[No. 29]

COMMITTEE ON VETERANS' AFFAIRS, HOUSE OF REPRESENTATIVES

VETERANS' ADMINISTRATION,

OFFICE OF THE ADMINISTRATOR OF VETERANS' AFFAIRS,

Hon. RAY ROBERTS,

Washington, D.C., July 7, 1975.

Chairman, Committee on Veterans' Affairs,

House of Representatives, Washington, D.C.

DEAR MR. CHAIRMAN: This will respond to your request for a report by the Veterans' Administration on H.R. 1543, 94th Congress, a bill "To amend section 620, title 38, United States Code, to authorize payment of a higher proportion of hospital costs in establishing amounts payable for nursing home care of certain veterans, and for other purposes."

The subject bill would amend section 620 of title 38 to authorize the Administrator to provide community nursing home care if he determines that the cost of such nursing home care will not exceed 45 percent of the cost of care furnished in a Veterans' Administration facility. Under current law, the cost of such community nursing home care must not exceed 40 percent of the cost of care furnished in a Veterans' Administration facility.

The restriction limiting the cost of community nursing home care to 40 percent of the cost of care furnished in a VA facility has, in a few localities, restricted our ability to provide needed nursing home care to veterans. The subject bill would enable us to provide needed nursing home care in those localities, and would provide needed flexibility for the VA to parallel other Federal/State public assistance payments, and compete for skilled nursing beds in community facilities.

Accordingly, we favor the enactment of H.R. 1543.

Since costs in most areas can now be met within the 40 percent of costs of care in VA facilities limit as currently provided by law, there are only a few localities where the new 45 percent limit proposed in the bill would be used. Therefore, the cost of the subject bill, if enacted, would be minimal.

We are advised by the Office of Management and Budget that there is no objection to the presentation of this report from the standpoint of the Administration's program.

Sincerely,

ODELL W. VAUGHN,

Deputy Administrator

(For and in the absence of

Richard L. Roudebush, Administrator).

94TII CONGRESS 1ST SESSION

H. R. 3347

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 19, 1975

Mr. SATTERFIELD introduced the following bill; which was referred to the Committee on Veterans' Affairs

A BILL

To amend title 38 of the United States Code in order to revise the eligibility requirements and the medical benefits provided to eligible veterans, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 3 That subchapters I and II of chapter 17 of title 38, United 4 States Code, are amended to read as follows:

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"For purposes of this chapter

"(1) The term 'health services' means:

"(A) inpatient care, whether short-term, inter

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mediate, or long-term care, provided in a hospital, nursing home, domiciliary, or similar facility;

"(B) outpatient or ambulatory care;

"(C) physician and dentist services (including consultant and referral services by a physician or

dentist);

"(D) such mental health services, consultation, professional counseling, and training of the members of the immediate family or legal guardian of the veteran, or of such person in whose household such veteran certifies his intention to live, as may be

necessary or appropriate to the effective treatment and rehabilitation of the veteran;

"(E) diagnostic laboratory services and diagnostic and therapeutic radiologic services; "(F) home health services;

"(G) preventive health services;

"(H) physical medicine and rehabilitative medical services (including physical therapy);

"(I) prescription drugs prescribed in the course

of the provision of basic health services;

"(J) outpatient dental services and treatment, and related dental appliances, for any dental condi

tion or disability which is

"(ii) service-connected and noncompensable in degree, but only (I) if it is shown to have been in existence at time of discharge

or release from active military, naval, or air

service, and (II) if application for treatment is made within one year after such discharge or release, except that if a disqualifying discharge or release has been corrected by competent authority, application may be made within one year after the date of correction or the date of

enactment of this exception, whichever is later, but the treatment furnished under this subpara

graph shall be on a one-time completion basis unless the services rendered on a one-time com

pletion basis are found unacceptable within the limitations of good professional standards, in which event such additional services may be

afforded as are required to complete profes

sionally acceptable treatment,

"(iii) a service-connected dental condition or disability due to combat wounds or other

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service trauma, or of a former prisoner of war,

or

"(iv) associated with and is aggravating some other medical condition for which such dental care has been medically determined to be adjunct to the medical conditions under treatment;

"(K) optometrists' services;

"(L) podiatrists' services when such services. have been medically determined to be necessary; "(M) prosthetic appliances, aids, parts, or accessories which are required to replace, support, or

substitute for a deformed, weakened, or missing anatomical portion of the body (other than teeth), including fitting and training in the use of such material, and seeing eye or guide dogs for blind

veterans whose eligibility stems from section 610 (a) of this title;

"(N) therapeutic and medical rehabilitative devices, including invalid lifts, and such other medical equipment, supplies, and accessories as the Administrator determines to be reasonably neces

sary;

"(0) transportation and incidental expenses for any veteran who is in need of treatment for a