BOND FLOOR SPEECH ON CARES AMENDMENT
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November 12, 2003
I rise in strong opposition to the Clinton-Enzi amendment. It would deny up to $1 billion in funds to support our Nation's veterans. I especially object to the amendment because it would likely extend waiting lines for veterans already waiting for medical care.
These organizations all oppose the Clinton-Enzi amendment because they understand the problem the VA has.
In 1999, the General Accounting Office found that VA could spend billions of dollars operating hundreds of unneeded buildings over the next 5 years. The GAO reported that the VA wastes more than $1 million per day on medical care funds for unneeded infrastructure instead of direct patient care. This money could be used to provide medical care to over 100,000 veterans.
Our committee, the VA-HUD committee, after the GAO report, directed the VA to do something about it, to develop a comprehensive strategy. Thus, in 1999, under the Clinton administration, the VA created the CARES Commission to address this concern.
I have traveled around the State of Missouri. I have seen firsthand the need for construction funds to update surgical and intensive care units. By the way, I gave at the office. One of the first closures the VA instituted was of a surgery center in the State of Missouri because they weren't doing enough surgeries to be proficient. I believed our veterans needed the best care. So now we have a primary care facility and we send them to a surgical hospital where they do enough surgeries to be proficient and safe.
We know we have different needs from veterans than when the VA was set up many years ago. The Clinton-Enzi amendment would deny over $600 million in construction funds to build new hospitals in States such as Nevada, Florida, and Colorado. It would deny funds to address safety, seismic and other deficiencies for facilities in Kentucky, California, Colorado, Ohio, Pennsylvania, and others. It would deny construction of 48 new community-based outpatient clinics.
It would deny funding for 37 nursing home investments, such as construction of new nursing homes in West Virginia and Pennsylvania. This is not a fatally flawed process. I cannot agree with the assertion of the Senator from New York. In an October 27 letter to all Senators, this year Secretary Principi outlines the great extent to which he has gone to ensure that the process and review be thorough at every stage. Local veterans groups, union officials, as well as affiliate representatives participated directly in the development of these plans.
The CARES Commission received more than 169,000 public comments. I take exception to the characterization of the plan as a ``cost cutting'' plan. The draft proposes to spend $4.6 billion in construction funds to expand services. It preserves more than 97 percent of the current bed capacity. Further, the draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Let me repeat that. The draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care.
2. In some areas, the draft plan would increase overall bed capacity. In New York State, the realignment would increase overall bed capacity by about 10 percent. The CARES Commission has held field hearings, and the Senator from New York has attended two of them. The CARES Commission held 38 field hearings with over 700 witnesses and made 68 site visits. Clearly, Secretary Principi and the CARES Commission have been thorough, responsive, fair, and open.
This is a process that still is in its development stage. The Senate authorizing committee, chaired by Senator Specter, is working on legislation to establish funding for CARES, which will provide Congress an opportunity to review the final CARES plan before it can be implemented. The VA Committee held a hearing with Secretary Principi and the CARES Commission chair, Everett Alvarez, to provide oversight on the process.
I am committed to and fully supportive of CARES because we need to support veterans' medical care over unneeded buildings. To keep unneeded or excess buildings in operation deprives veterans of the care they need. There has been much opposition to this.
Mr. President, to reiterate, I oppose vigorously the Clinton-Enzi amendment to stop the VA's Capital Asset Realignment for Enhanced Services or CARES process. The amendment would deny up to $1 billion in funds to support our Nation's veterans. I object to this amendment because I believe in putting the needs of veterans ahead of the costs of keeping open unneeded buildings. I especially object to this amendment because it would likely extend the waiting lines for veterans already waiting for medical care. It is imperative that the CARES process moves forward so that the VA can move its outdated medical care infrastructure into the 21st Century.
Before I explain my reasons for opposing this amendment, I ask that letters from the Veterans of Foreign Wars, AMVETS, Disabled American Veterans, and the Paralyzed Veterans of America be added to the RECORD. As the largest veterans' service organizations in the Nation, they all oppose the Clinton-Enzi amendment because of its negative impact on veterans.
Why does the amendment hurt veterans? In 1999, the General Accounting Office (GAO) performed a study of the VA's medical care infrastructure and found that the VA ``could spend billions of dollars operating hundreds of unneeded buildings over the next five years.'' The GAO reported that the VA wastes $1 million per day in medical care funds on unneeded infrastructure, instead of direct patient care. Therefore, instead of wasting some $400 million annually on unneeded buildings, the VA could use these funds to provide medical care to over 100,000 needy veterans.
In response to the GAO's report, our committee directed VA to develop a comprehensive strategy to realign its medical care facilities so that it can deliver health care in a more accessible and effective manner. Thus, in 1999, the VA created the CARES initiative during the Clinton Administration to address this concern.
The amendment also hurts veterans by denying much-needed construction funds to areas that need modernized facilities to serve its veteran population. In my travels around my own home State of Missouri, I have seen first-hand the need for construction funds to update surgical suites and intensive care units, among other things. For those Senators who have veterans in rural areas, they know that there is a critical need for outpatient clinics so veterans do not have to travel hundreds of miles to the nearest hospital. With an aging veteran population, there is a significant need to build nursing homes and long-term care facilities. The Clinton-Enzi amendment will deny over $600 million in construction funds to these places. It will deny funds to build new hospitals in States such as Nevada, Florida, and Colorado. It will deny funds to address safety, seismic, and other deficiencies for facilities in States such as Kentucky, California, Colorado, Ohio, and Pennsylvania. It will deny the construction of 48 new community based outpatient clinics throughout the country. It will deny funding for 37 nursing home investments, such as the construction of new nursing homes in States such as West Virginia and Pennsylvania.
Another reason why I oppose the Clinton-Enzi amendment is that the CARES process is still in its developmental stage and it is premature to pull the plug. Yet, Senator CLINTON has already concluded that the CARES process is ``fundamentally flawed'' and the CARES Commission has ``neglected'' the important health care issues facing our veterans. Further, she characterizes CARES as a ``cost-cutting'' plan.
I do not agree with the Senator's assertions and I think it is unfortunate that she has been so critical of Secretary Principi who has been extremely responsive to the Congress's concerns. To Secretary Principi's credit, he has made the CARES process open and fair for all affected parties, including veterans to participate.
In an October 27, 2003 letter sent to all Senators, Secretary Principi outlines the great extent he has gone through to ensure that ``the process and review be thorough at every stage.'' Local veterans groups, local officials, union officials as well as affiliate representatives participated directly in the development of local
plans. Since the announcement of the Draft National CARES Plan, the CARES Commission has received more than 169,000 public comments.
According to the VA, all comments will be made a part of the official record and will be considered by the CARES Commission during its deliberations.
I take great exception to Senator CLINTON's characterization of CARES as a ``cost-cutting plan.'' The Draft plan proposes to spend $4.6 billion in construction funds to expand services. It preserves more than 97 percent of VA's current bed capacity. Ninety-seven percent. It increases outpatient capacity by more than 12 million visits a year. It creates 48 new community-based outpatient clinics and at least 2 new hospitals. Further, the Draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Let me repeat that last sentence. The Draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Moreover, in some areas, the Draft plan's realignment would increase overall bed capacity. For example, in New York State, the realignment would increase overall bed capacity by about 10 percent. The Draft plan provides for all of these enhanced services and additional facilities despite the VA's projections that the veteran population is expected to decline by more than 25 percent over the next 20 years. I ask my Senate colleagues, does this sound like a cost-cutting plan?
Further, the CARES Commission has held a number of field hearings and site visits across the Nation to listen first-hand to the concerns of interested parties. In fact, Senator CLINTON participated in two CARES hearings. In total, the CARES Commission held 38 field hearings that included over 700 witnesses and made 68 site visits. In some instances, the Commission altered its schedule to respond to local interests such as in New York.
Clearly, Secretary Principi and the CARES Commission have been thorough, responsive, fair, and open in moving the process. For example, at Senator SCHUMER's request, Secretary Principi agreed to visit the Canandaigua VA hospital before making any final decision.
I also stress again that the CARES process is still in its developmental stage. The Commission has not completed its work. No final decisions have been made. The current plan is only a draft and is an interim step to the overall process. Delaying or stopping this process is premature and ends up hurting more than helping our veterans. The CARES Commission must complete the plan and the Secretary and the Congress must approve it.
The Senate authorizing committee, chaired by Senator SPECTER, is working on legislation that establishes criteria for funding CARES projects,
the draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Let me repeat that. The draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care.
In some areas, the draft plan would increase overall bed capacity. In New York State, the realignment would increase overall bed capacity by about 10 percent. The CARES Commission has held field hearings, and the Senator from New York has attended two of them. The CARES Commission held 38 field hearings with over 700 witnesses and made 68 site visits. Clearly, Secretary Principi and the CARES Commission have been thorough, responsive, fair, and open.
This is a process that still is in its development stage. The Senate authorizing committee, chaired by Senator Specter, is working on legislation to establish funding for CARES, which will provide Congress an opportunity to review the final CARES plan before it can be implemented. The VA Committee held a hearing with Secretary Principi and the CARES Commission chair, Everett Alvarez, to provide oversight on the process.
I am committed to and fully supportive of CARES because we need to support veterans' medical care over unneeded buildings. To keep unneeded or excess buildings in operation deprives veterans of the care they need. There has been much opposition to this.
Mr. President, to reiterate, I oppose vigorously the Clinton-Enzi amendment to stop the VA's Capital Asset Realignment for Enhanced Services or CARES process. The amendment would deny up to $1 billion in funds to support our Nation's veterans. I object to this amendment because I believe in putting the needs of veterans ahead of the costs of keeping open unneeded buildings. I especially object to this amendment because it would likely extend the waiting lines for veterans already waiting for medical care. It is imperative that the CARES process moves forward so that the VA can move its outdated medical care infrastructure into the 21st Century.
Before I explain my reasons for opposing this amendment, I ask that letters from the Veterans of Foreign Wars, AMVETS, Disabled American Veterans, and the Paralyzed Veterans of America be added to the RECORD. As the largest veterans' service organizations in the Nation, they all oppose the Clinton-Enzi amendment because of its negative impact on veterans.
Why does the amendment hurt veterans? In 1999, the General Accounting Office (GAO) performed a study of the VA's medical care infrastructure and found that the VA ``could spend billions of dollars operating hundreds of unneeded buildings over the next five years.'' The GAO reported that the VA wastes $1 million per day in medical care funds on unneeded infrastructure, instead of direct patient care. Therefore, instead of wasting some $400 million annually on unneeded buildings, the VA could use these funds to provide medical care to over 100,000 needy veterans.
In response to the GAO's report, our committee directed VA to develop a comprehensive strategy to realign its medical care facilities so that it can deliver health care in a more accessible and effective manner. Thus, in 1999, the VA created the CARES initiative during the Clinton Administration to address this concern.
The amendment also hurts veterans by denying much-needed construction funds to areas that need modernized facilities to serve its veteran population. In my travels around my own home State of Missouri, I have seen first-hand the need for construction funds to update surgical suites and intensive care units, among other things. For those Senators who have veterans in rural areas, they know that there is a critical need for outpatient clinics so veterans do not have to travel hundreds of miles to the nearest hospital. With an aging veteran population, there is a significant need to build nursing homes and long-term care facilities. The Clinton-Enzi amendment will deny over $600 million in construction funds to these places. It will deny funds to build new hospitals in States such as Nevada, Florida, and Colorado. It will deny funds to address safety, seismic, and other deficiencies for facilities in States such as Kentucky, California, Colorado, Ohio, and Pennsylvania. It will deny the construction of 48 new community based outpatient clinics throughout the country. It will deny funding for 37 nursing home investments, such as the construction of new nursing homes in States such as West Virginia and Pennsylvania.
Another reason why I oppose the Clinton-Enzi amendment is that the CARES process is still in its developmental stage and it is premature to pull the plug. Yet, Senator CLINTON has already concluded that the CARES process is ``fundamentally flawed'' and the CARES Commission has ``neglected'' the important health care issues facing our veterans. Further, she characterizes CARES as a ``cost-cutting'' plan.
I do not agree with the Senator's assertions and I think it is unfortunate that she has been so critical of Secretary Principi who has been extremely responsive to the Congress's concerns. To Secretary Principi's credit, he has made the CARES process open and fair for all affected parties, including veterans to participate.
In an October 27, 2003 letter sent to all Senators, Secretary Principi outlines the great extent he has gone through to ensure that ``the process and review be thorough at every stage.'' Local veterans groups, local officials, union officials as well as affiliate representatives participated directly in the development of local
plans. Since the announcement of the Draft National CARES Plan, the CARES Commission has received more than 169,000 public comments. According to the VA, all comments will be made a part of the official record and will be considered by the CARES Commission during its deliberations.
I take great exception to Senator CLINTON's characterization of CARES as a ``cost-cutting plan.'' The Draft plan proposes to spend $4.6 billion in construction funds to expand services. It preserves more than 97 percent of VA's current bed capacity. Ninety-seven percent. It increases outpatient capacity by more than 12 million visits a year. It creates 48 new community-based outpatient clinics and at least 2 new hospitals. Further, the Draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Let me repeat that last sentence. The Draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Moreover, in some areas, the Draft plan's realignment would increase overall bed capacity. For example, in New York State, the realignment would increase overall bed capacity by about 10 percent. The Draft plan provides for all of these enhanced services and additional facilities despite the VA's projections that the veteran population is expected to decline by more than 25 percent over the next 20 years. I ask my Senate colleagues, does this sound like a cost-cutting plan?
Further, the CARES Commission has held a number of field hearings and site visits across the Nation to listen first-hand to the concerns of interested parties. In fact, Senator CLINTON participated in two CARES hearings. In total, the CARES Commission held 38 field hearings that included over 700 witnesses and made 68 site visits. In some instances, the Commission altered its schedule to respond to local interests such as in New York.
Clearly, Secretary Principi and the CARES Commission have been thorough, responsive, fair, and open in moving the process. For example, at Senator SCHUMER's request, Secretary Principi agreed to visit the Canandaigua VA hospital before making any final decision.
I also stress again that the CARES process is still in its developmental stage. The Commission has not completed its work. No final decisions have been made. The current plan is only a draft and is an interim step to the overall process. Delaying or stopping this process is premature and ends up hurting more than helping our veterans. The CARES Commission must complete the plan and the Secretary and the Congress must approve it.
The Senate authorizing committee, chaired by Senator SPECTER, is working on legislation that establishes criteria for funding CARES projects,
These organizations all oppose the Clinton-Enzi amendment because they understand the problem the VA has.
In 1999, the General Accounting Office found that VA could spend billions of dollars operating hundreds of unneeded buildings over the next 5 years. The GAO reported that the VA wastes more than $1 million per day on medical care funds for unneeded infrastructure instead of direct patient care. This money could be used to provide medical care to over 100,000 veterans.
Our committee, the VA-HUD committee, after the GAO report, directed the VA to do something about it, to develop a comprehensive strategy. Thus, in 1999, under the Clinton administration, the VA created the CARES Commission to address this concern.
I have traveled around the State of Missouri. I have seen firsthand the need for construction funds to update surgical and intensive care units. By the way, I gave at the office. One of the first closures the VA instituted was of a surgery center in the State of Missouri because they weren't doing enough surgeries to be proficient. I believed our veterans needed the best care. So now we have a primary care facility and we send them to a surgical hospital where they do enough surgeries to be proficient and safe.
We know we have different needs from veterans than when the VA was set up many years ago. The Clinton-Enzi amendment would deny over $600 million in construction funds to build new hospitals in States such as Nevada, Florida, and Colorado. It would deny funds to address safety, seismic and other deficiencies for facilities in Kentucky, California, Colorado, Ohio, Pennsylvania, and others. It would deny construction of 48 new community-based outpatient clinics.
It would deny funding for 37 nursing home investments, such as construction of new nursing homes in West Virginia and Pennsylvania. This is not a fatally flawed process. I cannot agree with the assertion of the Senator from New York. In an October 27 letter to all Senators, this year Secretary Principi outlines the great extent to which he has gone to ensure that the process and review be thorough at every stage. Local veterans groups, union officials, as well as affiliate representatives participated directly in the development of these plans.
The CARES Commission received more than 169,000 public comments. I take exception to the characterization of the plan as a ``cost cutting'' plan. The draft proposes to spend $4.6 billion in construction funds to expand services. It preserves more than 97 percent of the current bed capacity. Further, the draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Let me repeat that. The draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care.
2. In some areas, the draft plan would increase overall bed capacity. In New York State, the realignment would increase overall bed capacity by about 10 percent. The CARES Commission has held field hearings, and the Senator from New York has attended two of them. The CARES Commission held 38 field hearings with over 700 witnesses and made 68 site visits. Clearly, Secretary Principi and the CARES Commission have been thorough, responsive, fair, and open.
This is a process that still is in its development stage. The Senate authorizing committee, chaired by Senator Specter, is working on legislation to establish funding for CARES, which will provide Congress an opportunity to review the final CARES plan before it can be implemented. The VA Committee held a hearing with Secretary Principi and the CARES Commission chair, Everett Alvarez, to provide oversight on the process.
I am committed to and fully supportive of CARES because we need to support veterans' medical care over unneeded buildings. To keep unneeded or excess buildings in operation deprives veterans of the care they need. There has been much opposition to this.
Mr. President, to reiterate, I oppose vigorously the Clinton-Enzi amendment to stop the VA's Capital Asset Realignment for Enhanced Services or CARES process. The amendment would deny up to $1 billion in funds to support our Nation's veterans. I object to this amendment because I believe in putting the needs of veterans ahead of the costs of keeping open unneeded buildings. I especially object to this amendment because it would likely extend the waiting lines for veterans already waiting for medical care. It is imperative that the CARES process moves forward so that the VA can move its outdated medical care infrastructure into the 21st Century.
Before I explain my reasons for opposing this amendment, I ask that letters from the Veterans of Foreign Wars, AMVETS, Disabled American Veterans, and the Paralyzed Veterans of America be added to the RECORD. As the largest veterans' service organizations in the Nation, they all oppose the Clinton-Enzi amendment because of its negative impact on veterans.
Why does the amendment hurt veterans? In 1999, the General Accounting Office (GAO) performed a study of the VA's medical care infrastructure and found that the VA ``could spend billions of dollars operating hundreds of unneeded buildings over the next five years.'' The GAO reported that the VA wastes $1 million per day in medical care funds on unneeded infrastructure, instead of direct patient care. Therefore, instead of wasting some $400 million annually on unneeded buildings, the VA could use these funds to provide medical care to over 100,000 needy veterans.
In response to the GAO's report, our committee directed VA to develop a comprehensive strategy to realign its medical care facilities so that it can deliver health care in a more accessible and effective manner. Thus, in 1999, the VA created the CARES initiative during the Clinton Administration to address this concern.
The amendment also hurts veterans by denying much-needed construction funds to areas that need modernized facilities to serve its veteran population. In my travels around my own home State of Missouri, I have seen first-hand the need for construction funds to update surgical suites and intensive care units, among other things. For those Senators who have veterans in rural areas, they know that there is a critical need for outpatient clinics so veterans do not have to travel hundreds of miles to the nearest hospital. With an aging veteran population, there is a significant need to build nursing homes and long-term care facilities. The Clinton-Enzi amendment will deny over $600 million in construction funds to these places. It will deny funds to build new hospitals in States such as Nevada, Florida, and Colorado. It will deny funds to address safety, seismic, and other deficiencies for facilities in States such as Kentucky, California, Colorado, Ohio, and Pennsylvania. It will deny the construction of 48 new community based outpatient clinics throughout the country. It will deny funding for 37 nursing home investments, such as the construction of new nursing homes in States such as West Virginia and Pennsylvania.
Another reason why I oppose the Clinton-Enzi amendment is that the CARES process is still in its developmental stage and it is premature to pull the plug. Yet, Senator CLINTON has already concluded that the CARES process is ``fundamentally flawed'' and the CARES Commission has ``neglected'' the important health care issues facing our veterans. Further, she characterizes CARES as a ``cost-cutting'' plan.
I do not agree with the Senator's assertions and I think it is unfortunate that she has been so critical of Secretary Principi who has been extremely responsive to the Congress's concerns. To Secretary Principi's credit, he has made the CARES process open and fair for all affected parties, including veterans to participate.
In an October 27, 2003 letter sent to all Senators, Secretary Principi outlines the great extent he has gone through to ensure that ``the process and review be thorough at every stage.'' Local veterans groups, local officials, union officials as well as affiliate representatives participated directly in the development of local
plans. Since the announcement of the Draft National CARES Plan, the CARES Commission has received more than 169,000 public comments.
According to the VA, all comments will be made a part of the official record and will be considered by the CARES Commission during its deliberations.
I take great exception to Senator CLINTON's characterization of CARES as a ``cost-cutting plan.'' The Draft plan proposes to spend $4.6 billion in construction funds to expand services. It preserves more than 97 percent of VA's current bed capacity. Ninety-seven percent. It increases outpatient capacity by more than 12 million visits a year. It creates 48 new community-based outpatient clinics and at least 2 new hospitals. Further, the Draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Let me repeat that last sentence. The Draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Moreover, in some areas, the Draft plan's realignment would increase overall bed capacity. For example, in New York State, the realignment would increase overall bed capacity by about 10 percent. The Draft plan provides for all of these enhanced services and additional facilities despite the VA's projections that the veteran population is expected to decline by more than 25 percent over the next 20 years. I ask my Senate colleagues, does this sound like a cost-cutting plan?
Further, the CARES Commission has held a number of field hearings and site visits across the Nation to listen first-hand to the concerns of interested parties. In fact, Senator CLINTON participated in two CARES hearings. In total, the CARES Commission held 38 field hearings that included over 700 witnesses and made 68 site visits. In some instances, the Commission altered its schedule to respond to local interests such as in New York.
Clearly, Secretary Principi and the CARES Commission have been thorough, responsive, fair, and open in moving the process. For example, at Senator SCHUMER's request, Secretary Principi agreed to visit the Canandaigua VA hospital before making any final decision.
I also stress again that the CARES process is still in its developmental stage. The Commission has not completed its work. No final decisions have been made. The current plan is only a draft and is an interim step to the overall process. Delaying or stopping this process is premature and ends up hurting more than helping our veterans. The CARES Commission must complete the plan and the Secretary and the Congress must approve it.
The Senate authorizing committee, chaired by Senator SPECTER, is working on legislation that establishes criteria for funding CARES projects,
the draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Let me repeat that. The draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care.
In some areas, the draft plan would increase overall bed capacity. In New York State, the realignment would increase overall bed capacity by about 10 percent. The CARES Commission has held field hearings, and the Senator from New York has attended two of them. The CARES Commission held 38 field hearings with over 700 witnesses and made 68 site visits. Clearly, Secretary Principi and the CARES Commission have been thorough, responsive, fair, and open.
This is a process that still is in its development stage. The Senate authorizing committee, chaired by Senator Specter, is working on legislation to establish funding for CARES, which will provide Congress an opportunity to review the final CARES plan before it can be implemented. The VA Committee held a hearing with Secretary Principi and the CARES Commission chair, Everett Alvarez, to provide oversight on the process.
I am committed to and fully supportive of CARES because we need to support veterans' medical care over unneeded buildings. To keep unneeded or excess buildings in operation deprives veterans of the care they need. There has been much opposition to this.
Mr. President, to reiterate, I oppose vigorously the Clinton-Enzi amendment to stop the VA's Capital Asset Realignment for Enhanced Services or CARES process. The amendment would deny up to $1 billion in funds to support our Nation's veterans. I object to this amendment because I believe in putting the needs of veterans ahead of the costs of keeping open unneeded buildings. I especially object to this amendment because it would likely extend the waiting lines for veterans already waiting for medical care. It is imperative that the CARES process moves forward so that the VA can move its outdated medical care infrastructure into the 21st Century.
Before I explain my reasons for opposing this amendment, I ask that letters from the Veterans of Foreign Wars, AMVETS, Disabled American Veterans, and the Paralyzed Veterans of America be added to the RECORD. As the largest veterans' service organizations in the Nation, they all oppose the Clinton-Enzi amendment because of its negative impact on veterans.
Why does the amendment hurt veterans? In 1999, the General Accounting Office (GAO) performed a study of the VA's medical care infrastructure and found that the VA ``could spend billions of dollars operating hundreds of unneeded buildings over the next five years.'' The GAO reported that the VA wastes $1 million per day in medical care funds on unneeded infrastructure, instead of direct patient care. Therefore, instead of wasting some $400 million annually on unneeded buildings, the VA could use these funds to provide medical care to over 100,000 needy veterans.
In response to the GAO's report, our committee directed VA to develop a comprehensive strategy to realign its medical care facilities so that it can deliver health care in a more accessible and effective manner. Thus, in 1999, the VA created the CARES initiative during the Clinton Administration to address this concern.
The amendment also hurts veterans by denying much-needed construction funds to areas that need modernized facilities to serve its veteran population. In my travels around my own home State of Missouri, I have seen first-hand the need for construction funds to update surgical suites and intensive care units, among other things. For those Senators who have veterans in rural areas, they know that there is a critical need for outpatient clinics so veterans do not have to travel hundreds of miles to the nearest hospital. With an aging veteran population, there is a significant need to build nursing homes and long-term care facilities. The Clinton-Enzi amendment will deny over $600 million in construction funds to these places. It will deny funds to build new hospitals in States such as Nevada, Florida, and Colorado. It will deny funds to address safety, seismic, and other deficiencies for facilities in States such as Kentucky, California, Colorado, Ohio, and Pennsylvania. It will deny the construction of 48 new community based outpatient clinics throughout the country. It will deny funding for 37 nursing home investments, such as the construction of new nursing homes in States such as West Virginia and Pennsylvania.
Another reason why I oppose the Clinton-Enzi amendment is that the CARES process is still in its developmental stage and it is premature to pull the plug. Yet, Senator CLINTON has already concluded that the CARES process is ``fundamentally flawed'' and the CARES Commission has ``neglected'' the important health care issues facing our veterans. Further, she characterizes CARES as a ``cost-cutting'' plan.
I do not agree with the Senator's assertions and I think it is unfortunate that she has been so critical of Secretary Principi who has been extremely responsive to the Congress's concerns. To Secretary Principi's credit, he has made the CARES process open and fair for all affected parties, including veterans to participate.
In an October 27, 2003 letter sent to all Senators, Secretary Principi outlines the great extent he has gone through to ensure that ``the process and review be thorough at every stage.'' Local veterans groups, local officials, union officials as well as affiliate representatives participated directly in the development of local
plans. Since the announcement of the Draft National CARES Plan, the CARES Commission has received more than 169,000 public comments. According to the VA, all comments will be made a part of the official record and will be considered by the CARES Commission during its deliberations.
I take great exception to Senator CLINTON's characterization of CARES as a ``cost-cutting plan.'' The Draft plan proposes to spend $4.6 billion in construction funds to expand services. It preserves more than 97 percent of VA's current bed capacity. Ninety-seven percent. It increases outpatient capacity by more than 12 million visits a year. It creates 48 new community-based outpatient clinics and at least 2 new hospitals. Further, the Draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Let me repeat that last sentence. The Draft plan provides for no reduction in VA capacity to provide domiciliary or long-term care, including long-term mental health care. Moreover, in some areas, the Draft plan's realignment would increase overall bed capacity. For example, in New York State, the realignment would increase overall bed capacity by about 10 percent. The Draft plan provides for all of these enhanced services and additional facilities despite the VA's projections that the veteran population is expected to decline by more than 25 percent over the next 20 years. I ask my Senate colleagues, does this sound like a cost-cutting plan?
Further, the CARES Commission has held a number of field hearings and site visits across the Nation to listen first-hand to the concerns of interested parties. In fact, Senator CLINTON participated in two CARES hearings. In total, the CARES Commission held 38 field hearings that included over 700 witnesses and made 68 site visits. In some instances, the Commission altered its schedule to respond to local interests such as in New York.
Clearly, Secretary Principi and the CARES Commission have been thorough, responsive, fair, and open in moving the process. For example, at Senator SCHUMER's request, Secretary Principi agreed to visit the Canandaigua VA hospital before making any final decision.
I also stress again that the CARES process is still in its developmental stage. The Commission has not completed its work. No final decisions have been made. The current plan is only a draft and is an interim step to the overall process. Delaying or stopping this process is premature and ends up hurting more than helping our veterans. The CARES Commission must complete the plan and the Secretary and the Congress must approve it.
The Senate authorizing committee, chaired by Senator SPECTER, is working on legislation that establishes criteria for funding CARES projects,
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