Summary: H.R.2327 — 100th Congress (1987-1988)All Information (Except Text)

Bill summaries are authored by CRS.

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Passed Senate amended (10/16/1987)

(Measure passed Senate, amended, in lieu of S. 1464, roll call #337 (89-1))

Veterans' Administration Beneficiary Travel, Quality Assurance, and Readjustment Counseling Amendments of 1987 - Title I: Beneficiary Travel Program - Amends Federal veterans' benefits provisions relating to the payment of travel expenses of veterans traveling to a Veterans Administration (VA) health care center for treatment to direct the Administrator of Veterans Affairs (the Administrator), in exercising authority to make such payments, to make them to the following persons: (1) a person receiving veterans' benefits for or in connection with a service-connected disability; (2) a veteran receiving veterans' pension benefits; (3) a person whose annual income does not exceed the annual veterans' pension rate or who is unable to defray the expenses of such travel; and (4) a person whose travel to a VA facility was incident to a scheduled compensation and pension examination.

Authorizes the Administrator to deduct $3.75 from the amount otherwise payable for each trip to or from a VA facility. Sets a maximum deductible of $22.50 per month for veterans making six or more one-way trips during a calendar month or months. Provides that no such deduction shall be taken in the case of a person whose travel to a VA facility was either required to be performed by a special mode of travel which was authorized beforehand by the Administrator, or was in connection with a medical emergency where delay caused by prior authorization by the Administrator would have been hazardous to such person's life or health. Authorizes the Administrator to waive the required deduction in the case of the travel of any veteran for whom the imposition of the deduction would cause severe financial hardship. Authorizes the Administrator to increase (or decrease) proportionately the deductible amount whenever the amount of the reimbursement itself is increased or decreased.

Directs the Administrator, with respect to any fiscal year in which he or she exercises authority to make such payments, to allocate funds to each VA facility to enable its head to make such payments to veterans using it and authorized to receive such payments. Directs the head of each such facility to use such funds solely to make such reimbursement payments.

Directs the Chief Medical Director of the VA's Department of Medicine and Surgery (the CMD), whenever it is determined that less than the maximum payments authorized have been made at any such facility, to allow, on April 12, 1987, at the facility's request, payments at less than the authorized maximum if it would be in the best interest of furnishing care and services to eligible veterans there. Permits the use of any funds authorized for such payments, but unexpended, for direct patient-care services.

Directs the Administrator to facilitate the establishment of a program under which volunteer organizations or individuals would take responsibility for the transportation of such veterans, without reimbursement from the VA, to VA facilities for services and benefits. Directs the Administrator, no later than six months after the enactment of the above provisions, to report to the Senate and House Veterans' Affairs Committees on the implementation of such program.

Title II: Quality Assurance Program - Establishes in the Office of the CMD of the Department an Office of Medical Inspector General (MIG). Makes the MIG directly responsible to the CMD, and requires him or her to review, monitor, and investigate any adverse incident which is experienced by a patient during the course of care in a VA health-care facility, including any incident that would not normally be considered a natural consequence of the patient's disease or illness and any incident that would carry a recognized need for medical intervention. Authorizes the MIG to also review and investigate matters he or she considers necessary to identify problems in the provision of health care to veterans and propose any corrective measures to the CMD. States that the MIG shall have sole discretion in determining whether to investigate any incident involving patient care or to study or review any problem in the provision of health care to veterans.

Directs the MIG to submit a report, no later than February 1, annually, to the Administrator of Veterans Affairs, the CMD, and the Senate and House Veterans' Affairs Committees on the activities of the Office under this Act during the preceding fiscal year.

Requires the MIG to be an ex officio, nonvoting member of all policymaking bodies within the central office of the Department that are concerned with the quality of health care provided in VA facilities or that are concerned with quality assurance in the provision of such care. Denies the MIG, however, any direct responsibility for quality assurance activities.

Directs the Administrator to transfer to the Office funds necessary to support five full-time medical doctors and five full-time support personnel.

Requires that, in the Office of the CMD, one of the Assistant Chief Medical Directors shall be a qualified physician trained in or having suitable experience in health-care quality assurance and risk management. Makes such Assistant Director responsible to the CMD for carrying out responsibilities in such areas.

Requires the CMD to ensure that all personnel of the Department: (1) are periodically given an explanation of their quality assurance responsibilities in such Department; and (2) are advised that any failure to comply with quality assurance procedures within the Department will result in appropriate disciplinary action.

Establishes in the VA's office of the Inspector General the position of the Assistant Inspector General for Health Care Quality Assurance Review (the AIG). Requires the AIG to be a qualified doctor of medicine appointed by the Inspector General of the VA. Outlines various duties and responsibilities of the Assistant Inspector, all of which relate to the monitoring, review, and appropriate investigations of incidents involving quality assurance of health-care services to veterans and its related functions within the Department.

Directs the Inspector General of the VA, no later than February 1 annually, to submit to the Administrator of Veterans Affairs and the Senate and House Veterans' Affairs Committees a report containing: (1) a discussion of the activities, conclusions, and recommendations of the AIG concerning corrective action required in the Department relating to the quality of health care provided to veterans; and (2) a discussion of the activities undertaken by the AIG to monitor the Medical Inspector of the VA during the preceding fiscal year, and the AIG's findings, conclusions, assessment, and recommendations based on such monitoring, including any possible remedial and disciplinary actions.

Title III: Vietnam Veterans' Readjustment Counseling Programs - Expands eligibility for veterans' readjustment counseling and related mental health services (currently available only to Vietnam veterans) to include any veteran or person who served on active duty after May 7, 1975, in an area during a period in which hostilities occurred. Also authorizes such services, upon request, to any veteran who served on active duty during World War II or the Korean Conflict. Requires such assistance to include an assessment of whether the person or veteran has mental or psychological problems associated with such individual's active service.

Requires that professional, paraprofessional, and lay personnel trained to provide readjustment counseling services for veterans, and who complete two years of continuous employment in such training program and are still so employed on the 90th day following the enactment of this provision, shall be converted to a career-conditional or career employment status within a specified conditional period after the completion of such training. Directs the Administrator, no later than 15 days after an individual becomes eligible for such employment position conversion, to notify such individual of such entitlement and the timetable for such employee's conversion.

Prohibits any Vet Center in existence on July 1, 1987, from being closed or relocated unless the CMD: (1) determines that such closure or relocation will not adversely affect readjustment counseling services to eligible persons in the geographical area served by such center; (2) ensures that certain requirements outlined later in this Act are met; and (3) provides notice to the Senate and House Veterans' Affairs Committees, at least 60 day prior to such a closure or relocation. Outlines various factors to be given consideration by the CMD when determining whether such a closure or relocation is appropriate, including the distribution of Vietnam-era veterans in areas served by a center, distances required for travel to such center, personnel acceptability of such closures or relocations, the availability of other entities to provide such services, and so forth.

Provides that, in the event of a relocation of a Vet Center to a general VA facility, no less than the average annual budget and personnel ceiling provided to the Center in each of the three fiscal years prior to such move will remain available to furnish readjustment counseling services for two full fiscal years following such relocation. Authorizes the CMD to reduce such budget and personnel ceiling levels in appropriate circumstances and after appropriate congressional notification.

States that any proposed closure or relocation during any fiscal year after FY 1988 of more than ten percent of the Vet Centers in existence as of July 1, 1987, shall be deemed an administrative reorganization (requiring the submission to the Congress of a detailed plan and justification for such closure or relocation prior to such a move). Prohibits any more than five percent of the Vet Centers in existence as of the above date from being closed or relocated prior to October 1, 1988. Requires the Administrator, in the event of an administrative reorganization as outlined above, to submit, in lieu of the detailed plan and justification required, a notification which includes information as to each Vet Center proposed to be closed or relocated and a justification for such reorganization.

Extends until April 1, 1988, the due date of a report from the Administrator to the Senate and House Veterans' Affairs Committees on the effectiveness of providing sufficient readjustment counseling services to Vietnam-era veterans.

Authorizes the Vet Centers, in addition to providing readjustment counseling services, to provide other assistance (such as benefits application assistance) that the Administrator is authorized to furnish to such veterans.

Directs the Administrator, no later than 150 days after the enactment of this Act, to report to the Senate and House Veterans' Affairs Committees on the implementation of VA readjustment counseling employee requirements as outlined in this Act.

Amends the Veterans' Health Care Amendments of 1983 to extend until October 1, 1987, the due date for a report from the Administrator to the Senate and House Veterans' Affairs Committees concerning a study of post-traumatic stress disorder and other post-war psychological problems experienced by Vietnam veterans.

Prohibits any functions and authorities assigned to the CMD by any provision of this Act from being delegated to or exercised by any other official.