Veterans Health Care Full Funding Act - Requires each fiscal year budget submitted to Congress by the President to include requests for amounts for veterans health care programs. Requires amounts appropriated for such programs to be available for two consecutive fiscal years.
Establishes the Veterans Health Care Funding Review Board within the Department of Veterans Affairs. Directs the Board, beginning with FY 2005, to determine the level of funding needed for such programs for that fiscal year and the next and to publish such determination in the Federal Register. Outlines veterans' health care needs factors to be considered by the Board in arriving at such determination.
Repeals requirements for certain congressional notifications in connection with a funding request for a Department major medical facility project or lease.
Provides a 30-day standard for access to medical care for veterans seeking primary or specialized care, as measured from: (1) the time the veteran contacts the Department seeking an appointment until the date a visit is completed (primary care); and (2) the date on which the veteran is referred to a specialist until the date a visit is completed (specialty care). Directs the Secretary of Veterans Affairs to develop a standard of waiting time during a visit and to periodically review the performance of Department facilities compared to that standard.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2475 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 2475
To amend title 38, United States Code, to provide an enhanced funding
process to ensure an adequate level of funding for veterans health care
programs of the Department of Veterans Affairs, to establish standards
of access to care for veterans seeking health care from the Department
of Veterans Affairs, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 16, 2003
Mr. Smith of New Jersey (for himself, Mr. Simmons, Mr. Brown of South
Carolina, Mr. Baker, Mr. Miller of Florida, Mr. Boozman, Mr. Bradley of
New Hampshire, Ms. Ginny Brown-Waite of Florida, Mr. Renzi, Mr. Murphy,
Mr. Gibbons, Mr. Tom Davis of Virginia, Mr. Goss, Mr. LaHood, Mr.
Hefley, Mr. Jones of North Carolina, Mr. Pickering, Mr. Pallone, Mr.
Gillmor, Mr. Pearce, Mr. LoBiondo, Mrs. Jo Ann Davis of Virginia, Mr.
Terry, Mrs. Kelly, Mr. Issa, Mrs. Capito, Mr. Vitter, Mr. Calvert, Mr.
Jenkins, Mr. Gilchrest, Mr. Paul, Mr. King of New York, Mr. Houghton,
Mr. Platts, Ms. Hart, Mr. Wilson of South Carolina, Mr. Whitfield, Mr.
Hayes, and Mr. Saxton) introduced the following bill; which was
referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to provide an enhanced funding
process to ensure an adequate level of funding for veterans health care
programs of the Department of Veterans Affairs, to establish standards
of access to care for veterans seeking health care from the Department
of Veterans Affairs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Veterans Health Care Full Funding
Act''.
SEC. 2. ENHANCED PROCESS FOR FUNDING VETERANS HEALTH CARE PROGRAMS.
(a) In General.--(1) Chapter 3 of title 38, United States Code, is
amended by adding at the end the following new section:
``Sec. 320. Enhanced funding process for veterans health care
``(a) In the President's budget for each fiscal year transmitted
under section 1105 of title 31, amounts shall be requested for veterans
health care programs in accordance with this section. Amounts
appropriated for veterans health care programs shall be available for
obligation for a period of two consecutive fiscal years.
``(b)(1) For each fiscal year (beginning with fiscal year 2005),
the Veterans Health Care Funding Review Board shall determine the level
of funding needed for veterans health care programs for that fiscal
year and the next fiscal year. The Board shall make such determination,
and shall publish such determination in the Federal Register, not later
than November 1 of the year preceding the year in which the budget for
such fiscal year is transmitted to Congress.
``(2) In making any such determination under paragraph (1), the
Board shall take into consideration the most recent information
relating to economic assumptions provided to the Board by the Director
of the Office of Management and Budget pursuant to subsection
(f)(4)(b).
``(c) The amount determined under subsection (b) for any two-
fiscal-year period is the amount needed to be appropriated to the
Department for that two-fiscal-year period for veterans health care
programs. The President shall include the full amount so determined in
the budget transmitted to Congress under section 1105 of title 31 for
the first fiscal year in such two-year period and shall include the
amount of the second fiscal year as a budget forecast year.
``(d)(1) The Board shall make its determination of the level of
funding needed for veterans health care programs for any two-fiscal-
year period under subsection (b) based upon an annual review of those
programs and of veterans health care needs.
``(2) The Board shall ensure that its determination of the level of
funding needed for veterans health care programs for any period is in
an amount sufficient to provide for--
``(A) the health care needs of veterans estimated to be
enrolled in the Department health care system under section
1705(a) of this title (other than veterans described in
paragraph (8) of such section);
``(B) the health care needs of veterans with service-
connected disabilities who are not required to enroll in such
health care system;
``(C) timely access to health care under standards for
access prescribed under section 1703(d)(1) of this title;
``(D) maintenance of capacities of Department nursing home
facilities as required by section 1710B(b) of this title and of
specialized programs as required by section 1706(b)(1) of this
title;
``(E) the health care needs of persons eligible for
benefits under chapter 17 of this title based upon subchapter
VIII of that chapter;
``(F) the necessary maintenance, improvement, upgrading,
expanding, repairing, and replacing of major and minor medical
facilities, capital equipment, and systems to ensure that
health care facilities of the Department are adequate for the
purposes of programs and benefits authorized for the care of
veterans under chapter 17 of this title; and
``(G) unanticipated requirements, including--
``(i) changes in benefits;
``(ii) changes in beneficiaries;
``(iii) changes in economic conditions or
assumptions; and
``(iv) such other factors as the Board considers
appropriate.
``(3) Each such review under paragraph (1) shall consider--
``(A) demographic information;
``(B) utilization and cost trends for veterans enrolled
under section 1705 of this title and other Department health-
care beneficiaries;
``(C) requirements for support of other core missions of
the Department related to health care;
``(D) the degree of efficiency (or the lack of efficiency)
by which the Secretary actually delivers health care services
to veterans; and
``(E) such other factors as the Board considers
appropriate.
``(4)(A) The Board shall submit to Congress an annual report, not
later than the date on which the President transmits the budget to
Congress under section 1105 of title 31 each year, on its most recent
determination under subsection (b) and its most recent review under
paragraph (1).
``(B) The report shall include the following:
``(i) A statement of the amount determined for each of the
two fiscal years covered by such determination under subsection
(b).
``(ii) A description of the economic assumptions and other
assumptions made by the Board in making such determination and
how that determination was developed.
``(iii) Any recommendations to Congress or the Secretary
that the Board considers appropriate concerning the means and
methods for the Secretary to achieve optimal efficiencies or
savings in delivering health care to veterans.
``(5) Following the submission of the report under paragraph (4)
each year, the Board shall review and reconsider the matters contained
in the report and shall, during the five-day period ending on May 1 of
that year, submit to Congress a report updating the matters in the
report submitted under paragraph (4). The Board shall include in that
report any revision it considers appropriate to its most recent
determination under subsection (b), together with the reasons for any
such revision.
``(e) For purposes of this section, the term `veterans health care
programs' means programs, functions, and activities of the Veterans
Health Administration other than--
``(1) medical and prosthetic research; and
``(2) grants under subchapter III of chapter 81 of this
title.
``(f)(1) There is established in the Department of Veterans Affairs
a Veterans Health Care Funding Review Board. The Board shall consist of
three members who shall be appointed by the Secretary. Persons
appointed to the Board shall have professional backgrounds and
experience in health care policy analysis, health care statistics,
health care insurance, or health care economics or have similar
qualifications considered suitable by the Secretary.
``(2)(A) Except as provided in subparagraph (B), the members of the
Board shall serve for a term of 15 years, except that a member of the
Board appointed to fill a vacancy occurring before the end of the term
for which the member's predecessor was appointed shall only serve until
the end of such term. A member may serve after the end of the term of
the member until the successor of that member has taken office. A
member of the Board may be removed by the Secretary for misconduct or
failure to perform functions vested in the Board, and for no other
reason.
``(B) Of the members of the Board who are first appointed under
this paragraph, one each shall be appointed for terms ending five, ten,
and 15 years, respectively, after the date of appointment, as
designated by the Secretary at the time of appointment.
``(3) A member of the Board who is not otherwise an employee of the
United States is entitled to receive pay at the daily equivalent of the
annual rate of basic pay of the highest rate of basic pay under the
General Schedule of subchapter III of chapter 53 of title 5, for each
day the member is engaged in the performance of duties vested in the
Board, and is entitled to travel expenses, including a per diem
allowance, in accordance with section 5703 of title 5.
``(4)(A) The Secretary shall furnish the Board all papers, records,
information, and other materials it requires in order to carry out its
functions under this section.
``(B) The Director of the Office of Management and Budget shall
furnish to the Board complete information on the economic assumptions
(including assumptions as to inflation, unemployment, revenues and
expenses, and energy costs) that inform or guide the President's
overall budgetary presentation to Congress, including those assumptions
that would be expected to particularly affect health care costs in the
Department, or the cost of care to veterans.
``(5) Funds for the expenses of the Board for any fiscal year shall
be provided from amounts available for that fiscal year for veterans
health care programs. The Board shall include consideration of its own
budget requirements in determinations under subsection (b).''.
(2) The table of sections at the beginning of such chapter is
amended by adding at the end the following new item:
``320. Enhanced funding process for veterans health care.''.
(b) Effective Date.--Sections 320 of title 38, United States Code,
as added by subsection (a), shall take effect on January 1, 2004.
(c) Repeal of Construction Authorization Requirement.--Effective
October 1, 2004, subsections (a), (b), (c), and (d) of section 8104 of
title 38, United States Code, are repealed.
(d) Appointment of Initial Members of Board.--The initial
appointment of the members of the Board established under subsection
(f) of section 320 of title 38, United States Code, as added by
subsection (a), shall be completed not later than 90 days after the
date of the enactment of this Act.
(e) Initial Funding for Board.--For fiscal year 2004, the Secretary
of Veterans Affairs shall provide amounts needed for the operation of
the Board established under subsection (f) of section 320 of title 38,
United States Code, as added by subsection (a), in a total amount not
to exceed $2,000,000, from amounts appropriated to the Department of
Veterans Affairs for that fiscal year for Medical Care.
SEC. 3. ACCESS TO CARE STANDARDS.
(a) Required Standard for Access to Care.--Section 1703 of title
38, United States Code, is amended by adding at the end the following
new subsection:
``(d)(1) The following are the standards for access to care for the
Department:
``(A) For a veteran seeking primary care, the standard for
access is 30 days, determined from the date on which the
veteran contacts the Department seeking an appointment until
the date on which a visit with a primary care provider is
completed.
``(B) For a veteran seeking specialized care, the standard
for access is 30 days, determined from the date on which the
veteran is referred for specialty care by a primary care
provider until the date on which a visit with an appropriate
specialty primary care provider is completed.
``(2) The Secretary shall develop and disseminate an appropriate
standard of waiting time, determined from the time at which the
veteran's visit is scheduled until the veteran is seen by the provider.
The Secretary shall periodically review performance of Department
facilities compared to that standard. The Secretary shall annually
report to the Committees on Veterans' Affairs of the Senate and House
of Representatives an assessment of the Department's performance
against that standard.
``(3) In a case in which the Secretary is unable to meet the
standard for access to care, the Secretary shall use the authority of
subsection (a) to furnish health care and services for that veteran in
a non-Department facility.''.
(b) Effective Date.--The amendment made by subsection (a) shall
take effect on the first day of the first month beginning more than six
months after the date of the enactment of this Act.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Veterans' Affairs.
Referred to the Subcommittee on Health.
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