[Congressional Record Volume 145, Number 81 (Wednesday, June 9, 1999)]
[Extensions of Remarks]
[Page E1196]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          INTRODUCTION OF VETERANS' MILLENNIUM HEALTH CARE ACT

                                 ______
                                 

                           HON. CLIFF STEARNS

                               of florida

                    in the house of representatives

                        Wednesday, June 9, 1999

  Mr. STEARNS. Mr. Speaker, I'm pleased to introduce a bill adopted 
unanimously at markup this morning by the Subcommittee on Health of the 
Veterans' Affairs Committee.
  This important legislation tackles some of the major challenges 
facing the VA health care system. In doing so, it offers a blueprint to 
help position VA for the future, and I think it is appropriately titled 
the Veterans' Millennium Health Care Act.
  Foremost among VA's challenges are the long-term care needs of aging 
veterans. For many among the World War II population, long term care 
has become as important as acute care. However the long-term care 
challenge has gone unanswered for too long. This legislation would 
squarely address this issue and would adopt some of the key 
recommendations of a blue-ribbon advisory committee, while going 
further to provide VA important new tools to improve veterans' access 
to long term care.
  Similarly, the bill tackles the challenge posed by a recent General 
Accounting Office audit which found that VA may spend billions of 
dollars in the next five years to operate unneeded buildings. In 
testimony before my Subcommittee, GAO stated that one of every four VA 
medical care dollars is spent in maintaining buildings rather than 
caring for patients. This is not just an abstract concern. It is no 
secret that VA is discussing closing hospitals. And in some locations, 
that may be appropriate. The point is that VA has closure authority and 
has already used it. In fact, we could expect closures of needed 
facilities under the disastrous budget submitted by the President this 
year.
  This bill instead calls for a process to be sure that decisions on 
closing hospitals can only be made based on comprehensive studies and 
planning. That planning process must include the participation of 
veterans organizations and employee groups. In short, the bill sets 
numerous safeguards in place, and would specifically provide that VA 
cannot simply stop operating a hospital and walk away from its 
responsibilities to veterans. It must ``re-invest'' savings in a new, 
improved treatment facility or improved services in the area.
  Overall, the bill has four central themes: (1) to provide new 
direction to address veterans' long-term care needs; (2) to expand 
veterans' access to care; (3) to close gaps in current eligibility law; 
and (4) to establish needed reforms to improve the VA health care 
system.
  The bill's key provisions would:
  (1) require VA to maintain its long-term care programs and to 
increase both home and community-based long-term care;
  (2) mandate that VA provide needed long-term care for 50% service-
connected veterans and veterans needing care for a service-related 
condition;
  (3) require co-payments for long-term care for all other veterans, 
based on ability to pay and with such payments helping to support 
expanded services;
  (3) establish limits and conditions for considering closure of VA 
medical centers or parts of medical centers (such as ceasing to provide 
acute hospital care at a VA medical center), and would require that VA 
re-invest savings from a closure to establish new outpatient facilities 
and other improved services in any affected area;
  (4) authorize VA care of TRICARE-eligible military retirees who are 
not otherwise eligible for priority VA care, subject to DOD reimbursing 
VA, as well as provide specific authority for VA care of veterans who 
were injured in combat and earned the Purple Heart;
  (5) authorize VA to pay reasonable emergency care costs for service-
connected, low-income and other high priority veterans who have no 
health insurance or other medical coverage, and who rely on VA care;
  (6) authorize VA to (a) increase the copayment on prescriptions 
drugs; and (b) establish reasonable copayments on other costly items 
provided for care of a nonservice-connected condition (subject to 
exemptions on copayments in existing law), and provide that these new 
revenues would help fund VA medical care;
  (7) require that, if the Federal government prevails in a suit 
against tobacco companies to recover costs incurred by the Government 
attributable to tobacco-related illnesses, VA shall retain the amount 
of such recovery attributable to VA's costs of providing such care for 
use in providing medical care and conducting research on such 
illnesses;
  (8) reform the criteria for awarding grants for construction and 
remodeling of State veterans' homes;
  (9) extend VA's authority to make grants to assist homeless veterans; 
and
  (10) authorize the VA to carry out a three-year pilot program in up 
to four of VA's networks to provide primary care services (subject to 
reimbursement) to dependents of veterans.
  Mr. Speaker, this is an important bill which major veterans groups 
have praised and endorsed. The work on it has been a real bipartisan 
effort. I urge Members to support it.

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