I
107TH CONGRESS
1ST SESSION
H. R. 2792
To amend title 38, United States Code, to authorize the Secretary of Veterans
Affairs to make service dogs available to disabled veterans and to make
various other improvements in health care benefits provided by the De-
partment of Veterans Affairs, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 2, 2001
Mr. MORAN of Kansas (for himself, Mr. SMITH of New Jersey, and Mr. SIM-
MONS) introduced the following bill; which was referred to the Committee
on Veterans’ Affairs
A BILL
To amend title 38, United States Code, to authorize the
Secretary of Veterans Affairs to make service dogs avail-
able to disabled veterans and to make various other
improvements in health care benefits provided by 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. SHORT TITLE.
This Act may be cited as the ‘‘Disabled Veterans
Service Dog and Health Care Improvement Act of 2001’’.
SEC. 2. AUTHORIZATION FOR SECRETARY OF VETERANS
AFFAIRS TO PROVIDE SERVICE DOGS FOR
DISABLED VETERANS.
(a) AUTHORITY.—Section 1714 of title 38, United
States Code, is amended—
(1) in subsection (b)—
(A) by striking ‘‘seeing-eye or’’ the first
place it appears;
(B) by striking ‘‘who are entitled to dis-
ability compensation’’ and inserting ‘‘who are
enrolled under section 1705 of this title’’;
(C) by striking ‘‘, and may pay’’ and all
that follows through ‘‘such seeing-eye or guide
dogs’’; and
(D) by striking ‘‘handicap’’ and inserting
‘‘disability’’; and
(2) by adding at the end the following new sub-
sections:
‘‘(c) The Secretary may provide—
‘‘(1) service dogs trained for the aid of the
hearing impaired to veterans who are hearing im-
paired and are enrolled under section 1705 of this
title; and
‘‘(2) service dogs trained for the aid of persons
with spinal cord injury or dysfunction or other
chronic impairment that substantially limits mobility
to veterans with such injury, dysfunction, or impair-
ment who are enrolled under section 1705 of this
title.
‘‘(d) In the case of a veteran provided a dog under
subsection (b) or (c), the Secretary may pay travel and
incidental expenses for that veteran under the terms and
conditions set forth in section 111 of this title to and from
the veteran’s home for expenses incurred in becoming ad-
justed to the dog.’’.
(b) CLERICAL AMENDMENTS.—
(1) The heading for such section is amended to
read as follows:
‘‘§ 1714. Fitting and training in use of prosthetic ap-
pliances; guide dogs; service dogs’’.
(2) The item relating to such section in the
table of sections at the beginning of chapter 17 of
such title is amended to read as follows:
‘‘1714. Fitting and training in use of prosthetic appliances; guide dogs; service
dogs.’’.
SEC. 3. MAINTENANCE OF CAPACITY FOR SPECIALIZED
TREATMENT AND REHABILITATIVE NEEDS OF
DISABLED VETERANS.
(a) MAINTENANCE OF CAPACITY ON A SERVICE-NET-
WORK BASIS.—Paragraph (1) of section 1706(b) of title
38, United States Code, is amended—
(1) in the first sentence, by inserting ‘‘(and
each geographic service area of the Veterans Health
Administration)’’ after ‘‘ensure that the Depart-
ment’’;
(2) in clause (B), by inserting ‘‘(and each geo-
graphic service area of the Veterans Health Admin-
istration)’’ after ‘‘overall capacity of the Depart-
ment’’; and
(3) by inserting after the first sentence the fol-
lowing new sentence: ‘‘The capacity of the Depart-
ment (and each geographic service area of the Vet-
erans Health Administration) to provide for the spe-
cialized treatment and rehabilitative needs of dis-
abled veterans (including veterans with spinal cord
dysfunction, blindness, amputations, and mental ill-
ness) within distinct programs or facilities shall be
measured by the annual amount (adjusted for infla-
tion) expended for care of such veterans in dedicated
programs which provide such specialized treatment
and 
rehabilitative 
services 
through 
specialized
staff.’’.
(b) EXTENSION
OF ANNUAL REPORT REQUIRE-
MENT.—Paragraph (2) of such section is amended by
striking ‘‘April 1, 1999, April 1, 2000, and April 1, 2001’’
and inserting ‘‘April 1 of each year through 2004’’.
SEC. 4. THRESHOLD FOR VETERANS HEALTH CARE ELIGI-
BILITY MEANS TEST TO REFLECT LOCALITY
COST-OF-LIVING VARIATIONS.
(a) REVISED THRESHOLD.—Subsection (b) of section
1722 is amended to read as follows:
‘‘(b) For purposes of subsection (a)(3), the income
threshold applicable to a veteran is the greater of the fol-
lowing:
‘‘(1) For any calendar year after 2000—
‘‘(A) in the case of a veteran with no de-
pendents, $23,688, as adjusted pursuant to
subsection (c); or
‘‘(B) in the case of a veteran with one or
more dependents, $28,429, as so adjusted, plus
$1,586, as so adjusted, for each dependent in
excess of one.
‘‘(2) The amount in effect under the HUD Low
Income Index that is applicable in the area in which
the veteran resides.’’.
(b) HUD LOW INCOME INDEX.—Subsection (b) of
such section is further amended by adding at the end the
following new paragraph:
‘‘(3) For purposes of paragraph (1)(B), the term
‘HUD Low Income Index’ means the family income ceiling
amounts determined by the Secretary of Housing and
Urban Development under section 3(b)(2) of the United
States Housing Act of 1937 (42 U.S.C. 1437a(b)(2)) for
purposes of the determination of ‘low-income families’
under that section.’’.
(c) CONFORMING AMENDMENTS.—Such section is
further amended—
(1) in subsection (b)(2), by striking ‘‘December
31, 1990’’ and inserting ‘‘December 31, 2001’’; and
(2) in subsection (c), by striking ‘‘subsection
(b)’’ and inserting ‘‘subsection (b)(1)’’.
(d) EFFECTIVE DATE.—The amendments made by
this section shall take effect on April 1, 2002.
SEC. 5. PILOT PROGRAM FOR COORDINATION OF AMBULA-
TORY COMMUNITY HOSPITAL CARE.
(a) IN GENERAL.—Chapter 17 of title 38, United
States Code, is amended by inserting after section 1725
the following new section:
‘‘§ 1725A. Coordination of hospital benefits: pilot pro-
gram
‘‘(a) PILOT PROGRAM.—Subject to the availability of
funds specified in subsection (g), the Secretary shall carry
out a pilot program in not more than four geographic
areas of the United States to improve access to, and co-
ordination of, inpatient care of eligible veterans. Under the
pilot program, the Secretary, subject to subsection (b),
shall pay certain costs described in subsection (b) for
residence of the veteran, and (ii) located within the
geographic area in which the Secretary is carrying
out the program described in subsection (a);
‘‘(B) has received care under this chapter with-
in the 24-month period preceding the veteran’s ap-
plication for enrollment in the pilot program;
‘‘(C) as determined by the Secretary before the
hospitalization of the veteran (i) requires such hos-
pital care and services for a non-service-connected
condition, and (ii) could not receive such services
from a clinic operated by the Secretary; and
‘‘(D) elects to receive such care under a health-
care plan (other than under this title) under which
the veteran is entitled to receive such care.
‘‘(2) Nothing in this section shall be construed to re-
duce the authority of the Secretary to contract with non-
Department facilities for care of a service-connected dis-
ability of a veteran.
‘‘(3) Notwithstanding subparagraph (D) of para-
graph (1), the Secretary shall ensure that not less than
15 percent of the veterans participating in the program
are veterans who do not have a health-care plan.
‘‘(d) CASE MANAGEMENT.—As part of the program
under this section, the Secretary shall, through provision
of case-management, coordinate the care being furnished
purposes of this section from any other funds available
to the Secretary for the delivery of health care services
to veterans, including funds appropriated or otherwise
available for the care and treatment of veterans who re-
quire specialized care and resources.
‘‘(h) HEALTH-CARE PLAN DEFINED.—For purposes
of this section, the term ‘health-care plan’ has the mean-
ing given that term in section 1725(f)(3) of this title.’’.
(b) CLERICAL AMENDMENT.—The table of sections
at the beginning of such chapter is amended by inserting
after the item relating to section 1725 the following new
item:
‘‘1725A. Coordination of hospital benefits: pilot program.’’.
SEC. 6. PILOT PROGRAM FOR CONTRACT HOSPITALIZA-
TION AND FEE BASIS AMBULATORY CARE.
(a) ESTABLISHMENT OF PROGRAM.—The Secretary
of Veterans Affairs shall conduct a pilot program under
which veterans receiving fee basis and contract hos-
pitalization under sections 1703 and 1728 of title 38,
United States Code, in selected service areas of the Vet-
erans Health Administration shall be provided such hos-
pitalization through a contractor that is a managed care
coordinator. The program shall be conducted during the
three-year period beginning on July 1, 2002.
(b) SITES FOR PROGRAM.—The Secretary shall con-
duct the pilot program in not less than four geographic
service areas of the Veterans Health Administration that
are selected by the Secretary for participation in the pro-
gram from among such service areas that are located in
areas that the Secretary determines exhibit mature man-
aged care markets. Under the program, to the extent prac-
ticable all fee basis and contract hospitalization provided
by the Secretary in a selected geographic service area shall
be provided through a managed care coordinator con-
tractor.
(c) SELECTION
OF CONTRACTOR.—The Secretary
shall select a contractor for the pilot program not later
than six months after the date of the enactment of this
Act. The contractor shall be an experienced managed care
coordinator with an in-place network of credentialed pro-
viders.
(d) AUTOMATIC ENROLLMENT.—Each veteran who is
enrolled under section 1705 of title 38, United States
Code, who resides in a geographic service area selected for
participation in the pilot program, and who as of the com-
mencement of the pilot program is authorized use of non-
VA care services through fee basis programs of the De-
partment, or who is eligible for contract hospitalization
under section 1703 or 1728 of title 38, United States
Code, shall be automatically enrolled for participation in
the pilot program. Each such veteran shall be provided
a directory of credentialed health care providers from
which to choose when approved by the Secretary to receive
non-VA care or to use in health emergencies in the case
of contract hospitalization.
(e) PROGRAM FEATURES.—As part of the program,
the Secretary shall provide for the following:
(1) Use of commercial-industry standards (or in
their absence, Department standards) for access,
timeliness, patient satisfaction measures, and utiliza-
tion management.
(2) Assignment of a primary care manager at
each department medical center participating in the
program.
(3) Establishment by the contractor of a toll-
free telephone system staffed by registered nurses to
provide advice and health care referral information
to veterans enrolled in the pilot program on a 24-
hour a day, seven-day a week basis.
(4) Establishment by the contractor of a vet-
erans service telephone line for the provision of in-
formation on eligibility, enrollment, and provider lo-
cations.
(5) Concurrent review.
(6) Demand management.
(7) Disease management.
(8) Health and wellness programs.
(f) PRIMARY CARE MANAGER FUNCTIONS.—Each
primary care manager provided for pursuant to subsection
(e)(2) shall have responsibility for the coordination and
case management of each veteran enrolled under section
1705 of title 38, United States Code, through that medical
center who is enrolled in the pilot program pursuant to
subsection (d), to ensure that such veterans receive the
appropriate care, and that the veteran is brought back into
the VA system for followup whenever possible and appro-
priate.
(g) REPORTS.—(1) Not later than October 1, 2003,
the Secretary shall submit to Congress a report on the
operation of the pilot program through June 30, 2003.
That report shall include the Secretary’s assessment of—
(A) the adequacy of the managed care net-
works;
(B) patient satisfaction surveys completed by
veterans participating in the program;
(C) cost savings to the Department as a result
of care provided through the program; and
(D) proposed uses for savings if the pilot pro-
gram were implemented on a permanent basis
throughout the Department for the management of
non-VA care.
(2) Not later than October 1, 2004, the Secretary
shall submit a report to Congress on the program through
June 30, 2004. The Secretary shall include in that report
the matters specified in paragraph (1) and the Secretary’s
recommendation for implementing on a nationwide basis
the management system tested in the pilot program.
(h) GAO REVIEW.—Not later than June 30, 2005,
the Comptroller General of the United States shall con-
duct a review of the pilot program and shall provide to
Congress the Comptroller General’s findings and rec-
ommendations concerning the program.
(i) NON-VA CARE DEFINED.—For purposes of this
section, the term ‘‘non-VA care’’ means care provided in
a facility other than a facility of the Veterans Health Ad-
ministration or by a health care provider who is not an
employee of the Veterans Health Administration.
SEC. 7. RECODIFICATION OF BEREAVEMENT COUNSELING
AUTHORITY AND CERTAIN OTHER HEALTH-
RELATED AUTHORITIES.
(a) STATUTORY REORGANIZATION.—Subchapter I of
chapter 17 of title 38, United States Code, is amended—
(1) in section 1701(6)—
(A) by striking subparagraph (B) and the
sentence following that subparagraph;
(B) by striking ‘‘services—’’ in the matter
preceding subparagraph (A) and inserting
‘‘services, the following:’’; and
(C) by striking subparagraph (A) and in-
serting the following:
‘‘(A) Surgical services.
‘‘(B) Dental services and appliances as de-
scribed in sections 1710 and 1712 of this title.
‘‘(C) Optometric and podiatric services.
‘‘(D) Preventive health services.
‘‘(E) In the case of a person otherwise receiving
care or services under this chapter—
‘‘(i) wheelchairs, artificial limbs, trusses,
and similar appliances;
‘‘(ii) special clothing made necessary by
the wearing of prosthetic appliances; and
‘‘(iii) such other supplies or services as the
Secretary determines to be reasonable and nec-
essary.
‘‘(F) Travel and incidental expenses pursuant
to section 111 of this title.’’; and
(2) in section 1707—
(A) by inserting ‘‘(a)’’ at the beginning of
the text of the section; and
(B) by adding at the end the following:
‘‘(b) The Secretary may furnish sensori-neural aids
only in accordance with guidelines prescribed by the Sec-
retary.’’.
(b) CONSOLIDATION OF PROVISIONS RELATING TO
PERSONS OTHER THAN VETERANS.—Such chapter is fur-
ther amended by adding at the end the following new sub-
chapter:
‘‘SUBCHAPTER VIII—HEALTH CARE OF
PERSONS OTHER THAN VETERANS
‘‘§ 1782. Counseling, training, and mental health serv-
ices for immediate family members
‘‘(a) COUNSELING FOR FAMILY MEMBERS OF VET-
ERANS RECEIVING SERVICE-CONNECTED TREATMENT.—
In the case of a veteran who is receiving treatment for
a service-connected disability pursuant to paragraph (1)
or (2) of section 1710(a) of this title, the Secretary shall
provide to individuals described in subsection (c) such con-
sultation, professional counseling, training, and mental
health services as are necessary in connection with that
treatment.
‘‘(b) COUNSELING FOR FAMILY MEMBERS OF VET-
ERANS RECEIVING NON-SERVICE-CONNECTED TREAT-
MENT.—In the case of a veteran who is eligible to receive
treatment for a non-service-connected disability under the
conditions described in paragraph (1), (2), or (3) of sec-
tion 1710(a) of this title, the Secretary may, in the discre-
tion of the Secretary, provide to individuals described in
subsection (c) such consultation, professional counseling,
training, and mental health services as are necessary in
connection with that treatment if—
‘‘(1) those services were initiated during the
veteran’s hospitalization; and
‘‘(2) the continued provision of those services
on an outpatient basis is essential to permit the dis-
charge of the veteran from the hospital.
‘‘(c) ELIGIBLE INDIVIDUALS.—Individuals who may
be provided services under this subsection are—
‘‘(1) the members of the immediate family or
the legal guardian of a veteran; or
‘‘(2) the individual in whose household such vet-
eran certifies an intention to live.
‘‘(d) TRAVEL
AND
TRANSPORTATION
AUTHOR-
IZED.—Services provided under subsections (a) and (b)
may include, under the terms and conditions set forth in
section 111 of this title, travel and incidental expenses of
individuals described in subsection (c) in the case of—
‘‘(1) a veteran who is receiving care for a serv-
ice-connected disability; and
‘‘(2) a dependent or survivor receiving care
under the last sentence of section 1783(b) of this
title.
‘‘§ 1783. Bereavement counseling
‘‘(a) DEATHS OF VETERANS.—In the case of an indi-
vidual who was a recipient of services under section 1782
of this title at the time of the death of the veteran, the
Secretary may provide bereavement counseling to that in-
dividual in the case of a death—
‘‘(1) that was unexpected; or
‘‘(2) that occurred while the veteran was par-
ticipating in a hospice program (or a similar pro-
gram) conducted by the Secretary.
‘‘(b) DEATHS IN ACTIVE SERVICE.—The Secretary
may provide bereavement counseling to an individual who
is a member of the immediate family of a member of the
Armed Forces who dies in the active military, naval, or
air service in the line of duty and under circumstances
not due to the person’s own misconduct.
‘‘(c) BEREAVEMENT COUNSELING DEFINED.—For
purposes of this section, the term ‘bereavement counseling’
means such counseling services, for a limited period, as
the Secretary determines to be reasonable and necessary
to assist an individual with the emotional and psycho-
logical stress accompanying the death of another indi-
vidual.
‘‘§ 1784. Humanitarian care
‘‘The Secretary may furnish hospital care or medical
services as a humanitarian service in emergency cases, but
the Secretary shall charge for such care and services at
rates prescribed by the Secretary.’’.
(c) TRANSFER
OF CHAMPVA SECTION.—Section
1713 of such title is—
(1) transferred to subchapter VIII of chapter
17 of such title, as added by subsection (b), and in-
serted after the subchapter heading;
(2) redesignated as section 1781; and
(3) amended by adding at the end of subsection
(b) the following new sentence: ‘‘A dependent or sur-
vivor receiving care under the preceding sentence
shall be eligible for the same medical services as a
veteran, including services under sections 1782 and
1783 of this title.’’.
(d) REPEAL OF RECODIFIED AUTHORITY.—Section
1711 of such title is amended by striking subsection (b).
(e) CROSS REFERENCE AMENDMENTS.—Such title is
further amended as follows:
(1) Section 103(d)(5)(B) is amended by strik-
ing ‘‘1713’’ and inserting ‘‘1781’’.
(2) Sections 1701(5) is amended by striking
‘‘1713(b)’’ in subparagraphs (B) and (C)(i) and in-
serting ‘‘1781(b)’’.
(3) Section 1712A(b) is amended—
(A) in the last sentence of paragraph (1),
by striking ‘‘section 1711(b)’’ and inserting
‘‘section 1784’’; and
(A) in paragraph (2), by striking ‘‘section
1701(6)(B)’’ and inserting ‘‘sections 1782 and
1783’’.
(4) Section 1729(f) is amended by striking
‘‘section 1711(b)’’ and inserting ‘‘section 1784’’.
(5) Section 1729A(b) is amended—
(A) by redesignating paragraph (7) as
paragraph (8); and
(B) by inserting after paragraph (6) the
following new paragraph (7):
‘‘(7) Section 1784 of this title.’’.
(6) Section 8111(g) is amended—
(A) in paragraph (4), by inserting ‘‘serv-
ices under sections 1782 and 1783 of this title’’
after ‘‘of this title,’’; and
(B) in paragraph (5), by striking ‘‘section
1711(b) or 1713’’ and inserting ‘‘section 1782,
1783, or 1784’’.
(7) Section 8111A(a)(2) is amended by insert-
ing ‘‘, and the term ‘medical services’ includes serv-
ices under sections 1782 and 1783 of this title’’ be-
fore the period at the end.
(8) Section 8152(3) is amended by inserting
‘‘services under sections 1782 and 1783 of this title’’
after ‘‘of this title),’’.
(9) Sections 8502(b), 8520(a), and 8521 are
amended by striking ‘‘the last sentence of section
1713(b)’’ and inserting ‘‘the penultimate sentence of
section 1781(b)’’.
(f) CLERICAL AMENDMENTS.—
(1) The table of sections at the beginning of
such chapter is amended—
(A) by striking the item relating to section
1707 and inserting the following:
‘‘1707. Limitations.’’;
(B) by striking the item relating to section
1713; and
(C) by adding at the end the following:
‘‘SUBCHAPTER VIII—HEALTH CARE OF PERSONS OTHER THAN VETERANS
‘‘1781. Medical care for survivors and dependents of certain veterans.
‘‘1782. Counseling, training, and mental health services for immediate family
members.
‘‘1783. Bereavement counseling.
‘‘1784. Humanitarian care.’’.
(2) The heading for section 1707 is amended to
read as follows:
‘‘§ 1707. Limitations’’.
SEC. 8. EXTENSION OF EXPIRING COLLECTIONS AUTHORI-
TIES.
Sections 1710(f)(2)(B) and 1729(a)(2)(E) of title 38,
United States Code, are each amended by striking ‘‘Sep-
tember 30, 2002’’ and inserting ‘‘September 30, 2007’’.
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