Bill summaries are authored by CRS.

Shown Here:
Conference report filed in House (11/16/1999)

Veterans' Millennium Health Care and Benefits Act - Title I: Access to Care - Subtitle A: Long-Term Care - Directs the Secretary of Veterans Affairs (Secretary), through December 31, 2003, to provide nursing home care to any veteran in need of such care: (1) for a service-connected disability; or (2) who has a service-connected disability rated at 70 percent or more. Prohibits a veteran receiving such care from being transferred from the providing facility without the consent of the veteran or his or her representative.

Includes noninstitutional extended care services within the definition of "medical services" authorized to be provided to eligible veterans through the above date.

Directs the Secretary to operate and maintain a program to provide the following extended care services to eligible veterans: (1) geriatric evaluation; (2) nursing home care, either in facilities of the Department of Veterans Affairs or in community-based facilities; (3) domiciliary services; (4) adult day health care; (5) noninstitutional alternatives to nursing home care; and (6) respite care. Prohibits the Secretary from furnishing such services for a non-service-connected disability unless the veteran agrees to make a copayment for services of more than 21 days in a year. Requires the Secretary to establish a methodology for establishing the copayment amount. Establishes in the Treasury the Department of Veterans Affairs Extended Care Fund for deposits and disbursements to cover such care.

Authorizes the Secretary to furnish adult day health care to veterans enrolled in the Department's annual patient enrollment system who would otherwise require nursing home care.

Authorizes the Secretary to furnish respite care services through contract arrangements.

Requires the Secretary to report to the congressional veterans' committees on the operation of this section.

(Sec. 102) Directs the Secretary to carry out three pilot programs to determine the effectiveness of different models of all-inclusive care-delivery in reducing the use of hospital and nursing home care by frail, elderly veterans. Requires the Secretary, under one pilot program, to provide services to eligible veterans: (1) directly through Department facilities and personnel; (2) through a combination of services provided under contract with appropriate public and private entities and those provided through Department facilities and personnel; and (3) through a combination of services provided through cooperative arrangements with appropriate public and private entities and services provided through Department facilities and personnel. Terminates each pilot program three years after its commencement. Requires a report from the Secretary to the veterans' committees.

(Sec. 103) Authorizes the Secretary to carry out a pilot program to determine the feasibility and practicability of enabling eligible veterans to secure needed assisted living services as an alternative to nursing home care. Requires such program to be carried out at a designated Department health care region selected by the Secretary. Authorizes the Secretary, under such program, to enter into contractual arrangements for the provision of up to six months of assisted living services for eligible veterans. Requires a program report from the Secretary to the veterans' committees. Terminates such program three years after its commencement.

Subtitle B: Other Access-to-Care Matters - Authorizes the Secretary to reimburse for the reasonable value of emergency treatment furnished in a non-Department facility those veterans who are active Department health-care participants (enrolled in the annual patient enrollment system and recipients of Department hospital, nursing home, or domiciliary care under such system within the last 24-month period) and who are personally liable for such treatment. Provides reimbursement limitations. Provides an independent right of recovery for the United States when a third party subsequently makes a payment for the same treatment. Requires the veteran to notify the Secretary of any third party payment. Authorizes the Secretary to waive recovery of such payment in the best interests of the United States. Requires the Secretary to include in FY 2002 and 2003 budget justification materials a report on the implementation of the reimbursement program.

(Sec. 112) Requires the Secretary to furnish hospital and medical services, and authorizes the Secretary to furnish nursing home care, to any veteran awarded a Purple Heart.

(Sec. 113) Directs the Secretary of Defense to enter into an agreement with the Secretary for reimbursement to the Secretary for medical care provided by the Department to military retirees eligible for care under the TRICARE Program (a Department of Defense managed health care program). Provides agreement conditions and limitations. Requires such agreement to be entered into within nine months after enactment of this Act. Directs the Secretary of Defense to include in each future TRICARE contract provisions to implement such agreement.

(Sec. 114) Removes certain restrictions on the authorized use of Department facilities to treat military personnel for an alcohol or drug dependence or abuse disability.

(Sec. 115) Revises a program providing counseling and treatment for veterans who have experienced sexual trauma to: (1) extend such program through calendar year 2004; (2) require (currently authorizes) the Secretary to provide such care and services to those in need; and (3) ensure that information about such care and services is revised and updated and made available through appropriate means (requiring a report from the Secretary to the veterans' committees on implementation of such outreach efforts).

Requires the Secretary to: (1) study, and report to the veterans' committees on, the possibility of extending eligibility for such care and services to former reserve personnel; and (2) report to such committees on implementation of the sexual trauma program. Requires the Secretary and the Secretary of Defense to jointly report to the appropriate congressional committees describing the efforts of their respective departments to ensure that military personnel, upon separation, are provided appropriate and current information about such counseling and treatment programs, including eligibility requirements and application procedures.

(Sec. 116) Directs the Secretary to carry out a program to enhance the provision of specialized mental health services to veterans, including programs relating to the treatment of post-traumatic stress disorder and substance abuse disorders. Requires: (1) a minimum of $15 million to be allocated for such program; and (2) a report from the Secretary to the veterans' committees on program implementation.

Title II: Medical Program Administration - Authorizes the Secretary, with respect to required copayments by veterans for medication furnished by the Department on an outpatient basis for the treatment of a nonservice-connected disability or condition, to: (1) increase the amount of such copayment (currently $2 for each 30-day supply of medication); and (2) establish maximum monthly and annual copayments for veterans who have multiple outpatient prescriptions.

(Sec. 202) Establishes in the Treasury the Department of Veterans Affairs Health Services Improvement Fund for the deposit and disbursement of funds used for improving various health services to veterans, including services under this Act.

(Sec. 203) Allows amounts from the Department of Veterans Affairs Medical Care Collections Fund to be distributed to each Department medical facility (currently, each designated health care region).

(Sec. 204) Revises provisions establishing nonprofit research corporations at Department medical centers to: (1) authorize such corporations to provide education and training to Veterans Health Administration (VHA) health-care personnel; (2) include additional personnel on its board of directors; and (3) prohibit such corporations from expending funds for an education activity unless it is approved under procedures prescribed by the Department's Under Secretary for Health.

(Sec. 205) Extends through calendar year 2003 the veterans' readjustment counseling program. Amends the Persian Gulf War Veterans' Benefits Act to extend through such year: (1) a newsletter concerning medical care furnished to Persian Gulf War veterans; and (2) a program for evaluating the health of spouses and children of such veterans.

(Sec. 206) Amends the Veterans' Health Care Act of 1984 to extend certain required reports concerning the provision of care to veterans suffering from post-traumatic stress disorder.

(Sec. 207) Directs the Secretary to prescribe for each State the number of nursing home and domiciliary beds for which assistance under veterans' domiciliary, nursing home, and hospital care may be authorized. Requires such number to be based on the projected demand for such care ten years after enactment of this Act by veterans who are 65 years old or older. Directs the Secretary, with respect to State applications for the construction or acquisition of new nursing facilities or the replacement or increase of beds at a current facility, to characterize the need of such facility as great, significant, or limited and to grant applications accordingly. Allows financial assistance only for renovation projects for which total construction costs are in excess of $400,000. Outlines State application requirements for such projects or assistance.

(Sec. 208) Adds as a required condition to the authority of the Secretary to enter into an enhanced-use lease (the leasing of Department property not currently used by the Department) the Secretary's determination that the business plan proposed by the Under Secretary for Health for applying lease payments to the provision of medical care and services demonstrably improves services to eligible veterans in the geographic service-delivery area within which the leased property is located. Increases to 75 years the maximum authorized term for such leases. Requires funds received under such a lease and remaining after expense deductions to be deposited in the Department of Veterans Affairs Health Services Improvement Fund and used for authorized purposes. Extends through December 31, 2011, the authority to enter into such leases. Directs the Secretary to: (1) provide appropriate training and outreach to personnel of Department medical facilities regarding enhanced-use lease authority; and (2) secure an independent analysis of Department opportunities for using such lease authority.

(Sec. 209) Makes ineligible for employment as a VHA health-care professional an individual who was licensed, registered, or certified to practice in more than one State when any of those States has since terminated such license, registration, or certification.

(Sec. 210) Directs the Secretaries of Veterans Affairs and Defense to report jointly to the veterans' and defense committees on cooperation between their respective departments in the procurement of pharmaceuticals and medical supplies.

(Sec. 211) Directs the Secretary, during the one-year period beginning on the date of enactment of this Act, to use the fee-for-service payment schedule for the reimbursement of medical expenses of veterans in Alaska rather than the Participating Physician Fee Schedule under the Medicare program. Requires a joint report from the Secretaries of Veterans Affairs and Health and Human Services to the veterans' committees on the use of the latter program to calculate such reimbursement rates.

Title III: Miscellaneous Medical Provisions - Prohibits the Secretary from closing in any fiscal year more than 50 percent of the beds within a Department medical center unless the Secretary first submits to the veterans' committees a justification for such closure. Prohibits any such closure until 21 days after submission of the report. Requires the Secretary to report annually to such committees on bed closures during the preceding fiscal year.

(Sec. 302) Revises provisions concerning the Veterans Canteen Service to remove a provision limiting such services to the sales of merchandise and services for consumption and use on the premises.

(Sec. 303) Requires the Department's Under Secretary for Health to establish a VHA policy regarding the role of chiropractic treatment in the care of veterans.

(Sec. 304) Designates the hospital bed replacement facility under construction at the Ioannis A. Lougaris Department of Veterans Affairs Medical Center in Reno, Nevada, as the Jack Streeter Building.

Title IV: Construction and Facilities Matters - Authorizes the Secretary to: (1) carry out major medical facility projects in Lebanon, Pennsylvania; Fargo, North Dakota; Kansas City, Missouri; Atlanta, Georgia; Leavenworth, Kansas; and Orlando, Florida; and (2) enter into leases for medical facilities at Lubbock, Texas, and San Diego, California.

(Sec. 403) Authorizes appropriations for FY 2000 and 2001 for the Construction, Major Projects, account and the Medical Care account.

Title V: Benefits and Employment Matters - Subtitle A: Compensation and DIC - John William Rolen Act - Authorizes the payment of dependency and indemnity compensation (DIC) for the surviving spouse of a former prisoner of war whose disability was continuously rated as totally disabling for the one-year period immediately preceding death.

(Sec. 502) States that the remarriage of the surviving spouse of a veteran shall not bar the furnishing of the following benefits to such person if the remarriage has been terminated by death or divorce, unless the Secretary determines that the divorce was secured through fraud or collusion: (1) DIC; (2) medical care for survivors and dependents of certain veterans; (3) educational assistance; and (4) housing loans.

(Sec. 503) Includes bronchiolo-alveolar carcinoma within the list of diseases presumed to be service-connected, in the case of exposure to ionizing radiation, and therefore compensable for purposes of veterans' disability compensation and medical care.

Subtitle B: Employment - Amends Federal employment law to provide for the competitive and appointment status of preference eligible veterans.

Title VI: Memorial Affairs Matters - Subtitle A: American Battle Monuments Commission - Directs the American Battle Monuments Commission to solicit and accept contributions for establishing the World War II memorial in the District of Columbia or its environs (authorized under prior law). Establishes in the Treasury a fund to hold and expend such contributions. Authorizes the Commission to: (1) borrow up to $65 million from the Treasury to ensure that memorial groundbreaking, construction, and dedication are completed on a timely basis; and (2) accept voluntary services in furtherance of fund-raising activities (authorizing reimbursement of volunteer incidental expenses). Extends until December 31, 2005 (currently, May 25, 2000) the authority to construct the memorial.

(Sec. 602) Revises current Commission authority to receive State, local, and private amounts for establishing the memorial to: (1) authorize the Commission to solicit (currently, only receive) such contributions; and (2) require the deposit of such amounts in a separate Treasury account. Requires the Commission to establish written guidelines for the acceptance of funds and in-kind contributions.

(Sec. 603) Authorizes the Commission to adopt, obtain, use, register, and license trademarks, copyrights, and patents in connection with intellectual property and related items.

Subtitle B: National Cemeteries - Directs the Secretary to establish a national cemetery in each of the six areas of the United States determined to be in most need of such a cemetery to serve the needs of veterans and their families. Obligates FY 2000 funds for such projects. Requires reports from the Secretary to Congress on the establishment of such cemeteries.

(Sec. 612) Authorizes the Secretary to provide for flat grave markers at the Santa Fe National Cemetery, New Mexico.

(Sec. 613) Directs the Secretary to contract with one or more qualified organizations to conduct an independent study of national cemeteries, including repairs needed and additional cemeteries required. Requires a report from the organization to the Secretary, and from the Secretary to the veterans' committees.

Subtitle C: Burial Benefits - Directs the Secretary to contract with one or more qualified organizations to conduct a study for improvements to veterans' burial benefits. Requires a report from the organization to the Secretary, and from the Secretary to the veterans' committees.

Title VII: Education and Housing Matters - Subtitle A: Education Matters - Amends Federal veterans' educational assistance benefits provisions to authorize the use of such benefits for preparatory courses for tests for admission to colleges and graduate schools.

(Sec. 702) Continues eligibility for basic educational assistance benefits under the Montgomery GI Bill for individuals who are discharged from enlisted or warrant officer service for immediate reenlistment to accept, without a break in service, a commission as an officer for a period of active duty.

(Sec. 703) Directs the Secretary to report to the veterans' committees on veterans' education and vocational training benefits provided by the States.

Subtitle B: Housing Matters - Extends through September 30, 2007 (currently September 30, 2003) the eligibility of certain former members of the Selected Reserve for veterans' housing loans.

Title VIII: Department of Veterans Affairs Administrative Matters - Directs the Secretary to carry out a quality assurance program in the Veterans Benefits Administration of the Department, either through a single division or separate quality assurance entities. Requires: (1) the Under Secretary for Benefits to perform and oversee quality reviews of the Administration's organizational elements; (2) an adequate number of quality assurance personnel within the Administration; and (3) an annual report from the Secretary to Congress on quality assurance activities.

(Sec. 802) Extends through December 31, 2003: (1) the authority to maintain a regional office in the Republic of the Philippines; and (2) the Advisory Committee on Minority Veterans.

Title IX: Homeless Veterans Programs - Directs the Secretary to conduct, directly or by grant or contract, programs to expedite the reintegration of homeless veterans into the labor force. Authorizes the Secretary to monitor the expenditure of funds under such programs. Authorizes appropriations for FY 2000 through 2003.

(Sec. 902) Extends through December 31, 2003, a program for furnishing housing assistance for homeless veterans.

(Sec. 903) Amends the Homeless Veterans Comprehensive Service Programs Act of 1992 to: (1) extend through FY 2003 the authority to make grants for housing assistance for homeless veterans; and (2) authorize appropriations for such grants for FY 2000 and 2001.

(Sec. 904) Directs the Secretary to report to the veterans' committees a detailed plan for evaluating the effectiveness of programs to assist homeless veterans.

Title X: United States Court of Appeals for Veterans Claims - Court of Appeals for Veterans Claims Amendments of 1999 - Subtitle A: Transitional Provisions to Stagger Terms of Judges - Allows one eligible judge of the Court of Appeals for Veterans Claims (Court) to retire in 2000 or 2001, and one additional judge to retire in 2001. Provides early retirement requirements. Requires the judge to: (1) notify the President and the Court's chief judge of the intent to retire; and (2) retire during the calendar year in which notification is provided, but not earlier than 30 days following such notification. Makes recall-eligible retired judges and judges who were removed from such eligibility due to disability eligible for annual adjustments in judges' retired pay as provided by law. Requires a judge retiring early to continue to serve until a successor is appointed or the date on which the judge's original appointment would have expired, whichever is earlier. Allows a judge, during such transitional service, to continue to accrue retirement credit. Requires such judges to receive a combination of salary and retirement benefits equal to the pay of other judges.

(Sec. 1012) Makes the term of office of the first two judges appointed to the Court after the enactment of this Act 13 years. Makes such judges eligible for retirement after such 13-year (currently 15-year) period.

Subtitle B: Other Matters Relating to Retired Judges - Authorizes a retired Court judge to be recalled for further service if such judge, at the time of retirement, provided written notice of such judge's availability for further service. Allows the Court chief judge to recall such a judge if substantial service is expected to be performed for the recall period. Prohibits a recalled judge from serving for more than 90 days in a calendar year without the judge's consent or for more than 180 days during a calendar year in any event. Requires a chief judge to remove from the recall-eligible list a judge who: (1) is recalled but declines; or (2) becomes permanently disabled and unable to perform judicial service.

(Sec. 1022) Provides retired pay computation for judges who were recall-eligible but lost such status and for judges who chose not to provide a notice of availability for recall. Allows for a cost-of-living adjustment to the retired pay of a Court judge only up to an amount that would make the retired pay equal to the pay received by a current Court judge.

(Sec. 1023) Makes a surviving spouse of a Court judge eligible for a survivor annuity after being married for at least one year (currently, two years) before such judge's death. Allows a Court judge to elect to participate in a survivor annuity within six months after marriage if such judge has retired. Reduces the percentage of pay reduction required of active judges as contributions toward retirement annuities.

Prohibits interest payments on retirement pay reductions in the case of Court judges for any period during which such judges: (1) were separated from judicial service or service as a Member of Congress or congressional employee; and (2) were not receiving retired pay or annuities based on such service.

Allows a surviving annuity to be paid to the survivors of a judge who dies after having rendered at least 18 months (currently, five years) of creditable civilian service. Allows a survivor annuity without a creditable service requirement in the case of a judge who is assassinated. Repeals a current requirement that a surviving spouse be at least 50 years of age before receiving such annuity.

(Sec. 1024) States that a recall-eligible retired Court judge who legally represents a client in a claim for veterans' benefits shall be considered to have declined recall service and be removed from recall-eligible status.

Subtitle C: Rotation of Service of Judges as Chief Judge of the Court - Eliminates the requirement of a separate appointment to the position of chief judge. Designates as chief judge the most senior judge of the Court. Requires such chief judge to serve in such position for five years or until becoming 70 years of age, after which the next most senior judge would assume such duties.

(Sec. 1033) Requires Court judge salaries to be the same as U.S. district court judges.

Title XI: Voluntary Separation Incentive Program - Department of Veterans Affairs Employment Reduction Assistance Act of 1999 - Requires the Secretary, before obligating any funds for the payment of voluntary separation incentive payments under this title, to submit to the Director of the Office of Management and Budget an operational plan concerning such payments. Limits the number of Department personnel and elements to which such plan may apply. Requires plan approval by the Director.

(Sec. 1103) Authorizes the Secretary to pay a voluntary separation incentive payment to a Department employee who has been employed continuously for at least three years only: (1) to the extent necessary to reduce or restructure the positions and functions identified in the approved plan; and (2) if the Under Secretary or staff head concerned approves such payment to such employee.

(Sec. 1104) Requires an individual who accepts such a payment and is reemployed with the Federal Government within five years to repay, before such reemployment, the entire amount of such payment. Authorizes the waiver of such repayment for certain individuals possessing unique abilities who are the only qualified applicants.

(Sec. 1105) Requires the Secretary to contribute a specified amount to the Civil Service Retirement and Disability Fund as agency contributions toward retirement annuities for such separated personnel.

(Sec. 1106) Provides continued health insurance coverage for individuals involuntarily separated from a position in the Department due to a reduction in force or a staffing readjustment.

(Sec. 1107) Prohibits the total full-time equivalent employment in the Department from being reduced by reason of the separation of such employees.

(Sec. 1109) Prohibits any separation incentive payment from being made under this title based on the separation of an employee after December 31, 2000.