[Congressional Record Volume 149, Number 108 (Monday, July 21, 2003)]
[House]
[Pages H7187-H7189]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              VETERANS HEALTH CARE IMPROVEMENT ACT OF 2003

  Mr. SIMMONS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 2357) to amend title 38, United States Code, to establish 
standards of access to care for veterans seeking health care from the 
Department of Veterans Affairs, and for other purposes, as amended.
  The Clerk read as follows:

                               H.R. 2357

       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 ``Veterans Health Care 
     Improvement Act of 2003''.

     SEC. 2. APPOINTMENT OF CHIROPRACTORS IN THE VETERANS HEALTH 
                   ADMINISTRATION.

       (a) Appointments.--Section 7401 of title 38, United States 
     Code, is amended--
       (1) by inserting ``and chiropractic care'' in the matter 
     preceding paragraph (1) after ``medical care''; and
       (2) by inserting ``chiropractors,'' in paragraph (1) after 
     ``podiatrists,''.
       (b) Qualifications of Appointees.--Section 7402(b) of such 
     title is amended--
       (1) by redesignating paragraph (10) as paragraph (11); and
       (2) by inserting after paragraph (9) the following new 
     paragraph (10):
       ``(10) Chiropractor.--To be eligible to be appointed to a 
     chiropractor position, a person must--
       ``(A) hold the degree of doctor of chiropractic, or its 
     equivalent, from a college of chiropractic approved by the 
     Secretary; and
       ``(B) be licensed to practice chiropractic in a State.''.
       (c) Period of Appointments and Promotions.--Section 
     7403(a)(2) of such title is amended by adding at the end the 
     following new subparagraph:
       ``(H) Chiropractors.''.
       (d) Grades and Pay Scales.--Section 7404(b)(1) of such 
     title is amended by striking the third center heading in the 
     table and inserting the following:

    ``CLINICAL PODIATRIST, CHIROPRACTOR, AND OPTOMETRIST SCHEDULE''.

       (e) Temporary and Part-Time Appointments.--Section 7405(a) 
     of such title is amended--
       (1) by adding at the end of paragraph (1) the following new 
     subparagraph:
       ``(E) Chiropractors.''; and
       (2) by adding at the end of paragraph (2) the following new 
     subparagraph:
       ``(D) Chiropractors.''.
       (f) Residencies and Internships.--Section 7406(c) of such 
     title is amended--
       (1) in paragraph (1)--
       (A) by inserting ``and chiropractic'' after ``medical'' the 
     first place it appears; and
       (B) by inserting ``or chiropractic'' after ``medical'' the 
     second place it appears;
       (2) in paragraph (2)(B), by inserting ``or chiropractic'' 
     after ``medical'' the first place it appears; and
       (3) in paragraph (3)(A), by inserting ``or chiropractic'' 
     after ``medical''.
       (g) Malpractice and Negligence Protection.--Section 7316(a) 
     of such title is amended--
       (1) in paragraph (1), by inserting ``or chiropractic'' 
     after ``medical'' each place it appears; and
       (2) in paragraph (2)--
       (A) by inserting ``or chiropractic'' after ``medical'' the 
     first place it appears; and
       (B) by inserting ``chiropractor,'' after ``podiatrist,''.
       (h) Treatment as Scarce Medical Specialists for Contracting 
     Purposes.--Section 7409(a) of such title is amended by 
     inserting ``chiropractors,'' in the second sentence after 
     ``optometrists,''.
       (i) Reimbursement of Continuing Professional Education 
     Expenses.--Section 7411 of such title is amended by striking 
     ``or dentist'' and inserting ``, dentist, or chiropractic''.
       (j) Collective Bargaining Exemption.--Section 7421(b) of 
     such title is amended by adding at the end the following new 
     paragraph:
       ``(8) Chiropractors.''.
       (k) Effective Date.--The amendments made by this section 
     shall take effect at the end of the 180-day period beginning 
     on the date of the enactment of this Act.

     SEC. 3. ELIGIBILITY FOR DEPARTMENT OF VETERANS AFFAIRS HEALTH 
                   CARE OF CERTAIN FILIPINO WORLD WAR II VETERANS 
                   RESIDING IN THE UNITED STATES.

       (a) Eligibility.--The text of section 1734 of title 38, 
     United States Code, is amended to read as follows:
       ``(a) The Secretary shall furnish hospital and nursing home 
     care and medical services to any individual described in 
     subsection (b) in the same manner, and subject to the same 
     terms and conditions, as apply to the furnishing of such care 
     and services to individuals who are veterans as defined in 
     section 101(2) of this title. Any disability of an individual 
     described in subsection (b) that is a service-connected 
     disability for purposes of this subchapter (as provided for 
     under section 1735(2) of this title) shall be considered to 
     be a service-connected disability for purposes of furnishing 
     care and services under the preceding sentence.
       ``(b) Subsection (a) applies to any individual who is a 
     Commonwealth Army veteran or new Philippine Scout and who--
       ``(1) is residing in the United States; and
       ``(2) is a citizen of the United States or an alien 
     lawfully admitted to the United States for permanent 
     residence.''.
       (b) Limitation.--(1) The amendment made by subsection (a) 
     shall take effect on the date on which the Secretary of 
     Veterans Affairs submits to the Committees on Veterans' 
     Affairs of the Senate and House of Representatives and 
     publishes in the Federal Register a certification described 
     in paragraph (2).
       (2) A certification referred to in paragraph (1) is a 
     certification that sufficient resources are available for the 
     fiscal year during which the certification is submitted to 
     carry out section 1734 of title 38, United States Code, as 
     amended by such amendment, during that fiscal year at each 
     significantly affected health care facility of the Department 
     of Veterans Affairs.
       (3) For purposes of paragraph (2), the term ``significantly 
     affected health care facility'' means a health care facility 
     at which, as determined by the Secretary, it is reasonably 
     foreseeable that the implementation of the provisions of 
     section 1734 of title 38, United States Code, as amended by 
     subsection (a), will result in a significant increase in the 
     use of health care resources due to the number of veterans 
     described in subsection (b) of that section who are 
     considered to be likely to seek hospital or nursing home care 
     or medical services, as authorized by subsection (a) of that 
     section, at that facility.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Connecticut (Mr. Simmons) and the gentlewoman from California (Mrs. 
Davis) each will control 20 minutes.
  The Chair recognizes the gentleman from Connecticut (Mr. Simmons).
  Mr. SIMMONS. Mr. Speaker, I yield myself such time as I may consume.
   Mr. Speaker, I rise in strong support of H.R. 2357, as amended, the 
Veterans Health Care Improvement Act of 2003. H.R. 2357 would provide 
two important new health services to veterans. First, the bill would 
clearly establish the authority of the Department of Veterans Affairs 
to appoint chiropractors within its health care system, allowing 
veterans to receive this care in VA facilities. Currently, veterans are 
not receiving this specialty care from VA because the VA has decided 
that chiropractic care is not necessary and duplicates services already 
provided by physicians, nurses, and physical therapists.
   For nearly 3 years, the Committee on Veterans' Affairs has been 
working to include chiropractic care as part of the VA's health care 
system. Through provisions in the Veterans Millennium Health Care and 
Benefits Act, the Department of Veterans Affairs Health Care Programs 
Enhancement Act of 2001, the VA has been required to establish a policy 
for the role of chiropractic care for veterans and to provide 
chiropractic care and services for veterans in its health care system. 
By law, VA has also been required to establish a Chiropractic Advisory 
Committee within the Department.
   Although some progress has been made by the Advisory Committee on 
chiropractic care, veterans are dissatisfied with the VA's reluctance 
to fulfill its obligations under law. The gentleman from Kansas (Mr. 
Moran), our former Health Subcommittee chairman, has spearheaded this 
important effort for our veterans, and I thank him for his leadership 
on this issue.
   Mr. Speaker, our bill would also authorize VA to provide health care 
services to Filipino World War II veterans who legally reside in the 
United States. During World War II, the Commonwealth of the Philippines 
army was called to serve with the U.S. Armed Forces. Tens of thousands 
of Filipino soldiers served alongside U.S. soldiers during World War 
II, exhibiting great courage and determination at the epic battles of 
Bataan and Corregidor and contributing to the successful outcome of the 
war.
   After the Philippines became an independent Nation, Congress passed 
the Rescission Act of 1946, reducing or eliminating many of the 
benefits that Filipino veterans had been eligible for

[[Page H7188]]

based on service in the Commonwealth army. Today, almost 60 years 
later, 60,000 World War II Filipino veterans are alive and continue to 
seek restoration of these benefits. Approximately 14,000 Filipino 
veterans in the U.S. would be eligible for the VA health care services 
this bill would authorize.
   Today, Commonwealth army veterans and new Philippine Scouts residing 
in United States are only eligible for VA health care services if they 
are in receipt of a disability compensation. This legislation before us 
today would broaden eligibility for VA health care for all Filipino 
veterans residing in the United States. Commonwealth army veterans and 
new Philippine Scouts living in the United States would be subject to 
the same eligibility and means test requirements as American veterans.
   This bill would honor our commitment to those veterans by covering 
hospital, nursing home, and medical care services.
   I want to commend the gentleman from New Jersey, my chairman, the 
chairman of the full Committee on Veterans' Affairs, for his leadership 
in bringing this legislation forward; and I also commend the gentleman 
from California (Mr. Filner) who has championed the cause of Filipino 
veterans for years and is due a great deal of credit for the 
legislation we put before the House today.
  Mr. Speaker, I reserve the balance of my time.
  Mrs. DAVIS of California. Mr. Speaker, I yield myself such time as I 
may consume.
   Mr. Speaker, I am pleased to join with the gentleman from 
Connecticut (Mr. Simmons) today and rise in strong support of H.R. 
2357. First, I would also like to recognize the commitment of the 
gentleman from California (Mr. Filner), a long-time member of the 
Committee on Veterans' Affairs and my San Diego colleague, to the cause 
of Filipino veterans.
   Mr. Speaker, the Filipino soldiers recruited to fight in the Pacific 
during the Second World War served proudly under General MacArthur and 
fought courageously against the enemies of the United States. Because 
their contributions were crucial to our victory, these brave soldiers 
thought that when the war was won, they would receive the same 
recognition as American soldiers fighting by their side.
   Unfortunately, Mr. Speaker, in 1946, Congress passed an act that 
rescinded the benefits it had granted to thousands of Filipino 
veterans, and this was wrong. This was wrong. And passing H.R. 2357 
today will help correct this injustice.
   H.R. 2357 also contains a provision to allow the VA to hire 
chiropractors. Mr. Speaker, it is time that the VA recognized the value 
chiropractors can add as part of a health care service continuum. 
Chiropractors can help promote and maintain wellness rather than simply 
treating illness. Millions of Americans rely on their services to 
manage pain and treat a broad range of conditions.
   I am pleased to stand up on these bills today.
  Mr. Speaker, I reserve the balance of my time.
  Mr. SIMMONS. Mr. Speaker, I yield 4 minutes to the distinguished 
gentleman from Kansas (Mr. Moran), formerly the chairman of the Health 
Subcommittee of the Committee on Veterans' Affairs, currently serving 
as vice chairman of that subcommittee and a tireless advocate for 
chiropractic care for our veterans.
  Mr. MORAN of Kansas. Mr. Speaker, I thank the gentleman from 
Connecticut (Mr. Simmons) for yielding me this time.
   Mr. Speaker, I am pleased to be here today as provisions of H.R. 
2414, the Department of Veterans Affairs Chiropractic Employment Act, a 
bill that I introduced earlier this year, are included in this bill now 
before the House.
   I thank the gentleman from New Jersey (Mr. Smith), chairman of the 
full committee, as well as the gentleman from Connecticut (Mr. 
Simmons), my predecessor as the chairman of the Health Subcommittee for 
their leadership and assistance in advancing this measure to the House 
floor today.
   Mr. Speaker, these provisions will prompt the Department of Veterans 
Affairs to make chiropractic care available to America's veterans in VA 
facilities by granting specific employment authority in VA for 
chiropractic care as clinicians under title 38 of the United States 
Code.
   Millions of Americans use the services of doctors of chiropractic. 
However, veterans who are enrolled in the VA health care system are 
unable to receive this specialty care. Numerous studies have 
demonstrated that chiropractic care can and is an effective therapy.
   Mr. Speaker, Congress has acted twice before on chiropractic care in 
the VA health care system, but our intent has not yet been implemented 
by the Department of Veterans Affairs. Signed into law in 1999, section 
303 of Public Law 106-117 required the VA Under Secretary for Health to 
establish a defined policy regarding the role of chiropractic care for 
veterans enrolled in the Veterans Health Administration. Almost a year 
later, the VA established what it deemed to be a ``policy'' on 
chiropractic care. However, the Committee on Veterans' Affairs found 
the VA's response to be inadequate.
   As a result, in 2001, 2 years later, Congress enacted section 204 of 
Public Law 107-135. This legislation required the Secretary of VA to 
create a program of chiropractic care and services for veterans who are 
enrolled in the VA health care system and specified that each of the 
VA's health care networks put at least one program in place. This law 
also required the establishment of a Chiropractic Advisory Committee 
within the Department and charged the committee to provide assistance 
to the Secretary in developing and implementing the chiropractic health 
care program.
   While some progress has been made by the VA's Advisory Committee, 
the Department is now contending that formal organizational, 
qualification, and classification studies are needed due to the VA's 
lack of a specified employment authority in title 38 of the United 
States Code. Such an undertaking by the VA would probably require 
extensive use of specialized resources and more bureaucracy on the part 
of the Central Office, the Advisory Committee, the Office of Personnel 
Management, as well as outside consultants. We can remedy this 
situation with the bill before the House today to speed the VA's 
decision-making on establishing chiropractic clinical care positions 
within the Department.
   Mr. Speaker, I urge my colleagues to support this legislation. Our 
bill will provide a specialty care program for our Nation's veterans, 
who are most deserving of this benefit.
   I again thank the chairman for his leadership.
  Mr. LARSON of Connecticut. Mr. Speaker, I rise today in support of 
H.R. 2357. This legislation was originally drafted to establish 
standards of care for veterans seeking health care from the Department 
of Veterans Affairs. I commend the gentlewoman from Florida (Ms. Brown-
Waite) for introducing this legislation that, when introduced, would 
have ensured that veterans receive health care within thirty days of 
their initial request for appointments at VA facilities or if the VA 
could not meet this requirement, allow veterans to receive care at non-
VA facilities. In its original form, this legislation closely resembled 
a bill that I first introduced in the 107th Congress and reintroduced 
in February. Like the bill the gentlewoman from Florida introduced, the 
21st Century Veterans Equitable Treatment Act, H.R. 890, would 
establish standards for appointments at VA facilities and allow 
veterans to receive care at non-VA facilities if the VA was not able to 
meet its obligation. Additionally, my legislation recommends the used 
of ``smart card'' technology to expedite reimbursements for services 
and reduce complicated paperwork.
  As you may know, the President's Task Force to Improve Health Care 
Delivery for Our Nation's Veterans recently released its final report 
and found that due to the number of veterans seeking access to the VA 
and Department of Defense health care system, those with service-
connected disabilities and indigent veterans have been faced with 
diminished access to care. I agree with the Task Force that this 
situation is unacceptable and concur with one of their recommendations 
that ``VA facilities should be held accountable to meet the VA's access 
standards for enrolled Priority Groups 1 through 7 (new). In instances 
where an appointment cannot be offered within the access standard, VA 
should be required to arrange for care with a non-VA provider, unless 
the veteran elects to wait for an available appointment with VA.'' The 
bill introduced by the gentlewoman from Florida, as well as my 
legislation, was created to accomplish this.
  Unfortunately, during markup of this legislation in the Veterans' 
Affairs Committee, this

[[Page H7189]]

provision was removed from H.R. 2357. The bill that we are debating now 
would no longer ``establish standards of access to care for veterans 
seeking health care from the Department of Veterans Affairs'' as is 
indicated by its title but instead authorizes the Secretary to hire 
chiropractors and makes certain Filipino World War II veterans living 
in the United States eligible for VA health care. I am very 
disappointed that this critical issue in veterans' health care access 
and element of the President's Task Force recommendations is not being 
voted on by the House today. However, I am encouraged to hear of the 
possibility that the Committee will hold a hearing on this very 
important issue when we return from the August recess. I wholeheartedly 
support further debate and would look forward to testifying before the 
Committee.
  While disappointed that the appointment standards for the VA have 
been stripped from this bill, I am pleased that this legislation will 
give the Secretary of Veterans Affairs the authority to hire 
chiropractors. Congress has passed legislation numerous times to ensure 
that veterans have access to chiropractic care and I hope that this 
bill will clear any final hurdles that have prevented veterans from 
receiving this type of care.
  Mr. Speaker, I ask my colleagues to join me today in supporting this 
legislation that is a small, yet important, step to meeting our 
commitment to those Americans who made the sacrifice to serve their 
nation in the armed forces. As future veterans face combat in Iraq, we 
in Congress must live up to our pledge by providing health care to all 
veterans, by ensuring that it is accessible, and by fully funding the 
VA health care system. I urge my colleagues to join me in calling for 
additional legislation to meet these goals so that we may return to 
this floor in the near future and step closer to meeting our promise.
  Mr. FILNER. Mr. Speaker, and colleagues, I rise today to urge support 
for H.R. 2357, legislation which includes a provision from my bill, 
H.R. 664, that would authorize the Department of Veterans Affairs to 
provide health care to Filipino World War II veterans who legally 
reside in the United States.
  As my colleagues know, I have been working to restore these benefits 
for many years. By passing this legislation for Filipino World War II 
veterans, we are providing a giant step forward in our quest to correct 
the injustice that was inflicted upon them by the 1946 Congress, 
shortly after World War II ended.
  Over 50 years ago, Filipino soldiers were drafted into service by 
President Franklin D. Roosevelt. They fought side-by-side with soldiers 
from the United States mainland, exhibiting great courage at the epic 
battles of Bataan and Corrigidor. Their participation was critical to 
the successful outcome of the war in the Far East. It was quite a shock 
when Congress deprived many of the benefits that they were expecting.
  Because these veterans are in their 70s and 80s, their most urgent 
need is for health care. So I sincerely appreciate the actions of 
Veterans' Affairs Committee Chairman Chris Smith and Ranking Member 
Lane Evans, and Chairman Bob Simmons and Ranking Member Ciro Rodriguez 
of the VA Health Subcommittee, as well as of VA Secretary Anthony 
Principi, to restore VA health care benefits to them.
  This bill is also about restoring dignity and honor to these proud 
veterans. Over fifty years of injustice burns in the hearts of the 
Filipino World War II veterans and in the hearts of their sons and 
daughters. This bill says that we will begin to remedy this historical 
injustice. We will make good on the promise of America.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise in support of H.R. 
2357, the Veterans Health Care Improvement Act of 2003. This piece of 
legislation amends Title 38 of the United States Code, to establish 
standards of access to care for veterans seeking health care from the 
Department of Veterans Affairs. Mr. Speaker, this piece of legislation 
is long overdue. This legislation provides new health care benefits to 
Filipino veterans.
   Mr. Speaker, at this time there are thousands of Filipino veterans 
who have proudly served this country in World War II and still, to this 
day, aren't eligible to receive health care benefits from Veterans 
Affairs. That is simply unacceptable. Under this legislation, any 
individual who is a veteran of the Philippine Commonwealth Army or a 
former New Philippine Scout living legally in the United States would 
be eligible for these benefits. The Congressional Budget Office 
estimates that by 2004, if this legislation is enacted, 9,500 Filipino 
veterans would qualify for these new benefits.
  In addition to providing much over due health care benefits to 
Filipino veterans, this bill will serve to enhance the quality of 
chiropractic care offered by VA facilities. Currently, the VA is 
required to make chiropractic care available to veterans at least one 
site in each of VA's 21 geographic service areas, however, the 
bureaucracy often involved in hiring these chiropractors makes it 
difficult to comply. This legislation makes it easier to hire 
chiropractors by allowing the VA to appoint and hire the practitioners 
by specifying that they be treated as other medical professionals like 
optometrists and podiatrists. This would also allow these medical 
professionals to become eligible for part-time or temporary employment, 
educational expense reimbursements, and enhanced protection from 
malpractice suites.
  Again, Mr. Speaker, I urge my colleagues to support this worthwhile 
legislation. It is our duty to provide our veterans with world-class 
health care for the countless sacrifices that they have made on behalf 
of our country.
  Mrs. DAVIS of California. Mr. Speaker, I have no further requests for 
time, and I yield back the balance of my time.
  Mr. SIMMONS. Mr. Speaker, I urge my colleagues to support the 
Veterans Health Care Improvement Act of 2003.
   Mr. Speaker, I have no further requests for time, and I yield back 
the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Connecticut (Mr. Simmons) that the House suspend the 
rules and pass the bill, H.R. 2357, as amended.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill, as amended, was passed.
  The title of the bill was amended so as to read: ``A bill to amend 
title 38, United States Code, to provide for the appointment of 
chiropractors in the Veterans Health Administration of the Department 
of Veterans Affairs and to provide eligibility for Department of 
Veterans Affairs health care for certain Filipino World War II veterans 
residing in the United States.''.
  A motion to reconsider was laid on the table.

                          ____________________