February 12, 2014

In Speech, Udall Urges Support for his Bill to Improve Care for Rural Veterans

Shares stories of how bill would help rural N.M. veterans who have struggled with lack of access to mental health services, high turnover, long-distance travel to doctors

WASHINGTON - Today, U.S. Senator Tom Udall spoke on the Senate floor about a bipartisan bill he introduced with Senator Dean Heller (R-Nev.) to address some of the biggest barriers to health care for veterans in rural communities. To illustrate the need for the bill, Udall told the stories of many rural New Mexico veterans who have struggled to access health care - traveling long distances and enduring high turnover among doctors and staff at rural VA clinics, among other problems - and discussed how his Rural Veterans Improvement Act would help improve care.

While traveling throughout New Mexico, Udall has spoken with veterans about their frustrations with accessing care. In his speech, Udall told the story of one veteran who traveled over three hours each way, multiple times per week for two years, to receive essential mental health care that likely saved his life. He also discussed a veteran in Carlsbad who spends the entire day traveling to appointments in Albuquerque, and another in Chama who must travel 80 miles through the mountains to reach a clinic - a trip that can be impassable during the winter.

In response to their frustrations and concerns, Udall took a four-pronged approach to improving rural veterans' health care. His bill would:
-Expand mental health services by providing better access to treatment and including alternative therapies, as well as traditional Native American healing methods.
-Expand transportation grants to include rural communities to help ensure rural veterans can get a ride to far-away doctors' appointments.
-Help retain and recruit staff to work at rural clinics through increased financial incentives, medical training programs geared toward preparing doctors and nurses for work in rural communities, and streamlined hiring of military medical professionals into the VA system.
- Create tools for the VA and Congress to more effectively prioritize expansions and improvements of VA clinics in rural and highly rural areas by requiring a comprehensive review of those clinics.

"Rural veterans should not be left behind. They should get the care they need and deserve," Udall said in his speech. "Our bill is a step forward for the health and well-being of our veterans. This is about essential care, about access, and about honoring our commitment to the men and women who have sacrificed so much for our country."

The following are Udall's remarks as prepared for delivery on the Senate floor. Click here for video and here for audio.

Madam President, I rise today to talk about health care for rural veterans. This is a critical issue. Too many veterans are left behind. Too many are not getting the care they need.

But first, Madam President, I want to say how important it is that we have reached an agreement to restore the cut to pensions for working-age military retirees. The cut in cost-of-living adjustments for this group of veterans never should have been made.

The bipartisan budget agreement was critical for New Mexico and our nation, because it rolled back damaging sequestration cuts-cuts that hurt our military and military families. But working-age military retirees should not have to bear the burden. Many of these men and women have given decades of service to our nation. They were willing to give everything for us. They should get the benefits they earned.

I have been working from the beginning to restore this cut to their COLA benefits. I'm very happy that we have a bipartisan agreement to move forward, and ensure we keep our promise to them.

Now, Madam President, I have come to the floor today to talk about the Rural Veterans Improvement Act. I was proud to introduce this bill with Senator Heller earlier this week, because when it comes to veterans' health care, we know there are challenges. We know we can do better, and we know we have to.

Over 6 million veterans live in rural areas, including about one third of those who fought in Afghanistan and Iraq. Three million of those rural veterans receive care through the VA. Our veterans have fought half way around the world for our freedom. We should go the extra mile for them. Senator Heller and I both come from rural states. We know the difficulties veterans face when distances are too far, and choices are too few.

Our bill will do four things: Improve access to mental health services, expand transportation grants, hire and retain more medical professionals in rural areas, and give Congress and the VA improved tools to improve the quality of rural facilities.

First, mental health care is crucial. Veterans are struggling when the help they need is not available, or is very far away. One of my constituents lives in a rural area in northern New Mexico. He fought in Vietnam, and was diagnosed with Post Traumatic Stress. He required therapy two full days a week for two years-vital care that probably saved his life. The VA was there for him, and he is grateful. But he had to drive to Albuquerque-over three hours away-to get that essential care.

The veterans in my state are clear. They need better access to treatment and more mental health options. One size does not fit all. Conventional therapy does not work for everyone. Veterans groups like the Wounded Warrior Project have long supported alternative treatments and more holistic methods. Tribal governments are also working with the VA to use traditional Native American healing techniques, helping their veterans with PTSD or other diagnoses.

These veterans are in pain. They are at increased risk of suicide. Help has to be there when they need it. Our bill will enable the VA to work with non-VA fee-for-service providers-for veterans with service-connected mental health issues when conventional treatment is not available, or where alternative treatment is not an option.

Second, even the best health care is useless if you can't get to it. I have talked with many veterans in my state about this and it is a big problem across the state. Veterans in Carlsbad face a six hour drive to the VA Hospital in Albuquerque-300 miles one way. One such veteran fought bravely in World War II. He is in his 80s now. He has to get up at 5 a.m., make the trip to Albuquerque to see medical specialists. Sometimes he doesn't get home until midnight. Thanks to great volunteer drivers-at the Southeast New Mexico Veterans Transportation Network-he is able to get there, but it is an exhausting day.

One of my constituents recently retired to Chama, a rural community in northern New Mexico. He and his wife built a home there, looking forward to retirement. The VA outreach clinic was nearby, but its contract was not renewed and it closed. His only option now is the VA clinic in Espanola-80 miles each way through the Southern Rockies. And when winter storms come-as they do in northern New Mexico-he may not be able to get there at all.

The VA offers transportation grants to help, but only for veterans in highly rural areas with fewer than four people per square mile-not for those in rural areas. In small towns like Chama in New Mexico, and in Nevada, and so many other states, they need help too. The miles are just as long. The journey is just as hard. Our bill will help by expanding VA transportation grants to include rural communities. And it will not require matching funds for grants up to $100,000, making it easier for these communities to apply for assistance.

Third, rural VA clinics, like their private counterparts, have trouble getting staff and keeping staff. This is not news to veterans who see constant turnover of doctors, nurses, and other health professionals. Or who have to travel long distances just to see anyone at all. Our bill will establish a VA training program, working with university medical centers to train health care professionals serving rural veterans at outpatient clinics. Those who complete the program-and a three-year assignment-will receive a hiring preference for jobs with the Veterans Health Administration.

We also propose a pilot program for housing incentives for healthcare professionals to work in rural VA facilities. And we are proposing that the VA streamline the hiring of military medical professionals transitioning to the civilian world into the VA system. Rural VA health centers have a big job. They do their best. We have to do all we can to help them to get staff and to keep staff-with incentives, with training, with innovation. It isn't easy, but it is essential.

Fourth, we call for a full review of VA community based outpatient clinics in rural and highly rural areas, so we can prioritize expansions and improvements, making sure dollars are well spent, and resources go as far as possible.

We also call for a report to Congress on whether to add polytrauma centers in rural areas to help veterans from Iraq and Afghanistan recover from multiple major injuries like serious burns and traumatic brain injuries.

Every day, America's service members wake up far from home. And every day, they stand the watch. They do the job they promised to do, and not only if it's easy, or only if it's convenient. We owe them the same promise. Rural veterans should not be left behind. They should get the care they need and deserve.

I want to again thank Senator Heller for working with me on this bill. He understands the problem and he is committed to finding solutions. Our bill is a step forward for the health and well-being of our veterans. This is about essential care, about access, and about honoring our commitment to the men and women who have sacrificed so much for our country. I urge my colleagues to support this bill.