To require the Secretary of Veterans Affairs to modify the formula, known as the Veterans Equitable Resource Allocation (VERA) system, for the allocation of funds appropriated to the Department of Veterans Affairs for medical care to different geographic regions of the Nation, and for other purposes.

January 8, 2003

Mr. FRELINGHUYSEN (for himself, Mrs. KELLY, Mr. HINCHEY, and Mr. KING of New York) introduced the following bill; which was referred to the Committee on Veterans' Affairs

To require the Secretary of Veterans Affairs to modify the formula, known as the Veterans Equitable Resource Allocation (VERA) system, for the allocation of funds appropriated to the Department of Veterans Affairs for medical care to different geographic regions of the Nation, and for other purposes.

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 `Equitable Care for All Veterans Act'.

SEC. 2. REVISION TO MEDICAL CARE FUNDING ALLOCATION FORMULA FOR DEPARTMENT OF VETERANS AFFAIRS.

(a) MODIFICATION TO VERA FORMULA- The funding allocation formula for the Department of Veterans Affairs medical care system known as the Veterans Equitable Resource Allocation (VERA) system, established pursuant to section 429 of Public Law 104-204 (110 Stat. 2929), shall be modified by the Secretary of Veterans Affairs in accordance with this section. Such modifications shall provide for the incorporation of regional differences in the cost of providing health care to veterans (due to different regional cost of living, long travel distance, and other appropriate factors) as part of the criteria used to determine the national means differential used in the existing system.

(b) EVALUATION- At the end of the second fiscal year beginning after the date of the enactment of this Act, the Secretary of Veterans Affairs shall evaluate the effects of the modifications implemented pursuant to subsection (a) on the regional allocation of funds available to the Department of Veterans Affairs for health care. The Secretary shall submit to Congress not later than 60 days after the end of such fiscal year the determination of the Secretary as to whether those modifications have resulted in a substantive shift in the funding allocations among the different service regions of the Veterans Health Administration compared to the allocations before such modifications.

(c) CONTINGENT TERMINATION OF VERA FORMULA- If in the report submitted pursuant to subsection (b) the Secretary of Veterans Affairs determines that the modifications have not resulted in a substantive shift in the funding allocations described in that subsection, the Secretary shall immediately terminate use of the Veterans Equitable Resource Allocation system for the regional allocation of funds available to the Department of Veterans Affairs for health care.

SEC. 3. STANDBY ALTERNATIVE SYSTEM.

(a) DEVELOPMENT OF REPLACEMENT FORMULA- If pursuant to section 2(c) the Secretary of Veterans Affairs is required to terminate the use of the Veterans Equitable Resource Allocation system, the Secretary shall develop a new formula for the allocation of funds appropriated to the Department of Veterans Affairs for Medical Care to the national service regions, known as Veterans Integrated Service Networks (VISNs), of the Department. In developing such formula, the Secretary shall take the following requirements into account:

(1) For any fiscal year for which the amount appropriated for Medical Care is an increase from the preceding year, the funding level provided under the new formula to any VISN may not be less than the amount provided for the preceding year.

(2) The new formula shall take into account additional costs incurred by a VISN due to any of the following factors at that VISN being in excess of the median for all VISNs:

(A) The number of veterans moving into the geographic area of that VISN.

(B) The median age of veterans in that VISN.

(C) The number of veterans in that VISN requiring complex care or nursing home care.

(D) The age of Department of Veterans Affairs health care facilities in that VISN.

(b) TRANSITION FORMULA- Until a replacement funding allocation formula is implemented pursuant to subsection (a), the funding allocation formula to be applied by the Secretary to amounts appropriated for veterans medical care shall be the formula in effect before the Veterans Equitable Resource Allocation system.

SEC. 4. AUTHORIZATIONS OF APPROPRIATIONS.

(a) AUTHORIZATION FOR REPLACEMENT ALLOCATION FORMULA- There is authorized to be appropriated to the Department of Veterans Affairs for fiscal year 2003 the amount of $10,000,000 for purposes of this Act.

(b) ADDITIONAL `MEDICAL CARE' AUTHORIZATIONS- There is authorized to be appropriated to the Department of Veterans Affairs for fiscal year 2003 the amount of $100,000,000 for `Medical Care' for the Department of Veterans Affairs. Such amount is in addition to any other amount authorized to be appropriated to the Department of Veterans Affairs for fiscal year 2003 and shall be allocated by the Secretary to the national service regions, known as Veterans Integrated Service Networks (VISNs), of the Department of Veterans Affairs on the basis of need, as follows:

(1) First, to the VISN that has experienced the greatest reduction in funding from the funding levels for fiscal year 1997.

(2) Second, to any other VISN that has experienced an overall five-year funding decrease.

(3) Third, if any amount appropriated pursuant to such authorization remains after allocations pursuant to paragraphs (1) and (2), such amount shall be allocated equally among the remaining 22 VISNs before implementation of the new formula.

END