[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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