I 
108TH CONGRESS 
1ST SESSION 
H. R. 271
To require the Secretary of Veterans Affairs to modify the formula, known 
as the Veterans Equitable Resource Allocation (VERA) system, for the 
allocation of funds appropriated to the Department of Veterans Affairs 
for medical care to different geographic regions of the Nation, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 8, 2003
Mr. FRELINGHUYSEN (for himself, Mrs. KELLY, Mr. HINCHEY, and Mr. KING 
of New York) introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
A BILL 
To require the Secretary of Veterans Affairs to modify the 
formula, known as the Veterans Equitable Resource Allo-
cation (VERA) system, for the allocation of funds appro-
priated to the Department of Veterans Affairs for med-
ical care to different geographic regions of the Nation, 
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 ‘‘Equitable Care for All 
Veterans Act’’.
SEC. 2. REVISION TO MEDICAL CARE FUNDING ALLOCA-
TION FORMULA FOR DEPARTMENT OF VET-
ERANS AFFAIRS. 
(a) MODIFICATION TO VERA FORMULA.—The fund-
ing allocation formula for the Department of Veterans Af-
fairs medical care system known as the Veterans Equi-
table Resource Allocation (VERA) system, established 
pursuant to section 429 of Public Law 104–204 (110 
Stat. 2929), shall be modified by the Secretary of Vet-
erans Affairs in accordance with this section. Such modi-
fications shall provide for the incorporation of regional dif-
ferences in the cost of providing health care to veterans 
(due to different regional cost of living, long travel dis-
tance, and other appropriate factors) as part of the cri-
teria used to determine the national means differential 
used in the existing system. 
(b) EVALUATION.—At the end of the second fiscal 
year beginning after the date of the enactment of this Act, 
the Secretary of Veterans Affairs shall evaluate the effects 
of the modifications implemented pursuant to subsection 
(a) on the regional allocation of funds available to the De-
partment of Veterans Affairs for health care. The Sec-
retary shall submit to Congress not later than 60 days 
after the end of such fiscal year the determination of the 
Secretary as to whether those modifications have resulted 
in a substantive shift in the funding allocations among the
different service regions of the Veterans Health Adminis-
tration compared to the allocations before such modifica-
tions. 
(c) CONTINGENT TERMINATION
OF VERA FOR-
MULA.—If in the report submitted pursuant to subsection 
(b) the Secretary of Veterans Affairs determines that the 
modifications have not resulted in a substantive shift in 
the funding allocations described in that subsection, the 
Secretary shall immediately terminate use of the Veterans 
Equitable Resource Allocation system for the regional allo-
cation of funds available to the Department of Veterans 
Affairs for health care. 
SEC. 3. STANDBY ALTERNATIVE SYSTEM. 
(a) DEVELOPMENT OF REPLACEMENT FORMULA.—
If pursuant to section 2(c) the Secretary of Veterans Af-
fairs is required to terminate the use of the Veterans Eq-
uitable Resource Allocation system, the Secretary shall de-
velop a new formula for the allocation of funds appro-
priated to the Department of Veterans Affairs for Medical 
Care to the national service regions, known as Veterans 
Integrated Service Networks (VISNs), of the Department. 
In developing such formula, the Secretary shall take the 
following requirements into account: 
(1) For any fiscal year for which the amount 
appropriated for Medical Care is an increase from
the preceding year, the funding level provided under 
the new formula to any VISN may not be less than 
the amount provided for the preceding year. 
(2) The new formula shall take into account ad-
ditional costs incurred by a VISN due to any of the 
following factors at that VISN being in excess of the 
median for all VISNs: 
(A) The number of veterans moving into 
the geographic area of that VISN. 
(B) The median age of veterans in that 
VISN. 
(C) The number of veterans in that VISN 
requiring complex care or nursing home care. 
(D) The age of Department of Veterans 
Affairs health care facilities in that VISN. 
(b) TRANSITION FORMULA.—Until a replacement 
funding allocation formula is implemented pursuant to 
subsection (a), the funding allocation formula to be ap-
plied by the Secretary to amounts appropriated for vet-
erans medical care shall be the formula in effect before 
the Veterans Equitable Resource Allocation system. 
SEC. 4. AUTHORIZATIONS OF APPROPRIATIONS. 
(a) AUTHORIZATION FOR REPLACEMENT ALLOCA-
TION FORMULA.—There is authorized to be appropriated
to the Department of Veterans Affairs for fiscal year 2003 
the amount of $10,000,000 for purposes of this Act. 
(b) ADDITIONAL
‘‘MEDICAL
CARE’’ AUTHORIZA-
TIONS.—There is authorized to be appropriated to the De-
partment of Veterans Affairs for fiscal year 2003 the 
amount of $100,000,000 for ‘‘Medical Care’’ for the De-
partment of Veterans Affairs. Such amount is in addition 
to any other amount authorized to be appropriated to the 
Department of Veterans Affairs for fiscal year 2003 and 
shall be allocated by the Secretary to the national service 
regions, known as Veterans Integrated Service Networks 
(VISNs), of the Department of Veterans Affairs on the 
basis of need, as follows: 
(1) First, to the VISN that has experienced the 
greatest reduction in funding from the funding levels 
for fiscal year 1997. 
(2) Second, to any other VISN that has experi-
enced an overall five-year funding decrease. 
(3) Third, if any amount appropriated pursuant 
to such authorization remains after allocations pur-
suant to paragraphs (1) and (2), such amount shall 
be allocated equally among the remaining 22 VISNs 
before implementation of the new formula.
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