[Congressional Record Volume 162, Number 145 (Monday, September 26, 2016)]
[House]
[Pages H5891-H5892]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    VETERANS EMERGENCY TREATMENT ACT

  Mr. MILLER of Florida. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 3216) to amend title 38, United States Code, to 
clarify the emergency hospital care furnished by the Secretary of 
Veterans Affairs to certain veterans.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 3216

       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 Emergency Treatment 
     Act'' or the ``VET Act''.

     SEC. 2. CLARIFICATION OF EMERGENCY HOSPITAL CARE FURNISHED BY 
                   THE SECRETARY OF VETERANS AFFAIRS TO CERTAIN 
                   VETERANS.

       (a) In General.--Chapter 17 of title 38, United States 
     Code, is amended by inserting after section 1730A the 
     following new section:

     ``Sec. 1730B. Examination and treatment for emergency medical 
       conditions and women in labor

       ``(a) Medical Screening Examinations.--In carrying out this 
     chapter, if any enrolled veteran requests, or a request is 
     made on behalf of the veteran, for examination or treatment 
     for a medical condition, regardless of whether such condition 
     is service-connected, at a hospital emergency department of a 
     medical facility of the Department, the Secretary shall 
     ensure that the veteran is provided an appropriate medical 
     screening examination within the capability of the emergency 
     department, including ancillary services routinely available 
     to the emergency department, to determine whether an 
     emergency medical condition exists.
       ``(b) Necessary Stabilizing Treatment for Emergency Medical 
     Conditions and Labor.--(1) If an enrolled veteran comes to a 
     medical facility of the Department and the Secretary 
     determines that the veteran has an emergency medical 
     condition, the Secretary shall provide either--
       ``(A) such further medical examination and such treatment 
     as may be required to stabilize the medical condition; or
       ``(B) for the transfer of the veteran to another medical 
     facility of the Department or a non-Department facility in 
     accordance with subsection (c).
       ``(2) The Secretary is deemed to meet the requirement of 
     paragraph (1)(A) with respect to an enrolled veteran if the 
     Secretary offers the veteran the further medical examination 
     and treatment described in such paragraph and informs the 
     veteran (or an individual acting on behalf of the veteran) of 
     the risks and benefits to the veteran of such examination and 
     treatment, but the veteran (or individual) refuses to consent 
     to the examination and treatment. The Secretary shall take 
     all reasonable steps to secure the written informed consent 
     of such veteran (or individual) to refuse such examination 
     and treatment.
       ``(3) The Secretary is deemed to meet the requirement of 
     paragraph (1) with respect to an enrolled veteran if the 
     Secretary offers to transfer the individual to another 
     medical facility in accordance with subsection (c) of this 
     section and informs the veteran (or an individual acting on 
     behalf of the veteran) of the risks and benefits to the 
     veteran of such transfer, but the veteran (or individual) 
     refuses to consent to the transfer. The hospital shall take 
     all reasonable steps to secure the written informed consent 
     of such veteran (or individual) to refuse such transfer.
       ``(c) Restriction of Transfers Until Veteran Stabilized.--
     (1) If an enrolled veteran at a medical facility of the 
     Department has an emergency medical condition that has not 
     been stabilized, the Secretary may not transfer the veteran 
     to another medical facility of the Department or a non-
     Department facility unless--
       ``(A)(i) the veteran (or a legally responsible individual 
     acting on behalf of the veteran), after being informed of the 
     obligation of the Secretary under this section and of the 
     risk of transfer, requests in writing a transfer to another 
     medical facility;
       ``(ii) a physician has signed a certification (including a 
     summary of the risks and benefits) that, based upon the 
     information available at the time of transfer, the medical 
     benefits reasonably expected from the provision of 
     appropriate medical treatment at another medical facility 
     outweigh the increased risks to the veteran and, in the case 
     of labor, to the unborn child from effecting the transfer; or
       ``(iii) if a physician is not physically present in the 
     emergency department at the time a veteran is transferred, a 
     qualified medical person (as defined by the Secretary in 
     regulations) has signed a certification described in clause 
     (ii) after a physician, in consultation with the person, has 
     made the determination described in such clause, and 
     subsequently countersigns the certification; and
       ``(B) the transfer is an appropriate transfer as described 
     in paragraph (2).
       ``(2) An appropriate transfer to a medical facility is a 
     transfer--
       ``(A) in which the transferring medical facility provides 
     the medical treatment within the capacity of the facility 
     that minimizes the risks to the health of the enrolled 
     veteran and, in the case of a woman in labor, the health of 
     the unborn child;
       ``(B) in which the receiving facility--
       ``(i) has available space and qualified personnel for the 
     treatment of the veteran; and
       ``(ii) has agreed to accept transfer of the veteran and to 
     provide appropriate medical treatment;
       ``(C) in which the transferring facility sends to the 
     receiving facility all medical records (or copies thereof), 
     related to the emergency condition for which the veteran has 
     presented, available at the time of the transfer, including 
     records related to the emergency medical condition of the 
     veteran, observations of signs or symptoms, preliminary 
     diagnosis, treatment provided, results of any tests and the 
     informed written consent or certification (or copy thereof) 
     provided under paragraph (1)(A), and the name and address of 
     any on-call physician (described in subsection (d)(1)(C) of 
     this section) who has refused or failed to appear within a 
     reasonable time to provide necessary stabilizing treatment;
       ``(D) in which the transfer is effected through qualified 
     personnel and transportation equipment, as required including 
     the use of necessary and medically appropriate life support 
     measures during the transfer; and
       ``(E) that meets such other requirements as the Secretary 
     may find necessary in the interest of the health and safety 
     of veterans transferred.
       ``(d) Charges.--(1) Nothing in this section may be 
     construed to affect any charges that the Secretary may 
     collect from a veteran or third party.
       ``(2) The Secretary shall treat any care provided by a non-
     Department facility pursuant to this section as care 
     otherwise provided by a non-Department facility pursuant to 
     this chapter for purposes of paying such non-Department 
     facility for such care.
       ``(e) Nondiscrimination.--A medical facility of the 
     Department or a non-Department facility, as the case may be, 
     that has specialized capabilities or facilities (such as burn 
     units, shock-trauma units, neonatal intensive care units, or 
     (with respect to rural areas) regional referral centers as 
     identified by the Secretary in regulation) shall not refuse 
     to accept an appropriate transfer of an enrolled veteran who 
     requires such specialized capabilities or facilities if the 
     facility has the capacity to treat the veteran.
       ``(f) No Delay in Examination or Treatment.--A medical 
     facility of the Department or a non-Department facility, as 
     the case may be, may not delay provision of an appropriate 
     medical screening examination required under subsection (a) 
     or further medical examination and treatment required under 
     subsection (b) of this section in order to inquire about the 
     method of payment or insurance status of an enrolled veteran.
       ``(g) Whistleblower Protections.--The Secretary may not 
     take adverse action against an employee of the Department 
     because the employee refuses to authorize the transfer of an 
     enrolled veteran with an emergency medical condition that has 
     not been stabilized or because the employee reports a 
     violation of a requirement of this section.
       ``(h) Definitions.--In this section:
       ``(1) The term `emergency medical condition' means--
       ``(A) a medical condition manifesting itself by acute 
     symptoms of sufficient severity (including severe pain) such 
     that the absence of immediate medical attention could 
     reasonably be expected to result in--
       ``(i) placing the health of the enrolled veteran (or, with 
     respect to an enrolled veteran who is a pregnant woman, the 
     health of the woman or her unborn child) in serious jeopardy;
       ``(ii) serious impairment to bodily functions; or
       ``(iii) serious dysfunction of any bodily organ or part; or
       ``(B) with respect to an enrolled veteran who is a pregnant 
     woman having contractions--
       ``(i) that there is inadequate time to effect a safe 
     transfer to another hospital before delivery; or
       ``(ii) that transfer may pose a threat to the health or 
     safety of the woman or the unborn child.
       ``(2) The term `enrolled veteran' means a veteran who is 
     enrolled in the health care system established under section 
     1705(a) of this title.
       ``(3) The term `to stabilize' means, with respect to an 
     emergency medical condition described in paragraph (1)(A), to 
     provide such medical treatment of the condition as may be 
     necessary to assure, within reasonable medical probability, 
     that no material deterioration of the condition is likely to 
     result from or occur during the transfer of the enrolled 
     veteran from a facility, or, with respect to an emergency 
     medical condition described in paragraph (1)(B), to deliver 
     (including the placenta).
       ``(4) The term `stabilized' means, with respect to an 
     emergency medical condition described in paragraph (1)(A), 
     that no material deterioration of the condition is likely, 
     within reasonable medical probability, to result from or 
     occur during the transfer of the individual from a facility, 
     or, with respect to an emergency medical condition described 
     in

[[Page H5892]]

     paragraph (1)(B), that the woman has delivered (including the 
     placenta).
       ``(5) The term `transfer' means the movement (including the 
     discharge) of an enrolled veteran outside the facilities of a 
     medical facility of the Department at the direction of any 
     individual employed by (or affiliated or associated, directly 
     or indirectly, with) the Department, but does not include 
     such a movement of an individual who--
       ``(A) has been declared dead; or
       ``(B) leaves the facility without the permission of any 
     such person.''.
       (b) Clerical Amendment.--The table of sections of such 
     chapter is amended by inserting after the item relating to 
     section 1730A the following new item:

``1730B. Examination and treatment for emergency medical conditions and 
              women in labor.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Miller) and the gentleman from California (Mr. Takano) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Florida.

                              {time}  1630


                             General Leave

  Mr. MILLER of Florida. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days in which to revise and extend their 
remarks and to add extraneous material.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. MILLER of Florida. Mr. Speaker, I yield myself such time as I may 
consume.
  I rise in support of H.R. 3216, the Veterans Emergency Treatment--or 
VET--Act.
  It should be common sense, if a veteran is in need of medical 
attention and arrives on the grounds of a Department of Veterans 
Affairs medical facility, that veteran would be seen, assessed, and 
treated immediately. However, recently, a veteran who experienced a 
medical emergency in Washington State traveled as far as the parking 
lot of his local VA emergency room before finding he could go no 
further, and he called the VA and asked for help in making it through 
the doors. He was told by the VA staff who answered his call that he 
should hang up and dial 911.
  To hear the VA staff express an unwillingness or an apprehension 
about assisting a veteran in the midst of his having a medical 
emergency in its own parking lot is not only unacceptable, it is 
emblematic of how much the VA has lost its way.
  H.R. 3216 would require the VA to determine whether a medical 
emergency exists among any enrolled veteran who presents at a VA 
facility and would prohibit the VA from transferring a medically 
unstable veteran unless the veteran submits a written request to be 
transferred or it finds that it is clinically unnecessary. It would 
also prohibit the VA from taking an adverse action against any employee 
who refuses to authorize a transfer or who prevents the VA from 
delaying needed care by inquiring about payment method or insurance 
status. This legislation would help ensure that, in the case of a 
medical emergency, a veteran's health remains the number one priority, 
which is where it should always belong.
  This bill is sponsored by my friend and colleague, Congressman Dan 
Newhouse from Washington State. I am grateful to him for sponsoring 
this measure, and I urge all of my colleagues to join me in support of 
it.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  I rise in regard to H.R. 3216, the Veterans Emergency Treatment Act.
  This bill requires that, if an enrolled veteran in the VA requests 
treatment at a VA Emergency Department, he or she will get that 
examination or treatment whether or not it is related to a service-
connected condition. It also prohibits the VA from transferring a 
patient to another facility without its having the written consent of 
that veteran unless a physician deems the transfer medically necessary. 
It further prohibits the VA from taking adverse action against any VA 
employee in his refusing to authorize the transfer of an enrolled 
veteran if it is contrary to the veteran's wishes. The purpose of this 
legislation is to have the VA follow the Emergency Medical Treatment & 
Labor Act.
  Mr. Speaker, I support this bill.
  I reserve the balance of my time.
  Mr. MILLER of Florida. Mr. Speaker, I yield 4 minutes to the 
gentleman from the Fourth District of Washington State (Mr. Newhouse), 
the sponsor of this piece of legislation.
  Mr. NEWHOUSE. Mr. Speaker, I thank the gentleman from Florida for 
yielding me some time to speak on this important bill.
  Mr. Speaker, President Abraham Lincoln once famously charged all 
Americans with the responsibility ``to care for him who shall have 
borne the battle.'' If you speak with veterans today, you will learn 
that the quality of health care provided to them, many times, does not 
reflect this duty.
  In recent years, we have learned of multiple incidents in which the 
VA has failed to provide emergency care to veterans in need. In 
addition to the incidents that happened in my home State, another 
notable incident occurred in New Mexico, in the year 2014, when a 
veteran collapsed in the cafeteria of a VA facility, and he ultimately 
died when the VA refused to transport him 500 yards across the campus 
to the ER.
  My legislation will ensure that every enrolled veteran who arrives at 
the Emergency Department of a VA medical facility and who seeks 
emergency treatment is assessed and treated in order to prevent further 
injury or death. This is accomplished by applying the statutory 
requirements of the Emergency Medical Treatment & Labor Act, or EMTALA, 
to emergency care that is furnished by the VA to our veterans.
  This is a 1986 Federal statute that grants every individual a Federal 
right to emergency care. It requires a hospital to conduct a medical 
examination to determine if an emergency medical condition exists. If 
one does, then the hospital must either stabilize the patient or 
effectuate a proper transfer at the patient's request. Currently, VA 
hospitals are considered to be non-participating hospitals and, 
therefore, are not obligated to fulfill the requirements of EMTALA. The 
VET Act will remove the non-participating designation from VA hospitals 
and require them to fulfill the requirements of EMTALA, just as every 
other hospital does.
  Mr. Speaker, I urge the House to support and pass H.R. 3216. It is 
time we ensure that our veterans receive proper medical treatment 
during emergency medical situations, all without requiring additional 
spending.
  Mr. TAKANO. Mr. Speaker, I ask my colleagues to join me in supporting 
H.R. 3216, the Veterans Emergency Treatment Act.
  I yield back the balance of my time.
  Mr. MILLER of Florida. Mr. Speaker, I ask all of my colleagues to 
support Mr. Newhouse's piece of legislation.
  I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Florida (Mr. Miller) that the House suspend the rules 
and pass the bill, H.R. 3216.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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