{ "id": "R45390", "type": "CRS Report", "typeId": "REPORTS", "number": "R45390", "active": true, "source": "EveryCRSReport.com", "versions": [ { "source": "EveryCRSReport.com", "id": 587234, "date": "2018-11-01", "retrieved": "2019-12-20T20:43:39.157970", "title": "VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act; P.L.115-182)", "summary": "On June 6, 2018, the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018, or the VA MISSION Act of 2018 (S. 2372; P.L. 115-182; H.Rept. 115-671), was signed into law. The Department of Veterans Affairs Expiring Authorities Act of 2018 (S. 3479; P.L. 115-251), enacted on September 29, 2018, made some changes and technical amendments to the VA MISSION Act. This act, as amended, broadly addresses four major areas.\nFirst, it establishes a new permanent Veterans Community Care Program (VCCP), replacing the current Veterans Choice Program (VCP). The VA MISSION Act stipulates that the new program must be operational when regulations are published by the Department of Veterans Affairs (VA) no later than one year after the date of enactment (June 6, 2018), or when the VA determines that 75% of the amounts deposited in the Veterans Choice Fund (VCF) have been exhausted.\nSecond, it expands the current Program of Comprehensive Assistance for Family Caregivers, in two phases, to all eligible veterans who served prior to September 11, 2001.\nThird, it establishes an asset and infrastructure review process by establishing an Asset and Infrastructure Review Commission. The purpose of the commission is to examine the VA\u2019s assets and to make recommendations for modernizing and realigning medical facilities.\nFourth, it provides various statutory authorities to the Veterans Health Administration (VHA) of the VA to recruit and retain health care providers.\nVeterans Community Care Program (VCCP)\nThe VA MISSION Act establishes a new permanent discretionary community care program known as VCCP. The act provides conditions under which the VA is required to provide care in the community once the program is established. Generally, all veterans enrolled in the VA health care system would be able to qualify when (1) the VA does not offer the care or service required by the veteran; or (2) the veteran resides in a state without a full-service VA medical facility; or (3) the veteran previously qualified under the 40-mile criterion of the VCP; or (4) the VA cannot provide the veteran with care and services that comply with designated access and quality standards; or (5) the veteran and the veteran\u2019s primary care provider agree that it is in the best interest of the veteran to receive care in the community. In addition, the VA is required to enter into contracts to build a network of private community providers. \nExpansion of Comprehensive Assistance for Family Caregivers \nThe VA MISSION Act expands the Program of Comprehensive Assistance for Family Caregivers to pre-9/11 veterans in two phases. Under the first phase, veterans with serious service-connected injuries incurred on or before May 7, 1975, would qualify for benefits over a two-year period beginning on the date when the VA certifies to Congress that it has fully implemented the information technology system required for this program. Under the second phase, those with serious service-connected injuries incurred between May 7, 1975, and September 11, 2001, would qualify for the Comprehensive Assistance for Family Caregivers program two years after implementation of the first phase. \nCapital Asset Review\nThe VA MISSION Act establishes a process for realigning and modernizing facilities of the VHA. Under this process, the VA will develop criteria for selecting VHA facilities to dispose of, modernize, or acquire, so as to better meet the health care needs of veterans. VA must then create a list of recommendations based on those criteria and submit it to a newly created Asset Infrastructure Review (AIR) Commission. The AIR Commission shall review the VA\u2019s recommendations but may not alter them, unless it determines that one or more recommendations are inconsistent with the criteria. The commission shall submit the list of recommendations to the President, who shall either approve the list in its entirety or send it back to the AIR Commission. The AIR Commission may change the recommendations and resubmit a revised list to the President for reconsideration. The President may approve or disapprove of the revised list. If the President approves of the original or revised list, then VA must begin implementation of the recommendations within three years, unless Congress passes a joint resolution of disapproval, in which case the asset review process terminates.\nRecruiting and Retaining Health Care Providers in the VHA\nThe VA MISSION Act authorizes or expands several programs, with the intention of recruiting and retaining health care providers in the VHA. Among other things, the act\nincreases the maximum amount of student loan debt that may be reduced under VA\u2019s Education Debt Reduction Program (EDRP);\nauthorizes designated scholarships for physicians and dentists under the VA Health Professional Scholarship Program (HPSP);\nestablishes the VA specialty education loan repayment program to incentivize VHA employees to pursue education and training in medical specialties for which VA determines there is a shortage;\nestablishes a pilot Veterans Healing Veterans Medical Access and Scholarship Program; and\nextends eligibility for VA\u2019s EDRP to clinical staff working at Vet Centers.\n\nThe act also requires the VHA to establish a program to deploy mobile health teams to serve in underserved VA medical facilities. \nLastly, the VA MISSION Act authorizes and appropriates $5.2 billion in mandatory funding for the VCP until the VCCP is operational.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "https://www.crs.gov/Reports/R45390", "sha1": "13646379682a637c37f8337b1221b6f3c892df87", "filename": "files/20181101_R45390_13646379682a637c37f8337b1221b6f3c892df87.html", "images": { "/products/Getimages/?directory=R/html/R45390_files&id=/0.png": "files/20181101_R45390_images_bfadb871bdb2d09397aa0ebca06cc2c474a00b7b.png", "/products/Getimages/?directory=R/html/R45390_files&id=/1.png": "files/20181101_R45390_images_de40d50eda3bda5b83eba5146e684a3a058bd2e2.png" } }, { "format": "PDF", "encoding": null, "url": "https://www.crs.gov/Reports/pdf/R45390", "sha1": "f56073bb1d1215efe74b1eb876c1fc5f19f86dbc", "filename": "files/20181101_R45390_f56073bb1d1215efe74b1eb876c1fc5f19f86dbc.pdf", "images": {} } ], "topics": [ { "source": "IBCList", "id": 4849, "name": "Veterans & Military Health Care" } ] } ], "topics": [ "Aging Policy", "American Law", "Economic Policy", "Environmental Policy", "Health Policy", "Legislative Process", "Veterans Policy" ] }