[House Report 115-683]
[From the U.S. Government Publishing Office]
115th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 115-683
======================================================================
MILITARY SEXUAL ASSAULT VICTIMS EMPOWERMENT ACT
_______
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. 3642]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 3642) to direct the Secretary of Veterans
Affairs to carry out a pilot program to improve the access to
private health care for veterans who are survivors of military
sexual trauma, having considered the same, report favorably
thereon with an amendment and recommend that the bill as
amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 3
Background and Need for Legislation.............................. 4
Hearings......................................................... 5
Subcommittee Consideration....................................... 6
Committee Consideration.......................................... 6
Committee Votes.................................................. 6
Committee Oversight Findings..................................... 6
Statement of General Performance Goals and Objectives............ 6
New Budget Authority, Entitlement Authority, and Tax Expenditures 6
Earmarks and Tax and Tariff Benefits............................. 7
Committee Cost Estimate.......................................... 7
Congressional Budget Office Estimate............................. 7
Federal Mandates Statement....................................... 8
Advisory Committee Statement..................................... 8
Constitutional Authority Statement............................... 9
Applicability to Legislative Branch.............................. 9
Statement on Duplication of Federal Programs..................... 9
Disclosure of Directed Rulemaking................................ 9
Section-by-Section Analysis of the Legislation................... 9
Changes in Existing Law Made by the Bill as Reported............. 11
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Military Sexual Assault Victims
Empowerment Act'' or the ``Military SAVE Act''.
SEC. 2. PILOT PROGRAM FOR PRIVATE HEALTH CARE FOR VETERANS WHO ARE
SURVIVORS OF MILITARY SEXUAL TRAUMA.
(a) Establishment.--The Secretary of Veterans Affairs shall carry out
a pilot program to furnish hospital care and medical services to
eligible veterans through non-Department health care providers to treat
injuries or illnesses which, in the judgment of a professional employed
by the Department, resulted from a physical assault of a sexual nature,
battery of a sexual nature, or sexual harassment which occurred while
the veteran was serving on active duty, active duty for training, or
inactive duty training.
(b) Duration.--The Secretary shall carry out the pilot program under
subsection (a) for a three-year period. If at the completion of the
pilot program an eligible veteran is receiving hospital care and
medical services from a non-Department health care provider under the
pilot program, the Secretary may approve, on a case-by-case basis, the
continuation of such hospital care and medical services from that non-
Department health care provider until the completion of the episode of
care.
(c) Eligible Veterans.--A veteran is eligible to participate in the
pilot program under subsection (a) if the veteran--
(1) is eligible to receive counseling and appropriate care
and services under section 1720D of title 38, United States
Code; and
(2) resides in a site selected under subsection (d).
(d) Sites.--
(1) Selection.--The Secretary shall select not more than five
sites in which to carry out the pilot program under subsection
(a). Each site shall meet each of the following criteria:
(A) Except as provided by paragraph (2), the site
consists of a city with a population between 200,000
and 500,000, as determined by the Bureau of the Census
as of the first day of the pilot program.
(B) The site is in a State in which the National
Violence Against Women Prevention Research Center or
the Centers for Disease Control and Prevention, or
both, has determined the rate of sexual assault to be a
substantial problem.
(C) The site is in a State that, as of the first day
of the pilot program, has a weighted percentage of
reported rape of not less than 20 percent but not more
than 30 percent of sexual assault cases, in accordance
with the finding of the Centers for Disease Control and
Prevention contained in the ```Lifetime Prevalence of
Sexual Violence by any Perpetrator'' (NISVS 2010).
(2) Rural site.--Not fewer than one site selected under
paragraph (1) shall be rural, as determined by the Secretary.
(e) Participation.--
(1) Election.--Subject to paragraph (2), an eligible veteran
may elect to participate in the pilot program under subsection
(a). Such election shall not affect the ability of the veteran
to receive health care furnished by Department providers.
(2) Number.--Not more than 75 veterans may participate in the
pilot program under subsection (a) at each site selected under
subsection (d).
(3) Choice of non-department health care providers.--An
eligible veteran who participates in the pilot program under
subsection (a) may freely choose from which non-Department
health care provider the veteran receives hospital care or
medical services under the pilot program, except that the
Secretary shall--
(A) ensure that each such non-Department health care
provider maintains at least the same or similar
credentials and licenses as those credentials and
licenses that are required of health care providers of
the Department, as determined by the Secretary for the
purposes of this section; and
(B) make a reasonable effort to ensure that such non-
Department health care provider is familiar with the
conditions and concerns that affect members of the
Armed Forces and veterans and is trained in evidence-
based psychotherapy
(4) Provision of information.--The Secretary shall--
(A) notify eligible veterans of the ability to make
an election under paragraph (1); and
(B) provide to such veterans educational referral
materials, including through pamphlets and internet
websites, on the non-Department providers in the sites
selected under subsection (d).
(f) Authorization and Monitoring of Care.--In accordance with
subsection (e), the Secretary shall ensure that the Department of
Veterans Affairs authorizes and monitors the hospital care and medical
services furnished under the pilot program for appropriateness and
necessity. In authorizing and monitoring such care, the Secretary
shall--
(1) treat a non-Department health care provider that
furnishes to such a veteran hospital care or medical services
under the pilot program as an authorized recipient of records
of such veteran for purposes of section 7332(b) of title 38,
United States Code; and
(2) ensure that such non-Department health care provider
transmits to the Department such records as the Secretary
determines appropriate.
(g) Payments.--
(1) Current providers.--If a non-Department health care
provider has entered into a contract, agreement, or other
arrangement with the Secretary pursuant to another provision of
law to furnish hospital care or medical services to veterans,
the Secretary shall pay the health care provider for hospital
care or medical services furnished under this section using the
same rates and payment schedules as provided for in such
contract, agreement, or other arrangement.
(2) New providers.--If a non-Department health care provider
has not entered into a contract, agreement, or other
arrangement with the Secretary pursuant to another provision of
law to furnish hospital care or medical services to veterans,
the Secretary shall pay the health care provider for hospital
care or medical services furnished under this section using the
same rates and payment schedule as if such care and services
was furnished pursuant to section 1703 of title 38, United
States Code.
(3) New contracts and agreements.--The Secretary shall take
reasonable efforts to enter into a contract, agreement, or
other arrangement with a non-Department health care provider
described in subsection (a) to ensure that future care and
services authorized by the Secretary and furnished by the
provider are subject to such a contract, agreement, or other
arrangement
(h) Surveys.--The Secretary shall conduct a survey of a sample of
eligible veterans to assess the hospital care and medical services
furnished to such veterans either pursuant to this section or section
1720D of title 38, United States Code, as the case may be.
(i) Report.--Not later than 60 days before the completion of the
pilot program under subsection (a), the Secretary shall submit to the
Committees on Veterans' Affairs of the House of Representatives and the
Senate a report on the pilot program. The report shall include the
following:
(1) The results of the pilot program, including, to the
extent possible, an assessment of the health outcomes of
veterans who participated in the pilot program.
(2) The recommendation of the Secretary with respect to
extending or making permanent the pilot program.
(j) Definitions.--In this section:
(1) The term ``non-Department health care provider'' means an
entity specified in section 101(a)(1)(B) of section 101 of the
Veterans Access, Choice, and Accountability Act of 2015 (Public
Law 113-146; 38 U.S.C. 1701) or any other health care provider
that has entered into a contract, agreement, or other
arrangement with the Secretary pursuant to another provision of
law to furnish hospital care or medical services to veterans.
(2) The term ``sexual harassment'' has the meaning given that
term in section 1720D of title 38, United States Code.
(3) The term ``State'' has the meaning given that term in
section 101(20) of title 38, United States Code.
Purpose and Summary
H.R. 3642, as amended, the ``Military Sexual Assault
Victims Empowerment Act'' or the ``Military SAVE Act'' would
require the Department of Veterans Affairs (VA) to carry out a
pilot program to furnish care in the community to veterans who
have experienced military sexual trauma (MST). Representative
Andy Barr of Kentucky introduced H.R. 3642 on August 4, 2017.
Background and Need for Legislation
Section 1720D of title 38 United States Code (U.S.C.)
requires VA to provide counseling, care, and services to
veterans who are experiencing ``psychological trauma, which in
the judgment of a mental health professional employed by the
Department, resulted from a physical assault of a sexual
nature, battery of a sexual nature, or sexual harassment which
occurred while the veteran was serving on active duty or active
duty for training.'' Such trauma is commonly referred to as
MST. Diagnoses that are commonly associated with MST include
posttraumatic stress disorder, depression, other mood
disorders, and substance use disorder.\1\
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\1\Military Sexual Trauma. Veterans Health Administration Office of
Mental Health Care. https://www.mentalhealth.va.gov/docs/
mst_general_factsheet.pdf. Accessed April 26, 2018.
---------------------------------------------------------------------------
In fiscal year (FY) 2017, the Veterans Health
Administration (VHA)--which manages and oversees the VA
healthcare system--provided MST-related outpatient care to
142,750 veterans.\2\ In addition, the Readjustment Counseling
Service--which manages and oversee VA's Vet Center program--
provided MST-related care to 11,892 veterans in FY 2017.
According to VA, ``[c]onsistent with previous years, the total
number of veterans who received MST-related care and the total
number of encounters provided [by VA for MST] has increased
relative to FY 2016,'' and, ``[i]n fact, the total number of
veterans who received MST-related care and the total number of
encounters [provided by VA for MST] has increased every year
since VA Office of Mental Health and Suicide Prevention's
National MST Support Team began monitoring them.''\3\
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\2\``Department of Veterans Affairs Annual Report on Training and
Certification for Health Care Providers on Care for Veterans and Active
Duty Servicemembers who Experienced Military Sexual Trauma for Fiscal
Year 2017,'' January 17, 2018.
\3\Ibid.
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VHA Directive 2010-033 provides VA policy for MST
programming and states that MST-related care must be provided
in a setting that is therapeutically appropriate and takes into
account the circumstances that resulted in the need for such
care.\4\ It also states that care in the community is available
for veterans who have experienced MST when it is clinically
inadvisable to provide such care in a VA facility, when VA
facilities are geographically inaccessible, or when VA
facilities are unable to provide care in a timely manner.\5\
However, testimony before the Committee from MST survivors and
other stakeholders in recent years has called into question
VA's ability to adequately meet veterans' MST-related needs and
to refer veterans to community providers for MST-related care
when it is requested by the veteran.\6\\7\ This testimony is
particularly concerning given the growing need within VA's
patient population for MST-related care.
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\4\VHA Directive 2010-033, ``Military Sexual Trauma (MST)
Programming,'' July 14, 2010.
\5\Ibid.
\6\United States Cong. House Committee on Veterans' Affairs.
``Legislative Hearing'' October 24, 2017. 115th Cong. 1st sess.
Washington: GPO, 2017 (statement of the Honorable Andy Barr, U.S. House
of Representatives, 6th District, Kentucky).
\7\United States Cong. House Committee on Veterans' Affairs
Subcommittee on Health. ``Legislative Hearing'' November 17, 2015.
114th Cong. 1st sess. Washington: GPO, 2015 (statement of Susan
Moseley).
---------------------------------------------------------------------------
Section 2 of the bill would create a three-year pilot
program to furnish care in the community to veterans who have
experienced MST. VA would select up to five sites to
participate in the pilot program. Up to 75 veterans per site
would be eligible to participate in the pilot program and these
veterans would be able to select a community provider of their
choice to receive MST-related care from. Community providers
participating in the pilot program who have entered into a
contract, agreement, or other arrangement with VA would be
reimbursed pursuant to such contract, agreement, or other
arrangement. However, community providers participating in the
pilot program who have not entered into a contract, agreement,
or other arrangement with VA would be reimbursed using the same
rates or payment schedule as if such care were provided
pursuant to VA's authority to provide care in the community in
section 1703 of title 38 U.S.C. and VA would be required to
make a reasonable effort to ensure that future care or services
provided by that community provider is pursuant to a contract,
agreement, or other arrangement. VA would further be
responsible for: notifying eligible veterans of the pilot
program and providing them with relevant educational materials;
ensuring that community providers participating in the pilot
program are appropriately licensed, credentialed, trained, and
culturally competent; for authorizing and monitoring the care
that veterans receive under the pilot program to include
ensuring medical documentation return from community providers;
and reporting to the Committees on Veterans' Affairs of the
House of Representatives and the Senate with the results of the
pilot program and a recommendation with respect to extending or
making it permanent. In addition, VA would be required to
conduct a survey of a sample of eligible veterans to assess the
provision of MST-related counseling, care, or services through
VA or pursuant to the pilot program.
HEARINGS
On October 24, 2017, the full Committee conducted a
legislative hearing on a number of bills including H.R. 3642.
The following witnesses testified:
The Honorable Jim Banks, U.S. House of
Representatives, 3rd District, Indiana; The Honorable
Mike Gallagher, U.S. House of Representatives, 8th
District, Wisconsin; The Honorable John R. Carter, U.S.
House of Representatives, 31st District, Texas; The
Honorable Glenn Thompson, U.S. House of
Representatives, 5th District, Pennsylvania; The
Honorable Neal P. Dunn, U.S. House of Representatives,
2nd District, Florida; The Honorable Andy Barr, U.S.
House of Representatives, 6th District, Kentucky; The
Honorable David J. Shulkin, M.D., Secretary, U.S.
Department of Veterans Affairs, who was accompanied by
Carolyn Clancy M.D., the Executive in Charge of the
Veterans Health Administration, and Laurie Zephyrin
M.D., MPH, MBA, the Acting Deputy Under Secretary for
Health for Community Care for the Veterans Health
Administration; Adrian M. Atizado, Deputy National
Legislative Director, Disabled American Veterans;
Roscoe G. Butler, Deputy Director for Health Care,
Veterans Affairs and Rehabilitation Division, The
American Legion; and, Kayda Keleher, Associate
Director, National Legislative Service, Veterans of
Foreign Wars of the United States.
Statements for the record were submitted by:
American Federation of Government Employees, AFL-CIO;
American Health Care Association; American Medical
Association; AMVETS; Concerned Veterans of America;
Fleet Reserve Association; Got Your 6; Health IT Now;
Iraq and Afghanistan Veterans of America; Military
Officers Association of America; Military Order of the
Purple Heart; National Alliance on Mental Illness;
National Guard Association of the United States; Nurses
Organization of Veterans Affairs/Association of VA
Psychologist Leaders/Association of VA Social Workers/
Veterans Healthcare Action Campaign; Paralyzed Veterans
of America; Reserve Officers Association; University of
Pittsburgh; Vietnam Veterans of America; the Wounded
Warrior Project; The American Congress of Obstetrics
and Gynecologists; the University of California,
Riverside School of Medicine; the American Society of
Transplant Surgeons; and, the National Indian Health
Board.
SUBCOMMITTEE CONSIDERATION
There was no Subcommittee consideration of H.R. 3642.
COMMITTEE CONSIDERATION
On May 8, 2018, the full Committee met in open markup
session, a quorum being present, and ordered H.R. 3642, as
amended, to be reported favorably to the House of
Representatives by voice vote. During consideration of the
bill, the following amendment was considered and agreed to by
voice vote:
An amendment in the nature of a substitute offered by
Representative Bruce Poliquin of Maine.
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. 3642,
as amended, reported to the House. A motion by Representative
Tim Walz of Minnesota, Ranking Member of the Committee on
Veterans' Affairs, to report H.R. 3642, as amended, favorably
to the House of Representatives was adopted by voice vote.
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 create a pilot program to provide
MST-related care to veterans in the community.
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. 3642, as amended, 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.
3642, as amended, prepared by the Director of 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. 3642, as amended, provided by the Director of 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. 3642, the Military
Sexual Assault Victims Empowerment Act.
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. 3642--Military Sexual Assault Victims Empowerment Act
Summary: H.R. 3642 would require the Department of Veterans
Affairs (VA) to conduct a three-year pilot program to provide
treatment at non-VA medical facilities to veterans who have
experienced medical sexual trauma (MST). CBO estimates that
implementing the bill would cost $6 million over the 2019-2023
period, assuming appropriation of the necessary amounts.
Enacting the bill would not affect direct spending or
revenues; therefore, pay-as-you-go procedures do not apply.
CBO estimates that enacting H.R. 3642 would not increase
net direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2029.
H.R. 3642 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
Estimated cost to the Federal Government: The estimated
budgetary effect of H.R. 3642 is shown in the following table.
The costs of the legislation fall within budget function 700
(veterans benefits and services).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-----------------------------------------------------------------
2018 2019 2020 2021 2022 2023 2019--2023
----------------------------------------------------------------------------------------------------------------
INCREASES IN SPENDING SUBJECT TO APPROPRIATION
Estimated Authorization Level................. 0 1 1 2 1 1 6
Estimated Outlays............................. 0 1 1 2 1 1 6
----------------------------------------------------------------------------------------------------------------
* = less than $500,000.
Basis of estimate: For this estimate, CBO assumes that H.R.
3642 will be enacted at the beginning of fiscal year 2019 and
that the estimated amounts will be appropriated each year.
Estimated outlays are based on historical spending patterns for
similar programs.
The bill would require VA to implement a three-year pilot
program to treat MST patients at non-VA medical facilities.
After completion of the pilot program, VA would be authorized
to continue to provide such care to participants through the
remainder of their treatment. The pilot program would operate
in not more than five locations in the VA health care system
and would include no more than 75 participants at each
location, or a total of 375 participants.
On the basis of information from VA on the costs and
duration of treatment for MST patients, CBO estimates an
average annual cost of $5,700 per patient over a three-year
treatment period. CBO expects that VA would allow patients
whose treatment was ongoing at the end of the pilot to complete
that treatment in the private sector. Implementing this bill,
therefore, would cost $6 million over the 2019-2023 period,
assuming appropriation of the necessary amounts, CBO estimates.
Pay-As-You-Go considerations: None.
Increase in long-term direct spending and deficits: CBO
estimates that enacting H.R. 3642 would not increase net direct
spending or on-budget deficits in any of the four consecutive
10-year periods beginning in 2029.
Mandates: H.R. 3642 contains no intergovernmental or
private-sector mandates as defined in UMRA.
Estimate prepared by: Federal Costs: Ann E. Futrell;
Mandates: Andrew Laughlin.
Estimate reviewed by: Sarah Jennings, Chief, Defense and
International Affairs Cost Estimates Unit; 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. 3642, as amended, prepared by the
Director of 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.
3642, as amended.
STATEMENT OF CONSTITUTIONAL AUTHORITY
Pursuant to Article I, section 8 of the United States
Constitution, H.R. 3642, as amended, 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. 3642, as amended, 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.
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. 3642, as amended, 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. 3642, as amended, 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. 3642, as amended, as the ``Military Sexual Assault Victims
Empowerment Act'' or the ``Military SAVE Act''.
Section 2. Pilot program for private health care for veterans who are
survivors of military sexual trauma
Section 2(a) of the bill would require VA to carry out a
pilot program to furnish hospital care and medical services to
eligible veterans through community providers to treat injuries
or illnesses which, in the judgement of a VA professional,
resulted from a physical assault of a sexual nature, battery of
a sexual nature, or sexual harassment which occurred while the
veteran was serving on active duty, active duty for training,
or inactive duty for training.
Section 2(b) of the bill would require VA to carry out the
pilot program for a three year period and authorize VA, at the
completion of the pilot program, to approve, on a case-by-case
basis, the continuation of hospital care or medical services
from a community provider until the completion of the episode
of care.
Section 2(c) of the bill would define a veteran who is
eligible to participate in the pilot program as a veteran who
is eligible to receive counseling and appropriate care and
services under section 1720D of title 38 U.S.C. and resides in
a site selected under section 2(d) of the bill.
Section 2(d) of the bill would require VA to select not
more than five pilot sites in which to carry out the pilot
program under section 2(a) of the bill and require each site
to: consist of a city with a population between 200,000 and
500,000 as determined by the Bureau of Census as of the first
day of the pilot program (except that at least one pilot site
would be required to be in a rural area as determined by VA);
be a site within a State in which the National Violence Against
Women Prevention Research Center or the Centers for Disease
Control and Prevention, or both, has determined the rate of
sexual assault to be a substantial problem; and be a site
within a State that, as of the first day of the pilot program,
has a weighted percentage of reported rape of not less than 20
percent but not more than 30 percent of sexual assault cases in
accordance with the finding of the Centers for Disease Control
and Prevention contained in the ``Lifetime Prevalence of Sexual
Violence by any Perpetrator (NISVS 2010).
Section 2(e) of the bill would authorize up to 75 eligible
veterans per site to elect to participate in the pilot program
under section 2(a) of the bill and require that such an
election does not affect the ability of such veteran to receive
health care from VA providers. Section 2(e) of the bill would
also authorize an eligible veteran who participates in the
pilot program under section 2(a) of the bill to freely choose
which community provider the veteran receives hospital care or
medical services from under the pilot program. Section 2(e)
would further require VA: to ensure that each community
provider who participates in the pilot program maintains at
least the same or similar credentials and licenses as those
required by VA providers, as determined by VA; to make a
reasonable effort to ensure that such community provider is
familiar with the conditions and concerns that affect members
of the Armed Forces and veterans and is trained in evidence-
based psychotherapy; to notify eligible veterans of their
ability to elect to participate in the pilot program; and to
provide eligible veterans with educational materials regarding
community providers participating in the pilot program,
including through pamphlets and internet websites.
Section 2(f) of the bill would require VA to authorize and
monitor the hospital care and medical services furnished to
eligible veterans under the pilot program for appropriateness
and necessity and to treat each community provider
participating in the pilot program as an authorized recipient
of records for the purposes of section 7332(b) of title 38
U.S.C. and to ensure that such community providers transmit to
VA such records as VA determines appropriate.
Section 2(g) of the bill would require VA to reimburse
community providers participating in the pilot program at the
same rates and payment schedules as provided for in such
contract, agreement, or other arrangement. Section 2(g) of the
bill would also require VA to reimburse community providers
participating in the pilot program who VA has not entered into
a contract, agreement, or other arrangement with using the same
rates and payment schedules as if such care and services was
furnished pursuant to section 1703 of title 38 U.S.C. and to
take reasonable efforts to ensure that future care and services
authorized by VA and furnished by such providers are subject to
a contract, agreement, or other arrangement.
Section 2(h) of the bill would require VA to conduct a
survey of a sample of eligible veterans to assess the hospital
care and medical services furnished to veterans either pursuant
to section 2 of the bill or to section 1720D of title 38 U.S.C.
Section 2(i) of the bill would require VA to submit a
report to the Committees on Veterans' Affairs of the House of
Representatives and the Senate not later than 60 days before
the completion of the pilot program established under section
2(a) of the bill on the pilot program and to include the
results of the pilot program--including, to the extent
possible, an assessment of the health outcomes of veterans who
participated in the pilot program--and VA's recommendation with
respect to extending or making the pilot program permanent.
Section 2(j) of the bill would define: the term ``non-
Department health care provider'' as an entity specified in
section 101(a)(1)(B) of section 101 of the Veterans Access,
Choice, and Accountability Act of 2015 (Public Law 113-146; 38
U.S.C. 1701) or any other health care provider that has entered
into a contract, agreement, or other arrangement with VA
pursuant to another provision of law to furnish hospital care
or medical services to veterans; the term ``sexual harassment''
as the meaning given that term in section 1720D of title 38
U.S.C.; and the term ``State'' as the meaning given that term
in section 101(20) of title 38 U.S.C.
CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
If enacted, this bill would make no changes in existing
law.
[all]