S. 1912 — Protecting Veteran Community Care Act

This section states nine congressional findings concerning the VA MISSION Act of 2018 (P.L. 115-182), including its intent to expand veterans' access to community health care providers (reforming the Veterans Choice Program under P.L. 113-146) for all medical services such as mental health treatments and institutional extended care without eligibility standards that limit options; current Department of Veterans Affairs limitations on community mental health care access despite many veterans' lack of local VA facilities; persistent veteran suicide rates; and the inadequacy of 30-day approval waits for mental health services or telehealth as a substitute for in-person care for veterans in crisis.

This section expands the conditions for required furnishing of residential mental health or substance-use services under the Veterans Community Care Program (VCCP; i.e., VA program enabling eligible veterans to receive hospital care, medical services, and extended care from non-VA providers when VA cannot meet access standards or other criteria) by adding subsection (d)(1)(F), which covers veterans who (i) meet VA criteria for priority admission to a Mental Health Residential Rehabilitation Treatment Program (MH RRTP) but VA cannot accommodate them or (ii) request such services from an MH RRTP but VA cannot furnish them consistent with specialty care access standards. It further (1) adds subsection (d)(5), prohibiting VA from prioritizing referral to another VA MH RRTP over timely community care under (d)(1)(F) unless requested by the veteran; (2) inserts new subsection (q), requiring community providers of such services to be state-licensed and accredited by the Joint Commission or Commission on Accreditation of Rehabilitation Facilities (with authority to consider alternatives or grant case-by-case waivers if needed); and (3) directs the Secretary, not later than 90 days after enactment, to revise access standards so mental health care under the VCCP is no more restrictive than specialty care standards.

This section prohibits the Secretary of Veterans Affairs from determining a covered veteran ineligible for community care under 38 U.S.C. §1703 solely because providers eligible under subsection (c) (i.e., non-VA community providers) cannot meet applicable wait-time or access standards. It further requires the Secretary to permit such a veteran to elect a preferred option among multiple available choices for that care.

This section requires the Department of Veterans Affairs (VA) annual review of its community care program—under which eligible veterans may obtain hospital care, medical services, or extended care services from non-VA providers when the VA cannot furnish such care timely or appropriately—to include specified metrics for the covered year, applicable to reviews conducted after enactment. The required metrics are (1) the number of instances of care or services requested; (2) the number of requests approved; (3) the number denied; (4) the number of appeals of denials under subsection (f), including final appeal decisions; (5) the eligibility criteria under which each eligible veteran qualified for care or services; and (6) data on mental health-related requests and authorizations for emergency care (including whether transportation or further care or a hospital stay was required).

This section requires enactment of a joint resolution approving any modification by the Secretary of Veterans Affairs to the conditions under which community care must be provided to veterans under 38 U.S.C. 1703(d)—including designated access standards (e.g., drive times, appointment wait times), Secretary-developed criteria, or related regulations. (As background, these standards, established by the VA MISSION Act of 2018, determine when VA facilities must refer eligible veterans to non-VA community providers.)