Sen. Collins good afternoon. I welcome all of you, veterans, caregivers, and advocates, especially my former colleague, senator Elizabeth Dole, who is an extraordinary advocate for our military caregivers. Our military families, heroes in plain clothing, are serving in American Cities and towns every single day. The effects of military Service Often do not end with a tour of duty. For many veterans and their families, the journey sometimes extends for a lifetime. For some with both visible and invisible scars, the transition home is not easy. Recovery, too, can take decades. Along the way, mothers, fathers, wives, husbands, and other family members and friends, step in to serve. Today, we will focus on those who care for americas 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 veterans. They are often vital in assisting veterans to make the transition all the way home. Military caregivers improve recovery, rehabilitation, and reintegration of wounded, injured, and disabled veterans. The number of military caregivers has been on the rise as veterans from iraq and afghanistan return home. Approximately 20 of military caregivers today are caring for a post9 11 veteran. The needs and experiences of post9 11 veterans differ from those of pre9 11 veterans. While veterans from past conflicts and wars are aging and facing agerelated conditions including alzheimers and cardiovascular diseases, post9 11 veterans tend to be younger, and face higher rates of ptsd, depression, Substance Abuse, and traumatic brain injury. Today, we will learn more about the unique needs of military caregivers, and how to better support them. We will also unveil a rand report, commissioned by the Elizabeth Dole foundation, called improving support for americas Hidden Heroes. This report is a 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 that their loved ones have the care they need. They may have to miss work, turn down promotions, or even leave the workforce, creating enormous financial strain for families. This toll affects the National Economy as a whole. The loss in productivity just among post9 11 caregivers costs our nation approximately 6 billion per year. I have introduced Bipartisan Legislation that would better serve caregivers, including military caregivers. The raise family caregivers 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 baldwin, has passed the help committee, and i look forward to seeing it signed into law as a result of the advocacy of many here today. In addition, the bipartisan military and veteran Caregiver Services improvement act would expand eligibility for Vas Caregiver Program to veterans of all generations, not just the post9 11 generation. This is a program that helps veterans who are wounded, ill, or injured, by supporting and providing resources to those who have taken on a caregiver role for veterans. And, the lifespan respite care reauthorization act would authorize 15 million per year over the next five years to allow fulltime caregivers to take a temporary break from their responsibilities. This respite care is critical. Is crucial. It protects the health of caregivers, decreases the need for professional longterm care, and allow individuals who require care to remain at home. Despite their enormous sacrifice, military caregivers typically do not receive awards and admiration that americas veterans do. That does not mean that they dont deserve it. 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. Sen. Casey thank you, chairman collins. I appreciate you calling this hearing. And i want to thank you and so many others today. I want to thank, as well, our 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 bearing marks of that service. Joining us today are some of those who served bravely so that america can remain the land of the free. To paraphrase what my father once said, we pray for military families and their loved ones serving around the globe, but we also pray for ourselves that we valor. Rthy of their thank you for your service to our country. In order to better serve you, we are holding this hearing todayto recognize not only our veterans, but the Hidden Heroes of the military the estimated 5. 5 million military caregivers across the country. Military caregivers come in many different forms spouses, family, friends, neighbors, and fellow veterans among them. 6 , ority, roughly roughly 60 , percentof these caregivers are women. We will hear from our witnesses that caring for a loved one can be stressful physically, emotionally, and financially. We have made progress in helping caregivers, but as our witnesses will tell us, we have more to do. We must strengthen the supports that are currently available and help more caregivers who need to access those supports. Whether a soldier served in vietnam or afghanistan, their caregivers should receive the same benefits and support from the va. That is 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. And many veterans cannot access va services, for example, because they do not have a va facility nearby. Sometimes, family members do not qualify for va services. That is when other Coverage Options become important. Medicaid provides health care to over 900,000 workingage 340,000 of whom gained coverage following recent action by some states to expand medicaid and 660,000 veterans spouses. For these families who served our country and for millions more children, individuals with disabilities and seniors, seniorsmedicaid must be protected. Since medicaid covers more than 900,000 veterans and 660,000 spouses, proposals to cut medicaid and substantially change health care 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. This appears to be North Carolina day. It is always main and andsylvania day, maine pennsylvania day. We are fortunate that both senators from North Carolina served on the committee and one of our chief witnesses, plus some of our veterans are from North Carolina. I would like to give senator burr and senator tillis the opportunity to welcome those who are here from your home state. Thank you chairman collins and Ranking Member casey for holding this important hearing on military caregivers. I practically want to thank you witnessesal carolina here to testify and represent. Military caregivers is an important issue nationally and certainly in North Carolina where veterans make up 10 of our adult population. We have two Power Couples fighting for veterans and for my half of the introductions, i want to welcome my former colleague in the senate, Elizabeth Dole back to the senate. She has a long and distinguished record of Public Service in and out of government that many here know well from leading the department of transportation and serving as secretary of labor to serving as resident of the American Red Cross as president of the amendment calls the American Red Cross, she has been there with grace. T i want to slit her today what i want to salute her for today is the latest chapter in her story of service and that is veterans advocacy. Not only has she stood by the side of a certain army captain who knows his way around the senate halls, but she has also been a relentless advocate through the Elizabeth Dole foundation of all of our nations veterans. Bob and elizabeth all Elizabeth Dole continue to serve our nation and speak up on behalf of the needs of veterans and caregivers at i am glad that our committee will be hearing from them today and learning important lessons about what is working and where we still need to improve. I thank you senator dole for the grace and steadfast attention you bring to any issue you tackle. 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 tillis. You tillis i appreciate and this advocacy for Hidden Heroes at and i have had many discussions. I enjoyed the kickoff. I look forward to continuing to provide support. Chairman collins ahead the distinct village to introduce to other constituents, mary and tom ward could im at the month a few different occasions and i even get to pet the dog. They would let me do it today. Here and iraveled have to say it is a real testament to their commitment to the issue of caregiving, not only for themselves but for everybody else. I appreciate your leadership and advocacy. Services dates back to 1975. 1993, think you are about 13 years in your marriage when tom contracted encephalitis and andr a lengthy treatment size of cognitive difficulties surfaced, in 2010, he was diagnosed with als a progressive disease that veterans develop an rate higher than the general population. Mary will share her story as caregiver for her husband. Madam chair, i am pleased to have the wards here today and look forward to the testimony. I will tell you that tom and mary, im on the Veterans Affairs committee which is meeting at the same time right now. I am going to step out of this committee and try to get back because you all know the work we do there is directly related to this issue. You have my commitment as a chair of the personnel subcommittee that we are try to get this right from the time someone is in active service until the time they move their way to veterans status. I want to add a few comments about the work he 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 tremendous challenges facing our nation, 5. 5 million military caregivers. She has worked across the aisle and brought nancy pelosi and me together. Bill. Port of a that shows the work that senator dole has done to create a community of military caregivers to which they can connect, share advice and stories and advocate for more support. I want to point out that senator old does this just as a volunteer. I want to thank her leadership has been extraordinarily extraordinary. I am familiar with the dole Caregiver Fellowship Program and had an individual from the state of maine participate and i want to thank you for your service and i look forward to hearing your testimony. Ryan is an actor, director and writer. More importantly from todays perspective, he is an ambassador of the Elizabeth Dole foundation s Hidden Heroes campaign which helps connect military caregivers to Critical Resources and connect them to other caregivers. Ryan, thank you for supporting our Hidden Heroes who care for our veteran heroes each and every day. Senator dole, please proceed. Ms. Dole thank you chairman collins, Ranking Member casey, and members of the committee for calling todays hearing. By doing so, the committee demonstrates its dedication to recognizing our nations Hidden Heroestheir honorable service, their enormous sacrifice, and their selfless daily, and often lifelong, journey of care. Chairman collins, i owe you special thanks for your support of key legislation and the Hidden Heroes caucus, sending a strong 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 39 years ago, as a member of the federal trade commission. And, like each of you, i once sat up there on the dais as a member of this committee. To be honest, with the many issues before the senate, i didnt know at the time the true benefit military and veteran caregivers are making to our nation. And the huge personal toll it is taking. That all changed for me in 2011 when my husband bob was hospitalized at walter reed. I became friends with young spouses, mothers, dadssitting mothers, dads sitting beside setting bedside selflessly , looking after their wounded, ill or injured veteran. Their strength was incredible. Yet, i could see they were carrying an emotional weight almost too heavy to bear. As they reeled over their loved ones injuries, they were being asked to make extremely difficult decisions without any preparation. And they were quietly wrestling with the fact that they might be serving in this new role for the rest of their lives. Just as heartbreaking is the story of pre9 11 caregivers who were supporting their loved ones for years without any acknowledgment, struggling to care for the latent effects of undiagnosed post traumatic stress, agent orange, exposure to burn pits, or decadesold traumatic brain injuries that are now causing early onset dementia. These caregivers are just as terrified. Just as isolated. Just as important to their veterans. But when they apply for the va caregiver stipend, they are told that the timing of their Veterans Service does not qualify them for support. An incredible 5. 5 million americans act you should legal challenges and much more. Doing a tremendous job but are clearly suffering under the circumstances. There is also an economic argument. Nearly 13,000 a year as an involuntary work force. Lester year, Hidden Heroes was launched. Full of carefully vetted resources and a safe secure place to connect. Cities aced hidden galvanizing of cities. I am proud to say we have recruited 100 cities from augustine to pittsburgh. By actorign is chaired tom hanks. The goodlooking guy sitting t to me, Brian Phillip bay stars. Illipe he has become a passionate advocate for our caregivers. And god here on the redeye and tonight will head back to california on another redeye. God bless you. As you listen to him and the other panelists, i urge you to take two actions. Improvementartisan act the law of the land. This would expand caregiving and all eras. This will include things like respite, child care, financial advice, education. 43ave a letter signed by Hidden Heroes partner organizations. They are right here behind me. Particularhis lifechanging legislation will pass. We also ask that congress and vest in the Critical Research necessary. Panel you will hear from someone who will identify Urgent Research priorities. We urge you to listen carefully and champion the research. I have to tell you, based on what we know, we expect more to be uncovered. We are hearing more about caregiver Substance Abuse and suicide. Marriage between caregivers and veterans. The long road ahead is becoming too much for too many. Our nation has long respected military men and women knew served our country so valley attlee and reserve a special honor for those who returned from service with physical and emotional scars. Is for caregivers to be appreciated and recognized for their service. Woven into the very fabric of the nations appreciation of our military. Thank you so very much. You to use so much. Thank you senator told for the kind words. Before you get started, i will take a moment in light of this events. S i speak for all of us when i say our thoughts and prayers are with them. I speak for everyone here when i say to senator donald, we are truly inspired by your tirelessp, vision, and work. You are a shining light on our countries Hidden Heroes. I want to thank each of you for the opportunity to be heard today. It is an honor. A experience growing up in military family helped prepare me for this role. My grandfathers fought in world war ii. The Pacific Theater and the world berlin. My uncles were infantry men. All the members of my family who served, thankfully returned. I