IB 

Union Calendar No. 102

108TH CONGRESS 

1ST SESSION H. R. 2357

[Report No. 108–198] 

To amend title 38, United States Code, 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 5, 2003

Ms. GINNY BROWN-WAITE of Florida (for herself, Mr. SMITH of New Jersey, 

and Mr. MILLER of Florida) introduced the following bill; which was referred to the Committee on Veterans’ Affairs 

JULY 10, 2003

Additional sponsors: Mr. PAUL, Mr. PEARCE, Mr. BRADLEY of New Hampshire, Mr. WILSON of South Carolina, Mr. GILLMOR, Mr. JONES of North 

Carolina, Ms. BORDALLO, Mrs. BLACKBURN, Mr. FROST, Mr. DEAL of 

Georgia, Mrs. JO ANN DAVIS of Virginia, Mr. ROYCE, Mr. ENGLISH, and 

Mr. GOODE

JULY 10, 2003

Reported with amendments, committed to the Committee of the Whole House 

on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL

To amend title 38, United States Code, to establish standards of access to care for veterans seeking health care 
2

•HR 2357 RH 

from the Department of Veterans Affairs, and for other 

purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. ACCESS TO CARE STANDARDS. 

4 (a) REQUIRED STANDARDS FOR ACCESS TO CARE.—

5 Section 1703 of title 38, United States Code, is amended 

6 by adding at the end the following new subsection: 

7 ‘‘(d)(1) The following are the standards for access to 

8 care for the Department: 

9 ‘‘(A) For a veteran seeking primary care, the 

10 standard for access is 30 days, determined from the 

11 date on which the veteran contacts the Department 

12 seeking an appointment until the date on which a 

13 visit with a primary care provider is completed. 

14 ‘‘(B) For a veteran seeking specialized care, the 

15 standard for access is 30 days, determined from the 

16 date on which the veteran is referred for specialty 

17 care by a primary care provider until the date on 

18 which a visit with an appropriate specialty primary 

19 care provider is completed. 

20 ‘‘(2) The Secretary shall develop and disseminate an 

21 appropriate standard of waiting time, determined from the 

22 time at which the veteran’s visit is scheduled until the vet23 eran is seen by the provider. The Secretary shall periodi24 cally review performance of Department facilities com-
3

•HR 2357 RH 

1 pared to that standard. The Secretary shall annually re2 port to the Committees on Veterans’ Affairs of the Senate 

3 and House of Representatives an assessment of the De4 partment’s performance against that standard. 

5 ‘‘(3) In a case in which the Secretary is unable to 

6 meet the standard for access to care, the Secretary shall 

7 use the authority of subsection (a) to furnish health care 

8 and services for that veteran in a non-Department facil9 ity.’’. 

10 (b) EFFECTIVE DATE.—The amendment made by 

11 subsection (a) shall take effect on the first day of the first 

12 month beginning more than six months after the date of 

13 the enactment of this Act.

14 SECTION 1. SHORT TITLE. 

15 This Act may be cited as the ‘‘Veterans Health Care 

16 Improvement Act of 2003’’. 

17 SEC. 2. APPOINTMENT OF CHIROPRACTORS IN THE VET18 ERANS HEALTH ADMINISTRATION. 

19 (a) APPOINTMENTS.—Section 7401 of title 38, United 

20 States Code, is amended—

21 (1) by inserting ‘‘and chiropractic care’’ in the 

22 matter preceding paragraph (1) after ‘‘medical care’’; 

23 and 

24 (2) by inserting ‘‘chiropractors,’’ in paragraph 

25 (1) after ‘‘podiatrists,’’. 
4

•HR 2357 RH 

1 (b) QUALIFICATIONS OF APPOINTEES.—Section 

2 7402(b) of such title is amended—

3 (1) by redesignating paragraph (10) as para4 graph (11); and 

5 (2) by inserting after paragraph (9) the fol6 lowing new paragraph (10): 

7 ‘‘(10) CHIROPRACTOR.—To be eligible to be appointed 

8 to a chiropractor position, a person must—

9 ‘‘(A) hold the degree of doctor of chiropractic, or 

10 its equivalent, from a college of chiropractic approved 

11 by the Secretary; and 

12 ‘‘(B) be licensed to practice chiropractic in a 

13 State.’’. 

14 (c) PERIOD OF APPOINTMENTS AND PROMOTIONS.—

15 Section 7403(a)(2) of such title is amended by adding at 

16 the end the following new subparagraph: 

17 ‘‘(H) Chiropractors.’’. 

18 (d) GRADES AND PAY SCALES.—Section 7404(b)(1) of 

19 such title is amended by striking the third center heading 

20 in the table and inserting the following:

‘‘CLINICAL PODIATRIST, CHIROPRACTOR, AND OPTOMETRIST 

SCHEDULE’’.

21 (e) TEMPORARY AND PART-TIME APPOINTMENTS.—

22 Section 7405(a) of such title is amended—

23 (1) by adding at the end of paragraph (1) the 

24 following new subparagraph: 
5

•HR 2357 RH 

1 ‘‘(E) Chiropractors.’’; and 

2 (2) by adding at the end of paragraph (2) the 

3 following new subparagraph: 

4 ‘‘(D) Chiropractors.’’.

5 (f) RESIDENCIES AND INTERNSHIPS.—Section 7406(c) 

6 of such title is amended—

7 (1) in paragraph (1)—

8 (A) by inserting ‘‘and chiropractic’’ after 

9 ‘‘medical’’ the first place it appears; and 

10 (B) by inserting ‘‘or chiropractic’’ after 

11 ‘‘medical’’ the second place it appears; 

12 (2) in paragraph (2)(B), by inserting ‘‘or chiro13 practic’’ after ‘‘medical’’ the first place it appears; 

14 and 

15 (3) in paragraph (3)(A), by inserting ‘‘or chiro16 practic’’ after ‘‘medical’’. 

17 (g) MALPRACTICE AND NEGLIGENCE PROTECTION.—

18 Section 7316(a) of such title is amended—

19 (1) in paragraph (1), by inserting ‘‘or chiro20 practic’’ after ‘‘medical’’ each place it appears; and 

21 (2) in paragraph (2)—

22 (A) by inserting ‘‘or chiropractic’’ after 

23 ‘‘medical’’ the first place it appears; and 

24 (B) by inserting ‘‘chiropractor,’’ after ‘‘po25 diatrist,’’. 
6

•HR 2357 RH 

1 (h) TREATMENT AS SCARCE MEDICAL SPECIALISTS

2 FOR CONTRACTING PURPOSES.—Section 7409(a) of such 

3 title is amended by inserting ‘‘chiropractors,’’ in the second 

4 sentence after ‘‘optometrists,’’. 

5 (i) REIMBURSEMENT OF CONTINUING PROFESSIONAL

6 EDUCATION EXPENSES.—Section 7411 of such title is 

7 amended by striking ‘‘or dentist’’ and inserting ‘‘, dentist, 

8 or chiropractic’’. 

9 (j) COLLECTIVE BARGAINING EXEMPTION.—Section 

10 7421(b) of such title is amended by adding at the end the 

11 following new paragraph: 

12 ‘‘(8) Chiropractors.’’. 

13 (k) EFFECTIVE DATE.—The amendments made by this 

14 section shall take effect at the end of the 180–day period 

15 beginning on the date of the enactment of this Act. 

16 SEC. 3. ELIGIBILITY FOR DEPARTMENT OF VETERANS AF17 FAIRS HEALTH CARE OF CERTAIN FILIPINO 

18 WORLD WAR II VETERANS RESIDING IN THE 

19 UNITED STATES. 

20 (a) ELIGIBILITY.—The text of section 1734 of title 38, 

21 United States Code, is amended to read as follows: 

22 ‘‘(a) The Secretary shall furnish hospital and nursing 

23 home care and medical services to any individual described 

24 in subsection (b) in the same manner, and subject to the 

25 same terms and conditions, as apply to the furnishing of 
7

•HR 2357 RH 

1 such care and services to individuals who are veterans as 

2 defined in section 101(2) of this title. Any disability of an 

3 individual described in subsection (b) that is a service-con4 nected disability for purposes of this subchapter (as pro5 vided for under section 1735(2) of this title) shall be consid6 ered to be a service-connected disability for purposes of fur7 nishing care and services under the preceding sentence. 

8 ‘‘(b) Subsection (a) applies to any individual who is 

9 a Commonwealth Army veteran or new Philippine Scout 

10 and who— 

11 ‘‘(1) is residing in the United States; and 

12 ‘‘(2) is a citizen of the United States or an alien 

13 lawfully admitted to the United States for permanent 

14 residence.’’. 

15 (b) LIMITATION.—(1) The amendment made by sub16 section (a) shall take effect on the date on which the Sec17 retary of Veterans Affairs submits to the Committees on Vet18 erans’ Affairs of the Senate and House of Representatives 

19 and publishes in the Federal Register a certification de20 scribed in paragraph (2). 

21 (2) A certification referred to in paragraph (1) is a 

22 certification that sufficient resources are available for the 

23 fiscal year during which the certification is submitted to 

24 carry out section 1734 of title 38, United States Code, as 

25 amended by such amendment, during that fiscal year at 
8

•HR 2357 RH 

1 each significantly affected health care facility of the Depart2 ment of Veterans Affairs. 

3 (3) For purposes of paragraph (2), the term ‘‘signifi4 cantly affected health care facility’’ means a health care fa5 cility at which, as determined by the Secretary, it is reason6 ably foreseeable that the implementation of the provisions 

7 of section 1734 of title 38, United States Code, as amended 

8 by subsection (a), will result in a significant increase in 

9 the use of health care resources due to the number of vet10 erans described in subsection (b) of that section who are 

11 considered to be likely to seek hospital or nursing home care 

12 or medical services, as authorized by subsection (a) of that 

13 section, at that facility.

Amend the title so as to read: ‘‘A bill to amend title 

38, United States Code, to provide for the appointment 

of chiropractors in the Veterans Health Administration of 

the Department of Veterans Affairs and to provide eligibility for Department of Veterans Affairs health care for 

certain Filipino World War II veterans residing in the 

United States.’’.

Union Calendar No. 102

108TH CONGRESS 

1ST SESSION H.R. 2357

[Report No. 108–198] 

A BILL

To amend title 38, United States Code, to establish 

standards of access to care for veterans seeking health care from the Department of Veterans Affairs, and for other purposes. 

JULY 10, 2003

Reported with amendments, committed to the Committee 

of the Whole House on the State of the Union, and ordered to be printed