APPENDIX A

98TH CONGRESS 2D SESSION

Calendar No. 929

S.2514

[Report No. 98-487]

To amend title 38, United States Code, to enhance the management of Veterans' Administration medical treatment programs by providing for the referral of veterans to non-Veterans' Administration entities and arrangements for additional necessary services, to revise and clarify the authority for the furnishing of care for veterans suffering from alcohol or drug dependence, to require the Administrator to establish the position of Associate Director for Post Traumatic Stress Disorder, to require the Administrator to submit a report to Congress regarding programs of the Veterans' Administration providing hospice and respite care to certain veterans, and to authorize the Administrator of Veterans' Affairs to provide telecaption television decoders to totally deaf veterans in certain cases, and for other purposes.

IN THE SENATE OF THE UNITED STATES

MARCH 30 (legislative day, MARCH 26), 1984

Mr. SIMPSON introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs

MAY 25, 1984

Reported, under authority of the order of the Senate of May 11 (legislative day, April 30), 1984, by Mr. SIMPSON, with an amendment and an amendment to the title

[Strike out all after the enacting clause and insert the part printed in italic]

A BILL

To amend title 38, United States Code, to enhance the management of Veterans' Administration medical treatment programs by providing for the referral of veterans to non

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Veterans' Administration entities and arrangements for additional necessary services, to revise and clarify the authority for the furnishing of care for veterans suffering from alcohol or drug dependence, to require the Administrator to establish the position of Associate Director for Post Traumatic Stress Disorder, to require the Administrator to submit a report to Congress regarding programs of the Veterans' Administration providing hospice and respite care to certain veterans, and to authorize the Administrator of Veterans' Affairs to provide telecaption television decoders to totally deaf veterans in certain cases, and for other purposes.

Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 That (a) this Aet may be eited as the "Veterans' Administra

4 tion Health Care Amendments of 1984".

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(b) Except as otherwise specifically provided whenever 6 in this Aet an amendment or repeal is expressed in terms of 7 an amendment to, or repeal of, a section or other provision, 8 the reference shall be considered to be made to a section or

9 other provision of title 38, United States Code.

REFERRALS AND ARRANGEMENTS FOR COMMUNITY

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SERVICES

SEO. 2. (a) Chapter 73 is amended by adding at the end

13 of subchapter + the following new section:

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1 "84120. Referrals and arrangements for community

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services

"In order to enhance the management of Veterans' Ad4 ministration eare and treatment programs, the Administrator 5 shall designate one office in each Veterans' Administration 6 health care facility and in central office to coordinate and 7 make arrangements for the provision of referral services to 8 assist veterans, to the maximum extent practicable, in obtain9 ing health and health-related services from sources outside 10 the Veterans' Administration, not at Veterans' Administra 11 tion expense, when such services are reasonably necessary in 12 the treatment of veterans eligible for eare under chapter 17 13 of this title. In earrying out this section, the Administrator 14 shall place particular emphasis on the needs of veterans with 15 service connected disabilities rated at 50 per centum or more 16 and veterans age sixty-five or older.".

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(b) The table of sections at the beginning of chapter 78 18 is amended by adding after the item relating to section 4119

19 the following:

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2225

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"4120. Referrals and arrangements for community services.":

ALCOHOL TREATMENT AND REHABILITATION

SEO. 3. (a) Section 620A is amended

(1) by amending paragraph (1) of subsection (a) te read as follows:

"(1)(A) The Administrator, in furnishing hospital,

nursing home and domiciliary eare, and medical and

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rehabilitative services under this chapter, may contract

for eare and treatment and rehabilitative services in halfway houses, at such per diem rates as the Adminis trator shall by regulation prescribe consistent with prevailing rates in the community.

"(B) For the purposes of this section, the term 'halfway house' means a treatment facility not under the direet jurisdiction of the Administrator, offering a community based, peer group oriented, residential program of treatment and rehabilitation for alcohol or drug dependence or abuse disabilities, which provides food, lodging, and supportive services in a drug and alcohol-free environment for veterans recovering from active alcohol or drug abuse.

"(C) The maximum period for one treatment episode under the authority established by paragraph (1)(A) of this subsection shall be limited to sixty days.";

(2) by redesignating paragraph (2) of subsection

(a) as paragraph (D);

(3) by striking out subsection (e);

(4) by redesignating all subsections, paragraphs, elauses, and eross-references accordingly; and

(5) by adding at the end the following new sub

section:

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"(b) The Administrator shall prescribe regulations, not

2 later than twelve months after the date of enactment of this

"(1) to establish maximum periods of treatment

and rehabilitation for alcohol or drug dependence or abuse disabilities of a veteran eligible for eare under this chapter consistent with the average periods of such treatment and rehabilitation experienced in programs not administered by the Veterans' Administra tion, to include specifie maximum periods for

"(A) detoxification to stabilize the veteran's

condition;

"(B) acute inpatient care and treatment;

"(C) additional extended eare and treatment

in eases involving multiple and complex diag noses; and

"(D) outpatient care and treatment including appropriate referral services under section 4120 of this title; and

"(2) to ensure that individual treatment plans are developed, implemented, and monitored (including at least one year of followup monitoring after discharge from inpatient care and treatment) for each veteran reeeiving eare for alcohol or drug dependence or abuse disabilities.";

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