[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3447 Enrolled Bill (ENR)]
H.R.3447
One Hundred Seventh Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Wednesday,
the third day of January, two thousand and one
An Act
To amend title 38, United States Code, to enhance the authority of the
Secretary of Veterans Affairs to recruit and retain qualified nurses for
the Veterans Health Administration, to provide an additional basis for
establishing the inability of veterans to defray expenses of necessary
medical care, to enhance certain health care programs of the Department
of Veterans Affairs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

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(a) Short Title.--This Act may be cited as the ``Department of
Veterans Affairs Health Care Programs Enhancement Act of 2001''.
(b) Table of Contents.--The table of contents for this Act is as
follows:

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reemployed annuitants to fill nurse positions.
Subtitle B--Retention Authorities

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TITLE I

-ENHANCEMENT OF NURSE RECRUITMENT AND RETENTION AUTHORITIES

health care professionals in the Veterans Health
Administration.

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registered nurses within the Veterans Health Administration.

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in Department of Veterans Affairs facilities.
Subtitle C--Other Authorities

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certain health-care professionals before April 7, 1986.

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Subtitle D--National Commission on VA Nursing

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dogs for veterans with certain disabilities.

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TITLE II

-OTHER MATTERS

rehabilitative needs of disabled veterans.

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who served in Southwest Asia during the Persian Gulf War.

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Except as otherwise expressly provided, whenever in this Act an
amendment or repeal is expressed in terms of an amendment to, or repeal
of, a section or other provision, the reference shall be considered to
be made to a section or other provision of title 38, United States
Code.
Subtitle A--Recruitment Authorities

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(a) Permanent Authority.--(1) Section 7676 is repealed.
(2) The table of sections at the beginning of chapter 76 is amended
by striking the item relating to section 7676.
(b) Minimum Period of Department Employment for Eligibility.--
Section 7672(b) is amended by striking ``2 years'' and inserting ``one
year''.
(c) Scholarship Amount.--Subsection (b) of section 7673 is
amended--
(1) in paragraph (1), by striking ``for any 1 year'' and
inserting ``for the equivalent of one year of full-time
coursework''; and
(2) by striking paragraph (2) and inserting the following new
paragraph (2):
``(2) in the case of a participant in the Program who is a
part-time student, shall bear the same ratio to the amount that
would be paid under paragraph (1) if the participant were a full-
time student in the course of education or training being pursued
by the participant as the coursework carried by the participant to
full-time coursework in that course of education or training.''.
(d) Limitation on Payment.--Subsection (c) of section 7673 is
amended to read as follows:
``(c) Limitations on Period of Payment.--(1) The maximum number of
school years for which a scholarship may be paid under subsection (a)
to a participant in the Program shall be six school years.
``(2) A participant in the Program may not receive a scholarship
under subsection (a) for more than the equivalent of three years of
full-time coursework.''.
(e) Full-Time Coursework.--Section 7673 is further amended by
adding at the end the following new subsection:
``(e) Full-Time Coursework.--For purposes of this section, full-
time coursework shall consist of the following:
``(1) In the case of undergraduate coursework, 30 semester
hours per undergraduate school year.
``(2) In the case of graduate coursework, 18 semester hours per
graduate school year.''.
(f) Annual Adjustment of Maximum Scholarship Amount.--Section 7631
is amended--
(1) in subsection (a)(1), by striking ``and the maximum
Selected Reserve member stipend amount'' and inserting ``the
maximum Selected Reserve member stipend amount, the maximum
employee incentive scholarship amount,''; and
(2) in subsection (b)--
(A) by redesignating paragraph (4) as paragraph (6); and
(B) by inserting after paragraph (3) the following new
paragraph (4):
``(4) The term `maximum employee incentive scholarship amount'
means the maximum amount of the scholarship payable to a
participant in the Department of Veterans Affairs Employee
Incentive Scholarship Program under subchapter VI of this chapter,
as specified in section 7673(b)(1) of this title and as previously
adjusted (if at all) in accordance with this section.''.
(g) Technical Amendments.--Section 7631(b) is further amended by
striking ``this subsection'' each place it appears and inserting ``this
section''.

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(a) Permanent Authority.--(1) Section 7684 is repealed.
(2) The table of sections at the beginning of chapter 76 is amended
by striking the item relating to section 7684.
(b) Eligible Individuals.--Subsection (a)(1) of section 7682 is
amended--
(1) by striking ``under an appointment under section 7402(b) of
this title in a position'' and inserting ``in a position (as
determined by the Secretary) providing direct-patient care services
or services incident to direct-patient care services''; and
(2) by striking ``(as determined by the Secretary)'' and
inserting ``(as so determined)''.
(c) Maximum Debt Reduction Amount.--Section 7683(d)(1) is amended--
(1) by striking ``for a year''; and
(2) by striking ``exceed--'' and all that follows through the
end of the paragraph and inserting ``exceed $44,000 over a total of
five years of participation in the Program, of which not more than
$10,000 of such payments may be made in each of the fourth and
fifth years of participation in the Program.''.
(d) Annual Adjustment of Maximum Debt Reduction Payments Amount.--
(1) Section 7631, as amended by section 101(f) of this Act, is further
amended--
(A) in subsection (a)(1), by inserting before the period at the
end of the first sentence the following: ``and the maximum
education debt reduction payments amount''; and
(B) in subsection (b), by inserting after paragraph (4) the
following new paragraph (5):
``(5) The term `maximum education debt reduction payments
amount' means the maximum amount of education debt reduction
payments payable to a participant in the Department of Veterans
Affairs Education Debt Reduction Program under subchapter VII of
this chapter, as specified in section 7683(d)(1) of this title and
as previously adjusted (if at all) in accordance with this
section.''.
(2) Notwithstanding section 7631(a)(1) of title 38, United States
Code, as amended by paragraph (1), the Secretary of Veterans Affairs
shall not increase the maximum education debt reduction payments amount
under that section in calendar year 2002.
(e) Temporary Expansion of Individuals Eligible for Participation
in Program.--(1) Notwithstanding section 7682(c) of title 38, United
States Code, the Secretary of Veterans Affairs may treat a covered
individual as being a recently appointed employee in the Veterans
Health Administration under section 7682(a) of that title for purposes
of eligibility in the Education Debt Reduction Program if the Secretary
determines that the participation of the individual in the Program
under this subsection would further the purposes of the Program.
(2) For purposes of this subsection, a covered individual is any
individual otherwise described by section 7682(a) of title 38, United
States Code, as in effect on the day before the date of the enactment
of this Act, who--
(A) was appointed as an employee in a position described in
paragraph (1) of that section, as so in effect, between January 1,
1999, and December 31, 2001; and
(B) is an employee in such position, or in another position
described in paragraph (1) of that section, as so in effect, at the
time of application for treatment as a covered individual under
this subsection.
(3) The Secretary shall make determinations regarding the exercise
of the authority in this subsection on a case-by-case basis.
(4) The Secretary may not exercise the authority in this subsection
after June 30, 2002. The expiration of the authority in this subsection
shall not affect the treatment of an individual under this subsection
before that date as a covered individual for purposes of eligibility in
the Education Debt Reduction Program.
(5) In this subsection, the term ``Education Debt Reduction
Program'' means the Department of Veterans Affairs Education Debt
Reduction Program under subchapter VII of chapter 76 of title 38,
United States Code.

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REEMPLOYED ANNUITANTS TO FILL NURSE POSITIONS.
(a) Report.--Not later than March 28 of each of 2002 and 2003, the
Secretary of Veterans Affairs shall submit to the Committees on
Veterans' Affairs of the Senate and the House of Representatives and to
the National Commission on VA Nursing established under subtitle D a
report describing each request of the Secretary, during the fiscal year
preceding such report, to the Director of the Office of Personnel
Management for the following:
(1) A waiver under subsection (i)(1)(A) of section 8344 of
title 5, United States Code, of the provisions of such section in
order to meet requirements of the Department of Veterans Affairs
for appointments to nurse positions in the Veterans Health
Administration.
(2) A waiver under subsection (f)(1)(A) of section 8468 of
title 5, United States Code, of the provisions of such section in
order to meet requirements of the Department for appointments to
such positions.
(3) A grant of authority under subsection (i)(1)(B) of section
8344 of title 5, United States Code, for the waiver of the
provisions of such section in order to meet requirements of the
Department for appointments to such positions.
(4) A grant of authority under subsection (f)(1)(B) of section
8468 of title 5, United States Code, for the waiver of the
provisions of such section in order to meet requirements of the
Department for appointments to such positions.
(b) Information on Responses to Requests.--The report under
subsection (a) shall specify for each request covered by the report--
(1) the response of the Director to such request; and
(2) if such request was granted, whether or not the waiver or
authority, as the case may be, assisted the Secretary in meeting
requirements of the Department for appointments to nurse positions
in the Veterans Health Administration.
Subtitle B--Retention Authorities

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HEALTH CARE PROFESSIONALS IN THE VETERANS HEALTH
ADMINISTRATION.
(a) In General.--Section 7454(b) is amended--
(1) by inserting ``(1)'' after ``(b)''; and
(2) by adding at the end the following new paragraph:
``(2) Health care professionals employed in positions referred to
in paragraph (1) shall be entitled to additional pay on the same basis
as provided for nurses in section 7453(c) of this title.''.
(b) Applicability.--The amendments made by subsection (a) shall
apply with respect to pay periods beginning on or after the date of the
enactment of this Act.

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REGISTERED NURSES WITHIN THE VETERANS HEALTH
ADMINISTRATION.
(a) Annuity Computation.--Section 8415 of title 5, United States
Code, is amended by adding at the end the following new subsection:
``(i) In computing an annuity under this subchapter, the total
service of an employee who retires from the position of a registered
nurse with the Veterans Health Administration on an immediate annuity,
or dies while employed in that position leaving any survivor entitled
to an annuity, includes the days of unused sick leave to the credit of
that employee under a formal leave system, except that such days shall
not be counted in determining average pay or annuity eligibility under
this subchapter.''.
(b) Deposit Not Required.--Section 8422(d) of such title is
amended--
(1) by inserting ``(1)'' before ``Under such regulations''; and
(2) by adding at the end the following:
``(2) Deposit may not be required for days of unused sick leave
credited under section 8415(i).''.
(c) Effective Date.--The amendments made by this section shall take
effect 60 days after the date of the enactment of this Act and shall
apply to individuals who separate from service on or after that
effective date.

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CLINICS.
(a) Evaluation.--The Secretary of Veterans Affairs shall carry out
an evaluation of the efficacy of the nurse managed health care clinics
of the Department of Veterans Affairs. The Secretary shall complete the
evaluation not later than 18 months after the date of the enactment of
this Act.
(b) Clinics To Be Evaluated.--(1) In carrying out the evaluation
under subsection (a), the Secretary shall consider nurse managed health
care clinics, including primary care clinics and geriatric care
clinics, located in three different geographic service areas of the
Department.
(2) If there are not nurse managed health care clinics located in
three different geographic service areas as of the commencement of the
evaluation, the Secretary shall--
(A) establish nurse managed health care clinics in additional
geographic service areas such that there are nurse managed health
care clinics in three different geographic service areas for
purposes of the evaluation; and
(B) include such clinics, as so established, in the evaluation.
(c) Matters To Be Evaluated.--In carrying out the evaluation under
subsection (a), the Secretary shall address the following:
(1) Patient satisfaction.
(2) Provider experiences.
(3) Cost of care.
(4) Access to care, including waiting time for care.
(5) The functional status of patients receiving care.
(6) Any other matters the Secretary considers appropriate.
(d) Report.--Not later than 18 months after the date of the
enactment of this Act, the Secretary shall submit to the Committees on
Veterans' Affairs of the Senate and the House of Representatives a
report on the evaluation carried out under subsection (a). The report
shall address the matters specified in subsection (c) and include any
other information, and any recommendations, that the Secretary
considers appropriate. The Secretary shall provide a copy of the report
to the National Commission on VA Nursing established under subtitle D.

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(a) In General.--Section 8110(a) is amended--
(1) in paragraph (1), by inserting after ``complete care of
patients,'' in the fifth sentence the following: ``and in a manner
consistent with the policies of the Secretary on overtime,''; and
(2) in paragraph (2)--
(A) by inserting ``, including the staffing required to
maintain such capacities,'' after ``all Department medical
facilities'';
(B) by striking ``and to minimize'' and inserting ``, to
minimize''; and
(C) by inserting before the period the following: ``, and
to ensure that eligible veterans are provided such care and
services in an appropriate manner''.
(b) Nationwide Policy on Staffing.--Paragraph (3) of that section
is amended--
(1) in subparagraph (A), by inserting ``the adequacy of staff
levels for compliance with the policy established under
subparagraph (C),'' after ``regarding''; and
(2) by inserting after subparagraph (B) the following new
subparagraph:
``(C) The Secretary shall, in consultation with the Under Secretary
for Health, establish a nationwide policy on the staffing of Department
medical facilities in order to ensure that such facilities have
adequate staff for the provision to veterans of appropriate, high-
quality care and services. The policy shall take into account the
staffing levels and mixture of staff skills required for the range of
care and services provided veterans in Department facilities.''.

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EXPERIENCED NURSES.
(a) Annual Report.--(1) Subchapter II of chapter 73 is amended by
adding at the end the following new section:
``Sec. 7324. Annual report on use of authorities to enhance retention
of experienced nurses
``(a) Annual Report.--Not later than January 31 each year, the
Secretary, acting through the Under Secretary for Health, shall submit
to Congress a report on the use during the preceding year of
authorities for purposes of retaining experienced nurses in the
Veterans Health Administration, as follows:
``(1) The authorities under chapter 76 of this title.
``(2) The authority under VA Directive 5102.1, relating to the
Department of Veterans Affairs nurse qualification standard, dated
November 10, 1999, or any successor directive.
``(3) Any other authorities available to the Secretary for
those purposes.
``(b) Report Elements.--Each report under subsection (a) shall
specify for the period covered by such report, for each Department
medical facility and for each geographic service area of the
Department, the following:
``(1) The number of waivers requested under the authority
referred to in subsection (a)(2), and the number of waivers granted
under that authority, to promote to the Nurse II grade or Nurse III
grade under the Nurse Schedule under section 7404(b)(1) of this
title any nurse who has not completed a baccalaureate degree in
nursing in a recognized school of nursing, set forth by age, race,
and years of experience of the individuals subject to such waiver
requests and waivers, as the case may be.
``(2) The programs carried out to facilitate the use of nursing
education programs by experienced nurses, including programs for
flexible scheduling, scholarships, salary replacement pay, and on-
site classes.''.
(2) The table of sections at the beginning of chapter 73 is amended
by inserting after the item relating to section 7323 the following new
item:
``7324. Annual report on use of authorities to enhance retention of
experienced nurses.''.
(b) Initial Report.--The initial report required under section 7324
of title 38, United States Code, as added by subsection (a), shall be
submitted to the National Commission on VA Nursing established under
subtitle D as well as to Congress.

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ASSISTANTS IN DEPARTMENT OF VETERANS AFFAIRS FACILITIES.
(a) Report.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall submit
to the Committees on Veterans' Affairs of the Senate and the House of
Representatives and to the National Commission on VA Nursing
established under subtitle D a report on the mandatory overtime
required of licensed nurses and nursing assistants providing direct
patient care at Department of Veterans Affairs medical facilities
during 2001.
(b) Mandatory Overtime.--For purposes of the report under
subsection (a), mandatory overtime shall consist of any period in which
a nurse or nursing assistant is mandated or otherwise required, whether
directly or indirectly, to work or be in on-duty status in excess of--
(1) a scheduled workshift or duty period;
(2) 12 hours in any 24-hour period; or
(3) 80 hours in any period of 14 consecutive days.
(c) Elements.--The report under subsection (a) shall include the
following:
(1) A description of the amount of mandatory overtime described
in that subsection at each Department medical facility during the
period covered by the report.
(2) A description of the mechanisms employed by the Secretary
to monitor overtime of the nurses and nursing assistants referred
to in that subsection.
(3) An assessment of the effects of the mandatory overtime of
such nurses and nursing assistants on patient care, including any
reported association with medical errors.
(4) Recommendations regarding mechanisms for preventing
mandatory overtime in other than emergency situations by such
nurses and nursing assistants.
(5) Any other matters that the Secretary considers appropriate.
Subtitle C--Other Authorities

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SERVICE.
Section 7306(a)(5) is amended by inserting ``, and report directly
to,'' after ``responsible to''.

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CERTAIN HEALTH-CARE PROFESSIONALS BEFORE APRIL 7, 1986.
Section 7426 is amended by adding at the end the following new
subsection:
``(c) The provisions of subsection (b) shall not apply to the part-
time service before April 7, 1986, of a registered nurse, physician
assistant, or expanded-function dental auxiliary. In computing the
annuity under the applicable provision of law specified in that
subsection of an individual covered by the preceding sentence, the
service described in that sentence shall be credited as full-time
service.''.

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Section 7451 is amended--
(1) in subsection (d)(3)--
(A) in subparagraph (A), by striking ``beginning rates of''
each place it appears;
(B) in subparagraph (B), by striking ``beginning rates of''
the first place it appears; and
(C) in subparagraph (C)(i), by striking ``beginning rates
of'' each place it appears;
(2) in subsection (d)(4)--
(A) by striking ``or at any other time that an adjustment
in rates of pay is scheduled to take place under this
subsection'' in the first sentence; and
(B) by striking the second sentence; and
(3) in subsection (e)(4)--
(A) in subparagraph (A), by striking ``grade in a'';
(B) in subparagraph (B)--
(i) by striking ``grade of a''; and
(ii) by striking ``that grade'' and inserting ``that
position''; and
(C) in subparagraph (D), by striking ``grade of a''.
Subtitle D--National Commission on VA Nursing

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(a) Establishment.--There is hereby established in the Department
of Veterans Affairs a commission to be known as the ``National
Commission on VA Nursing'' (hereinafter in this subtitle referred to as
the ``Commission'').
(b) Composition.--The Commission shall be composed of 12 members
appointed by the Secretary of Veterans Affairs as follows:
(1) At least two shall be recognized representatives of
employees (including nurses) of the Department of Veterans Affairs.
(2) At least one shall be a representative of professional
associations of nurses of the Department or similar organizations
affiliated with the Department's health care practitioners.
(3) At least one shall be a nurse from a nursing school
affiliated with the Department of Veterans Affairs.
(4) At least two shall be representatives of veterans.
(5) At least one shall be an economist.
(6) The remainder shall be appointed in such manner as the
Secretary considers appropriate.
(c) Chair of Commission.--The Secretary of Veterans Affairs shall
designate one of the members of the Commission to chair the Commission.
(d) Period of Appointment; Vacancies.--Members shall be appointed
for the life of the Commission. Any vacancy in the Commission shall be
filled in the same manner as the original appointment.
(e) Initial Organization Requirements.--All appointments to the
Commission shall be made not later than 60 days after the date of the
enactment of this Act. The Commission shall convene its first meeting
not later than 60 days after the date as of which all members of the
Commission have been appointed.

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(a) Assessment.--The Commission shall--
(1) consider legislative and organizational policy changes to
enhance the recruitment and retention of nurses and other nursing
personnel by the Department of Veterans Affairs; and
(2) assess the future of the nursing profession within the
Department.
(b) Recommendations.--The Commission shall recommend legislative
and organizational policy changes to enhance the recruitment and
retention of nurses and other nursing personnel in the Department.

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(a) Commission Report.--The Commission shall, not later than two
years after the date of its first meeting, submit to Congress and the
Secretary of Veterans Affairs a report on the Commission's findings and
recommendations.
(b) Secretary of Veterans Affairs Report.--Not later than 60 days
after the date of the Commission's report under subsection (a), the
Secretary shall submit to Congress a report--
(1) providing the Secretary's views on the Commission's
findings and recommendations; and
(2) explaining what actions, if any, the Secretary intends to
take to implement the recommendations of the Commission and the
Secretary's reasons for doing so.

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(a) Hearings.--The Commission or, at its direction, any panel or
member of the Commission, may, for the purpose of carrying out the
provisions of this subtitle, hold hearings and take testimony to the
extent that the Commission or any member considers advisable.
(b) Information.--The Commission may secure directly from any
Federal department or agency information that the Commission considers
necessary to enable the Commission to carry out its responsibilities
under this subtitle.

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(a) Pay of Members.--Members of the Commission shall serve without
pay by reason of their work on the Commission.
(b) Travel Expenses.--The members of the Commission shall be
allowed travel expenses, including per diem in lieu of subsistence, at
rates authorized for employees of agencies under subchapter I of
chapter 57 of title 5, United States Code, while away from their homes
or regular places of business in the performance of services for the
Commission.
(c) Staff.--(1) The Secretary may, without regard to the provisions
of title 5, United States Code, governing appointments in the
competitive service, appoint a staff director and such additional
personnel as may be necessary to enable the Commission to perform its
duties.
(2) The Secretary may fix the pay of the staff director and other
personnel appointed under paragraph (1) without regard to the
provisions of chapter 51 and subchapter III of chapter 53 of title 5,
United States Code, relating to classification of positions and General
Schedule pay rates, except that the rate of pay fixed under this
paragraph for the staff director may not exceed the rate payable for
level V of the Executive Schedule under section 5316 of such title and
the rate of pay for other personnel may not exceed the maximum rate
payable for grade GS-15 of the General Schedule.
(d) Detail of Government Employees.--Upon request of the Secretary,
the head of any Federal department or agency may detail, on a
nonreimbursable basis, any personnel of that department or agency to
the Commission to assist it in carrying out its duties.

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The Commission shall terminate 90 days after the date of the
submission of its report under section 143(a).

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SERVICE DOGS FOR VETERANS WITH CERTAIN DISABILITIES.
(a) Authority.--Section 1714 is amended--
(1) in subsection (b)--
(A) by striking ``seeing-eye or'' the first place it
appears;
(B) by striking ``who are entitled to disability
compensation'' and inserting ``who are enrolled under section
1705 of this title'';
(C) by striking ``, and may pay'' and all that follows
through ``such seeing-eye or guide dogs''; and
(D) by striking ``handicap'' and inserting ``disability'';
and
(2) by adding at the end the following new subsections:
``(c) The Secretary may, in accordance with the priority specified
in section 1705 of this title, provide--
``(1) service dogs trained for the aid of the hearing impaired
to veterans who are hearing impaired and are enrolled under section
1705 of this title; and
``(2) service dogs trained for the aid of persons with spinal
cord injury or dysfunction or other chronic impairment that
substantially limits mobility to veterans with such injury,
dysfunction, or impairment who are enrolled under section 1705 of
this title.
``(d) In the case of a veteran provided a dog under subsection (b)
or (c), the Secretary may pay travel and incidental expenses for that
veteran under the terms and conditions set forth in section 111 of this
title to and from the veteran's home for expenses incurred in becoming
adjusted to the dog.''.
(b) Clerical Amendments.--(1) The heading for such section is
amended to read as follows:
``Sec. 1714. Fitting and training in use of prosthetic appliances;
guide dogs; service dogs''.
(2) The item relating to such section in the table of sections at
the beginning of chapter 17 is amended to read as follows:
``1714. Fitting and training in use of prosthetic appliances; guide
dogs; service dogs.''.

995c0187f3d8828954c93f42d71c27fc04b647206b034577b20e1eb8a0730c5d

(a) Priority of Enrollment in Patient Enrollment System.--Section
1705(a) is amended by striking paragraph (7) and inserting the
following new paragraphs:
``(7) Veterans described in section 1710(a)(3) of this title
who are eligible for treatment as a low-income family under section
3(b) of the United States Housing Act of 1937 (42 U.S.C. 1437a(b))
for the area in which such veterans reside, regardless of whether
such veterans are treated as single person families under paragraph
(3)(A) of such section 3(b) or as families under paragraph (3)(B)
of such section 3(b).
``(8) Veterans described in section 1710(a)(3) of this title
who are not covered by paragraph (7).''.
(b) Reduced Copayments for Care.--Subsection (f) of section 1710 is
amended--
(1) in paragraph (1), by inserting ``or (4)'' after ``paragraph
(2)'';
(2) by redesignating paragraph (4) as paragraph (5); and
(3) by inserting after paragraph (3) the following new
paragraph (4):
``(4) In the case of a veteran covered by this subsection who is
also described by section 1705(a)(7) of this title, the amount for
which the veteran shall be liable to the United States for hospital
care under this subsection shall be an amount equal to 20 percent of
the total amount for which the veteran would otherwise be liable for
such care under subparagraphs (2)(B) and (3)(A) but for this
paragraph.''.
(c) Effective Date.--The amendments made by this section shall take
effect on October 1, 2002.

267c5d52052383893c0cd796748394241c1cad2fc185f3f038a21467014800bc

REHABILITATIVE NEEDS OF DISABLED VETERANS.
(a) Maintenance of Capacity on a Geographic Service Area Basis.--
Section 1706(b) is amended--
(1) in paragraph (1)--
(A) in the first sentence, by inserting ``(and each
geographic service area of the Veterans Health
Administration)'' after ``ensure that the Department''; and
(B) in clause (B), by inserting ``(and each geographic
service area of the Veterans Health Administration)'' after
``overall capacity of the Department'';
(2) by redesignating paragraphs (2) and (3) as paragraphs (5)
and (6), respectively; and
(3) by inserting after paragraph (1) the following new
paragraphs;
``(2) For purposes of paragraph (1), the capacity of the Department
(and each geographic service area of the Veterans Health
Administration) to provide for the specialized treatment and
rehabilitative needs of disabled veterans (including veterans with
spinal cord dysfunction, traumatic brain injury, blindness, prosthetics
and sensory aids, and mental illness) within distinct programs or
facilities shall be measured for seriously mentally ill veterans as
follows (with all such data to be provided by geographic service area
and totaled nationally):
``(A) For mental health intensive community-based care, the
number of discrete intensive care teams constituted to provide such
intensive services to seriously mentally ill veterans and the
number of veterans provided such care.
``(B) For opioid substitution programs, the number of patients
treated annually and the amounts expended.
``(C) For dual-diagnosis patients, the number treated annually
and the amounts expended.
``(D) For substance-use disorder programs--
``(i) the number of beds (whether hospital, nursing home,
or other designated beds) employed and the average bed
occupancy of such beds;
``(ii) the percentage of unique patients admitted directly
to outpatient care during the fiscal year who had two or more
additional visits to specialized outpatient care within 30 days
of their first visit, with a comparison from 1996 until the
date of the report;
``(iii) the percentage of unique inpatients with substance-
use disorder diagnoses treated during the fiscal year who had
one or more specialized clinic visits within three days of
their index discharge, with a comparison from 1996 until the
date of the report;
``(iv) the percentage of unique outpatients seen in a
facility or geographic service area during the fiscal year who
had one or more specialized clinic visits, with a comparison
from 1996 until the date of the report; and
``(v) the rate of recidivism of patients at each
specialized clinic in each geographic service area of the
Veterans Health Administration.
``(E) For mental health programs, the number and type of staff
that are available at each facility to provide specialized mental
health treatment, including satellite clinics, outpatient programs,
and community-based outpatient clinics, with a comparison from 1996
to the date of the report.
``(F) The number of such clinics providing mental health care,
the number and type of mental health staff at each such clinic, and
the type of mental health programs at each such clinic.
``(G) The total amounts expended for mental health during the
fiscal year.
``(3) For purposes of paragraph (1), the capacity of the Department
(and each geographic service area of the Veterans Health
Administration) to provide for the specialized treatment and
rehabilitative needs of disabled veterans within distinct programs or
facilities shall be measured for veterans with spinal cord dysfunction,
traumatic brain injury, blindness, or prosthetics and sensory aids as
follows (with all such data to be provided by geographic service area
and totaled nationally):
``(A) For spinal cord injury and dysfunction specialized
centers and for blind rehabilitation specialized centers, the
number of staffed beds and the number of full-time equivalent
employees assigned to provide care at such centers.
``(B) For prosthetics and sensory aids, the annual amount
expended.
``(C) For traumatic brain injury, the number of patients
treated annually and the amounts expended.
``(4) In carrying out paragraph (1), the Secretary may not use
patient outcome data as a substitute for, or the equivalent of,
compliance with the requirement under that paragraph for maintenance of
capacity.''.
(b) Extension of Annual Report Requirement.--Paragraph (5) of such
section, as so redesignated, is amended--
(1) by inserting ``(A)'' before ``Not later than'';
(2) by striking ``April 1, 1999, April 1, 2000, and April 1,
2001'' and inserting ``April 1 of each year through 2004'';
(3) by adding at the end of subparagraph (A), as designated by
paragraph (1), the following new sentence: ``Each such report shall
include information on recidivism rates associated with substance-
use disorder treatment.''; and
(4) by adding at the end of such paragraph the following new
subparagraphs:
``(B) In preparing each report under subparagraph (A), the
Secretary shall use standardized data and data definitions.
``(C) Each report under subparagraph (A) shall be audited by the
Inspector General of the Department, who shall submit to Congress a
certification as to the accuracy of each such report.''.

87accb22a76877e11aa51a69b91cf039346064383e6b6653f1996999ca770ac2

VETERANS.
(a) Requirement for Program.--Subject to the provisions of this
section, the Secretary of Veterans Affairs shall carry out a program to
provide chiropractic care and services to veterans through Department
of Veterans Affairs medical centers and clinics.
(b) Eligible Veterans.--Veterans eligible to receive chiropractic
care and services under the program are veterans who are enrolled in
the system of patient enrollment under section 1705 of title 38, United
States Code.
(c) Location of Program.--The program shall be carried out at sites
designated by the Secretary for purposes of the program. The Secretary
shall designate at least one site for such program in each geographic
service area of the Veterans Health Administration. The sites so
designated shall be medical centers and clinics located in urban areas
and in rural areas.
(d) Care and Services Available.--The chiropractic care and
services available under the program shall include a variety of
chiropractic care and services for neuro-musculoskeletal conditions,
including subluxation complex.
(e) Other Administrative Matters.--(1) The Secretary shall carry
out the program through personal service contracts and by appointment
of licensed chiropractors in Department medical centers and clinics.
(2) As part of the program, the Secretary shall provide training
and materials relating to chiropractic care and services to Department
health care providers assigned to primary care teams for the purpose of
familiarizing such providers with the benefits of chiropractic care and
services.
(f) Regulations.--The Secretary shall prescribe regulations to
carry out this section.
(g) Chiropractic Advisory Committee.--(1) The Secretary shall
establish an advisory committee to provide direct assistance and advice
to the Secretary in the development and implementation of the
chiropractic health program.
(2) The membership of the advisory committee shall include members
of the chiropractic care profession and such other members as the
Secretary considers appropriate.
(3) Matters on which the advisory committee shall assist and advise
the Secretary shall include the following:
(A) Protocols governing referral to chiropractors.
(B) Protocols governing direct access to chiropractic care.
(C) Protocols governing scope of practice of chiropractic
practitioners.
(D) Definition of services to be provided.
(E) Such other matters the Secretary determines to be
appropriate.
(4) The advisory committee shall cease to exist on December 31,
2004.

72e4799bfaadf39a63e5f601680e9fedf9e5d9c8ff1da497d91ad1040fcd0395

AND ASSURANCE.
(a) In General.--Section 7303 is amended by adding at the end the
following new subsection:
``(e) Amounts for the activities of the field offices of the Office
of Research Compliance and Assurance of the Department shall be derived
from amounts appropriated for the Veterans Health Administration for
Medical Care (rather than from amounts appropriated for the Veterans
Health Administration for Medical and Prosthetic Research).''.
(b) Applicability to Fiscal Year 2002.--In order to carry out
subsection (e) of section 7303 of title 38, United States Code, as
added by subsection (a), for fiscal year 2002, the Secretary of
Veterans Affairs shall transfer such sums as necessary for that purpose
from amounts appropriated for the Veterans Health Administration for
Medical and Prosthetic Research for fiscal year 2002 to amounts
appropriated for the Veterans Health Administration for Medical Care
for that fiscal year.

4d1519ef7e182c8a287530791a42a14fa60aefb276c878cfbd0e6d735147004d

(a) Project Authorized.--The Secretary of Veterans Affairs may
carry out a major medical facility project for the renovation from
electrical fire of the Department of Veterans Affairs Medical Center,
Miami, Florida, in an amount not to exceed $28,300,000.
(b) Authorization of Appropriations.--There is authorized to be
appropriated to the Secretary of Veterans Affairs for the Construction,
Major Projects Account, for fiscal year 2002, $28,300,000 for the
project authorized by subsection (a).
(c) Limitation.--The project authorized by subsection (a) may only
be carried out using--
(1) funds appropriated for fiscal year 2002 pursuant to the
authorization of appropriations in subsection (b);
(2) funds appropriated for Construction, Major Projects, for a
fiscal year before fiscal year 2002 that remain available for
obligation; and
(3) funds appropriated for Construction, Major Projects, for
fiscal year 2002 for a category of activity not specific to a
project.

b6a7dcf3b5ba22f0e1c3f1bd2dc8eff6abec868600bc297c45b1bdb8d035db80

It is the sense of Congress that the Secretary of Veterans Affairs
should conduct an assessment of all special telephone services for
veterans (such as help lines and hotlines) that are provided by the
Department of Veterans Affairs and that any such assessment, if
conducted, should include assessment of the geographical coverage,
availability, utilization, effectiveness, management, coordination,
staffing, and cost of those services and should include a survey of
veterans to measure their satisfaction with current special telephone
services and the demand for additional services.

f1ab9280e6a8b7e25eea90d1aef590f52195892be39f692dd297c37b7f1e95d5

CERTAIN OTHER HEALTH-RELATED AUTHORITIES.
(a) Statutory Reorganization.--Subchapter I of chapter 17 is
amended--
(1) in section 1701(6)--
(A) by striking subparagraph (B) and the sentence following
that subparagraph;
(B) by striking ``services--'' in the matter preceding
subparagraph (A) and inserting ``services, the following:'';
and
(C) by striking subparagraph (A) and inserting the
following:
``(A) Surgical services.
``(B) Dental services and appliances as described in sections
1710 and 1712 of this title.
``(C) Optometric and podiatric services.
``(D) Preventive health services.
``(E) In the case of a person otherwise receiving care or
services under this chapter--
``(i) wheelchairs, artificial limbs, trusses, and similar
appliances;
``(ii) special clothing made necessary by the wearing of
prosthetic appliances; and
``(iii) such other supplies or services as the Secretary
determines to be reasonable and necessary.
``(F) Travel and incidental expenses pursuant to section 111 of
this title.''; and
(2) in section 1707--
(A) by inserting ``(a)'' at the beginning of the text of
the section; and
(B) by adding at the end the following:
``(b) The Secretary may furnish sensori-neural aids only in
accordance with guidelines prescribed by the Secretary.''.
(b) Consolidation of Provisions Relating to Persons Other Than
Veterans.--Such chapter is further amended by adding at the end the
following new subchapter:
``SUBCHAPTER VIII--HEALTH CARE OF PERSONS OTHER THAN VETERANS
``Sec. 1782. Counseling, training, and mental health services for
immediate family members
``(a) Counseling for Family Members of Veterans Receiving Service-
Connected Treatment.--In the case of a veteran who is receiving
treatment for a service-connected disability pursuant to paragraph (1)
or (2) of section 1710(a) of this title, the Secretary shall provide to
individuals described in subsection (c) such consultation, professional
counseling, training, and mental health services as are necessary in
connection with that treatment.
``(b) Counseling for Family Members of Veterans Receiving Non-
Service-Connected Treatment.--In the case of a veteran who is eligible
to receive treatment for a non-service-connected disability under the
conditions described in paragraph (1), (2), or (3) of section 1710(a)
of this title, the Secretary may, in the discretion of the Secretary,
provide to individuals described in subsection (c) such consultation,
professional counseling, training, and mental health services as are
necessary in connection with that treatment if--
``(1) those services were initiated during the veteran's
hospitalization; and
``(2) the continued provision of those services on an
outpatient basis is essential to permit the discharge of the
veteran from the hospital.
``(c) Eligible Individuals.--Individuals who may be provided
services under this subsection are--
``(1) the members of the immediate family or the legal guardian
of a veteran; or
``(2) the individual in whose household such veteran certifies
an intention to live.
``(d) Travel and Transportation Authorized.--Services provided
under subsections (a) and (b) may include, under the terms and
conditions set forth in section 111 of this title, travel and
incidental expenses of individuals described in subsection (c) in the
case of any of the following:
``(1) A veteran who is receiving care for a service-connected
disability.
``(2) A dependent or survivor receiving care under the last
sentence of section 1783(b) of this title.
``Sec. 1783. Bereavement counseling
``(a) Deaths of Veterans.--In the case of an individual who was a
recipient of services under section 1782 of this title at the time of
the death of the veteran, the Secretary may provide bereavement
counseling to that individual in the case of a death--
``(1) that was unexpected; or
``(2) that occurred while the veteran was participating in a
hospice program (or a similar program) conducted by the Secretary.
``(b) Deaths In Active Service.--The Secretary may provide
bereavement counseling to an individual who is a member of the
immediate family of a member of the Armed Forces who dies in the active
military, naval, or air service in the line of duty and under
circumstances not due to the person's own misconduct.
``(c) Bereavement Counseling Defined.--For purposes of this
section, the term `bereavement counseling' means such counseling
services, for a limited period, as the Secretary determines to be
reasonable and necessary to assist an individual with the emotional and
psychological stress accompanying the death of another individual.
``Sec. 1784. Humanitarian care
``The Secretary may furnish hospital care or medical services as a
humanitarian service in emergency cases, but the Secretary shall charge
for such care and services at rates prescribed by the Secretary.''.
(c) Transfer of CHAMPVA Section.--Section 1713 is--
(1) transferred to subchapter VIII of chapter 17 of title 38,
United States Code, as added by subsection (b), and inserted after
the subchapter heading;
(2) redesignated as section 1781; and
(3) amended by adding at the end of subsection (b) the
following new sentence: ``A dependent or survivor receiving care
under the preceding sentence shall be eligible for the same medical
services as a veteran, including services under sections 1782 and
1783 of this title.''.
(d) Repeal of Recodified Authority.--Section 1711 is amended by
striking subsection (b).
(e) Cross Reference Amendments.--Title 38, United States Code, is
further amended as follows:
(1) Section 103(d)(5)(B) is amended by striking ``1713'' and
inserting ``1781''.
(2) Section 1701(5) is amended by striking ``1713(b)'' in
subparagraphs (B) and (C)(i) and inserting ``1781(b)''.
(3) Section 1712A(b) is amended--
(A) in the last sentence of paragraph (1), by striking
``section 1711(b)'' and inserting ``section 1784''; and
(A) in paragraph (2), by striking ``section 1701(6)(B)''
and inserting ``sections 1782 and 1783''.
(4) Section 1729(f) is amended by striking ``section 1711(b)''
and inserting ``section 1784''.
(5) Section 1729A(b) is amended--
(A) by redesignating paragraph (7) as paragraph (8); and
(B) by inserting after paragraph (6) the following new
paragraph (7):
``(7) Section 1784 of this title.''.
(6) Section 8111(g) is amended--
(A) in paragraph (4), by inserting ``services under
sections 1782 and 1783 of this title'' after ``of this
title,''; and
(B) in paragraph (5), by striking ``section 1711(b) or
1713'' and inserting ``section 1782, 1783, or 1784''.
(7) Section 8111A(a)(2) is amended by inserting ``, and the
term `medical services' includes services under sections 1782 and
1783 of this title'' before the period at the end.
(8) Section 8152(1) is amended by inserting ``services under
sections 1782 and 1783 of this title,'' after ``of this title),''.
(9) Sections 8502(b), 8520(a), and 8521 are amended by striking
``the last sentence of section 1713(b)'' and inserting ``the
penultimate sentence of section 1781(b)''.
(f) Clerical Amendments.--
(1) The table of sections at the beginning of such chapter is
amended--
(A) by striking the item relating to section 1707 and
inserting the following:
``1707. Limitations.'';
(B) by striking the item relating to section 1713; and
(C) by adding at the end the following:
``subchapter viii--health care of persons other than veterans
``1781. Medical care for survivors and dependents of certain veterans.
``1782. Counseling, training, and mental health services for immediate
family members.
``1783. Bereavement counseling.
``1784. Humanitarian care.''.
(2) The heading for section 1707 is amended to read as follows:
``Sec. 1707. Limitations''.

4a291d77b3edab9a79a90ac3be41946c58a66a0c010e36c0b501b39c6d5800b1

(a) Health Care Copayments.--Section 1710(f)(2)(B) is amended by
striking ``September 30, 2002'' and inserting ``September 30, 2007''.
(b) Medical Care Cost Recovery.--Section 1729(a)(2)(E) is amended
by striking ``October 1, 2002'' and inserting ``October 1, 2007''.

1663cb06f3c82e8c247640d4cbc7befd3e4d078e1323b6e75e462467d47ab33d

CONNECTED DISABILITIES.
(a) Evaluation and Study.--The Secretary of Veterans Affairs shall
carry out an evaluation and study of the feasibility and desirability
of providing a personal emergency response system to veterans who have
service-connected disabilities. The evaluation and study shall be
commenced not later than 60 days after the date of the enactment of
this Act.
(b) Report.--Not later than 180 days after the date of the
enactment of this Act, the Secretary shall submit to the Committees on
Veterans' Affairs of the Senate and House of Representatives a report
on the evaluation and study under subsection (a). The Secretary shall
include in the report the Secretary's findings resulting from the
evaluation and study and the Secretary's conclusion as to whether the
Department of Veterans Affairs should provide a personal emergency
response system to veterans with service-connected disabilities.
(c) Authority To Provide System.--If the Secretary concludes in the
report under subsection (b) that a personal emergency response system
should be provided by the Department of Veterans Affairs to veterans
with service-connected disabilities--
(1) the Secretary may provide such a system, without charge, to
any veteran with a service-connected disability who is enrolled
under section 1705 of title 38, United States Code, and who submits
an application for such a system under subsection (d); and
(2) the Secretary may contract with one or more vendors to
furnish such a system.
(d) Application.--A personal emergency response system may be
provided to a veteran under subsection (c)(1) only upon the submission
by the veteran of an application for the system. Any such application
shall be in such form and manner as the Secretary may require.
(e) Definition.--For purposes of this section, the term ``personal
emergency response system'' means a device--
(1) that can be activated by an individual who is experiencing
a medical emergency to notify appropriate emergency medical
personnel that the individual is experiencing a medical emergency;
and
(2) that provides the individual's location through a Global
Positioning System indicator.

d98d090648674e061d448b389c063296368ecd9c732dee4d0ccb2929f2d2d288

WHO SERVED IN SOUTHWEST ASIA DURING THE PERSIAN GULF WAR.
Section 1710(e)(3)(B) is amended by striking ``December 31, 2001''
and inserting ``December 31, 2002''.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.

d9df250da88bd80b88b9044d513b705f930780793653ca384eec065cc9d62c36

Department of Veterans Affairs Health Care Programs Enhancement Act of 2001

Other Sections

TITLE I

TITLE II

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