A bill to amend chapter 17 of title 38, United States Code, to establish a program of rural health-care clinics, and for other purposes.

Summary: Directs the Secretary of Veterans Affairs, during the three-year period beginning on October 1, 1993, to conduct a rural health-care clinic program in States where significant numbers of veterans reside in areas geographically remote from existing health-care facilities of the Department of Veterans Affairs.  Directs the Secretary to commence operation of at least three such clinics in each fiscal year of the program.  Directs the Secretary to report to the Congress on an evaluation of the program. 
Authorizes appropriations.

SECTION 1. RURAL HEALTH-CARE CLINIC PROGRAM.

    (a) Program.--(1) Chapter 17 of title 38, United States Code, is 
amended by adding at the end of subchapter II the following new 
section:
``Sec. 1720E. Rural health-care clinics: pilot program
    ``(a) During the three-year period beginning on October 1, 1993, 
the Secretary shall conduct a rural health-care clinic program in 
States where significant numbers of veterans reside in areas 
geographically remote from existing health-care facilities (as 
determined by the Secretary). The Secretary shall conduct the program 
in accordance with this section.
    ``(b)(1) In carrying out the rural health-care clinic program, the 
Secretary shall furnish medical services to the veterans described in 
subsection (c) through use of--
            ``(A) mobile health-care clinics equipped, operated, and 
        maintained by personnel of the Department; and
            ``(B) other types of rural clinics, including part-time 
        stationary clinics for which the Secretary contracts and part-
        time stationary clinics operated by personnel of the 
        Department.
    ``(2) The Secretary shall furnish services under the rural health-
care clinic program in areas--
            ``(A) that are more than 100 miles from a Department 
        general health-care facility; and
            ``(B) that are less than 100 miles from such a facility, if 
        the Secretary determines that the furnishing of such services 
        in such areas is appropriate.
    ``(c) A veteran eligible to receive medical services through rural 
health-care clinics under the program is any veteran eligible for 
medical services under section 1712 of this title.
    ``(d) The Secretary shall commence operation of at least three 
rural health-care clinics (at least one of which shall be a mobile 
health-care clinic) in each fiscal year of the program. The Secretary 
may not operate more than one mobile health-care clinic under the 
authority of this section in any State in any such fiscal year.
    ``(e) Not later than December 31, 1997, the Secretary shall submit 
to Congress a report containing an evaluation of the program. The 
report shall include the following:
            ``(1) A description of the program, including information 
        with respect to--
                    ``(A) the number and type of rural health-care 
                clinics operated under the program;
                    ``(B) the States in which such clinics were 
                operated;
                    ``(C) the medical services furnished under the 
                program, including a detailed specification of the cost 
                of such services;
                    ``(D) the veterans who were furnished services 
                under the program, setting forth (i) the numbers and 
                percentages of the veterans who had service-connected 
                disabilities, (ii) of the veterans having such 
                disabilities, the numbers and percentages who were 
                furnished care for such disabilities, (iii) the ages of 
                the veterans, (iv) taking into account the veterans' 
                past use of Department health-care facilities, an 
                analysis of the extent to which the veterans would have 
                received medical services from the Department outside 
                the program and the types of services they would have 
                received, and (v) the financial circumstances of the 
                veterans; and
                    ``(E) the types of personnel who furnished services 
                to veterans under the program, including any 
                difficulties in the recruitment or retention of such 
                personnel.
            ``(2) An assessment by the Secretary of the cost-
        effectiveness and efficiency of furnishing medical services to 
        veterans through various types of rural clinics (including 
        mobile health-care clinics operated under the pilot program 
        conducted pursuant to section 113 of the Veterans' Benefits and 
        Services Act of 1988 (Public Law 100-322; 38 U.S.C. 1712 
        note)).
            ``(3) Any plans for administrative action, and any 
        recommendations for legislation, that the Secretary considers 
        appropriate.
    ``(f) For the purposes of this section, the term `Department 
general health-care facility' has the meaning given such term in 
section 1712A(i)(2) of this title.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 1720D the 
following new item:

``1720E. Rural health-care clinics: pilot program.''.
    (b) Authorization of Appropriations.--(1) There is authorized to be 
appropriated to the Department of Veterans Affairs to carry out the 
rural health-care clinics program provided for in section 1720E of 
title 38, United States Code (as added by subsection (a)), the 
following:
            (A) For fiscal year 1994, $3,000,000.
            (B) For fiscal year 1995, $6,000,000.
            (C) For fiscal year 1996, $9,000,000.
    (2) Amounts appropriated pursuant to such authorization may not be 
used for any other purpose.
    (3) No funds may be expended to carry out the rural health-care 
clinics program provided for in such section 1720E (as so added) unless 
expressly provided for in an appropriations Act.