[Congressional Record Volume 147, Number 112 (Friday, August 3, 2001)]
[Extensions of Remarks]
[Pages E1532-E1533]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  DISABLED VETERANS SERVICE DOGS & HEALTH CARE IMPROVEMENT ACT OF 2001

                                 ______
                                 

                            HON. JERRY MORAN

                               of kansas

                    in the house of representatives

                        Thursday, August 2, 2001

  Mr. MORAN of Kansas. Mr. Speaker, as Chairman of the Veterans 
Subcommittee on Health I am introducing the ``Veterans Service Dogs & 
Health Care Improvement Act of 2001.'' This legislation improves 
veterans' health care services in several important ways.
  It allows the VA to provide service dogs to disabled veterans. It 
mandates improvement in VA capacity for specialized medical programs 
for veterans, such as serious mental illness, spinal cord injury, 
blindness, amputees and traumatic brain injuries. It modifies the VA's 
``ability to pay'' formula so that low-income veterans can receive the 
care they need. Finally, the bill establishes innovative pilot programs 
to help us learn how we can improve veterans' benefits in the future.
  We all know that dog is man's best friend, but for many disabled 
veterans, a dog is much more than a friend. Service dogs can greatly 
enhance the quality of life for many seriously disabled veterans. This 
bill authorizes the Secretary of Veterans Affairs to provide enrolled 
veterans with spinal cord injuries, immobility due to chronic 
impairment and hearing impairment to use service dogs in day-today 
activities. Training, travel, and incidental expenses incurred while 
adjusting to the dog may also be paid.
  This bill also seeks to strengthen mandates for VA to maintain 
capacity in specialized medical programs, such as serious mental 
illness, spinal cord injury, blinded veterans, veterans with 
amputations and veterans suffering from traumatic brain injuries, in 
each VISN. Although overall capacity has increased in the VA, there has 
been a decrease in the number of veterans with substance-use and mental 
illness served in specialized programs. With over 225,000 homeless 
veterans currently living on our streets, we cannot allow this to 
continue. Only 11 of 25 spinal cord injury facilities are providing the 
number of staffed beds specified by a VHA Directive. We must extend the 
reporting requirement to ensure VA is doing what was directed to care 
for our at-risk veteran population.

[[Page E1533]]

  Beyond the VHA Directive regarding capacity, this bill seeks to 
modify the current VA means-test threshold. For about fifteen years, 
the VA has determined a nonservice-connected veteran's ability to pay 
by comparing a veteran's income to a predetermined ``means-test 
threshold.'' The threshold, expressed in annual household income, is an 
assumed income level that would be sufficient to a veteran to pay for 
health care in the community. If a veteran's income is below 
the ``ability to pay'' threshold, (currently $23,688 for a single 
veteran without dependents) he or she is eligible for VA care, and 
permits the veteran to avoid the co-payments charged to higher-income 
veterans for VA health care services.

  VA's one national standard income threshold has been criticized for 
years because of the disparities in living costs throughout the 
country.
  The Department of Housing and Urban Development employs a system of 
ascertaining poverty levels for subsidized housing that is much more 
reflective of the cost of living around the country than the VA's means 
test. The Chairman of the Full Committee and I believe the HUD index 
should be used by VA to better reflect differences in economic factors.
  Another provision of this bill explores improved coordination of VA 
ambulatory and community hospital care. This calls for a 4-year, 4-site 
pilot project in which the VA refers enrolled veterans to local 
community hospitals rather than transporting them to an urban VA 
facility hours away. This is one more way the VA can work to bring VA 
services closer to the veterans they serve.
  Another pilot program proposed in this bill is a 4-year, 4-VISN 
program for managed care through an outside contractor in VA's $500 
million fee-basis and contract hospitalization program. A contractor 
would provide resource information and referral services to eligible 
veterans, RN staffed advice lines, coordination with assigned VA case 
managers, and a variety of reports and data on utilization, 
satisfaction, quality, access, and outcomes. This program provides care 
to service-connected veterans whose places of residence or health 
conditions prevents them to be geographically accessible to VA 
facilities, or available VA facilities cannot furnish the care or 
services required. This would also provide health care for life 
threatening emergencies when no VA facility is available.
  Mr. Speaker, this bill makes important improvements in our veterans 
health care system. When Congress returns from the August break, the 
Subcommittee will consider this important legislation. I urge the 
members to support the bill on behalf of veterans.

                          ____________________