H. R. 2116—4
care for a service-connected disability, and (2) to any veteran who
is in need of such care and who has a service-connected disability
rated at 70 percent or more.
‘‘(b)(1) The Secretary shall ensure that a veteran described
in subsection (a) who continues to need nursing home care is
not, after placement in a Department nursing home, transferred
from the facility without the consent of the veteran, or, in the
event the veteran cannot provide informed consent, the representa-
tive of the veteran.
‘‘(2) Nothing in subsection (a) may be construed as authorizing
or requiring that a veteran who is receiving nursing home care
in a Department nursing home on the date of the enactment of
this section be displaced, transferred, or discharged from the facility.
‘‘(c) The provisions of subsection (a) shall terminate on
December 31, 2003.’’.
(2) The table of sections at the beginning of such chapter
is amended by inserting after the item relating to section 1710
the following new item:
‘‘1710A. Required nursing home care.’’.
(b) REQUIRED NONINSTITUTIONAL EXTENDED CARE SERVICES.—
Section 1701 is amended by adding at the end the following new
paragraph:
‘‘(10)(A) During the period beginning on the date of the enact-
ment of the Veterans Millennium Health Care and Benefits Act
and ending on December 31, 2003, the term ‘medical services’
includes noninstitutional extended care services.
‘‘(B) For the purposes of subparagraph (A), the term ‘noninstitu-
tional extended care services’ means such alternatives to institu-
tional extended care which the Secretary may furnish (i) directly,
(ii) by contract, or (iii) (through provision of case management)
by another provider or payor.’’.
(c) PROGRAM OF EXTENDED CARE SERVICES.—(1) Chapter 17
is amended by inserting after section 1710A, as added by subsection
(a), the following new section:
‘‘§ 1710B. Extended care services
‘‘(a) The Secretary (subject to section 1710(a)(4) of this title
and subsection (c) of this section) shall operate and maintain a
program to provide extended care services to eligible veterans in
accordance with this section. Such services shall include the fol-
lowing:
‘‘(1) Geriatric evaluation.
‘‘(2) Nursing home care (A) in facilities operated by the
Secretary, and (B) in community-based facilities through con-
tracts under section 1720 of this title.
‘‘(3) Domiciliary services under section 1710(b) of this title.
‘‘(4) Adult day health care under section 1720(f ) of this
title.
‘‘(5) Such other noninstitutional alternatives to nursing
home care as the Secretary may furnish as medical services
under section 1701(10) of this title.
‘‘(6) Respite care under section 1720B of this title.
‘‘(b) The Secretary shall ensure that the staffing and level
of extended care services provided by the Secretary nationally in
facilities of the Department during any fiscal year is not less than
H. R. 2116—5
the staffing and level of such services provided nationally in facili-
ties of the Department during fiscal year 1998.
‘‘(c)(1) Except as provided in paragraph (2), the Secretary may
not furnish extended care services for a non-service-connected dis-
ability other than in the case of a veteran who has a compensable
service-connected disability unless the veteran agrees to pay to
the United States a copayment (determined in accordance with
subsection (d)) for any period of such services in a year after
the first 21 days of such services provided that veteran in that
year.
‘‘(2) Paragraph (1) shall not apply—
‘‘(A) to a veteran whose annual income (determined under
section 1503 of this title) is less than the amount in effect
under section 1521(b) of this title; or
‘‘(B) with respect to an episode of extended care services
that a veteran is being furnished by the Department on the
date of the enactment of the Veterans Millennium Health Care
and Benefits Act.
‘‘(d)(1) A veteran who is furnished extended care services under
this chapter and who is required under subsection (c) to pay an
amount to the United States in order to be furnished such services
shall be liable to the United States for that amount.
‘‘(2) In implementing subsection (c), the Secretary shall develop
a methodology for establishing the amount of the copayment for
which a veteran described in subsection (c) is liable. That method-
ology shall provide for—
‘‘(A) establishing a maximum monthly copayment (based
on all income and assets of the veteran and the spouse of
such veteran);
‘‘(B) protecting the spouse of a veteran from financial hard-
ship by not counting all of the income and assets of the veteran
and spouse (in the case of a spouse who resides in the commu-
nity) as available for determining the copayment obligation;
and
‘‘(C) allowing the veteran to retain a monthly personal
allowance.
‘‘(e)(1) There is established in the Treasury of the United States
a revolving fund known as the Department of Veterans Affairs
Extended Care Fund (hereafter in this section referred to as the
‘fund’). Amounts in the fund shall be available, without fiscal year
limitation and without further appropriation, exclusively for the
purpose of providing extended care services under subsection (a).
‘‘(2) All amounts received by the Department under this section
shall be deposited in or credited to the fund.’’.
(2) The table of sections at the beginning of such chapter
is amended by inserting after the item relating to section 1710A,
as added by subsection (a)(2), the following new item:
‘‘1710B. Extended care services.’’.
(d) ADULT
DAY
HEALTH
CARE.—Section 1720(f )(1)(A) is
amended to read as follows:
‘‘(f )(1)(A) The Secretary may furnish adult day health care
services to a veteran enrolled under section 1705(a) of this title
who would otherwise require nursing home care.’’.
(e) RESPITE CARE PROGRAM.—Section 1720B is amended—
(1) in subsection (a), by striking ‘‘eligible’’ and inserting
‘‘enrolled’’;
H. R. 2116—6
(2) in subsection (b)—
(A) by striking ‘‘the term ‘respite care’ means hospital
or nursing home care’’ and inserting ‘‘the term ‘respite
care services’ means care and services’’;
(B) by striking ‘‘is’’ at the beginning of each of para-
graphs (1), (2), and (3) and inserting ‘‘are’’; and
(C) by striking ‘‘in a Department facility’’ in paragraph
(2); and
(3) by adding at the end the following new subsection:
‘‘(c) In furnishing respite care services, the Secretary may enter
into contract arrangements.’’.
(f ) CONFORMING AMENDMENTS.—Section 1710(a) is amended—
(1) in paragraph (1), by striking ‘‘, and may furnish nursing
home care,’’;
(2) in paragraph (2)(A), by inserting ‘‘or, with respect to
nursing home care during any period during which the provi-
sions of section 1710A(a) of this title are in effect, a compensable
service-connected disability rated less than 70 percent’’ after
‘‘50 percent’’;
(3) in paragraph (4), by inserting ‘‘, and the requirement
in section 1710B of this title that the Secretary provide a
program of extended care services,’’ after ‘‘medical services’’;
and
(4) by adding at the end the following new paragraph:
‘‘(5) During any period during which the provisions of section
1710A(a) of this title are not in effect, the Secretary may furnish
nursing home care which the Secretary determines is needed to
any veteran described in paragraph (1), with the priority for such
care on the same basis as if provided under that paragraph.’’.
(g) STATE HOMES.—Section 1741(a)(2) is amended by striking
‘‘adult day health care in a State home’’ and inserting ‘‘extended
care services described in any of paragraphs (4) through (6) of
section 1710B(a) of this title under a program administered by
a State home’’.
(h) EFFECTIVE DATE.—(1) Except as provided in paragraph
(2), the amendments made by this section shall take effect on
the date of the enactment of this Act.
(2) Subsection (c) of section 1710B of title 38, United States
Code (as added by subsection (b)), shall take effect on the effective
date of regulations prescribed by the Secretary of Veterans Affairs
under subsections (c) and (d) of such section. The Secretary shall
publish the effective date of such regulations in the Federal Reg-
ister.
(3) The provisions of section 1710(f ) of title 38, United States
Code, shall not apply to any day of nursing home care on or
after the effective date of regulations under paragraph (2).
(i) REPORT.—Not later than January 1, 2003, the Secretary
shall submit to the Committees on Veterans’ Affairs of the Senate
and House of Representatives a report on the operation of this
section (including the amendments made by this section). The Sec-
retary shall include in the report—
(1) the Secretary’s assessment of the experience of the
Department under the provisions of this section;
(2) the costs incurred by the Department under the provi-
sions of this section and a comparison of those costs with
the Secretary’s estimate of the costs that would have been
H. R. 2116—7
incurred by the Secretary for extended care services if this
section had not been enacted; and
(3) the Secretary’s recommendations, with respect to the
provisions of section 1710A(a) of title 38, United States Code,
as added by subsection (a), and with respect to the provisions
of section 1701(10) of such title, as added by subsection (b),
as to—
(A) whether those provisions should be extended or
made permanent; and
(B) what modifications, if any, should be made to those
provisions.
SEC. 102. PILOT PROGRAMS RELATING TO LONG-TERM CARE.
(a) PILOT PROGRAMS.—The Secretary shall carry out three pilot
programs for the purpose of determining the effectiveness of dif-
ferent models of all-inclusive care-delivery in reducing the use of
hospital and nursing home care by frail, elderly veterans.
(b) LOCATIONS OF PILOT PROGRAMS.—In selecting locations in
which the pilot programs will be carried out, the Secretary may
not select more than one location in any given health care region
of the Veterans Health Administration.
(c) SCOPE OF SERVICES UNDER PILOT PROGRAMS.—Each of the
pilot programs under this section shall be designed to provide
participating veterans with integrated, comprehensive services
which include the following:
(1) Adult-day health care services on an eight-hour per
day, five-day per week basis.
(2) Medical services (including primary care, preventive
services, and nursing home care, as needed).
(3) Coordination of needed services.
(4) Transportation services.
(5) Home care services.
(6) Respite care.
(d) PROGRAM REQUIREMENTS.—In carrying out the pilot pro-
grams under this section, the Secretary shall—
(1) employ the use of interdisciplinary care-management
teams to provide the required array of services;
(2) determine the appropriate number of patients to be
enrolled in each program and the criteria for enrollment; and
(3) ensure that funding for each program is based on the
complex care category under the resource allocation system
(known as the Veterans Equitable Resource Allocation system)
established pursuant to section 429 of Public Law 104–204
(110 Stat. 2929).
(e) DESIGN OF PILOT PROGRAMS.—To the maximum extent fea-
sible, the Secretary shall use the following three models in designing
the three pilot programs under this section:
(1) Under one of the pilot programs, the Secretary shall
provide services directly through facilities and personnel of
the Department.
(2) Under one of the pilot programs, the Secretary shall
provide services through a combination of—
(A) services provided under contract with appropriate
public and private entities; and
(B) services provided through facilities and personnel
of the Department.
H. R. 2116—8
(3) Under one of the pilot programs, the Secretary shall
arrange for the provision of services through a combination
of—
(A) services provided through cooperative arrange-
ments with appropriate public and private entities; and
(B) services provided through facilities and personnel
of the Department.
(f ) IN-KIND ASSISTANCE.—In providing for the furnishing of
services under a contract in carrying out the pilot program described
in subsection (e)(2), the Secretary may, subject to reimbursement,
provide in-kind assistance (through the services of Department
employees and the sharing of other Department resources) to a
facility furnishing care to veterans. Such reimbursement may be
made by reduction in the charges to the Secretary under such
contract.
(g) LIMITATION.—In providing for the furnishing of services
in carrying out a pilot program described in subsection (e)(2) or
(e)(3), the Secretary shall make payment for services only to the
extent that payment for such services is not otherwise covered
(notwithstanding any provision of title XVIII or XIX of the Social
Security Act) by another government or nongovernment entity or
program.
(h) DURATION OF PROGRAMS.—The authority of the Secretary
to provide services under a pilot program under this section shall
cease on the date that is three years after the date of the commence-
ment of that pilot program.
(i) REPORT.—(1) Not later than nine months after the comple-
tion of all of the pilot programs under this section, the Secretary
shall submit to the Committees on Veterans’ Affairs of the Senate
and the House of Representatives a report on those programs.
(2) The report shall include the following:
(A) A description of the implementation and operation of
each such program.
(B) An analysis comparing use of institutional care and
use of other services among enrollees in each of the pilot
programs with the experience of comparable patients who are
not enrolled in one of the pilot programs.
(C) An assessment of the satisfaction of participating vet-
erans with each of those programs.
(D) An assessment of the health status of participating
veterans in each of those programs and of the ability of those
veterans to function independently.
(E) An analysis of the costs and benefits under each of
those programs.
SEC. 103. PILOT PROGRAM RELATING TO ASSISTED LIVING.
(a) PROGRAM AUTHORITY.—The Secretary may carry out a pilot
program for the purpose of determining the feasibility and practica-
bility of enabling eligible veterans to secure needed assisted living
services as an alternative to nursing home care.
(b) LOCATION
OF PILOT PROGRAM.—The pilot program shall
be carried out in a designated health care region of the Department
selected by the Secretary for purposes of this section.
(c) SCOPE OF PROGRAM.—In carrying out the pilot program,
the Secretary may enter into contracts with appropriate facilities
for the provision for a period of up to six months of assisted
H. R. 2116—9
living services on behalf of eligible veterans in the region where
the program is carried out.
(d) ELIGIBLE VETERANS.—A veteran is an eligible veteran for
purposes of this section if the veteran—
(1) is eligible for placement assistance by the Secretary
under section 1730(a) of title 38, United States Code;
(2) is unable to manage routine activities of daily living
without supervision and assistance; and
(3) could reasonably be expected to receive ongoing services
after the end of the contract period under another government
program or through other means.
(e) REPORT.—(1) Not later than 90 days before the end of
the pilot program under this section, the Secretary shall submit
to the Committees on Veterans’ Affairs of the Senate and the
House of Representatives a report on the program.
(2) The report under paragraph (1) shall include the following:
(A) A description of the implementation and operation of
the program.
(B) An analysis comparing use of institutional care among
participants in the program with the experience of comparable
patients who are not enrolled in the program.
(C) A comparison of assisted living services provided by
the Department through the pilot program with domiciliary
care provided by the Department.
(D) The Secretary’s recommendations, if any, regarding
an extension of the program.
(f ) DURATION.—The authority of the Secretary to provide serv-
ices under the pilot program shall cease on the date that is three
years after the date of the commencement of the pilot program.
(g) DEFINITION.—For purposes of this section, the term ‘‘assisted
living services’’ means services in a facility that provides room
and board and personal care for and supervision of residents as
necessary for the health, safety, and welfare of residents.
(h) STANDARDS.—The Secretary may not enter into a contract
with a facility under this section unless the facility meets the
standards established in regulations prescribed under section 1730
of title 38, United States Code.
Subtitle B—Other Access to Care Matters
SEC. 111. REIMBURSEMENT FOR EMERGENCY TREATMENT IN NON-
DEPARTMENT OF VETERANS AFFAIRS FACILITIES.
(a) AUTHORITY TO PROVIDE REIMBURSEMENT.—Chapter 17 is
amended by inserting after section 1724 the following new section:
‘‘§ 1725. Reimbursement for emergency treatment
‘‘(a) GENERAL AUTHORITY.—(1) Subject to subsections (c) and
(d), the Secretary may reimburse a veteran described in subsection
(b) for the reasonable value of emergency treatment furnished the
veteran in a non-Department facility.
‘‘(2) In any case in which reimbursement is authorized under
subsection (a)(1), the Secretary, in the Secretary’s discretion, may,
in lieu of reimbursing the veteran, make payment of the reasonable
value of the furnished emergency treatment directly—
‘‘(A) to a hospital or other health care provider that fur-
nished the treatment; or
H. R. 2116—10
‘‘(B) to the person or organization that paid for such treat-
ment on behalf of the veteran.
‘‘(b) ELIGIBILITY.—(1) A veteran referred to in subsection (a)(1)
is an individual who is an active Department health-care participant
who is personally liable for emergency treatment furnished the
veteran in a non-Department facility.
‘‘(2) A veteran is an active Department health-care participant
if—
‘‘(A) the veteran is enrolled in the health care system
established under section 1705(a) of this title; and
‘‘(B) the veteran received care under this chapter within
the 24-month period preceding the furnishing of such emer-
gency treatment.
‘‘(3) A veteran is personally liable for emergency treatment
furnished the veteran in a non-Department facility if the veteran—
‘‘(A) is financially liable to the provider of emergency treat-
ment for that treatment;
‘‘(B) has no entitlement to care or services under a health-
plan contract (determined, in the case of a health-plan contract
as defined in subsection (f )(2)(B) or (f )(2)(C), without regard
to any requirement or limitation relating to eligibility for care
or services from any department or agency of the United
States);
‘‘(C) has no other contractual or legal recourse against
a third party that would, in whole or in part, extinguish such
liability to the provider; and
‘‘(D) is not eligible for reimbursement for medical care
or services under section 1728 of this title.
‘‘(c) LIMITATIONS ON REIMBURSEMENT.—(1) The Secretary, in
accordance with regulations prescribed by the Secretary, shall—
‘‘(A) establish the maximum amount payable under sub-
section (a);
‘‘(B) delineate the circumstances under which such pay-
ments may be made, to include such requirements on requesting
reimbursement as the Secretary shall establish; and
‘‘(C) provide that in no event may a payment under that
subsection include any amount for which the veteran is not
personally liable.
‘‘(2) Subject to paragraph (1), the Secretary may provide
reimbursement under this section only after the veteran or the
provider of emergency treatment has exhausted without success
all claims and remedies reasonably available to the veteran or
provider against a third party for payment of such treatment.
‘‘(3) Payment by the Secretary under this section on behalf
of a veteran to a provider of emergency treatment shall, unless
rejected and refunded by the provider within 30 days of receipt,
extinguish any liability on the part of the veteran for that treat-
ment. Neither the absence of a contract or agreement between
the Secretary and the provider nor any provision of a contract,
agreement, or assignment to the contrary shall operate to modify,
limit, or negate the requirement in the preceding sentence.
‘‘(d) INDEPENDENT RIGHT OF RECOVERY.—(1) In accordance with
regulations prescribed by the Secretary, the United States shall
have the independent right to recover any amount paid under
this section when, and to the extent that, a third party subsequently
makes a payment for the same emergency treatment.
H. R. 2116—11
‘‘(2) Any amount paid by the United States to the veteran
(or the veteran’s personal representative, successor, dependents,
or survivors) or to any other person or organization paying for
such treatment shall constitute a lien in favor of the United States
against any recovery the payee subsequently receives from a third
party for the same treatment.
‘‘(3) Any amount paid by the United States to the provider
that furnished the veteran’s emergency treatment shall constitute
a lien against any subsequent amount the provider receives from
a third party for the same emergency treatment for which the
United States made payment.
‘‘(4) The veteran (or the veteran’s personal representative, suc-
cessor, dependents, or survivors) shall ensure that the Secretary
is promptly notified of any payment received from any third party
for emergency treatment furnished to the veteran. The veteran
(or the veteran’s personal representative, successor, dependents,
or survivors) shall immediately forward all documents relating to
such payment, cooperate with the Secretary in the investigation
of such payment, and assist the Secretary in enforcing the United
States right to recover any payment made under subsection (c)(3).
‘‘(e) WAIVER.—The Secretary, in the Secretary’s discretion, may
waive recovery of a payment made to a veteran under this section
that is otherwise required by subsection (d)(1) when the Secretary
determines that such waiver would be in the best interest of the
United States, as defined by regulations prescribed by the Secretary.
‘‘(f ) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘emergency treatment’ means medical care
or services furnished, in the judgment of the Secretary—
‘‘(A) when Department or other Federal facilities are
not feasibly available and an attempt to use them before-
hand would not be reasonable;
‘‘(B) when such care or services are rendered in a
medical emergency of such nature that a prudent layperson
reasonably expects that delay in seeking immediate medical
attention would be hazardous to life or health; and
‘‘(C) until such time as the veteran can be transferred
safely to a Department facility or other Federal facility.
‘‘(2) The term ‘health-plan contract’ includes any of the
following:
‘‘(A) An insurance policy or contract, medical or hos-
pital service agreement, membership or subscription con-
tract, or similar arrangement under which health services
for individuals are provided or the expenses of such services
are paid.
‘‘(B) An insurance program described in section 1811
of the Social Security Act (42 U.S.C. 1395c) or established
by section 1831 of that Act (42 U.S.C. 1395j).
‘‘(C) A State plan for medical assistance approved
under title XIX of such Act (42 U.S.C. 1396 et seq.).
‘‘(D) A workers’ compensation law or plan described
in section 1729(a)(2)(A) of this title.
‘‘(E) A law of a State or political subdivision described
in section 1729(a)(2)(B) of this title.
‘‘(3) The term ‘third party’ means any of the following:
‘‘(A) A Federal entity.
‘‘(B) A State or political subdivision of a State.
‘‘(C) An employer or an employer’s insurance carrier.
H. R. 2116—12
‘‘(D) An automobile accident reparations insurance car-
rier.
‘‘(E) A person or entity obligated to provide, or to
pay the expenses of, health services under a health-plan
contract.’’.
(b) CONFORMING
AMENDMENTS.—(1) Section 1729A(b) is
amended—
(A) by redesignating paragraphs (5) and (6) as paragraphs
(6) and (7), respectively; and
(B) by inserting after paragraph (4) the following new
paragraph:
‘‘(5) Section 1725 of this title.’’.
(2) The table of sections at the beginning of such chapter
is amended by inserting after the item relating to section 1724
the following new item:
‘‘1725. Reimbursement for emergency treatment.’’.
(c) EFFECTIVE DATE.—The amendments made by this section
shall take effect 180 days after the date of the enactment of this
Act.
(d) IMPLEMENTATION REPORTS.—The Secretary shall include
with the budget justification materials submitted to Congress in
support of the Department of Veterans Affairs budget for fiscal
year 2002 and for fiscal year 2003 a report on the implementation
of section 1725 of title 38, United States Code, as added by sub-
section (a). Each such report shall include information on the experi-
ence of the Department under that section and the costs incurred,
and expected to be incurred, under that section.
SEC. 112. ELIGIBILITY FOR CARE OF COMBAT-INJURED VETERANS.
Chapter 17 is amended—
(1) in section 1710(a)(2)(D), by inserting ‘‘or who was
awarded the Purple Heart’’ after ‘‘former prisoner of war’’;
and
(2) in section 1705(a)(3), by inserting ‘‘or who were awarded
the Purple Heart’’ after ‘‘former prisoners of war’’.
SEC. 113. ACCESS TO CARE FOR TRICARE-ELIGIBLE MILITARY
RETIREES.
(a) INTERAGENCY AGREEMENT.—(1) The Secretary of Defense
shall enter into an agreement (characterized as a memorandum
of understanding or otherwise) with the Secretary of Veterans
Affairs with respect to the provision of medical care by the Secretary
of Veterans Affairs to eligible military retirees in accordance with
the provisions of subsection (c). That agreement shall include provi-
sions for reimbursement of the Secretary of Veterans Affairs by
the Secretary of Defense for medical care provided by the Secretary
of Veterans Affairs to an eligible military retiree and may include
such other provisions with respect to the terms and conditions
of such care as may be agreed upon by the two Secretaries.
(2) Reimbursement under the agreement under paragraph (1)
shall be in accordance with rates agreed upon by the Secretary
of Defense and the Secretary of Veterans Affairs. Such reimburse-
ment may be made by the Secretary of Defense or by the appropriate
TRICARE Managed Care Support contractor, as determined in
accordance with that agreement.
(3) In entering into the agreement under paragraph (1), particu-
larly with respect to determination of the rates of reimbursement
H. R. 2116—13
under paragraph (2), the Secretary of Defense shall consult with
TRICARE Managed Care Support contractors.
(4) The Secretary of Veterans Affairs may not enter into an
agreement under paragraph (1) for the provision of care in accord-
ance with the provisions of subsection (c) with respect to any
geographic service area, or a part of any such area, of the Veterans
Health Administration unless—
(A) in the judgment of that Secretary, the Department
of Veterans Affairs will recover the costs of providing such
care to eligible military retirees; and
(B) that Secretary has certified and documented, with
respect to any geographic service area in which the Secretary
proposes to provide care in accordance with the provisions
of subsection (c), that such geographic service area, or des-
ignated part of any such area, has adequate capacity (consistent
with the requirements in section 1705(b)(1) of title 38, United
States Code, that care to enrollees shall be timely and accept-
able in quality) to provide such care.
(5) The agreement under paragraph (1) shall be entered into
by the Secretaries not later than nine months after the date of
the enactment of this Act. If the Secretaries are unable to reach
agreement, they shall jointly report, by that date or within 30
days thereafter, to the Committees on Armed Services and the
Committees on Veterans’ Affairs of the Senate and House of Rep-
resentatives on the reasons for their inability to reach an agreement
and their mutually agreed plan for removing any impediments
to final agreement.
(b) DEPOSITING
OF REIMBURSEMENTS.—Amounts received by
the Secretary of Veterans Affairs under the agreement under sub-
section (a) shall be deposited in the Department of Veterans Affairs
Health Services Improvement Fund established under section
1729B of title 38, United States Code, as added by section 202.
(c) COPAYMENT REQUIREMENT.—The provisions of subsections
(f )(1) and (g)(1) of section 1710 of title 38, United States Code,
shall not apply in the case of an eligible military retiree who
is covered by the agreement under subsection (a).
(d) PHASED IMPLEMENTATION.—(1) The Secretary of Defense
shall include in each TRICARE contract entered into after the
date of the enactment of this Act provisions to implement the
agreement under subsection (a).
(2) The provisions of the agreement under subsection (a)(2)
and the provisions of subsection (c) shall apply to the furnishing
of medical care by the Secretary of Veterans Affairs in any area
of the United States only if that area is covered by a TRICARE
contract that was entered into after the date of the enactment
of this Act.
(e) ELIGIBLE MILITARY RETIREES.—For purposes of this section,
an eligible military retiree is a member of the Army, Navy, Air
Force, or Marine Corps who—
(1) has retired from active military, naval, or air service;
(2) is eligible for care under the TRICARE program estab-
lished by the Secretary of Defense;
(3) has enrolled for care under section 1705 of title 38,
United States Code; and
(4) is not described in paragraph (1) or (2) of section 1710(a)
of such title.
H. R. 2116—14
SEC. 114. TREATMENT AND SERVICES FOR DRUG OR ALCOHOL
DEPENDENCY.
(a) AUTHORITY TO PROVIDE TREATMENT
AND SERVICES
FOR
MEMBERS ON ACTIVE DUTY.—Section 1720A(c) is amended in the
first sentence of paragraph (1)—
(1) by striking ‘‘may not be transferred’’ and inserting ‘‘may
be transferred’’; and
(2) by striking ‘‘unless such transfer is during the last
thirty days of such member’s enlistment or tour of duty’’.
(b) CONFORMING AMENDMENT.—The first sentence of paragraph
(2) of that section is amended by striking ‘‘during the last thirty
days of such person’s enlistment period or tour of duty’’.
SEC. 115. COUNSELING AND TREATMENT FOR VETERANS WHO HAVE
EXPERIENCED SEXUAL TRAUMA.
(a) EXTENSION OF PERIOD OF PROGRAM.—Subsection (a) of sec-
tion 1720D is amended—
(1) in paragraph (1), by striking ‘‘December 31, 2001’’ and
inserting ‘‘December 31, 2004’’; and
(2) in paragraph (3), by striking ‘‘December 31, 2001’’ and
inserting ‘‘December 31, 2004’’.
(b) MANDATORY NATURE OF PROGRAM.—(1) Subsection (a)(1)
of such section is further amended by striking ‘‘may provide coun-
seling to a veteran who the Secretary determines requires such
counseling’’ and inserting ‘‘shall operate a program under which
the Secretary provides counseling and appropriate care and services
to veterans who the Secretary determines require such counseling
and care and services’’.
(2) Subsection (a) of such section is further amended—
(A) by striking paragraph (2); and
(B) by redesignating paragraph (3) (as amended by sub-
section (a)(2)) as paragraph (2).
(c) OUTREACH EFFORTS.—Subsection (c) of such section is
amended—
(1) by inserting ‘‘and treatment’’ in the first sentence and
in paragraph (2) after ‘‘counseling’’;
(2) by striking ‘‘and’’ at the end of paragraph (1);
(3) by redesignating paragraph (2) as paragraph (3); and
(4) by inserting after paragraph (1) the following new para-
graph (2):
‘‘(2) shall ensure that information about the counseling
and treatment available to veterans under this section—
‘‘(A) is revised and updated as appropriate;
‘‘(B) is made available and visibly posted at appropriate
facilities of the Department; and
‘‘(C) is made available through appropriate public
information services; and’’.
(d) REPORT ON IMPLEMENTATION OF OUTREACH ACTIVITIES.—
Not later than six months after the date of the enactment of
this Act, the Secretary of Veterans Affairs shall submit to the
Committees on Veterans’ Affairs of the Senate and House of Rep-
resentatives a report on the Secretary’s implementation of para-
graph (2) of section 1720D(c) of title 38, United States Code, as
added by subsection (c). Such report shall include examples of
the documents and other means of communication developed for
compliance with that paragraph.
H. R. 2116—15
(e) STUDY OF EXPANDING ELIGIBILITY FOR COUNSELING AND
TREATMENT.—(1) The Secretary of Veterans Affairs, in consultation
with the Secretary of Defense, shall conduct a study to determine—
(A) the extent to which former members of the reserve
components of the Armed Forces experienced physical assault
of a sexual nature or battery of a sexual nature while serving
on active duty for training;
(B) the extent to which such former members have sought
counseling from the Department of Veterans Affairs relating
to those incidents; and
(C) the additional resources that, in the judgment of the
Secretary, would be required to meet the projected need of
those former members for such counseling.
(2) Not later than 16 months after the date of the enactment
of this Act, the Secretary of Veterans Affairs shall submit to the
Committees on Veterans’ Affairs of the Senate and House of Rep-
resentatives a report on the results of the study conducted under
paragraph (1).
(f ) OVERSIGHT OF OUTREACH ACTIVITIES.—Not later than 14
months after the date of the enactment of this Act, the Secretary
of Veterans Affairs and the Secretary of Defense shall submit
to the appropriate congressional committees a joint report
describing in detail the collaborative efforts of the Department
of Veterans Affairs and the Department of Defense to ensure that
members of the Armed Forces, upon separation from active military,
naval, or air service, are provided appropriate and current informa-
tion about programs of the Department of Veterans Affairs to
provide counseling and treatment for sexual trauma that may have
been experienced by those members while in the active military,
naval, or air service, including information about eligibility require-
ments for, and procedures for applying for, such counseling and
treatment. The report shall include proposed recommendations from
both the Secretary of Veterans Affairs and the Secretary of Defense
for the improvement of their collaborative efforts to provide such
information.
(g) REPORT ON IMPLEMENTATION OF SEXUAL TRAUMA TREAT-
MENT PROGRAM.—Not later than 14 months after the date of the
enactment of this Act, the Secretary shall submit to the Committees
on Veterans’ Affairs of the Senate and House of Representatives
a report on the use made of the authority provided under section
1720D of title 38, United States Code, as amended by this section.
The report shall include the following with respect to activities
under that section since the enactment of this Act:
(1) The number of veterans who have received counseling
under that section.
(2) The number of veterans who have been referred to
non-Department mental health facilities and providers in
connection with sexual trauma counseling and treatment.
SEC. 116. SPECIALIZED MENTAL HEALTH SERVICES.
(a) IMPROVEMENT TO SPECIALIZED MENTAL HEALTH SERVICES.—
The Secretary, in furtherance of the responsibilities of the Secretary
under section 1706(b) of title 38, United States Code, shall carry
out a program to expand and improve the provision of specialized
mental health services to veterans. The Secretary shall establish
the program in consultation with the Committee on Care of Severely
H. R. 2116—50
recall-eligible judge shall apply only during periods when the judge
is serving in recall status.’’.
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of such chapter is amended by adding at the end the following
new item:
‘‘7299. Limitation on activities of retired judges.’’.
Subtitle C—Rotation of Service of Judges
as Chief Judge of the Court
SEC. 1031. REPEAL OF SEPARATE APPOINTMENT OF CHIEF JUDGE.
Subsection (a) of section 7253 is amended to read as follows:
‘‘(a) COMPOSITION.—The Court of Appeals for Veterans Claims
is composed of at least three and not more than seven judges,
one of whom shall serve as chief judge in accordance with subsection
(d).’’.
SEC. 1032. DESIGNATION AND TERM OF CHIEF JUDGE OF COURT.
(a) ROTATION.—Subsection (d) of section 7253 is amended to
read as follows:
‘‘(d) CHIEF JUDGE.—(1) The chief judge of the Court shall be
the judge of the Court in regular active service who is senior
in commission among the judges of the Court who—
‘‘(A) have served for one or more years as judges of the
Court; and
‘‘(B) have not previously served as chief judge.
‘‘(2) In any case in which there is no judge of the Court in
regular active service who has served as a judge of the Court
for at least one year, the judge of the court in regular active
service who is senior in commission and has not served previously
as chief judge shall act as the chief judge.
‘‘(3) Except as provided in paragraph (4), a judge of the Court
shall serve as the chief judge under paragraph (1) for a term
of five years or until the judge becomes age 70, whichever occurs
first. If no other judge is eligible under paragraph (1) to serve
as chief judge upon the expiration of that term, that judge shall
continue to serve as chief judge until another judge becomes eligible
under that paragraph to serve as chief judge.
‘‘(4)(A) The term of a chief judge shall be terminated before
the end of the term prescribed by paragraph (3) if—
‘‘(i) the chief judge leaves regular active service as a judge
of the court; or
‘‘(ii) the chief judge notifies the other judges of the court
in writing that such judge desires to be relieved of the duties
of chief judge.
‘‘(B) The effective date of a termination of the term under
subparagraph (A) shall be the date on which the chief judge leaves
regular active service or the date of the notification under subpara-
graph (A)(ii), as the case may be.
‘‘(5) If a chief judge is temporarily unable to perform the duties
of chief judge, those duties shall be performed by the judge of
the court in active service who is present, able and qualified to
act, and is next in precedence.
H. R. 2116—51
‘‘(6) Judges who have the same seniority in commission shall
be eligible for service as chief judge in accordance with their relative
precedence.’’.
(b) INELIGIBILITY OF JUDGES ON TEMPORARY SERVICE.—A person
serving as a judge of the Court under section 1011 may not serve
as chief judge of the Court.
SEC. 1033. SALARY.
Subsection (e) of section 7253 is amended to read as follows:
‘‘(e) SALARY.—Each judge of the Court shall receive a salary
at the same rate as is received by judges of the United States
district courts.’’.
SEC. 1034. PRECEDENCE OF JUDGES.
Subsection (d) of section 7254 is amended to read as follows:
‘‘(d) PRECEDENCE OF JUDGES.—The chief judge of the Court
shall have precedence and preside at any session that the chief
judge attends. The other judges shall have precedence and preside
according to the seniority of their original commissions. Judges
whose commissions bear the same date shall have precedence
according to seniority in age.’’.
SEC. 1035. CONFORMING AMENDMENTS.
Chapter 72 is amended as follows:
(1) Section 7281(g) is amended to read as follows:
‘‘(g) The chief judge of the Court may exercise the authority
of the Court under this section whenever there are not at least
two other judges of the Court.’’.
(2) Sections 7296(a)(2) and 7297(a)(2) are amended by
striking ‘‘the chief judge or an associate judge’’ and inserting
‘‘a judge’’.
SEC. 1036. APPLICABILITY OF AMENDMENTS.
(a) EFFECTIVE DATE.—The amendments made by this subtitle
shall take effect on the date of the enactment of this Act.
(b) SAVINGS PROVISION
FOR INCUMBENT CHIEF JUDGE.—The
amendments made by this subtitle shall not apply while the indi-
vidual who is chief judge of the Court on the date of the enactment
of this Act continues to serve as chief judge. If that individual,
upon termination of service as chief judge, provides notice under
section 7257 of title 38, United States Code, of availability for
service in a recalled status, the rate of pay applicable to that
individual under section 7296(c)(1)(A) of such title while serving
in a recalled status shall be at the rate of pay applicable to that
individual at the time of retirement, if greater than the rate other-
wise applicable under that section.
TITLE XI—VOLUNTARY SEPARATION
INCENTIVE PROGRAM
SEC. 1101. SHORT TITLE.
This title may be cited as the ‘‘Department of Veterans Affairs
Employment Reduction Assistance Act of 1999’’.