Home > 106th Congressional Bills > H.R. 2116 (eh) To amend title 38, United States Code, to establish a program of extended care services for veterans and to make other improvements in health care programs of the Department of Veterans Affairs. [Engrossed in House] ...

H.R. 2116 (eh) To amend title 38, United States Code, to establish a program of extended care services for veterans and to make other improvements in health care programs of the Department of Veterans Affairs. [Engrossed in House] ...


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                  In the Senate of the United States,

                                                      November 5, 1999.
    Resolved, That the bill from the House of Representatives (H.R. 
2116) entitled ``An Act to amend title 38, United States Code, to 
establish a program of extended care services for veterans and to make 
other improvements in health care programs of the Department of 
Veterans Affairs.'', do pass with the following

                              AMENDMENTS:

            Strike out all after the enacting clause and insert:

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans Benefits 
Act of 1999''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.

                         TITLE I--MEDICAL CARE

                       Subtitle A--Long-Term Care

Sec. 101. Continuum of care for veterans.
Sec. 102. Pilot programs relating to long-term care of veterans.
Sec. 103. Pilot program relating to assisted living services.

       Subtitle B--Management of Medical Facilities and Property

Sec. 111. Enhanced-use lease authority.
Sec. 112. Designation of hospital bed replacement building at 
                            Department of Veterans Affairs Medical 
                            Center in Reno, Nevada, after Jack 
                            Streeter.

                Subtitle C--Other Health Care Provisions

Sec. 121. Emergency health care in non-Department of Veterans Affairs 
                            facilities for enrolled veterans.
Sec. 122. Improvement of specialized mental health services for 
                            veterans.
Sec. 123. Treatment and services for drug or alcohol dependency.
Sec. 124. Allocation to Department of Veterans Affairs health care 
                            facilities of amounts in Medical Care 
                            Collections Fund.
Sec. 125. Extension of certain Persian Gulf War authorities.
Sec. 126. Report on coordination of procurement of pharmaceuticals and 
                            medical supplies by the Department of 
                            Veterans Affairs and the Department of 
                            Defense.
Sec. 127. Reimbursement of medical expenses of veterans located in 
                            Alaska.
Sec. 128. Repeal of four-year limitation on terms of Under Secretary 
                            for Health and Under Secretary for 
                            Benefits.

Subtitle D--Major Medical Facility Projects Construction Authorizations

Sec. 131. Authorization of major medical facility projects.

                       TITLE II--BENEFITS MATTERS

                     Subtitle A--Homeless Veterans

Sec. 201. Extension of program of housing assistance for homeless 
                            veterans.
Sec. 202. Homeless veterans comprehensive service programs.
Sec. 203. Authorizations of appropriations for homeless veterans' 
                            reintegration projects.
Sec. 204. Report on implementation of General Accounting Office 
                            recommendations regarding performance 
                            measures.

                       Subtitle B--Other Matters

Sec. 211. Payment rate of certain burial benefits for certain Filipino 
                            veterans.
Sec. 212. Extension of authority to maintain a regional office in the 
                            Republic of the Philippines.
Sec. 213. Extension of Advisory Committee on Minority Veterans.
Sec. 214. Dependency and indemnity compensation for surviving spouses 
                            of former prisoners of war.
Sec. 215. Repeal of limitation on payments of benefits to incompetent 
                            institutionalized veterans.
Sec. 216. Clarification of veterans employment opportunities.

                      TITLE III--EDUCATION MATTERS

Sec. 301. Short title.
Sec. 302. Availability of Montgomery GI Bill benefits for preparatory 
                            courses for college and graduate school 
                            entrance exams.
Sec. 303. Increase in basic benefit of active duty educational 
                            assistance.
Sec. 304. Increase in rates of survivors and dependents educational 
                            assistance.
Sec. 305. Increased active duty educational assistance benefit for 
                            contributing members.
Sec. 306. Continuing eligibility for educational assistance of members 
                            of the Armed Forces attending officer 
                            training school.
Sec. 307. Eligibility of members of the Armed Forces to withdraw 
                            elections not to receive Montgomery GI Bill 
                            basic educational assistance.
Sec. 308. Accelerated payments of basic educational assistance.
Sec. 309. Veterans education and vocational training benefits provided 
                            by the States.

                       TITLE IV--MEMORIAL AFFAIRS

                Subtitle A--Arlington National Cemetery

Sec. 401. Short title.
Sec. 402. Persons eligible for burial in Arlington National Cemetery.
Sec. 403. Persons eligible for placement in the columbarium in 
                            Arlington National Cemetery.

                   Subtitle B--Other Memorial Matters

Sec. 411. Establishment of additional national cemeteries.
Sec. 412. Use of flat grave markers at Santa Fe National Cemetery, New 
                            Mexico.

                   Subtitle C--World War II Memorial

Sec. 421. Short title.
Sec. 422. Fund raising by American Battle Monuments Commission for 
                            World War II Memorial.
Sec. 423. General authority of American Battle Monuments Commission to 
                            solicit and receive contributions.
Sec. 424. Intellectual property and related items.

      TITLE V--UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

Sec. 501. Temporary service of certain judges of United States Court of 
                            Appeals for Veterans Claims upon expiration 
                            of their terms or retirement.
Sec. 502. Modified terms for certain judges of United States Court of 
                            Appeals for Veterans Claims.
Sec. 503. Temporary authority for voluntary separation incentives for 
                            certain judges on United States Court of 
                            Appeals for Veterans Claims.
Sec. 504. Definition.

SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

    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.

                         TITLE I--MEDICAL CARE

                       Subtitle A--Long-Term Care

SEC. 101. CONTINUUM OF CARE FOR VETERANS.

    (a) Inclusion of Noninstitutional Extended Care Services in 
Definition of Medical Services.--Section 1701 is amended--
            (1) in paragraph (6)(A)(i), by inserting ``noninstitutional 
        extended care services,'' after ``preventive health 
        services,''; and
            (2) by adding at the end the following new paragraphs:
            ``(10) The term `noninstitutional extended care services' 
        includes--
                    ``(A) home-based primary care;
                    ``(B) adult day health care;
                    ``(C) respite care;
                    ``(D) palliative and end-of-life care; and
                    ``(E) home health aide visits.
            ``(11) The term `respite care' means hospital care, nursing 
        home care, or residence-based care which--
                    ``(A) is of limited duration;
                    ``(B) is furnished in a Department facility or in 
                the residence of an individual on an intermittent basis 
                to an individual who is suffering from a chronic 
                illness and who resides primarily at that residence; 
                and
                    ``(C) is furnished for the purpose of helping the 
                individual to continue residing primarily at that 
                residence.''.
    (b) Conforming Amendments to Title 38.--(1)(A) Section 1720 is 
amended by striking subsection (f).
    (B) The section heading of such section is amended by striking ``; 
adult day health care''.
    (2) Section 1720B is repealed.
    (3) Chapter 17 is further amended by redesignating sections 1720C, 
1720D, and 1720E as sections 1720B, 1720C, and 1720D, respectively.
    (c) Clerical Amendments.--The table of sections for chapter 17 is 
amended--
            (1) in the item relating to section 1720, by striking ``; 
        adult day health care''; and
            (2) by striking the items relating to sections 1720B, 
        1720C, 1720D, and 1720E and inserting the following:

``1720B. Noninstitutional alternatives to nursing home care.
``1720C. Counseling and treatment for sexual trauma.
``1720D. Nasopharyngeal radium irradiation.''.
    (d) Additional Conforming Amendment.--Section 101(g)(2) of the 
Veterans Health Programs Extension Act of 1994 (Public Law 103-452; 108 
Stat. 4785; 38 U.S.C. 1720D note) is amended by striking ``section 
1720D'' both places it appears and inserting ``section 1720C''.

SEC. 102. PILOT PROGRAMS RELATING TO LONG-TERM CARE OF VETERANS.

    (a) In General.--The Secretary of Veterans Affairs shall carry out 
three pilot programs for the purpose of determining the feasibility and 
practicability of a variety of methods of meeting the long-term care 
needs of eligible veterans. The pilot programs shall be carried out in 
accordance with the provisions of this section.
    (b) Locations of Pilot Programs.--(1) Each pilot program under this 
section shall be carried out in two designated health care regions of 
the Department of Veterans Affairs selected by the Secretary for 
purposes of this section.
    (2) In selecting designated health care regions of the Department 
for purposes of a particular pilot program, the Secretary shall, to the 
maximum extent practicable, select designated health care regions 
containing a medical center or medical centers whose current 
circumstances and activities most closely mirror the circumstances and 
activities proposed to be achieved under such pilot program.
    (3) The Secretary may not carry out more than one pilot program in 
any given designated health care region of the Department.
    (c) Scope of Services Under Pilot Programs.--(1) The services 
provided under the pilot programs under this section shall include a 
comprehensive array of health care services and other services that 
meet the long-term care needs of veterans, including--
            (A) inpatient long-term care in intermediate care beds, in 
        nursing homes, and in domiciliary care facilities; and
            (B) non-institutional long-term care, including hospital-
        based primary care, adult day health care, respite care, and 
        other community-based interventions and care.
    (2) As part of the provision of services under the pilot programs, 
the Secretary shall also provide appropriate case management services.
    (3) In providing services under the pilot programs, the Secretary 
shall emphasize the provision of preventive care services, including 
screening and education.
    (4) The Secretary may provide health care services or other 
services under the pilot programs only if the Secretary is otherwise 
authorized to provide such services by law.
    (d) Direct Provision of Services.--Under one of the pilot programs 
under this section, the Secretary shall provide long-term care services 
to eligible veterans directly through facilities and personnel of the 
Department of Veterans Affairs.
    (e) Provision of Services Through Cooperative Arrangements.--(1) 
Under one of the pilot programs under this section, the Secretary shall 
provide long-term care services to eligible veterans through a 
combination (as determined by the Secretary) of--
            (A) services provided under cooperative arrangements with 
        appropriate public and private non-Governmental entities, 
        including community service organizations; and
            (B) services provided through facilities and personnel of 
        the Department.
    (2) The consideration provided by the Secretary for services 
provided by entities under cooperative arrangements under paragraph 
(1)(A) shall be limited to the provision by the Secretary of 
appropriate in-kind services to such entities.
    (f) Provision of Services by Non-Department Entities.--(1) Under 
one of the pilot programs under this section, the Secretary shall 
provide long-term care services to eligible veterans through 
arrangements with appropriate non-Department entities under which 
arrangements the Secretary acts solely as the case manager for the 
provision of such services.
    (2) Payment for services provided to veterans under the pilot 
programs under this subsection shall be made by the Department to the 
extent that payment for such services is not otherwise provided by 
another government or non-government entity.
    (g) Data Collection.--As part of the pilot programs under this 
section, the Secretary shall collect data regarding--
            (1) the cost-effectiveness of such programs and of other 
        activities of the Department for purposes of meeting the long-
        term care needs of eligible veterans, including any cost 
        advantages under such programs and activities when compared 
        with the Medicare program, Medicaid program, or other Federal 
        program serving similar populations;
            (2) the quality of the services provided under such 
        programs and activities;
            (3) the satisfaction of participating veterans, non-
        Department, and non-Government entities with such programs and 
        activities; and
            (4) the effect of such programs and activities on the 
        ability of veterans to carry out basic activities of daily 
        living over the course of such veterans' participation in such 
        programs and activities.

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