrown into financial hardship because of the health care co payments that they must pay to the v a catastrophic disabled veterans have severely d conditions that compromised their ability to carry out activities of daily living including such basics as self care eating bathing and dressing disabled veterans in situations like this have enough challenges on a daily basis and scraping together enough money to make their co payment should not be another challenge that they have to deal with and i will allow the rest of my testimony to be included in the record the other bill  nine which authorizes the to make available supportive services to family caregivers who provide critical health care services to our wounded warriors my bill would provide counseling with locating support services from the public and nonprofit agency last year my stepson was severely injured while serving in afghanistan we were just relieved that he was simply alive that of course was our number one priority after that it was clear that he would make it through all of his at walter reed our immediate concern then became how are we going to take care of him he was not in a good state and needed constant care we were blessed to have the resources and the time available to drive him to his rehabilitation every day and take care of him at home as he recuperated thankfully after time and rehabilitation he's going to be fine but it was that experience however that has given me the insight to understand the sacrifices that family caregivers a bill that we were able to bring forward at this time if anybody has questions for any of the bills that are before us if not we will bring up pan health care for family caregivers act of two thousand and nine in the words of former first lady rosalyn carter there are only four kinds of people in the world those who have been those who are currently caregivers those who will be caregivers and those w need mrs carter's observations are particularly telling when considering our brave men and women in uniform today more than ever revolutionary advances in military medicine has significantly increased the servicemembers chances of surviving a catastrophic combat but in many cases surviving such injuries is only half the battle recovering requires a long term commitment not only from the veteran but also from those who love and care for the better simply stated taking care of our veterans taking care of those who care for them when they are unable to care for themselves once an injured better and returned home from treatment at a hospital it is often a mother father decisions regarding professional goals commitments and obligations twenty seven thirty four health care for family would help provide some relief to those family caregivers with the difficult decisions related to caring for a veteran confronting a catastrophic injury the bill would expand extend benefits to eligible family caregivers of a select group of veterans defined as those who receive special monthly compensation for aid and attendant care and homebound care under title thirty eight benefit is limited to the primary family caregiver health care coverage family members are defined to include nuclear and extended family members as well as family members and there is no residency requirement whereby the family member must live with the better because many family caregivers leave their positions of employment to undertake the full time task of caring for the veteran bill also exempt eligible family caregivers from deductibles and those for their continued support i would also like to thank the department of veterans affairs for their testimony and willingness to work cooperatively to advance responsible legislation which effectively addresses the needs of veterans and those who care for them i look forward to meeting with leaders and  thank you was meant since there is seven minutes left for us to vote what we're going to do is the panel three and panel four instead of making you wait til we're done with our twenty seven votes or somewhere around there we're going to have you all submit your testimony for the record and we'll have anybody with questions will submit them and we'll make sure everybody has a record of that with that with that i'd like to