Statement of Administration Policy: H.R. 901 - Veterans' Health-Care Program Amendments of 1989

(House)
(Montgomery (D) MS and 23 others)

The Administration opposes House passage of H.R. 901, although it generally shares the aims of this legislation and supports enactment of several of its provisions. For example, the bill would make permanent the respite care program and extend the expiring authorizations for State Home grants and care for homeless chronically mentally ill veterans. The bill would also make desirable improvements in Department of Veterans Affairs (VA) Compensated Work Therapy programs, and includes certain useful statutory changes concerning VA medical care personnel recruitment and retention.

However, these provisions are outweighed by various objectionable provisions in H.R. 901. Most notably, we object to the provision which would expand outpatient care eligibility to authorize comprehensive outpatient care for all so-called "Category A" veterans; i.e., primarily veterans with lower incomes or service-connected disabilities. This provision represents a significant enlargement of the group of veterans for whom VA must provide comprehensive outpatient treatment under current law, and could entail additional costs to VA in excess of $1 billion annually. Any changes or expansion of eligibility should be held in abeyance and considered in a broader context.

Other objectionable provisions of the bill include:

• preventing the VA from contracting out Veterans Canteen Service (VCS) functions, thereby depriving the Department of the flexibility necessary to operate the VCS according to its needs; and prohibiting the head of the VCS from being required to report to any VA official other than the Secretary or Deputy Secretary of the Department, another unnecessary and counter-productive limitation on the Secretary's flexibility;
• rescinding a VA regulation regarding contract nursing home care to non-service-connected disabled veterans. The bill would thus have the effect of restoring old regulations, which did not include well-defined criteria for extending the period of care, and therefore permitted virtually unlimited extensions; and

authorizing provision of VA health care to Department of Defense (DOD) dependents at VA facilities under VA/DOD sharing agreements. The Administration does not favor such a concept at this time, since it raises numerous unresolved issues that could have a significant impact on the VA medical care system.