I 

108TH CONGRESS 

2D SESSION H. R. 3777

To amend title 38, United States Code, to require the Secretary of Veterans 

Affairs to enter into contracts with community health care providers 

to improve access to health care for veterans in highly rural areas, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 4, 2004

Mr. MCINNIS (for himself, Mr. WALDEN of Oregon, Mr. PETERSON of Pennsylvania, Mr. PICKERING, Mr. ISTOOK, Mr. ISAKSON, Mr. FROST, Mr. 

CASE, Mr. GOODE, Mr. SIMPSON, Mr. SANDLIN, Mr. HASTINGS of Washington, Mr. GREEN of Wisconsin, Mr. PETERSON of Minnesota, Mrs. 

CAPITO, Mr. KING of Iowa, Mr. PEARCE, Mr. FILNER, Mrs. MUSGRAVE, 

Mr. BOUCHER, Mr. PAUL, and Mr. MARSHALL) introduced the following 

bill; which was referred to the Committee on Veterans’ Affairs 

A BILL

To amend title 38, United States Code, to require the Secretary of Veterans Affairs to enter into contracts with 

community health care providers to improve access to 

health care for veterans in highly rural areas, 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,
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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Help Establish Access 

3 to Local Timely Healthcare for Your Vets (HEALTHY 

4 Vets) Act of 2004’’. 

5 SEC. 2. ENHANCED CONTRACT CARE AUTHORITY FOR 

6 HEALTH CARE NEEDS OF VETERANS IN HIGH7 LY RURAL AREAS. 

8 (a) RURAL VETERANS.—Section 1703 of title 38, 

9 United States Code, is amended by adding at the end the 

10 following new subsection: 

11 ‘‘(d)(1) In the case of a veteran for whom Depart12 ment facilities are geographically inaccessible (as provided 

13 in paragraph (2)), the Secretary shall use the contract au14 thority provided in subsection (a) for the following care: 

15 ‘‘(A) Primary care. 

16 ‘‘(B) Acute or chronic symptom management. 

17 ‘‘(C) Nontherapeutic medical services. 

18 ‘‘(D) Other medical services as determined ap19 propriate by the director of the appropriate geo20 graphic service region of the Department, after con21 sultation with the Department physician responsible 

22 for primary care of the veteran. 

23 ‘‘(2) Department facilities shall be deemed to be geo24 graphically inaccessible for purposes of paragraph (1) in 

25 the case of a veteran whose residence meets any of the 

26 following criteria: 
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1 ‘‘(A) The residence is in a county with a popu2 lation density of less than 7.0 people per square mile 

3 and is more than 75 miles from the nearest Depart4 ment health care facility. 

5 ‘‘(B) The residence is in a county with a popu6 lation density of more than 7.0 and less than 8.0 

7 people per square mile and is more than 100 miles 

8 from the nearest Department health care facility. 

9 ‘‘(C) The residence is in a county with a popu10 lation density of more than 8.0 and less than 9.0 

11 people per square mile and is more than 125 miles 

12 from the nearest Department health care facility. 

13 ‘‘(D) The residence is more than 150 miles 

14 from the nearest Department health care facility. 

15 ‘‘(3) The Secretary may waive the requirement in 

16 paragraph (1) in the case of a particular veteran if the 

17 Secretary demonstrates on an individual basis through a 

18 cost-benefit analysis that the costs to the Department of 

19 providing care to that veteran pursuant to paragraph (1) 

20 significantly outweigh the benefits of localized health care 

21 for the individual veteran. 

22 ‘‘(4) For purposes of paragraph (2), a distance in 

23 miles shall be determined on the basis of the most conven24 ient highway route that is available to the veteran, as de25 termined by the Secretary.’’. 
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1 (b) EFFECTIVE DATE.—Subsection (d) of section 

2 1703 of title 38, United States Code, as added by sub3 section (a), shall take effect at the end of the 120-day 

4 period beginning on the date of the enactment of this Act.

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