LEADER ON HOUSE VETERANS’ AFFAIRS SUBCOMMITTEE ON HEALTH

Mike currently serves as the Ranking Member of the Veterans' Affairs Subcommittee on Health.  The Subcommittee on Health has legislative and oversight jurisdiction for VA health care system, programs, and research apparatus. Mike has worked to increase the VA health care budget, secure advanced funding for the VA, pass legislation to improve health care for veterans, and provide oversight of the VA health care system.

The Health Subcommittee has sustained an ambitious schedule, including holding hearings on Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD), mental health care, long-term care, caregivers, health care for women veterans, access to care in rural areas, VA outreach initiatives, and VA’s health infrastructure.

EXPANDING ACCESS TO HEALTH CARE FOR MAINE VETERANS

As a leader on the House Veterans' Affairs Subcommittee on Health, Mike has jurisdiction over the VA's health care network expansion process and has held several hearings on the issue of health care access over the years.  In 2006, provisions Mike authored were included in a bill that became Public Law 109-461, which directed the VA to develop a business plan for enhanced access to outpatient care for veterans in Maine.  As a result, Maine now has a new VA health care access point in Houlton, a new community based outpatient clinic (CBOC) in Bangor, and a will soon have a new CBOC in Lewiston.

Most recently, Mike helped author a bill that was passed into law that provides advanced funding for veterans health care for the first time in the history of the VA.  This will help Togus VA Medical Center and all VA outreach efforts in Maine.

PROVIDING ADVANCED FUNDING FOR THE VA

Mike worked with a bipartisan group of his colleagues in the House and Senate to pass into law a landmark bill that ensures timely funding for veterans’ health care. H.R.1016, the Veterans Health Care Budget Reform and Transparency Act, authorizes Congress to approve VA medical care funding one year in advance of the start of each fiscal year.  An advance appropriation provides the VA with up to a year to plan how to deliver the most efficient and effective care to an increasing number of veterans with increasingly complex medical conditions.  Mike has been pushing this idea for years because uneven budgets cycles and funding shortfalls have contributed to the rationing of VA health care and the inability of the VA to properly plan from year to year.

Mike joined congressional leaders at the White House on October 22, 2009 as President Obama signed H.R. 1016 into law.  The President thanked Michaud for his leadership on the issue during a speech in which he highlighted the importance of the legislation.

SECURING VA FUNDING

VA Funding for Fiscal Year 2009 - Over the past decade, the VA has transformed their health care system to include over 600 health care facilities.  This includes adding medical centers, nursing homes and hundreds of community-based outpatient clinics.  These facilities are organized into service networks throughout the nation.  They care for an estimated 5.2 million veterans.

During the 110th Congress, Mike worked hard with a bipartisan group of his colleagues in promoting increased FY2009 funding for the VA.  The FY 2009 VA appropriations bill built upon the achievement of FY 2008's bill and provided $4.5 billion in discretionary spending above the prior year's level. It was the second budget in a row that exceeded the request of the Independent Budget, which is formulated by a coalition of veterans' organizations.

VA Funding for Fiscal Year 2010 - Mike continued his longstanding support for veterans by working with his colleagues to secure an 11.7 percent increase for veterans’ health care and other services in the FY2010 Budget Resolution (S.Con.Res.13), which was approved on April 29, 2009.  The FY2010 budget provided more funding for VA research and treatment of mental health, post-traumatic stress disorder, and traumatic brain injury.  On December 16, 2009, the President signed into law a bill that contained $45.1 billion for veterans' health programs in FY 2010, plus the $48.2 billion in advance appropriations for FY 2011.  The bill also provided $1.2 billion for major construction modernization projects, alteration and improvement of VA facilities — $271 million (29%) more than the current level.

IMPROVING ECONOMIC OPPORTUNITIES FOR VETERANS

The hardworking men and women who fight for our nation deserve affordable job training opportunities. During the 110th Congress, Mike introduced H.R. 1824, which expands the scope of the Montgomery GI Bill benefits to include accelerated payments of educational assistance to cover commercial driver's license training programs. These programs are helping to give our veterans the training they need for jobs in the commercial trucking industry.

Veterans Education Improvement Act - Mike supports amending the Montgomery GI Bill educational assistance program for veterans so that they can use the benefits for business courses and seminars, courses taken to prepare for licensing or certification tests, and the repayment of federal student loans.  He also supports extending the increase in benefits for certain individuals pursuing apprenticeships or on-job training and provides additional areas of work-study for veterans.

GI Bill for the 21st Century - Congress enacted the new GI Bill for the 21st Century (the "Post-9/11 GI Bill") to restore the promise of a full, four-year college education for Iraq and Afghanistan veterans. As of May 1st, 2009 veterans can begin to apply for a certificate of eligibility for the new college benefits.

The Supplemental Appropriations Act of 2009 (Public Law 111-32) expanded the Post-9/11 G.I. Bill to cover the full cost of college for surviving military children. A veteran is eligible for the new benefits if they have completed at least 90 days of active duty service on or after September 11, 2001, and were honorably discharged.  The new benefits also cover those discharged with a service-connected disability after 30 days who were honorably discharged.  In general, the benefits are correlated on a sliding scale to years served.  To receive the maximum benefit, a veteran must have served on active duty for three years.

American Recovery and Reinvestment Act - Support for veterans was included as part of the Recovery Act, which became Public Law 111-5, and provided a $1.4 billion increase for the Department of Veterans Affairs for maintenance at VA medical facilities, construction of veterans’ extended care facilities, and veteran cemetery repairs.  The Recovery Act also provided a payment of $250 to Social Security recipients, SSI recipients, Railroad Retirement beneficiaries, and disabled veterans receiving benefits from the Department of Veterans Affairs. This payment is tax-free and it will not count toward income that would reduce other federal benefits such as Medicaid or Food Stamps. For more information, go here.

Wounded Veteran Job Security Act - Mike voted to pass this bill, which provides protection for workers who are absent from employment by reason of the receipt of medical treatment for a service-connected disability. The bill was not taken up by the Senate after the House passed it.

PROMOTING ECONOMIC SECURITY AND ENDING HOMELESSNESS

Many low income veterans and veteran families live at the financial margins. In the absence of permanent housing solutions and support services, they are at risk of becoming homeless.  Currently, 1.5 million veterans have incomes that fall below the federal poverty level, including 634,000 with incomes 50% below the poverty line. According to the VA, nearly 200,000 veterans are homeless on any given night - living on the streets, in shelters or in community based organizations. A VA report conducted each year estimated that Maine currently has over 140 homeless veterans. More needs to be done to provide housing for homeless veterans and economic stability for other low-income veterans.

Homeless Veterans Reintegration Program Reauthorization Act - Promoting economic stability among veterans is one of Mike's biggest concerns. On March 30, 2009, H.R.1171, the Homeless Veterans Reintegration Reauthorization Act, was passed by the House. Mike was a cosponsor of this legislation which is an important step toward ensuring that the VA is prepared to provide comprehensive services to prevent veteran homelessness. This bill reauthorizes the Homeless Veterans Reintegration Program through 2014 and includes an additional $10 million to provide dedicated services for homeless women veterans and homeless veterans with children.  Grants are available to provide job training, counseling, placement services, and child care services to expedite the reintegration of veterans into the labor force. Unfortunately the Senate never took up the bill.

Homes for Heroes Act - Mike joined with Congressman Al Green (TX-09) to introduce the Homes for Heroes Act, which makes housing rental vouchers available to all homeless veterans, regardless of medical condition. It also includes veterans in public housing planning and excludes veterans' benefits from income for purposes of Housing and Urban Development (HUD) assisted housing rental determinations.  Finally, the bill directs the HUD Secretary to provide assistance to private nonprofit organizations and consumer cooperatives to expand the supply of supportive housing for very low-income veteran families.

Many homeless veterans are not connected to the vital housing and supportive services that they need.  VA currently reaches only 33 percent of those veterans in need, while the National Coalition for Homeless Veterans (NCHV)-member community-based organizations reaches only 35 percent.  This means that there are 150,000 homeless veterans who do not have access to these critical housing and supportive services programs every year. H.R. 403 would provide tangible solutions so that veterans can get off the streets and get into sustainable housing

Veterans' Compensation Cost-of-Living Adjustment (COLA) Acts - Mike has helped pass a number of Veterans' Compensation Cost-of-Living Adjustment (COLA) Acts throughout his time in Congress. These pieces of legislation increased the rates of veterans' benefits.  Wartime disability compensation, the clothing allowance for certain disabled adult children, and dependency and indemnity compensation for surviving spouses and children were also all increased under these bills.

PROVIDING QUALITY HEALTH CARE TO VETERANS

Upon returning home, those who have volunteered to risk their lives and defend our nation deserve the very best care. Many servicemen and women come home with injuries and disabilities that require quality assistance. Unfortunately, access to care is a significant challenge for rural veterans. Throughout Maine and elsewhere, VA hospitals are too far apart to be accessible and convenient to those they are supposed to service. Through his position on the Veterans' Affairs Subcommittee on Health, Mike has worked tirelessly to improve rural veterans' access to health care.

Helping State Veterans Homes - Mike is currently working to ensure State Veterans Homes, particularly those that are Medicare/Medicaid certified, are able to receive full payment for their services to severely service-connected disabled veterans.  

Improving Health Care for Women Veterans - Mike is a cosponsor of H.R.1211, the Women Veterans Health Care Improvement Act, which passed the House on June 23, 2009.  This bill would expand and improve VA health care services for the 1.8 million women who have bravely served our country.  H.R. 1211 would focus on the health care needs of those serving in Operation Iraqi Freedom and Operation Enduring Freedom.  The bill requires the VA to provide medical care for newborn children of women veterans, establish a pilot program for child care services, and enhance programs available to veterans suffering from military sexual trauma and post-traumatic stress disorder. This bill passed as a part of larger bill and was signed into law.

Veterans' Insurance and Health Care Improvement Act - Mike and his colleagues introduced H.R. 3219, the Veterans’ Insurance and Health Care Improvement Act, which passed the House in July of 2009. This bipartisan bill addresses a variety of issues facing our veterans. Among the bill’s many provisions, it would allow the Servicemembers’ Group Life Insurance (SGLI) coverage to continue for two years after separation if the servicemember is totally disabled.  It also establishes the position of Director of Physician Assistance Services within the Veterans Health Administration of the VA, to help coordinate the education and training, employment, appropriate utilization, and optimal participation of physician assistants within VA health programs.  The bill would prohibit the VA from collecting copayments or other fees for medical services or hospital or nursing home care for veterans who are catastrophically disabled from non-service connected causes and who have income above the means tested levels. A “committee on Care of Veterans with Traumatic Brain Injury” would also be established within the VHA, to evaluate the care, identify system-wide problems, identify specific facilities in need of improvement, and identify model programs for the successful treatment and rehabilitation of veterans with TBI.  The bill became public law.

Veterans Physical Therapy Services Improvement Act - Mike is a cosponsor of H.R.1036, the Veterans Physical Therapy Services Improvement Act of 2009. This bill would establish the position of Director of Physical Therapy Service within the VA and also stipulate degree and license requirements for appointment to a physical therapist position. H.R.1036 would also establish the Department of Veterans Affairs Geriatric, Amputee, Polytrauma, and Rehabilitation Research Fellowships Program to assist in the recruitment of qualified physical therapists for VHA positions specializing in the areas of geriatrics, amputee rehabilitation, polytrauma care, and rehabilitation research.

Department of Veterans Affairs Medical Facility Authorization and Lease Act - During the 110th Congress, Mike introduced H.R. 5856, the Department of Veterans Affairs Medical Facility Authorization and Lease Act of 2008.   This legislation authorized major medical facility projects and leases for the Department of Veterans Affairs in FY 2009.  The facilities authorized in this legislation provided much needed physical and mental health care to our veterans.  H.R. 5856 was passed by the House of Representatives on May 21 and it became public law on October 10th, 2008 as a part of S. 2162, the Veterans' Mental Health and Other Care Improvements Act of 2008.    

The Veterans Mental Health Screening and Assessment Act - Suicide remains a growing problem among veterans suffering from PTSD.  Veterans have an increased chance of suicide due to various increased risk factors such as combat exposure, traumatic brain injury (TBI), strained social support structures, and access to lethal means. It is estimated that veterans could account for 20% of the suicide deaths in the United States.

Mike recognizes that combat stress has been a growing issue for military leaders and families as fighting in Iraq and Afghanistan has taken its toll on the soldiers.  In order to help establish vigilant outreach to all our servicemembers and veterans, Mike is a cosponsor of H.R.1308, the Veterans Mental Health Screening and Assessment Act.  This bill acknowledges that the increasing rate of suicide among veterans returning from Operations Enduring Freedom and Iraqi Freedom is a serious problem. To address this issue, the bill requires the DOD to conduct mandatory, face-to-face, and confidential mental health and traumatic brain injury screenings for each member of the Armed Forces.

CARING FOR OUR WOUNDED WARRIORS

Mike is a founding member of the newly-formed Invisible Wounds Caucus, which seeks to promote awareness of and solutions for the mental health challenges facing our service members and veterans.  Among other concerns, the caucus will explore responses to rising incidents of post traumatic stress disorder (PTSD), traumatic brain injury (TBI), depression, substance abuse, and suicide among veterans and active duty military.  Further, it will identify and support the mental health programs and services at the Departments of Defense and VA that work, and will fight to break down the stigma of PTSD and other mental health issues that prevent so many of our heroes in need from seeking treatment.

The CARE Act - Compelled by his strong desire to take care of those who sacrifice the most for our nation, Mike worked hard to ensure that H.R. 3155, the Caregiver Assistance and Resource Enhancement Act (CARE Act), advances through the Congress.  The bill, which passed the House on July 27th, 2009, would establish a family caregiver program for veterans seriously injured while on active duty or in training for Operation Enduring Freedom or Operation Iraqi Freedom (OEF/OIF).  The family caregiver program created by the CARE Act provides instruction, counseling, and training to the caregiver or another individual designated by the veteran, as well as reimburses the caregiver for travel, lodging, and per diem expenses for accompanying the veteran to medical appointments.  In addition to direct support to the caregivers, the CARE Act calls for VA to institute a long term plan to provide enduring support services for caregivers. It also mandates that the VA conduct an informational, fact-finding survey once every three years on veterans’ caregivers in order to improve the quality of coverage. The CARE Act became law as a part of a larger bill.

Improving Long-Term Support for Traumatic Brain Injuries - Traumatic brain injury has become the signature health care issue of the Afghanistan and Iraq wars.  A traumatic brain injury (TBI) occurs when a sudden trauma causes damage to the brain.  Common problems associated with TBI include physical symptoms and emotional issues such as post traumatic stress disorder, depression, and anxiety disorders.  Since the VA began screening veterans who fought in Iraq or Afghanistan, 11,804 (19.26%) of the veterans screened have screened positive for TBI symptoms.  Many of these veterans live in rural areas.  Mike has worked hard over the years to pass legislation that will increase the focus and funding of the VA to treat TBI.
 
Expansion of Veteran Eligibility for Emergency Treatment Reimbursement - Mike worked to pass H.R.1377, a bill that would expand veteran eligibility to require the VA to pay for emergency treatment for a non-service connected condition if a third party is not responsible for paying for the full cost of care.  The bill, which was signed into law on February 1, 2010, protects veterans by clarifying that they are not liable for any remaining balance due to the provider after the third party insurer and the VA have made their payments.

Agent Orange - Agent Orange exposure continues to be linked to an increasing number of ailments for our Vietnam Veterans.  Getting the Department of Veterans Affairs to expand their list of ailments that are recognized as being caused by Agent Orange is an on-going issue.  In response to growing pressure from Congress, the VA announced it would establish a service-connection for Vietnam Veterans with B cell leukemias, Parkinson’s Disease, and ischemic heart disease, but additional illnesses still remain unrecognized as being service-connected.  

TREATING VETERANS WITH SUBSTANCE ABUSE DISORDERS

Of the approximately 300,000 veterans from Operations Enduring and Iraqi Freedom who have accessed VA health care, nearly 50,000 have been diagnosed with a substance abuse disorder.  Additionally, more than 70% of homeless veterans suffer from alcohol and other drug abuse problems.  Mike is extremely concerned about this issue.

Justin Bailey Veterans Substance Use Disorders Prevention and Treatment Act - On March 6, 2008, Mike introduced H.R. 5554, the Justin Bailey Veterans Substance Use Disorders Prevention and Treatment Act.  The bill was a tribute to Justin Bailey, who, after returning from service in Operation Iraqi Freedom, died in a VA facility while receiving care for PTSD and a substance use disorder.  This bill addresses this issue head on by requiring the VA to provide the full continuum of care for substance abuse disorders, and by requiring that this full spectrum of care be available at every VA medical center.  The legislation also directs the VA to conduct a pilot program for internet-based substance use disorder treatment for veterans of Operations Enduring Freedom and Iraqi Freedom.  H.R. 5554 passed the House of Representatives on May 20, 2008 and became public law (P.L. 110-387) on October 10, 2008 as a part of S. 2162, the Veterans' Mental Health and Other Care Improvements Act.