Mark Takano

Mr. TAKANO

Mr. TAKANO. Madam Speaker, I certainly appreciate the partnership and the spirit of the ranking member of the committee in addressing this national crisis of veteran suicide, and H.R. 2333 is an essential and significant step that we are taking to address this crisis. Madam Speaker, I ask all my colleagues to join me in passing H.R. 2333, and I yield back the balance of my time.

Mr. TAKANO. Madam Speaker, I yield myself such time as I may consume. As I said in my remarks related to Mr. Brindisi's legislation, I visited the Atlanta VA Medical Center and it receives 3,600 referrals per year from the Veterans Crisis Line, which is the highest number of crisis line referrals any individual veteran medical center receives nationwide. I know that at the medical center itself that there is a 22 percent vacancy rate among mental health professionals. They have lost eight psychiatrists across their hospital and outpatient clinics since the beginning of the year. Staff who resigned have cited salaries and workload stress as their main reasons for leaving the VA. Mr. Brindisi's legislation goes to, however, the position of suicide prevention coordinators, and currently, the coordinators at this particular medical center are staffed up, but we are trying to figure out where these staff coordinator positions across the country may be vacant or insufficient because we know these crisis lines are being used. We have to make sure that we have the coordinators to respond to them. But in addition to that, we need coordinators to do the outreach events to reach those veterans who are not connected with the VA. So the VA medical center in Atlanta is just one example of the staffing shortages in VA hospitals and clinics throughout the country. We know that beyond the stress and strain of our psychiatrists and of our suicide prevention coordinators, which Mr. Brindisi's bill addresses, there are nearly 50,000 vacancies at VA. If we want to fully address the veteran suicide crisis in this country, we need to make sure that suicide prevention teams are sufficiently staffed and do more to address mental health clinician understaffing. Mr. Brindisi's legislation is a significant step in making sure all of this happens. Madam Speaker, I reserve the balance of my time.

Mr. TAKANO. Madam Speaker, I yield 4 minutes to the gentleman from New York (Mr. Brindisi), my good friend and the author of H.R. 2333.

Mr. TAKANO. Madam Speaker, I yield myself such time as I may consume. Madam Speaker, according to the National Suicide Data Report for 2005-2016, approximately 20 veterans, Active Duty servicemembers, and members of the National Guard and Reserves die by suicide each day. This rate is disproportionately higher than that of the civilian population. Of those 20 a day, 14 are not enrolled in the VA healthcare system. Part of the VA's effort to combat veteran suicide is by strengthening the role of the suicide prevention coordinator. The VA is the only healthcare system that has full-time employees dedicated to suicide prevention. Suicide prevention coordinators identify high-risk veterans and ensure they receive appropriate care, conduct outreach, and promote awareness and best practices within the VA system. As of April 2019, the VA had approximately 444 suicide prevention coordinators stationed at medical centers across the country. These coordinators manage care for almost 30,000 veterans who are high risk for suicide, in addition to managing their other duties as assigned. In fiscal year 2018, these coordinators conducted more than 20,000 outreach events, reaching almost 2 million people. During the oversight trips to VA facilities, VA committee staff heard from coordinators who are overworked and struggled to keep up with their casework. Last week, I visited the Atlanta VA Medical Center and one of three Veterans Crisis Line call centers. Last year, the Atlanta VA crisis line received 3,600 referrals. The Atlanta suicide prevention team is staffed with only eight social workers and one employee for administrative support to respond to all crisis line referrals and approximately 200 veterans identified as high risk for suicide. Let me repeat that. They have eight social workers to manage 3,600 referrals and 200 high-risk patients a year. This team does all it can to keep up with the staggering number of referrals, but they simply do not have the capacity to conduct outreach to veterans in the community who may need help. Suicide prevention team staffing shortages in Atlanta and at VA medical facilities across the country is why H.R. 2333, introduced by Congressman Brindisi, is so important. It would direct the Government Accountability Office to access the workload and vacancy rates of VA suicide prevention coordinators. This report is essential to better informing Congress of the current state of suicide prevention coordinators, the resources at the facilities where they work, and the challenges they face in addressing the needs of our most vulnerable veterans. The role of these coordinators is vital to combating veteran suicide, and this report will illustrate where the gaps in care delivery exists, especially for the clinicians, social workers, and suicide prevention coordinators working on the front lines. I fully support this bill and I really want to thank Mr. Brindisi for championing this legislation, and I urge my colleagues to vote ``yes'' on H.R. 2333. I reserve the balance of my time.

Mr. TAKANO. Madam Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks and include extraneous material on H.R. 2333.

Mr. TAKANO. Madam Speaker, I move to suspend the rules and pass the bill (H.R. 2333) to direct the Comptroller General of the United States to conduct an assessment of the responsibilities, workload, and vacancy rates of Department of Veterans Affairs suicide prevention coordinators, and for other purposes.

Mr. TAKANO

Mr. TAKANO. Madam Speaker, I yield myself the balance of my time. Madam Speaker, before I begin my closing comments, I want to correct my remarks. I misunderstood. Chief Petty Officer Bill Mulder is deceased, and so I mean no disrespect to his family. We certainly are honored to have this piece of legislation carry his name in the hopes that it is going to serve many more veterans. In his memory, I am most honored and privileged to make sure that this legislation passes. Madam Speaker, I want to thank Mr. Levin and Mr. Bilirakis for these necessary improvements to the Transition Assistance Program. A testament to their work is the broad support they received from committee members on this bill, and I look forward to their future work on this as they continue to focus on and redefine the program. Madam Speaker, I ask my colleagues to join me in passing H.R. 2326, as amended, and I yield back the balance of my time.

Mr. TAKANO. Madam Speaker, let me say that I extend my commendations to the work of my colleague from Texas (Mr. Arrington). I thank him also for naming the bill after such a distinguished warrior and someone who exemplifies the need for this legislation. We certainly wish Chief Petty Officer Navy SEAL Bill Mulder all the success in the world. Madam Speaker, I have no further speakers, and I am prepared to close, so I reserve the balance of my time.

Mr. TAKANO. Madam Speaker, I yield 2 minutes to the gentleman from South Carolina (Mr. Cunningham), my good friend and member of the Economic Opportunity Subcommittee and cosponsor of H.R. 2326.

Mr. TAKANO. Madam Speaker, I yield 3 minutes to the gentleman from California (Mr. Levin), my good friend, the chairman of the Economic Opportunity Subcommittee, and also the author of H.R. 2326.

Mr. TAKANO. Madam Speaker, I yield myself such time as I may consume. Madam Speaker, I rise in support of H.R. 2326, as amended, the Navy SEAL Chief Petty Officer William ``Bill'' Mulder (Ret.) Transition Improvement Act of 2019. I would like to recognize the Economic Opportunity Subcommittee chairman and ranking member, Mr. Levin and Mr. Bilirakis, for their bipartisan focus on this issue, and the bipartisan way in which they have crafted this piece of legislation and have moved it forward. Almost 30 years ago, the National Defense Authorization Act created the first transition policy to assist servicemembers entering civilian life. This law provides that those who are being separated from Active Duty are provided services for counseling, training opportunities, finding employment, and other related information and services. These services, more commonly known as the Transition Assistance Program, or TAP, were amended recently by the VOW to Hire Heroes Act of 2011. This legislation called for mandatory participation of all servicemembers and improved transition resources by lengthening the process and lowering the class sizes. While our veterans have found the TAP program to be highly beneficial, they find the sheer amount of information too overwhelming to absorb. Today, I ask my colleagues to support H.R. 2326, as amended, which aims to solve this problem. This legislation would do several things to make TAP more effective. First, this act would create a pilot program offering transition training off military bases, making the transition process easier to access for veterans and spouses. A review by the Government Accountability Office concluded that a program held off base would be beneficial, and the committee believes that such a program is worth examining in further detail. In my own visits to TAP classes, I heard from servicemembers who felt they needed to attend TAP multiple times before they transition to civilian life because the resources aren't available off base. The legislation would create a grant program for organizations to provide multiple transition assistance services such as resume assistance, interview training, and job recruitment training from one program, location, and source. Next, this act would give the Department of Labor's Veterans' Employment and Training Service and VA access to the Social Security Administration's resources to track in real time when a participant receives a new job. This is going to help improve programs and provide a better accountability of services provided by the VA. Lastly, this bill would require a 1-year independent assessment of the effectiveness of TAP, as well as a 5-year longitudinal study of TAP which compares the effectiveness of using the program. The 1-year independent assessment of the Transition Assistance Program's effectiveness shall be conducted not later than 90 days after the enactment of this act. The legislation requires the VA enter into an agreement with an entity with experience in adult education to carry out an independent assessment of TAP. It also requires the Secretary of Labor, Secretary of Veterans Affairs, and the Small Business Administration to conduct a 5-year longitudinal study of TAP to determine the need for TAP off base and determine if this program would ease the process of participation for servicemembers, veterans, and spouses who may have had difficulty attending classes on bases. Upon completion of the respective 1-year and 5-year studies, the Secretary of the VA shall submit the findings to Congress, where we can, again, assess the quality of transition resources provided to veterans and servicemembers. Madam Speaker, I reserve the balance of my time.

Mr. TAKANO. Madam Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material on H.R. 2326.

Mr. TAKANO. Madam Speaker, I move to suspend the rules and pass the bill (H.R. 2326) to amend the Social Security Act, to amend the Dignified Burial and Other Veterans' Benefits Improvement Act of 2012, and to direct the Secretaries of Veterans Affairs, Defense, Labor, and Homeland Security, and the Administrator of the Small Business Administration, to take certain actions to improve transition assistance to members of the Armed Forces who separate, retire, or are discharged from the Armed Forces, and for other purposes, as amended.

Mr. TAKANO

Mr. TAKANO. Madam Speaker, I move to suspend the rules and pass the bill (H.R. 1812) to amend title 38, United States Code, to furnish Vet Center readjustment counseling and related mental health services to certain individuals, as amended.

Mr. TAKANO. Madam Speaker, I yield 3 minutes to the gentleman from California (Mr. Levin), my good friend and fellow Californian, the chairman of the Economic Opportunity Subcommittee, and also a cosponsor of H.R. 1812.

Mr. TAKANO. Madam Speaker, I yield myself as much time as I may consume. Madam Speaker, the VA is authorized to provide counseling through Vet Centers to a broad group of veterans and servicemembers. These veterans and servicemembers include National Guard and Reserve members, those who have served on Active Duty in any combat theater or area of hostility, veterans and servicemembers who experienced military sexual trauma, those who provided direct emergent medical care or mortuary services to casualties of war, or servicemembers and veterans who deployed to combat zones or areas of hostility in a direct support role. However, members of the National Guard, Reserve, or Coast Guard who participated in a drug interdiction or who served in a response to a national emergency, major disaster, or civil disorder are currently not eligible to receive Vet Center care. This is all despite the effects such experiences can have on mental health. H.R. 1812, as amended, the Vet Center Eligibility Expansion Act, introduced by Ranking Member Roe, would correct this oversight by extending eligibility for Vet Center care to these individuals. It would also require the VA to submit a plan to Congress for providing Vet Center services to geographical areas in which no Vet Centers are located. These areas include territories of the United States, rural, and insular areas. By assessing the steps necessary to provide access to Vet Centers for veterans living in these underserved areas, the Vet Center Eligibility Expansion Act is ensuring veterans, servicemembers, reservists, and members of the Coast Guard and National Guard are allowed access to the lifesaving services Vet Centers provide. This legislation increases access to services that provide early intervention for mental healthcare issues, which can reduce the risks associated with suicide. The sad statistics show that, of the 20 veterans and military servicemembers who die by suicide, 14 of those 20 have not received VA healthcare. This bill is one step towards changing this tragic number. Madam Speaker, I want to thank my colleague, Dr. Roe, for his work on this important measure, and I call upon all of our colleagues to join us in voting ``yes'' on this life-changing piece of legislation. Madam Speaker, I reserve the balance of my time.

Mr. TAKANO. Madam Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous material on H.R. 1812.

Mr. TAKANO

Mr. TAKANO. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 2359) to direct the Secretary of Veterans Affairs to submit to Congress a report on the Department of Veterans Affairs advancing of whole health transformation, as amended.

Mr. TAKANO. Madam Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous material on H.R. 2359.

Mr. TAKANO. Madam Speaker, I yield myself such time as I may consume. Madam Speaker, before I begin my comments on H.R. 2359, let me acknowledge the centennial year of women's suffrage and the wonderful yellow roses we are wearing in acknowledgment of that centennial year. Happy 100th year to women's suffrage in America. Madam Speaker, American healthcare systems are grappling with the need to redesign the delivery of care model to better meet the needs of veterans struggling with mental health conditions. Two decades of increased social isolation, economic inequality, and prohibitive healthcare costs have seen an increased use of complementary and alternative medicine such as health coaching, chiropractic services, acupuncture, yoga, meditation, and equine therapy. The Veterans Health Administration is one of the first healthcare systems to redesign care with a focus on maintaining patient well-being and early intervention, rather than a system designed to treat conditions and diseases only after they have occurred. This redesign, VA's whole health transformation, will accommodate the veteran population and their unique needs while empowering veterans to control their health and well-being. By improving well-being, veterans build resiliency that assists in the early intervention and identification of mental healthcare symptoms that, left untreated, can advance to the point of crisis. In 2017, VA launched the whole health transformation program at 18 flagship sites, with positive early outcomes. According to a February 2019 memo on VA's whole health transformation, VA plans to expand the full program to an additional 18 sites by summer 2019, and 140 medical centers have elements of this program. The pace, efficacy, and reach of the whole health program are not known to Congress. H.R. 2359, as amended, offered by Congressman Lamb, requires the delivery of a report on VA's whole health transformation. It will contain an analysis of the accessibility of critical services so that Congress can better inform its efforts to ensure veterans are treated as whole people and not just episodes of care. This is particularly true for socially isolated veterans and veterans living far away from a VA facility. A two-pronged strategy is needed to effectively address the veteran suicide public health crisis. The second prong is treating those veterans in crisis and making treatment more accessible. The first prong must address the complex set of social determinants that can lead to a crisis. Early interventions in mental healthcare can prevent veterans from falling into crisis and having suicidal ideations. This legislation falls under the first prong of the strategy, which will support creating opportunities for early, pre-crisis intervention. Congress must understand how VA has rolled out the initial expansion outcomes and the resources needed to continue the whole health program. This body must do everything in its power to reduce the number of veteran suicides in this country because this is a sustained, prolonged, and frustrating national public health crisis. Sadly, over the weekend, yet another veteran died by suicide at a VA Hospital. This bill is the first of five measures we will consider today to address mental healthcare and suicide prevention efforts at VA. Our work, however, does not end today. We will write more legislation. We will hold more bipartisan hearings. In fact, a hearing right this very moment, this afternoon, with the Armed Services Subcommittee on Military Personnel and our Health Subcommittee brought VA and DOD to the same table to help end this crisis. It is a joint hearing through this joint subcommittee between the Veterans' Affairs Committee and the Armed Services Committee. We will do whatever it takes to end these tragic incidents of suicide. I am fully committed to this effort. Losing 20 veterans a day is unacceptable. I will be voting ``yes'' on this critical piece of legislation, and I call on every Member of this body to do the same and help reduce veteran suicide. Madam Speaker, I reserve the balance of my time.

Mr. TAKANO. Madam Speaker, I yield 5 minutes to the gentleman from Pennsylvania (Mr. Lamb), my good friend, the vice chairman of the House Committee on Veterans' Affairs, and the author of H.R. 2359.

Mr. TAKANO. Madam Speaker, I yield 2 minutes to the gentleman from Ohio (Mr. Ryan), my good friend and cosponsor of H.R. 2359.

Mr. TAKANO. Madam Speaker, I yield the gentleman an additional 30 seconds.

Mr. TAKANO. Madam Speaker, I also would like to take this moment to ask my colleagues to join me in passing H.R. 2359, as amended. Madam Speaker, I yield back the balance of my time.

Mr. TAKANO

Mr. TAKANO. Madam Speaker, ``We the People'' is a bold opening statement enshrined in our Constitution. Yet, the truth is that in most parts of our country, LGBTQ Americans are not included in ``We the People.'' Students in Arizona should go to school free from fear and bullying. Workers in Texas should not be afraid of being fired because of who they are. Renters in Mississippi should not be evicted because of who they love. No person, no matter where they live in America, should face discrimination. Equality should not depend on the ZIP Code where you live. It is time to make equality for LGBTQ people the law of the land and to ensure that we, too, are part of ``We the People.'' I urge my colleagues to be on the right side of history and to vote ``yes'' on the Equality Act.