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Witness Testimony of Hon. John T. Salazar, a Representative in Congress from the State of Colorado

Thank you Mr. Chairman.

Mr. Chairman - I’m pleased to bring H.R. 2005 to the subcommittee this morning, and I look forward to the discussion on this important legislation.

The Rural Veterans Healthcare Improvement Act seeks to improve healthcare services to veterans living in rural areas. 

A study of more than 767,000 veterans by researchers working for the Department of Veterans Affairs shows vets in rural areas are in poorer health than vets living closer to cities.

The VA found that the health of rural veterans still persisted, even after researchers adjusted for socioeconomic factors such as race, education or employment status.

It was identified in the study, that access to care is a key factor. 

The study suggested, that in addition to establishing more clinics in rural areas, VA should consider coordinating services with Medicare or other healthcare services based in rural areas.

As a way to begin addressing some of these issues, the Veterans Benefits, Health Care, and Information Technology Act of 2006, which passed at the end of the 109th Congress, created the Office of Rural Health within the VA.

Dr. Kussman’s testimony will tell you that the VA is opposed to this legislation because the Office of Rural Health is charged with these tasks…

I would like to make the point that even though Congress directed VA to establish this office, it has yet to be implemented.

This new office, when the VA does decide to set it up, needs support, direction, and resources in order to fulfill its mission of coordinating care to this vital constituency. 

The Rural Veterans Healthcare Improvement Act of 2007 would task the Director of the Office of Rural Health with developing:

  • demonstration projects
  • centers of excellence
  • a transportation grant program

and the bill would also more fairly reimburse veterans in rural areas for the traveling expenses they incur when driving long distances to VA medical facilities. 

Mr. Chairman… with both an ailing veteran population to care for, and a new generation of veterans returning from service in Iraq and Afghanistan, we immediately need to address access to care issues for our rural vets.

It is estimated, that nearly 45% of all new recruits are coming from Rural America, and with a large percentage of this war burdened by our National Guard, that number is only going to increase.

Many vets must travel hundreds of miles to access the medical care we’ve promised and they do so almost entirely at their own expense. 

Currently, we reimburse veterans at a rate of $0.11 cents per mile, a rate that has not increased since 1978. 

In 1978… the average price of gasoline was $0.63 cents.  I don’t have to remind the committee of the price of gasoline today.

This legislation would increase the reimbursement rate to $0.48 cents per mile, the same rate paid to federal employees.

This legislation also establishes a transportation grant program called VetsRide. 

VetsRide encourages Veterans Service Organizations to develop innovative transportation options to vets in rural areas. 

With a grant up to $50,000, a VSO could purchase a van, or find other ways to assists veterans with travel to VA medical centers.

This bill also establishes Centers of Excellence to research ways to improve care for rural veterans.  These centers would be based at VA Medical Centers with strong academic connections.

The outcome of these Centers would be the development of specific models to be used by VA in providing health services to vets in rural areas.

The Rural Veterans Healthcare Improvement Act also tasks the Office of Rural Health with following their studies own advice.

It develops demonstration projects that would examine the feasibility of expanding care in rural areas through partnerships.

Partnerships between the VA; Centers for Medicare and Medicaid Services; and the Department of Health and Human Services through critical access hospitals and community health centers.

Demonstration projects would also be carried out in partnership with the Indian Health Service to improve healthcare for Native American veterans.

In 2003, the VA entered into a Memorandum of Understanding with these departments to encourage partnerships just like these, however 4 years have passed without accomplishment and our vets have suffered.

Mr. Chairman… We must explore every option, to ensure that the healthcare services we promised to our veterans are delivered.

The Rural Veterans Healthcare Improvement Act of 2007 aims to improve one of the greatest problems that plague the VA system.

I am proud of the bipartisan work that has gone into this bill and the forty cosponsors that share these goals.

Thank you Mr. Chairman.  I’m happy to answer any questions the committee might have.