II 

109TH CONGRESS 

1ST SESSION S. 1176 

To improve the provision of health care and services to veterans in Hawaii, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 7, 2005 

Mr. AKAKA introduced the following bill; which was read twice and referred 

to the Committee on Veterans’ Affairs 

A BILL 

To improve the provision of health care and services to 

veterans in Hawaii, 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 ‘‘Neighbor Islands Vet5 erans Health Care Improvements Act of 2005’’. 

6 SEC. 2. VET CENTER ENHANCEMENTS. 

7 (a) ADDITIONAL COUNSELORS FOR CERTAIN CLIN8 ICS.—The Secretary of Veterans Affairs shall assign an 

9 additional counselor to each vet center as follows: 
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1 (1) The vet center on the Island of Maui, Ha2 waii. 

3 (2) The vet center in Hilo, Hawaii. 

4 (b) ESTABLISHMENT OF NEW VET CENTER.—The 

5 Secretary shall establish and operate a new vet center on 

6 the Island of Oahu, Hawaii, at a location to be selected 

7 by the Secretary. 

8 (c) VET CENTER DEFINED.—In this section, the 

9 term ‘‘vet center’’ means a center for the provision of re10 adjustment counseling and related mental health services 

11 for veterans under section 1712A of title 38, United 

12 States Code. 

13 SEC. 3. HEALTH CARE CLINICS. 

14 (a) ESTABLISHMENT OF CLINICS.— 

15 (1) SATELLITE CLINICS.—The Secretary of 

16 Veterans Affairs shall establish and operate a sat17 ellite health care clinic at a location selected by the 

18 Secretary on each island as follows: 

19 (A) The Island of Lanai, Hawaii. 

20 (B) The Island of Molokai, Hawaii. 

21 (2) MEDICAL CARE CLINIC.—The Secretary 

22 may establish and operate a medical care clinic at a 

23 location selected by the Secretary on the west side 

24 of the Island of Kauai, Hawaii. 
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1 (b) ELEMENTS OF SATELLITE CLINICS.—Each sat2 ellite clinic established under subsection (a)(1) shall in3 clude— 

4 (1) a vet center, which shall provide readjust5 ment counseling and related mental health services 

6 for veterans under section 1712A of title 38, United 

7 States Code; and 

8 (2) a community based outpatient clinic 

9 (CBOC), which shall provide to veterans— 

10 (A) the medical services and other health11 care related services provided by community 

12 based outpatient clinics operated by the Depart13 ment of Veterans Affairs; and 

14 (B) such other care and services as the 

15 Secretary considers appropriate. 

16 (c) STAFFING AND OTHER RESOURCES.— 

17 (1) SATELLITE CLINICS.—(A) The staff of the 

18 satellite clinics established under subsection (a)(1) 

19 shall be derived from staff of the vet center, and of 

20 the community based outpatient clinic, on the Island 

21 of Maui, Hawaii, who shall be assigned by the Sec22 retary to such satellite clinics under this section. In 

23 making such assignments, the Secretary may not re24 duce the size of the staff of the vet center, or of the 

25 community based outpatient clinic, on the Island of 
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1 Maui below its size as of the date of the enactment 

2 of this Act. 

3 (B) Each satellite clinic established under sub4 section (a)(1) shall have a computer system of na5 ture and quality equivalent to the computer systems 

6 of the community based outpatient clinics operated 

7 by the Department, including the capability to con8 duct medical tracking. 

9 (C) Each satellite clinic established under sub10 section (a)(1) shall have appropriate telemedicine 

11 equipment. 

12 (2) MEDICAL CARE CLINIC.—The medical care 

13 clinic established under subsection (a)(2) shall have 

14 such staff as the Secretary considers appropriate for 

15 its activities. 

16 (d) HOURS OF OPERATION.— 

17 (1) SATELLITE CLINICS.—Each satellite clinic 

18 established under subsection (a)(1) shall have hours 

19 of operation each week determined by the Secretary. 

20 The number of hours so determined for a week shall 

21 consist of a number of hours equivalent to not less 

22 than three working days in such week. 

23 (2) MEDICAL CARE CLINIC.—The medical care 

24 clinic established under subsection (a)(2) shall have 
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1 such hours of operation as the Secretary considers 

2 appropriate for its activities. 

3 SEC. 4. LONG-TERM CARE. 

4 (a) MEDICAL CARE FOSTER PROGRAM.—The Sec5 retary of Veterans Affairs shall establish and operate on 

6 the Island of Oahu, Hawaii, a medical care foster pro7 gram. The program shall be established utilizing as a 

8 model the Medical Care Foster Program at the Center Ar9 kansas Veterans Health Care System of the Department 

10 of Veterans Affairs. 

11 (b) ADDITIONAL CLINICAL STAFF FOR NON-INSTI12 TUTIONAL LONG-TERM CARE.— 

13 (1) ASSIGNMENT OF STAFF.—The Secretary 

14 shall assign to the community based outpatient clin15 ics (CBOCs) of the Department of Veterans Affairs 

16 referred to in paragraph (2) such additional clinical 

17 staff as the Secretary considers appropriate in order 

18 to ensure that such clinics provide non-institutional 

19 long-term care for veterans in accordance with the 

20 provisions of subtitle A of title I of the Veterans Mil21 lennium Health Care and Benefits Act (Public Law 

22 106–117) and the amendments made by such provi23 sions. Such additional clinical staff shall include a 

24 home health nurse. 
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1 (2) COVERED COMMUNITY BASED OUTPATIENT

2 CLINICS.—The community based outpatient clinics 

3 referred to in this paragraph are the community 

4 based outpatient clinics as follows: 

5 (A) The community based outpatient clinic 

6 in Hilo, Hawaii. 

7 (B) The community based outpatient clinic 

8 on the Island of Kauai, Hawaii. 

9 (C) The community based outpatient clinic 

10 in Kona, Hawaii. 

11 (D) The community based outpatient clinic 

12 on the Island of Maui, Hawaii. 

13 SEC. 5. MENTAL HEALTH CARE. 

14 (a) ESTABLISHMENT OF MENTAL HEALTH CEN15 TER.—The Secretary of Veterans Affairs shall establish 

16 and operate in Hilo, Hawaii, at an appropriate location 

17 selected by the Secretary, a new center for the provision 

18 of mental health care and services to veterans. 

19 (b) CARE AND TREATMENT AVAILABLE THROUGH

20 CENTER.—The mental health center established under 

21 subsection (a) shall provide the following: 

22 (1) Day mental health care and treatment. 

23 (2) Outpatient mental health care and treat24 ment. 
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1 (3) Such other mental health care and treat2 ment as the Secretary considers appropriate. 

3 (c) STAFF.—The mental health center established 

4 under subsection (a) shall have as its staff a drug abuse 

5 counselor, a nurse practitioner, and such other staff as 

6 the Secretary considers appropriate for its activities. 

7 SEC. 6. STUDY ON ACCESS TO SPECIALIZED CARE AND FEE8 BASIS CARE. 

9 (a) IN GENERAL.—The Secretary of Veterans Affairs 

10 shall carry out a study of the demand for, and access to, 

11 specialized care and fee-basis care from the Department 

12 of Veterans Affairs for veterans on the neighbor islands 

13 of Hawaii, including whether or not the specialized care 

14 or fee-basis care, as the case may be, available to veterans 

15 from the Department on the neighbor islands is adequate 

16 to meet the demands of veterans for such care. 

17 (b) REPORT.—Not later than six months after the 

18 date of the enactment of this Act, the Secretary shall sub19 mit to the Committees on Veterans’ Affairs of the Senate 

20 and the House of Representatives a report on the study 

21 required by subsection (a). The report shall set forth the 

22 results of the study and include such recommendations for 

23 legislative or administrative action as the Secretary con24 siders appropriate in light of the study. 
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1 SEC. 7. CONSTRUCTION OF MENTAL HEALTH CENTER AT 

2 TRIPLER ARMY MEDICAL CENTER, HAWAII. 

3 (a) AUTHORIZATION OF MAJOR MEDICAL FACILITY

4 PROJECT.—The Secretary of Veterans Affairs may carry 

5 out a major medical facility project for the construction 

6 of a mental health center at Tripler Army Medical Center, 

7 Hawaii, in the amount of $10,000,000. 

8 (b) AUTHORIZATION OF APPROPRIATIONS.— 

9 (1) IN GENERAL.—There is authorized to be 

10 appropriated to the Secretary of Veterans Affairs for 

11 fiscal year 2006 for the Construction, Major 

12 Projects, account, $10,000,000 for the project au13 thorized by subsection (a). 

14 (2) LIMITATION.—The project authorized by 

15 subsection (a) may only be carried out using— 

16 (A) funds appropriated for fiscal year 2006 

17 pursuant to the authorization of appropriations 

18 in paragraph (1); 

19 (B) funds appropriated for Construction, 

20 Major Projects, for a fiscal year before fiscal 

21 year 2006 that remain available for obligation; 

22 and 

23 (C) funds appropriated for Construction, 

24 Major Projects, for fiscal year 2006 for a cat25 egory of activity not specific to a project. 
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1 (c) FACILITIES.—The facilities at the mental health 

2 center authorized to be constructed by subsection (a) shall 

3 include residential rehabilitation beds for patients with 

4 Post Traumatic Stress Disorder (PTSD) and such other 

5 facilities as the Secretary considers appropriate. 

6 SEC. 8. FUNDING. 

7 (a) AUTHORIZATION OF APPROPRIATIONS.—There is 

8 authorized to be appropriated to the Secretary of Veterans 

9 Affairs for fiscal year 2006 such sums as may be nec10 essary to carry out sections 2 through 6. 

11 (b) AVAILABILITY.—Amounts appropriated pursuant 

12 to the authorization of appropriations in subsection (a) 

13 shall be available only to carry out sections 2 through 6. 

14 (c) CONSTRUCTION WITH OTHER FUNDING FOR

15 HEALTH CARE FOR VETERANS IN HAWAII.—It is the 

16 sense of Congress that the amount authorized to be appro17 priated by subsection (a) for fiscal year 2006 should— 

18 (1) supplement amounts authorized to be ap19 propriated to the Secretary of Veterans Affairs for 

20 that fiscal year for health care for veterans in Ha21 waii for activities other than those specified in sec22 tions 2 through 6; and 

23 (2) not result in any reduction in the amount 

24 that would have been appropriated to the Secretary 

25 of Veterans Affairs for that fiscal year for health 
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1 care for veterans in Hawaii for such activities had 

2 the amount in subsection (a) not been authorized to 

3 be appropriated. 

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