Prior to discussing major health care issues, this report provides a brief overview of the VA, the Veterans Health Administration (VHA) within the VA which oversees the largest integrated health care system in the country, and the veteran population it serves. VA carries out its veterans' programs nationwide through three administrations and the Board of Veterans Appeals (BVA). The Veterans Benefits Administration (VBA) is responsible for compensation, pension, vocational rehabilitation, education assistance, home loan guaranty and insurance among other things. The National Cemetery Administration's (NCA) responsibilities include maintaining 120 national cemeteries in 39 states and Puerto Rico. Veterans' Health Care System

VHA operates the nation's largest integrated direct health care delivery system. Eligibility for Veterans' Health Care

		"Promise of Free Health Care"

To understand some of the issues discussed later in this report, it is important to understand eligibility for VA health care, VA's enrollment process, and its enrollment priority groups. Veterans enrolled in Priority Groups 1-6 include:
veterans in need of care for a service-connected disability; veterans who have a compensable service-connected condition; veterans whose discharge or release from active military, naval or air service was for a compensable disability that was incurred or aggravated in the line of duty; veterans who are former prisoners of war (POWs); veterans awarded the purple heart; veterans who have been determined by VA to be catastrophically disabled (these are veterans who have a permanent severely disabling injury, disorder, or disease that compromises the ability to carry out the activities of daily living); veterans of World War I; veterans who were exposed to hazardous agents (such as Agent Orange in Vietnam) while on active duty; and veterans who have an annual income and net worth below a VA- established means test threshold. Health Services

VHA provides a standard benefits package to all enrolled veterans. Since the terrorist attacks of September 11, 2001, U.S. Armed Forces have been deployed in two major theaters of operation. Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) constitute the largest sustained ground combat mission undertaken by the United States since the Vietnam War. Veterans from these conflicts and from previous wars are exerting tremendous stress on the VA health care system. With increased patient workload and rising health care costs, the 110 th Congress is focused on ensuring a "seamless transition" process for veterans moving from active duty into the VA health care system. The goal of MHSP is to anticipate need and fill in the gaps of current mental health programs based on the CARES model (Capital Asset Realignment for Enhanced Services, discussed later in the report) and recommendations from the President's New Freedom Commission on Mental Health. 1382 ), Assured Funding for Veterans Health Care Act ( H.R. In October 2000, VA established the CARES program with the goal of evaluating the projected health care needs of veterans over the next 20 years, and of realigning VA's infrastructure to better meet those needs. Veterans Health Care Legislation

		Health Care Legislation Enacted into Law

			Joshua Omvig Veterans Suicide Prevention Act (H.R. 327, H.Rept. P.L. H.R. H.R. Chiropractic Care Available to All Veterans Act (H.R. 1470)

The House passed H.R. H.R. 2199 , as amended, would require mandatory screening of veterans for traumatic brain injury (TBI). 1315, H.Rept. Among other things, H.R. On November 14, 2007, the Senate Veterans' Affairs Committee ordered the following bills reported without amendment: S. 2004 (to amend Title 38 U.S.C.
The Department of Veterans Affairs (VA) provides services and benefits to veterans who meet certain eligibility criteria. VA carries out its programs nationwide through three administrations and the Board of Veterans Appeals (BVA). The Veterans Health Administration (VHA) is responsible for veterans' health care programs. The Veterans Benefits Administration (VBA) is responsible for providing compensation, pensions, and education assistance, among other things. The National Cemetery Administration's (NCA) responsibilities include maintaining national veterans cemeteries.
VHA operates the nation's largest integrated health care system. Unlike most other federal health programs, VHA is a direct service provider rather than a health insurer or payer for health care. VA health care services are generally available to all honorably discharged veterans of the U.S. Armed Forces who are enrolled in VA's health care system. VA has a priority enrollment system that places veterans in priority groups based on various criteria. Under the priority system, VA decides each year whether its appropriations are adequate to serve all enrolled veterans. If not, VA could stop enrolling those in the lowest-priority groups.
Since the terrorist attacks of September 11, 2001, U.S. Armed Forces have been deployed in two major theaters of operation. Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) constitute the largest sustained ground combat mission undertaken by the United States since the Vietnam War. Veterans from these conflicts and from previous wars are exerting tremendous stress on the VA health care system. With increased patient workload and rising health care costs, the 110th Congress is focused on such issues as how to contain costs and at the same time maintain high-quality health care services to veterans who need them. Among other things, Congress may address the best method of funding for veterans' health care, while continuing to focus on ensuring a "seamless transition" process for servicemembers moving from the military health system into the VA health care system, improving mental health care services for veterans with Post Traumatic Stress Disorder (PTSD), and improving rehabilitation and mental health services for those with Traumatic Brain Injuries (TBI).
In recent years, VA has made an effort to realign its capital assets, primarily its buildings, to better serve veterans' needs. VA established the Capital Asset Realignment for Enhanced Services (CARES) initiative to identify how well the geographic distribution of VA health care resources matches the projected needs of veterans. Given the tremendous interest in the implementation of the CARES initiative in the previous Congress, the 110th Congress will likely continue to monitor the CARES implementation. H.R. 327 was enacted into law (P.L. 110-110) on November 5. The House has passed several measures to improve and expand health care services to veterans: H.R. 327, H.R. 612, H.R. 1315, H.R. 1470, H.R. 2199, H.R. 2623, and H.R. 2874. The Senate VA Committee has reported the following measures: S. 1233, S. 2004, S. 2142, S. 2160, and S. 2162.
This report will be updated as legislative activities warrant.