Chairman, Ranking member, members of the Subcommittee, thank you.  I am here today to testify about H.R. 6122, the Veterans Pain Care Act of 2008, which I introduced on May 21, 2008.  This bill requires the Secretary of the VA to develop and implement a comprehensive policy on pain management for veterans enrolled in the VA health care system and to carry out a program of research, training and education on acute and chronic pain.

Pain is a leading cause of disability among veterans.  Modern warfare also often leads to serious but survivable injuries to the central nervous system.  And while advances in medical technology have saved the lives of many wounded soldiers, many veterans of our Armed Forces are afflicted by acute and chronic pain.  As a result, providing adequate pain management is a crucial component of improving veteran health care.

VA recognizes that chronic and acute pain among our veterans is a serious problem, and I applaud VA’s existing pain care programs.  But comprehensive pain care is not consistently provided on a uniform basis throughout the VA’s health care system.  My legislation will give VA the necessary tools to serve the needs of our veterans, building on the work VA is already doing.  By also making clear that Congress considers pain care a priority, and putting it in law, VA’s pain care programs will be less subject to the winds of politics ands its unpredictability.

At the same time, the bill is not duplicative of the efforts VA is making - though by building on what VA is already doing means that my bill should not be expensive nor cumbersome.  It will not be cumbersome especially since the bill is not overly prescriptive either – a concern with earlier versions of the bill but which I believe has been rectified in the version before you.

On that note, I have made a special effort to make my bill virtually identical to a bill in the Senate that was reworked in cooperation with the minority and now has the support of both the Chairman and the Ranking member on the Senate Veterans Affairs Committee.  This bill, rolled into a larger bill, just passed the Senate by unanimous consent on Tuesday.  I am hopeful that my bill, which also has bipartisan support, will move quickly through Congress and become law.

This bill is also part of an effort to provide pain care for our service members across their careers, and nicely complements a companion measure on pain care among the military which was originally introduced by Congressman Loebsack and has now passed the House as part of the National Defense Authorization Act for FY2009.  In this way, the two bills will help provide that seamless transition for our service members that we know is so important.

This bill has the support of a broad coalition of groups who are involved in pain care management, including the Pain Care Coalition and the American Pain Foundation.

I am also very pleased that a number of Veterans Service Organizations are here today to express their support for the bill.  There is also a role for them in the implementation of this bill, as VA will work with veterans service organizations and other experts in pain management to continually improve its comprehensive pain care policy.  There is also an oversight mechanism, so that Congress has a role in ensuring that this happens: the VA is required to report regularly to Congress on the progress it is making in implementing and improving its pain management policy.

With these oversight mechanisms, and by directing VA to update its pain management policy in light of experience and evolving best practices as well as to carry out a research component, the ultimate aim of the bill is to lay a foundation for the ongoing improvement in pain care treatment of our veterans and, in combination with the companion military bill, for our service members across their careers.  In that way, we can work towards fulfilling what I believe is a moral obligation to care for these veterans with the most innovative pain management techniques, so that they can have the highest quality of life possible.

I urge you to support our veterans by supporting this bill.  Thank you.

Pain Care Coalition
Washington, DC.
May 15, 2008

Pain Care Coalition—A National Coalition for Responsible Pain Care
American Academy of Pain Medicine, American Headache Society, American Pain Society, American Society of Anesthesiologists

The Honorable Tim Walz
United States House of Representatives
1529 Longworth House Office Building
Washington, DC 20515

Re: Veterans Pain Care Act of 2008

Dear Congressman Walz:

The Pain Care Coalition applauds your leadership in championing the Veterans Pain Care Act. We enthusiastically support the measure, and pledge the assistance of our organizations as you move the bill forward in the House. As your bill mirrors bi-partisan legislation under consideration in the Senate, and complements a DoD pain care initiative included in the House FY 2009 Defense Authorization bill, we are optimistic that it will receive wide support.

Pain is a huge public health problem for veterans. Virtually every service member injured in current and past conflicts experienced acute pain at the time of injury. Many others suffered acute pain in connection with non-combat related injury or disease. For too many, the acute pain progresses to a chronic pain condition that threatens the veteran’s basic quality of life. These same chronic pain conditions can be cost “drivers” in VA health and disability systems. With prompt and aggressive treatment, much acute pain can be alleviated, and much chronic pain avoided or managed.

The Department of Veterans Affairs is doing much to provide good pain care and advance important pain research, but much, much more remains to be done. Your bill will make pain care a national priority within the VA health care programs. Millions of veterans who have served our country deserve no less.

Respectfully submitted,

Richard Rosenquist, M.D.
Chair
 

Consensus Statement Supporting the Congressional Military Pain Bill and the Veterans Pain Bill

Acute and chronic pain afflicts both military personnel and veterans in proportions far exceeding the general population. Pain is the leading cause of disability among veterans. Characteristics of modern warfare produce serious, but survivable, injuries to the central and peripheral nervous systems that inflict terrible acute pain and lead to chronic pain in many cases. Providing adequate pain management is a crucial component to improving military and veteran health care. A growing number of wounded veterans are experiencing long-term problems with chronic pain; left untreated, pain can have life-long consequences.

As members of organizations dedicated to improving the lives of veterans and military personnel and organizations dedicated to improving the quality of pain management, the undersigned organizations support and urge passage of legislation to improve pain care for active duty military and veterans. In particular we support legislation which:

• Requires Uniformed Service Secretaries to implement a comprehensive pain care initiative to require prompt assessment and reassessment of pain in all health setting; emphasizes assessment, diagnosis, treatment & management of pain as an integral part of military health care; and deploys acute pain services to all combat support hospitals and, where feasible, on the battlefield.
• Requires Tricare plans to provide pain care services that ensure appropriate assessment, diagnosis, treatment and management of acute and chronic pain and provide comprehensive interdisciplinary services for hard to treat chronic pain patients.
• Requires the Department of Veterans Affairs to implement in VA health facilities and programs a pain care initiative comparable to that required for DOD programs.
• Requires the VA to increase its research effort in the areas of acute and chronic pain, including identifying priority research areas most relevant to veterans.
• Requires the VA to emphasize education and training of VA personnel in pain management.
• Establishes cooperative research center for acute and chronic pain, including one with a special focus on central and peripheral nervous system damage.
• Directs the GAO to evaluate the consistency of military and veteran pain care services across different programs, facilities, demographic groups and geographic areas; and
• Assesses the adequacy and appropriateness of pain care services based on performance measures previously adopted by the VA.

Signed,

Air Compassion for Veterans
Alliance of State Pain Initiatives
Alpharma Pharmaceuticals LLC
American Academy of Pain Medicine
American Association of Diabetes Educators
American Cancer Society
American RSDHope
Ava Mina Pain Clinic
The American Chronic Pain Association
American Headache Society
American Pain Foundation
American Pain Society
American Pharmacists Association
American Society of Anesthesiologists
American Society for Pain Management Nursing
Amputee Coalition of America
AVANCEN LLC
Boston Scientific
Brave New Foundation
Cause
Cephalon, Inc.
Comfort Care Unlimited
Coming Home Project
Endo Pharmaceuticals
Florida Pain Initiative
HealthSouth Valley of the Sun Rehabilitation Hospital
Homes for Our Troops
Jacob's Light Foundation, Inc.
Indiana Hospice and Palliative Care Organization
Indiana Pain Initiative
Iraq and Afghanistan Veterans of America
Medtronic, Inc.
Michigan Cancer Pain Initiative
Missouri Pain Initiative
Montana Cancer Control Coalition
National Fibromyalgia Research Association
National Pain Foundation
National Veterans Legal Services Program
National Vulvodynia Association
One Freedom, Inc.
Operation Helmet
Operation Home Front
Pain Care Coalition
Pain Connection
Pain Treatment Topics
P.A.N.D.O.R.A.
Project Return to Work, Inc.
Purdue Pharma L.P.
Reflex Sympathetic Dystrophy Syndrome Association
South Dakota Injured Workers Coalition
St. Jude Medical's Neuromodulation Division Advanced Neuromodulation Systems
Swords to Plowshares
The Pathway Home (Veterans Home of California)
There is Hope...for Chronic Pain
Veterans for America
Washington - Alaska Pain Initiative