[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 271 Introduced in House (IH)]






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 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.

    Be it enacted by the Senate and House of Representatives 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 ALLOCATION FORMULA FOR 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) Modification to Vera Formula.--The funding allocation formula 
for the Department of Veterans Affairs medical care system known as the 
Veterans Equitable Resource Allocation (VERA) system, established 
pursuant to section 429 of Public Law 104-204 (110 Stat. 2929), shall 
be modified by the Secretary of Veterans Affairs in accordance with 
this section. Such modifications shall provide for the incorporation of 
regional differences in the cost of providing health care to veterans 
(due to different regional cost of living, long travel distance, and 
other appropriate factors) as part of the criteria 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 Department of Veterans Affairs for health care. The 
Secretary 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 
Administration compared to the allocations before such modifications.
    (c) Contingent Termination of VERA Formula.--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 allocation 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 Affairs is required to terminate the use 
of the Veterans Equitable Resource Allocation system, the Secretary 
shall develop a new formula for the allocation of funds appropriated 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 additional 
        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 applied by the Secretary to amounts 
appropriated for veterans medical care shall be the formula in effect 
before the Veterans Equitable Resource Allocation system.

SEC. 4. AUTHORIZATIONS OF APPROPRIATIONS.

    (a) Authorization for Replacement Allocation 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'' Authorizations.--There is 
authorized to be appropriated to the Department of Veterans Affairs for 
fiscal year 2003 the amount of $100,000,000 for ``Medical Care'' for 
the Department 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 experienced an 
        overall five-year funding decrease.
            (3) Third, if any amount appropriated pursuant to such 
        authorization remains after allocations pursuant 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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