II 110th CONGRESS 1st Session S. 1146 IN THE SENATE OF THE UNITED STATES April 18, 2007 Mr. Salazar (for himself, Mr. Thune, Mr. Tester, Mr. Burr, Mrs. Murray, Mr. Grassley, Mr. Wyden, Ms. Collins, Mr. Pryor, Mr. Enzi, Mrs. Lincoln, Ms. Snowe, Mr. Kerry, Mr. Bingaman, Mr. Smith, Mr. Baucus, and Mr. Dorgan) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To amend title 38, United States Code, to improve health care for veterans who live in rural areas, and for other purposes.

1.

Short title

This Act may be cited as the Rural Veterans Health Care Improvement Act of 2007.

2.

Travel reimbursement for veterans receiving treatment at facilities of the Department of Veterans Affairs

Section 111 of title 38, United States Code, is amended— (1)in subsection (a)— (A)by striking subsistence), and inserting subsistence at a rate equivalent to the rate provided to Federal employees under section 5702 of title 5),; and (B)by striking traveled, and inserting (at a rate equivalent to the rate provided to Federal employees under section 5704 of title 5),; (2)by striking subsection (g); and (3)by redesignating subsection (h) as subsection (g).

3.

Centers for rural health research, education, and clinical activities

(a)

In general

Subchapter II of chapter 73 of title 38, United States Code, is amended by adding at the end the following new section:

7330A.

Centers for rural health research, education, and clinical activities

(a)

Establishment of centers

The Secretary, through the Director of the Office of Rural Health, shall establish and operate not less than one and not more than five centers of excellence for rural health research, education, and clinical activities, which shall— (1)conduct research on the provision of health services in rural areas; (2)develop specific models to be used by the Department in furnishing health services to veterans in rural areas; (3)provide education and training for health care professionals of the Department on the furnishing of health services to veterans in rural areas; and (4)develop and implement innovative clinical activities and systems of care for the Department for the furnishing of health services to veterans in rural areas. (b)

Geographic dispersion

The Secretary shall ensure that the centers authorized under this section are located at health care facilities that are geographically dispersed throughout the United States. (c)

Selection criteria

The Secretary may not designate a health care facility as a location for a center under this section unless— (1)the peer review panel established under subsection (d) determines that the proposal submitted by such facility meets the highest competitive standards of scientific and clinical merit; and (2)the Secretary determines that the facility has, or may reasonably be anticipated to develop, the following: (A)An arrangement with an accredited medical school to provide residents with education and training in health services for veterans in rural areas. (B)The ability to attract the participation of scientists who are capable of ingenuity and creativity in health care research efforts. (C)A policymaking advisory committee, composed of appropriate health care and research representatives of the facility and of the affiliated school or schools, to advise the directors of such facility and such center on policy matters pertaining to the activities of such center during the period of the operation of such center. (D)The capability to conduct effectively evaluations of the activities of such center. (d)

Panel To evaluate proposals

(1)The Director of the Office of Rural Health shall establish a panel— (A)to evaluate the scientific and clinical merit of proposals submitted to establish centers under this section; and (B)to provide advice to the Director regarding the implementation of this section. (2)The panel shall review each proposal received from the Secretary and shall submit its views on the relative scientific and clinical merit of each such proposal to the Secretary. (3)The panel established under paragraph (1) shall be comprised of experts in the fields of public health research, education, and clinical care. (4)Members of the panel shall serve as consultants to the Department for a period not to exceed two years. (5)The panel shall not be subject to the Federal Advisory Committee Act (5 U.S.C. App.). (e)

Funding

(1)There are authorized to be appropriated to the Medical Care Account and the Medical and Prosthetics Research Account of the Department of Veterans Affairs such sums as may be necessary for the support of the research and education activities of the centers operated under this section. (2)There shall be allocated to the centers operated under this section, from amounts authorized to be appropriated to the Medical Care Account and the Medical and Prosthetics Research Account by paragraph (1), such amounts as the Under Secretary of health considers appropriate for such centers. Such amounts shall be allocated through the Director of the Office of Rural Health. (3)Activities of clinical and scientific investigation at each center operated under this section— (A)shall be eligible to compete for the award of funding from funds appropriated for the Medical and Prosthetics Research Account; and (B)shall receive priority in the award of funding from such account to the extent that funds are awarded to projects for research in the care of rural veterans.

. (b)

Clerical amendment

The table of sections at the beginning of chapter 73 of such title is amended by inserting after the item relating to section 7330 the following new item: 7330A. Centers for rural health research, education, and clinical activities. .

4.

Transportation grants for rural veterans service organizations

(a)

Grants authorized

(1)

In general

The Secretary of Veterans Affairs shall establish a grant program to provide innovative transportation options to veterans in remote rural areas. (2)

Use of funds

Grants awarded under this section may be used by State veterans’ service agencies and veterans service organizations to— (A)assist veterans in remote rural areas to travel to Department of Veterans Affairs medical centers; and (B)otherwise assist in providing medical care to veterans in remote rural areas. (3)

Maximum amount

The amount of a grant under this section may not exceed $50,000. (4)

No matching requirement

The recipient of a grant under this section shall not be required to provide matching funds as a condition for receiving such grant. (b)

Regulations

The Secretary shall prescribe regulations for— (1)evaluating grant applications under this section; and (2)otherwise administering the program established by this section. (c)

Veterans service organization definition

In this section, the term veterans service organization means any organization recognized by the Secretary of Veterans Affairs for the representation of veterans under section 5902 of title 38, United States Code. (d)

Authorization of appropriations

There are authorized to be appropriated $3,000,000 for each of fiscal years 2008 through 2012 to carry out this section.

5.

Demonstration projects on alternatives for expanding care for veterans in rural areas

(a)

In general

The Secretary of Veterans Affairs, through the Director of the Office of Rural Health, shall carry out demonstration projects to examine alternatives for expanding care for veterans in rural areas, including the following: (1)Establishing a partnership between the Department of Veterans Affairs and the Centers for Medicare and Medicaid Services of the Department of Health and Human Services to coordinate care for veterans in rural areas at critical access hospitals (as designated or certified under section 1820 of the Social Security Act (42 U.S.C. 1395i–4)). (2)Establishing a partnership between the Department of Veterans Affairs and the Department of Health and Human Services to coordinate care for veterans in rural areas at community health centers. (3)Expanding coordination between the Department of Veterans Affairs and the Indian Health Service to expand care for Native American veterans. (b)

Geographic distribution

The Secretary of Veterans Affairs shall ensure that the demonstration projects authorized under subsection (a) are located at facilities that are geographically distributed throughout the United States. (c)

Report

Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit a report on the results of the demonstration projects conducted under subsection (a) to— (1)the Committee on Veterans' Affairs and the Committee on Appropriations of the Senate; and (2)the Committee on Veterans' Affairs and the Committee on Appropriations of the House of Representatives.

6.

Report to Congress on matters related to care for veterans who live in rural areas

(a)

Annual report

The Secretary of Veterans Affairs shall submit to Congress each year, together with documents submitted to Congress in support of the budget of the President for the fiscal year beginning in such year (as submitted pursuant to section 1105 of title 31, United States Code), an assessment, current as of the fiscal year ending in the year before such report is submitted, of the following: (1)The implementation of the provisions of this Act, including the amendments made by this Act. (2)The establishment and function of the Office of Rural Health under section 7308 of title 38, United States Code. (b)

Additional requirements for initial report

The Secretary of Veterans Affairs shall submit to Congress, together with the first report submitted under subsection (a), an assessment of the following: (1)The fee-basis health-care program required by subsection (b) of section 212 of the Veterans Benefits, Health Care, and Information Technology Act of 2006 (Public Law 109–461; 120 Stat. 3422). (2)The outreach program required by section 213 of such Act.