,,ii #aagth ,,congress #b;d ,session ,s4 #ecdh ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #ba1 #bjbb ,mr4 ,daines 7for himself and ,ms4 ,lummis7 introduced the following bill2 which was read twice and referred to the ,committee on ,veterans' ,affairs ,a ,,bill ,to amend title #ch1 ,united ,states ,code1 to expand access to the ,veterans ,community ,care ,program of the ,department of ,veterans ,affairs to include certain veterans seeking mental health or substance-use services and toxic-exposed veterans1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,protecting ,veteran ,community ,care ,act4 #b4 ,findings ,congress finds the following3 7#a7 ,on ,june #f1 #bjah1 the ,john ,s4 ,mc,cain ,,iii1 ,daniel ,k4 ,akaka1 and ,samuel ,r4 ,johnson ,,va ,maintaining ,internal ,systems and ,strengthening ,integrated ,outside ,networks ,act of #bjah 7,public ,law #aae-ahb7 7in this section referred to as the ,,va ,,mission ,act7 became law4 7#b7 ,congressional intent with the ,,va ,,mission ,act was to reform and replace the program under section #aja of the ,veterans ,access1 ,choice1 and ,accountability ,act of #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #agja note7 to ensure access of veterans to community health care providers4 7#c7 ,the eligibility standards established by the ,,va ,,mission ,act were not meant to be used to limit health care options for veterans or to be applied to community providers1 which would result in reduced health care options4 7#d7 ,many veterans do not have access to a medical facility of the ,department of ,veterans ,affairs in their community and each medical facility of the ,department may not be able to adequately address the specific health care needs of a particular veteran4 7#e7 ,it was the intent of ,congress in the ,,va ,,mission ,act that all medical services1 including mental health treatments and institutional extended care services for mental health1 were to be available to veterans in the community4 7#f7 ,the ,department is limiting access of veterans to community care for mental health treatments4 7#g7 ,despite the best efforts of the ,department1 veteran suicide remains at significant levels throughout the ,united ,states4 7#h7 ,no veteran should have to wait #cj days for mental health services to be approved by the ,department4 7#i7 ,telehealth appointments represent a valuable complementary health care option for underserved veterans1 but do not offer the same quality of care as in-person visits to facilities of the ,department or in the community4 #c4 ,expansion of ,veterans ,community ,care ,program to include access to mental health or substance-use services for veterans unable to timely access ,mental ,health ,residential ,treatment ,programs 7a7 ,in general ,section #agjc of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7d7-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,d71 by striking 2 or and inserting a semicolon2 7ii7 in subparagraph 7,e71 by striking the period at the end and inserting 2 or2 and 7iii7 by adding at the end the following new subparagraph3 7,f7 in the case of residential mental health or substance-use services1 the covered veteran-- 7i7 meets the criteria of the ,department for priority admission to a ,mental ,health ,residential ,rehabilitation ,treatment ,program of the ,department and the ,department is unable to accommodate such priority admission2 or 7ii7 has contacted the ,department to request such services from a ,mental ,health ,residential ,rehabilitation ,treatment ,program of the ,department and the ,department is not able to furnish such services in a manner than complies with the access standards of the ,department for specialty care provided under this section by a health care provider specified in subsection 7c74 2 and 7,b7 by adding at the end the following new paragraph 7#d73 7#d7 ,in the case of a covered veteran entitled to mental health or substance-use services under paragraph 7#a77;,f71 the ,secretary shall ensure that referral of a veteran to an alternate ,mental ,health ,residential ,rehabilitation ,treatment ,program of the ,department does not take precedence over timely access to such services under this section pursuant to such paragraph unless such referral is requested by the covered veteran4 2 7#b7 by redesignating subsection 7o7 as subsection 7p72 and 7#c7 by inserting after subsection 7n7 the following new subsection 7o73 7o7 ,minimum standards for residential mental health or substance-,use services 7#a7 ,subject to paragraph 7#b71 in furnishing residential mental health or substance-use services to covered veterans pursuant to subsection 7d77#a77;,f71 the ,secretary shall ensure that programs or facilities providing such services under this section meet the following standards3 7,a7 ,a treatment program or facility must be licensed and accredited by a ,state for the provision of the services provided4 7,b7 ,a treatment program must be accredited under either the ,joint ,commission ,behavioral ,health ,standards or the ,behavioral ,health ,standards manual 7residential treatment7 of the ,commission on ,accreditation of ,rehabilitation ,facilities1 or any successor standards or manual4 7#b7 ,if a program or facility to which a covered veteran is to be referred pursuant to subsection 7d77#a77;,f7 does not meet the standards specified under paragraph 7#a71 the ,secretary1 acting through the director of the facility of the ,department carrying out the referral-- 7,a7 shall consider an alternate program or facility2 and 7,b7 may waive such standards on an individual basis if no other alternate program or facility is available or such waiver is in the best interest of the veteran4 4 7b7 ,modification of access standards ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall develop or amend existing access standards of the ,department of ,veterans ,affairs to ensure that access to mental health care under the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code1 as amended by subsection 7a71 is not more restrictive than the access standards for specialty care under such section4 #d4 ,requirement to provide care under ,veterans ,community ,care ,program for toxic-exposed veterans ,section #agjc7;d77#a7 of title #ch1 ,united ,states ,code1 as amended by section #b7;a77#a77;,a71 is further amended-- 7#a7 in subparagraph 7,e71 by striking 2 or and inserting a semicolon2 7#b7 in subparagraph 7,f71 by striking the period at the end and inserting 2 or2 and 7#c7 by adding at the end the following new subparagraph3 7,g7 the covered veteran is a toxic-exposed veteran4 4 #e4 ,prohibition on certain limitations on access of veterans to care ,section #agjc7n7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new paragraphs3 7#c7 ,in applying wait times or access standards under this section for purposes of determining eligibility of a covered veteran for care or services under this section1 the ,secretary may not determine that the veteran is ineligible for such care or services due solely to the fact that health care providers specified in subsection 7c7 are unable to provide such care or services in compliance with such wait times or access standards4 7#d7 ,if multiple options are available to a covered veteran for care or services under this section1 the ,secretary shall permit the veteran to elect the option that the veteran prefers4 4 #f4 ,development of community care metrics 7a7 ,in general ,section #agjc7m77#a7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subparagraph3 7,c7 ,the review submitted under subparagraph 7,a7 shall include1 for the year covered by the review1 the following3 7i7 ,the number of instances of care or services requested4 7ii7 ,the number of such requests that were approved4 7iii7 ,the number of such requests that were denied4 7iv7 ,the number of appeals under subsection 7f7 of such requests that were denied1 including the final decision of such appeal4 7v7 ,the eligibility criteria under which each eligible veteran has qualified for care or services under this section4 7vi7 ,data with respect to the following3 7,i7 ,requests for care or services relating to mental health4 7,,ii7 ,authorizations for emergency care1 including whether transportation for such care was required or whether further care or a hospital stay was required4 4 7b7 ,application ,the amendment made by subsection 7a7 shall apply to each review conducted under subparagraph 7,a7 of such section after the date of the enactment of this ,act4 #g4 ,limitation on modification of community care access standards ,any modification on or after the date of the enactment of this ,act by the ,secretary of ,veterans ,affairs of the conditions under which care is required to be provided under section #agjc7;d7 of title #ch1 ,united ,states ,code1 either through a modification of the designated access standards under paragraph 7#a77;,d7 of such section1 a modification of the criteria developed by the ,secretary under paragraph 7#a77;,e7 of such section1 or otherwise through regulation1 shall not take effect until a joint resolution is enacted approving such modification to the conditions under which care is required to be provided under such section4