Bill summaries are authored by CRS.

Shown Here:
Passed Senate amended (09/28/1996)


Title I: Eligibility Reform

Title II: Construction Authorization

Title III: Health Care and Administration

Subtitle A: Health Care Sharing and Administration

Subtitle B: Care of Women Veterans

Subtitle C: Readjustment Counseling and Mental Health


Subtitle D: Other Provisions

Veterans' Health Care Eligibility Reform Act of 1996 - Title I: Eligibility Reform - Requires the Secretary of Veterans Affairs to furnish hospital care and medical services to, among others, any veteran: (1) with a compensable service-connected disability (currently, for any service-connected disability, regardless of compensation); or (2) who is unable to defray the expenses of necessary medical care and services. Authorizes the Secretary, with respect to veterans not otherwise eligible for such care and services, to furnish needed hospital, medical, and nursing home care.

(Sec. 102) Makes a Vietnam-era herbicide-exposed veteran eligible for hospital care, medical services, and nursing home care for any disability, notwithstanding that there is insufficient medical evidence that such disability may be associated with such exposure. Makes a radiation-exposed veteran eligible for such care and services for: (1) any disease currently listed in Federal provisions which presume a relation between such disease and a veteran's disability; or (2) any disease for which the Secretary determines there is credible evidence of a positive association between the occurrence of such disease and exposure to ionizing radiation. Provides exceptions from such coverage.

(Sec. 103) Repeals the requirement that veterans be eligible to receive hospital care through the Department of Veterans Affairs in order to receive surgical, dental, optometric, and podiatric services, but requires such eligibility before such veterans may receive certain prosthetic appliances, special clothing necessitated by the wearing of such appliances, and other reasonable and necessary supplies and services.

(Sec. 104) Directs the Secretary, in managing the provision of hospital care and medical services, to establish and operate a system of annual patient enrollment, with specified priorities relating to the degree of disability of a veteran and related factors. Requires the system to be managed to ensure the provision of timely and acceptable care to enrollees. Authorizes the Secretary to establish additional care priorities and exceptions to the special priorities where dictated by compelling medical reasons. Requires veterans to enroll in the system to be eligible for such care, but provides automatic coverage for a 12-month period following a veteran's discharge or release from active service.

Requires the Secretary to design, establish, and manage Department of Veterans Affairs health care programs so as to promote cost-effective delivery of health care services in the most clinically appropriate setting. Requires the Department to maintain its capacity to provide for the specialized treatment and rehabilitative needs of disabled veterans, with at least the same capacity to provide such services as in existence on the date of enactment of this Act. Requires a compliance report from the Secretary to the Senate and House Veterans' Affairs Committees (veterans' committees).

(Sec. 105) Authorizes appropriations for FY 1997 and 1998 for the Department's Medical Care Account.

(Sec. 106) Directs the Secretary to establish information systems to assess, and report to the veterans' committees on: (1) the effect of this title on the demand for Department health care services by veterans; (2) any differing patterns of such demand; and (3) the extent to which the Department has met such demand. Requires the report to include certain information with respect to FY 1997 on: (1) the veterans enrolled for care at a Department medical facility who did not receive such care in the three preceding fiscal years or who applied for, but were denied, care; and (2) the number and characteristics of, and the type and extent of health care provided to, enrolled and non-enrolled veterans.

Title II: Construction Authorization - Authorizes the Secretary to: (1) carry out nine specified ambulatory care addition major medical facility projects; (2) carry out eight specified environmental improvement major medical facility projects; (3) carry out seismic corrections at a Department medical center in Palo Alto, California; and (4) enter into six leases for specified medical facilities.

(Sec. 203) Authorizes appropriations to the Secretary for FY 1997 and 1998 for the Construction, Major Projects, account and the Medical Care account.

(Sec. 204) Replaces an annual reporting requirement regarding operational and construction plans for Department medical facilities with a requirement that the Secretary report annually to the veterans' committees: (1) regarding long-range health planning of the Department, including a five-year strategic plan for the provision of medical care to eligible veterans through coordinated networks of medical facilities; and (2) showing the current Department priorities (listing the top 20) for proposed major medical construction projects.

(Sec. 205) Specifies additional information required to be included in a prospectus submitted by the Secretary to the veterans' committees in connection with proposed medical facilities, including data on demographics, projected workload and utilization, operating costs, funding priority, and alternatives to facility construction.

(Sec. 206) Redefines a "major medical facility project" for purposes of provisions governing medical facility acquisition as a project involving a total expenditure of more than $4 million (currently, $3 million).

Repeals a provision of the Veterans' Medical Programs Amendments of 1992 which makes inapplicable to projects for which funds were appropriated prior to the enactment of such Act a prohibition on the appropriation, obligation, or expenditure of funds for any major medical facility project unless funds for such project have been specifically authorized by law.

Prohibits the Secretary from obligating funds in excess of $500,000 from the Department's Advance Planning Fund toward design or development of a major medical facility project until the Secretary reports to the veterans' committees.

Title III: Health Care and Administration - Subtitle A: Health Care Sharing and Administration - Authorizes the Secretary to enter into arrangements for the exchange and mutual use of health care resources between Department health care facilities and non-Department health care providers. (Currently, such sharing is authorized only for specialized medical resources.) Makes eligible as additional parties to such agreements health care plans and insurers and any organizations, institutions, or other entities that furnish health care resources. Allows the use of other-than-competitive procedures when the health care resource required is a commercial service, or involves the use of medical equipment, space, or research. Authorizes the Secretary to prescribe simplified acquisition procedures in such cases. Outlines requirements for procurements to be conducted on a sole-source basis. Repeals a requirement of reciprocal reimbursement under sharing arrangements. Allows the provision of services under such arrangements to non-veterans only if the Secretary determines that veterans will receive priority and that such an arrangement: (1) is necessary to maintain an acceptable level of quality and service to veterans at that facility; or (2) will result in the improvement of services to eligible veterans.

(Sec. 302) Provides for the obligation of funds received from a non-Federal entity as payment for services under a sharing arrangement. Ratifies arrangements entered into between October 1, 1996, and the date of enactment of this Act. Empowers the United States to collect from primary health providers of covered beneficiaries the charges for care or services covered under the primary health-plan contract which are provided through the Department.

(Sec. 303) Exempts from inclusion under Department full-time-equivalent position limitations positions held by persons providing health-care resources under resource sharing arrangements.

(Sec. 304) Revises the waiting period following congressional notification required before undertaking Department administrative reorganizations.

(Sec. 305) Directs the Secretary to include in annual budget materials submitted to the Congress a report on activities and proposals involving contracting for performance by contractor personnel of work previously performed by Department employees.

Subtitle B: Care of Women Veterans - Prohibits a mammogram from being performed at a Department facility not accredited for such purpose by a designated private nonprofit organization. Directs the Secretary to prescribe quality assurance and control standards relating to the performance and interpretation of mammograms and the use of Department mammogram equipment and facilities consistent with related standards under the Public Health Service Act. Requires an annual inspection of such equipment and facilities. Requires the Secretary to prescribe and report on implementation of mammogram standards.

(Sec. 322) Directs the Secretary to conduct a survey of, and report to the Congress on, deficiencies of each Department medical center relating to privacy afforded to women patients which may interfere with appropriate patient treatment. Requires high priority to be given to any plans and steps to correct such deficiencies.

(Sec. 323) Requires the Department's Center for Women Veterans to assess the use by women veterans of health services through the Department, including counseling for sexual trauma and mental health services. Requires related reports.

(Sec. 324) Amends the Veterans Health Care Act of 1992 to extend through 1998 and include additional information in an annual reporting requirement on the provision of health care and services for, and research relating to, women veterans.

Subtitle C: Readjustment Counseling and Mental Health Care - Directs the Secretary to furnish readjustment counseling to any veteran who served on active duty: (1) in a theater of combat operations during the Vietnam era; (2) in an area in which hostilities occurred after May 7, 1975; or (3) during the Vietnam era and who seeks or is furnished such counseling before January 1, 2000. Authorizes the Secretary to furnish such assistance to any other veteran upon request.

(Sec. 332) Directs the Secretary to report to the veterans' committees on the feasibility and desirability of providing: (1) for the collocation of Vet Centers and outpatient clinics of the Department as current leases for such centers and clinics expire; and (2) a limited battery of health care services to veterans at Department readjustment counseling centers.

(Sec. 333) Establishes in the Department the Advisory Committee on the Readjustment of Veterans to perform advisory services with respect to veterans' readjustment, taking into special account the needs of veterans who have served in a theater of combat operations. Requires specified reports from the Advisory Committee and the Secretary.

(Sec. 334) Directs the Secretary to establish and operate centers for mental illness research, education, and clinical activities to represent various U.S. geographic regions. Allows the designation of no more than five centers. Outlines requirements for proposals submitted for designation as a center. Requires the Veterans Health Administration (VHA) official responsible for mental health and behavioral sciences matters to establish a peer review panel to assess the scientific and clinical merit of such proposals. Requires the Under Secretary for Health of the Department (Under Secretary) to ensure that at least three centers emphasize research into improving the quality of care for veterans suffering from mental illness through the development of community-based alternatives to institutional treatment. Requires the dissemination of information obtained through mental illness research. Authorizes appropriations for FY 1998 through 2001 for basic support of center activities. Directs the Under Secretary to allocate other Department funds for such centers. Requires annual reports. Requires at least one center to be designated by January 1, 1998.

(Sec. 335) Directs the Secretary to establish in the VHA a Committee on Care of Severely Chronically Mentally Ill Veterans, which shall continually assess the capability of VHA to meet the treatment and rehabilitation needs of mentally ill veterans (including women) whose mental illnesses are severe and chronic and who are eligible for health care furnished by the Department. Requires various reports with respect to such Committee and its assessments.

Subtitle D: Other Provisions - Directs the Secretary to conduct a research study to: (1) determine the desirability of furnishing hospice care to terminally ill veterans; and (2) evaluate the most cost-effective and efficient way to do so. Requires a report to the veterans' committees.

(Sec. 342) Authorizes the Secretary to pay each State a per diem rate for each veteran receiving adult day health care in a State home.

(Sec. 343) Extends through December 31, 2000, the authority to establish Department research corporations. Removes the requirement that such corporations must, within a four-year period following their establishment, be recognized by the Internal Revenue Service as a tax-exempt organization specifically under section 501(c)(3) of the Internal Revenue Code or be dissolved (thereby allowing such corporations to remain established if so recognized under any Code provision). Revises reporting requirements with respect to the establishment of such corporations.

(Sec. 344) Requires the Office of the Under Secretary to be staffed to provide expertise in the treatment and rehabilitation of disabled veterans and appropriate clinical care disciplines.

(Sec. 345) Authorizes the use of disbursement agreements for the administration of pay, benefits, and records of medical residents and interns serving in Department facilities furnishing hospital care or medical services (currently, in Department hospitals).

(Sec. 346) Authorizes the Secretary to suspend special pay agreements in the case of Department physicians and dentists who enter residency training programs, such suspension to last for the duration of the program.

(Sec. 347) Repeals a Federal provision prohibiting certain Department health-care personnel from providing care and treatment to patients other than patients at a Department facility.

(Sec. 348) Authorizes the Secretary to allow Milwaukee County, Wisconsin, to transfer certain real property conveyed to it in 1954 to another party for civic and recreational purposes.

(Sec. 349) Authorizes the Secretary to modify reversionary interests to permit Cheyenne, Wyoming, to grant all or part of specified land to the Cheyenne Federal Credit Union.

(Sec. 350) Designates the Mountain Home Department of Veterans Affairs medical center in Johnson City, Tennessee, as the James H. Quillen Department of Veterans Affairs Medical Center.

(Sec. 351) Directs the Secretary to report to the veterans' committees on the health care needs of veterans in east central Florida, including their need for psychiatric and long-term care. Prohibits the obligation of funds for the conversion of the former Orlando Naval Training Center Hospital in Orlando, Florida, until 45 days after such report is submitted.

(Sec. 352) Amends the Persian Gulf War Veterans' Benefits Act to extend through December 31, 1998, the authority for a Department evaluation of the health status of spouses and children of Persian Gulf War veterans. Ratifies any diagnostic testing and medical examinations undertaken for such study during the period beginning on October 1, 1996, and ending on the date of enactment of this Act.