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 re-
ferred to the Committee on Veterans’ Affairs 
JULY 10, 2003
Additional sponsors: Mr. PAUL, Mr. PEARCE, Mr. BRADLEY of New Hamp-
shire, 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 stand-
ards of access to care for veterans seeking health care
from the Department of Veterans Affairs, and for other 
purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. ACCESS TO CARE STANDARDS. 
(a) REQUIRED STANDARDS FOR ACCESS TO CARE.—
Section 1703 of title 38, United States Code, is amended 
by adding at the end the following new subsection: 
‘‘(d)(1) The following are the standards for access to 
care for the Department: 
‘‘(A) For a veteran seeking primary care, the 
standard for access is 30 days, determined from the 
date on which the veteran contacts the Department 
seeking an appointment until the date on which a 
visit with a primary care provider is completed. 
‘‘(B) For a veteran seeking specialized care, the 
standard for access is 30 days, determined from the 
date on which the veteran is referred for specialty 
care by a primary care provider until the date on 
which a visit with an appropriate specialty primary 
care provider is completed. 
‘‘(2) The Secretary shall develop and disseminate an 
appropriate standard of waiting time, determined from the 
time at which the veteran’s visit is scheduled until the vet-
eran is seen by the provider. The Secretary shall periodi-
cally review performance of Department facilities com-
pared to that standard. The Secretary shall annually re-
port to the Committees on Veterans’ Affairs of the Senate 
and House of Representatives an assessment of the De-
partment’s performance against that standard. 
‘‘(3) In a case in which the Secretary is unable to 
meet the standard for access to care, the Secretary shall 
use the authority of subsection (a) to furnish health care 
and services for that veteran in a non-Department facil-
ity.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect on the first day of the first 
month beginning more than six months after the date of 
the enactment of this Act.
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veterans Health Care 
Improvement Act of 2003’’. 
SEC. 2. APPOINTMENT OF CHIROPRACTORS IN THE VET-
ERANS HEALTH ADMINISTRATION. 
(a) APPOINTMENTS.—Section 7401 of title 38, United 
States Code, is amended—
(1) by inserting ‘‘and chiropractic care’’ in the 
matter preceding paragraph (1) after ‘‘medical care’’; 
and 
(2) by inserting ‘‘chiropractors,’’ in paragraph 
(1) after ‘‘podiatrists,’’.
(b) 
QUALIFICATIONS
OF
APPOINTEES.—Section 
7402(b) of such title is amended—
(1) by redesignating paragraph (10) as para-
graph (11); and 
(2) by inserting after paragraph (9) the fol-
lowing new paragraph (10): 
‘‘(10) CHIROPRACTOR.—To be eligible to be appointed 
to a chiropractor position, a person must—
‘‘(A) hold the degree of doctor of chiropractic, or 
its equivalent, from a college of chiropractic approved 
by the Secretary; and 
‘‘(B) be licensed to practice chiropractic in a 
State.’’. 
(c) PERIOD OF APPOINTMENTS AND PROMOTIONS.—
Section 7403(a)(2) of such title is amended by adding at 
the end the following new subparagraph: 
‘‘(H) Chiropractors.’’. 
(d) GRADES AND PAY SCALES.—Section 7404(b)(1) of 
such title is amended by striking the third center heading 
in the table and inserting the following:
‘‘CLINICAL PODIATRIST, CHIROPRACTOR, AND OPTOMETRIST 
SCHEDULE’’.
(e) TEMPORARY AND PART-TIME APPOINTMENTS.—
Section 7405(a) of such title is amended—
(1) by adding at the end of paragraph (1) the 
following new subparagraph:
‘‘(E) Chiropractors.’’; and 
(2) by adding at the end of paragraph (2) the 
following new subparagraph: 
‘‘(D) Chiropractors.’’.
(f) RESIDENCIES AND INTERNSHIPS.—Section 7406(c) 
of such title is amended—
(1) in paragraph (1)—
(A) by inserting ‘‘and chiropractic’’ after 
‘‘medical’’ the first place it appears; and 
(B) by inserting ‘‘or chiropractic’’ after 
‘‘medical’’ the second place it appears; 
(2) in paragraph (2)(B), by inserting ‘‘or chiro-
practic’’ after ‘‘medical’’ the first place it appears; 
and 
(3) in paragraph (3)(A), by inserting ‘‘or chiro-
practic’’ after ‘‘medical’’. 
(g) MALPRACTICE AND NEGLIGENCE PROTECTION.—
Section 7316(a) of such title is amended—
(1) in paragraph (1), by inserting ‘‘or chiro-
practic’’ after ‘‘medical’’ each place it appears; and 
(2) in paragraph (2)—
(A) by inserting ‘‘or chiropractic’’ after 
‘‘medical’’ the first place it appears; and 
(B) by inserting ‘‘chiropractor,’’ after ‘‘po-
diatrist,’’.
(h) TREATMENT AS SCARCE MEDICAL SPECIALISTS 
FOR CONTRACTING PURPOSES.—Section 7409(a) of such 
title is amended by inserting ‘‘chiropractors,’’ in the second 
sentence after ‘‘optometrists,’’. 
(i) REIMBURSEMENT OF CONTINUING PROFESSIONAL 
EDUCATION EXPENSES.—Section 7411 of such title is 
amended by striking ‘‘or dentist’’ and inserting ‘‘, dentist, 
or chiropractic’’. 
(j) COLLECTIVE BARGAINING EXEMPTION.—Section 
7421(b) of such title is amended by adding at the end the 
following new paragraph: 
‘‘(8) Chiropractors.’’. 
(k) EFFECTIVE DATE.—The amendments made by this 
section shall take effect at the end of the 180–day period 
beginning on the date of the enactment of this Act. 
SEC. 3. ELIGIBILITY FOR DEPARTMENT OF VETERANS AF-
FAIRS HEALTH CARE OF CERTAIN FILIPINO 
WORLD WAR II VETERANS RESIDING IN THE 
UNITED STATES. 
(a) ELIGIBILITY.—The text of section 1734 of title 38, 
United States Code, is amended to read as follows: 
‘‘(a) The Secretary shall furnish hospital and nursing 
home care and medical services to any individual described 
in subsection (b) in the same manner, and subject to the 
same terms and conditions, as apply to the furnishing of
such care and services to individuals who are veterans as 
defined in section 101(2) of this title. Any disability of an 
individual described in subsection (b) that is a service-con-
nected disability for purposes of this subchapter (as pro-
vided for under section 1735(2) of this title) shall be consid-
ered to be a service-connected disability for purposes of fur-
nishing care and services under the preceding sentence. 
‘‘(b) Subsection (a) applies to any individual who is 
a Commonwealth Army veteran or new Philippine Scout 
and who— 
‘‘(1) is residing in the United States; and 
‘‘(2) is a citizen of the United States or an alien 
lawfully admitted to the United States for permanent 
residence.’’. 
(b) LIMITATION.—(1) The amendment made by sub-
section (a) shall take effect on the date on which the Sec-
retary of Veterans Affairs submits to the Committees on Vet-
erans’ Affairs of the Senate and House of Representatives 
and publishes in the Federal Register a certification de-
scribed in paragraph (2). 
(2) A certification referred to in paragraph (1) is a 
certification that sufficient resources are available for the 
fiscal year during which the certification is submitted to 
carry out section 1734 of title 38, United States Code, as 
amended by such amendment, during that fiscal year at
each significantly affected health care facility of the Depart-
ment of Veterans Affairs. 
(3) For purposes of paragraph (2), the term ‘‘signifi-
cantly affected health care facility’’ means a health care fa-
cility at which, as determined by the Secretary, it is reason-
ably foreseeable that the implementation of the provisions 
of section 1734 of title 38, United States Code, as amended 
by subsection (a), will result in a significant increase in 
the use of health care resources due to the number of vet-
erans described in subsection (b) of that section who are 
considered to be likely to seek hospital or nursing home care 
or medical services, as authorized by subsection (a) of that 
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 eligi-
bility 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 Af-
fairs, 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 or-
dered to be printed