| Home > 106th Congressional Bills > H.R. 2116 (enr) To amend title 38, United States Code, to establish a program of [Enrolled bill] ...
H.R. 2116 (enr) To amend title 38, United States Code, to establish a program of [Enrolled bill] ...
106th CONGRESS 1st Session H. R. 2116 _______________________________________________________________________ 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. 106th CONGRESS 1st Session H. R. 2116 _______________________________________________________________________ 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. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE; TABLE OF CONTENTS; REFERENCES TO TITLE 38, UNITED STATES CODE. (a) Short Title.--This Act may be cited as the ``Veterans' Millennium Health Care Act''. (b) Table of Contents.--The table of contents of this Act is as follows: Sec. 1. Short title; table of contents; references to title 38, United States Code. TITLE I--ACCESS TO CARE Sec. 101. Extended care services. Sec. 102. Reimbursement for emergency treatment. Sec. 103. Eligibility for care of combat-injured veterans. Sec. 104. Access to care for military retirees. Sec. 105. Benefits for persons disabled by participation in compensated work therapy program. Sec. 106. Pilot program of medical care for certain dependents of enrolled veterans. Sec. 107. Enhanced services program at designated medical centers. Sec. 108. Counseling and treatment for veterans who have experienced sexual trauma. TITLE II--PROGRAM ADMINISTRATION Sec. 201. Medical care collections. Sec. 202. Health Services Improvement Fund. Sec. 203. Veterans Tobacco Trust Fund. Sec. 204. Authority to accept funds for education and training. Sec. 205. Extension and revision of certain authorities. Sec. 206. State Home grant program. Sec. 207. Expansion of enhanced-use lease authority. Sec. 208. Ineligibility for employment by Veterans Health Administration of health care professionals who have lost license to practice in one jurisdiction while still licensed in another jurisdiction. TITLE III--MISCELLANEOUS Sec. 301. Review of proposed changes to operation of medical facilities. Sec. 302. Patient services at Department facilities. Sec. 303. Report on assisted living services. Sec. 304. Chiropractic treatment. Sec. 305. Designation of hospital bed replacement building at Ioannis A. Lougaris Department of Veterans Affairs Medical Center, Reno, Nevada. TITLE IV--CONSTRUCTION AND FACILITIES MATTERS Sec. 401. Authorization of major medical facility projects. Sec. 402. Authorization of major medical facility leases. Sec. 403. Authorization of appropriations. (c) 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--ACCESS TO CARE SEC. 101. EXTENDED CARE SERVICES. (a) Requirement To Provide Extended Care Services.--(1) Chapter 17 is amended by inserting after section 1710 the following new section: ``Sec. 1710A. Extended care services ``(a) The Secretary (subject to section 1710(a)(4) of this title and subsection (c) of this section) shall operate and maintain a program to provide extended care services to eligible veterans in accordance with this section. Such services shall include the following: ``(1) Geriatric evaluation. ``(2) Nursing home care (A) in facilities operated by the Secretary, and (B) in community-based facilities through contracts under section 1720 of this title. ``(3) Domiciliary services under section 1710(b) of this title. ``(4) Adult day health care under section 1720(f) of this title. ``(5) Such other noninstitutional alternatives to nursing home care, including those described in section 1720C of this title, as the Secretary considers reasonable and appropriate. ``(6) Respite care under section 1720B of this title. ``(b)(1) In carrying out subsection (a), the Secretary shall provide extended care services which the Secretary determines are needed (A) to any veteran in need of such care for a service-connected disability, and (B) to any veteran who is in need of such care and who has a service-connected disability rated at 50 percent or more. ``(2) The Secretary, in making placements for nursing home care in Department facilities, shall give highest priority to veterans (A) who are in need of such care for a service-connected disability, or (B) who have a service-connected disability rated at 50 percent or more. The Secretary shall ensure that a veteran described in this subsection who continues to need nursing home care shall not after placement in a Department nursing home be transferred from the facility without the consent of the veteran, or, in the event the veteran cannot provide informed consent, the representative of the veteran. ``(c)(1) The Secretary, in carrying out subsection (a), shall prescribe regulations governing the priorities for the provision of nursing home care in Department facilities so as to ensure that priority for such care is given (A) for patient rehabilitation, (B) for clinically complex patient populations, and (C) for patients for whom there are not other suitable placement options. ``(2) The Secretary may not furnish extended care services for a non-service-connected disability other than in the case of a veteran who has a service-connected disability rated at 50 percent or more unless the veteran agrees to pay to the United States a copayment for extended care services of more than 21 days in any year. ``(d)(1) A veteran who is furnished extended care services under this chapter and who is required under subsection (c)(2) to pay an amount to the United States in order to be furnished such services shall be liable to the United States for that amount. ``(2) In implementing subsection (c)(2), the Secretary shall develop a methodology for establishing the amount of the copayment for which a veteran described in subsection (c) is liable. That methodology shall provide for-- ``(A) establishing a maximum monthly copayment (based on all income and assets of the veteran and the spouse of such veteran); ``(B) protecting the spouse of a veteran from financial hardship by not counting all of the income and assets of the veteran and spouse (in the case of a spouse who resides in the community) as available for determining the copayment obligation; and ``(C) allowing the veteran to retain a monthly personal allowance. ``(e)(1) There is established in the Treasury of the United States a revolving fund known as the Department of Veterans Affairs Extended Care Fund (hereinafter in this section referred to as the `fund'). Amounts in the fund shall be available, without fiscal year limitation and without further appropriation, exclusively for the purpose of providing extended care services under subsection (a). ``(2) All amounts received by the Department under this section shall be deposited in or credited to the fund.''. (2) The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1710 the following new item: ``1710A. Requirement to provide extended care.''. (b) Requirement To Increase Extended Care Services.--(1) Not later than January 1, 2000, the Secretary of Veterans Affairs shall develop and begin to implement a plan for carrying out the recommendation of the Federal Advisory Committee on the Future of Long-Term Care to increase, above the level of extended care services which were provided as of September 30, 1998-- (A) the options and services for home and community-based care for eligible veterans; and (B) the percentage of the Department of Veterans Affairs medical care budget dedicated to such care. (2) The Secretary shall ensure that the staffing and level of extended care services provided by the Secretary nationally in facilities operated by the Secretary during any fiscal year is not less than the level of such services provided nationally in facilities operated by the Secretary during fiscal year 1998. (c) Adult Day Health Care.--Section 1720(f)(1)(A) is amended to read as follows: ``(f)(1)(A) The Secretary may furnish adult day health care services to a veteran enrolled under section 1705(a) of this title who would otherwise require nursing home care.'' (d) Respite Care Program.--Section 1720B is amended-- (1) in subsection (a), by striking ``eligible'' and inserting ``enrolled''; (2) in subsection (b)-- (A) by striking ``the term `respite care' means hospital or nursing home care'' and inserting ``the term `respite care services' means care and services''; (B) by striking ``is'' at the beginning of each of paragraphs (1), (2), and (3) and inserting ``are''; and (C) by striking ``in a Department facility'' in paragraph (2); and (3) by adding at the end the following new subsection: ``(c) In furnishing respite care services, the Secretary may enter into contract arrangements.''. (e) Conforming Amendments.--Section 1710 is amended-- (1) in subsection (a)(1), by striking ``may furnish nursing home care,''; and (2) in subsection (a)(4), by inserting ``, and the requirement in section 1710A of this title that the Secretary provide a program of extended care services,'' after ``medical services''. (f) State Homes.--Section 1741(a)(2) is amended by striking ``adult day health care in a State home'' and inserting ``extended care services described in any of paragraphs (4) through (6) of section 1710A(a) of this title under a program administered by a State home''. (g) Effective Date.--(1) Except as provided in paragraph (2), the amendments made by this section shall take effect on the date of the enactment of this Act. (2) Subsection (c)(2) of section 1710A(a) of title 38, United States Code (as added by subsection (a)), shall take effect on the effective date of regulations prescribed by the Secretary of Veterans Affairs under subsections (c)(2) and (d) of such section. The Secretary shall publish the effective date of such regulations in the Federal Register. (3) The provisions of section 1710(f) of title 38, United States Code, shall not apply to any day of nursing home care on or after the effective date of regulations under paragraph (2). SEC. 102. REIMBURSEMENT FOR EMERGENCY TREATMENT. (a) Authority To Provide Reimbursement.--Chapter 17 is amended by inserting after section 1724 the following new section: ``Sec. 1725. Reimbursement for emergency treatment ``(a) General Authority.--(1) Subject to subsections (c) and (d), the Secretary may reimburse a veteran described in subsection (b) for the reasonable value of emergency treatment furnished the veteran in a non-Department facility. ``(2) In any case in which reimbursement is authorized under subsection (a)(1), the Secretary, in the Secretary's discretion, may, in lieu of reimbursing the veteran, make payment of the reasonable value of the furnished emergency treatment directly-- ``(A) to a hospital or other health care provider that furnished the treatment; or ``(B) to the person or organization that paid for such treatment on behalf of such veteran. ``(b) Eligibility.--(1) A veteran referred to in subsection (a)(1) is an individual who is an active Department health-care participant who is personally liable for emergency treatment furnished the veteran in a non-Department facility. ``(2) A veteran is an active Department health-care participant if the veteran-- ``(A) is described in any of paragraphs (1) through (6) of section 1705(a) of this title; ``(B) is enrolled in the health care system established under such section; and ``(C) received care under this chapter within the 12-month period preceding the furnishing of such emergency treatment. ``(3) A veteran is personally liable for emergency treatment furnished the veteran in a non-Department facility if the veteran-- ``(A) is financially liable to the provider of emergency treatment for that treatment; ``(B) has no entitlement to care or services under a health-plan contract; ``(C) has no other contractual or legal recourse against a third party that would, in whole or in part, extinguish such liability to the provider; and ``(D) is not eligible for reimbursement for medical care or services under section 1728 of this title. ``(c) Limitations on Reimbursement.--(1) The Secretary, in accordance with regulations prescribed by the Secretary, shall-- ``(A) establish the maximum amount payable under subsection (a); ``(B) delineate the circumstances under which such payments
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