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S. HRG. 110–378

HEARING ON PENDING LEGISLATION

HEARING

BEFORE THE

COMMITTEE ON VETERANS’ AFFAIRS 

UNITED STATES SENATE

ONE HUNDRED TENTH CONGRESS

FIRST SESSION

NOVEMBER 14, 2007

Printed for the use of the Committee on Veterans’ Affairs

(

Available via the World Wide Web: http://www.access.gpo.gov/congress/senate 

(II)

COMMITTEE ON VETERANS’ AFFAIRS 

DANIEL K. AKAKA, Hawaii, Chairman 

JOHN D. ROCKEFELLER IV, West Virginia 

PATTY MURRAY, Washington 

BARACK OBAMA, Illinois 

BERNARD SANDERS, (I) Vermont 

SHERROD BROWN, Ohio 

JIM WEBB, Virginia 

JON TESTER, Montana 

RICHARD BURR, North Carolina, Ranking 

Member 

ARLEN SPECTER, Pennsylvania 

LARRY E. CRAIG, Idaho 

JOHNNY ISAKSON, Georgia 

LINDSEY O. GRAHAM, South Carolina 

KAY BAILEY HUTCHISON, Texas 

JOHN ENSIGN, Nevada 

WILLIAM E. BREW, Staff Director 

LUPE WISSEL, Republican Staff Director 

(III)

C O N T E N T S 

SENATORS 

Page 

Akaka, Hon. Daniel K., Chairman, U.S. Senator from Hawaii ........................... 1

Burr, Hon. Richard, Ranking Member, U.S. Senator from North Carolina ....... 2

Murray, Hon. Patty, U.S. Senator from Washington ........................................... 3

Sanders, Hon. Bernard, U.S. Senator from Vermont ........................................... 5

Tester, Hon. Jon, U.S. Senator from Montana ...................................................... 5

Craig, Hon. Larry E., U.S. Senator from Idaho .................................................... 9

(1)

HEARING ON PENDING LEGISLATION 

WEDNESDAY, NOVEMBER 14, 2007 

U.S. SENATE, COMMITTEE ON VETERANS’ AFFAIRS, Washington, D.C. 

The Committee met, pursuant to notice, at 9:33 a.m., in room 

562, Dirksen Senate Office Building, Hon. Daniel K. Akaka, Chairman of the Committee, presiding. 

Present: Senators Akaka, Rockefeller, Murray, Brown, Tester, 

Sanders, Burr, Craig, and Isakson. 

OPENING STATEMENT OF HON. DANIEL K. AKAKA, CHAIRMAN,

U.S. SENATOR FROM HAWAII 

Chairman AKAKA. The Senate Committee on Veterans Affairs 

will come to order. I want to say aloha to everyone and welcome 

to today’s markup of legislation that is pending before the Committee on Veterans Affairs. 

This is our second markup of this session, the first with Senator 

Burr serving as our Ranking Member, and it is focused exclusively 

on health care matters. We have four items on the agenda. 

Before we begin the actual markup, I have a comment on the 

CBS News report on what they are calling the ‘‘veteran suicide epidemic.’’ The report that the rate of suicide among veterans is double that of the general population is deeply troubling to me, and 

simply unacceptable. 

I am pleased that earlier this month, President Bush signed into 

law the Joshua Omvig Suicide Prevention Act, legislation that we 

reported this summer. In light of the grim news in the CBS story, 

I hope that the sense of urgency which has guided the committee’s 

extensive action on mental health issues this session will continue. 

In particular, I am pleased that the Ranking Member and I have 

been able to find agreement on a comprehensive and very substantial mental health bill. For too many veterans, returning home 

from battle will not bring an end to conflict. They will return home, 

but the war will follow them in their hearts and minds. Invisible 

wounds are complicated and wide ranging and our solutions must 

rise to the challenge. 

There is no question that action is needed. One in five Iraq war 

veterans are likely to develop PTSD, as studies have estimated, 

and this is but one aspect of the mental health challenges faced by 

veterans. 

In April, the committee held a hearing on veterans’ mental 

health concerns and on VA’s response. We heard heart-wrenching 

testimony from the witnesses. Randall Omvig spoke of his son’s 

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suicide upon returning from Iraq. Tony Bailey spoke of his son’s 

struggle with substance abuse and of his death. Patrick Campbell 

shared his own experience with PTSD and the experiences of his 

close friends. Witnesses urged us to learn and they urge us to act. 

The provisions of this bill are a direct outgrowth of that hearing 

and the testimony given by those who have suffered with mental 

health issues and by their family members. This bill addresses the 

immediate needs of veterans by ensuring high-quality mental 

health services at VA facilities and in their communities. The bill 

also looks to the future with a renewed focus on research. 

Also on the agenda is the Veterans’ Pain Care Initiative. This bill 

would enhance the VA’s pain care management program through 

better clinical practices and the coordination of research and education. The management of chronic and acute pain is especially 

critical today as advances in battlefield medicine have allowed 

many service members to survive injuries that otherwise would 

have been fatal. Many of these veterans now face conditions such 

as TBI and polytrauma. Effective pain management is an important part of improving the quality of life for all wounded veterans. 

Senators Murray and Craig worked together on the legislation to 

establish Epilepsy Centers of Excellence within the VA health care 

system. We know of the elevated risk for seizures among veterans 

who have suffered a TBI. This underscores the need for better understanding of epilepsy and more effective treatment strategies. 

Finally, we have Senator Brown’s legislation directed at fixing 

the problems associated with reimbursement procedures for veterans who receive emergency care at non- veteran VA facilities. His 

field hearing in Ohio unearthed issues with the transfer rules implemented by VA that control reimbursement. This bill will ensure 

veterans need not worry about where they are treated in an emergency. 

In conclusion, I thank all the members for their participation and 

hope that we can move forward in the legislative process in a spirit 

of bipartisan cooperation. Thank you. 

Now I will call on our Ranking Member for his remarks. 

STATEMENT OF HON. RICHARD BURR, RANKING MEMBER,

U.S. SENATOR FROM NORTH CAROLINA 

Senator BURR. Aloha, Mr. Chairman, and thank you. 

Chairman AKAKA. Aloha. 

Senator BURR. This is an incredibly important markup and the 

committee’s attention on this legislation to address the health care 

needs specifically of our nation’s veterans. 

First, I would again like to compliment the Senator from Ohio for 

his legislation to address a problem with the current payment 

structure for emergency care provided outside the VA health care 

system. I noted at our hearing in October that I thought this was 

a fine example of the way in which good legislation is produced and 

I am proud to support Senator Brown’s initiative today. 

Second, Mr. Chairman, I especially appreciate your willingness 

to work with me to improve a couple of the bills that we are considering today. As you know, our staffs have been in discussions about 

the pain care legislation, S. 2160. I look forward to working with 

you to ensure that before S. 2160 passes the Senate, it focuses the 

3

proper attention on the issue of pain management and the needs 

of our veterans who suffer from debilitating pain. I believe we can 

do so without getting too far down into the weeds of the everyday 

practice of medicine. By working together, I am sure that this goal 

can be accomplished. 

In addition, Mr. Chairman, I want to thank you for working with 

me to make some changes to the mental health bill that is before 

us today. I am proud to be a cosponsor of the bill and I think we 

have made a number of improvements with the version that is before this committee today. Of course, I think we could make the bill 

even better by adopting some of the amendments that have been 

noticed, but I will wait until later on to talk about that. It is my 

hope that we can get an eighth member back in, Mr. Chairman, 

and we can very quickly get this bill passed. 

But again, I thank the committee. 

Chairman AKAKA. Thank you very much. Senator Murray? 

STATEMENT OF HON. PATTY MURRAY,

U.S. SENATOR FROM WASHINGTON 

Senator MURRAY. Thank you, Mr. Chairman and Ranking Member Burr. 

Before I talk about the important bills that we are considering 

today, I, too, want to take just a couple minutes to talk about the 

CBS special news report that was on last night. I hope that everyone here had an opportunity to see that, and if you didn’t, that you 

go back and take a look at it. I believe the second part is going to 

be tonight. It talked about a subject that is very tragic and really 

receives too little attention in our country today, and that is the 

number of veterans who are taking their own lives. 

CBS did a 5-month investigation and found that 6,256 veterans 

committed suicide in 2005 alone—6,256. That is a death rate of 

about 120 a week. That is twice the national average for other 

Americans. Even more importantly, it found out that veterans between the ages of 20 and 24 that were most likely to serve in the 

War on Terror are taking their own lives at rates that are estimated between two and four times higher than the same age group 

in this country. 

Those findings, I think, are just horrifying and they are really 

tragic, and Mr. Chairman, I hope it makes us refocus again on 

what we need to be doing to go out and find those young men and 

women and make sure they are getting the help and support they 

need in all of our communities. Truly, if these statistics don’t wake 

up this country, nothing will. 

Mr. Chairman, you talked about the hearing that we had and the 

testimony we had from Joshua Omvig and Justin Bailey, two veterans who tragically took their own lives after they returned home 

from Iraq. Their families’ heartbreaking testimony and their advocacy did lead us to pass the Joshua Omvig Suicide Prevention Act 

that was the first step that I think we need to be taking. It was 

signed into law by the President last week and it was a commendable first step. 

But if we watched that report, none of us, I think, can walk away 

from it saying we have done enough. I think we have to really look 

at what the cost and consequences of this war are, what we are 

4

doing to reach out. We need to wake up our neighbors, our communities, our employers, our schools, and have them look around and 

saying, is there anybody here that I can reach out to and bring in 

and make sure they get the help. And I really hope that this wakes 

up the White House and that they take a very tough stance and 

reach out and make sure we are getting the numbers so that we 

can follow up and do what we need to be doing here. 

So, Mr. Chairman, I just wanted to mention this at the top of 

this and thank you and Ranking Member Burr and say we have 

got a lot more to do. 

With that said, I do want to say that I look forward to working 

with you on the bills that are in front of this committee today and 

hope that we can get them passed to the President quickly. 

I do want to thank Senator Craig for working with me on the 

Epilepsy Centers of Excellence bill that is being considered today. 

You know, our bill will simply ensure that the VA is prepared and 

equipped to deal with what is going to be one of the long-term impacts of traumatic brain injury. It is a topic we have had a lot of 

discussion on here. We establish six Centers of Excellence in the 

VA system. It is based on the successful MS Centers of Excellence 

and Parkinson’s disease research and education clinics that are 

currently operated by the VA. We know very little about the longterm impacts of TBI today and it is too early to determine what 

they are for our veterans from Iraq and Afghanistan, but we do 

know from past wars that many of the injuries associated with 

service take years or even decades to develop, so we have to be 

doing what we can right now to be prepared for these veterans 

with traumatic brain injury and what they are going to be facing 

down the road. So I thank you very much, Mr. Chairman, for considering that. 

And one final comment. I am deeply concerned, at a time when 

we face so many challenges with our veterans, and this committee, 

in fact, has passed two good bills. Mr. Chairman, I heard you out 

on the floor this week trying to get them up for a vote. But we all 

know that the President made a splash by actually announcing a 

head of VA on October 30, General James Peake, but it has been 

2 weeks and this committee still hasn’t gotten the papers, so we 

can’t move forward on considering this nomination until we get 

those. Mr. Chairman, I hope that the White House moves expeditiously so that we can get that nominee in front of us so we can 

put somebody in charge of the VA at a time where we have a lot 

of critical issues that need to be addressed. 

Thank you very much, Mr. Chairman. 

Chairman AKAKA. Thank you very much, Senator Murray. 

Senator BURR. Mr. Chairman, could I inform Senator Murray 

that it is my hope that all of that paperwork will be here on Thursday. Clearly, the White House has expedited the FBI report. Until 

that officially comes up, the questionnaire that goes from the committee—but we are working on an expedited timeframe. It is my 

hope that the Chairman is in agreement that when we return from 

Thanksgiving, we would have an opportunity to potentially have a 

hearing and do a confirmation. 

Senator MURRAY. Thank you very much. 

5

Chairman AKAKA. I am glad to hear that. We will move as expeditiously as we can. 

Noticing that we have eight members now present, I invite a motion to take up the agenda items. 

Senator SANDERS. So moved. 

Senator MURRAY. Mr. Chairman——

Chairman AKAKA. It has been moved. Is there a second? 

Senator BURR. Second. 

Chairman AKAKA. It has been seconded. The motion has been 

made and seconded. Is there any discussion on the motion before 

we act? 

Senator TESTER. Mr. Chairman? 

Chairman AKAKA. Senator Tester? 

Senator TESTER. The motion includes all four of the bills? 

Chairman AKAKA. Yes. 

Senator TESTER. Is it appropriate now for me to make a statement and potentially offer an amendment? 

Chairman AKAKA. Let me complete my statement. 

Senator TESTER. OK. 

Chairman AKAKA. The vote is on a motion that the committee 

approve the agenda items en bloc, subject to any subsequently 

adopted amendments. All those in favor, say aye. 

[Chorus of ayes.] 

Chairman AKAKA. Opposed, say no. 

[No response.] 

Chairman AKAKA. The ayes have it and the motion is agreed to 

and the agenda items are ordered reported to the Senate, subject 

to any amendments adopted during the markup. 

Senator Tester? 

Senator TESTER. Mr. Chairman, I would assume by looking at 

the agenda that the only bill that there are amendments for is S.

2162, is that correct? 

Chairman AKAKA. That is correct. 

Senator TESTER. So I will address that bill at this point in time 

and I want to echo my comrades here on this committee for you 

holding this markup. 

I have an amendment that I want to offer at this point in time. 

This amendment will allow the VA to implement a system of automatically enrolling into the VA system the members of the National Guard who are demobilizing after they have served in a combat zone. According to the National Guard Association of the 

United States, only about 55 percent of the demobilizing Guardsmen register in the VA system. Those who do not immediately enroll often encounter delays of several days when they first try to 

get access to health care from the VA. 

If a Guardsman does not register with the VA at the time of demobilization and decides to seek care from the VA, he or she must 

first go to a regional office. In Montana or other rural areas, this 

requires a significant time commitment and travel distance just to 

register. It then takes a day or two to get the name entered in the 

data base, and finally the Guardsman must go to a central VA facility for initial exam. In all, the process may take several days and 

involve considerable cost and time, all of which are disincentives 

for health care. And in the case where the Guardsman’s needs are 

6

mental health services, it may be such a disincentive that he or she 

may choose not to get health care at all. 

I have had a visit with the Ranking Member on this committee, 

Senator Burr, and correct me if I say anything wrong, Senator 

Burr. He has agreed to work with my staff, his staff, and the 

Chairman’s staff to resolve some issues that occur in this amendment, and I will just say that I have agreed to do that and I will 

withdraw the amendment, but I want to make one statement. 

This amendment is the right thing to do. I don’t think there is 

anybody on this committee that doesn’t want to see people who 

fight for this country on the battlefield to get VA benefits. I look 

forward to working with Senator Burr and Senator Akaka on getting this amendment onto the first available bill on the floor that 

we can get it onto. I hope that we hold the bureaucracy’s feet to 

the fire with this and don’t just take excuses for them. We will give 

them the resources they need and get these people in the VA system. 

So with that, Mr. Chairman, I withdraw this amendment. I look 

forward to working with Senator Burr and you to make this 

amendment a reality. 

Senator BURR. Mr. Chairman? 

Chairman AKAKA. Thank you very much, Senator Tester. Thank 

you for withdrawing it. I just want you to know that we will work 

with you at fixing it, as well. 

Senator TESTER. Thank you. 

Chairman AKAKA. Senator Burr? 

Senator BURR. Mr. Chairman, thank you, and I want to thank 

Senator Tester. I think the spirit of what he is proposing, I think 

he stated very correctly. We all share the intent of this. 

I am committed to work with you on the language and to accomplish the intent. As I shared with Senator Tester this morning, one 

of the challenges that we have as we look at the VA is to figure 

out how to better enable the VA to manage the population that 

they have got. I think it is safe to say if automatic enrollment is 

right for the Guard, then it would be right for everybody else, too. 

And all of a sudden, with the automatic enrollment, potentially the 

rolls are so large and the VA’s inability to identify how many people are going to access entry points is so difficult that it would be 

extremely tough for them to get it right. 

So I think there are ways that we can accomplish the spirit of 

what Senator Tester is trying to do, working with other members 

of this committee, working with the Veterans Administration, and 

figure out exactly how to structure it in a way, because I share, 

coming from a State that has many rural areas to it, that sometimes we think it is fairly easy for an individual to enroll or get 

health care, and you are right if you have transportation or if you 

know where to go, and that is not always the case. 

So I want to make sure that what we create, they can manage, 

and what we create doesn’t implode something else in the delivery 

system and create another problem for us. 

Chairman AKAKA. Thank you, Senator Burr. 

Senator BURR. Mr. Chairman, if nobody is seeking recognition, I 

would like to——

7

Chairman AKAKA. I was going to ask you to offer your amendment. 

Senator BURR. Thank you. It is my intention to offer an amendment, Mr. Chairman, and I am, in the spirit of this committee, also 

going to withdraw my amendment. But as Senator Tester said, he 

thinks he is right. I think I am right, too, and it was my intent 

to have everybody vote on it. I am not going to do that, but I think 

it is time, especially hearing you and Senator Murray talk about 

the CBS story, that we admit that as it relates to the mental 

health services, the system that we currently have our veterans in 

just doesn’t work. It may work for some, but it clearly doesn’t work 

for all. 

What my amendment would do is very simple. It would create 

an option for veterans, call it Option B. Option A is in place today. 

You come out, you need mental health services, you have a rehabilitation schedule. The likelihood is you file a disability claim. Six 

months, 8 months, 12 months down the road, your disability is approved and you get a check for everything back to the beginning. 

The problem is you have got a veteran then challenged for, one, 

the health care that they need, and two, the cash that they need 

to survive. My option would say we leave it totally up to a veteran. 

You can enter that system. You can file a disability claim. You can 

roll the dice on when that comes due and then be approved for a 

monthly check. Or you can say, I am willing to delay filing my disability claim and I am willing to accept up to a year of the type 

of rehabilitation a medical professional tells me I need. And if I enroll in that rehabilitation, I get a cash stipend right up front. And 

every 90 days that they can verify that I have gone for treatment, 

I get another cash stipend. And if the treatment schedule is 6 

months or if it is 9 months, up to 12 months, I will delay filing my 

disability claim until I have completed the rehabilitation. 

You see, the system today is not designed truly to make somebody well again because it is left up to them as to whether they 

come for the appointment. Now, Senator Murray, I know, is passionate about this. We have to find an incentive that encourages 

these veterans to actually come for their treatment. 

My fear is that when they are strapped for cash, the likelihood 

is they will not show up for the appointment. As a matter of fact, 

Mr. Chairman, just in the Los Angeles Times yesterday, there was 

an in-depth article. I won’t read it for everybody, but I will read 

two lines at the end of it that I think summarize it very well. 

‘‘The months go by. One disability check comes and then the 

next, about $2,500 a month. Miller sees Barringer, the psychiatrist, 

but only occasionally.’’ Sometimes you just have to look at the culture of a small town—I won’t name the State. Blake graduated 

from high school and had no future, so he joined the Marines and 

now he is home and has a steady income. Things are good. But 

sometimes, that is more of a negative than a positive, he said. Look 

at every time you go out to the mailbox and you get a disability 

check. It tells you how sick you are. 

What we can do is we can offer veterans an option, a choice, 

something that they get the opportunity to exercise up front. Do I 

want treatment, rehabilitation, and recovery, or do I want the system that we have got right now where once I start getting my 

8

check, I am less likely, because it is permanent, to come in and 

seek treatment? 

I would only challenge my colleagues, if you believe the system 

that we have today works, then don’t work with me. If you believe 

the system that we have today is broken and we have to change, 

then come with a better idea or help me to perfect this one, because I think our veterans deserve an option that is different than 

what we have currently got. 

Plain and simple, the Dole-Shalala Commission came out and 

recognized it. The Disability Commission recognized it. The Disability Commission felt so strongly about focusing on the treatment 

of those with mental health, particularly PTSD, that they recommended that we condition the receipt of compensation on the receipt of treatment. Condition the receipt of compensation on the receipt of treatment. That is all we are doing. 

We are actually saying, we are going to give you a cash incentive 

to be treated, to actually go to your appointment, to get the rehabilitation that we all agree you have to get if you want the outcome 

to be different. It is not to get around disability claims. It is not 

to get around a disability payment. It is to say, if we can take 

somebody from this level of disability and through rehab get them 

to this point, their quality of life is better because we have encouraged them, created the incentive, pushed them, challenged them to 

get the services they need. 

I believe it is important. I believe it is important that we try 

something different. If this is not it, share with me what it is we 

need to do. But I think this certainly sets a marker out there that 

we are willing to think outside the box to make sure that our veterans get the type of treatment and that they are committed to actually go. 

I thank the Chair. 

Chairman AKAKA. I want to thank you, Senator Burr, for withdrawing your amendment, but I also want to urge you to introduce 

this amendment as a bill. When you do, I will tell you now that 

certainly I will hold a hearing on that so we can deal with it. 

Senator BURR. Thank you, Mr. Chairman. 

Chairman AKAKA. Thank you very much. 

Senator MURRAY. Mr. Chairman, could I just comment? 

Chairman AKAKA. Senator Murray? 

Senator MURRAY. Senator Burr, I want to thank you for your trying to reach outside the box and deal with this issue, and I am glad 

you withdrew this and I hope, Mr. Chairman, that he does introduce it as a bill, that we do have the time to look at it. I would 

just tell you that for many of our veterans, it isn’t the benefits 

check, it is that they are lost in a remote community and they have 

no idea why they go home and have nightmares or don’t understand why they can’t remember where their keys are or why they 

feel that they are a different person and they really feel that this 

country doesn’t understand them. That is why they often reach the 

end of their rope. 

I think an important part of any package we put together has 

to have a better support system for families, and that is who we 

always leave behind in the VA. We take care of the veteran themselves. We talk about that all the time. But it is the mothers, the 

9

fathers, the sisters, the brothers, the wives, the husbands who really need the support network and who need to know how they can 

reach out when they see their loved one getting lost and not knowing where to turn. 

So I will take a look at what you have offered. I would like to 

see it and see what the consequences are. I fear that if we tell 

someone they cannot seek a new claim for a year, that some of 

these men and women who come home who don’t even understand 

what has happened to them will fear that a few months down the 

road, they will discover they have traumatic brain injury and they 

will be denied the ability to change any claim if they have already 

said that they have mental health conditions, and I don’t want to 

put anything on someone that will tell them, I don’t want to seek 

treatment for mental health. 

So I think we have to be very cautious as we move forward and 

I urge this committee to look at all options, but I hope, Mr. Chairman, that what we really look at is how we are reaching out to 

family members themselves to give them the support they need to 

get that government in for care. 

Chairman AKAKA. Thank you very much, Senator Murray. 

Senator CRAIG. Mr. Chairman? 

Chairman AKAKA. Senator Craig? 

Senator CRAIG. Mr. Chairman, I am going to have to leave for 

another hearing. I wanted to ask unanimous consent that an opening statement that reflects the nominee that we are going to have 

before us in a few moments become a part of the record. 

Chairman AKAKA. Without objection, it will be made a part of the 

record. 

Senator CRAIG. Thank you. 

Chairman AKAKA. Are there any other comments? 

Senator BURR. Mr. Chairman, can I just respond to Senator Murray real quick? I just want to make two points. 

Chairman AKAKA. Senator Burr? 

Senator BURR. One, no veteran would have to give up his or her 

right to receive compensation. Veterans at any point could file their 

disability claim. However, the wellness stipend that I have talked 

about would only be paid if the veteran agrees to stay faithfully in 

the program and to hold off of the claims during that treatment. 

Second, a veteran doesn’t have to give up compensation in order 

to receive the wellness program. The stipend would be lower if the 

veteran is already in receipt of compensation, but this program is 

designed to encourage service-connected conditions to get treated, 

as well. There is no requirement that compensation be reevaluated 

at the end of the year if the treatment works, and the Institute of 

Medicine says it does, that this is very crucial, then the veterans 

will have a better life to live as they seek additional treatment. 

I really want to stress with my colleagues, this is not a substitute, this is an option. This is to say to a veteran, here is the 

pathway. This is the one we have got today. You evaluate it. Here 

is another one. If this fits your condition, if it fits your expectations, if it fits your financial needs better, then the option is to 

choose it. At any time if you want to stop if you are in Option B, 

stop and go back and file your disability claim and eventually get 

a monthly payment, that is fine. 

10

But I truly believe that we have to recognize the fact that today, 

for whatever host of reasons, that a person is seeing there are mental health services that are needed, they may start the first week, 

the first month, but over time, they begin to miss those appointments and we know—we know and the medical profession has 

proven that a satisfactory outcome for mental health involves a 

very regimented schedule of individuals receiving services. I want 

us to simply try something that encourages these kids to actually 

get those services. 

Senator MURRAY. Mr. Chairman, I would commend that. I would 

just remind you that too many of our veterans have called for an 

appointment and haven’t gotten one, so we have to make sure that 

we have enough resources available that they are not denied those 

services once they try to enter the VA. But I don’t disagree with 

you that getting them in to get the counseling is absolutely critical. 

Finding a way to incentivize that and make it happen is truly important. 

Chairman AKAKA. Thank you very much. 

Well, I believe that concludes the amendments. 

Before we adjourn this markup, I express my appreciation to 

each of the members of this committee as well as their staffs who 

have worked hard on this. In my opinion, we have produced a solid 

body of legislation that will benefit millions of veterans and their 

families. I extend a big thank you to the Ranking Minority Member 

and his staff for their contributions to this process. I look forward 

to continuing to work together with all of you in the weeks and 

months to come. There is much that remains to be done, but we 

have made a large step in the right direction. 

After I adjourn this markup, which I will do shortly, we will 

reset the room and proceed to a hearing on a nomination. 

This markup stands adjourned. 

[Whereupon, at 10:07 a.m., the committee was adjourned.]

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