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The House Committee on Veterans' Affairs Subcommittee on Health recently held a legislative hearing on 12 bills addressing veterans' health care, five of which had a focus on improving rural access to care and three more focused on general access issues such as reducing waiting times for care.
“Since 2003, the number of patients VA is treating has grown from 4.8 million to an expected 5.8 million in fiscal year 2008,” said Jeff Miller (R-Fla.), subcommittee ranking member. “In 2008, VA anticipates treating 263,000 Operation Iraqi Freedom and Operation Enduring Freedom veterans, 25.8 percent more than the 2007 level. This surge in demand for health care is expected to continue and creates new challenges for VA's capacity to deliver both primary and specialty care.”
A summary of each bill, with the member of Congress introducing it, follows:
H.R. 92, Veterans Timely Access to Health Care Act; (Brown-Waite, R-Fla.)
• Makes the standard for access to care for a veteran seeking primary care from the Department of Veterans Affairs (VA) 30 days from the date the veteran contacts the department. Directs the Secretary of Veterans Affairs to prescribe an appropriate standard for waiting times at department health-care facilities as measured from the time a visit is scheduled until the time the veteran is seen.
• Directs VA to periodically review the performance of department health care facilities in meeting such standards. Authorizes VA to contract for health care services in non-department facilities in a case in which VA is unable to meet access standards. Prohibits such contracting-out with respect to a department geographic service area that has a compliance rate in meeting such standards of 90 percent or more.
• Requires quarterly reports from the secretary to the Congressional veterans' committees on the department's experience with respect to waiting times.
H.R. 315, Help Establish Access to Local Timely Healthcare for Your Vets (HEALTHY Vets) Act of 2007; (Pearce, R-N.M.)
• Directs the Secretary of Veterans Affairs, in the case of a veteran for whom VA medical facilities are geographically inaccessible, to use current authority for contracting out veterans' medical care to non-department facilities in order to provide the following care to such veterans: (1) primary care; (2) acute or chronic symptom management; (3) non-therapeutic medical services; and (4) other medical services determined appropriate by the director of that geographic service region, after consultation with the department physician responsible for the veteran's primary care.
• Outlines conditions under which department facilities shall be deemed geographically inaccessible.
• Authorizes VA to waive the requirement of geographic inaccessibility, on a case-by-case basis, if the costs to the department of providing such care significantly outweigh the benefits of localized health care for the veteran.
H.R. 339, Veterans Outpatient Care Access Act of 2007; (Duncan. R-Tenn.)
Directs the Secretary of Veterans Affairs to provide needed medical services from sources outside the VA when veterans are informed that the waiting period for such services in a department outpatient clinic will be six months or longer.
H.R. 463, Honor Our Commitment to Veterans Act; (Rothman, D-N.J.)
Directs the Secretary of Veterans Affairs to administer the health care enrollment system of the VA so as to enroll any eligible veteran who applies. (This directive in effect terminates an administrative freeze on the enrollment of veterans in the lowest priority enrollment category.)
H.R. 538, South Texas Veterans Access to Care Act of 2007; (Ortiz, D-Texas)
Directs the Secretary of Veterans Affairs to determine, and notify Congress, whether the needs of veterans for acute inpatient hospital care in 24 counties comprising Far South Texas shall be met through: (1) a public-private venture to provide such services and long-term care to veterans in an existing facility in Far South Texas; (2) a project for construction of a new full-service, 50-bed hospital with a 125-bed nursing home in Far South Texas; or (3) a sharing agreement with a military treatment facility in Far South Texas. Requires the secretary to take appropriate action depending on the option selected.
H.R. 542, to require the Department of Veterans Affairs to provide mental health services in languages other than English, as needed, for veterans with limited English proficiency, and for other purpose; (Solis, D-Calif.)
• Amends federal veterans' benefits provisions to direct the Secretary of Veterans Affairs, in providing counseling and other mental health services to a veteran who has limited proficiency in English, to ensure that such services are available in both English and a language in which that veteran is proficient, if requested by the veteran.
• Requires VA to implement a system by which persons with limited English proficiency can access services provided by the VA consistent with, and without unduly burdening, the department's fundamental mission.
• Requires a report from the secretary to the Congressional veterans' committees on the implementation by the department's Veterans Health Administration of a specified directive to implement prohibitions on discrimination on the basis of national origin for persons with limited English proficiency in federally-conducted programs and activities and in federal financial-assisted programs.
H.R. 1426, the Richard Helm Veterans' Access to Local Health Care Options and Resources Act; (Latham, R-Iowa)
• Allows a veteran enrolled in the VA annual patient enrollment system to elect to receive covered health services through a non-VA facility. (Currently, the Secretary of Veterans Affairs may contract for such services when VA facilities are not capable of furnishing economic hospital care or medical services because of geographical inaccessibility or are not capable of furnishing the care or services required.) Directs VA to authorize such services pursuant to a contract with such facility.
• Authorizes the secretary to furnish to veterans through a VA health care facility drugs and medicines ordered on prescription of a duly licensed private physician under contract with the VA.
H.R. 1471, Better Access to Chiropractors to Keep our Veterans Healthy Act (BACK Veterans Health Act); (Filner, D-Calif.)
• Includes chiropractic services and counseling, as well as periodic and preventative chiropractic examinations and services, among the medical, rehabilitative, and preventive health services available to veterans.
• Directs the Secretary of Veterans Affairs to permit eligible veterans to receive medical, rehabilitative, and preventative health services from a licensed doctor of chiropractic on a direct access basis at the election of the veteran, if such services are within the State scope of practice of such doctor. Prohibits VA from discriminating among licensed health-care providers in the determination of needed services.
H.R. 1527, the Rural Veterans Access to Care Act; (Moran, R-Kan.)
• Allows a highly rural veteran who is enrolled in the system of patient enrollment of the VA to elect to receive covered health services through a non-VA health care provider. Defines a "highly rural veteran" as one who: (1) resides more than 60 miles from the nearest VA facility providing primary care services, more than 120 miles from a VA facility providing acute hospital care, or more than 240 miles from a VA facility providing tertiary care (depending on which services the veteran needs); or (2) otherwise experiences such hardships or other difficulties in travel to the nearest appropriate VA facility that such travel is not in the best interest of the veteran.
• Directs the Secretary of Veterans Affairs to furnish to a highly rural veteran such drugs and medicines as may be ordered on prescription of a duly licensed physician in the treatment of any illness or injury.
H.R. 1944, Veterans Traumatic Brain Injury Treatment Act of 2007; (Altmire, D-Pa.)
• This bill directs VA to set up a program to screen veterans for traumatic brain injury (TBI).
• Directs VA to set up a comprehensive program for long-term traumatic brain injury rehabilitation.
• Directs VA to establish a TBI transition office at each of the 21 polytrauma network sites to coordinate the provision of health care services for veterans who suffer from a moderate to severe TBI and are in need of services not immediately offered at the VA.
• Establishes a TBI health registry for the purposes of research and to significant developments in the treatment of TBI.
Draft Rural Health Care Bill; (Michaud, D-Maine)
• Directs VA to conduct a pilot program for the operation of at least two mobile Vet Centers in rural areas.
• Establishes a health information technology pilot program to ensure a continuum of quality of care for rural veterans.
• Establishes an Advisory Committee on Rural Veterans.
• Establishes rural health research, education and clinical centers.
• Requires VA to enhance the education, training, retention, and recruitment of health professionals in rural areas.
“The discussion today on legislation that will help us provide us the best care for our veterans, whether it is through contract care, or requiring more VA medical centers to provide chiropractic services, was productive,” Miller said. “I look forward to working on a bipartisan basis with my colleagues to move forward legislation from among today's offerings that will truly help our veterans and their families.”
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