I 

108TH CONGRESS 

1ST SESSION H. R. 271

To require the Secretary of Veterans Affairs to modify the formula, known 

as the Veterans Equitable Resource Allocation (VERA) system, for the 

allocation of funds appropriated to the Department of Veterans Affairs 

for medical care to different geographic regions of the Nation, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 8, 2003

Mr. FRELINGHUYSEN (for himself, Mrs. KELLY, Mr. HINCHEY, and Mr. KING

of New York) introduced the following bill; which was referred to the 

Committee on Veterans’ Affairs 

A BILL

To require the Secretary of Veterans Affairs to modify the 

formula, known as the Veterans Equitable Resource Allocation (VERA) system, for the allocation of funds appropriated to the Department of Veterans Affairs for medical care to different geographic regions of the Nation, 

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. SHORT TITLE. 

4 This Act may be cited as the ‘‘Equitable Care for All 

5 Veterans Act’’. 
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1 SEC. 2. REVISION TO MEDICAL CARE FUNDING ALLOCA2 TION FORMULA FOR DEPARTMENT OF VET3 ERANS AFFAIRS. 

4 (a) MODIFICATION TO VERA FORMULA.—The fund5 ing allocation formula for the Department of Veterans Af6 fairs medical care system known as the Veterans Equi7 table Resource Allocation (VERA) system, established 

8 pursuant to section 429 of Public Law 104–204 (110 

9 Stat. 2929), shall be modified by the Secretary of Vet10 erans Affairs in accordance with this section. Such modi11 fications shall provide for the incorporation of regional dif12 ferences in the cost of providing health care to veterans 

13 (due to different regional cost of living, long travel dis14 tance, and other appropriate factors) as part of the cri15 teria used to determine the national means differential 

16 used in the existing system. 

17 (b) EVALUATION.—At the end of the second fiscal 

18 year beginning after the date of the enactment of this Act, 

19 the Secretary of Veterans Affairs shall evaluate the effects 

20 of the modifications implemented pursuant to subsection 

21 (a) on the regional allocation of funds available to the De22 partment of Veterans Affairs for health care. The Sec23 retary shall submit to Congress not later than 60 days 

24 after the end of such fiscal year the determination of the 

25 Secretary as to whether those modifications have resulted 

26 in a substantive shift in the funding allocations among the 
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1 different service regions of the Veterans Health Adminis2 tration compared to the allocations before such modifica3 tions. 

4 (c) CONTINGENT TERMINATION OF VERA FOR5 MULA.—If in the report submitted pursuant to subsection 

6 (b) the Secretary of Veterans Affairs determines that the 

7 modifications have not resulted in a substantive shift in 

8 the funding allocations described in that subsection, the 

9 Secretary shall immediately terminate use of the Veterans 

10 Equitable Resource Allocation system for the regional allo11 cation of funds available to the Department of Veterans 

12 Affairs for health care. 

13 SEC. 3. STANDBY ALTERNATIVE SYSTEM. 

14 (a) DEVELOPMENT OF REPLACEMENT FORMULA.—

15 If pursuant to section 2(c) the Secretary of Veterans Af16 fairs is required to terminate the use of the Veterans Eq17 uitable Resource Allocation system, the Secretary shall de18 velop a new formula for the allocation of funds appro19 priated to the Department of Veterans Affairs for Medical 

20 Care to the national service regions, known as Veterans 

21 Integrated Service Networks (VISNs), of the Department. 

22 In developing such formula, the Secretary shall take the 

23 following requirements into account: 

24 (1) For any fiscal year for which the amount 

25 appropriated for Medical Care is an increase from 
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1 the preceding year, the funding level provided under 

2 the new formula to any VISN may not be less than 

3 the amount provided for the preceding year. 

4 (2) The new formula shall take into account ad5 ditional costs incurred by a VISN due to any of the 

6 following factors at that VISN being in excess of the 

7 median for all VISNs: 

8 (A) The number of veterans moving into 

9 the geographic area of that VISN. 

10 (B) The median age of veterans in that 

11 VISN. 

12 (C) The number of veterans in that VISN 

13 requiring complex care or nursing home care. 

14 (D) The age of Department of Veterans 

15 Affairs health care facilities in that VISN. 

16 (b) TRANSITION FORMULA.—Until a replacement 

17 funding allocation formula is implemented pursuant to 

18 subsection (a), the funding allocation formula to be ap19 plied by the Secretary to amounts appropriated for vet20 erans medical care shall be the formula in effect before 

21 the Veterans Equitable Resource Allocation system. 

22 SEC. 4. AUTHORIZATIONS OF APPROPRIATIONS. 

23 (a) AUTHORIZATION FOR REPLACEMENT ALLOCA24 TION FORMULA.—There is authorized to be appropriated 
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1 to the Department of Veterans Affairs for fiscal year 2003 

2 the amount of $10,000,000 for purposes of this Act. 

3 (b) ADDITIONAL ‘‘MEDICAL CARE’’ AUTHORIZA4 TIONS.—There is authorized to be appropriated to the De5 partment of Veterans Affairs for fiscal year 2003 the 

6 amount of $100,000,000 for ‘‘Medical Care’’ for the De7 partment of Veterans Affairs. Such amount is in addition 

8 to any other amount authorized to be appropriated to the 

9 Department of Veterans Affairs for fiscal year 2003 and 

10 shall be allocated by the Secretary to the national service 

11 regions, known as Veterans Integrated Service Networks 

12 (VISNs), of the Department of Veterans Affairs on the 

13 basis of need, as follows: 

14 (1) First, to the VISN that has experienced the 

15 greatest reduction in funding from the funding levels 

16 for fiscal year 1997. 

17 (2) Second, to any other VISN that has experi18 enced an overall five-year funding decrease. 

19 (3) Third, if any amount appropriated pursuant 

20 to such authorization remains after allocations pur21 suant to paragraphs (1) and (2), such amount shall 

22 be allocated equally among the remaining 22 VISNs 

23 before implementation of the new formula.

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