[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[S. 1345 Introduced in Senate (IS)]







104th CONGRESS
  1st Session
                                S. 1345

 To amend title 53, United States Code, and various other statutes, to 
   reform eligibility for Department of Veterans Affairs health-care 
  benefits, improve the operation of the Department, and improve the 
  processes and procedures the Department uses to administer various 
         benefit programs for veterans; and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

             October 19 (legislative day, October 18), 1995

Mr. Simpson (by request) introduced the following bill; which was read 
        twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
 To amend title 53, United States Code, and various other statutes, to 
   reform eligibility for Department of Veterans Affairs health-care 
  benefits, improve the operation of the Department, and improve the 
  processes and procedures the Department uses to administer various 
         benefit programs for veterans; and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Department of 
Veterans Affairs Improvement and Reinvention Act of 1995''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.
                 TITLE I--VETERANS HEALTH-CARE PROGRAMS

          part a--reform of the health-care eligibility system

Sec. 101. Definitions.
Sec. 102. Eligibility for health care.
Sec. 103. Exposure related treatment authorities.
Sec. 104. Mental health services and bereavement counseling for family 
                            members.
Sec. 105. Consolidation of special authorities pertaining to prosthetic 
                            devices, aids for the blind, and aids for 
                            the hearing impaired.
Sec. 106. Dental care.
Sec. 107. Home improvements and structural alterations.
Sec. 108. Furnishing medications prescribed by non-VA physicians.
Sec. 109. Furnishing care in community nursing homes.
Sec. 110. Furnishing residential care.
Sec. 111. Expansion of authority to share health-care resources.
Sec. 112. Authorization of appropriations.
Sec. 113. Conforming amendments.
             part b--administration of health-care benefits

Sec. 120. Means test reform.
Sec. 121. VA retention of funds collected from third parties.
                       TITLE II--BENEFIT PROGRAMS

                     part a--loan guaranty program

Sec. 201. Termination of the manufactured housing loan program.
Sec. 202. Loan fees.
Sec. 203. Contracting for portfolio loan services.
                       part b--education programs

Sec. 210. Electronic signatures on documents concerning education 
                            benefits for veterans.
Sec. 211. Electronic funds transfer for education benefits payments.

SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

    Except as otherwise expressly provided, whenever in this Act an 
amendment is expressed in terms of an amendment to a section or other 
provision, the reference shall be considered to be made to a section or 
other provision of title 38, United States Code.

                 TITLE I--VETERANS HEALTH-CARE PROGRAMS

          PART A--REFORM OF THE HEALTH CARE ELIGIBILITY SYSTEM

SEC. 101. DEFINITIONS.

    Section 1701 is amended by striking out paragraphs numbered (5), 
(6), (7), (8), and (9) and inserting in lieu thereof the following:
    ``(5) The term `health care' means the most appropriate care and 
treatment for the patient furnished in the most appropriate setting, as 
determined by the Secretary, including the provision of such 
pharmaceuticals, supplies, equipment, devices, appliances and other 
materials as the Secretary determines to be necessary, and including 
hospital care, nursing home care, domiciliary care, outpatient care, 
rehabilitative care, home care, respite care, preventive care, and 
dental care.
    ``(6) The term `hospital care' means care and treatment for a 
disability furnished to an individual who has been admitted to a 
hospital as a patient.
    ``(7) The term `nursing home care' means care and treatment for a 
disability furnished to an individual who has been admitted to a 
nursing home as a resident.
    ``(8) The term `domiciliary care' means the furnishing of shelter 
and food, and includes necessary care and treatment for a disability 
furnished to a veteran with no adequate means of support, who has been 
admitted as a resident to a domiciliary facility under the direct 
jurisdiction of the Secretary.
    ``(9) The term `outpatient care' means care and treatment for a 
disability, and preventive health services, furnished to an individual 
other than hospital, nursing home, or domiciliary care.
    ``(10) The term `rehabilitative care' means such professional, 
counseling, and guidance services and treatment programs (other than 
those types of vocational rehabilitation services provided under 
chapter 31 of this title) as are necessary to restore, to the maximum 
extent possible, the physical, mental, and psychological functioning of 
an ill or disabled person.
    ``(11) The term `home care' means outpatient care, rehabilitative 
care, and preventive health services furnished to an individual in the 
individual's home or other place of residence but may not include care 
or services that any other person or entity has a contractual or legal 
obligation to provide.
    ``(12) The term `residential care' means the provision of room and 
board and such limited personal care for and supervision of residents 
as the Secretary determines, in accordance with regulations, are 
necessary for the health, safety, and welfare of residents, and the 
term `community residential-care' means the provision of residential-
care in a non-VA facility.
    ``(13) The term `respite care' means care furnished on an 
intermittent basis in a department facility for a limited period to a 
veteran suffering from a chronic illness, who resides primarily in a 
private residence when such care will help the veteran to continue 
residing in such private residence.
    ``(14) The term `preventive health services' means care and 
treatment furnished to prevent disease or illness including periodic 
examinations, immunization, patient health education, and such other 
services as the Secretary determines are necessary to provide effective 
and economical preventive health care.''.

SEC. 102. ELIGIBILITY FOR HEALTH CARE.

    Section 1710 is amended to read as follows:
``Sec. 1710. Eligibility for health care
    ``(a)(1) The Secretary shall, to the extent and in the amount 
provided in advance in appropriations acts for these purposes, furnish 
health care which the Secretary determines is needed to any veteran 
described in clauses (A), (C), and (D) of subsection (c)(1), subject to 
the priorities set forth in subsection (c) and to section 1715 and 
excluding care described in subsection (b).
    ``(2) The Secretary may furnish health care which the Secretary 
determines is needed to any veteran not described in clauses (A) 
through (D) of subsection (c)(1).
    ``(b) Subject to the priorities set forth in subsection (c), the 
Secretary may furnish nursing home care, respite care, home care, and 
domiciliary care which the Secretary determines is needed to any 
veteran.
    ``(c)(1) To the extent and in the amount provided in advance in 
appropriations acts for these purposes, the Secretary shall furnish 
health care under subsections (a) and (b) and sections 1712, 1712A, 
1712B, 1714, 1717, 1718, 1719, 1720B, and 1751, in accordance with the 
following order of priority:
            ``(A) Veterans (i) who have compensable service-connected 
        disabilities, (ii) who are former prisoners of war, (iii) whose 
        discharge or release from the active military, naval or air 
        service was for a disability incurred or aggravated in line of 
        duty, and (iv) who are in receipt of, or who, but for a 
        suspension pursuant to section 1152 (or both such a suspension 
        and the receipt of retired pay), would be entitled to 
        disability compensation, but only to the extent that the 
        veterans' continuing eligibility for such care is provided for 
        in the judgment or settlement described in section 1151.
            ``(B) Veterans receiving care under sections 1712, 1712A, 
        1719, and 1720B.
            ``(C) Veterans with noncompensable service-connected 
        disabilities, veterans of the Mexican Border period or World 
        War I, and veterans receiving increased pension or additional 
        compensation or allowances based on the need of regular aid and 
        attendance or by reason of being permanently housebound.
            ``(D) Veterans with attributable income less then the 
        threshold amount specified in section 1722 which is applicable 
        to those veterans, provided they sign a declaration that their 
        net worth, together with that of their spouse and dependent 
        children, if any, does not exceed $50,000, and veterans 
        receiving care under section 1751.
            ``(E) Veterans with attributable income greater then the 
        threshold amount specified in section 1722 which is applicable 
        to those veterans and veterans who do not sign the declaration 
        described in clause (D).
    ``(2) The Secretary may, by regulation, establish additional 
priorities within each priority group established in paragraph (1) of 
this subsection, as the Secretary determines necessary.
    ``(d) Nothing in this section requires the Secretary to furnish 
care to a veteran to whom another agency of Federal, State, or local 
government has a duty under law to provide care in an institution of 
such government.
    ``(e)(1) The Secretary may furnish health care under subsections 
(a) and (b) of this section to any veteran described in subsection 
(c)(1)(E) who has attributable income greater then the amount specified 
in section 1722(a) which is applicable to that veteran, only if the 
veteran agrees to pay the United States the applicable amount 
determined under paragraph (2) of this subsection.
    ``(2) A veteran who is required under paragraph (1) of this 
subsection to agree to pay an amount to the United States in order to 
be furnished such care shall be liable to the United States for an 
amount equal to--
            ``(A) for hospital care--
                    ``(i) the lesser of the cost of furnishing such 
                care, as determined by the Secretary, or the amount 
                determined under paragraph (3) of this subsection; and
                    ``(ii) $10 for every day the veteran receives 
                hospital care;
            ``(B) for nursing home care--
                    ``(i) the lesser of the cost of furnishing such 
                care, as determined by the Secretary, or the amount 
                determined under paragraph (3) of this subsection; and
                    ``(ii) $5 for every day the veteran receives 
                hospital care; and
            ``(C) for outpatient care, an amount equal to 20 percent of 
        the estimated cost of care, as determined by the Secretary.
    ``(3)(A) In the case of hospital care furnished during any 365-day 
period, the amount referred to in paragraph (2)(A)(i) of this 
subsection is--
            ``(i) the amount of the inpatient Medicare deductible, plus
            ``(ii) one-half of such amount for each 90 days of care (or 
        fraction thereof) after the first 90 days of such care during 
        such 365-day period.
    ``(B) In the case of nursing home care furnished during any 365-day 
period, the amount referred to in paragraph (2)(B)(i) of this 
subsection is the amount of the inpatient Medicare deductible for each 
90 days of such care (or fraction thereof) during such 365-day period.
    ``(C)(i) Except as provided in clause (ii) of this subparagraph, in 
the case of a veteran who is admitted for nursing home care under this 
section after being furnished during the preceding 365-day period, 
hospital care for which the veteran has paid the amount of the 
inpatient Medicare deductible under this subsection and who has not 
been furnished 90 days of hospital care in connection with such 
payment, the veteran shall not incur any liability under paragraph 
(2)(B)(i) of this subsection with respect to such nursing home care 
until--
            ``(I) the veteran has been furnished, beginning with the 
        first day of such hospital care furnished in connection with 
        such payment, a total of 90 days of hospital care and nursing 
        home care; or
            ``(II) the end of the 365-day period applicable to the 
        hospital care for which payment was made,
whichever occurs first.
    ``(ii) In the case of a veteran who is admitted for nursing home 
care under this section after being furnished, during any 365-day 
period, hospital care for which the veteran has paid an amount under 
subparagraph (A)(ii) of this paragraph and who has not been furnished 
90 days of hospital care in connection with such payment, the amount of 
the liability of the veteran under paragraph (2)(B)(i) of this 
subsection with respect to the number of days of such nursing home care 
which, when added to the number of days of such hospital care, is 90 or 
less, is the difference between the inpatient Medicare deductible and 
the amount paid under such subparagraph until--
            ``(I) the veteran has been furnished, beginning with the 
        first day of such hospital care furnished in connection with 
        such payment, a total of 90 days of hospital care and nursing 
        home care; or
            ``(II) the end of the 365-day period applicable to the 
        hospital care for which payment was made,
whichever occurs first.
    ``(D) In the case of a veteran who is admitted for hospital care 
under this section after having been furnished, during the preceding 
365-day period, nursing home care for which the veteran has paid the 
amount of the inpatient Medicare deductible under this subsection and 
who has not been furnished 90 days of nursing home care in connection 
with such payment, the veteran shall not incur any liability under 
paragraph (2) of this subsection with respect to such hospital care 
until--
            ``(i) the veteran has been furnished, beginning with the 
        first day of such nursing home care furnished in connection 
        with such payment, a total of 90 days of nursing home care and 
        hospital care; or
            ``(ii) the end of the 365-day period applicable to the 
        nursing home care for which payment was made,
whichever occurs first.
    ``(E) A veteran may not be required to make a payment under 
paragraph (2)(A)(i) or paragraph (2)(B)(i) of this subsection for any 
days of care in excess of 360 days of care during any 365-calendar-day 
period.
    ``(4) Amounts collected or received on behalf of the United States 
under this subsection shall be deposited in the Treasury as 
miscellaneous receipts.
    ``(5) For the purposes of this subsection, the term `inpatient 
Medicare deductible' means the amount of the inpatient hospital 
deductible in effect under section 1813(b) of the Social Security Act 
(42 U.S.C. 1395(b)) on the first day of the 365-day period applicable 
under paragraph (3) of this subsection.''.

SEC. 103. EXPOSURE-RELATED TREATMENT AUTHORITIES.

    Section 1712 is amended to read as follows:
``Sec. 1712. Treatment for veterans exposed to certain toxic substances 
              or hazards
    ``(a) Subject to subsections (b) and (c), and to the extent and in 
the amount provided in advance in appropriations acts for these 
purposes, the Secretary shall furnish hospital care and may furnish 
other health care to--
            ``(1) a veteran--
                    ``(A) who served on active duty in the Republic of 
                Vietnam during the Vietnam era, and
                    ``(B) who the Secretary finds may have been exposed 
                during such service to dioxin or was exposed during 
                such service to a toxic substance found in a herbicide 
                or defoliant used in connection with military purposes 
                during such era,
        for any disability, notwithstanding that there is insufficient 
        medical evidence to conclude that such disability may be 
        associated with such exposure;
            ``(2) a veteran who the Secretary finds was exposed while 
        serving on active duty to ionizing radiation from the 
        detonation of a nuclear device in connection with such 
        veteran's participation in the test of such a device or with 
        the American occupation of Hiroshima and Nagasaki, Japan, 
        during the period beginning on September 11, 1945, and ending 
        on July 1, 1946, for any disability, notwithstanding that there 
        is insufficient medical evidence to conclude that such 
        disability may be associated with such exposure; and
            ``(3) a veteran who the Secretary finds may have been 
        exposed while serving on active duty in the Southwest Asia 
        theater of operations during the Persian Gulf War to a toxic 
        substance or environmental hazard for any disability, 
        notwithstanding that there is insufficient medical evidence to 
        conclude that such disability may be associated with such 
        exposure.
    ``(b) Hospital and health care may not be provided under subsection 
(a) with respect to a disability that is found, in accordance with 
guidelines issued by the Under Secretary for Health, to have resulted 
from a cause other than an exposure described in paragraph (1), (2), or 
(3) of subsection (a) in the case of a veteran described in the 
applicable paragraph.
    ``(c) Hospital and health care may not be provided--
            ``(1) after December 31, 1996, in the case of a veteran 
        described in paragraph (1) of subsection (a); and
        ``(2) after September 30, 1997, in the case of a veteran 
        described in paragraph (3) of subsection (a).''.

SEC. 104. MENTAL HEALTH SERVICES AND BEREAVEMENT COUNSELING FOR FAMILY 
              MEMBERS.

    Chapter 17 is amended by adding the following new section:
``Sec. 1712C. Mental Health services and bereavement counseling for 
              family members
    ``(a) If necessary for the effective treatment and rehabilitation 
of a patient who is either a veteran or a dependent or survivor 
receiving care under the last sentence of section 1713(b), the 
Secretary may furnish the services described in subsection (b) to 
members of the immediate family of the patient, the patient's legal 
guardian, or the individual in whose household such patient certifies 
an intention to live.
    ``(b) The services referred to in subsection (a) are--
            ``(1) consultation, professional counseling, and training 
        as necessary in connection with the treatment of any disability 
        of a patient receiving outpatient care for a physical 
        condition;
            ``(2) mental health services, consultation, professional 
        counseling, and training as necessary in connection with the 
        treatment of a patient receiving hospital care for any 
        disability, or receiving outpatient care for a service-
        connected mental health condition; and
            ``(3) mental health services, consultation, professional 
        counseling, and training as necessary in connection with the 
        treatment of a patient receiving outpatient care for a 
        nonservice-connected mental health condition, but only if the 
        patient's treatment for the mental health condition was begun 
        during a period of hospitalization and the services to the 
        family member, guardian, or other person were commenced prior 
        to the patient's discharge from such period of hospital care.
    ``(c) The Secretary may furnish counseling services for a limited 
period to any individual who was a recipient of services under 
subsection (a) of this section at the time of--
            ``(1) the unexpected death of the veteran; or
            ``(2) the death of the veteran while the veteran was 
        participating in a hospice program (or a similar program) 
        conducted by the Secretary,
if the Secretary determines that furnishing such services would be 
reasonable and necessary to assist such individual with the emotional 
and psychological stress accompanying the veteran's death.''.

SEC. 105. CONSOLIDATION OF SPECIAL AUTHORITIES PERTAINING TO PROSTHETIC 
              DEVICES, AIDS FOR THE BLIND, AND AIDS FOR THE HEARING 
              IMPAIRED.

    Section 1714 is amended--
            (1) by amending the heading to read as follows:
``Sec. 1714. Prosthetic devices and aids for the blind and hearing 
              impaired'';
            (2) by designating subsection (b) as subsections (d) and 
        inserting after subsection (a) the following new subsections 
        (b) and (c):
    ``(b) The Secretary may procure medical equipment, prosthetic 
devices and similar appliances furnished under section 1710 or 
subsections (d) and (e) of this section by purchase or by manufacture, 
whichever the Secretary determines may be advantageous and reasonably 
necessary.
    ``(c) The Secretary may repair or replace any prosthetic or 
orthotic device or similar appliance (not including dental appliances) 
reasonably necessary to a veteran and belonging to such veteran which 
was damaged or destroyed by a fall or other accident caused by a 
service-connected disability for which such veteran is in receipt of, 
or but for the receipt of retirement pay would be entitled to, 
disability compensation.''; and
            ``(3) by adding at the end the following new subsection 
        (e):
    ``(e) The Secretary may furnish devices for assisting in overcoming 
the handicap of deafness (including telecaptioning television decoders) 
to any veteran who is profoundly deaf and is entitled to compensation 
on account of hearing impairment.''.

SEC. 106. DENTAL CARE.

    Section 1715 is amended to read as follows:
``Sec. 1715. Dental care
    ``(a) The Secretary may, within the limits of Department 
facilities, furnish a veteran receiving hospital, nursing home, or 
domiciliary care in a Department facility with--
            ``(1) any dental services and treatment, and related dental 
        appliances necessary for continued safe and effective treatment 
        of other disabilities for which the veteran is receiving care 
        in the VA facility; and
            ``(2) any dental services and treatment for which the 
        veteran is eligible under subsection (b) of this section.
    ``(b)(1) The Secretary may furnish outpatient dental services and 
treatment, and related dental appliances under this chapter only for a 
dental condition or disability--
            ``(A) which is service-connected and compensable in degree;
            ``(B) which is service-connected, but not compensable in 
        degree, but only if--
                    ``(i) the dental condition or disability is shown 
                to have been in existence at the time of the veteran's 
                discharge or release from active military, naval, or 
                air service;
                    ``(ii) the veteran had served on active duty for a 
                period of not less than 180 days or, in the case of a 
                veteran who served on active duty during the Persian 
                Gulf War, 90 days immediately before such discharge or 
                release;
                    ``(iii) application for treatment is made within 90 
                days after such discharge or release, except that (I) 
                in the case of a veteran who reentered active military, 
                naval, or air service within 90 days after the date of 
                such veteran's prior discharge or release from such 
                service, application may be made within 90 days from 
                the date of such veteran's subsequent discharge or 
                release from such service, and (II) if a disqualifying 
                discharge or release has been corrected by competent 
                authority, application may be made within 90 days after 
                the date of correction; and
                    ``(iv) the veteran's certificate of discharge or 
                release from active duty does not bear a certification 
                that the veteran was provided, within the 90-day period 
                immediately before the date of such discharge or 
                release, a complete dental examination (including 
                dental X-rays) and all appropriate dental services and 
                treatment indicated by the examination to be needed;
            ``(C) which is a service-connected dental condition or 
        disability due to combat wounds or other service trauma, or of 
        a former prisoner of war;
            ``(D) which is associated with and is aggravating a 
        disability resulting from some other disease or injury which 
        was incurred in or aggravated by active military, naval, or air 
        service;
            ``(E) which is a nonservice-connected condition or 
        disability of a veteran for which treatment was begun while 
        such veteran was receiving hospital care under this chapter and 
        such services and treatment are reasonably necessary to 
        complete such treatment;
            ``(F) from which a veteran who is a former prisoner of war 
        and who was detained or interned for a period of not less than 
        90 days is suffering;
            ``(G) from which a veteran who has a service-connected 
        disability rated as total is suffering; or
            ``(H) the treatment of which is medically necessary (i) in 
        preparation for hospital admission, or (ii) for veteran 
        otherwise receiving care or services under this chapter.
    ``(2) The Secretary concerned shall at the time a member of the 
Armed Forces is discharged or released from a period of active 
military, naval, or air service of not less than 180 days or, in the 
case of a veteran who served on active duty during the Persian Gulf 
War, 90 days to provide to such member a written explanation of the 
provisions of clause (B) of paragraph (1) of this section and enter in 
the service records of the member a statement signed by the member 
acknowledging receipt of such explanation (or, if the member refuses to 
sign such statement, a certification from an officer designated for 
such purpose by the Secretary concerned that the member was provided 
such explanation).
    ``(3) The total amount which the Secretary may expend for 
furnishing, during any twelve-month period, outpatient dental services, 
treatment, or related dental appliances to a veteran under this section 
through private facilities for which the Secretary has contracted under 
clause (1), (2), or (5) of section 1703(a) of this title may not exceed 
$1,000 unless the Secretary determines, prior to the furnishing of such 
services, treatment, or appliances and based on an examination of the 
veteran by a dentist employed by the Department (or, in an area where 
no such dentist is available, by a dentist conducting such examination 
under a contract or fee arrangement), that the furnishing of such 
services, treatment, or appliances at such cost is reasonably 
necessary.
    ``(4)(A) Except as provided in subparagraph (B) of this subsection, 
in any year in which the President's Budget for the fiscal year 
beginning October 1 of such year includes an amount for expenditures 
for contract dental care under the provisions of section 1710(a) of 
this title (other than care for a veteran of the Mexican border period 
or of World War I, and a veteran who is in receipt of increased pension 
or additional compensation or allowances based on the need of regular 
aid and attendance or by reason of being permanently housebound (or 
who, but for the receipt of retired pay, would be in receipt of such 
pension, compensation or allowance)) and section 1703 of this title 
during such fiscal year in excess of the level of expenditures made for 
such purpose during fiscal year 1978, the Secretary shall, not later 
than February 15 of such year, submit a report to the appropriate 
committees of the Congress justifying the requested level of 
expenditures for contract dental care and explaining why the 
application of the criteria prescribed in section 1703 of this title 
for contracting with private facilities and in section 1715(a) of this 
title for furnishing incidental dental care to hospitalized veterans 
will not preclude the need for expenditures for contract dental care in 
excess of the fiscal year 1978 level of expenditures for such purpose. 
In any case in which the amount included in the President's Budget for 
any fiscal year for expenditures for contract dental care under such 
provisions is not in excess of the level of expenditures made for such 
purpose during fiscal year 1978 and the Secretary determines after the 
date of submission of such budget and before the end of such fiscal 
year that the level of expenditures for such contract dental care 
during such fiscal year will exceed the fiscal year 1978 level of 
expenditures, the Secretary shall submit a report to the appropriate 
committees of the Congress containing both a justification (with 
respect to the projected level of expenditures for such fiscal year) 
and an explanation as required in the preceding sentence in the case of 
a report submitted pursuant to such sentence. Any report submitted 
pursuant to this paragraph shall include a comment by the Secretary on 
the effect of the application of the criteria prescribed in section 
1715(a) of this title for furnishing incidental dental care to 
hospitalized veterans.
    ``(B) A report under subparagraph (A) of this paragraph with 
respect to a fiscal year is not required if, in the documents submitted 
by the Secretary to the Congress in justification for the amounts 
included for Department programs in the President's Budget, the 
Secretary specifies with respect to contract dental care described in 
such subparagraph--
            ``(i) actual level of expenditures for such care in the 
        fiscal year preceding the fiscal year in which such Budget is 
        submitted;
            ``(ii) a current estimate of the level of expenditures for 
        such care in the fiscal year in which such Budget is submitted; 
        and
            ``(iii) the amount included in such Budget for such care.
    ``(c) Dental services and related appliances for a dental condition 
or disability described in paragraph (1)(B) of subsection (b) of this 
section shall be furnished on a one-time completion basis, unless the 
services rendered on a one-time completion basis are found unacceptable 
within the limitations of good professional standards, in which event 
such additional services may be afforded as are required to complete 
professionally acceptable treatment.
    ``(d) Dental appliances, to be furnished by the Secretary under 
this section may be procured by the Secretary either by purchase or by 
manufacture, whichever the Secretary determines may be advantageous and 
reasonably necessary.''.

SEC. 107. HOME IMPROVEMENTS AND STRUCTURAL ALTERATIONS.

    Section 1717 is amended to read as follows:
``Sec. 1717. Home improvements and structural alterations
    ``(a) The Secretary may furnish improvements and structural 
alterations to the home of a veteran if necessary for the effective and 
economical treatment of a disability of the veteran, but only if the 
improvements or alterations are necessary to assure the continuation of 
treatment or to provide the veteran access to the home or to essential 
lavatory and sanitary facilities.
    ``(b) The cost of improvements and structural alterations (or the 
amount of reimbursement therefor) furnished under subsection (a) may 
not exceed--
            ``(1) $4,100 if needed--
                    ``(A) for treatment of a service-connected 
                disability (including a disability that was incurred or 
                aggravated in line of duty and for which the veteran 
                was discharged or released from the active military, 
                naval, or air service);
                    ``(B) for any disability of a veteran who has a 
                service-connected disability rated at 50 percent or 
                more; and
                    ``(C) to any veteran for a disability for which the 
                veteran is in receipt of compensation under section 
                1151 of this title or for which the veteran would be 
                entitled to compensation under that section but for a 
                suspension pursuant to that section (but in the case of 
                such a suspension, such medical services may be 
                furnished only to the extent that such person's 
                continuing eligibility for medical services is provided 
                for in the judgment or settlement described in that 
                section); and
            ``(2) $1,200 in all other cases.''.

SEC. 108. FURNISHING MEDICATIONS PRESCRIBED BY NON-VA PHYSICIANS.

    Section 1719 is amended to read as follows:
``Sec. 1719 Medications prescribed by non-VA physicians; immunization 
              programs
    ``(a) The Secretary shall, to the extent and in the amount provided 
in advance in appropriation acts for these purposes, furnish to each 
veteran who is receiving additional compensation or allowance under 
chapter 11 of this title, or increased pension as a veteran of a period 
of war, by reason of being permanently housebound or in need of regular 
aid and attendance, such drugs and medicines as may be ordered on 
prescription of a duly licensed physician as specific therapy in the 
treatment of any illness or injury suffered by such veteran: Provided, 
That the Secretary shall continue to furnish such drugs and medicines 
so ordered to any such veteran in need of regular aid and attendance 
whose pension payments have been discontinued solely because such 
veteran's annual income is greater than the applicable maximum annual 
income limitation, but only so long as such veteran's annual income 
does not exceed such maximum annual income limitation by more than 
$1,000.
    ``(b) In order to assist the Secretary of Health and Human Services 
in carrying out national immunization programs under other provisions 
of law, the Secretary may authorize the administration of immunizations 
to eligible veterans who voluntarily request such immunizations in 
connection with the provision of care for a disability under this 
chapter in any Department health care facility. Any such immunization 
shall be made using vaccine furnished by the Secretary of Health and 
Human Services at no cost to the Department. For such purpose, 
notwithstanding any other provision of law, the Secretary of Health and 
Human Services may provide such vaccine to the Department at no cost. 
Section 7316 of this title shall apply to claims alleging negligence or 
malpractice on the part of Department personnel granted immunity under 
such section.''.

SEC. 109. FURNISHING CARE IN COMMUNITY NURSING HOMES.

    Section 1720 is amended--
            (1) in the heading by striking out the semicolon and all 
        that follows;
            (2) in subsection (a)(1)(A)(i), by striking out ``hospital 
        care, nursing home care, or domiciliary'' and inserting in lieu 
        thereof ``health'';
            (3) by striking out subsection (d) and redesignating 
        subsection (e) as subsection (d); and
            (4) by striking out subsection (f).

SEC. 110. FURNISHING RESIDENTIAL CARE.

    Section 1730 is amended--
            (1) by redesignating subsections (a), (b), (c), (d), and 
        (e) as subsections (b), (c), (d), (e), and (f), respectively;
            (2) by inserting the following new subsection (a):
    ``(a)(1) The Secretary may furnish residential care to a veterans 
in receipt of hospital care in a VA facility when such care would be an 
alternative to continued hospital care.
    ``(2) The Secretary may only furnish care under paragraph (1) of 
this subsection through contracts with community residential-care 
facilities--
            ``(A) when the veteran has no resources to pay for the 
        care, as determined by the Secretary in regulations;
            ``(B) for a period not to exceed 90 days during any 12-
        month period.'';
            (3) by amending subsection (b), as so redesigned, to read 
        as follows:
    ``(b) Subject to this section and regulations to be prescribed by 
the Secretary under this section, the Secretary may assist a veteran 
who does not meet the requirement set forth in subsection (a)(2)(A) of 
this section by referring the veteran for placement in, and aiding the 
veteran in obtaining placement in, a community residential-care 
facility if--
            ``(1) at the time of initiating the assistance, the 
        Secretary--
                    ``(A) is furnishing the veteran hospital, 
                domiciliary, nursing home, or outpatient care; or
                    ``(B) has furnished the veteran such care or 
                services within the preceding 12 months; and
            ``(2) placement of the veteran in a community residential-
        care facility is appropriate.'';
            (4) in subsection (c), as so redesignated, by striking out 
        ``subsection (a) of'' in paragraph (1), and by inserting 
        ``community residential-care'' before ``facility'' the first 
        time it appears in paragraph (2);
            (5) in subsection (d), as so redesignated, by striking out 
        ``(b)'' and inserting in lieu thereof ``(c)'';
            (6) in subsection (e), as so redesignated, by striking out 
        ``(b)'' and inserting in lieu thereof ``(c)'';
            (7) in subsection (f), as so redesignated, by striking out 
        ``(b)(2) or (c)(1)'' and ``(d)'' and inserting in lieu thereof 
        ``(c)(2) or (d)(1)'' and ``(e)''; and
            (8) by striking subsection (g).

SEC. 111. EXPANSION OF AUTHORITY TO SHARE HEALTH-CARE RESOURCES.

    (a) The text of section 8151 is amended to read as follows: ``It is 
the purpose of this subchapter to improve the quality of health care 
provided veterans under this title, by authorizing the Secretary to 
enter into agreements with health-care providers in order to share 
health-care resources with, and receive health-care resources from 
those health care providers, provided there is no diminution of 
services to veterans. Among other things, it is intended by these means 
to strengthen the medical programs at Department facilities located in 
small cities or rural areas that are remote from major medical 
centers.''.
    (b) Section 8152 is amended--
            (1) by striking out paragraphs (1) and (2) and 
        redesignating paragraphs (3) and (4) as paragraphs (1) and (2), 
        respectively;
            (2) by amending paragraph (1), as so redesignated, to read 
        as follows:
            ``(1) The term `health-care resource' includes health care 
        as that term is defined in paragraph (5) of section 1701, any 
        other health-care service, and any health-care support or 
        administrative resource.''; and
            (3) by adding at the end the following new paragraph (3):
            ``(3) The term `health-care providers' includes health-care 
        plans, insurers, organizations, institutions, or any other 
        entity or individual who furnishes any health-care resource.''.
    (c) Section 8153 is amended--
            (1) by amending the heading to read as follows:
``Sec. 8153. Health-care resource sharing'';
            (2) by amending paragraph (1) of subsection (a) to read as 
        follows:
    ``(a)(1) The Secretary may, when the Secretary determines it to be 
necessary in order to secure health-care resources which otherwise 
might not be feasibly available, or to effectively utilize health-care 
resources, make arrangements, by contract or other form of agreement, 
without regard to any law or regulation pertaining to competitive 
procedures, for the mutual use, or exchange of use, of health-care 
resources between Department health-care facilities and non-Department 
health-care providers.'';
            (3) in subsection (c), by striking out ``hospital care and 
        medical services'' and ``hospital care or medical services'' 
        and inserting in lieu thereof ``health care'' in both places;
            (4) in subsection (d), by striking out ``hospital care and 
        health services'' and inserting in lieu thereof ``health 
        care''; and
            (5) by striking out subsection (e).
    (d) The table of sections at the beginning of chapter 81 is amended 
by striking out the item relating to section 8153 and inserting in lieu 
thereof the following:

``8153. Health care resource sharing''.

SEC. 112. AUTHORIZATION OF APPROPRIATIONS.

    Subchapter II of chapter 17 is amended by adding at the end the 
following new section:
``Sec. 1720D. Authorization of appropriations
    ``There are authorized to be appropriated such sums as are 
necessary to carry out this subchapter.''

SEC. 113. CONFORMING AMENDMENTS.

    (a) Section 1703 is amended--
            (1) by amending the section heading to read as follows:
``Sec. 1703. Contracts for hospital and outpatient care'';
            (2) by striking out the words ``medical services'' wherever 
        they appear and inserting in lieu thereof ``outpatient care'';
            (3) in the first sentence of subsection (a), by striking 
        out ``or services'' and `` or 1712'';
            (4) by amending paragraph (2) of subsection (a) to read as 
        follows:
            ``(2) Outpatient care for the treatment of any disability 
        of--
                    ``(A) a veteran with a service-connected disability 
                rated at 50 percent or more;
                    ``(B) a veteran who has been furnished hospital 
                care, nursing home care, or domiciliary care, when 
                reasonably necessary to complete treatment incident to 
                such care for a period up to 12 months after discharge 
                from such care unless the Secretary authorizes a longer 
                period of care after finding that a longer period is 
                required by reason of the disability being treated; or
                    ``(C) a veteran of the Mexican border period or 
                World War I, or a veteran who is in receipt of 
                increased pension or additional compensation or 
                allowances based on the need of regular aid and 
                attendance or by reason of being permanently housebound 
(or who, but for the receipt of retired pay, would be in receipt of 
such pension, compensation, or allowance) if the Secretary has 
determined, based on an examination by a physician employed by the 
Department (or, in areas where no such physician is available, by a 
physician carrying out such function under a contract or fee 
arrangement), that the medical condition of such veteran precludes 
appropriate treatment in Department facilities.'';
            (5) by amending paragraph (5) of subsection (a) to read as 
        follows:
            ``(5) Hospital care, or outpatient care for veterans in a 
        State (other than the Commonwealth of Puerto Rico) not 
        contiguous to the contiguous States.'';
            (6) in paragraph (6) of subsection (a), by striking out 
        ``to obviate the need for hospital admission''; and
            (7) in paragraph (7) of subsection (a), by striking out 
        ``1712(b)(1)(F)'' and inserting in lieu thereof 
        ``1715(b)(1)(F)''.
    (b) Section 1704 is repealed.
    (c) Section 1711 is amended by striking ``medical services'' 
wherever it appears and inserting in lieu thereof ``outpatient care''.
    (d) Section 1712A is amended--
            (1) in subsection (b)(1), by striking ``1712(a)(5)(B) and 
        inserting in lieu thereof ``1710'';
            (2) in subsection (b)(2), by striking ``1701(6)(B)'' and 
        inserting in lieu thereof ``1712C''; and
            (3) in subsection (e)(1), by striking ``sections 
        1712(a)(1)(B) and'' and inserting in lieu thereof ``section''.
    (e) Section 1713 is amended by striking out ``medical care'' each 
place it appears and inserting in lieu thereof ``health care''.
    (f) Section 1718 is amended in subsection (e), by striking out 
``1712(i) of this title'' and inserting ``1710(c)'' in lieu thereof.
    (g) Section 1720A is amended--
            (1) by striking out ``hospital, nursing home, and 
        domiciliary care and medical and rehabilitative services'' and 
        inserting in lieu thereof ``health care''; and
            (2) by striking out ``1995'' and inserting in lieu thereof 
        ``1997''.
    (h) Section 1720B is repealed.
    (i) Section 1720D is redesignated as section 1720B.
    (j) Section 1724 is amended--
            (1) by amending the heading to read as follows:
``Sec. 1724. Health care abroad''; and
            (2) by striking out ```medical services'' wherever it 
        appears and inserting in lieu thereof ``outpatient care''.
    (k) Section 1727 is amended by striking out ``medical services'' 
and inserting in lieu thereof ``outpatient care''.
    (l) Section 1728 is amended by striking out ``medical services'' 
and inserting in lieu thereof ``outpatient care''.
    (m) Section 1734 is amended--
            (1) by amending the heading to read as follows:
``Sec. 1734. Health care in the United States''; and
            (2) by striking ``hospital and nursing home care and 
        medical services'' and inserting in lieu thereof ``health 
        care''.
    (n) The table of sections for subchapters I, II, and III and IV at 
the beginning of chapter 17 is amended to read as follows:

                        ``SUBCHAPTER I--GENERAL

``Sec.
``1701. Definitions.
``1702. Presumption relating to psychosis.
``1703. Contracts for hospital and outpatient care.
   ``SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND 
                           MEDICAL TREATMENT

``1710. Eligibility for health care.
``1711. Care during examinations and in emergencies.
``1712. Treatment for veterans exposed to certain toxic substances or 
                            hazards.
``1712A. Eligibility for readjustment counseling and related mental 
                            health services.
``1712B. Counseling for former prisoners of war.
``1712C. Mental health services and bereavement counseling for family 
                            members.
``1713. Medical care for survivors and dependents of certain veterans.
``1714. Prosthetic devices and aids for the blind and hearing impaired.
``1715. Dental care.
``1716. Hospital care by other agencies of the United States.
``1717. Home improvements and structural alterations.
``1718. Therapeutic and rehabilitative activities.
``1719. Medications prescribed by non-VA physicians; immunization 
                            programs.
``1720. Transfers for nursing home care.
``1720A. Treatment and rehabilitation for alcohol or drug dependence or 
                            abuse disabilities.
``1720B. Counseling and treatment for sexual trauma.
``1720C. Noninstitutional alternatives to nursing home care: pilot 
                            program.
``1720D. Authorization of Appropriations.
  ``SUBCHAPTER III--MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND 
          NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS

``1721. Power to make rules and regulations.
``1722. Income thresholds.
``1722A. Copayment for medications.
``1723. Furnishing of clothing.
``1724. Hospital care, medical services, and nursing home care abroad.
``1726. Reimbursement for loss of personal effects by natural disaster.
``1727. Persons eligible under prior law.
``1728. Reimbursement of certain medical expenses.
``1729. Recovery by the United States of the cost of certain care and 
                            services.
``1730. Community residential care.
 ``SUBCHAPTER IV--HOSPITAL CARE AND MEDICAL TREATMENT FOR VETERANS IN 
                    THE REPUBLIC OF THE PHILIPPINES

``1731. Assistance to the Republic of the Philippines.
``1732. Contracts and grants to provide for the care and treatment of 
                            United States veterans by the Veterans 
                            Memorial Medical Center.
``1733. Supervision of program by the President.
``1734. Health care in the United States.
``1735. Definitions.''.

          PART B--GENERAL PROGRAM ADMINISTRATION IMPROVEMENTS

SEC. 120. MEANS TEST REFORM.

    (a) Section 1722 is amended to read as follows:
``Sec. 1722. Income thresholds
    ``(a)(1) For purposes of section 1710(c)(1)(D), section 
1710(c)(1)(E) and section 1710(e), the income threshold for the 
calendar year beginning on January 1, 1995, is--
            ``(A) $20,469 in the case of a veteran with no dependents; 
        and
            ``(B) $24,585 in the case of a veteran with one dependent, 
        plus $1,368 for each additional dependent.
    ``(2) Effective on January 1, of each year after 1995, the amounts 
specified in paragraph (1) shall be increased by the percentage by 
which the maximum rates of pension were increased under section 5312(a) 
during the preceding calendar year.
    ``(b) For purposes of this chapter, the term `attributable income 
of a veteran' means the income of a veteran for the previous year 
determined in the same manner as the manner in which a determination is 
made of the total amount of income by which the rate of pension for 
such veteran under section 1521 of this title would be reduced if such 
veteran were eligible for pension under that section.
    ``(c) If a veteran has attributable income greater than the 
applicable amount specified in subsection (a), but projections of the 
veteran's income for the current year are that it will be substantially 
below that amount, then to avoid a hardship to the veteran, the 
Secretary may deem the veteran to have an attributable income less than 
the applicable amount specified in subsection (a).
    ``(d) For the purposes of section 1724(c) of this title, the fact 
that a veteran is--
            ``(1) eligible to receive medical assistance under a State 
        plan approved under title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.);
            ``(2) a veteran with a service-connected disability; or
            ``(3) in receipt of pension under any law administered by 
        the Secretary,
shall be accepted as sufficient evidence of such veteran's inability to 
defray necessary expenses.''.
    (b) Section 1722A(a)(3)(B) is amended by inserting ``attributable'' 
before ``income''.

SEC. 121. VA RETENTION OF FUNDS COLLECTED FROM THIRD PARTIES.

    (a) Section 1729(g) is amended--
            (1) in paragraph (3)(A) by striking ``1710(f) of this title 
        for hospital care or nursing home care, under section 1712(f) 
        of this title for medical services'' and inserting in lieu 
        thereof ``1710(e) of this title for health care''.
            (2) by amending paragraph (4) to read as follows:
            ``(4) Not later than January 1 of each year, there shall be 
        deposited into the Treasury as miscellaneous receipts an amount 
        equal to the amount of the unobligated balance remaining in the 
        Fund at the close of business on September 30 of the preceding 
        year--
                    ``(A) minus any part of such balance that the 
                Secretary determines is necessary in order to enable 
                the Secretary to defray, during the fiscal year in 
                which the deposit is made, the expenses, payments, and 
                costs described in paragraph (3); and
                    ``(B) minus twenty-five percent of that part of 
                such balance that exceeds the baseline in the 
                President's Budget for third party deposits in that 
                fund for that fiscal year, which shall be retained by 
VA and distributed to VA health care facilities for use in improving 
the quality of health care provided by those facilities.''.

                       TITLE II--BENEFIT PROGRAMS

                     PART A--LOAN GUARANTY PROGRAM

SEC. 201. TERMINATION OF MANUFACTURED HOUSING LOAN PROGRAM.

    Section 3712 is amended--
            (1) by striking out subsection (l) in its entirety;
            (2) by redesignating subsection (m) as subsection (l); and
            (3) by inserting after subsection (l), as so redesignated, 
        the following new subsection:
    ``(m)(1) Except as provided in paragraph (2) of this subsection, no 
loan closed after September 30, 1995, may be guaranteed under this 
section.
    ``(2) Paragraph (1) of this subsection shall not apply to a loan 
described in subsection (a)(1)(F) of this section.''.

SEC. 202. LOAN FEES.

    (a) Section 3729(a)(2) is amended--
            (1) by striking out in subparagraph (A) ``or for any 
        purpose specified in section 3712 (other than section 
        3712(a)(1)(F)) of this title'';
            (2) by striking out in subparagraphs (B) and (C) ``(except 
        for a purchase referred to in section 3712(a) of this title)'' 
        each place it appears;
            (3) by inserting ``or'' at the end of clause (i) of 
        subparagraph (D);
            (4) by striking out clause (ii) of subparagraph (D);
            (5) by striking out in clause (iii) of subparagraph (D) 
        ``(other than a purchase referred to in section 3712 of this 
        title)''; and
            (6) by redesignating clause (iii) of subparagraph (D) as 
        clause (ii).
    (b) The amendments made by this section shall take effect October 
1, 1995.

SEC. 203. CONTRACTING FOR PORTFOLIO LOAN SERVICES.

    (a) Subchapter III of chapter 37 is amended by inserting after 
section 3735 the following new section:
``Sec. 3736. Portfolio loan servicing
    ``(a) Notwithstanding the provisions of any other law, the 
Secretary is authorized to contract with a private entity for the 
servicing of loans made or acquired by the Secretary under this 
chapter. The contract may provide for the contractor to retain, as 
compensation for the work performed under such contract, a portion of 
the interest collected on such loans. A contract under this subsection 
may be for a term not in excess of 15 years.
    ``(b) For purposes of the Federal Credit Reform Act of 1990, the 
deduction from interest retained by a contractor as authorized by 
subsection (a) of this section shall be deemed to be a cost of a direct 
loan or the cost of a loan guarantee, and not an administrative 
expense.''.
    (b) The table of sections at the beginning of such chapter is 
amended by inserting below the item relating to section 3735 the 
following new item:

``3736. Portfolio loan servicing.''.

                       PART B--EDUCATION PROGRAMS

SEC. 210. ELECTRONIC SIGNATURES ON DOCUMENTS CONCERNING EDUCATION 
              BENEFITS FOR VETERANS.

    (a) Section 3674(a)(3) is amended by inserting ``(A)'' before 
``Each'' and by adding at the end the following new subparagraph (B):
    ``(B) The Secretary may require that any report or certification 
required by this subsection be submitted to the Department 
electronically by such means and in such format as the Secretary may 
prescribe, including a requirement for the use of a digital signature 
or other individually identified electronic designation of the 
reporting or certifying party on the electronic reports and 
certifications submitted. Such a digital signature or other electronic 
designation will be deemed to be the original signature of the 
reporting or certifying party.''.
    (b) Section 3680(g) is amended--
            (1) by inserting ``(1)'' after the ``(g)'' at the 
        beginning; and
            (2) by adding at the end the following new paragraph:
            ``(2) The Secretary may require that any report or 
        certification required under this section be submitted to the 
        Department electronically by such means and in such format as 
        the Secretary may prescribe, including a requirement for the 
        use of a digital signature or other individually identified 
        electronic designation of the reporting or certifying party on 
        the electronic reports and certifications submitted. Such 
        digital signature or other electronic designation will be 
        deemed to be the original signature of the reporting or 
        certifying party.''
    (c) Section 3684 is amended by adding at the end the following new 
subsection:
    ``(d) For purposes of this section, the Secretary may require that 
any report or certification required by this section is to be submitted 
to the Department electronically by such means and in such format as 
the Secretary may prescribe, including a requirement for the use of a 
digital signature or other individually identified electronic 
designation of the reporting or certifying party on the electronic 
reports and certifications submitted. Such a digital signature or other 
electronic designation will be deemed to be the original signature of 
the reporting or certifying party.''.
    (d) Section 5101(a) is amended--
            (1) by inserting ``(1)'' after the ``(a)'' at the 
        beginning; and
            (2) by adding at the end the following new paragraph:
            ``(2) The Secretary is authorized to provide that a claim 
        for education benefits under laws administered by the 
        Department may be submitted to the Department electronically 
        through an electronic terminal, telephone, computer or other 
        electronic means in such manner as the Secretary may prescribe, 
        including a requirement for the use of a digital signature or 
        other individually identified electronic designation of the 
        claimant on the electronic claim submitted by the claimant. 
        Such a digital signature or other electronic designation will 
        be deemed to be the individual claimant's original 
        signature.''.
    (e) Chapter 53 is amended--
            (1) by adding at the end the following new section:
``Sec. 5320. Verification of education benefits information.
    ``(a) The Department may utilize data electronically provided to 
the Department by any individual in initially establishing or verifying 
eligibility or continued eligibility of an individual for education 
benefits under laws administered by the Department. The data will be in 
the form prescribed by the Secretary.
    ``(b) Notwithstanding section 552a(o) and (p) of title 5, the 
Secretary may suspend, terminate, or reduce payments based on the data 
described in subsection (a) once the Secretary (1) informs the 
individual of the data provided electronically, (2) gives the 
individual an explanation of the procedures to contest such data, and 
(3) gives notice of the individual's right to appeal the decision in 
the same manner as applies to other information and findings relating 
to eligibility for or entitlement to the payment of such benefits.''; 
and
            (2) by amending the table of sections for such chapter by 
        adding at the end the following new item:

``5320. Verification of education benefits information.''.

SEC. 211. ELECTRONIC FUNDS TRANSFER FOR EDUCATION BENEFITS PAYMENTS.

    Section 5120(d) is amended--
            (1) by striking out ``Notwithstanding'' and inserting in 
        lieu thereof ``(1) Except as provided in paragraph (2) of this 
        subsection, and notwithstanding''; and
            (2) by adding at the end thereof the following new 
        paragraph:
    ``(2)(A) Notwithstanding the provisions of section 3680(d)(4) of 
this title and subsection (a) of this section, the Secretary is 
authorized to require, pursuant to an agreement with the Secretary of 
the Treasury under which the Secretary certifies such benefits for 
payment, that education benefits provided under laws administered by 
the Department be paid through electronic funds transfer, to include a 
program combining use of vouchers and federally established electronic 
benefit transfer accounts or any other electronic funds transfer 
program designated by the Secretary.
    ``(B) For purposes of this paragraph, the term ``electronic funds 
transfer'' means any transfer of funds, other than a transaction 
originated by cash, check or similar paper instrument, that is 
initiated through an electronic terminal, telephone, computer, or 
magnetic tape, for the purpose of ordering, instructing, or authorizing 
a financial institution to debt or credit an account.''.
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