106TH CONGRESS
1ST SESSION
H. R. 2116
AN ACT
To amend title 38, United States Code, to establish a pro-
gram of extended care services for veterans and to make
other improvements in health care programs of the De-
partment of Veterans Affairs.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS; REF-
ERENCES TO TITLE 38, UNITED STATES CODE.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Veterans’ Millennium Health Care Act’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title; table of contents; references to title 38, United States Code.
TITLE I—ACCESS TO CARE
Sec. 101. Extended care services.
Sec. 102. Reimbursement for emergency treatment.
Sec. 103. Eligibility for care of combat-injured veterans.
Sec. 104. Access to care for military retirees.
Sec. 105. Benefits for persons disabled by participation in compensated work
therapy program.
Sec. 106. Pilot program of medical care for certain dependents of enrolled vet-
erans.
Sec. 107. Enhanced services program at designated medical centers.
Sec. 108. Counseling and treatment for veterans who have experienced sexual
trauma.
TITLE II—PROGRAM ADMINISTRATION
Sec. 201. Medical care collections.
Sec. 202. Health Services Improvement Fund.
Sec. 203. Veterans Tobacco Trust Fund.
Sec. 204. Authority to accept funds for education and training.
Sec. 205. Extension and revision of certain authorities.
Sec. 206. State Home grant program.
Sec. 207. Expansion of enhanced-use lease authority.
Sec. 208. Ineligibility for employment by Veterans Health Administration of
health care professionals who have lost license to practice in
one jurisdiction while still licensed in another jurisdiction.
TITLE III—MISCELLANEOUS
Sec. 301. Review of proposed changes to operation of medical facilities.
Sec. 302. Patient services at Department facilities.
Sec. 303. Report on assisted living services.
Sec. 304. Chiropractic treatment.
Sec. 305. Designation of hospital bed replacement building at Ioannis A.
Lougaris Department of Veterans Affairs Medical Center,
Reno, Nevada.
TITLE IV—CONSTRUCTION AND FACILITIES MATTERS
Sec. 401. Authorization of major medical facility projects.
Sec. 402. Authorization of major medical facility leases.
Sec. 403. Authorization of appropriations.
(c) REFERENCES
TO TITLE 38, UNITED STATES
CODE.—Except as otherwise expressly provided, whenever
in this Act an amendment or repeal is expressed in terms
of an amendment to, or repeal of, a section or other provi-
sion, the reference shall be considered to be made to a
section or other provision of title 38, United States Code.
TITLE I—ACCESS TO CARE
SEC. 101. EXTENDED CARE SERVICES.
(a) REQUIREMENT TO PROVIDE EXTENDED CARE
SERVICES.—(1) Chapter 17 is amended by inserting after
section 1710 the following new section:
‘‘§ 1710A. 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 following:
‘‘(1) Geriatric evaluation.
‘‘(2) Nursing home care (A) in facilities oper-
ated by the Secretary, and (B) in community-based
facilities through contracts 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, including those described in sec-
tion 1720C of this title, as the Secretary considers
reasonable and appropriate.
‘‘(6) Respite care under section 1720B of this
title.
‘‘(b)(1) In carrying out subsection (a), the Secretary
shall provide extended care services which the Secretary
determines are needed (A) to any veteran in need of such
care for a service-connected disability, and (B) to any vet-
eran who is in need of such care and who has a service-
connected disability rated at 50 percent or more.
‘‘(2) The Secretary, in making placements for nurs-
ing home care in Department facilities, shall give highest
priority to veterans (A) who are in need of such care for
a service-connected disability, or (B) who have a service-
connected disability rated at 50 percent or more. The Sec-
retary shall ensure that a veteran described in this sub-
section who continues to need nursing home care shall not
after placement in a Department nursing home be trans-
ferred from the facility without the consent of the veteran,
or, in the event the veteran cannot provide informed con-
sent, the representative of the veteran.
‘‘(c)(1) The Secretary, in carrying out subsection (a),
shall prescribe regulations governing the priorities for the
provision of nursing home care in Department facilities
so as to ensure that priority for such care is given (A)
for patient rehabilitation, (B) for clinically complex pa-
tient populations, and (C) for patients for whom there are
not other suitable placement options.
‘‘(2) The Secretary may not furnish extended care
services for a non-service-connected disability other than
in the case of a veteran who has a service-connected dis-
ability rated at 50 percent or more unless the veteran
agrees to pay to the United States a copayment for ex-
tended care services of more than 21 days in any year.
‘‘(d)(1) A veteran who is furnished extended care
services under this chapter and who is required under sub-
section (c)(2) 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)(2), the Secretary
shall develop a methodology for establishing the amount
of the copayment for which a veteran described in sub-
section (c) is liable. That methodology shall provide for—
‘‘(A) establishing a maximum monthly copay-
ment (based on all income and assets of the veteran
and the spouse of such veteran);
‘‘(B) protecting the spouse of a veteran from fi-
nancial hardship by not counting all of the income
and assets of the veteran and spouse (in the case of
a spouse who resides in the community) 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 (hereinafter in
this section referred to as the ‘fund’). Amounts in the fund
shall be available, without fiscal year limitation and with-
out 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 1710 the following new item:
‘‘1710A. Requirement to provide extended care.’’.
(b) REQUIREMENT TO INCREASE EXTENDED CARE
SERVICES.—(1) Not later than January 1, 2000, the Sec-
retary of Veterans Affairs shall develop and begin to im-
plement a plan for carrying out the recommendation of
the Federal Advisory Committee on the Future of Long-