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Section 2 of the bill would authorize the Administrator to furnish such medical services as he finds to be reasonably necessary to any veteran in receipt of increased pension or additional compensation or allowance based on the need of regular aid and attendance or by reason of being permanently housebound, or who, but for the receipt of retired pay, would be in receipt of such pension, compensation, or allowance. In passing, a technical error is noted in the corresponding (first) section of H.R. 6987. The reference to "subsection (b)" in line 3, page 1, obviously should be to "subsection (g)”.

This amendment would not only eliminate the conditional requirements for such further medical care as is now authorized for certain veterans suffering from one or more of the six specific conditions or diseases enumerated in 38 U.S.C. 612(g) but would also make unnecessary the prior period of hospitalization required under current law.

This proposal would extend to a group of approximately 144,000 disabled veterans now in receipt of the indicated monetary benefits, medical services equivalent to those available to veterans of the Spanish-American War. The majority of this group are receiving increased monetary benefits because of non-service-connected disabilities. The proposed legislation would authorize unlimited outpatient treatment for this group but would not provide a similar benefit to seriously disabled service-connected veterans who are not entitled to the increased monetary benefit. Such preferential treatment of the non-service-connected veteran would represent an anomalistic departure from the traditional priority accorded service-connected veterans in matters of medical care. The Veterans' Administration does not favor this change in emphasis.

Section 3 of the bill (sec. 2 of H.R. 6987) would authorize the furnishing of drugs and medicines at VA expense to veterans who are receiving additional compensation or allowance or increased pension by reason of being "permanently housebound.” Under existing law (38 U.S.C. 612(h)), drugs and medicines are so furnished to veterans receiving additional compensation or allowance or increased pension by reason of being in need of regular aid and attendance.

The proposed expansion of our outpatient program could provide precedent for demands that the Government also assume the responsibility for any outpatient treatment needed by such veterans and that this benefit be extended to other groups. It also poses a question as to how far the Government is prepared to go in granting medical services on a permanent basis for those whose disabilities originated in civilian life. It is our view that further liberalization of our outpatient program is not warranted at this time.

Section 4 of the bill, which would liberalize the dependency and indemnity compensation and death compensation programs by providing an increased monthly benefit for widows when they need the regular aid and attendance of another person, is similar in purpose to certain provisions of H.R. 3070 and H.R. 3301, on which a separate report is pending before the Bureau of the Budget. Our comments in that report are equally applicable to section 4 of H.R. 693 and the corresponding section of the other bills listed in the first paragraph of this report.

On the basis of current estimates, enactment of section 1 could be expected to generate an additional census of approximately 1,000

patients at an additional cost of $1,825,000 for the first year. It is further estimated that by the third year, and thereafter, the number of patients annually will approximate 2,000 at an annual cost of $3,650,000. The cost of the additional benefits provided under section 2 could range between $9,503,000 and $12,490,000 per year. The additional costs for drugs and medicines which would accrue to the Veterans' Administration if section 3 were enacted would approximate the following amounts: Fiscal year: 1970.

$3,400, 000 1971.

3, 600, 000 1972.

3, 800, 000 1973.

4, 000, 000 1974.

4, 200, 000 In summation and for the reasons stated above, I do not recommend favorable consideration of the provisions relating to hospital and domiciliary care or medical services in any of the foregoing bills.

We are advised by the Bureau of the Budget that there is no objection to the presentation of this report from the standpoint of the administration's program. Sincerely,

W. J. DRIVER, Administrator


Washington, D.C., April 10, 1969.
Hon. John W. McCORMACK,
Speaker of the House of Representatives,
Washington, D.C.

DEAR MR. SPEAKER: There is transmitted herewith a draft of a bill to revise the definition of a "child" for purposes of veterans' benefits provided by title 38, United States Code, to recognize an adopted child as a dependent from the date of issuance of an interlocutory decree with the request that it be introduced in order that it may be considered for enactment.

Subsection 101(4) of title 38, United States Code, defines the term "child” for purposes generally of the veterans' benefit programs provided by that title as including a “legally adopted child.” The determination of whạt constitutes a legal adoption depends on the governing statutes of the several 'States. Generally, a legal adoption is one in which a final decree of adoption has been granted or in which a prescribed period has expired following the issuance of the original decree. Until then, the interlocutory decree may be rescinded and the child will revert to his prior status.

The term "child” is defined in subsection 101 (4) for all purposes under title 38, except for insurance purposes under chapter 19 and for disposition of personal property of a decedent left upon the premises of a Veterans' Administration facility (sec. 5202(b)). Consequently, the proposed definition would extend to such benefit programs as disability and death compensation and pension, dependency and indemnity compensation, vocational rehabilitation, and the various programs of educational assistance.

By the time an adoptive parent has undertaken adoption proceedings and the appropriate adoption authority has issued an interlocutory decree of adoption, the adoptive parent ħas demonstrated his intention to assume parental duties and obligations with respect to the child and to make the relationship permanent, and the child has become a fully integrated member of the household and is regarded by the adoptive parent as his child. Moreover, the adoptive parent is responsible for the maintenance, care, and education of the child.

We believe that the concern for the child which the adoptive parent has thus expressed and the parent-child relationship which exists following the issuance of the interlocutory decree is at least as strong as that existing where an individual has accepted a stepchild into his household. Current law recognizes such children. It follows that the provisions of existing law which limit the recognition of an adoptive

child to those with respect to whom a final decree of adoption has been issued discriminate against both the adoptive parent and the adopted child.

The draft bill, if enacted, would permit the recognition as a "child” of one for whom an interlocutory decree of adoption has been granted and, if a claim was then pending, would permit the payment of benefits from the date of that decree, unless and until it is rescinded and provided that the child remains in the custody of the adopting parent or parents during the interlocutory period.

The definition of a "child" in 38 U.S.C. 101(4) was amended by Public Law 86–195, August 14, 1958, to include as an adopted child of a. veteran one who was a member of the household when the veteran died and who was "legally adopted” by the veteran's spouse within 2 years after the death or the date of enactment of the amendment. Our proposed legislation, if enacted, would apply to such children as well as those adopted by veterans.

While we do not have adequate data available upon which to accurately estimate the additional cost of this proposal if enacted, we believe that such cost would not be significant.

The Veterans' Administration recommends the favorable consideration by the Congress of the enclosed draft bill.

Advice has been received from the Bureau of the Budget that there is no objection from the standpoint of the Administration's program to the presentation of the draft legislation to the Congress. Sincerely,

W. J. DRIVER, Administrator.


Washington, D.C., April 28, 1969.
Hon. John W. McCORMACK,
Speaker of the House of Representatives,
Washington, D.C.

DEAR MR. SPEAKER: There is transmitted herewith a draft of a bill to amend title 38, United States Code, to liberalize the conditions under which the Administrator of Veterans' Affairs is required to effect recoupment from disability compensation otherwise payable to certain disabled veterans, with the request that it be introduced in order that it may be considered for enactment.

Under existing law, members of the Armed Forces of the United States rendered permanently unfit to perform their duties because of service-incurred disability may be granted disability retirement pay, a continuing payment, from the military department concerned, if they have more than 8 years of service and the disability, under the Veterans' Administration's schedule for rating disabilities, is 30 percent or more disabling. If the disability is less than 30-percent disabling or if the member has less than 8 years' service (regardless of the degree of the disability), disability severance pay is payable. This benefit is computed on the basis of rank and length of service and is a lump-sum, nonrecurring payment by the military department.

Under laws administered by the Veterans' Administration, disability compensation, a monthly repetitive payment, is payable for disabilities connected with military service. The amount of this benefit is determined by the rated degree of the veteran's disability (reflected in the mentioned schedule for rating disabilities) as shown by the findings made in the course of periodic examinations. Existing law (38 U.S.Č. 3104(a)) precludes any former member of the Armed Forces from receiving the full amount of disability compensation to which he is eligible from the Veterans' Administration and the full amount of retired or retirement pay to which he is eligible from the Armed Forces. Generally, based on the philosophy that no person should be compensated twice for the same disability, the veteran must elect between the benefits to which he is eligible. The only exception is contained in 38 U.S.C. 3105, which permits the payment of a combination of the two benefits, at the veteran's election, in an amount which does not exceed the greater of the two.

With respect to disability severance pay, 10 U.S.C. 1212(c) requires that the amount of such pay received by the former member of the Armed Forces

“Shall be deducted from any compensation for the same disability to which the former member of the Armed Forces or his dependents

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