Rural Veterans Health Care Act of 2006 - Directs the Secretary of Veterans Affairs to: (1) conduct an outreach program to identify and provide information to veterans who served in Operations Iraqi Freedom or Enduring Freedom and who reside in rural communities in order to enroll those veterans in the Department of Veterans Affairs (VA) health care system; (2) expand access to Vet Centers in rural areas; (3) develop and implement a plan for improving veterans access to health care in rural areas; (4) establish a health information technology pilot program to ensure quality care for rural veterans through VA facilities; (5) establish the Advisory Committee on Rural Veterans; (6) designate at least four VA health care facilities as centers of rural health research, education, and clinical activities; (7) include rural veterans in a current VA grant program for homeless veterans with special needs; (8) enhance the education, training, retention, and recruitment of health professionals in rural areas; and (9) expand VA health care presence in Native American, Native Hawaiian, and Native Alaskan rural communities.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5524 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 5524
To amend title 38, United States Code, to improve health care for
veterans in rural areas, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 6, 2006
Mr. Michaud (for himself, Mr. Evans, Mr. Filner, Mr. Gutierrez, Ms.
Corrine Brown of Florida, Ms. Herseth, Mr. Strickland, Ms. Hooley, Mr.
Reyes, Mr. Udall of New Mexico, and Mr. Salazar) introduced the
following bill; which was referred to the Committee on Veterans'
Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to improve health care for
veterans in rural areas, 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 ``Rural Veterans Health Care Act of
2006''.
SEC. 2. OUTREACH PROGRAM TO VETERANS IN RURAL AREAS.
(a) Program.--The Secretary of Veterans Affairs shall conduct an
extensive outreach program to identify and provide information to
veterans who served in the theater of operations for Operation Iraqi
Freedom or Operation Enduring Freedom and who reside in rural
communities in order to enroll those veterans in the health care system
of the Department of Veterans Affairs during the period when they are
eligible for such enrollment.
(b) Features of Program.--In carrying out the program under
subsection (a), the Secretary shall seek to work at the local level
with employers, State agencies, community health centers located in
rural areas, rural health clinics, and critical access hospitals
located in rural areas, and units of the National Guard and other
reserve components based in rural areas, in order to increase the
awareness of veterans and their families of the availability of health
care provided by the Secretary and the means by which those veterans
can achieve access to the health care services provided by the
Department of Veterans Affairs.
SEC. 3. ACCESS TO VET CENTERS IN RURAL AREAS.
(a) Expansion of Access.--The Secretary of Veterans Affairs shall
expand access to Vet Centers in rural areas. In carrying out this
section, the Secretary shall conduct a pilot program for the operation
of at least two mobile Vet Centers in rural areas for a period of five
years.
(b) Vet Center Defined.--In this section, the term ``Vet Center''
has the meaning given the term ``center'' in section 1712A(i)(1) of
title 38, United States Code.
SEC. 4. QUALITY CARE IN RURAL AREAS.
(a) Requirement.--The Secretary of Veterans Affairs shall develop
and implement a plan for improving the access of veterans to health
care in rural areas. The plan shall be developed in consultation with
the Advisory Committee on Rural Veterans established under section 546
of title 38, United States Code, as added by section 6.
(b) Matters to Be Included.--The plan developed under subsection
(a) shall include the following:
(1) A review of progress in implementing the proposed 156
community-based outpatient clinics, and plans for further
implementation of those proposed clinics, that were included in
the May 2004 Secretary's CARES Decision Document, announcing
the implementation of the Department of Veterans Affairs health
care planning process called Capital Asset Realignment for
Enhanced Services (CARES), plans for establishment of
additional community-based outpatient clinics, and plans for
health-care outreach centers.
(2) Measures for meeting the long-term care needs of rural
veterans through nursing homes of the Department of Veterans
Affairs and State veterans homes.
(3) Expansion for rural veterans of the adult day-care and
respite care programs of the Department.
(4) Expansion for rural veterans of the use of telemedicine
to enhance care coordination and access to specialized care for
such veterans.
(5) Measures for meeting the needs of rural veterans for
mental health care.
(c) Timetable.--The plan required by subsection (a) shall be
submitted to Congress not later than nine months after the date of the
enactment of this Act and shall be implemented not later than two years
thereafter.
SEC. 5. HEALTH INFORMATION TECHNOLOGY.
The Secretary of Veterans Affairs shall establish a health
information technology pilot program to ensure a continuum of quality
of care for rural veterans who receive health care provided by the
Secretary both directly through facilities of the Department of
Veterans Affairs and as fee-basis care through non-Department providers
and facilities, including, where appropriate, community health centers,
rural health clinics, and critical access hospitals. The pilot program
shall be conducted for a period of four years.
SEC. 6. ADVISORY COMMITTEE ON RURAL VETERANS.
(a) New Advisory Committee.--Chapter 5 of title 38, United States
Code, is amended by adding at the end the following new section:
``Sec. 546. Advisory Committee on Rural Veterans
``(a)(1) The Secretary shall establish an advisory committee to be
known as the Advisory Committee on Rural Veterans (hereinafter in this
section referred to as `the Committee').
``(2)(A) The Committee shall consist of members appointed by the
Secretary from the general public, including--
``(i) representatives of rural veterans;
``(ii) individuals who are recognized authorities in fields
pertinent to the needs of rural veterans, including specific or
unique health-care needs of rural veterans and access issues of
rural veterans;
``(iii) individuals who have expertise in the delivery of
mental health care in rural areas;
``(iv) individuals who have expertise in the delivery of
long-term care in rural areas;
``(v) at least one veterans service organization
representative from a rural State; and
``(vi) representatives of rural veterans with service-
connected disabilities.
``(B) The Committee shall include, as ex officio members--
``(i) the Secretary of Health and Human Services (or a
representative of the Secretary of Health and Human Services
designated by that Secretary);
``(ii) the Director of the Indian Health Service (or a
representative of that Director); and
``(iii) the Under Secretary for Health and the Under
Secretary for Benefits, or their designees.
``(C) The Secretary may invite representatives of other departments
and agencies of the United States to participate in the meetings and
other activities of the Committee.
``(3) The Secretary shall determine the number, terms of service,
and pay and allowances of members of the Committee appointed by the
Secretary, except that a term of service of any such member may not
exceed three years. The Secretary may reappoint any such member for
additional terms of service.
``(b) The Secretary shall, on a regular basis, consult with and
seek the advice of the Committee with respect to the administration of
benefits by the Department for rural veterans, reports and studies
pertaining to rural veterans, and the needs of rural veterans with
respect to primary care, mental health care, and long-term care needs
of rural veterans.
``(c)(1) Not later than September 1 of each odd-numbered year
through 2013, the Committee shall submit to the Secretary a report on
the programs and activities of the Department that pertain to rural
veterans. Each such report shall include--
``(A) an assessment of the needs of rural veterans with
respect to primary care, mental health care, and long-term care
needs of rural veterans and other benefits and programs
administered by the Department;
``(B) a review of the programs and activities of the
Department designed to meet such needs; and
``(C) such recommendations (including recommendations for
administrative and legislative action) as the Committee
considers appropriate.
``(2) The Secretary shall, within 60 days after receiving each
report under paragraph (1), submit to the Congress a copy of the
report, together with any comments concerning the report that the
Secretary considers appropriate.
``(3) The Committee may also submit to the Secretary such other
reports and recommendations as the Committee considers appropriate.
``(4) The Secretary shall submit with each annual report submitted
to the Congress pursuant to section 529 of this title a summary of all
reports and recommendations of the Committee submitted to the Secretary
since the previous annual report of the Secretary submitted pursuant to
such section.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by adding at the end the following new item:
``546. Advisory Committee on Rural Veterans.''.
SEC. 7. RURAL HEALTH RESEARCH, EDUCATION, AND CLINICAL CARE CENTERS.
(a) In General.--(1) Subchapter II of chapter 73 of title 38,
United States Code, is amended by adding at the end the following new
section:
``Sec. 7329. Rural health research, education, and clinical care
centers
``(a) The Secretary, upon the recommendation of the Under Secretary
for Health and pursuant to the provisions of this section, shall
designate a minimum of four Department health care facilities as the
locations for centers of rural health research, education, and clinical
activities and (subject to the appropriation of sufficient funds for
such purpose) shall establish and operate such centers at such
locations in accordance with this section.
``(b) The centers established under this section shall--
``(1) conduct research on rural health services;
``(2) allow the Department to use specific models for
furnishing services to treat rural veterans;
``(3) provide education and training for health care
professionals of the Department; and
``(4) develop and implement innovative clinical activities
and systems of care for the Department.
``(c) In designating locations for centers under subsection (a),
the Secretary, upon the recommendation of the Under Secretary for
Health, shall--
``(1) assure appropriate geographic distribution of such
centers;
``(2) assure that one of the centers shall focus on mental
health, including substance abuse treatment;
``(3) assure that one of the centers shall focus on case
management of chronic diseases;
``(4) assure that one of the centers shall focus on
telemedicine; and
``(5) assure that at least one of the centers shall be
located to collaborate with a Rural Health Research Center of
the Department of Health and Human Services in a geographic
service area of the Department of Veterans Affairs that
includes several rural States.
``(d) The Secretary may not designate a health care facility as a
location for a center under subsection (a) unless the peer review panel
established under subsection (e) has determined under that subsection
that the proposal submitted by such facility as a location for a new
center under subsection (a) is among those proposals that have met the
highest competitive standards of scientific and clinical merit and the
Secretary (upon the recommendation of the Under Secretary for Health)
determines that the facility has (or may reasonably be anticipated to
develop) each of the following:
``(1) An arrangement under which medical, nursing, or
allied health personnel receive training and education in the
unique aspects of rural care through regular rotation through
rurally located facilities and community based outpatient
clinics.
``(2) The ability to attract the participation of
scientists and clinicians who are capable of ingenuity and
creativity in health care research efforts.
``(3) A policymaking advisory committee composed of
appropriate health care and research representatives of the
facility and of the affiliated school or schools to advise the
directors of such facility and such center on policy matters
pertaining to the activities of such center during the period
of the operation of such center.
``(4) The capability to coordinate, as part of an
integrated national system, education, clinical, and research
activities within all facilities with such centers.
``(5) The capability to jointly develop a consortium of
providers with interest in improving quality care in rural
areas.
``(6) The capability to develop a national repository for
the collection of best practices and evidenced based care to
rural veterans.
``(7) The capability to effectively conduct evaluations of
the activities of such center.
``(e)(1) In order to provide advice to assist the Secretary and the
Under Secretary for Health in carrying out their responsibilities under
this section, the Assistant Under Secretary for Health shall establish
a panel to assess the scientific and clinical merit of proposals that
are submitted to the Secretary for the establishment of new centers
under this section.
``(2) The membership of the panel shall consist of experts in the
fields pertinent to the needs of rural veterans, including mental
health care and long-term care. Members of the panel shall serve as
consultants to the Department for a period of no longer than six
months.
``(3) The panel shall review each proposal submitted to the panel
by the Assistant Under Secretary and shall submit its views on the
relative scientific and clinical merit of each such proposal to the
Assistant Under Secretary.
``(4) The panel shall not be subject to the Federal Advisory
Committee Act.
``(f) Before providing funds for the operation of any such center
at a health care facility other than a health care facility designated
under subsection (c)(1), the Secretary shall assure that the center at
each facility designated under such subsection is receiving adequate
funding to enable such center to function effectively in the areas of
rural health care research, education, and clinical activities.
``(g) There are authorized to be appropriated such sums as may be
necessary for the support of the research and education activities of
the centers established pursuant to subsection (a). The Under Secretary
for Health shall allocate to such centers from other funds appropriated
generally for the Department medical care account and medical and
prosthetics research account, as appropriate, such amounts as the Under
Secretary for Health determines appropriate.
``(h) Activities of clinical and scientific investigation at each
center established under subsection (a) shall be eligible to compete
for the award of funding from funds appropriated for the Department
medical and prosthetics research account and shall receive priority in
the award of funding from such account insofar as funds are awarded to
projects for research in rural health care.''.
(2) The table of sections at the beginning of such chapter is
amended by inserting after the item relating to section 7328 the
following new item:
``7329. Rural health research, education, and clinical care centers.''.
(b) Designation of Centers.--The Secretary of Veterans Affairs
shall designate the centers for rural health research, education, and
clinical activities required by section 7329 of title 38, United States
Code (as added by subsection (a)), not later than one year after the
date of the enactment of this Act.
(c) Annual Reports.--
(1) Annual report.--Not later than 18 months after the date
of the designation of centers for rural health research,
education, and clinical activities required by section 7329 of
title 38, United States Code (as so added), and annually
thereafter for the next three years, the Secretary shall submit
to the Committees on Veterans' Affairs of the Senate and House
of Representatives a report on the status and activities of
such centers during the one-year period beginning on the date
of such designation, for the first such report, and for
successive one-year periods, for subsequent reports.
(2) Matter to be included.--Each such report shall include,
for the period covered by the report, the following:
(A) A description of the activities carried out at
each center and the funding provided for such
activities.
(B) A description of any advances made in the
participating programs of each center in research,
education, training, and clinical activities related to
rural health.
SEC. 8. HOMELESS RURAL VETERANS.
Section 2061(b) of title 38, United States Code, is amended--
(1) by striking ``or'' at the end of paragraph (3);
(2) by striking the period at the end of paragraph (4) and
inserting ``; and''; and
(3) by adding at the end the following new paragraph:
``(5) rural.''.
SEC. 9. RURAL EDUCATION AND TRAINING OF HEALTH PROFESSIONALS.
The Secretary of Veterans Affairs shall carry out activities to
enhance the education, training, retention, and recruitment of health
professionals in rural areas. As part of such activities, the Secretary
shall--
(1) establish additional rotations for medical residents in
rural areas;
(2) establish programs to enhance the education, training,
recruitment, and retention of nurses in rural areas; and
(3) establish programs to enhance the education, training,
recruitment, and retention of allied health professionals in
rural areas.
SEC. 10. NATIVE AMERICANS.
The Secretary of Veterans Affairs shall expand the health care
presence of the Department of Veterans Affairs in Native American,
Native Hawaiian, and Native Alaskan rural communities in order to
improve access to Department of Veterans Affairs health care services
for veterans in those communities.
<all>
Introduced in House
Introduced in House
Sponsor introductory remarks on measure. (CR E1024-1025)
Referred to the House Committee on Veterans' Affairs.
Referred to the Subcommittee on Health.
Sponsor introductory remarks on measure. (CR E1510)
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