This hearing will come to order. Good afternoon. I welcome all of you veterans, caregivers and advocates, especially my former colleague , senator Elizabeth Dole who has been an extranet advocate for military caregivers. Our military families, heroes in plain clothing are serving in americas cities and communities every single day. The effects of military service do not end with a tour of duty. For many veterans and their family, the journey sometimes extends for a lifetime. For some with both visible and invisible scars, the transition home is not easy. Recovery to can take decades. Along the way, mothers, fathers, wives, and other family members and friends step in to serve. Today we will focus on those who care for americans veterans. In the United States there are 5. 5 million military caregivers. These family members and loved ones provide care on a constant and routine basis to our veterans. They are often vital in assisting veterans to make the transition all the way home. Military caregivers prove recovery, rehabilitation and reintegration of wounded, injured and disabled veterans. The number of military caregivers has been on the rise since veterans from iraq and afghanistan returned home. Approximately 20 of military caregivers today are caring for a post 911 veteran. The needs and experiences of post 911 veterans differ from those pre911 veterans. While they are aging and facing agerelated conditions including alzheimers and cardiovascular diseases, post 911 veterans tend to be younger and face higher rates of ptsd and traumatic brain injury. Today we will learn more about the unique needs of military caregivers and what we can do to better support them. We will also unveil a report commissioned by the elizabeth Old Foundation called improving support for americas Hidden Heroes. This report is the Research Blueprint for the future that offers a vision to advance our understanding of caregiver needs. Our military caregivers, like all caregivers make many personal and Financial Sacrifices to ensure their loved ones have the care they need. They may have to miss work, turndown promotions, or even leave the workforce altogether, creating what seems, at times, an enormous financial strain for families. The loss and productivity post 911 caregivers caused our nation approximately 6 billion. Year. Ive introduced Bipartisan Legislation that would better serve caregivers including our military family. The caregiver act would require the department of health and Human Services to develop a National Strategy to recognize and support our more than 40 million Family Caregivers. This bill, which i introduced with senator tammy baldwin, has passed the Health Committee and i look forward to seeing it signed into law one day. Its a result of the advocacy of many who are here. In addition, the bipartisan military and veteran caregiver improvement act would expand eligibility for the ba Caregiver Program for not just the post 911 generation. This is the program that helps veterans who are wounded and injured by supporting and providing resources to those who have taken on the caregiver role for them. And, the lifespan reauthorization act would reauthorize 15 million. Year over the next five years to allow fulltime caregivers to take a temporary break from it responsibly. This respite care is crucial. It protects the health and caregivers, decreases the need for longterm care and allows individuals, who need care, to remain in the comfort of their own home. Despite their enormous sacrific sacrifice, military caregivers typically do not receive awards and admiration for American Veterans deservedly do. We must never forget our military caregivers who are also true heroes. Americas military caregivers enable veterans living with visible and invisible injuries to recover, remain involved with their communities, and enjoy fuller lives. We should do all that we can to support them. I am now pleased to turn to our Ranking Member senator casey for his opening remarks. Thank you german collins. We appreciate you calling this hearing. I want to thank you and so many others today. I want to thank her former colleague, senator dole for your tireless work on behalf of military caregivers. Many of the brave men and women who have served our country in the armed forces return home during the marks of that service. Training us today are some of those who served briefly so that america can remain the land of the free. To paraphrase what what my father once said, we paraphrase for military families and loved one serving around the globe but we also pray for ourselves that we may be worthy of their valor. Thank you for your service to our country. In order to better serve you, we are holding this hearing to recognize that not only our veterans, but the Hidden Heroes of the military, the estimated five and a half million military caregivers across the country. Military caregivers come in many different forms. Spouses, family, friends, neighbors, and of course fellow veterans among them. The majority, roughly 60 of those caregivers are women. We will also hear from our witnesses were caring for a loved one and understand that caring for a loved one can be stressful, it can be stressful physically, emotionally and financially. Weve made progress in helping our caregivers, but as our witnesses will tell us, we have more to do. We must strengthen the support that is currently available and help more caregivers who need access to these supports. Whether it was soldiers who served in vietnam or afghanistan, there caregivers should receive the same benefits and support from the va. Thats why i am a cosponsor of Bipartisan Legislation to expand the supports and Services Available to caregivers. Ensuring veterans and their families receive the care they need is also why i will continue to fight against efforts to decimate medicaid. A report released by the Congressional Research service explains that not all veterans are eligible for medical care from the va. Any veterans cannot access va services because they dont have a facility nearby. Sometimes family members dont qualify for va services. That is when other Coverage Options become important. Medicaid provides health care to over 900,000 veterans, 340 of whom gain coverage following recent action by some states to expand medicaid, and 660,000 veteran spouses covered as well. For these families who served our country and for millions more children and individuals with disabilities and seniors, medicaid must be protected. Since it covers those 900,000 veterans and over 660,000 spouses, proposes to cut medicaid and change healthcare should be the subject of hearings. I look forward to hearing from our Witnesses Today about additional steps congress can take to better support our nations military caregivers and their families. Thank you. Thank you senator casey. This appears to be North Carolina day, but for the aging committee, its always been a pennsylvania day. We are very fortunate that both senators from North Carolina serve on the committee and one of our chief witnesses and some of our veterans and caregivers are from North Carolina. I would like to give senator burr and senator tellis the opportunity to welcome those from our home state. Thank you for holding this important hearing on military caregivers. I particularly want to thank you for allowing senator tellis and myself the opportunity of introducing the fine North Carolina witnesses. Military caregivers is an extremely important issue nationally and certainly in North Carolina where veterans make up 10 of our adult appellation. We have to empower couples fighting for our representatives. I want to welcome elizabeth told back to the senate. She has a long and distinguished Public Record of Public Service inandout of government that many here know well. From leading the department of transportation to serving as secretary of labor and president of the american red cross, senator dole has been the when her nation called. She has been there with grace and diligence. What i want to salute her today is for just the latest chapter in her story of Public Service and that is her veterans advocacy. Not only has she stood by the side of a certain army captain who also knows his way around the senate hauls, but she has also been a relentless advocate to the elizabeth all foundation of all of our nations veterans. Bob and Elizabeth Dole, whether they are in the halls of the senate or the halls of walter reed continue to serve our nation and speak up on behalf of the needs of veterans and their caregivers. Im glad our committee will be hearing from them today and learning important lessons about whats working and where we still need to improve. I think you senator dole for the grace and the steadfast attention you bring to any issue you tackle and i know your Senate Family as well as our military Caregiving Community will be well served by hearing your voice today. I now turn to my friend and colleague senator tellis who will make additional introductions. Thank you. Its great to see you here. I appreciate you and this advocacy for Hidden Heroes. You and i have had many discussions about it and i enjoy the kickoff and i look forward to continuing to provide support. Ive had the distinct privilege to introduce to other constituents, mary and tom ward. I met them on a few different occasions and from time to time i even get to pet the dog but they wouldnt let me do it today. Theyve traveled here, and it is a testament to their commitment to the issue of caregiving, not only for themselves but everyone else. I appreciate your leadership and advocacy. We love it when you come visit. His Service Dates back from 1972 1975. In 1993 i think you were 13 years in your marriage when tom contracted and cellulitis and had signs of cognitive difficulty. He was diagnosed with als, a progressive disease that veterans develop in rates higher than the general population. Mary will share her story as her challenge of a caregiver and still remain employed. Madam chair, i am pleased to have them here today and i appreciate their leadership. I look forward to the testimony. I will also tell you, tom and mary, im on the Veterans Affairs committee which is meeting at the same time right now and i will step out of this committee and try to get back because you all know the work we do is also directly related to this issue. You also have my commitment that we are trying to get this right from the time someone enters service until the time they move through veteran status. Thank you for being here today. Thank you very much. Although senator dole has already been introduced, i do want to add just a few comments about the work that she has done as the founder of the Elizabeth Dole foundation, and a champion for military caregivers. Through the foundation, senator dole has shed light on the immense challenges facing our nations 5. 5 million military caregivers. She has really worked across the aisle, she actually brought nancy pelosi and i together to write an oped in support of the bill, not that that is shocking, but around here these days, that kind of bipartisan collaboration can be rare indeed. That shows to me the work that senator dole has done to create a community of military caregivers to which they can connect, share advice, stories and advocate for more support. I want to point out that senator dole does this just as a volunteer. I think her leadership has been extraordinary. I am familiar with the dole Caregiver Fellowship Program and i just want to thank you for your service and i look forward to hearing your testimony. On the same panel, we will hear from someone who my staff was all excited about meeting, and that is ryan filippini. As many of you know, he is an actor, director and more important from todays perspective, he is also an ambassador of the Elizabeth Dole foundations Hidden Hero Campaign which helps connect military caregivers to Critical Resources and connect them with other caregivers. Ryan, think you for supporting our Hidden Heroes who care for our heroes each and every day. Senator dole, please proceed. Thank you so much. Thank you chairman collins, Ranking Member and members of the committee for calling todays hearing. By doing so the committee demonstrates its dedication to recognizing our nations military and veteran caregivers. Chairman collins, iou special thanks for your strong support of key legislation in the Hidden Heroes caucus which you are cochairing. You are sending a very powerful signal that our nations leaders must stand with americas military caregivers. Thank you so very much. This is not my first time testifying before the Senate Special committee on aging. Recently, i came across testimony i gave on june 29, 1978. That was 39 years ago. I was a member of the federal trade commission. Like each of you, i once sat up there as a member of this committee. To be honest, with the many issues before the senate, i did not know the enormous benefit military and veteran caregivers are making to our nation. As well as the huge personal toll it is taking. That all change for me in 2011 when my husband bob was hospitalized at walter reed. I became friends with young spouses, mothers, dads, sitting bedside, selflessly looking after loved one. They were carrying an emotional weight almost too heavy to bear. As they reeled over their injuries were asked to make extremely difficult decisions without any preparation and they work wrestling with the fact that they might be serving in this new role for the rest of their lives. Just as heartbreaking are the stories of pre911 care givers. They were struggling to care with those with undiagnosed posttraumatic stress, agent orange or brain injuries that are causing early onset dementia. These are just as terrified and isolated, just as important to their veterans. When they apply for the va care giver stipend, they are told that the timing of their veteran service does not qualify them for support. An incredible five and half million americans act as military and veteran caregivers. They are serving in each of your states right now, dressing, bathing and feeding our veterans, performing athome injections, managing medications, staying on constant guard for emotional triggers. For many, its a 24 hour job. I found it elizabeth o foundation in 2010 to raise awareness and support for these Hidden Heroes. We began by undertaking the First Comprehensive nationwide evidencebased research on military caregivers. The experts concluded that the most important factor to a Wounded Warriors recovery or improvement was a well supported caregiver. This statement could have been the headline of the report, but it was overshadowed by more alarming findings. The Research Uncovered high instances of isolation, physical ailments, depression, unemployment, death, legal challenge, and much much more. They are doing a tremendous job but they are clearly suffering under the circumstances. Theres also an economic argument for supporting military caregivers. They provide nearly 14 billion. Year as an unpaid volunteer workforce. Last september the foundation launched Hidden Heroes, a Multifaceted Campaign featuring the first of its kind website full of carefully vetted resources and a safe secure place for caregivers to connect with one another. They announced hidden hero cities, the galvanizing of communities to identify caregivers in their midst and the local resources to support them. I am proud to say we have recruited 100 cities to date. Ryan is the investor. He is an awardwinning actor and star of usa network where he plays the role of military veteran. More significantly he has close family ties to the military family and has become a passionate advocate for our caregivers. My heartfelt thanks to you. He flew in, got here this morning on a redeye, and tonight he heads back to california on another redeye. God bless you ryan. As you listen to him and our other panelists, i urge you to consider taking two actions after todays hearings. Make the bipartisan Caregiver Services improvement act the law of the land. This bill will expand essential services for caregivers of all eras. It will also provide direct assistance with some of the top challenges that military caregivers face every day including respite, childcare, financial advice, legal counseling and education heard i had with me a letter signed by 43 Hidden Heroes organizations. They are already here but me and they urgently hope that this particular lifechanging legislation is going to pass. Our second ask is that the congressman invest in the Critical Research needed to sustain positive outcome for our caregivers in the coming year. In the next panel, you will hear from the brand that will unveil a blueprint based on the urgent resource priorities. We urge you to listen carefully and champion this research which