[House Report 115-685]
[From the U.S. Government Publishing Office]
115th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 115-685
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IMPROVING OVERSIGHT OF WOMEN VETERANS' CARE ACT OF 2017
_______
May 18, 2018.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Roe of Tennessee, from the Committee on Veterans' Affairs,
submitted the following
R E P O R T
[To accompany H.R. 4334]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 4334) to provide for certain reporting
requirements relating to medical care for women veterans
provided by the Department of Veterans Affairs and through
contracts entered into by the Secretary of Veterans Affairs
with non-Department medical providers, and for other purposes,
having considered the same, report favorably thereon without
amendment and recommend that the bill do pass.
CONTENTS
Page
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 2
Subcommittee Consideration....................................... 3
Committee Consideration.......................................... 3
Committee Votes.................................................. 3
Committee Oversight Findings..................................... 3
Statement of General Performance Goals and Objectives............ 3
New Budget Authority, Entitlement Authority, and Tax Expenditures 4
Earmarks and Tax and Tariff Benefits............................. 4
Committee Cost Estimate.......................................... 4
Congressional Budget Office Estimate............................. 4
Federal Mandates Statement....................................... 5
Advisory Committee Statement..................................... 5
Statement of Constitutional Authority............................ 5
Applicability to Legislative Branch.............................. 5
Statement on Duplication of Federal Programs..................... 5
Disclosure of Directed Rulemaking................................ 5
Section-by-Section Analysis of the Legislation................... 5
Changes in Existing Law Made by the Bill as Reported............. 6
PURPOSE AND SUMMARY
H.R. 4334, the ``Improving Oversight of Women Veterans'
Care Act of 2017,'' would (1) require the Department of
Veterans Affairs to submit to Congress an annual report on the
accessibility of covered gender-specific medical care furnished
to female veterans under contracts with non-VA providers, (2)
require VA Medical Centers (VAMC) to submit quarterly reports
on compliance with environment of care standards for women
veterans and (3) report to Congress, no later than 180 days
after enactment, on the Department's plan to strengthen such
care standards for women veterans at VA facilities.
Representative Louis Correa of California introduced H.R. 4334
on November 9, 2017.
BACKGROUND AND NEED FOR LEGISLATION
The Veterans Health Care Act of 1992 (P.L. 102-585)
authorized VA to provide gender-specific services for eligible
women veterans. That authority has become increasingly
important in recent years as the number of women veterans
continues to rise and reach critical levels. VA has responded
to the growing number of women veterans by targeting programs
and facilities to meet their unique health care needs.\1\
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\1\Women Veterans Report: The Past, Present, and Future of Women
Veterans. National Center for Veterans Analysis and Statistics,
Department of Veterans Affairs, Washington, DC. February 2017
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However, while significant gains have also been made at VA
medical facilities to ensure privacy and safety for women
veterans and to ensure timely access to gender-specific care in
the community when it is not available at VA medical
facilities, the provision of care to women veterans continues
to be an area of concern for veteran advocates, who call for
increased oversight and attention to these issues.\2\
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\2\Veterans of Foreign Wars. (2016). In Their Words: Evaluating VA
Health Care and Benefits for Women Veterans [PDF File].
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Section 2 of the bill would require VA to submit an annual
report to congress on access to (1) mammograms, (2) maternity
care, and (3) gynecological care for women veterans under
community care networks, to include data and performance
measures for wait times, drive times, and reasons why
appointments could not be scheduled.
Section 3 of the bill would require each VA Medical Center
to submit quarterly reports on compliance with environment of
care standards and report to Congress with a plan to strengthen
such standards, to include (1) a description of the process
established to verify noncompliance, and (2) a description of
the method by which VA will ensure that all patient care areas
are inspected as required and expand the list of items that
facility staff inspect for compliance to align with VA's
women's health handbook.\3\
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\3\United States Department of Veterans Affairs. (2017). VHA
Directive 1330.01(1) Health Care Services For Women Veterans.
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HEARINGS
On April 17, 2018, the Subcommittee on Health conducted a
legislative hearing on a number of bills including H.R. 4334.
The following witnesses testified:
The Honorable Beto O'Rourke, U.S. House of
Representatives, 16th District, Texas;
The Honorable Tim Walberg, U.S. House of
Representatives,7th District, Michigan;
The Honorable Neal Dunn, U.S. House of
Representatives, 2nd District, Florida;
The Honorable Luis Correa, U.S. House of
Representatives, 46th District, California;
The Honorable Mike Coffman, U.S. House of
Representatives, 6th District, Colorado;
Louis J. Celli, Director, National Veterans Affairs
and Rehabilitation Division, The American Legion;
Adrian M. Atizado, Deputy National Legislative
Director, Disabled American Veterans;
Sarah S. Dean, Associate Legislative Director,
Paralyzed Veterans of America; and
Kayda Keleher, Associate Director, National
Legislative Service, Veterans of Foreign Wars of the
United States.
Statements for the record were submitted by:
The Elizabeth Dole Foundation; The Independence Fund;
Veteran Cannabis Project; Wounded Warrior Project; and
Iraq and Afghanistan Veterans of America.
SUBCOMMITTEE CONSIDERATION
There was no subcommittee consideration of H.R. 4334.
COMMITTEE CONSIDERATION
On May 8, 2018, the full Committee met in open markup
session, a quorum being present, and ordered H.R. 4334 to be
reported favorably to the House of Representatives by voice
vote. A motion by Representative Tim Walz of Minnesota, Ranking
Member of the Committee on Veterans' Affairs, to report H.R.
4334 favorably to the House of Representatives was adopted by
voice vote.
COMMITTEE VOTES
In compliance with clause 3(b) of rule XIII of the Rules of
the House of Representatives, there were no recorded votes
taken on amendments or in connection with ordering H.R. 4334
reported to the House.
COMMITTEE OVERSIGHT FINDINGS
In compliance with clause 3(c)(1) of rule XIII and clause
(2)(b)(1) of rule X of the Rules of the House of
Representatives, the Committee's oversight findings and
recommendations are reflected in the descriptive portions of
this report.
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the Committee's performance
goals and objectives are to ensure non-VA network providers
adhere to and uphold established VA patient safety and privacy
guidelines for women veterans, and are able to provide a timely
and convenient alternative to VA-administered services.
NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee adopts as its
own the estimate of new budget authority, entitlement
authority, or tax expenditures or revenues contained in the
cost estimate prepared by the Director of the Congressional
Budget Office pursuant to section 402 of the Congressional
Budget Act of 1974.
EARMARKS AND TAX AND TARIFF BENEFITS
H.R. 4334 does not contain any Congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in
clause 9 of rule XXI of the Rules of the House of
Representatives.
COMMITTEE COST ESTIMATE
The Committee adopts as its own the cost estimate on H.R.
4334 prepared by the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
CONGRESSIONAL BUDGET OFFICE COST ESTIMATE
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
for H.R. 4334 provided by the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, May 9, 2018.
Hon. Phil Roe, M.D.,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 4334, the
Improving Oversight of Women Veterans' Care Act of 2017.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Ann E.
Futrell.
Sincerely,
Keith Hall,
Director.
Enclosure.
H.R. 4334--Improving Oversight of Women Veterans' Care Act of 2017
H.R. 4334 would require the Department of Veterans Affairs
(VA) to submit annual reports to the Congress about the access
of women veterans to gender-specific health care. The bill also
would require VA medical facilities to submit quarterly reports
on health care standards for women veterans. On the basis of
information from VA, CBO estimates that preparing such reports
would cost about $300,000 a year (or the equivalent of three
full-time employees). CBO estimates that implementing this bill
would cost $2 million over the 2019-2023 period, assuming
availability of appropriated amounts.
Enacting H.R. 4334 would not affect direct spending or
revenues; therefore, pay-as-you-go procedures do not apply.
CBO estimates that enacting H.R. 4334 would not increase
net direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2029.
H.R. 4334 contains no intergovernmental or private-sector
mandates as define in the Unfunded Mandates Reform Act.
The CBO staff contact for this estimate is Ann E. Futrell.
The estimate was reviewed by Leo Lex, Deputy Assistant Director
for Budget Analysis.
FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal
mandates regarding H.R. 4334 prepared by the Congressional
Budget Office pursuant to section 423 of the Unfunded Mandates
Reform Act.
ADVISORY COMMITTEE STATEMENT
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act would be created by H.R.
4334.
STATEMENT OF CONSTITUTIONAL AUTHORITY
Pursuant to Article I, section 8 of the United States
Constitution, H.R. 4334 is authorized by Congress' power to
``provide for the common Defense and general Welfare of the
United States.''
APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that H.R. 4334 does not relate to the
terms and conditions of employment or access to public services
or accommodations within the meaning of section 102(b)(3) of
the Congressional Accountability Act of 1995.
STATEMENT ON DUPLICATION OF FEDERAL PROGRAMS
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the
House of Representatives, the Committee finds that no provision
of H.R. 4334 establishes or reauthorizes a program of the
Federal Government known to be duplicative of another Federal
program, a program that was included in any report from the
Government Accountability Office to Congress pursuant to
section 21 of Public Law 111-139, or a program related to a
program identified in the most recent Catalog of Federal
Domestic Assistance.
DISCLOSURE OF DIRECTED RULEMAKING
Pursuant to section 3(i) of H. Res. 5, 115th Cong. (2017),
the Committee estimates that H.R. 4334 contains no directed
rulemaking that would require the Secretary to prescribe
regulations.
SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION
Section 1. Short title
Section 1 of the bill would provide the short title for
H.R. 4334 as the, ``Improving Oversight of Women Veterans' Care
Act of 2017.''
Section 2. Annual Report on Veteran access to covered sex-specific
services under community care contracts
Section 2(a) of the bill would direct the Under Secretary
of Veterans Affairs to submit to Congress an annual report on
the provision of covered gender-specific care to women veterans
under contracts with non-VA providers. Such a report shall
include: (1) average wait time between the veteran's preferred
appointment date and the date on which the appointment is
completed, (2) driving time required for veterans to attend
appointments, and (3) reasons why appointments could not be
scheduled with non-Department medical providers.
Section 2(b) defines the term ``covered sex-specific
medical care.''
Section 3(a) would require each VA Medical Center (VAMC) to
submit quarterly reports to the Secretary of Veterans Affairs
on the compliance or non-compliance of the facility with the
environment of care standard for women veterans, including the
names and roles of those responsible for compliance at each
facility.
Section 3(b) would require the Secretary of Veterans
Affairs, by no later than 180 days after enactment, to submit a
report to Congress detailing plans to strengthen the
environment of care standards for women veterans, including:
(1) a description of the process established to verify that
noncompliance information reported under section 3(a) is
accurate and complete; and, (2) a description of the method by
which the Secretary will (A) ensure that all patient care areas
of each facility are inspected, as required; and, (B) expand
the list of items that facility staff inspect for compliance
with VA's women's health handbook.
Section 3(c) defines the term ``environment of care
standards for women veterans.''
CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
If enacted, this bill would make no changes in existing
law.
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