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 Penn-
sylvania, Mr. PICKERING, Mr. ISTOOK, Mr. ISAKSON, Mr. FROST, Mr. 
CASE, Mr. GOODE, Mr. SIMPSON, Mr. SANDLIN, Mr. HASTINGS of Wash-
ington, 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 Sec-
retary 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.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Help Establish Access 
to Local Timely Healthcare for Your Vets (HEALTHY 
Vets) Act of 2004’’. 
SEC. 2. ENHANCED CONTRACT CARE AUTHORITY FOR 
HEALTH CARE NEEDS OF VETERANS IN HIGH-
LY RURAL AREAS. 
(a) RURAL VETERANS.—Section 1703 of title 38, 
United States Code, is amended by adding at the end the 
following new subsection: 
‘‘(d)(1) In the case of a veteran for whom Depart-
ment facilities are geographically inaccessible (as provided 
in paragraph (2)), the Secretary shall use the contract au-
thority provided in subsection (a) for the following care: 
‘‘(A) Primary care. 
‘‘(B) Acute or chronic symptom management. 
‘‘(C) Nontherapeutic medical services. 
‘‘(D) Other medical services as determined ap-
propriate by the director of the appropriate geo-
graphic service region of the Department, after con-
sultation with the Department physician responsible 
for primary care of the veteran. 
‘‘(2) Department facilities shall be deemed to be geo-
graphically inaccessible for purposes of paragraph (1) in 
the case of a veteran whose residence meets any of the 
following criteria:
‘‘(A) The residence is in a county with a popu-
lation density of less than 7.0 people per square mile 
and is more than 75 miles from the nearest Depart-
ment health care facility. 
‘‘(B) The residence is in a county with a popu-
lation density of more than 7.0 and less than 8.0 
people per square mile and is more than 100 miles 
from the nearest Department health care facility. 
‘‘(C) The residence is in a county with a popu-
lation density of more than 8.0 and less than 9.0 
people per square mile and is more than 125 miles 
from the nearest Department health care facility. 
‘‘(D) The residence is more than 150 miles 
from the nearest Department health care facility. 
‘‘(3) The Secretary may waive the requirement in 
paragraph (1) in the case of a particular veteran if the 
Secretary demonstrates on an individual basis through a 
cost-benefit analysis that the costs to the Department of 
providing care to that veteran pursuant to paragraph (1) 
significantly outweigh the benefits of localized health care 
for the individual veteran. 
‘‘(4) For purposes of paragraph (2), a distance in 
miles shall be determined on the basis of the most conven-
ient highway route that is available to the veteran, as de-
termined by the Secretary.’’.
(b) EFFECTIVE DATE.—Subsection (d) of section 
1703 of title 38, United States Code, as added by sub-
section (a), shall take effect at the end of the 120-day 
period beginning on the date of the enactment of this Act.
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