▶ 0:16:57e e
▶ 0:17:36on a few of the bills being considered I look forward to addressing our policy concerns and working with the minority on moving these bills forward in accordance with committee rules the subcommittee has contacted the Congressional budget office seeking informal preliminary cost estimates for each of these bills being considered this afternoon while many of the bills on our agenda will most likely have a score we do not have estimates for all of the bills on today's markup up none of the bills today include the offsets that would be necessary to move the bills forward however as we discuss what bills will
▶ 0:18:06go to the full committee markup and then to the floor We'll add offsets to ensure that we are in accordance with house rules and that we are protecting the American taxpayer I look forward to working with ranking member brownley and the other members of the subcommittee to find offsets for the common sense proposals considered today of note there are still multiple opportunities to improve and make necessary changes to these bills ranking member brownley and I will continue working with our colleagues on the committee and any stakeholders that have feedback on these bills as we continue to work through the legislative
▶ 0:18:36process to bring the best bills forward a majority of the bills on today's agenda including my bills are focused on ensuring quality mental health and prosthetic care and have bipartisan support I understand however that the minority may have concerns with several of our bills including representative Murphy's Bill hr1 1336 which would establish a pilot program to Prov to provide hyperbaric oxygen therapies to Veterans suffering from traumatic brain injury or post-traumatic stress disorder I commend representative Murphy for his efforts
▶ 0:19:06we should be doing all we can to help our veterans suffering from the wounds sustained during their service and Furnishing uh promising hbot therapies that take meaning meaningful steps towards that end I now recognize ranking member uh brownley for any opening remarks she may have thank thank you madam chair um for organizing this afternoon's um this afternoon's markup in the interest of promptly proceeding with our markup and the oversight hearing to follow I will forgo an opening
▶ 0:19:39statement happy thank thank you uh for that uh gracious concession ranking member brownley um today we have on block HR 2117 hr1 1971 HR 1107 hr1 1644 and hr1 1860 I now ask unanimous consent to consider the following five bills on block HR 217 hr1 1971 HR 1107 hr1 1644 and hr1
▶ 0:20:111860 hearing no objections so ordered the clerk shall report the bill HR 217 to amend title 38 United the bills were circulated in advance pursuant to committee rules I ask that the reading of the bills be dispensed with and the bills be open to Amendment at any point without objection so ordered does any m wish to speak on any of the bills included in the on block I wish to speak the chair recognize ranking member brownley thank you chairwoman I'm glad that this on block includes two bills that are priorities uh of our
▶ 0:20:41Democratic members this includes representative Underwoods copay fairness for veterans act HR 1644 which will eliminate Financial barriers that could prevent veterans from accessing basic preventive Health Care this legislation will wave co-pays for certain immunization certain Services recommended by the United States preventive service task force and preventive services for women including contraceptives approved by the FDA under the Affordable
▶ 0:21:11Care Act almost all Private health insurance plans are required to Pro to provide coverage of preventive services without charging co-pays however While most uh civilians have been able to access preventive services without Co co-pays for nearly 15 years thanks to the ACA the same guarantee does not exist for veterans who access Care at the VA representative Underwoods bill would correct this I'm also pleased that the on block includes hr1 1860 the women's veterans
▶ 0:21:41Cancer Care coordination Bill a bill I am co-leading with representative Sylvia Garcia through va's uh breast and Gynecology Oncology system of Excellence VA oncology Surgical and nursing Specialists are already providing worldclass care for these types of cancers directly through VA the system of Excellence also helps connect veterans with care in the community when necessary how excuse me however regardless of where individuals
▶ 0:22:11are receiving care cancer treatment is often very complex requires patients to regularly see many different providers for various treatments this can be very difficult for patients to navigate and our veterans deserve the highest level of support throughout this time representative Garcia's bill will help improve the quality of va's care coordination for breast and gynec gynecologic cancers the unblock also includes HR 1107 the protecting veterans access to Tele medicine Service
▶ 0:22:42Act sponsored by representative wac why am supportive of this leg legislation which SE seeks to exempt VA prescribers from a requirement to conduct an inperson medical exam prior to prescribing Controlled Substances making permanent a flex ability that has been extended to VA and nonv prescribers alike since the covid p pandemic I will note that VA did not provide views on this bill during our March 11 11th legislative hearing indicating that
▶ 0:23:12it would provide views via letter at a later date to my knowledge the committee has not yet received this letter if this bill is considered at a future full committee markup we should amend it to address any concerns or technical revisions that VA May request I hope our majority colleagues will work with us to ensure the committee advances a bill that VA and other stakeholders can support that said I'm glad to support the bills included in the on block and urge my colleagues to do the same and I yield back
▶ 0:23:42thank you rank ranking member brownley does any other member wish to speak on any of the bills in the unblock seeing none no amendments were filed to these bills does any member wish to offer an amendment hearing none I now recognize make ranking member brownley for a motion Madam chair Madam chairwoman I move that HR 2217 hr1 1971 HR 1107 hr1 1644 and hr1 1860 be reported favorably
▶ 0:24:13to the full committee there is a motion to favorably forward these bills included in the on block all those in favor say I I I all opposed say no in the opinion of the chair the eyes have it and the bills are favorably forwarded to the full committee the motion reconsider is laid upon the table I now call up hr1 1969 the clerk shall report the bill HR 1969 to amend the text was circulated in advance pursuant to committee rules without objection the first reading is dispensed with and the bill is now open
▶ 0:24:43for an amendment at any point I now recogize myself to offer an amendment in the nature of a substitute the clerk shall report the amendment in the nature of the substitute amendment in the nature of a substitute I ask unanimous consent that further reading of the amendment in the nature of the substitute be dispensed with I ask that it be considered base text for the purposes of the markup without objection so ordered I now recognize myself for 3 minutes to explain the amendment in the nature of the C substitute Fox grants have made a meaningful and measurable impact in the lives of our veterans it was designed
▶ 0:25:14with the simple but powerful idea in mind that no matter where a veteran turns to for help they should be able to access Mental Health Services they need without being turned away and it's working across the country we've seen veterans who are once struggling in silence now connect Ed to care thanks to the dedicated Partnerships between the VA and local organizations however while I believe there's room for improving certain aspects of the fox grant program we cannot ignore that this program is set to expire in the coming months this is an outcome I won't accept
▶ 0:25:44my amendment in the nature of a substitute reauthorizes the fox gr program 2026 to through 2026 to ensure that veterans continue to receive the vital Services they rely on today while giving us time and space to deliberately and thoughtfully act on potential reforms for the future administration of the program I yield back the balance of my time do any members wish to be recognized to comment on the amendment in the nature of a substitute the chair recognizes Dr
▶ 0:26:14Dexter for three minutes thank you madam chair first and foremost as a committee we must be focused on ensuring the VA has resources and Workforce for a robust Direct Care system this proven trusted system is best suited to care for our and by many accounts is where veterans want to receive their care at a base level I have concerns with the underlying legislation because it runs counter to this goal I also have significant concerns with the ANS to this bill which I believe was intended to address concerned
▶ 0:26:44stakeholders have with the program but which does not seem to fix any issues and instead introduces new concerns foremost among those concerns for me is the language in the ANS requiring grantees to use the Columbia suicide sever it rating scale or the CR cssrs to provide Baseline mental health screenings to program participants with any congressionally established program it is essential we collect and evaluate data so we can understand the relative effectiveness of the things we are investing
▶ 0:27:15in have serious concerns about the concept of Congress absent input from the scientific and Mental Health Community mandating a single screening tool to measure the success of the program while the Columbia protocol is a wellestablished clinical tool and provides crucial information to Providers about an individual's risk for suicide in a given moment it is not designed to measure every suicide risk factor nor is it capable of showing improvement over time for risk factors this approach provides no flexibility to
▶ 0:27:45ensure that the program has the tools to collect the best possible outcome data furthermore I believe Congressional intent in establishing this program also included a clear need to gather evidence on the utility of this program based on the preliminary data Congress has received from the first two mandated reports on evaluating it we are failing miserably short on this important aspect of it I am also concerned by a provision in the ANS that the that adds healthc care providers as an eligible grantee because the ANS does not
▶ 0:28:15define what kind of healthc care providers would be newly eligible I can only conclude that this change would potentially open up access to a new funding stream for Community Care Providers without the significant significant guard rail that they are usually subject to it is not a responsible or effective use of taxpayer dollars to extend a program that we have no way to prove in a datadriven scientific way is actually serving our veterans especially when it comes at the expense of investing in proven services at the VA
▶ 0:28:46as a committee and as members of Congress we should be investing in programs and interventions provided through the direct vaare system rather than creating new programs that divert those Investments outside VA for these reasons I cannot support this ANS today and thank you madam chair I yield back thank you very much Dr Dexter uh any other member wish to speak on the bill does any member wish to offer an amendment to the amendment in the nature of a substitute hearing none the question now occurs on agreeing to the amendment in the nature
▶ 0:29:16of a substitute to hr1 1969 all those in favor say I I all those opposed say no in the opinion of the chair the eyes hav it the amendment of the nature of a substitute is agreed two without objection um now a recorded vote has been requested pursuant to committee rules the vote will be postponed without objection the motion to reconsider is laid upon the table
▶ 0:29:46I now recognize uh representative hamade for a motion Madam chairman I move that the subcomittee favorably forward HR 1969 to the full committee we're postponing that my apologies we'll now go to hr1 1823 the VA budget accountability act representative Bergman I now call up HR 1823 the clerk shall report the bail hr1 1823 to direct the Secretary of Veterans Affairs and The Controller General of the United States to report on certain funding shortfalls in the Department
▶ 0:30:16of Veterans Affairs the text was circulated in advance pursu it to committee rules without objection the first reading is now dispensed with and the bill is now open for Amendment at any point I recognize myself to speak in favor of the bill I applaud representative Bergman for his leadership of hr1 1823 the bill would require the com Controller General of the United States to conduct a forensic audit of the Department of Veterans Affairs budgeting process to determine the cause of the va's alleged budget shortfall from last year we owe it to our taxpayers and to our veterans to
▶ 0:30:46get a full picture of the va's accounting errors to ensure accountability and prevent this from ever happening again I urge my colleagues to support this legislation does any other member wish to comment on the bill the chair now recognizes representative Burgman for three minutes thank you madam chair I will keep this brief Congress has the solemn duty to provide the VA with every single dollar it needs to give veterans the health care and benefits they've earned through their service the only way this can be done is through accurate
▶ 0:31:17budgeting and planning by the Department of Veterans Affairs budgeting failures at VA like those we saw last year are inexcusable and could directly impede our mission on behalf of veterans my Common Sense legislation would require The Controller General to perform an internal audit of the accounting mismanagement in the VA which resulted in their sudden shortfall report this will help ensure that such a budgeting mistake does not happen again
▶ 0:31:47while preventing the mismanagement of taxpayer funds and I repeat while mismanaging taxpayer funds I urge my colleagues to support h R 1823 and I back does any other member wish to speak on the bill I wish to speak Madam chair the chair now recognizes ranking member brownley for three minutes thank you uh Madam chair well I support the intent of this bill and I will vote in favor
▶ 0:32:17of advancing it to the full committee I would respectfully request that the majority work together with our staff to amend this bill when it is when it is marked up at the full committee level both GAO and oig are already working on reports that will identify the causes of the VHA and VBA shortfalls that came to light last summer in fact just days from now oig is set to publish two reports that were already mandated
▶ 0:32:48by the veterans benefits uh continuity and accountability supplemental Appropriations Act of 2024 GAO has separately initiated a review of VH vha's budget shortfall under the controller General's Authority and if and it significantly overlaps the scope of the VHA review that would be Mand mandated by General bergman's bill in addition I agree with the observation that VA made in its testimony for the legislative
▶ 0:33:18hearing where this bill was considered two weeks ago HR 1823 requires GAO to submit to submit its completed report to VA and then requires VA to submit gao's report to the congressional committees I don't think this makes a lot of sense as VA would not be adding anything to the report I agree with VA that it would be more logical for a GAO to directly submit the report directly to Congress when completed while I understand the eagerness
▶ 0:33:49to get to the bottom of what happened with va's budget estimates and monitoring of budget e execution last year I'm concerned that hr1 1823 as introduced would represent little more than a duplication of gaos and oig's existing reviews I hope that the majority staff will work with us to determine what aspects of the VBA and VHA budget short Falls may still need to be examined and amend this bill accordingly so that we can ensure
▶ 0:34:19the most efficient use of gao's resources with that I yield back thank you anking member brownley does any member wish to offer offer an amendment to hr1 1823 all right hearing none I now recognize representative King Hines for motion Madam chairwoman I move that the subcommittee favorably forward hr1 1823 to the full committee there is a motion to favorably forward hr1 1823 all those in favor say I I all opposed say no in the opinion of the
▶ 0:34:49chair the eyes have it and hr1 1823 is favorably forwarded to the full committee the motion to reconsider is laid upon the table I'm Now call up hr1 1336 the veterans National traumatic brain injury act the clerk shall report the bill hr1 1336 the text was circulated in advance pursuant to committee roles without objection the first reading is dispensed with and the bill is now open for Amendment at any point I now recognize Dr Murphy for three minutes in support of his Bill thank you madam chair wom um they say that doing the same thing over and over and
▶ 0:35:19expecting different results is the definition of insanity and we ose today 17 to 30 veterans every day to suicide so far nothing has worked last year uh when this committee was introduced with psychedelics I admit I was very skeptical at first but being objective reading the literature and coming to a conclusion that I thought was medically correct I agreed with this and we passed this in a bipartisan manner outside out of this committee we have witnessed veterans we've had Witnesses we've had veterans veterans groups
▶ 0:35:50come and attest to the salatary and life-saving effect for PTSD and TBI with hyperbaric oxygen I've worked with Dr Sha in Israel who has the world's largest experience in using the benefits of hyperbaric oxygen for TBI and PTSD there have been multiple NIH studies and I've handed them out to each of this committee uh and to the members of this committee before most recently I believe October was a men analysis showing 15 years of experience with close to 40 studies showing the beneficial
▶ 0:36:20and life shaving effects life-changing um effects of hyperbaric oxygen therapy for TBI this is is when our veterans sadly enough given the experience and what's being done at this point in time hit a wall there's no reason in my medical opinion of 30 years of being a surgeon and used this many many multiple times as a surgeon that we should not allow our veterans a chance when they literally have no other chances so today I I'd like to present
▶ 0:36:50my bill along with grateful co-sponsors bipartisan representative kiggins Davis Strickland Whitman and Orton malakas Ross bigs McDow and harder to this committee they are also supported by multiples vsos Daw assum daav wwp American Legion vva treat now Fleet ready reserve military veterans and Amvets to understand how deeply crucial it is that we do something now that is proven we have had an expert witness
▶ 0:37:20the esteemed Doctor Andrew ksky who came from the University of Iowa who is an hyperbaric oxygen medicine specialist this is something that is being done around the country I know in Durham North Carolina we have an excellent Institute that through funding through uh donations rather we are treating hundreds and hundreds of veterans each year I have personally met many of these individuals whom literally had no other hope and has made a difference in their life um
▶ 0:37:51I uh I would love that this P this committee passed this bipartisan this is good medicine and I believe it is something that will help our veterans in a time when we have not been helping them um up to this point Thank You Madame chairman I urge my colleagues both Republican and Democrat to vote for this Bill thank you Dr Murphy the chair now recognizes Dr Morrison for three minutes to speak on the bill thank you madam chair uh my amendment I do have an amendment at the desk Madam chair my amendment
▶ 0:38:21requires the VA to conduct a full literature review on the effectiveness of hbot as a treatment for PTS and TBI at the March 11th legislative hearing the subcommittee heard directly from va's testimony that there is currently no scientific basis to support the clinical efficacy of hbot as a can I ask the gentle lady to pause certainly okay the the clerk hasn't recorded the Amendments so we need to do that we're currently speaking on the bill not on amendments so can you pause we will come back all right Madam chair thank you
▶ 0:38:52do you wish to speak on the bill miss shis m oh yes yeah okay then uh the chair now recognizes representative van Ordon for three minutes thank you madam chair um we held a a round table here which unfortunately most of my Democrat colleagues couldn't seem to make time to make it there we had people that are psilocybin uh iasa we had talk therapy we had groups
▶ 0:39:22um for pete6 the guy that shot Osama bin lad is a friend of mine and he testified there another person that testified his name is Robert aonia he was my roommate in Seal training and we both did 26 years multiple combat tours he was a breacher instructor we were both diagnosed with PTSD and TBI as have really the majority of my friends and um so I'm on the Psychedelic caucus and I don't completely agree with it at all I've been
▶ 0:39:52very Frank with this General Bergman shares that and but it it saves at least veterans life one and that's enough hbot it works Robert conak is literally alive and his wife sh actually testified for him and he sat next to her and she explained how Robert using hbot hypobaric goou therapy gave her her husband back and who in the hell we to say that that's not
▶ 0:40:23okay that is not our place and if if it saves one veteran it's worth it one it's the power of one ma'am so when we're sitting on our high horse up here you guys have not walked the walk that I have you haven't or my friends you just have not I've had 21 of my friends commit suicide I'm 55 years 21 if I could bring any one of those back for five
▶ 0:40:54minutes I would do so I'd give my soul for that and for us to sit up here and say that we're not going to do this because it's not evidence-based Robert a coniac is a live doctor he is the evidence we don't need to do any more studies because every time we do a study nothing happens and our friends are killing themselves as we speak I stand in incredibly strong support of this bill I encourage my Democrat colleagues to
▶ 0:41:24go with me and visit my friends if you want and I will take you to them and you will talk to their wives and you can talk to the kids that don't have dads anymore because they killed themselves because treatments like this are available and then you put in your Amendment with that I yield back the chair will remind all members to address the chair not to um other members of the committee um thank you the chair now recognizes Dr Morrison for 3 minutes to speak on the
▶ 0:41:55bill thank you madam chair chair I have an amendment at the desk we're not on amendments we're speaking on the bill the chair now recognizes Dr Dexter to speak on behalf of the bill not any amendments yes thank you madam chair um and I want to recognize the importance of this issue to my colleagues and certainly our patients um I took care of veterans many with tbis and PTSD I very much appreciate the importance of um treating
▶ 0:42:26effectively and with um care and and due diligence and I also think as a physician is my responsibility to speak up when we are advancing policy that has not been proven to serve patients and will remove funding from other interventions that are datadriven and scientifically proven and to that end I will highlight here the research on hyperbaric oxygen treatment is flimsy at best it's
▶ 0:42:56certainly not rigorous it's certainly not compelling and I will be entering into the record for our previous legislative hearing several studies to that substantiate this point notably one of those studies shows that for mild TBI this treatment is no better than a sham treatment we also know that Placebo has an overall 30% Effectiveness rate and and people will feel better when they are having something done to them this is shown over and over again the difference is whether or not we compare
▶ 0:43:26the inter intervention with a placebo and that has not been proven to have efficacy here I would also suggest that some of the prior evidence um proposed or shown in the record had Clear and Present conflicts of interest with the folks who published the study having gain from that information and at the end of the day this is a question of resource allocation it is all of our responsibilities to make sure veterans get the best quality highest
▶ 0:43:57e efficacy care and we are not fully funding the Veterans Administration sufficiently to have extra funding to try other things and so I will not stand by quietly as we propose to waste taxpayer money and enrich special interest groups on a treatment that is not evidence-based when they are there are so many more pressing things for this patient population that are proven and are effective thank you madam chair yield back thank you does any other member wish to speak
▶ 0:44:27on the underlying Bill HR I the chair now recognizes Dr Conway for three minutes and I'll I'll try to be brief and and I want to um say first off um that I appreciate very much the experience life experience and the emotion behind this bill we Physicians face uh these uh this challenge very often where someone comes to the office and they have
▶ 0:44:57heard from a loved one or they've read on the Internet or they've um um gained some information which would suggest a particular treatment will be helpful to them and indeed Physicians do in individual cases have um you know plary authority to prescribe um in I would say limited circumstances anything which we think might help a patient who has um not been able to find um all the help they need uh to deal
▶ 0:45:27with their particular problem but when it comes to you know particularly when it comes to costly therapies uh therapies which may be harmful or even therapies which may uh not do any good at all uh we have to be particularly careful to always stick to our routines if you will the are the method that we apply to these very important decisions are there randomized control trials uh that support the recommendation of a particular
▶ 0:45:57therapy uh to a person's uh diagnosis to a person's problem and if that data is not there uh then um one we may very well be doing a disservice to the patient uh by not directing them to therapies that are proven and shown to work uh and I think in many ways we would be and I'm not making any accusations here that that we may indeed be doing things that are against the oath we take uh to provide uh the best
▶ 0:46:28advice uh and to conduct our our care with due diligence so while I appreciate um the emotion behind this and the fact that you will have in a uncontrolled non-experimental setting successes um the broad application of a particular therapy might not be warranted in many cases are not warranted by the data that's put before us and I think that's the point uh my colleagues are making and so um I'll just end there
▶ 0:46:58Madam chair and thank you for your Indulgence uh thank you the chair now recognizes uh uh General Bergman for three minutes for any uh comments he may have on the bill the chair now recognizes Dr Murphy for thank you General bur remaining time you know I I trying to sit back and realize what's been said I've handed out three here's a met analysis um random Placebo control tries
▶ 0:47:28there are 40 studies in this thing 40 that show a salutory benefit and maybe you weren't listening when I spoke at the beginning 40 have shown this we have had experts come across this country that don't just do this for their own benefit nobody's uh I take a little umage at the fact people are publishing this so they can get referrals that's ridiculous we're dealing with trying to do things for our veterans and as for spending more money we had a secretary of the VA come up here last year and say we're 10 million $12
▶ 0:47:59million 12 billion short no we're 6 billion that they spent $180 billion more where our VA level was flat so that's really not an argument so I would I would suggest to my colleagues this is a visceral issue for me because I have seen what it's done and I guarantee you I'm the only physician in the room that's actually actively used this therapy that these are true studies they're apolitical they're metaanalysis studies that go back and look at all of these things and I urge you and I'll be happy to supply further papers
▶ 0:48:29to you to show that this is a definitive treatment it has been put against sham treatment it has been done everything that it's supposed to do and yes we want to continue if if you want to continue what we're doing then we are resigning ourselves to letting 17 to 30 veterans die a day from suicide so no doing the same things as I started out my comments on saying the same things and doing the same things over and over is a pathway to disaster for veterans this is scientific proof
▶ 0:48:59it is not the scientific proof that uh we saw back during the pandemic when people lied to us this is scientific truth that I have scrubbed for the last decade thank you madam chairman I'll y back thank you Dr Bergman I now recognize myself for three minutes to speak in uh support of hr1 1336 as we've begun these topics on therapies other than traditional therapy for the treatment of PTSD uh mental well-being and suicide
▶ 0:49:30prevention it brings to mind the abysmal record that the VA has in treating what seems to be a refractory problem we have heard testimony from family members from veterans about their struggles accessing to care about the side effects from traditional antis psychotic anti- analytic medications significant side effects yet we continue down the same that's the point of pilot studies when the evidence may
▶ 0:50:00be to some equivocal or less robust than they want the purpose of the pilot study is to show whether or not there is true benefit when you do have randomized studies that may show a benefit I'd like to thank uh representative Murphy Dr Murphy for his continued leadership on the bill the veterans National traumatic brain injury act for the family members of people who are here in support of trying to end suicide and for this bill that would require
▶ 0:50:31the VA to establish a pilot program granting veterans access to hyperbaric oxygen Therapies in their Community none of us want to waste the va's money but in the past four years under the previous administration the funding increased to the VA was 126 billion the number of employees increased to the VA was 880,000 but the number of veterans receiving care enrolling for care or implying care even with the act act which isn't hasn't changed that number has been relatively flat so
▶ 0:51:01there has been in fact increased funding PTSD and TBI continue to take a devastating toll on our veterans of which I am one meaning veteran and we should be expanding not limiting treatment options it's why I support hr3 1336 and I urge all my colleagues to do the same I yield back the balance of my time do any other members wish to be recognized on the underlying Bill a h r 1336 seeing none does any member wish to offer an amendment
▶ 0:51:31to hr1 1336 the chair now recognizes Dr Morrison thank you madam chair I have an amendment at the desk the clerk shall read the amendment amendment to HR 1336 offered by Dr Morrison page two before line five insert the following new subsection consent that further reading of the amendment be dispensed with without objection so ordered I now recognize representative Morrison for 3 minutes to speak on the Amendment thank you madam chair you know I I think what unites us on this committee
▶ 0:52:01is our desire our passionate desire to ensure that those that put their lives on the line for our country get the care that they have earned and they deserve to get the best care so my Amendment simply requires VA to conduct a full literature review on the effectiveness of hbot as a treatment for PTSD and TBI at the March 11th legislative hearing this the subcommittee heard directly from va's testimony that there is currently no little or no
▶ 0:52:31scientific basis to support the clinical efficacy of hbot as a treatment for PTSD or TBI as a physician myself and a strong supporter of evidence-based medicine I have serious concerns about requiring the VA to proceed with this pilot program without full consideration of available research increasing access to PTSD and TBI treatments and encouraging the development of new treatments is a goal I know I share with my Republican colleagues on this committee however we have a responsibility to be thorough and carefully
▶ 0:53:02evaluate that the critical resources directed to veteran treatments deliver their intended outcomes the last thing any of us want is delayed development of new treatments or decrease resources to existing proven treatments for the sake of those lacking robust scientific vasis I urge my colleagues to vote in favor of this amendment and recognize the value of completing our due diligence through this review passing this amendment safeguards meaningful progress toward our shared goal of making sure that every veteran has access to the Quality PTSD
▶ 0:53:33and TBI treatments they deserve and with that I yield back Madam chair does any other member wish to comment on uh the Morrison amendment to hr1 1336 the chair now recognizes representative van Orton for three minutes I would think that one of the primary responsibilities in the how we should conduct ourselves in this committee is by listening to Veterans I would assume we all agree correct chairwoman's a veteran she supports this bill General bergman's the most senior ranking member of the military to ever
▶ 0:54:03be elected to congress he supports this bill I'm the longest serving and listed member of the United States military to ever be elected to congress in the history of our nation and I support this bill Jen kiggins is a veteran she supports us Phil Mr rd's a veteran he supports us Phil listen to Veterans that's us I yield back oh sorry uh I should say that I do not support this amendment at all and neither did any of these people that have served with a gun in our hand defending the rest of this committee without a yield back the gentleman Ys does any
▶ 0:54:33other member wish to comment on the Morrison amendment to hr1 1336 the chair now recognizes Dr Murphy for three minutes thank you madam chairman I'm going to urge my colleagues to vote no and it's not just merely because what's been said because it effectively kills the bill and I've said now probably for a third time um a full metanalysis study I'll be happy to walk it over to the VA and hand it to the Physicians if they want but it takes about 10 minutes to go back and do a literature search that has shown over the last 10 to 15 years through multiple studies
▶ 0:55:03and metaanalysis soes have a Sal salutory benefit of hyperbaric oxygen therapy um to not do this in my opinion is to go against my oath um so I would urge against this only because it strikes the whole bill another further delay and if they want the study uh the group of studies I'll walk down there with a stack with them I urge no vote seeing no other members that wish to speak the question now occurs on a grain to the Morrison
▶ 0:55:34Amendment shair now recognizes Dr Dexter for three minutes thank you madam chair I just wanted to point out that this amendment does not kill the bill if it is robust in the data and so if it is Data supported scientifically driven that absolutely would not kill the bill and I think we should all want to make sure we're doing no harm to our patients and with that I yield back thank you the gentle Ys do any other members wish to speak on the bill seeing none the question now occurs on green to the Morris an amendment to hr1 1336 all those
▶ 0:56:04in favor say I I all those opposed say no no in the opinion of M CH request a recorded vote a recorded vote has been requested pursuant to committee rules that vote will be postponed without objection the motion reconsider is laid on the table does any other member wish to offer an amendment to HR 36 the chair now recognizes representative sherff fiss McCormack Madam chairman I have an amendment at the desk the clerk shall report the amendment amendment to a I ask unanimous consent the further reading
▶ 0:56:34of the amend be dispensed with without objection so ordered I now recognize sh uh representative sheris McCormack for three minutes to speak on the amendment thank you madam chair my Amendment will require GAO to issue an update to its 2015 report regarding the E efficacy of hbot at the treatment for PTSD and TBI within one year of enactment G A's 2015 report which was mandated by The Joint explan explor explanatory statement accompanying the Consolidated and further
▶ 0:57:04continuing Appropriations Act of 2015 reviewed the findings of 32 peer-reviewed articles on research about the use of the hypobaric oxygen therapy to treat PTSD and TBI the report found mixed reviews in effective effectiveness of the treatment and that there was no standard design for the studies they reviewed we can all agree that a lot can change within 10 years particularly when it comes to PTSD and TBI treatment research gao's
▶ 0:57:34work will be help will be very helpful in ensuring transparency and ensuring veterans have access to the latest information about efficacy of this treatment I hope my all my colleagues will share my interest in understanding the results of the latest research of this topic in the last 10 years and with that um before I yield back I do want to mention that it's particularly important that we actually are documenting if this bill does move forward that we have some kind of safeguards that are present so we can see the results of it and so I don't
▶ 0:58:04believe that this amendment will have a negative impact on this bill and so I urge my colleagues to vote for this amendment so we can fully understand this treatment thank you a back gentoman yields does any other member uh the chair now recognizes Dr Murphy for three minutes I thank the gentle lady for her amendment I think it's a fair and friendly Amendment um we all want to study afterwards to see really how our veterans are treated so I would urge my colleagues to vote in favor of the amendment any other member wish to speak on the amendment
▶ 0:58:35okay the question now occurs on a green to the sheris mccormic amendment to hr1 1336 all those in favor say I I all those opposed say no in the opinion of the chair the eyes have it the chis McCormick is agreed to without objection to motion reconsider is laid on the table does any other member wish to offer an amendment to hr1 1336 Madam chair I have an amendment to recognizes representative brownley you have an amendment at the desk the clerk shall report the amendment amendment to H I ask unanimous consent that further reading
▶ 0:59:05the amendment to be dispensed with without objection so ordered I now recognize representative brownley for three minutes to speak on the amendment thank you madam chair like many of you I was horrified by the recent death of a 5-year-old boy in Michigan when a fire broke out in the hyperbaric chamber where he was receiving treatment for ADHD and sleep at as a result three of the medical facilities employees have since been charged with second deegree murder according to Michigan's attorney general who
▶ 0:59:36brought the charges it has come to light that the facility did not perform daily maintenance checks failed to perform safety checks or employ a patient work ground strap did not have a medical doctor or safety supervisor on the premises and did not ensure the treatment was performed formed by a licensed technician I am not here to dispute the many studies that have found hyperbaric oxygen therapy is safe when performed according to
▶ 1:00:06safety standards and by licensed individuals however this story should be a wakeup call to everyone of the dangers of failures of oversight my amendment is very simple and requires hbot providers that participate in VA programs to be accredited by The Joint Commission the undersee Hyperbaric Medical Society or another relevant accrediting body we cannot take risks when it comes
▶ 1:00:36to ensuring our veterans safety this is a common sense amendment to ensure veterans only receive care from a qualified safe licensed clinical providers and aren't taken advantage of by unscrupulous providers who have no business providing care to anyone let alone are veterans I sincerely hope all my colleagues will join me in supporting this amendment and I yield back thank you uh ranking member brownley does any other member wish to speak on the underlying Amendment chair now recognizes
▶ 1:01:06Dr Murphy for three minutes uh thank you madam chair I'm I uh will speak uh for this amendment tragedy that occurred sadly tragedies occur in medicine when we're trying to heal patients um from what I understand the child was allowed to have something in the chamber that was not supposed to be there but I don't know 100% of the facts the uh uh the fact that we want safety to occur is the prime directive that we have we want everything to First Do no harm um so I have no
▶ 1:01:36issue with this I think it strengthens the bill um we want what is best for our veterans the status quo is not good for our veterans and I have no problem with this and urge my colleagues to um vote in favor of the back thank you are there any other members who wish to speak on the under Amendment hearing none the question now occurs on a green to the brownly amendment to hr1 1336 all those in favor say I I all those opposed say no
▶ 1:02:06in the opinion of the chair the eyes have it and the brownle amendment is agreed to without objection the motion to reconsider as laid upon the table no other amendments were filed does any member wish to offer an amendment hearing none further proceedings on the bill will be we now move on to HR 65 6 658 I now recognize repres
▶ 1:02:40um the clerk will read the uh bill number and official titles HR 658 to amend tile the text was circulated in advance pursuant to committee rules without objection the first reading is dispensed with and the bill is now open for an amendment at any point I now recognize ranking member brownley for 3 minutes to discuss HR 658 uh thank you madam chair I appreciate that we are considering my bill to address the an inequity in VA promotional opportunities for licensed marriage and family therapists licensed marriage and family therapists
▶ 1:03:10assist individuals and couples in coping with interpersonal conflicts major life changes and a variety of other challenges currently VA hires licensed marriage family therapists who are licensed through a variety of organizations including through the commission of accreditation for marriage and family therapy education program and through the American Association for marriage and family therapy however va's current qualification standards hamstring nearly half
▶ 1:03:41of the licensed marriage and family therapists currently practicing since only those licensed through the commission on accreditation for marriage and family therapy education may be promoted to supervisory positions at VA va's current limitation discourages qualified license marriage and family therapists from wanting to serve at the VA unlike VA Tricare private insurance plans medical and K12 schools do not require their licensed
▶ 1:04:11marriage and family therapists to graduate from a commission on accreditation for marriage and family therapy education program to be promoted resulting in them leaving VA for better opportunities elsewhere my bill will address this inequity by allowing qualified licensed marriage and family therapists more opportunities to assist our nation's veterans and their families I urge my colleagues colleagues to join me in supporting this bill and with that I will yield back thank you raik member brownley
▶ 1:04:42for your statement although I have policy concerns with this bill I support moving this bill out of our subcommittee for further consideration do any other members wish to be recognized on HR 658 do any U members have an amendment no amendments were filed does any member wish to offer an amendment hearing none I now recognize ranking member brownley for a motion that HR 658 be reported favorably
▶ 1:05:12to the full committee there is a motion to favorably forward HR 658 all those in favor say I I all oppose say no in the opinion of the chair the eyes have it and HR 658 is favorably forwarded the full committee the motion to reconsider is laid upon the table we will take a brief recess uh to allow members to get here and allow the clerk to prepare the electronic voting
▶ 1:06:18the committee will now move to consider the postpone proceedings I ask unanimous consent that the committee staff be authorized to make technical clerical and conforming changes to the bills favorably forward a day the committee postponed the vote on agreeing to the amendment in the nature of a substitute to hr1 1969 members will record their vote using the electronic voting system
▶ 1:07:02the chairwoman intends to vote I I'll yield to the ranking member to discuss how she will vote I can't see if I'm I can't either what you can't either I think red is no and and uh green is
▶ 1:07:33but I had Cataract surgy and still cannot see but yeah can we put this on an 84 inch screen no I'm I apologize it's not on here I already pushed ma' not recorded I did I recorded I did there you go you got it I was there before
▶ 1:08:03okay have all members voted does does any member wish to change their vote hearing none the clerk will now close the vote and announce the total the clerk will announce the total miss chairwoman the vote is seven eyes and five nose there are seven eyes and five nose HR 1969 as amendment is agreed without objection the motion to reconsider is laid on the table I now recognize representative van Orton for a motion Madame
▶ 1:08:33chairwoman I move that the subcommittee favorably forward HR 1336 to the full committee all those in favor say I I all those opposed say no in the opinion of the chair the eyes have it this is 1969 yeah but did you say the wrong bill Madam chairwoman I move uh that the subcommittee favorably forward hr1 1996 to the full committee given that the electronic
▶ 1:09:03voting system is taking some getting used to 196 1969 I stand corrected 1 n69 all those in favor of hr1 969 say I I all those opposed say no in the opinion of the chair the eyes have it the motion is agreed to hr1 1969 as amendment is reported favorably to the house the mtee the committee postponed further procceedings on the Morrison
▶ 1:09:34amendment to hr1 1336 the question occurs on agreen to the amendment on hr1 1336 members will record their vote using the electronic voting system the chairman intends to vote no does the ranking member wish to discuss vote okay have all members voted does any member
▶ 1:10:04wish to change their vote hearing none the clerk will close the vote and announce the total Madame chairman the vote is five eyes and seven nose the nose have it the amendment to hr1 1336 is not agreed to the motion to reconsidered as laid upon the table I now recognize representative van Orton for a motion Madam chair when I move that the subcommittee favor forward HR 1336 to the full committee there is a motion to favorably forward HR
▶ 1:10:341336 as we have another amendment we did one by voice it's it's the third amendment did you call for recorded okay all right okay madam chairwoman apparently I moving to I move that the subcommittee favorably forward 1336 as amended
▶ 1:11:05to the full committee all those in favor say I I I all those oppos say no in the opinion of the chair the eyes have it in hr1 1336 if is favorably uh forwarded to the full committee the motion reconsider is laid upon the table the question occurs on a green to favorably forward to the full committee HR we did we only two amend we did the amendment wasn't there
▶ 1:11:35a roll vot we didn't vote I ask unanimous consent that the committee uh staff be authorized to make technical clerical and conforming changes to the bill favorably forward today we did not vote on the bill as amended which would we requested a vote we accepted the amendment we accepted the
▶ 1:12:12amendment we voted on two amendments voted down one Amendment and then voted on the bill as amended if you want me to we can redo it you don't need to vote on the under Bill okay I ask that unanimous consent that the committee uh staff be authorized to make
▶ 1:12:42technical clerical and conforming changes to the bills favorably forwarded today hearing no objection so ordered I thank the members for their attendance today and the subcommittee markup is
▶ 1:13:17you leaving us coun whether or not it's okay there was two of them 196 you were you were doing both