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96–135 2015

LEGISLATIVE HEARING ON H.R. 4720, THE MEDAL 

OF HONOR PRIORITY CARE ACT; H.R. 4887, 

THE EXPANDING CARE FOR VETERANS ACT; 

H.R. 4977, THE COVER (CREATING OPTIONS 

FOR VETERANS EXPEDITED RECOVERY ACT); 

H.R. 5059, THE CLAY HUNT SUICIDE PREVENTION FOR AMERICAN VETERANS ACT; H.R. 

5475, TO IMPROVE THE CARE PROVIDED BY 

VA TO NEWBORN CHILDREN; H.R. 5484, THE 

TOXIC EXPOSURE RESEARCH ACT; AND H.R. 

5686, THE PHYSICIAN AMBASSADORS HELPING 

VETERANS ACT 

HEARING 

BEFORE THE

SUBCOMMITTEE ON HEALTH 

OF THE

COMMITTEE ON VETERANS’ AFFAIRS 

U.S. HOUSE OF REPRESENTATIVES 

ONE HUNDRED THIRTEENTH CONGRESS 

SECOND SESSION 

WEDNESDAY, NOVEMBER 19, 2014 

Serial No. 113–92 

Printed for the use of the Committee on Veterans’ Affairs 

( 

Available via the World Wide Web: http://www.fdsys.gov 


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COMMITTEE ON VETERANS’ AFFAIRS 

JEFF MILLER, Florida, Chairman 

DOUG LAMBORN, Colorado 

GUS M. BILIRAKIS, Florida, Vice-Chairman 

DAVID P. ROE, Tennessee 

BILL FLORES, Texas 

JEFF DENHAM, California 

JON RUNYAN, New Jersey 

DAN BENISHEK, Michigan 

TIM HUELSKAMP, Kansas 

MIKE COFFMAN, Colorado 

BRAD R. WENSTRUP, Ohio 

PAUL COOK, California 

JACKIE WALORSKI, Indiana 

DAVID JOLLY, Florida 

MICHAEL H. MICHAUD, Maine, Ranking 

Minority Member 

CORRINE BROWN, Florida 

MARK TAKANO, California 

JULIA BROWNLEY, California 

DINA TITUS, Nevada 

ANN KIRKPATRICK, Arizona 

RAUL RUIZ, California 

GLORIA NEGRETE MCLEOD, California 

ANN M. KUSTER, New Hampshire 

BETO O’ROURKE, Texas 

TIMOTHY J. WALZ, Minnesota 

JON TOWERS, Staff Director 

NANCY DOLAN, Democratic Staff Director 

SUBCOMMITTEE ON HEALTH 

DAN BENISHEK, Michigan, Chairman 

DAVID P. ROE, Tennessee 

JEFF DENHAM, California 

TIM HUELSKAMP, Kansas 

BRAD R. WENSTRUP, Ohio 

JACKIE WALORSKI, Indiana 

DAVID JOLLY, Florida 

JULIA BROWNLEY, California, Ranking 

Member 

CORRINE BROWN, Florida 

RAUL RUIZ, California 

GLORIA NEGRETE MCLEOD, California 

ANN M. KUSTER, New Hampshire 

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records 

of the Committee on Veterans’ Affairs are also published in electronic form. The printed 

hearing record remains the official version. Because electronic submissions are used to 

prepare both printed and electronic versions of the hearing record, the process of converting 

between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process 

is further refined. 


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C O N T E N T S 

Wednesday, November 19, 2014 

Page 

Legislative Hearing on H.R. 4720, The Medal of Honor Priority Care Act; 

H.R. 4887, The Expanding Care for Veterans Act; H.R. 4977, The Cover 

(Creating Options for Veterans Expedited Recovery Act); H.R. 5059, The 

Clay Hunt Suicide Prevention for American Veterans Act; H.R. 5475, To 

Improve The Care Provided By VA to Newborn Children; H.R. 5484, The 

Toxic Exposure Research Act; and H.R. 5686, The Physician Ambassadors 

Helping Veterans Act ........................................................................................... 1 

OPENING STATEMENTS 

Hon. Dan Benishek, Chairman ............................................................................... 1 

Hon. Julia Brownley, Ranking Member ................................................................ 3 

WITNESSES 

The Hon. Tim Walberg, U.S. House of Representatives, 7th District, MI .......... 4 

Prepared Statement ......................................................................................... 36 

The Hon. Gus Bilirakis U.S. House of Representatives, 12th District, FL ........ 6 

Prepared Statement ......................................................................................... 37 

The Hon. Tim Walz, U.S. House of Representatives, 1st District, MN ............... 7 

Prepared Statement ......................................................................................... 38 

The Hon. Doug Collins, U.S. House of Representatives, 9th District, GA .......... 9 

Prepared Statement ......................................................................................... 39 

The Hon. John Culberson, U.S. House of Representatives, 7th District, TX ..... 11 

Prepared Statement ......................................................................................... 40 

Christopher Neiweem, Legislative Associate, Iraq and Afghanistan Veterans 

of America ............................................................................................................. 12 

Prepared Statement ......................................................................................... 41 

Brad Adams, Staff Attorney, Swords to Plowshares ............................................ 14 

Prepared Statement ......................................................................................... 46 

Aleks Morosky, Deputy Director, National Legislative Service, Veterans of 

Foreign Wars of the United States, .................................................................... 16 

Prepared Statement ......................................................................................... 59 

John Rowan, National President, Vietnam Veterans of America ........................ 18 

Prepared Statement by Richard Weidman ..................................................... 65 

Rajiv Jain M.D., Assistant Deputy Under Secretary for Health for Patient 

Care Services, VHA, U.S. Department of Veterans Affairs .............................. 28 

Prepared Statement ......................................................................................... 78 

Accompanied by: 

Jennifer Gray, Esq. Staff Attorney, Office of General Counsel, U.S. 

Department of Veterans Affairs 

FOR THE RECORD 

The Hon. Tammy Duckworth, U.S. House of Representatives, 8th District, 

IL ........................................................................................................................... 105 

American Legion ...................................................................................................... 106 

AMVETS ................................................................................................................... 113 

CNS Response .......................................................................................................... 122 


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IV 

Disabled American Veterans .................................................................................. 127 

Paralyzed Veterans of America .............................................................................. 134 

Wounded Warrior Project ........................................................................................ 140 


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LEGISLATIVE HEARING ON H.R. 4720, THE 

MEDAL OF HONOR PRIORITY CARE ACT; 

H.R. 4887, THE EXPANDING CARE FOR VETERANS ACT; H.R. 4977, THE COVER (CREATING OPTIONS FOR VETERANS EXPEDITED 

RECOVERY ACT); H.R. 5059, THE CLAY HUNT 

SUICIDE PREVENTION FOR AMERICAN VETERANS ACT; H.R. 5475, TO IMPROVE THE 

CARE PROVIDED BY VA TO NEWBORN CHILDREN; H.R. 5484, THE TOXIC EXPOSURE RESEARCH ACT; AND H.R. 5686, THE PHYSICIAN AMBASSADORS HELPING VETERANS 

ACT 

Wednesday, November 19, 2014 

U.S. HOUSE OF REPRESENTATIVES, 

COMMITTEE ON VETERANS’ AFFAIRS, 

SUBCOMMITTEE ON HEALTH, 

Washington, D.C. 

The subcommittee met, pursuant to notice, at 2:00 p.m., in Room 

334, Cannon House Office Building, Hon. Dan Benishek [chairman 

of the subcommittee] presiding. 

Present: Representatives Benishek, Roe, Huelskamp, Wenstrup, 

Walorski, Brownley, Brown, and Kuster. 

Also present: Representatives Bilirakis and Walz. 

OPENING STATEMENT OF CHAIRMAN DAN BENISHEK 

Dr. BENISHEK. The subcommittee will come to order. 

Before we begin I would like to ask unanimous consent for my 

friends, colleagues, and members of the Full Committee, Gus Bilirakis and Tim Walz from Minnesota to sit on the dais and participate in today’s proceedings. Without objection, so ordered. 

Good afternoon and thank you all for joining us today to discuss 

seven important legislative proposals that would impact the provision of healthcare to our Nation’s veterans through the Department 

of Veterans Affairs. 

The seven bills on our agenda today are H.R. 4720, the Medal 

of Honor Priority Care Act, and H.R. 4887 the Expanding Care for 

Veterans Act, H.R. 4977 the Creating Options for Veterans Expedited Recovery or the COVER Act, H.R. 5059 the Clay Hunt SuiVerDate Aug 31 2005 09:43 Mar 03, 2016 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 Y:\96-135.TXT PAT

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cide Prevention for American Veterans Act or SAV Act, and H.R. 

5475 to improve the care provided by VA to newborn children, and 

5484 the Toxic Exposure Research Act of 2014, and H.R. 5686 the 

Physician Ambassadors Helping Veterans Act. 

From increasing care available to newborn children of women 

veterans, to expanding and improving mental health treatment options, to providing priority access to Medal of Honor recipients, 

these seven measures address a wide range of critical issues facing 

our veterans, their families and the VA healthcare center. 

I am proud to join Chairman Miller and Congressman Walz and 

Congresswoman Duckworth in cosponsoring H.R. 5059 the Clay 

Hunt SAV Act. With an estimated 22 veterans each day committing suicide, it has never been more important for us to take aggressive action to ensure that VA and DoD’s mental health and suicide prevention programs are operating seamlessly, at the fullest 

strength to care for servicemembers and veterans struggling with 

mental illness and thoughts of suicide. 

I am also proud to sponsor H.R. 5484 the Toxic Exposure Research Act of 2014, which I introduced to improve the research and 

treatment available to veterans and their family members who 

have experienced negative affects of toxic exposure. 

H.R. 5484 would direct VA to select a medical center to serve as 

a national center for research on diagnosis and treatment of health 

conditions of descendents of Veterans exposed to toxic substances 

while serving as members of the Armed Forces. 

The National Research Center will be required to employ at least 

one licensed clinical social worker to coordinate access to care for 

impacted individuals to VA, as well as appropriate Federal, State, 

local, social and healthcare programs, and to provide case management services. 

Secondly, H.R. 5484 would direct VA to establish an advisory 

board to advise the National Research Center to determine which 

health conditions and the descendants of individuals who were exposed to toxic substances while serving in the Armed Forces result 

from such exposure, for purposes of determining those descendants 

eligibility for VA medical care, and A study and evaluate claims of 

service-related exposure to toxic substances by current and former 

members of the armed services. 

H.R. 5484 will also authorize DoD to declassify documents, other 

than those that would materially and immediately threaten national security related to any known incident in which not less 

than 100 members of the Armed Forces were exposed to a toxic 

substance that resulted in at least one case of disability. 

Finally, it would direct VA, DoD and the Department of Health 

and Human Services to jointly conduct a National outreach and 

education campaign to communicate information on toxic exposure 

incidents, resulting health conditions, and potential long-term impacts. 

When a service member volunteers to serve our Nation in the 

United States Military, it is with the full understanding that they 

may be exposed to high-pressure situations and the strains of combat. But not many are aware that their service may also expose 

them to harmful chemical toxins they have the ability to impact 


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not only their health, potentially the health of their children and 

grandchildren as well. 

Wounds that result from exposure from toxic chemicals can have 

lifelong and generational affects, the impacts of which we do not 

yet fully understand. 

Therefore, it is imperative that we take every available step to 

recognize, research and treat toxic exposure issues that arise during our veterans military service and thoroughly evaluate the longterm affects this exposure can have on a veteran and on his or her 

family. 

H.R. 5484 is not perfect and I recognize that some of today’s witnesses have particular concerns about a provision in the bill that 

would allow the advisory board to study and evaluate claims of 

service connected exposure. I understand those concerns and appreciate those who have brought them to my attention. 

I look forward to working closely with the VA, VSOs and other 

stakeholders in the coming days to make any amendments that 

may be necessary to clarify, and strengthen the intent of that provision and others on today’s agenda. 

Together we will ensure that these bills and all legislation advanced through this subcommittee are appropriate, effective, meaningful and most importantly contribute to the fulfillment of the 

promise made by President Lincoln to care for our Nation’s 

servicemembers, veterans and military families. 

Thank you to all of our witnesses for being here this afternoon. 

With that, I now yield to Ranking Member Brownley for any 

opening statement she may have. 

[THE PREPARED STATEMENT OF CHAIRMAN DAN BENISHEK AP- PEARS IN THE APPENDIX] 

OPENING STATEMENT OF RANKING MEMBER JULIA 

BROWNLEY 

Ms. BROWNLEY. Thank you, Mr. Chairman and I appreciate you 

holding this legislative hearing today. 

As you know, the purpose of today’s hearing is to explore the policy implications of seven bills before us, which cover a wide range 

of important topics that would expand and enhance VA’s 

healthcare programs and services for our Nation’s veterans. 

I look forward to hearing the views from our panelists and appreciate the hard work that their testimony demonstrates. While I am 

disappointed in the Department for not furnishing views on my 

bill, I understand that the VA is prepared to answer questions on 

the bill’s provisions. We hold these legislative hearings to ensure 

that the committee is as fully informed as possible on important 

veterans’ health issues. We rely on this input to make sound and 

well-educated decisions on whether to forward a bill from this subcommittee. 

Among the seven bills on the agenda today the subcommittee is 

considering my bill, H.R. 4887, the Expanding Care for Veterans 

Act, which would expand complementary and alternative medicine 

and mental healthcare options for our Nation’s veterans. 

As ranking member of the House Veterans’ Affairs Subcommittee 

on Health, I believe that we must find more and better ways to 

provide our veterans with the healthcare they need. 


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There are many organizations throughout the country that are 

achieving very positive results using complementary and alternative medicine to treat mental health issues. My bill would require the VA to do a better job of evaluating what works. And 

when it does, find a way to provide these therapies to our veterans 

who are in need. 

Specifically, the Expanding Care for Veterans Act would expand 

research and education on and delivery of complementary and alternative medicine to veterans. It would establish a program on integration of complementary and alternative medicine within the 

Department of Veterans Affairs medical centers. It would steady 

the barriers encountered by veterans and receiving, and administrators and clinicians in providing complementary and alternative 

medicine services furnished by the Department of Veterans Affairs, 

and establish a program on the use of wellness programs as a complementary approach to mental healthcare for veterans and family 

members of veterans. 

Complementary and alternative medicine is intended to enhance, 

reinforce and sometimes replace traditional mainstream therapies. 

For instance, in my congressional district Reins of Hope assisted 

psychotherapy program helps to improve mental health, self esteem, communication skills and interpersonal relationships. 

This subcommittee held a hearing in February in my District and 

I was very pleased that the Reins of Hope was invited to testify because of the successes highlighted at that hearing and through subsequent VA contact with the program, VA has decided to expand 

services with the Reins of Hope. 

Throughout the 113th Congress the VA Committee has held 

hearings at which we have heard from veterans about the need to 

expand, complementary and alternative medicine in order to improve care for our veterans, and reduce wait times for mental 

health visits. 

I am hopeful that my bill can move forward and appreciate the 

support that many of the VSOs have shown for my bill. 

Thank you, Mr. Chairman, and I yield back. 

[THE PREPARED STATEMENT OF HON. JULIA BROWNLEY APPEARS IN

THE APPENDIX] 

Dr. BENISHEK. I am honored to be joined today by several of my 

colleagues on our first panel. 

Joining us to discuss legislation they have sponsored is Representative Tim Walberg from the 7th District of Michigan, representative and committee member Gus Bilirakis from the 12th 

District of Florida, representative and committee member Tim 

Walz of the 1st District of Minnesota, Representative Doug Collins 

from the 9th District of Georgia, and Representative John Culberson from the 7th District of Texas. Thank you all for being here 

this afternoon. 

Representative Walberg, we will begin with you, please proceed 

with your testimony. 

STATEMENT OF HON. TIM WALBERG 

Mr. WALBERG. Chairman Benishek, Ranking Member Brownley 

and members of the subcommittee, I thank you for the opportunity 

to speak this afternoon in support of my legislation H.R. 4720, the 


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Medal of Honor Priority Care Act of 2014. I also thank you for the 

good work that you and all of the subcommittee here does for the 

benefit of our veterans. 

As the members of this committee are well aware, the Congressional Medal of Honor is the highest award for valor which can be 

bestowed upon an individual serving in the United States Armed 

Forces, and is awarded to soldiers who have displayed conspicuous 

gallantry and intrepidity at the risk of life above and beyond the 

call of duty. 

The Medal of Honor is a distinguished award given to a select 

few. Less than 3,500 have been awarded, and of those only 79 are 

living recipients. When one looks at the recent major conflicts in 

Iraq and Afghanistan, only 16 have been awarded. 

My State of Michigan is honored to have two living recipients of 

this award, Corporal Duane E. Dewey and Private First Class Robert E. Simanek, both received the decoration for their heroic action 

in the Korean War. And hearing of their harrowing stories of bravery has reminded me of the sacrifice American soldiers are willing 

to make to protect their comrades and their country. 

Medal of Honor recipients deserve our utmost appreciation and 

I believe a small portion of our servicemembers who have gone 

above and beyond the call of duty and have earned the highest 

honor in our Nation’s Armed Forces, have earned the right to be 

placed in the top priority group to receive their healthcare benefits. 

All veterans deserve access to the healthcare they have earned. 

But as you all know, the VA uses a priority system to determine 

eligibility for these healthcare services. Some of the factors that 

will affect the soldiers priority group ranking are whether the soldier has a service connected disability, whether they are former 

prisoners of war, the time and place of service, as well as income 

level. 

Currently, Medal of Honor recipients are in priority group 3. And 

as the VA Web site itself points out, veterans who meet the qualifications of priority group 1 receive expedited service. Moving 

Medal of Honor recipients to priority group 1 will allow this small 

group of outstanding individuals who have received expedited—to 

receive expedited care as well as other benefits, such as medication 

without copayments. 

I would be remiss in not pointing out that the idea to initially 

look into this legislation came from a veteran who lives in my District and works with the veteran community. This bill would not 

affect a large population of veterans, but I believe we have a duty 

to ensure these veterans have access through the VA when they 

need it. 

I am proud to have support of 13 of my colleagues from both 

sides of the aisle, as well as support from the VFW, Vietnam Veterans of America, IAVA, and the American Legion and AMVETS. 

I thank the Chair for permitting me to appear before the subcommittee today and ask for your support, thank you. 

[THE PREPARED STATEMENT OF MR. TIM WALBERG APPEARS IN

THE APPENDIX] 

Dr. BENISHEK. Thank you, Mr. Walberg. 

Mr. BILIRAKIS. please go ahead. 


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STATEMENT OF HON. GUS BILIRAKIS 

Mr. BILIRAKIS. Thank you, Mr. Chairman, I appreciate it very 

much. 

Chairman Benishek, Ranking Member Brownley and Members of 

the Health Subcommittee. Thank you for holding this very important hearing and providing me an opportunity to testify on my bill. 

The importance of exploring complementary alternative treatments for veterans with mental health concerns cannot be understated. As we all know, the cost of wars and the price for freedom 

are paid for through the valor of brave men and women. These individuals selflessly put themselves in harms way for the freedoms 

we enjoy on a daily basis. 

Statistics show that 20 percent, around 1 in 5 veterans who serve 

in Iraq and Afghanistan have been diagnosed with post traumatic 

stress. We must responsibly ask our questions. We must ask ourselves, are we doing enough when it comes to addressing mental 

health in our veterans population? I don’t think so. 

Recent data has shown that everyday in this country an estimated 22 veterans take their own lives, very sad. It is sad and 

alarming that more servicemembers have died from suicide than 

overseas in Iraq and Afghanistan. Many of these tragic suicides are 

the result of depression, homelessness and a lack of available resources to assist in their transition into civilian life. 

My bill H.R. 4977 the Creating Options for Veterans Expedited 

Recovery Act, COVER we call it, will help remedy this tragic problem, and provide additional therapies to our Nation’s wounded heroes. 

The COVER Act will establish a commission to examine the Department of Veterans Affairs current evidence-based therapy treatment model, for treating mental illnesses among veterans. 

Additionally, it will analyze the potential benefits for incorporating complementary alternative treatments available within 

our communities. Under the COVER Act the commission will conduct a patient-centered survey within each veterans integrated 

service network. 

The survey will examine the preferences and experiences of veterans with regard to their interactions with the Department of Veterans Affairs. Instead of presuming to know what is best for Veterans, we should simply ask them, don’t you think? We can work 

with them on finding the right solution that best fits their unique 

needs. 

The scope of the survey will include as follows the experience of 

a veteran when seeking mental or medical assistance within the 

Department of Veterans Affairs, the experience of veterans with 

non-VA medical facilities, veterans experience with healthcare professionals treating them for mental health illnesses, the preferences of a veteran on available treatments for mental health and 

which they believe to be the most effective, the prevalence of prescribing prescription drugs within the VA as remedies for treating 

mental health illnesses, and outreach efforts by the VA Secretary 

on available benefits and treatments. 

Additionally, the commission will be tasked with examining the 

available research on complementary alternative treatments for 

mental health. They will also identify what benefits could be atVerDate Aug 31 2005 09:43 Mar 03, 2016 Jkt 000000 PO 00000 Frm 00010 Fmt 6633 Sfmt 6633 Y:\96-135.TXT PAT

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tained with the inclusion of such treatments for our veterans. Some 

of these alternative therapies include among others; accelerated 

resolution therapy, training and care for service dogs, music therapy, yoga, acupuncture therapy, mediation and outdoor sports therapy. 

Finally the commission will study the potential increase and benefit claims for mental health issues for veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn. The VA must have the necessary resources and 

infrastructure to handle an increase in veterans you either, earn 

benefits to address the mental and physical ailments. 

Once the commission has successfully completed their duties, a 

final report will be issued and made available. The commission outlining its recommendations and findings based on their analysis of 

the patient centered survey, alternative treatments and evidencebased therapies. 

The commission will also be responsible for creating a plan implementing those findings in a feasible, timely and cost effective 

manner. I am happy to have the support from the veterans service 

organization, particularly the Iraq and Afghanistan Veterans of 

America, the American Legion, and Vets First who provided letters 

of support prior to this hearing. I am almost finished, Mr. Chairman. 

With the collaboration of our Nation’s greatest heroes, Congress 

and the VA, we can increase access to quality care for veterans 

across the country and help better meet their needs when asked— 

when seeking care. 

Thanks again for allowing me to testify on behalf of the COVER 

Act today and I urge all of my colleagues to support this important 

piece of legislation and show our veterans, our true American heroes, with action and not just promises that we have them covered. 

Thank you so much and I yield back. 

[THE PREPARED STATEMENT OF MR. BILIRAKIS APPEARS IN THE AP- PENDIX] 

Dr. BENISHEK. Thank you. 

Mr. Walz, you have five minutes for your statement. 

STATEMENT OF HON. TIM WALZ 

Mr. WALZ. Yes I do thank you very much. 

Thank you Chairman Benishek and Ranking Member Brownley, 

and thanks for your leadership and dedication to our Nation’s heroes. 

I am grateful for the opportunity both to have served on this 

committee for 8 years and what appears to be my last hearing. I 

am honored to tell you about an important piece of legislation to 

help rid our community of veteran suicide. 

H.R. 5059 is the Clay Hunt Suicide Prevention for American Veterans Act. It is an example of how we get things right on Capitol 

Hill. The legislation is named in honor of Iraq and Afghanistan war 

veteran suicide prevention advocate and my friend Clay Hunt. 

Clay epitomized what it meant to live a life of service, both as 

a Marine and as a civilian. He helped countless veterans overcome 

their demons, but tragically took his own life in March of 2011. The 

legacy left behind however will live on for generations. Clay’s mom, 


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Susan, is on the Hill today and if you get a chance, you may see 

her around. Make sure you thank her for what their family has 

given. 

The bill you see before you was the result of strong partnerships 

with our veteran service organization, strong bipartisan effort here 

in Congress and relentless shown by Clay’s parents to get this 

thing done. This bill is what you get when you have folks sitting 

around a table, trusting one another and working to get it right for 

our Nation’s veterans. 

I want to extend a special thank you to two Air Force veterans 

for helping to get this done. Thanks should go out to Ms. Christine 

Hill of Chairman Miller’s staff and Tony DeMarino from Ms. 

Duckworth’s staff for their incredible work. 

Our premise for this bill was simple, suicide occurs because 

many veterans return to their community and then disconnect from 

it. So we wanted to create a bill that would get the communities 

involved and coordinated. We also knew it would be important to 

increase the capacity and efficiency of the VA care to deal with 

over a million veterans returning from war. Specifically, this bill 

establishes a pure support and community outreach pilot program 

to assist transitioning servicemembers with accessing VA mental 

health services. It requires the VA to create a one-stop interactive 

Web site to serve as a centralized source of information regarding 

all mental health service for veterans. 

Three, it addresses the shortage of mental healthcare professionals by authorizing the VA to conduct student loan repayment 

pilot program, aimed at recruiting and retaining psychiatrists. 

It requires the DoD and the National Guard to review the staffing requirements for directors of psychological health in each State. 

And it requires a yearly evaluation conducted by a third party, of 

all mental healthcare, and suicide prevention practices programs at 

DoD and VA find out what is working and what is not working, 

and make recommendations for getting rid of those that don’t and 

improving those that do. 

It establishes a strategic relationship between the VA and the 

National Guard to facilitate greater continuity of care between the 

National Guard and the VA. 

And finally, it authorizes the Government Accountability Office 

report on the transition of care from PTS and TBI between the 

DoD and VA. One veteran lost to suicide is too many. With many 

of our warriors returning from war, all too often our heroes return 

only to face a war of their own. 

While there is no bill that will completely end veteran suicide, 

this comprehensive bipartisan measure is a step in the right direction. I am proud to have worked with Chairman Miller and his 

staff, Representative Duckworth, a combat veteran herself, Iraq 

and Afghanistan Veterans of America, and the VFW introduced 

this bipartisan piece of legislation. 

I also want to thank Senator McCain for taking up the Senate 

companion and making sure that this is on a track to end up on 

the President’s desk. I urge my colleagues to support this measure 

so we can pass it quickly into law and start addressing an issue 

that all of us know happens all too often. 

And with that, Mr. Benishek, I yield back and thank you. 


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[THE PREPARED STATEMENT OF MR. TIM WALZ APPEARS IN THE

APPENDIX] 

Dr. BENISHEK. Thank you, Mr. Walz. 

Mr. Collins, please go ahead. 

STATEMENT OF HON. DOUG COLLINS 

Mr. COLLINS. Thank you, Mr. Chairman and Ranking Member 

Brownley, and the distinguished members of the subcommittee, for 

my opportunity to testify on my piece of legislation, H.R. 5475 to 

amend title 38 of the United States Code to improve the care provided by the Secretary of Veterans Affairs to newborn babies. And 

just also as a current active Air Force reservist, I appreciate this 

committee and also the words spoken to those who come back as 

one who has come back from Iraq as well and the need for that I 

appreciate that very much. 

The model of the Veterans Administration basically comes 

straight from Abraham Lincoln’s second inaugural. And he got the 

idea straight from scripture. So the challenge for us is to care for 

him who shall have borne the battle and his widow and for his orphan isn’t a new one. 

Since September 11th, 2001 more than a quarter of a million 

women have answered the call to serve, they have faced terrorism 

in the deserts and the mountains of Iraq and Afghanistan, so in 

the 21st century we must also consider she who have borne the 

battle, when she returns, what of her children? 

The finest military in the world is powered by men and women 

in their physical prime. The young women who decide to serve this 

country in the Armed Forces aren’t immune from the same questions that all young women face about whether they pursue a career, a family or both. Yet they are offered a healthcare system 

that for so many years has been designed to serve men. 

With an increasing number of female veterans, the VA must expand its care and services to meet their needs. Maternity care tops 

that list of needs. And I have offered one way that we can help. 

In 2010 Congress passed and the President signed the Caregivers 

and Veterans Omnibus Health Services Act 2010, to provide shortterm newborn care for women veterans who receive their maternity 

care through the VA. It was signed into law on May 5th, 2010 and 

this legislation authorized up to 7 days for newborn care. 

On January 27th, 2012 the VA published a regulation officially 

amending VA’s medical benefits package to include up to 7 days of 

medical care for newborns delivered by female veterans who were 

receiving VA maternity care benefits. The rule which became effective December 19th applied retroactively to newborn care provided 

to eligible women that on or after May 5th of 2011. 

Since this 7 day authorization was enacted by Congress in 2010, 

we have learned more about the unique challenges facing female 

veterans and the changing trends and these veterans seeking maternity and newborn care from the VA. According to the study published in the women’s health issue journal this year from 2008 to 

2012 the overall delivery rate by female veterans utilizing VA maternity benefits increased by 44 percent, and a majority of the 

women using VA maternity benefits had service connected disability. 


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Unless Congress extends the authorization for newborn care coverage provided by the VA, these veterans will face difficult financial decisions and complexity in navigating insurance options at the 

same time their newborn is fighting for their life. 

That is why I introduced H.R. 5475. This legislation extends the 

authorization of care from 7 to 14 days, and provides for an annual 

report on the number of newborn children who received such services during the fiscal year. 

Improved data on trends and female veterans utilizing newborn 

care will help Congress and the VA better meet the needs in years 

to come. You see this is also a little personal for me. I know what 

it is like to be the parent of a little baby who needed intensive 

medical care for an extended period the moment she was born. 

It is my hope that any new mother who has given selflessly to 

her country wouldn’t have to worry about Congress standing in her 

way as she tries to give selflessly to her our own child. 

Our goal should always be to provide the mother with prenatal 

care she needs to give the newborn the best chance of healthy delivery with no postnatal complications. There are significant needs 

and challenges female veterans face when returning home from the 

battlefield, from homelessness to sexual and physical abuse, not to 

mental health conditions such as post traumatic stress disorder. 

This legislation won’t solve those challenges but 5475 will give 

a little peace of mind knowing that a newborn will get some extra 

help from the VA and Congress and that we are committed to her 

and her family. 

In a focus group conducted, one Marine said, I essentially say 

that I gave my reproductive years to the Marine Corps and those 

are the years you can serve. You know you do sacrifice and you 

say, well, mission first before family mission. Type of thing and the 

more I think about it, you know, the VA probably should address 

that part of womanhood and have that understanding. 

There are a multitude of ways the VA must adapt to better meet 

the needs of female veterans. By increasing the authorization in 

care, we can ensure Congress is not standing in the way of VA 

seeking to do just that. 

Absent legislative change, the VA cannot provide more than 7 

days care. I believe this is unacceptable. In closing, we owe it to 

our female veterans to expand the healthcare services that the VA 

can provide them and their children. Female veterans face unique 

challenges and barriers, including very limited newborn care coverage. 

While the majority of female veterans who receive maternity care 

from the VA are able to return home with newborns within current 

7 days time frame, some cannot due to newborn complications. It 

is these veterans and children that need our help today. And expanding this coverage will give them a little more peace and security. 

Mr. Chairman and Ranking Member, I do appreciate the opportunity to talk about this and I thank you for the opportunity to discuss this legislation. 

I yield back. 

[THE PREPARED STATEMENT OF MR. DOUG COLLINS APPEARS IN

THE APPENDIX] 


VACREP0180 with DISTILLER
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Dr. BENISHEK. Thank you, Mr. Collins. 

Mr. Culberson, please proceed with your statement. 

STATEMENT OF HON. JOHN CULBERSON 

Mr. CULBERSON. Mr. Chairman, thank you. I deeply appreciate 

the time today, Chairman Benishek, Ranking Member Brownley, 

and I want to thank the members of the subcommittee; you have 

coauthored this legislation with me that I present to you today. 

I want to thank in particular my colleagues from Texas, Representative O’Rourke and Representative Walz, thank you for coauthoring this with me. Representative Huelskamp has signed on 

with me, as well as Representative Ann Kirkpatrick. 

It is a straightforward, very simple, commonsense idea. When I 

was visiting the Texas Medical Center back in August, my district 

just abuts the medical center. It is the largest collection of hospitals in the United States. 155,000 people come in and out of the 

Texas Medical Center every day. And a radiologist whom I was visiting with that day, Dr. Beth Edeiken-Monroe told me that she repeatedly tried to volunteer her time at the VA hospital and they 

turned her away. And I just couldn’t believe it. 

In talking to her and other doctors, all of a sudden, I started getting doctors from up and down the hallway coming to talk to me 

when they found out not only that I was a Congressman, but I 

have the privilege of chairing the VA Military Construction Appropriations Subcommittee. So this is—you know, helping our veterans is near and dear to my heart as it is to you all. And I was 

just dumbfounded, every single doctor I talked to and nurse, I 

started getting these stories from all over the medical center that 

they had made repeated efforts to go down and volunteer at the VA 

hospital because they recognized there was a shortage of help for 

our veterans that they had heard about the waiting lists, and they 

were concerned. And they didn’t want any veteran to wait any 

longer than absolutely necessary, they wanted to get them in as 

quickly as possible to get care. 

And so they were willing to help for free and the VA turned them 

away, said, no, it is too complicated, we have got this hurdle and 

that hurdle you have to jump through, and we have this problem 

and that problem and turned them away. 

So I frankly was just outraged and concerned. And this very 

straightforward, simple piece of legislation is designed to make it 

easy to compel the VA to move rapidly to get any doctor who is licensed, doesn’t have a disciplinary problem with their State licensing board, to get them in the door of the hospital right away and 

help see our Veterans. Make sure they get the care that they need. 

It is designed also to address one the concerns the VA had. They 

said well, if we allow doctors to volunteer, what if they only they 

volunteer only a few hours a year. So there is a 40-hour minimum 

in here. The doctors of course want to make sure they provided the 

same medical liability protection that other doctors have under the 

Tort Claims Act. The VA already has a procedure for that. So any 

doctor who comes in and volunteers—this would apply not only to 

doctors, but healthcare professionals, nurses or other healthcare 

professionals that want to participate. They are given the same tort 

claims protection that other VA physicians are given. 


VACREP0180 with DISTILLER
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So it is a very straightforward, simple idea. I talked to Secretary 

Bob about this yesterday. He supports this legislation and would 

like to see it enacted. I have the support also of the Texas Medical 

Association, believes this is a very straightforward and simple idea. 

And that is why I present it to you today. 

I sincerely want to thank Dr. Beth Edeiken-Monroe, the folks at 

the Texas Medical Center, particularly MD Anderson Hospital 

which has done such extraordinary work in eliminating cancer, 

working to make it a treatable disease. And they are just a wonderful group of people and they just want to help. 

To think of a time when veterans are—it is just appalling and 

unacceptable that our veterans have to wait to get in to see a doctor at the VA. We just want to make sure that we have all hands 

on deck to help our men and women in uniform get the medical 

treatment that they deserve, that they have earned, and that is all 

this legislation does. 

And I would recommend it to your favorable consideration. 

Thank you very much. 

[THE PREPARED STATEMENT OF MR. JOHN CULBERSON APPEARS IN

APPENDIX] 

Dr. BENISHEK. Thank you, Mr. Culberson. 

Unfortunately there is a vote call on the floor so we are going 

to have to—not adjourn, but recess the subcommittee for a short 

time. Hopefully we will be back by about 3:05. 

So all the members are welcome to come back after. We are going 

to resume, but we will do the rest of our panels after that. 

So we are in recess for the time being. Thank you. 

[Recess.] 

Dr. BENISHEK. I call to order the Veterans’ Affairs subcommittee 

on Health hearing for the VA committee. 

We missed a couple of people unfortunately because the vote was 

right in the middle of our hearing, which is always frustrating, but 

we will just begin with the second panel. 

Joining us on the second panel is Christopher Neiweem, the legislative associate for the Iraq and Afghanistan Veterans of America, Brad Adams, staff attorney for Swords to Plowshares, Aleks 

Morosky, the deputy director of National Legislative Service for the 

Veterans of Foreign Wars of United States and John Rowan, the 

National president for the Vietnam Veterans for America. 

Thank you all for being here this afternoon and for your hard 

work and advocacy on behalf of our veterans. I appreciate you 

being here to present your views of your members. 

Well, we will begin with Mr. Neiweem. 

Mr. NEIWEEM. you have 5 minutes. 

STATEMENT OF CHRISTOPHER NEIWEEM 

Mr. NEIWEEM. Chairman Benishek, Ranking Member Brownley 

and distinguished members of the subcommittee, on behalf of Iraq 

and Afghanistan Veterans of America, we would like to extend our 

gratitude for the opportunity to share with you our important 

views and recommendations on the legislation under consideration 

today. 

IAVA supports each bill on the docket of this afternoon’s hearing. 

However, we would like to use our time for remarks to focus on 


VACREP0180 with DISTILLER
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H.R. 5059 the Clay Hunt Suicide Prevention for American Veterans 

Act or Clay Hunt SAV Act. 

This comprehensive piece of legislation is a very important first 

step to addressing and beginning to curtail the tragic statistic reported by VA that 22 veterans are lost by suicide each day. Combatting veteran suicide is IAVA’s top priority in 2014. In IAVA’s 

2014 member policy survey, over 47 percent of our respondents told 

us they knew a veteran who served in Iraq or Afghanistan who had 

attempted suicide and over 52 percent knew two or more veterans 

that had been lost to suicide. 

The SAV Act has many key provisions, and I will briefly speak 

to some of them now. Firstly, it requires independent evaluations 

of all DoD and VA mental health programs and suicide prevention 

programs. Simply put, these independent evaluations, will examine 

which programs are working and which programs may not be effective and need to be curtailed, reformulated or eliminated. 

Secondly, the bill instructs the VA to launch a new Web site to 

serve as a centralized resource to provide veterans with information regarding all of the mental health resources available to them 

and how to access those services. This includes a listing of where 

to find those services and a listing of key staff contacts that are 

available to field questions and address concerns. 

Further, the formal strategic relationships the bill requires VA 

and the DoD to enter into with the Chief and the National Guard 

Bureau and regional state commands will assist in referral of mental health resources to Reserve and Guard troops with service-connected disabilities. 

Too often Reserve and Guard forces return home from deployment without a firm pipeline of support to assist with their reintegration into their community. Additionally, the SAV Act aims 

to bolster the VA’s psychiatric workforce through a 3-year pilot program that provides student loan relief for eligible psychiatrists that 

want to serve veterans at the VA. This incentive would put VA on 

par with other Federal entities that already offer student loan repayment incentives, and is a great opportunity to promote their recruitment of talented, dedicated, young professionals in the VA’s 

ranks. 

The last section of the bill that I would like to focus these remarks on is the Community Outreach Provision which creates a 

pilot program that will marshal government and nonprofit resources collectively. This will create trained veteran peer networks 

that will assist fellow veterans in their transition after service. 

Additionally, the program will include the participation of community organizations, educational institutions and State and local 

governments. The SAV Act will improve policy in many categories 

to address the issue of veteran suicide. 

Mr. Chairman, in VA’s written remarks they state they support 

the intent of the Clay Hunt SAV Act, but want to slow down the 

bill’s progress and help recraft certain portions of the bill. The Department has known for months that this bill would move forward 

in either November or December, yet it failed to raise one objection 

until now, the very last minute. In fact, just yesterday, Clay Hunt’s 

mother, Susan, met with VA Secretary, Bob McDonald, who informed her that he absolutely supports the bill. 


VACREP0180 with DISTILLER
14 

While quick improvements at a markup are acceptable, we do not 

want to see forward progress on the Clay Hunt SAV Act slowed because the Department wants to move at a glacierly pace on this 

bill. The time to move forward, Mr. Chairman, in our view is now, 

so we can get this to the floor and get it passed before we all go 

enjoy the holidays, that unfortunately with this statistic we know 

22 veterans today we will lose to suicide and will not move forward 

to enjoy the holidays as we will. 

Mr. Chairman, we value the VA again. I appreciate the opportunity to offer our views on these important pieces of legislation. 

I look forward to continuing to work with each one of you and your 

staffs to improve the lives of Iraq and Afghanistan veterans and 

their families. 

I look forward—I appreciate your time and attention and I look 

forward to any questions you have of me. 

Thank you. 

[The prepared statement of Mr. Neiweem appears in the Appendix] 

Dr. BENISHEK. Thank you for your testimony. And I certainly 

agree with you about the glacier-like attitude there. 

Mr. Adams, you may begin your statement. 

STATEMENT OF BRAD ADAMS 

Mr. ADAMS. Chairman Benishek, Ranking Member Brownley and 

members of the subcommittee, thank you for inviting me to speak 

today. 

Thank you also to the sponsors and cosponsors of the Clay Hunt 

SAV Act for pursuing this important issue. 

My name is Bradford Adams, I am an Army Veteran. I served 

in Afghanistan. I am now an attorney at a veterans service organization called Swords to Plowshares. 

Swords to Plowshares has been providing direct services to the 

veteran community in San Francisco for 40 years, including long 

work with the homeless veterans population and veterans struggling with mental illness. I work with veterans who are at risk of 

suicide, who have attempted suicide, and unfortunately sometimes 

I work with veterans who complete suicide despite our best efforts. 

I want to discuss the specific provision of the Clay Hunt SAV Act 

and how it can be made stronger. Section 3 addresses an important 

problem. The problem is that there are a large number of at-risk 

veterans who are shut out of VA care. This happens because they 

have been discharged for some kind of misconduct. And when 

servicemembers are discharged for misconduct, the VA has the authority to deny them eligibility for VA services if the VA feels that 

their misconduct was so severe that it amounts to overall dishonorable service. 

The VA can do this and does do this even when that misconduct 

is a direct result of mental health trauma acquired in service. This 

happens too often and it needs to stop. 

I will give you an example of a servicemember who has not completed suicide, because I want to focus on the people that this bill 

can still help. Terrence Harvey was a combat infantryman. He 

served the 82nd in the first Gulf war, he cleared bunkers in Iraq 

and walked the highway of death in Kuwait. When he came back 


VACREP0180 with DISTILLER
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he started showing signs of severe PTSD and after a few months 

he attempted suicide in the service. He wasn’t getting the care he 

needed. He asked his command for leave to be with his family. 

When his command said no, he went anyway. When he came back, 

they discharged him for misconduct. 

He still struggles with PTSD. He has been in and out of psychiatric hospitalization, including this past year. He has lived on 

the streets, which is where Swords to Plowshares found him. And 

he has attempted suicide again. That was misconduct and Terrence 

needed to be separated from the service, but the VA is wrong to 

deny him access to its care because of that one misconduct they believe overshadows his service and renders him ineligible for VA 

benefits. 

That policy on the VA’s part is unfair and it is unsafe, both for 

Terrence and for people around him. Terrence does not deserve to 

die by suicide. And his daughter who killed herself age 16 did not 

deserve to live with a father with untreated combat PTSD. 

This will not be comprehensive suicide prevention bill as long as 

Veterans like Terrence are being shut out. Section 3 deals with this 

by asking the DoD to fix it. Section 3 instructs the DoD to take 

mental illness into account when veterans ask for discharge upgrades. The DoD should do so. But this is not a direct solution to 

the problem of suicide. The direct solution will deal with this 

through the VA itself. This is because it is the VA, not the DoD 

who decides eligibility for veterans’ services. The VA does not need 

the DoD’s permission on this, to grant eligibility for people like 

Terrence. 

Every day the VA evaluates servicemembers like Terrence and 

decides whether their misconduct was so severe and so dishonorable they should be shut out from care by the VA. It is it the VA’s 

call. This is where the problem is and that is where it can be fixed. 

There is a straightforward legislative solution to this. The VA already has the authority to let servicemembers like Terrence in, 

they already have procedures and policies for doing so, and they 

have already made their own criteria, not Congress’ criteria for 

making that decision. 

If Congress doesn’t like the results of that decision, they can simply give new criteria for the VA to implement, no additional costs, 

or procedures, or time. 

There are two shortcomings to this criteria that I would like to 

draw to your attention. First, they don’t fully account for mental 

health conditions. If the veterans misconduct was the result of the 

a mental health problem like it, was for Terrence, the VA will excuse that misconduct only if the severity arose to the level of criminal insanity. This doesn’t help Terrence. Terrence had severe lifethreatening PTSD, but he wasn’t insane so it doesn’t help him. 

Second, it doesn’t account for combat deployment. There is nothing in VA regulation or policy which says that its staff must take 

into account a combat deployment when deciding if someone is eligible for VA services. Clearly that has to stop. 

The committee should give the VA two instructions on this. First, 

when someone has served in combat or has a mental health condition acquired in service, only severe misconduct should render 

them ineligible for VA services. 


VACREP0180 with DISTILLER
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Second, while the VA is making up its mind about this, it should 

provide tentative eligibility for two essential services, medical care 

and housing services. That is the basic services that someone in a 

mental health crisis needs. 

The current backlog means that waiting for this decision can 

take 1 to 3 years. That is too long to wait. This is an opportunity 

to make sure veterans like Terrence are under VA care. I hope the 

committee will take this opportunity to fix that. Thank you very 

much. 

[The prepared statement of Mr. Adams appears in the Appendix] 

Dr. BENISHEK. Thank you for your impassioned testimony there, 

Mr. Adams. Good job. 

Mr. Morosky, you have 5 minutes. 

STATEMENT OF ALEKS MOROSKY 

Mr. MOROSKY. Chairman Benishek, Ranking Member Brownley 

and members of the subcommittee, on behalf of the men and 

women of the Veterans of Foreign Wars of the United States and 

our auxiliaries, I want to thank you for the opportunity to present 

the VFW’s stance on legislation pending before this subcommittee. 

The bills we are discussing today are aimed at improving 

healthcare for veterans and servicemembers and we thank the committee for bringing them forward. 

H.R. 4720, the Medal of Honor Priority Care Act: The VFW supports this legislation which would elevate medal of honor recipients 

from VA priority group 3 to priority group 1. The 79 living medal 

of honor recipients are held in the highest esteem by the veterans 

and military community. Accordingly, we believe it is entirely appropriate to grant them priority group 1 status as a small, but 

meaningful symbol of our appreciation for their heroic actions. 

H.R. 4887, Expanding Care for Veterans Act: The VFW supports 

this legislation which would expand VA research, education and delivery of Complementary and Alternative Medicine treatments, also 

known as CAM. 

All too often, the VFW hears stories from veterans who were prescribed ineffective medications to treat their mental health conditions, and powerful addictive medications to treat pain. While drug 

therapies may be the best solution for some, we recognize that 

CAM therapies are often a better, safer alternative for others. 

While already in use on a limited basis throughout the department, 

we believe that VA should continue to expand access to alternative 

treatments. 

H.R. 4977, Creating Options for Veterans Expedited Recovery or 

COVER Act: The VFW supports this legislation which would establish a commission to survey veterans and examine the efficacy of 

VA mental healthcare and CAM in order to identify ways to improve outcomes. 

With more than 1.4 million veterans receiving specialized VA 

mental health treatment each year, VA must ensure that such 

services are safe and effective. 

H.R. 5059, the Clay Hunt Suicide Prevention for American Veterans Act or the SAV Act: The VFW is proud to support the Clay 

Hunt SAV Act, which is aimed at Combatting veteran suicide. This 


VACREP0180 with DISTILLER
17 

widely known crisis is one that weighs heavily on our Nation, especially on those of us who have served in uniform. 

When a veteran or servicemember becomes so hopeless they decide to take their own life, it is equally as devastating as life lost 

in combat. We would like to thank Representative Walz and Chairman Miller for bringing forth this bipartisan legislation. The SAV 

Act contains numerous provisions that would have a significant impact on preventing veteran suicide. 

We would offer a meaningful change to the way unfavorable discharges are reviewed by the Department of Defense in cases where 

servicemembers were likely suffering from undiagnosed mental 

health wounds. It would require VA and the National Guard Bureau to enter into strategic partnerships to ensure guardsmen don’t 

fall between the cracks as they transition from duty. This legislation would also establish a VA community outreach program focused on successful active duty to veteran transition through peer 

support. 

The VFW believes these key provisions along with others contained in the bill will go a long way towards addressing the crisis 

of veteran suicide. 

H.R. 5475: The VFW supports this legislation which would expand VA’s authority to provide healthcare to a newborn child 

whose delivery is furnished by VA from 7 to 14 days post birth. According to the Centers for Disease Control and Prevention, newborn screenings are vital to diagnosing and preventing certain 

health conditions that can affect a child’s long-term health. The 

VFW understands the importance of high quality newborn 

healthcare and its impact on the lives of veterans and their families. We believe that VA should be authorized to do what is needed 

to ensure that newborn children whose delivery was furnished by 

VA receive the proper post-natal healthcare they may need. 

H.R. 5484, Toxic Exposure Research Act of 2014: The VFW supports this legislation which would establish an advisory board to 

assist VA in determining the association between adverse health 

conditions and exposure to toxic substances. It would also establish 

a national center for research to study the health affects of toxic 

exposures on the descendants of individuals who were exposed to 

such substances during their military service. 

The VFW does have concerns, however, with section 4, which 

would authorize the advisory board to determine whether a veteran 

who submits a claim has a health condition that would qualify 

them for VA healthcare or compensation benefits. 

Since the VA already has an established process for adjudicating 

disability claims, creating a new process for the unique purpose of 

deciding toxic exposure claims could add confusion to the disability 

evaluation system. 

We suggest that the advisory board’s role in this process be limited to whether its research found that a health condition is associated with exposure to toxic substances. Such a process should serve 

to inform veterans of the advisory board’s findings, not to determine a veterans eligibility for VA benefits. 

That being said, the VFW strongly believes that veterans should 

not have to wait decades before their illnesses associated with toxic 

exposures are recognized, and that more research is needed to deVerDate Aug 31 2005 09:43 Mar 03, 2016 Jkt 000000 PO 00000 Frm 00021 Fmt 6633 Sfmt 6633 Y:\96-135.TXT PAT

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termine what affects those exposures may have on their descendants. 

Mr. Chairman, this concludes my statement and I look forward 

to any questions you and other members of the subcommittee may 

have. 

[THE PREPARED STATEMENT OF MR. ALEKS MOROSKY APPEARS IN

THE APPENDIX] 

Dr. BENISHEK. Thank you very much, Mr. Morosky for your testimony. 

Mr. Rowan. 

STATEMENT OF JOHN ROWAN 

Mr. ROWAN. Good afternoon, Mr. Chairman, Ranking Member 

Brownley, distinguished members of the panel. 

First of all, Vietnam Veterans of America supports all the bills 

before you today and we want to be on the record for that. However, I do want to speak on a couple. First of all, we want to thank 

the chairman for his support of H.R. 5484. I will get into that secondly. 

I want to say a couple of words on the Clay Hunt SAV Act. Unfortunately I have been around in this business long enough and 

I am old enough to remember when Swords to Plowshares was created. And the problems they talk about today with suicide is still 

with the Vietnam vets. Sixty percent of veterans committing suicides today are my generation, over 50, they are the Vietnam vets 

primarily. It is still a problem for us. It was a problem for us when 

we came home and it is still a problem for us today. It is becoming 

more of a problem unfortunately as the veterans get older. 

So a lot of this effort is great and I am glad we are working on 

trying to save this younger veterans coming home and trying to do 

anything we can to save them. A lot of the Vietnam vets are mentoring these folks as they come home. 

But it is important also on this other issue, in 1972 Ralph Nader 

did a study that shows there were a half a million bad paper discharges issued during the Vietnam War, most of them for drugs, 

alcohol and AWOL. Minor nonsense stuff that cost people the rest 

of their lives to have an albatross around their neck. 

Many of them—veterans who came home from Vietnam and were 

stuck with another year of service who couldn’t deal with life back 

in barracks. We see that today as well so it is a real problem. This 

is not a new problem, it is an old problem. And maybe if we were 

doing research on these and other problems we’d know what to do 

today and we wouldn’t have to wait 35 years to figure it out. 

As far as the Toxic Research Exposure Act of 2014, this is an 

issue we have been looking at for quite a number of years now, especially in the last couple of years. Vietnam Veterans of America 

have held numerous over 100, almost 150 now of town hall meetings all across the country asking veterans about their exposures 

to Agent Orange and how they think it affected their families. And 

unfortunately, the answer is pretty horrifying. 

Now, I can’t tell you for absolutely sure that every issue and 

every illness is because of Agent Orange I would never say that. 

I am not an scientist, wouldn’t even think about it. But the reality 

is the VA has done very little in the way of studying Agent Orange 


VACREP0180 with DISTILLER
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affects in anybody ever, in the whole history of Vietnam veterans 

coming home. All the years that we have been dealing with the 

Agent Orange Act since 1991, there has always been outside research the IOM on how to review, not research done by the VA, or 

through the VA, or under the auspices of the VA. 

So we really must encourage you to get this bill passed and it 

may need some tweaking. And I can tell you we are not looking to 

play with the claims part of how claims are done. We are simply 

saying if we see something going on, and we see these issues coming up, you better start taking a look at whether or not it deserves 

a claim. 

And all we have asked people to do is if they think their child’s 

issues are related to their exposure as a veteran, file a claim, get 

denied, but at least let’s get it in. And we have got the VA putting 

all of those claims in one place in Denver so we can compile the 

information coming in and get an idea of what kind of wide range 

of unfortunate illnesses or issues we are dealing with. So that 

hopefully will give them some direction on what it is they need to 

research. 

So we encourage you to please pass this bill and if we have to 

tweak it, we will. But the key to this bill also, it is not just about 

us, it is not just about the Vietnam veterans. We may be the first 

and one of the largest groups to have been exposed—actually, we 

weren’t the first, talk to the atomic veterans from World War II, 

but we are the biggest probably of being exposed out there. 

But the Persian Gulf veterans frankly have more of a problem 

than we do in some ways. It is just that fortunately they didn’t 

send that 2 million people to the Persian Gulf the first time out. 

Now unfortunately they sent them back to the Persian Gulf for the 

second time out and we have got a couple million people who have 

tromped through Iraq, and Afghanistan, and other wonderful 

places and exposed to who knows what out there. 

And I can tell you after talking to some of the troops who have 

come home and talking about their illnesses already and some of 

their children’s illnesses already we have some real serious concerns about what they have been exposed to. So it is extremely important that this bill go through and we start getting this research 

done now. 

I am 69 years old. I have been waiting for this stuff for a long 

time. The children of the Vietnam veterans are in their forties. It 

is the grandchildren that now we are even looking at, who even 

those are in their twenties. I have friends of mine who are great 

great grand parents. So it is time, it is just that simple, it is time. 

Thank you. 

[THE PREPARED STATEMENT OF MR. JOHN ROWAN APPEARS IN THE

APPENDIX] 

Dr. BENISHEK. Thank you, Mr. Rowan, for your testimony. 

I appreciate the fact that all you gentleman came and testified 

today, that is really fabulous. 

I am going to yield myself 5 minutes for comments and questions. 

Let me just say that frankly I brought up this toxic exposure bill 

after talking to veterans in my District. I go around, have a group 

and try to meet with veterans in every little town I can at the VFW 


VACREP0180 with DISTILLER
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or the American Legion and they just brought up this issue of 

these burn pits, which frankly I hadn’t really heard of until they 

brought it to my attention, in the Persian Gulf war back in the 

1990s. 

We really need to be more on top of this possible exposure, because like you say, the Agent Orange issue didn’t come out until 

20 years after Vietnam, if not longer. And, we just need to be on 

top of these possible exposures in a more timely fashion. That is 

one of the reasons I brought forward the bill and we are happy to 

look at tweaks to it to make sure it doesn’t affect, the determination of disability. That is the reason we are having this hearing 

franking is to get input from other people to learn more about how 

to do things. 

The only other comment I wish to make was about the alternative therapies. I just got exposed to an equine therapy in my District. I went out with Ms. Brownley in California and got some exposure to Hope. And, I am not really a horse person, but I went 

to this equine therapy and I met some veterans there, Vietnam 

War veterans who were mentoring younger veterans who felt it 

was a real help to them, because as you know, not the same treatment is good for everyone. There should be a wide variety of options to treat people with PTSD and other combat trauma history. 

I thought it was really an awakening. 

The problem is how to make sure that, there is a good quality 

of treatment and there is a good effect with all this disparate types 

of alternative therapies. We have heard from yoga to acupuncture. 

How are we going to make sure this all makes sense to veterans? 

I am happy to explore that in this committee, but we need to make 

some progress. I think Ms. Brownley’s bill is a great step forward. 

Do any of you have comments on the alternative medical therapies as proposed and the couple of pieces of legislation I have 

today? Anybody want to weigh in? 

Mr. NEIWEEM. Mr. Chairman, I will just jump in. I think looking 

at complementing alternative medicines would be a step forward, 

and certainly some pieces of legislation start including survey instruments, you know, looking at veterans and sort of talking to 

them. I think when you focus on the veteran, you get that feedback, and so instead of asking VA, you are asking veterans. And 

many veterans can benefit from these types of treatments and it 

goes hand in hand with the peer support model of veterans tending 

to be comfortable talking to other veterans. 

Mr. ROWAN. Yeah, I would add too, that the only caveat we had 

about that is it needs to be reviewed scientifically, that we ensure 

that what they are doing is in fact scientifically correct, and that 

they can double-check it and triple-check it and make sure it is 

working. 

One of the other things I think you will find a lot of time with 

the alternatives therapies is they can’t be done alone. And that is 

one of the problems we got. Sometimes people tend to grab on one 

thing and say, oh, this is wonderful. This is all I have to do and 

I am going to be cured. Well, not really. 

I mean we got into that years ago with alcohol and substance 

abuse. We would clean people off, dry them out in the VA rehabs 

and all this stuff and they would come right back again because 


VACREP0180 with DISTILLER
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nobody never ever dealt with their PTSD, which is why they were 

getting drug and alcohol problems in the first place. You needed to 

do both. You had to dry them out at the same time you were treating them for PTSD. 

So yes, maybe somebody needs a therapy dog because it calms 

them down, and it is really cool, and I like dogs. And I can understand that, but at the same time, they still need to go to therapy, 

they still need to go to a rap group, they still need to talk their 

problems out. So as a complementary program, I think it would be 

very interesting, as long as the science works. 

Dr. BENISHEK. I definitely agree with that, Mr. Rowan. Thank 

you. 

I will yield the remainder of my time. 

Ms. BROWNLEY. I yield to you for 5 minutes. 

Ms. BROWNLEY. Thank you, Mr. Chairman. 

And I guess I just wanted to follow up on that with you, Mr. 

Rowan, because my understanding is at least with the bill that we 

were just talking about, 4887, that you had said that you felt hesitant about endorsing it because you felt like more research needed 

to be done, which is consistent with what you just said. 

And I wanted to make it clear that the bill before us today—actually includes the research component of that defined, to really determine its efficacy. And if it is a proven program, then to figure 

out how to integrate it into the various services, for our veterans. 

And so, I would love it if you would take another look and overwhelmingly support the bill, I would appreciate it very much. 

Mr. ROWAN. Yes, we will. The head of my veterans health council 

is the guy who is really the expert on all of this stuff. And so he 

is my PTSD person so he is going to be the one to follow it, I’m 

sure. 

And we will be happy to work with you on that one. 

Ms. BROWNLEY. Very good. Very good. 

And I know that the chair was speaking of Reigns of Hope that 

is in my district, equine therapy. But there is a psychotherapist 

there. And so it is complementary. 

And I know that the veterans who are going there for services 

tried all of the traditional methods and it wasn’t until they got out 

into a rather beautiful setting up in Ojai, if anybody has ever been 

in Ojai, it is in my district—in a beautiful open setting in an orange grove, around horses and a very calming atmosphere that, finally, veterans were willing to really begin to talk about what some 

of their issues are. 

Mr. ROWAN. Yeah. I think what—you are just making a good 

point, the issue of being out somewhere where it is nice and calm 

and peaceful. 

Vets—a lot of the vets—the Vietnam vets literally did that, ran 

into the hills. Couldn’t live in the cities. Had to get out. Had to get 

into the countryside. It was part of the way they coped. 

But, again, I think the key is the complementary aspect. You 

know, it is no question, if they can get calmed down, then they can 

get treatment. You can talk to them. If they are in an agitated 

state, somebody is not going to talk to you. 


VACREP0180 with DISTILLER
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So if the animals will calm them down or other kinds of treatments calm them down and they can get them into a program, get 

them into a rap group, boy, that is terrific. 

Ms. BROWNLEY. Yes. We have some veterans who are traveling 

6 hours to actually utilize this therapy because it has been the only 

thing that has really worked for them. 

Mr. NEIWEEM. am I pronouncing your name correctly? 

Mr. NEIWEEM. It is pretty close, Ms. Ranking Member. It is 

‘‘Neiweem.’’ 

Ms. BROWNLEY. ‘‘Neiweem.’’ I apologize. 

So in your testimony you stated that suicide prevention is obviously your number one priority, as is ours. And you talked about 

the Clay Hunt Bill as being a starting point. 

What else should we be doing? 

Mr. NEIWEEM. Well, I think there are several provisions in the 

Clay Hunt Bill, but just one example is the community outreach 

prevention. 

So we are looking at creating these veteran networks and expanding peer-to-peer support, and we reach out there. And you talk 

to veterans and they are always comfortable talking with other veterans. We hear that again and again. 

So it’s been sort of a successful approach. In some of the scenarios where, you know, that tragic ending occurs, usually that individual has lost touch with the community and left. 

And in, you know, VA’s written remarks, they sort of—you know, 

they talk about the peer support program they have right now. 

They describe it as, you know, a very robust support program that 

has at least three specialists at every VA medical center. Three 

people is very robust? I would disagree with that. 

Now, it is good and it is—it is working. I think it is successful 

in looking at the 973 peer specialists. But why aren’t we doubling 

down on that? Why aren’t we looking at that and expanding that 

to get more veterans out in the community? 

You know, we know that VA has had these mental health summits and reached out. But is that enough? So you have one summit 

and then it is sort of you all get together and then you lose touch. 

So this bill gets into that. 

And we appreciate all the support from all the members, especially Chairman Miller, Mr. Walz and others, pushing this bill. So 

that is one example. It just is emphasizing peer support. That is 

just one section of the bill, one example. 

And your bill, Congresswoman Brownley, looking at CAM—I 

mean, we have to look at that. And if we don’t look at it and work 

towards looking at evidence-based things, then we are never going 

to add it. 

And we have to get away from this ‘‘VA knows best,’’ you know 

sort of philosophy, ‘‘The VA knows,’’ ‘‘The VA.’’ Well, talk to the 

veterans. Because, for many, it is very therapeutic to horsebackride, fishing. The list goes on. So—— 

Ms. BROWNLEY. Thank you, sir. 

And I will yield back. 

Dr. BENISHEK. Thanks, Ms. Brownley. 

Dr. Roe. 

Dr. ROE. Thank you, Mr. Chairman. 


VACREP0180 with DISTILLER
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First of all, thank you all for your service. Mr. Rowan and I are 

of the same vintage. So thank you for your service in Vietnam. 

We have—one of our famous VA medical centers is the Alvin C. 

York Medical Center, a Medal of Honor winner. And when I was— 

we were doing the VA bill last—this last summer, before we went 

on recess and got it signed into law, I discovered, as Tim Walberg 

did, that a Medal of Honor winner was a category 3. I want them 

to have the Secretary’s name on speed dial. 

There are 79 of these men. I had the privilege of being at the 

Bristol Brothers Speedway in August with three Medal of Honor 

winners. And they had their convention in Knoxville that weekend. 

And those men should go to the front of the line. That is one—that 

is basically one Medal of Honor winner for every other major medical center. 

I don’t think it is going to create any big hardship for the VA 

to take care of these men, and—and I think they should be at the 

front of the line. If they want an appointment at 10 o’clock tomorrow, a Medal of Honor winner ought to have it. It ought to cost 

them absolutely nothing. 

So I would want to expand a little bit on Mr. Walberg’s and go 

full bore on that for a Medal of Honor winner. That is just a shoutout to them. We have had two in my district. These are incredible 

people and they need to be honored. 

And it is shameful that we had them ever as a category 3. They 

are number 1 in my book forever. As a matter of fact, they ought 

to have the President’s number on speed dial. That is how I feel 

about the Medal of Honor winners. 

Now, number two, on what Mr. Collins was talking about, typically, on a newborn baby, probably 95 percent of the issues that we 

see—and Dan can help me with this—but probably 95 percent of 

the issues that we see exacerbate themselves within 6 weeks. 

I don’t know what the problem is with just having a 6 weeks’ 

checkup included in that bill, like we do for any other pregnant 

mother. I took care of women for 30 years and delivered their babies and took care of their children. 

And I don’t know why 2 weeks is put in there. I have never seen 

a 2-week checkup. My children always got checked by the pediatrician, and they went on and had their 6 weeks’ checkup. And I 

would just expand that to 6 weeks and let’s get most of the issues 

out of the way. That is just a suggestion that I have. 

One of the things that—that I agree totally on are on your alternative therapies. Mr. Rowan is correct. We do need to use evidencebased therapy. I think you are right or you will end up wasting a 

lot of money and time and maybe not do any good. So I think that 

is extremely important. Ms. Brownley, I agree with you on that. 

And we are very much involved in this. My wife is helping set 

up a pet therapy program for our local VA, and many people want 

to help. We know those things help. I saw a veteran the other day 

with his service dog with him at a—at a Memorial—I mean, at a 

Veterans Day event. And I know this guy. And he is much, much 

better because of that therapy dog. There is no question about it. 

And he says he is and he can function now. 


VACREP0180 with DISTILLER
24 

But it needs to be studied. It is not for everybody. And I agree 

with you, Mr. Rowan. It is probably—adjunctive therapy, we should 

call it, not primary therapy. 

The one issue—and, Mr. Adams, I want you to respond to this. 

And this is a real problem I have had dealing with, because we 

have veterans, as Mr. Rowan pointed out, that come to my office— 

my Congressional office who—usually, it is Vietnam—who went 

AWOL after they got back. 

I know—when I was in the 2nd Infantry Division, we couldn’t 

tolerate that behavior, if you had someone that was disruptive like 

that. And probably there is no doubt—I was a medical officer in the 

2nd Infantry Division. I probably did a very poor job of identifying 

some of these folks with mental illness and—who should have 

been—had a general discharge, not dishonorable discharge, from 

the military and they would have been able to do what you do. 

But we all know that a soldier that goes AWOL puts his unit at 

risk. And that is the trouble I have had in dealing with that. 

How—how do you—I know it was a bad decision. It could have 

been because of something they had no control of. 

As Mr. Rowan said, going forward—it has taken us 40 years to 

figure this out—I think the DoD needs to be more careful when 

they discharge someone to—to be clear, instead of just getting it off 

the books quick and taking care of the problem, because it carries, 

as you pointed out, Mr. Adams, a lifetime of ramifications. Because 

that person could very well be brought back into society and have 

a perfectly productive life if they are treated right. Maybe we just 

missed it on the way in or out. 

So you have got to help me with that a little bit because I don’t— 

that one is tough for the military. It is. Because they can’t have 

disruptive behavior in a platoon or whatever. 

So if you would let me have about a minute and let him respond 

to that. 

Dr. BENISHEK. Sure. 

Dr. ROE. Thank you. 

Mr. ADAMS. Well, thanks for your interest in your question, Dr. 

Roe. 

I agree with you entirely. I agree with you entirely. And, as I 

said, in the case of Terrence Harvey, he needed probably to be separated from service. 

Now, the VA should have done it properly. It should have identified the problem, given him a medical discharge. They didn’t do 

that. And that should be corrected by the Armed Services Committee through the DoD. 

It is a different question today if that person who needed to have 

been separated from service for whatever reason deserves our society’s and country’s support dealing with the burdens they carry 

from the service. And the law is already written to separate those 

two things because they are different. 

The commander needs to make decisions today to ensure the effectiveness of his unit today. The VA needs to make decisions over 

the life of that veteran to ensure that we uphold our responsibilities to that veteran. They are two different things. 

If the committee puts the burden on the DoD for deciding who 

gets sent out of the VA, they are essentially combining those two 


VACREP0180 with DISTILLER
25 

things, giving responsibility to the commanders that the commanders don’t want. The commanders don’t want to be responsible 

for the lifetime after that veteran actually left service. 

By separating those, giving clear separate instructions to the VA, 

that allows the DoD and the VA to do their separate jobs and allows us to give appropriate response and treatment to veterans on 

a case-by-case basis. 

Dr. ROE. But they would be—they would be given a medical discharge, though. That has to happen at the DoD level. 

Mr. ADAMS. So the correct way to proceed, to take the example 

of Mr. Harvey, was he should have been recognized and diagnosed 

with PTSD and given a medical discharge. And if that had happened, he would be in the door at the VA. 

Dr. ROE. He would be fine. Right. 

Mr. ADAMS. He would be fine. 

Now, what we can do right now is you can tell him to go back 

to the DoD and ask them to change their mind. 

Dr. ROE. It will never happen. 

Mr. ADAMS. Well, yeah. I mean, I can—I do it. It takes 3 years, 

87 percent denial rate, depending on service. There is two different 

agencies, different forms, different procedures. It just doesn’t—it is 

not a solution to at-risk veterans. 

The VA can solve it on the spot. That is under the existing law. 

They just have rules that I think don’t reflect the public and certainly not my expectations of who should be in, who should be out. 

Dr. ROE. Thank you. 

I thank the Chairman for allowing me to have a little extra time. 

I yield back. 

Dr. BENISHEK. Absolutely. 

Mr. ROWAN. Mr. Chairman, can I respond to the Doctor’s question just quick? 

We did this back in the 1970s and 1980s. I did discharge upgrades. We upgraded 70 to 80 percent of the claims we did in New 

York City at the time. 

The reality—and we—and we are suing all of the military people 

right now about these discharges they gave out for the wrong diagnosis that should have been PTSD. 

But I wholeheartedly agree. The VA can bring all these people 

in tomorrow. They can take them. Unless they had a dishonorable 

discharge for serious crimes and offenses, they can take them in 

and treat them. And that is the key part, the treatment. 

Dr. BENISHEK. Mr. Bilirakis, 5 minutes. 

Mr. BILIRAKIS. Thank you, Mr. Chairman. I appreciate it again. 

And I want to thank the panel for their support and their testimony today, but thank you for the support of the COVER Act. And, 

again, that is why we are here. If you have any suggestions to improve my particular bill, please don’t ever hesitate. 

And, again, I am big on these alternative therapies or complementary therapies. I know they work because I speak to the veterans every day. But, of course, we do have to have the science. 

I have a couple questions and then—I would appreciate a yes or 

no. But if you have to elaborate quickly, that is fine, too. But I 

want—for the entire panel. 

I guess we will begin with Mr. Neiweem. 


VACREP0180 with DISTILLER
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Do you believe the therapies accepted and currently practiced by 

the VA are yielding the best wellness-based outcomes for veterans 

affected by the mental health concerns? 

Mr. NEIWEEM. Congressman, first of all, we support your bill 

strongly. 

I would say there is essentially sort of two tracks. There is the 

counseling track, and there is sort of the prescription drug track, 

in my experience. So those results vary greatly, depending on the 

individual. 

So that is my—my best answer is it varies. So the incorporation 

of CAM alternatives I think offers new alternatives that we need 

to look at. 

Mr. BILIRAKIS. Thank you. 

Mr. Adams. 

Mr. ADAMS. With respect, Mr. Congressman, our attention is 

really focused on those who are excluded entirely from the VA 

health system. 

There are two narrow benefits that are available to people, even 

if they have what—what we call bad paper, and they are too limited. 

One is access to the vet centers, which you may be familiar with. 

They have the same eligibility requirements, but they just basically 

don’t ask too many questions when people come in. 

They only provide talk therapy. We would love it if they also had 

access to medical treatment as well as complementary treatment. 

None of those are available to them, and we hope that that—that 

can be. 

Mr. BILIRAKIS. Mr. Morosky. 

Mr. MOROSKY. I would say some are more successful than others. 

More needs to be done. 

Mr. BILIRAKIS. Mr. Rowan. 

Mr. ROWAN. No. 

Mr. BILIRAKIS. Okay. Thank you very much. Appreciate it. 

Do you believe the veterans affected by mental health are being 

over-prescribed with prescription drugs for their ailments? If we 

can start right here again. 

Mr. NEIWEEM. I think, in some cases, that is true. And I think, 

in the case of many veterans, that is where, you know, sort of VA 

can be lagging, too, is the time that elapses between appointments, 

struggling to get, you know, an appointment with a, you know, VA 

outpatient clinic. 

If you have, you know, adverse reaction to certain medications, 

certainly, you know, you can call. But, again, until we improve sort 

of the time with which veterans can get in there, you know, I think 

we are going to still see, you know, issues with prescription medications and others as things can change. 

So consistency with—with VA appointments and timeliness with 

getting veterans in to see care I think is critical. 

Mr. BILIRAKIS. Mr. Adams. 

Mr. ADAMS. I do work with veterans who feel that they are overprescribed medication. From my perspective, often I think the problem is they don’t understand that they have options, even within 

medical responses. So veterans will say, ‘‘This makes me feel terrible. I am going off my meds.’’ 


VACREP0180 with DISTILLER
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Mr. BILIRAKIS. Are there options within the VA? 

Mr. ADAMS. Within—even within the VA. Even within medical 

treatment. I mean, there is really a sense of powerlessness 

among—among some. So some say, ‘‘I am going off meds. I just 

can’t take it.’’ 

And I say, ‘‘You know, you can do that if you want, but you can 

also go to your doctor and say, ‘I feel this way. I don’t feel good. 

This drug you put me on last week does make me feel bad. Do you 

have something else?’ ′′ 

And so I think encouraging both the existence of options within 

and outside the VA, inside and outside the medical—certainly the 

medical sphere—I think that can go a long way toward giving people control over their health. 

Mr. BILIRAKIS. Thank you, sir. 

Mr. Morosky. 

Mr. MOROSKY. We hear from veterans that feel overmedicated, 

that feel that they are medicated incorrectly. They are receiving 

pills that aren’t doing anything for them, but certainly are overmedicated. We know of people who have died from overdoses because of overmedication. 

So this is one of the reasons why we think CAM therapies are 

important, because it goes away from the one size fits all and gives 

people other safer alternatives. 

Mr. BILIRAKIS. Yeah. You know a lot of these alternative therapies are available. But the ranking member said, you know, you 

have to drive 6 hours for the equine therapy. And we have it in 

our district, too. 

But the problem is that, financially, a lot of these nonprofits are 

having a hard time during these economic times. And we need to 

reimburse them for these service, if they are effective. And I see 

that they are effective. 

Mr. Rowan. 

Mr. ROWAN. I think it is less of a problem than it was in the 

early days. I can tell you that. All they had was drug therapy originally. I mean, there were no—that is—there was nothing. They 

just—the guy went over there, they gave you a bunch of pills and 

you went home and often got yourself in deeper trouble. 

The key, I think, is the combination of all of the things. And I 

think the problem is it is just not enough staff time and not enough 

veteran centers out there. There is just not enough of anything out 

there. They need more staff. They need more help. They need to 

get people in to be treated quickly. That is the other problem. 

You can’t let somebody languish out there when they have a 

mental health question going on because often there is other 

issues. You know—and, you know, the typical thing that usually 

shows up is substance abuse or alcoholism, spousal abuse, child 

abuse. 

I mean, one of the key things, I think, that works, by the way, 

is the vet court system because that captures these folks and at 

least we get in—that forces them to get into a system and to have 

somebody supervise them—that is the other key question—having 

the outside agency like the court supervise their process and having a veteran mentor helping them through the process. 

Mr. BILIRAKIS. Very good. 


VACREP0180 with DISTILLER
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Mr. ROWAN. And some of that may be therapy. And some of—all 

the other kinds of things you are talking are very interesting. We 

would like to talk about it. 

Mr. BILIRAKIS. Thank you very much. 

I—well, my time has expired, Mr. Chairman. I yield back. 

Dr. BENISHEK. Thank you. 

I want to thank you gentleman for appearing before us today. 

And I really appreciate your input. And stay in touch with us so 

we can tweak these things that help us all better. Thanks so much. 

I would like to welcome the third and final panel to the witness 

table. 

Joining us from the Department of Veterans Affairs is Dr. Rajiv 

Jain, Assistant Deputy Under Secretary for Health for Patient 

Care Services. 

Dr. Jain is accompanied by Jennifer Gray, Staff Attorney for the 

VA Office of General Counsel. 

Thank you both for joining us today. 

STATEMENTS OF RAJIV JAIN, M.D., ASSISTANT DEPUTY 

UNDER SECRETARY FOR HEALTH FOR PATIENT CARE SERVICES, VETERANS HEALTH ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS; JENNIFER GRAY, ESQ., STAFF 

ATTORNEY, OFFICE OF GENERAL COUNSEL, U.S. DEPARTMENT OF VETERANS AFFAIRS 

STATEMENT OF RAJIV JAIN, M.D. 

Dr. JAIN. Thank you, Mr. Chairman. Good afternoon. And Ranking Member Brownley and members of the subcommittee, thank 

you for the opportunity to address the bills on today’s agenda and 

to discuss the impact of these bills and VHA’s healthcare operations. Joining me today is Jennifer Gray with VA’s Office of the 

General Counsel on my left. 

I want to first thank the subcommittee for the opportunity to testify concerning the bills we support, starting with H.R. 5475. 

VA supports H.R. 5475, which would expand coverage for 

newborns through their first 14 days of life. We are still analyzing 

the cost of this bill, but we believe it would provide an expanded 

benefit to a relatively small number of newborns who need the additional coverage. 

VA also fully supports and appreciates H.R. 4720, legislation designed to recognize the service of Medal of Honor recipients and to 

ensure that they receive cost-free care to maintain their health and 

well-being. Toward this end, VA believes that, in addition to moving them to priority group 1, we would need to amend the statutory 

authorities governing copayments. 

However, we would like to work with the committee to ensure 

that the end goal of costly care is attained as it is for other special 

categories of veterans, such as catastrophically disabled veterans, 

former prisoners of war, and Purple Heart recipients. 

VA also supports the goals of H.R. 4977, which would establish 

a commission to examine the efficacy of the evidence-based therapy 

model used for treating mental health illnesses, identify areas to 

improve wellness-based outcomes, conduct patient-centered surVerDate Aug 31 2005 09:43 Mar 03, 2016 Jkt 000000 PO 00000 Frm 00032 Fmt 6633 Sfmt 6633 Y:\96-135.TXT PAT

VACREP0180 with DISTILLER
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veys, and examine available research on complementary and alternative treatment therapies for mental health issues. 

However, as outlined in our testimony, we have concerns about 

the manner in which the bill would carry out that goal because of 

the duplicative nature of some of the requirements and the unintended burden it may place upon our veterans. We would like to 

work with the committee to address these concerns and develop a 

bill that addresses the needs of these veterans. 

Likewise, we believe that H.R. 5059, the Clay Hunt Suicide Prevention for American Veterans Act, is a very important piece of legislation, but may potentially overlap with programs already underway in VA. 

VA appreciates that Congress continues to raise awareness of 

mental healthcare and suicide prevention, two of our highest priorities. VA would welcome discussions with the committee to examine how best to address these issues and identify and fill gaps that 

may exist. 

We received H.R. 4887, the Expanded Care For Veterans Act, 

and H.R. 5686, the Physician Ambassadors Helping Veterans Act, 

just prior to today’s hearing. And, therefore, we were not able to 

provide views at this time. We would be happy to discuss either of 

these bills today or to meet with the committee to provide technical 

assistance going forward. 

Finally, let me state at the outset that, while we do not support 

H.R. 5484, we do support the goals behind many of the provisions 

in this bill. However, we are concerned that key elements are not 

clearly defined, such as how a newly established advisory board for 

toxic exposures would review claims and operate in relation to existing statutes, regulations, and processes for claims adjudication. 

We also feel that the center established by the bill would duplicate the work being done by other agencies that have been doing 

this sort of work for many years. We would like to acknowledge 

that more needs to be done in this area, and we would be happy 

to work with the VSOs and the committee to address these issues. 

In closing, thank you, Mr. Chairman, for the opportunity to testify before you today. My colleague and I would be pleased to respond to your questions. 

[THE PREPARED STATEMENT OF DR. JAIN APPEARS IN THE APPENDIX] 

Dr. BENISHEK. Thank you, Dr. Jain. 

I would like to yield myself 5 minutes to discuss this legislation 

and to ask some questions. 

I am curious about this written testimony that placed the Medal 

of Honor recipients in priority group 1 rather than priority group 

3. There was a statement, apparently, in your written testimony 

that said this would result in no additional benefit for the veteran. 

Dr. JAIN. Sir—— 

Dr. BENISHEK. What does that mean exactly? 

Dr. JAIN. Right, sir. Mr. Chairman, I will be happy to clarify. 

The issue here—and I will turn to my colleague here on the left 

in a second—but the issue is that the—the service of medal recipients who are in category 3, if we were to move them in category 

1, which we do support, would still not give them the cost-free care 


VACREP0180 with DISTILLER
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that we are looking for because the statutes that govern that piece 

are different statutes. 

But let me ask Ms. Gray to clarify that. 

Ms. GRAY. Right. So we have specific statutes that deal with copayments. For example, 1722A deals with the medication copayments, and that is tied—those who are exempted from paying the 

copayment, it is tied to either service connection or income or being 

a prisoner of war. 

So in order to make sure that recipients of the Medal of Honor 

are also exempt, we would have to make changes to 1722A and, 

likewise, 1710 and 1710B. 

Dr. BENISHEK. Is there any other difference, then, between the 

veterans in priority group 1 and priority group 3? Is there any difference, other than that provision, between the people that—— 

Dr. JAIN. No, sir, as far as we know. Now, those service of medal 

recipients that are already service-connected, they would automatically be in priority group 1. 

So the difference is whether they are service-connected or not, 

and that is what ends up being there in group 3. So we definitely 

support moving them to group 1. So that would be definitely the 

right thing to do. 

Dr. BENISHEK. All right. I have another question about H.R. 5059 

that you are somewhat unsure if we could do anything more for the 

veteran, because you think you are doing everything. 

It doesn’t seem to jibe with the fact that we have 22 veterans a 

day that are still committing suicide, and that number doesn’t 

seem to be changing all that dramatically to me. 

So, I mean, if this doesn’t do it, then, what would do it, Dr. Jain? 

I mean, I want to get that number down to zero. 

Dr. JAIN. Sir—Mr. Chairman, we fully agree with you. And so 

the issue is not that we don’t support the goals. We definitely support the goals. The only concern that we have is that we have other 

efforts underway in the VA that are achieving the kind of things 

that the bill would achieve. 

So I will give you some examples, sir. The—for example, the 

issue of the outside review, we have a contract with the National 

Academies of Science, which is a purely independent body that is 

currently in effect, and that is reviewing the mental health and the 

suicide prevention programs in the VA. 

We also have done data-sharing agreements with all the 50 

States to understand our understanding of the suicides. And we 

published a report in February 2013 from that to inform our prevention efforts. We also have a VA/DoD suicide data repository, 

and we published a report in January of 2014. 

But we do support, sir, the—that there should be a one-time targeted evaluation of the suicide prevention program to support the 

implementation of the 2013 joint VA and DoD clinical practice 

guidelines for management of risk of suicide. So—— 

Dr. BENISHEK. What has changed in the last 6 months, then, 

about suicide prevention practices within the VA that you have 

learned from the studies that you are already conducting? What 

have you changed? Have you changed anything in the last 6 

months, Dr. Jain? 


VACREP0180 with DISTILLER
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Dr. JAIN. So—yes, sir. I think—let me clarify. I think that there 

are—about 3 to 4 months ago, we did a very deep dive into the four 

or five major causes for suicide, which have to do with depression, 

sleep disorders, PTSD. 

So we worked with our subject matter experts to understand 

what is the evidence base, and we have updated the—the guidelines for treatment of some of these conditions. And we are now in 

the process of implementation of those guidelines. 

Dr. BENISHEK. Well, I certainly understand that you are giving 

me a long answer. But I am still very disappointed in the way the 

VA is taking care of veterans who are suicidal. 

I mean, that is basically—the reason that we are sitting here 

today, Dr. Jain, is that 22 veterans are committing suicide a day 

and we want to find an answer. 

And you tell me that, you are doing your own outside evaluations, but the numbers—aren’t going down, Dr. Jain, and that is 

a problem for me. 

Dr. JAIN. I would agree with that, sir. And that is definitely a 

problem for us. And we are always looking at better ways of doing 

things. We are looking at whatever the evidence base is, whatever 

we can do, whether it is complementary and alternative therapies. 

And I know that Ms. Brownley’s bill is—and we will talk about 

that in a minute. But we are always looking to see what other improvements we can put in place and how we can make the treatments better. 

Mr Benishek. Okay. Well—— 

Dr. JAIN. So to extent the bill would help us, we are certainly in 

support of that part. 

Dr. BENISHEK. All right. I am out of time. 

Ms. Brownley. 

Ms. BROWNLEY. Thank you, Mr. Chairman. 

Well, thank you for the segue in terms of talking about my bill. 

I appreciate that very much. 

And in your testimony you said you hadn’t really reviewed the 

bill. So if that is true, you don’t have any concerns one way or the 

other because you haven’t reviewed it. Or do you have some concerns regarding the efficacy of CAM therapies—if you will elaborate, please. 

Dr. JAIN. Sure. And I would be—certainly be giving you some 

sort of general views on this and not the official view, as you are 

saying. 

So I think what we are trying to do here, we definitely do support in the sense that the VA has already made a commitment to 

develop an integrated health coordinating center. 

So we—we have this in our strategic plan to be moving towards 

whole health approaches, to be looking at alternative medicine approaches for pain management, PTSD, depression, you name it. I 

think there are many conditions that could be benefited by use of 

alternative therapies. 

I think—as the previous panel indicated, I think the concern that 

we have is that we need to make sure that the evidence base is 

strong. And so the VA is launching a study with Institute of Medicine, for example, to have them do a review with us to see what 


VACREP0180 with DISTILLER
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the evidence base is and what their recommendations would be. So 

that is a brand-new effort. 

We are also implementing some new therapies. For example, we 

have implemented acceptance and commitment therapy for depression. 600 clinicians were trained in that particular therapy. We 

have chiropractic services. We have health coaching. We have 

music therapy. 

And then we have EMDR, or eye movement desensitization and 

reprocessing therapy, in some of the locations where we have 

trained providers. So we are beginning to move in this direction. 

We are also conducting research to further support that. 

We are partnering with the National Institute of Complementary 

and Alternative Medicine to work with them. Several of our staff 

on their—are on their advisory committee and working with them 

to understand what is working and how we can bring that into the 

VA. 

Ms. BROWNLEY. So in your research that you are speaking of and 

what you are doing to date, how are you interacting with veterans 

to find out what they want? 

Dr. JAIN. That is a very good question, and I—and you bring that 

up. And, actually, we are just in the process of sending out a survey to veterans—it should be in the next few weeks—that would 

be asking just that question, to understand what their needs are, 

how they feel about this thing, and what they would prefer. So that 

is very much in process now. 

Ms. BROWNLEY. Well, it is a little bit of a concern to me to hear 

that you are going down a path of research and training in some 

instances and not really understanding what our veterans want in 

terms of, what their priorities are. 

I mean, I would hope that, at the end of the day, their priorities 

would be our collective priorities. And so it is a little bit of a concern. It seems like it is an afterthought. 

Dr. JAIN. Well, let me just say this. I mean, I certainly understand their concern. And we take that to heart, and we will continue to engage with the veterans. 

As you were mentioning in your example, some of the CAM 

therapies are, frankly, coming up as local innovations in some of 

our medical centers. So we are not holding them back. So I think 

the equine therapy is a perfect example. 

So what happens is, at some of our medical centers, you have clinicians who very much believe in a certain type of alternative therapy and, with the support of the local management, they are going 

forward with some of these ideas because they do want to solve 

some of these issues for our veterans. 

But now we are taking a more systematic effort, as a systemwide, to understand what the needs are and what is it that we 

need to do. 

Ms. BROWNLEY. Are you familiar with the studies that the NIH 

and the VA, collaboratively are pursuing relative to alternative 

therapies in managing pain and other health conditions? 

Dr. JAIN. Yes, I am. And, actually, based on some of those studies and some of the work that is already there, there is a commitment that the—the Integrated Health Center has made to pick 


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two—at least two CAM therapies for chronic pain management by 

the end of next year. 

So this will require—now, you might ask why wait until the end 

of next year. So let me explain some of the challenges that we do 

face. There are issues relating to training of the providers. This 

really is a culture change. 

Most of our providers are trained in allopathic Western medicine. 

To bring in CAM therapies as adjunct therapies to main therapies 

will require the training of the staff. We are going to need to train 

our veterans. 

We are going to also work with—there are other challenges we 

are having. We don’t even have—many of the States don’t have licensing categories. They don’t have certification categories. Within 

our system, we don’t have professional groupings. 

So, for example, I will also tell you the acupuncturist is another 

example. So recently we—we do believe that acupuncture is a 

very—has a lot of the evidence now for pain management. And in 

order to hire the acupuncturist in the VA, we are now trying to create a professional category for acupuncturists. 

And as we are going out to hire those, we are finding out that 

most of the States have no provisions for acupuncturists in terms 

of licenses or certifications. So how do we even go out to recruit 

these folks when those things are not available? So we are at the 

cutting edge. And so I think we are dependent on some of these 

other things. 

Ms. BROWNLEY. Well, I know I have exceeded my time. But if I 

could just make one comment before we conclude? 

Dr. BENISHEK. Sure. 

Ms. BROWNLEY. So, I hear what you are saying. I don’t think, at 

the end of the day, it is a good idea for the VA to decide to take 

all of these sort of CAM therapies and try to determine their efficacy and then try to bring them all under the VA roof. 

As you said, there are—— 

Dr. JAIN. Right. 

Ms. BROWNLEY [continuing]. Various communities and programs 

that are taking place right now that are working—that we know 

are working for veterans and that I think we should take a—sort 

of a systematic approach towards that and begin to, contract with 

some of these groups who are already proven and successful so that 

we are providing services to veterans today and not waiting for a 

year or 2 years to bring, all of these new therapies under the roof 

of the VA. So I will just offer that as a comment. 

Thank you, Mr. Chair. 

Dr. Benishek. Ms. Brown. 

Ms. BROWN. Thank you. 

I guess my question goes back to the 22 veterans per day that 

is committing suicide. And what is exactly the Department doing 

to address this? Because I have found that it is not just one thing. 

I mean, are we working with the stakeholders? When we have a 

veteran that—let’s say a homeless vet, it is not just that he needs 

a house. He needs comprehensive services. 

And I don’t necessarily know whether the VA have to provide it. 

We can partner with some of our stakeholders. And so can you give 

us an update as to where we are. 


VACREP0180 with DISTILLER
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Dr. JAIN. Yes. So thank you, Congressman, for that question. 

And I couldn’t agree with you more. This is a very troubling 

issue, and we continue to be always looking to see what can we do 

better. 

And so I will just give you some of the examples of the kind of 

things we are constantly doing. And I realize it is still not enough 

because it still is a very significant issue. 

But—but over the last year or so, for example, we have developed a strong working collaboration with the Department of Defense where we develop the integrated health strategies that look 

at a combined guideline for suicide management. So this is a 

brand-new effort where the suicide management and DoD and the 

VA is now coordinated. 

We have this data registry that is joint between VA and DoD 

where we are able to exchange information with each other to understand what are the factors that are contributing to suicides. We 

have this partnership with the States where we exchange data 

with the States and understand what is happening in the States 

with veterans that we serve and veterans that we do not serve and 

what are the differences with that and what can we learn. 

And some of that data analysis, it is very interesting. And Mr. 

Rowan was testifying earlier that—that the numbers—when you 

look at the sheer numbers, the numbers are higher in our middle 

age to—you know, in the upper 50s, 60s veterans group, even 

though the younger veterans, the percentage is quite high. But the 

overall numbers are much higher in that group. 

So what we have found is that, within the VA—those veterans 

who receive care in the VA, those suicide rates are now starting to 

trend down as opposed to the veterans who do not receive care in 

the VA. 

So some of our programs are starting to have an impact, but it 

is not enough. And we are open to the idea of continuing to look, 

from any source, any ideas that we can find to implement those. 

Ms. BROWN. The question about alternative medicine and particularly the acupuncture, in Florida, I do know that we certify— 

there is a couple of schools in my area. 

And it seems that it works for pain. I don’t know about anything 

else, but pain—I know it don’t work for weight. But I do know it 

works for pain and it works for some other things. 

So, like I said, we have two schools. And I will gladly get you 

information on it. We have a school in Jacksonville and a school 

in Orlando. 

Dr. JAIN. Now, thank you, Ms. Brown. 

And I would agree with you. And that is why we have identified 

pain as one of the top areas where alternative matters can potentially help our veterans. So that is something that we will be looking at. 

Ms. BROWN. Thank you. 

I yield back the balance of my time. 

Did you have any other comments about any other bills before 

us? I see that you said one of them, you just received it yesterday. 

So you didn’t have any comments? 


VACREP0180 with DISTILLER
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Dr. JAIN. So I think the only—well, I did make a comment on 

Ms. Brownley’s bill. I think, in terms of the bill on the Physician 

Ambassadors Program—— 

Ms. BROWN. Yes. 5686. 

Dr. JAIN. Right. 5686. 

I think the only one comment that I wanted to offer is that, even 

though officially, again, we do not have a formal view, but, generally speaking—and I was a chief of staff in Pittsburgh and, also, 

in Salem for many years. And so we have provisions in Title 38 

now to bring the DoD compensation physicians. And I just found 

out that we currently have about 4,100 WOC physicians in the VA 

system. 

So I think that part of our concern is that a lot of this is there 

and we didn’t have the details, from what Congressman was saying, in terms of what the challenges are. But—but we are able to— 

I just wanted to say that we are able to bring WOC physicians 

now. And so that should not be an issue, unless there is some other 

concerns. 

Ms. BROWN. Thank you. 

And I yield back the balance of my time. 

Dr. BENISHEK. I am just going to follow up, as long as I have you 

here, Dr. Jain—— 

Dr. JAIN. Yes, sir. 

Mr. BENISHEK [continuing]. On a couple of things that came up 

in the other folks’ questions. 

And that is, apparently, Mr. Culberson was saying that, in talking to the VA that there wasn’t a way for the volunteers to—did 

you hear his testimony? 

Dr. JAIN. I did. And I really wanted to clarify with him because 

I was surprised about that, sir. 

Dr. BENISHEK. Well, I think we should look into that a little bit 

more. 

Dr. JAIN. All right. 

Dr. BENISHEK. The only other question that has come up several 

times today—and Ms. Brownley and I were talking about it—and, 

I have a concern about this alternative therapy, for example, 

equine therapy, because to scientifically prove that the equine therapy is actually helpful to the veteran, that study may take years. 

And I know I have a concern, in view of the fact that I talk to 

every veteran that has been through it, they are all really positive 

about it and, yet, the time that it takes to certify this—there is no 

American society of equine therapists that are going to certify the 

equine therapy. 

Is there a way within the VA to do an individual evaluation of 

a program, on an individual basis and qualify that program for 

some sort of reimbursement? 

Because the people that I was working with, it is all volunteer 

or, funded by a nonprofit outside the VA, which is all well and 

good. Maybe that is the way we are going to have to go until we 

can get some kind of a certification process. 

But is there a process within the VA to do an individual program 

such as this and provide some reimbursement for the people that 

are doing that? 

Dr. JAIN. So, Congressman, thank you for that question. 


VACREP0180 with DISTILLER
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I think that the general process that the VA follows to take an 

innovative idea like the one with equine therapy is to then validate 

that model with further research internally and then usually externally with Institute of Medicine. 

And we—over the years when—when you start talking about expanding the benefits package to include, we would have to then expand the benefit package to include this therapy. Because if you 

offer it in one part of the country—as you know, sir, we are a national system. 

So if we make it available in one part of the country, then we 

have to make it available to other veterans who may have need for 

that type of service. So that is always a challenge. So the process 

we usually follow is very heavily evidence-based. 

Dr. BENISHEK. Well, no. I understand the reasoning for that. 

And, you know, I certainly want evidenced-based therapy. But it is 

just that we have such a crisis on our hands here. 

Dr. JAIN. Right. 

Dr. BENISHEK. I am trying to figure out a way to reasonably expand the system without danger to our veterans, but also a way 

to get more people involved in the care. 

Dr. JAIN. So there are—two mechanisms come to mind, sir. I 

think one would be to—we do have a process where we expand the 

pilot and then make it broader based, and that usually allows us 

to gather more information. 

We also can conduct research studies that are multicenter that 

allows using the research Dollars to further investigate the topic. 

So we do have a couple of mechanisms. 

Dr. BENISHEK. All right. Thank you for your time this afternoon. 

I think we are just about done. 

I ask unanimous consent that all members have 5 legislative 

days to revise and extend their remarks, and include extraneous 

material. 

Without objection, that is ordered. 

I would also like to thank all the witnesses and audience members for joining us this afternoon. 

The hearing is now adjourned. 

[Whereupon, at 4:40 p.m., the subcommittee was adjourned.] 

APPENDIX 

PREPARED STATEMENT OF HON. TIM WALBERG (MI–07) 

Testimony for Medal of Honor Priority Care Act (H.R.4720) 

Chairman Benishek, Ranking Member Brownley and Members of the Subcommittee, I thank you for the opportunity to speak this morning in support of my 

legislation, H.R.4720, the Medal of Honor Priority Care Act of 2014. 

As the Members of this Committee are well aware, the Congressional Medal of 

Honor is the highest award for valor which can be bestowed upon an individual 

serving in the United States Armed Forces and is awarded to soldiers who have displayed conspicuous gallantry and intrepidity at the risk of life above and beyond the 

call of duty. The Medal of Honor is a distinguished award given to a select few. Less 

than 3,500 has been awarded, and of those, only 79 are living recipients. When one 

looks at the recent major conflicts in Iraq and Afghanistan, only 16 have been 

awarded. 

My state of Michigan is honored to have two living recipients of this award, Corporal Duane E. Dewey and Private First Class Robert E. Simanek. Both received 

the decoration for their heroic action in the Korean War, and hearing of their 

harrowing stories of bravery has reminded me of the sacrifice American soldiers are 

willing to make to protect their comrades and their country. 


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Medal of Honor recipients deserve our utmost appreciation, and I believe the 

small portion of our servicemembers who have gone above and beyond the call of 

duty and earned the highest honor in our nation’s Armed Forces have earned the 

right to be placed in the top priority group to receive their healthcare benefits. 

All veterans deserve access to the healthcare they have earned, but as you all 

know, the VA uses a priority system to determine eligibility for these healthcare 

services. Some of the factors that will affect a soldier’s priority group ranking are 

whether the soldier has a service-connected disability, whether they were a former 

prisoner of war, the time and place of service, as well as income level. Currently, 

Medal of Honor recipients are in Priority Group 3. 

I’d be remiss in not pointing out that the idea to initially look into this legislation 

came from a veteran who lives in my district and works with the veteran community. 

This bill would not affect a large population of veterans, but I believe we have 

a duty to ensure these heroes have access to the VA when they need it. I’m proud 

to have the support of 13 of my colleagues from both sides of the aisle, as well as 

support from the Disabled American Veterans. 

I thank the Chair for permitting me to appear before the Subcommittee today. 

f 

PREPARED STATEMENT OF THE HON. GUS M. BILIRAKIS (FL–12) 

Thank you for holding this very important hearing and for providing me an opportunity to testify on my bill and discuss the importance of exploring complementary 

alternative treatments for Veterans affected with mental health concerns. 

As we all know, the costs of wars and the price for freedom are paid for through 

the valor of brave men and women. These individuals selflessly put themselves in 

harm’s way so that we may enjoy the freedoms of our democracy. With statistics 

showing that one in five Veterans who served in Iraq and Afghanistan have been 

diagnosed with Post-Traumatic Stress, we must responsibly ask ourselves—are we 

doing enough when it comes to addressing mental health in our Veteran population? 

Recent data has shown that every day in this country—an estimated 22 Veterans 

take their own lives. It is unconscionable that more casualties have occurred with 

our servicemembers here domestically upon their return from active duty as opposed 

to overseas while serving their country. Many of these tragic suicides are the result 

of depression, homelessness and a lack of available resources to assist in their transition into civilian life. My bill, H.R. 4977, the Creating Options for Veterans Expedited Recovery Act (COVER) will help remedy this tragic problem and provide additional therapies to our nation’s wounded heroes. 

The COVER Act will establish a commission to examine the Department of Veterans Affairs current evidence-based therapy treatment model for treating mental 

illnesses among veterans. Additionally, it will analyze the potential benefits of incorporating complementary alternative treatments available within our communities. 

The duties of the commission designated under the COVER Act include conducting a patient-centered survey within each Veterans Integrated Service Network. 

The survey will examine several different factors related to the preferences and experiences of Veterans with regard to their interactions with the Department of Veterans Affairs. Instead of presuming to know what is best for Veterans, we should 

simply ask them and work with them on finding the right solutions that best fits 

their unique needs. 

The scope of the survey will include: the experience of a Veteran when seeking 

medical assistance with the Department of Veterans’ Affairs; the experience of Veterans with non-VA medical facilities and health professionals for treating mental 

health illnesses; the preferences of a Veteran on available treatments for mental 

health and which they believe to be most effective; the prevalence of prescribing prescription drugs within the VA as remedies for treating mental health illnesses; and 

outreach efforts by the VA Secretary on available benefits and treatments. 

Additionally, the commission will be tasked with examining the available research 

on complementary alternative treatments for mental health and identify what benefits could be attained with the inclusion of such treatments for our Veterans seeking 

care at the VA. Some of these alternative therapies include, among others: accelerated resolution therapy, caring and training service dogs, music therapy, yoga, acupuncture therapy, meditation, and outdoor sports therapy. Finally, the commission 

will study the potential increase in benefit claims for mental health issues for Veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, and 

Operation New Dawn. We must ensure that the VA is prepared with the necessary 


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resources and infrastructure to handle the increase in those utilizing their earned 

benefits to address the mental and physical ailments incurred from military service. 

Once the Commission has successfully completed their duties, a final report will 

be issued and made available outlining its recommendations and findings based on 

their analysis of the patient-centered survey, alternative treatments and evidencebased therapies. The Commission will also be responsible for creating a plan to implement those findings in a feasible, timely, and cost effective manner. 

I am happy to have the support of the Iraq and Afghanistan Veterans of America, 

the American Legion, and VetsFirst. With the collaboration of our nation’s greatest 

heroes, Congress, and the VA, we can increase access to quality care for Veterans 

across the country and help better meet their needs when seeking the care they 

need. 

Thank you for allowing me to testify on behalf of the COVER Act today and I urge 

all of my colleagues to support this important piece of legislation and show our Veterans with action, and not just promises, that we have them ‘‘covered.’’ 

f 

PREPARED STATEMENT OF HON. TIM WALZ (MN–01) 

In support of H.R. 5059, the Clay Hunt SAV Act. 

Chairman Miller, Ranking Member Michaud, thank you for your leadership and 

dedication to our nation’s heroes. I am very grateful for the opportunity to tell you 

about a very important piece of legislation to help rid our communities of veteran 

suicide. 

H.R. 5059, the Clay Hunt Suicide Prevention for American Veterans Act, is an 

example of how we get things right on Capitol Hill. The legislation is named in 

honor of Iraq and Afghanistan War Veteran and suicide prevention advocate, Clay 

Hunt. Clay epitomized what it meant to live a life of service, both in and out of uniform. He helped countless veterans overcome their demons but tragically took his 

own life in March of 2011. The legacy he left behind, however, will live on for generations to come. 

The bill you see before you was the result of strong partnerships with our veteran 

service organizations, strong bipartisanship efforts here in Congress, and relentlessness shown by Clay’s parents, to get this thing done. This bill is what you get when 

you have folks sitting around the table, trusting one another, and working together 

to get it right for our nation’s veterans. I’d like to send a special note of thanks to 

two Air Force vets for helping get this thing done. Thanks go to Christine Hill from 

Chairman Miller’s staff and Tony DeMarino from Ms. Duckworth’s staff for their 

hard work. 

Our premise for this bill was simple: suicide occurs because many vets return to 

their community and then disconnect from it. So, we wanted to create a bill that 

would get the communities involved and coordinated. We also knew it would be important to increase the capacity and efficiency of VA care to deal with over a million 

veterans returning from war. 

Specifically, the bill: 

1. Establishes a peer support and community outreach pilot program to assist 

transitioning servicemembers with accessing VA mental healthcare services. 

2. Requires the VA to create a one-stop, interactive website to serve as a centralized source of information regarding all mental health services for veterans. 

3. Addresses the shortage of mental healthcare professionals by authorizing the 

VA to conduct a student loan repayment pilot program aimed at recruiting and retaining psychiatrists. 

4. Requires the DoD and National Guard to review the staffing requirements for 

Directors of Psychological Health in each state. 

5. Requires a yearly evaluation, conducted by a third party, of all mental 

healthcare and suicide prevention practices and programs at the DoD and VA to 

find out what’s working and what’s not working and make recommendations to improve care. 

6. Establishes a strategic relationship between the VA and the National Guard 

to facilitate a greater continuity of care between the National Guard and the VA. 

7. Authorizes a Government Accountability Office (GAO) report on the transition 

of care for PTSD and TBI between the DoD and the VA. 

One veteran lost to suicide is one too many. With many of our warriors returning 

from war, all too often our heroes return only to face a war of their own at home. 

While there is no bill that will completely end veteran suicide, this comprehensive, 

bipartisan measure is a step in the right direction. I’m proud to have worked with 

Chairman Miller, Rep. Duckworth, a combat veteran herself, IAVA, and the VFW 


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to introduce this bipartisan, important legislation. And I urge my colleagues to support this measure so that we can pass it quickly into law. Thank you. 


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PREPARED STATEMENT OF HON. DOUG COLLINS (GA–09) 

Chairman Benishek, Ranking Member Brownley, and distinguished members of 

subcommittee, thank you for the opportunity to testify on H.R. 5475, to amend title 

38, United States Code, to improve the care provided by the Secretary of Veterans 

Affairs to newborn children. I am very appreciative of the Subcommittee’s consideration of this legislation. 

The motto of the Veterans Administration comes straight from Abraham Lincoln’s 

Second Inaugural. He got the idea straight from scripture. So the challenge for us 

to ‘‘care for him who shall have borne the battle, and for his widow, and his orphan,’’ isn’t a new one. 

Since September 11, 2001, more than a quarter of a million women have answered the call to serve. They’ve faced terrorism in the deserts and mountains of 

Iraq and Afghanistan. So in the 21st century, we must also consider she who shall 

have borne the battle. 

When she returns, what of her children? 

The finest military in the world is powered by men and women in their physical 

prime. The young women who decide to serve this country in the armed forces aren’t 

immune from the same questions that all young women face about whether they 

pursue a career, a family, or both. Yet they are offered a healthcare system that 

for so many years has been designed to serve men. 

With the increasing number of female veterans, the VA must expand its care and 

services to meet their needs. Maternity care tops that list of needs, and I’ve offered 

one way we can help. In 2010, Congress passed and the President signed the ‘‘Caregivers and Veterans Omnibus Health Services Act of 2010’’ to provide short-term 

newborn care for women veterans who received their maternity care through the 

VA. Signed into law on May 5, 2010, this legislation authorized up to seven days 

of newborn care. 

On January 27, 2012, The Department of Veterans Affairs published a regulation 

officially amending VA’s medical benefits package to include up to seven days of 

medical care for newborns delivered by female Veterans who are receiving VA maternity care benefits. The rule, which became effective Dec. 19, applied retroactively 

to newborn care provided to eligible women vets on or after May 5, 2011. 

Since this seven day authorization was enacted by Congress in 2010, we’ve 

learned more about the unique challenges facing female veterans and the changing 

trends in these veterans seeking maternity and newborn care from the VA. According to a study published in the Women’s Health Issues Journal this year, from 

2008–2012 the overall delivery rate by female veterans utilizing VA maternity benefits increased by 44 percent and a majority of the women using VA maternity benefits had a service-connected disability. 

Unless Congress extends the authorization for length of newborn care coverage 

provided by the VA, there will be veterans who face difficult financial decisions and 

complexity in navigating insurance options at the same time that their newborn is 

fighting for their life. This is why I introduced H.R. 5475. This legislation extends 

the authorization of care from seven days to 14 days and provides for an annual 

report on the number of newborn children who received such services during such 

fiscal year. Improved data on the trends in female veterans utilizing newborn care 

will help Congress and the VA better meet their needs in the years to come. 

I know what it’s like to be the parent of a little baby who needed intensive medical care for an extended period the moment she was born. It’s my hope that any 

new mother, who has given selflessly to her country, wouldn’t have to worry about 

Congress standing in her way as she tries to give selflessly to her own child. 

Our goal should always be to provide the mother with the pre-natal care she 

needs to give her newborn the best chance of a healthy delivery with no post-natal 

complications. There are significant needs and challenges that a female veteran 

faces when returning home from the battlefield such as homelessness, sexual and 

physical abuse, and mental health conditions such as Post Traumatic Stress Disorder. And this legislation won’t solve all of those great challenges. But my hope 

is H.R. 5475 will give her a little peace of mind knowing her newborn will get some 

extra help from the VA and that Congress is committed to her and her family. 

In a focus group conducted on Women Veterans’ Reproductive Health Preferences 

and Experiences and published by Women’s Health Issues Journal in 2011, one Marine said, ‘‘I can essentially say that I gave my reproductive years to the Marine 

Corps. And those are the years you can serve . . . You know, you do sacrifice and 

you say, well, ‘‘mission first before a family mission,’’ type of thing and the more 

I think about I think, you know, the VA probably should address that part of womanhood and have that understanding.’’ 


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There are multitudes of ways that the VA must adapt to better meet the needs 

of female veterans. By increasing the authorization of care, we can ensure that Congress is not standing in the way of the VA seeking to do just that. Absent the legislative change made by H.R. 5475, the VA cannot provide more than 7 days of care. 

And I believe that is unacceptable. 

In closing, we owe it to our female veterans to expand and improve the healthcare 

services that the VA can provide them and their children. Female veterans face 

unique challenges and barriers, including very limited newborn care coverage. While 

the majority of female veterans who receive maternity care from the VA are able 

to return home with their newborn within the current seven day time frame, some 

cannot due to newborn health complications. It is these veterans and their children 

that need Congress’ help today. 

Expanding the authorization of care from seven to 14 days will give these female 

veterans more time to make alternate arrangements and secure private or public 

insurance for their newborn’s continued health needs. 

I thank the Chairman and Ranking Member for holding this hearing and I’m 

happy to discuss this legislation further with any of my colleagues. Thank you. 

f 

PREPARED STATEMENT OF HON. JOHN CULBERSON (TX–07) 

H.R. 5686—Physician Volunteer Ambassadors Helping Veterans. 

I recently had a chance to speak with a top physician from MD Anderson in Houston, who was frustrated that she and her talented colleagues had been rebuffed several times when offering to volunteer their time and expertise at VA hospitals. As 

Chairman of the Military Construction and Veterans Affairs Appropriations Subcommittee I find it incredibly troubling that at a time when veterans are forced to 

go outside of the VA healthcare system because of waiting lists and staffing shortages or wait months for an appointment, a physician from one of the best hospitals 

in America is told by VA that they do not want her free help. Together Dr. Beth 

Edeiken-Monroe and I decided that Congress should cut through the bureaucracy 

holding up the volunteer process for qualified physicians at VA facilities. 

After looking into it, I found that Congress already told VA to accept volunteers 

in its facilities—over two decades ago; it just rarely chooses to use this authority. 

It seems that VA needs more guidance as to when Congress expects it to use this 

valuable resource—so I crafted legislation that does just that. I spelled out that 

when volunteers are available and willing to help in facilities that are strained by 

appointment waiting times or staffing shortages, VA should make every effort to accept their assistance in a prompt manner. 

By accepting the help of more volunteer physicians within VA hospitals, we will 

be able to keep more veterans within the VA healthcare system while alleviating 

some of the pressure on strained facilities. This would allow VA to continue its management over the quality, consistency, and specificity of more veterans’ care. While 

this bill is not intended to solve long-term staffing problems, it could be a step in 

helping more veterans gain prompt access to reliable and high quality care within 

their local VA. 

Through the existing privilege granting process these volunteer doctors are covered from medical malpractice liability just as any other physician within the VA 

or Health and Human Services systems is covered. I also wanted to be sure that 

VA received a substantial benefit for its effort in granting privileges to these doctors 

so I included a 40 hour minimum volunteer service hours per year requirement. We 

have received an outpouring of support from doctors who are excited about this bill 

and want to volunteer their time with the VA. 

I’m thankful for the opportunity to hear about this issue from Dr. Edeiken in 

Houston. This simple idea could potentially help hundreds of our veterans get quick 

access to high quality and reliable healthcare. 

For generations, veterans have shown untold courage and sacrifice to ensure that 

our American way of life can continue long into the future. The men and women 

who have served our country are truly American heroes, and it’s not surprising that 

people around the country want to help the VA serve our veterans. This is a simple, 

cost effective, community building resource that we should be using to help veterans 

quickly access the high-quality and reliable healthcare within the VA system that 

they have earned. 


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FOR THE RECORD 

PREPARED STATEMENT CONGRESSWOMAN TAMMY DUCKWORTH (IL–08) 

In support of H.R. 5059, Clay Hunt Suicide Prevention for American Veterans Act 

Chairman Miller, Ranking Member Michaud, thank you for your leadership and 

dedicated service to our nation’s Veterans. I appreciate this opportunity to offer testimony in support of H.R. 5059, the Clay Hunt Suicide Prevention for American Veterans Act, which I was proud to help introduce with Chairman Jeff Miller and Representative Tim Walz. 

The bill, named after 28-year-old Marine Veteran Clay Hunt, who tragically took 

his own life in March 2011, will provide accountability for the mental healthcare 

and suicide prevention programs that serve our nation’s service men and women 

and Veterans. 

After four years of distinguished service in the Marine Corps, including earning 

a Purple Heart for injuries sustained in Iraq, Clay Hunt had significant problems 

accessing the mental healthcare he knew he needed. After Clay’s service he sought 

medical care from the VA and filed for disability related to Post Traumatic Stress. 

Clay’s mom testified before this Committee that while working through this process 

Clay met multiple challenges, including inability to schedule timely appointments 

for care, his files being lost by the VA, and once he was finally able to secure an 

appointment, only receiving prescription medication rather than comprehensive 

care. Clay’s appeal for his disability claim was approved 18 months after the request 

was filed and five weeks after his death. 

Navigating VA healthcare and benefits systems can be daunting for anyone, let 

alone those who have urgent mental health needs. Clay’s story highlights the barriers to care Veterans face, but unfortunately it is not unique. It is a heartbreaking 

reality that twenty-two Veterans take their own lives each day. Adding to this tragedy is the fact that five of these twenty-two Veterans have been in the care of VA 

prior to taking their own lives. These are all casualties of war. As a nation, we are 

failing these brave men and women. 

Currently, there are over 2 million Post 9/11 Veterans across the country, and this 

number will only increase as our military force structure continues to draw down. 

As the nature of war changes, the injuries our warriors sustain also change. Increasingly, theirs are invisible wounds, which do not have simple treatment and do 

not always manifest immediately. 

Just as these Veterans remained faithful to our country on the battlefield, it is 

our turn as their Representatives to remain faithful to them and it is our responsibility as a nation to, in the words of Abraham Lincoln, ‘‘care for him who shall have 

borne the battle, and for his widow, and his orphan.’’ 

This responsibility includes ensuring that when our service men and women make 

the brave decision to seek help, they get the quality assistance and treatment they 

deserve in a timely manner. 

I was proud to work with Chairman Miller and Representative Tim Walz on H.R. 

5059, the Clay Hunt Suicide Prevention for American Veterans Act in an effort to 

reduce the barriers that prevent our Veterans from receiving quality healthcare. 

This legislation will task an independent, third party to annually review both the 

Department of Defense and VA mental healthcare and suicide prevention programs 

to find out what’s working and what’s not. It will also make recommendations on 

how to improve care. The bill also requires VA to create a one-stop, interactive 

website to serve as a centralized source of information for all mental health services 

for Veterans. This bill not only seeks to review and modify current VA practices, 

but also provides the tools to help meet increasing demands and focus on future care 

through provisions that address the shortage of mental healthcare professionals. Finally, through a pilot program established by this bill, Veterans will receive reintegration assistance directly from the communities in which they live, fostering a 

smoother and more inclusive transition to life after the uniform. 

Post 9/11 Veterans step out of their combat boots and into their work shoes 

searching for meaningful employment, access to healthcare, and engagement in 

their communities. As a nation, we have a commitment to ensure that they receive 

the care that they need when they need it. 

Thank you again for the opportunity to offer my testimony. I urge all of the Members of this Committee to support this legislation so that we can begin to turn the 

tide against suicide. 


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