81 FR 10504 - Veterans Transportation Service

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 81, Issue 40 (March 1, 2016)

This document adopts as a final rule, with changes, a Department of Veterans affairs (VA) proposed rule concerning VA's direct transportation of persons for the purposes of examination, treatment, and care. Section 202 of the Dignified Burial and Other Veterans' Benefits Improvement Act of 2012, as amended, authorized VA to carry out a program to transport any person to or from a VA facility or VA-authorized facility, for the purpose of examination, treatment, or care. VA is authorized to carry out this program until December 31, 2016. These regulations provide guidelines for veterans and the public regarding this program, hereafter referred to as the Veterans Transportation Service (VTS).

[Federal Register Volume 81, Number 40 (Tuesday, March 1, 2016)]
[Rules and Regulations]
[Pages 10504-10508]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-04281]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 70

RIN 2900-AO92


Veterans Transportation Service

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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SUMMARY: This document adopts as a final rule, with changes, a 
Department of Veterans affairs (VA) proposed rule concerning VA's 
direct transportation of persons for the purposes of examination, 
treatment, and care. Section 202 of the Dignified Burial and Other 
Veterans' Benefits Improvement Act of 2012, as amended, authorized VA 
to carry out a program to transport any person to or from a VA facility 
or VA-authorized facility, for the purpose of examination, treatment, 
or care. VA is authorized to carry out this program until December 31, 
2016. These regulations provide guidelines for veterans and the public 
regarding this program, hereafter referred to as the Veterans 
Transportation Service (VTS).

DATES: Effective Date: This rule is effective March 31, 2016.

FOR FURTHER INFORMATION CONTACT: David Riley, Director, Veterans 
Transportation Program, Chief Business Office (10NB2G), 2957 Clairmont 
Rd., Atlanta, GA 30329-1647, (404) 828-5601. (This is not a toll-free 
number.)

SUPPLEMENTARY INFORMATION: A proposed rule concerning VA's direct 
transportation of persons for the purposes of examination, treatment, 
and care was published in the Federal Register on May 27, 2015. 80 FR 
30190. This rule set forth proposed regulations for the VTS, a program 
where VA would directly transport veterans and other persons to or from 
VA or VA-authorized facilities for the purposes of examination, 
treatment, or care. Specifically, these regulations would define 
eligible persons, how they may apply for transportation benefits, and 
how VA would provide transportation, including such limitations as 
would be necessary for the safe and effective operation of VTS.
    VA invited interested persons to submit comments on the proposed 
rule on or before July 27, 2015, and we received one comment regarding 
inconsistent use of and reference to the term ``service dog'' in 
proposed 38 CFR 70.71(b)(2) and 70.73(a). Section 70.71 relates to 
eligibility for VTS, and Sec.  70.71(b)(2) as proposed would create VTS 
eligibility for enrolled veterans for the purpose of retrieval of, 
adjustment of, or training concerning medications, prosthetic 
appliances, or a service dog (as defined in 38 CFR 17.148). Section 
70.73 relates to arrangement of and requests for transportation under 
VTS, and Sec.  70.73(a) as proposed would require an eligible person 
that wanted to use VTS to provide VA with certain information to 
include any special needs that must be accommodated to allow for 
transportation (e.g. wheelchair, oxygen tank, service or guide dog). 
Unlike Sec.  70.71(b)(2) as proposed, Sec.  70.73(a) as proposed did 
not reference Sec.  17.148 and therefore would not be limited by the 
meaning of the term ``service dog'' as it is defined in Sec.  17.148. 
As noted by the commenter, the lack of consistency in referencing Sec.  
17.148 in both Sec. Sec.  70.71(b)(2) and 70.73(a) creates confusion as 
to whether a different meaning of the term ``service dog'' should be 
applied when determining VTS eligibility under Sec.  70.71, versus when 
determining what is required to arrange or request VTS transport under 
Sec.  70.73. As also noted by the commenter, a proposed revision to 
another VA regulation would define the term ``service animal'' in 38 
CFR 1.218(a)(11) more broadly than the term ``service dog'' is defined 
in Sec.  17.148. See 79 FR 69379. Since VA received this comment, Sec.  
1.218(a)(11) has been revised to include this broader definition of 
``service animal.'' See 80 FR 49157. Ultimately, the commenter asserted 
that Sec.  70.71(b)(2) should be revised to refer to the broader 
definition of ``service animal'' in Sec.  1.218(a)(11).
    We agree with the commenter that if a person is eligible for VTS 
and traveling with a service animal, then the broader definition of 
``service animal'' in Sec.  1.218(a)(11) should be used in VTS 
regulations. As noted by the commenter, if the broader definition of 
``service animal'' in Sec.  1.218(a)(11) was not used in VTS 
regulations, then VA may create conflicting situations where a person 
would be permitted to bring a ``service animal'' as defined in Sec.  
1.218(a)(11) into a VA facility, but would not be able to use VTS to be 
transported with such an animal to or from a VA facility. We therefore 
revise Sec.  70.73(a) to add a reference to Sec.  1.218(a)(11). This 
revision to Sec.  70.73(a) addresses the commenter's concern that VA's 
definition of ``service animal'' in Sec.  1.218(a)(11) should be 
applied consistently in the context of service animal access, whether 
the issue is a veteran getting into a VA facility with their service 
animal, or a veteran getting to the entrance of that VA facility with 
their service animal via VA transportation.
    We do not, however, adopt the commenter's suggestion to revise 
Sec.  70.71(b)(2) to reference ``service animal'' as defined in Sec.  
1.218(a)(11). As stated earlier in this final rule, Sec.  70.71(b)(2) 
as proposed would create VTS eligibility for, among other things, 
transportation related to training a ``service dog'' that is recognized 
under Sec.  17.148. If we revised Sec.  70.71(b)(2) to replace the 
reference to ``service dog'' in Sec.  17.148 with a reference to 
``service animal'' in Sec.  1.218(a)(11), we would instead create VTS 
eligibility for transportation related to training a ``service animal'' 
that is recognized under Sec.  1.218(a)(11). However, this would 
conflict with VA's service dog benefits standards in Sec.  17.148, 
because Sec.  17.148(c) has specific training requirements that are not 
present in Sec.  1.218(a)(11). The commenter's suggested revision to 
Sec.  70.71(b)(2) would create scenarios where VA could provide VTS 
transport to support the non-specific training of a ``service animal'' 
that is recognized under Sec.  1.218(a)(11), although VA could not 
recognize that training under Sec.  17.148(c) for the purposes of 
providing service dog benefits. Such a practice could be interpreted as 
VA supporting non-specific training that is not recognized under Sec.  
17.148(c), and would erode VA's training requirements in Sec.  
17.148(c). To avoid this conflict between VA standards related to 
service animal access in Sec.  1.218(a)(11) and VA standards related to 
service dog benefits in Sec.  17.148, we do not make the revision to 
Sec.  70.71(b)(2) as suggested by the commenter.
    We additionally clarify that VTS travel to receive training with 
approved service dogs under Sec.  17.148 would only be approved travel 
under Sec.  70.72(d). The types of authorized transportation under 
Sec.  70.72(a)-(c) must be to or from VA or

[[Page 10505]]

VA-authorized facilities. However, transportation to participate in 
``retrieval of, adjustment of, or training concerning . . . a service 
dog under Sec.  17.148'' (as stated in Sec.  70.71(b)(2)) would not be 
to or from a VA or VA-authorized facility because VA does not conduct, 
facilitate, or pay for service dog training. While VA does recognize 
specific training under Sec.  17.148(c) for the purpose of paying 
service dog benefits, the training facilities themselves are not 
considered VA or VA-authorized facilities. Section 70.72(d) authorizes 
VTS transportation between locations other than VA or VA-authorized 
facilities, and such transportation may only be authorized when a VA 
clinician has determined that such transportation would be needed to 
promote, preserve, or restore the health of the individual. We 
reiterate from the proposed rule that Sec.  70.72(d) is intended to 
authorize transportation that is the basis for promoting, preserving, 
or restoring the health of the individual, such as with aiding a 
visually impaired person to learn or update navigation skills, or to 
provide therapeutic day-trips or outings for individuals in VA 
residential treatment programs such as a VA Community Living Center. 
Under this analysis above as reiterated from the proposed rule, we 
interpret that transportation for ``retrieval of, adjustment of, or 
training concerning . . . a service dog . . .'' under Sec.  70.71(b)(2) 
could be a type of approved transportation in Sec.  70.72(d) if a VA 
clinician determined it was needed to promote, preserve, or restore 
health. We note that Sec.  70.71(a) prevents individuals from claiming 
benefits under the VTS program and the beneficiary travel program for 
the same trip to obtain a service dog that is recognized under Sec.  
17.148. We also note that in most cases we anticipate that individuals 
would use the beneficiary travel benefit instead of VTS to obtain a 
service dog that is recognized in Sec.  17.148, because VTS travel 
resources cannot be relied upon to travel greater distances that 
typically necessitate air travel, for instance, and service dog 
training organizations recognized under Sec.  17.148 are not located in 
every State.
    We additionally clarify one issue that was not raised by the 
commenter related the transportation of guests using VTS resources. 
Section 70.71(i) permits guests to travel with a veteran or 
servicemember if resources are available after providing services to 
eligible individuals in Sec.  70.71(b)-(h). As permitted by Sec.  
70.71(i), guests may travel with a veteran or servicemember, but may 
not travel unaccompanied. We recognize that in some cases, a guest that 
travels with a veteran or servicemember to a VA medical facility may 
need to make a return trip from the VA medical facility unaccompanied, 
such as when a veteran or servicemember must be admitted to an 
inpatient treatment setting. In such a case, the guest of such a 
veteran or servicemember may make the return trip from the VA medical 
facility unaccompanied, because VA anticipated in any case completing a 
return trip for the guest as part of the travel permitted under Sec.  
70.71(i). We do not make any changes to the regulation text, however, 
because we interpret a return trip from a VA medical facility for an 
unaccompanied guest to be part of traveling with the veteran or 
servicemember under Sec.  70.71(i).
    Based on the rationale set forth here and in the proposed rule, VA 
is adopting the provisions of the proposed rule as a final rule with 
the changes to Sec.  70.73(a) as described above.

Effect of Rulemaking

    Title 38 of the Code of Federal Regulations, as revised by this 
final rulemaking, represents VA's implementation of its legal authority 
on this subject. Other than future amendments to this regulation or 
governing statutes, no contrary guidance or procedures are authorized. 
All existing or subsequent VA guidance must be read to conform with 
this rulemaking if possible or, if not possible, such guidance is 
superseded by this rulemaking.

Paperwork Reduction Act

    This final rule at Sec.  70.73 contains new collections of 
information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-
3521). On May 27, 2015, in a proposed rule published in the Federal 
Register, we requested public comments on the new collections of 
information. 80 FR 30190. We did not receive any comments on the new 
collection of information. The information collection is pending OMB 
approval. Notice of OMB approval for this information collection will 
be published in a future Federal Register document. Until VA receives 
approval from OMB for the information collection, VA will not collect 
information associated with this rulemaking until OMB approves the 
information collection.

Regulatory Flexibility Act

    The Secretary hereby certifies that this final rule will not have a 
significant economic impact on a substantial number of small entities 
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. This final rule directly affects only individuals and will not 
directly affect small entities. Therefore, pursuant to 5 U.S.C. 605(b), 
this rulemaking is exempt from the final regulatory flexibility 
analysis requirements of 5 U.S.C. 604.

Executive Orders 12866 and 13563

    Executive Orders 12866 and 13563 direct agencies to assess the 
costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, and other advantages; distributive impacts; 
and equity). Executive Order 13563 (Improving Regulation and Regulatory 
Review) emphasizes the importance of quantifying both costs and 
benefits, reducing costs, harmonizing rules, and promoting flexibility. 
Executive Order 12866 (Regulatory Planning and Review) defines a 
``significant regulatory action,'' requiring review by the Office of 
Management and Budget (OMB), unless OMB waives such review, as ``any 
regulatory action that is likely to result in a rule that may: (1) Have 
an annual effect on the economy of $100 million or more or adversely 
affect in a material way the economy, a sector of the economy, 
productivity, competition, jobs, the environment, public health or 
safety, or State, local, or tribal governments or communities; (2) 
Create a serious inconsistency or otherwise interfere with an action 
taken or planned by another agency; (3) Materially alter the budgetary 
impact of entitlements, grants, user fees, or loan programs or the 
rights and obligations of recipients thereof; or (4) Raise novel legal 
or policy issues arising out of legal mandates, the President's 
priorities, or the principles set forth in this Executive Order.''
    The economic, interagency, budgetary, legal, and policy 
implications of this regulatory action have been examined, and it has 
been determined that it is not a significant regulatory action under 
Executive Order 12866 because it is likely to result in a regulatory 
action that may have an annual effect on the economy of $100 million or 
more. VA's impact analysis can be found as a supporting document at 
http://www.regulations.gov, usually within 48 hours after the 
rulemaking document is published. Additionally, a copy of the 
rulemaking and its impact analysis are available on VA's Web site at 
http://www.va.gov/orpm/, by

[[Page 10506]]

following the link for VA Regulations Published from FY 2004 through 
fiscal year to date.

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in the expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any one year. This final rule will have no such effect on 
State, local, and tribal governments, or on the private sector.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance numbers and titles for 
the programs affected by this document are as follows: 64.007, Blind 
Rehabilitation Centers; 64.009, Veterans Medical Care Benefits; 64.010, 
Veterans Nursing Home Care; 64.011, Veterans Dental Care; 64.013, 
Veterans Prosthetic Appliances; 64.018, Sharing Specialized Medical 
Resources; 64.019, Veterans Rehabilitation Alcohol and Drug Dependence; 
and 64.022, Veterans Home Based Primary Care.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Robert D. 
Snyder, Interim Chief of Staff, Department of Veterans Affairs, 
approved this document on January 28, 2016, for publication.

List of Subjects in 38 CFR Part 70

    Administrative practice and procedure, Alcohol abuse, Alcoholism, 
Claims, Day care, Dental health, Drug abuse, Foreign relations, 
Government contracts, Grant programs--health, Grant programs--Veterans, 
Health care, Health facilities, Health professions, Health records, 
Homeless, Medical and dental schools, Medical devices, Medical 
research, Mental health programs, Nursing homes, Philippines, Reporting 
and recordkeeping requirements, Scholarships and fellowships, Travel 
and transportation expenses, Veterans.

    Dated: February 24, 2016.
Michael P. Shores,
Chief Impact Analyst, Office of Regulation Policy & Management, Office 
of the General Counsel, Department of Veterans Affairs.

    For the reasons set forth in the preamble, VA amends 38 CFR part 70 
as follows:

PART 70--VETERANS TRANSPORTATION PROGRAMS

0
1. The authority citation for part 70 is revised to read as follows:

    Authority:  38 U.S.C. 101, 111, 111A, 501, 1701, 1714, 1720, 
1728, 1782, 1783, and E.O. 11302, 31 FR 11741, 3 CFR, 1966-1970 
Comp., p. 578, unless otherwise noted.


0
2. Revise the heading for part 70 to read as set forth above.


Sec. Sec.  70.1 through 70.50  [Designated as Subpart A]

0
3. Designate Sec. Sec.  70.1 through 70.50 as subpart A and add a 
heading for subpart A to read as follows:

Subpart A--Beneficiary Travel and Special Mode Transportation Under 
38 U.S.C. 111

0
4. Add subpart B to read as follows:
Subpart B--Veterans Transportation Service Under 38 U.S.C. 111A
Sec.
70.70 Purpose and definitions.
70.71 Eligibility.
70.72 Types of transportation.
70.73 Arranging transportation services.

Subpart B--Veterans Transportation Service Under 38 U.S.C. 111A


Sec.  70.70  Purpose and definitions.

    (a) Purpose. This subpart implements the Veterans Transportation 
Service (VTS), through which VA transports eligible persons to or from 
a VA or VA-authorized facility or other place for the purpose of 
examination, treatment, or care.
    (b) Definitions. For purposes of this subpart:
    Attendant has the meaning set forth in Sec.  70.2, and also means 
an individual traveling with a veteran or servicemember who is eligible 
for travel under VTS and requires the aid and/or assistance of another 
person.
    Eligible person means a person described in Sec.  70.71.
    Guest means any individual the veteran or servicemember would like 
to have accompany him or her to an appointment but whose presence is 
not medically required.
    Scheduled visit means that a VA beneficiary had an appointment that 
was made before she or he appeared at a VA, or VA-authorized, facility, 
or that a VA beneficiary was specifically authorized to appear at such 
facility on the date of the visit in order to obtain examination, 
treatment, or care. Examples of scheduled visits include: Regular 
appointments for examination, treatment, or care; visits to undergo 
laboratory work; or doctor-recommended visits to clinics with open 
hours.
    Unscheduled visit means a visit to a VA, or VA-authorized, facility 
for purposes of examination, treatment, or care that was not recorded 
in VA's scheduling system prior to the veteran's visit. For example, an 
unscheduled visit may be for a simple check of a person's blood 
pressure, for counseling, or for clinical intervention.

(Authority: 38 U.S.C. 111A, 501, 1714)

Sec.  70.71  Eligibility.

    Except as provided in paragraph (j) of this section, VA facilities 
may provide VTS benefits to the following:
    (a) Persons eligible for beneficiary travel. All persons eligible 
for beneficiary travel benefits in Sec.  70.10 are eligible for VTS 
benefits (however, persons cannot claim benefits under both programs 
for the same trip or portion of a trip).
    (b) Enrolled veterans. Regardless of a veteran's eligibility for 
beneficiary travel, VA may provide VTS to veterans enrolled in VA's 
health care system who need transportation authorized under Sec.  70.72 
for:
    (1) A scheduled visit or urgent care;
    (2) Retrieval of, adjustment of, or training concerning medications 
and prosthetic appliances, or a service dog (as defined in 38 CFR 
17.148);
    (3) An unscheduled visit; or
    (4) To participate and attend other events or functions, as 
clinically determined by VA, for the purposes of examination, 
treatment, or care.
    (c) Non-enrolled veterans. VA may provide VTS to veterans not 
enrolled in VA's health care system who need transportation authorized 
under Sec.  70.72 for:
    (1) A compensation and pension examination;
    (2) An unscheduled or walk-in visit;
    (3) To apply for enrollment or health care benefits; or
    (4) To participate and attend other events or functions, as 
clinically determined by VA, for the purposes of examination, 
treatment, or care.
    (d) Servicemembers. VA may provide VTS to a member of the Armed 
Forces (including the National Guard or Reserve) traveling to a VA or 
VA-authorized facility for VA hospital care or medical services, 
including

[[Page 10507]]

examination, treatment or care, a compensation and pension examination, 
or to enroll or otherwise receive benefits for which they are eligible.
    (e) Prospective Family Caregivers and Family Caregivers. (1) VA may 
provide VTS to a prospective Family Caregiver who has applied for 
designation as a Family Caregiver under 38 CFR 71.25(a) when the travel 
is for purposes of assessment and training under 38 CFR 71.25(c) and 
(d).
    (2) VA may provide VTS to a Family Caregiver (who is approved and 
designated under 38 CFR 71.25) of veteran or servicemember described in 
paragraphs (b) through (d) of this section to:
    (i) Accompany or travel independently from a veteran or 
servicemember for purposes of examination, treatment, or care of the 
veteran or servicemember; or
    (ii) Receive benefits under 38 CFR 71.40(b) or (c). For health care 
benefits provided under 38 CFR 71.40(c)(3), Primary Family Caregivers 
may travel using VTS for care only if it is provided at a VA facility 
through the Civilian Health and Medical Program of the Department of 
Veterans Affairs (CHAMPVA) Inhouse Treatment Initiative (CITI).
    (f) Attendants. VA may provide VTS to an attendant of a veteran or 
servicemember described in paragraphs (b) through (d) of this section.
    (g) Persons receiving counseling, training, or mental health 
services. VA may provide VTS to persons receiving counseling, training, 
or mental health services under 38 U.S.C. 1782 and 38 CFR 71.50.
    (h) CHAMPVA beneficiaries. VA may provide VTS to persons eligible 
for health care under the Civilian Health and Medical Program of the 
Department of Veterans Affairs (CHAMPVA) under 38 CFR 17.270 through 
17.278, provided that such care is being provided at a VA facility 
through the CHAMPVA Inhouse Treatment Initiative (CITI).
    (i) Guests. For each veteran described in paragraph (b) or (c) of 
this section or member of the Armed Forces described in paragraph (d) 
of this section, a guest may travel with the veteran or servicemember 
provided resources are still available after providing services to 
individuals identified in paragraphs (b) through (h) of this section.
    (j) Limitations on eligibility. Notwithstanding an individual's 
eligibility under this section:
    (1) A person may be ineligible for transportation services if VA 
determines the person's behavior has jeopardized or could jeopardize 
the health or safety of other eligible users of VTS or VA staff, or 
otherwise has interfered or could interfere with the safe 
transportation of eligible persons to or from a VA facility or other 
place.
    (2) Only one person may travel with an eligible veteran or 
servicemember as a Family Caregiver, attendant, or guest, unless a VA 
clinician determines that more than one such person is needed or would 
otherwise be beneficial to the examination, treatment, or care of the 
eligible veteran or servicemember. Family Caregivers traveling for 
benefits under paragraph (e)(1) or (e)(2)(ii) of this section are not 
subject to this limitation.
    (3) Persons under the age of 18 may accompany another person using 
VTS with the consent of their parent or legal guardian and the medical 
facility director or designee. VA transportation of children is not 
available if State law requires the use of a child restraint, such as a 
child safety seat or booster seat. In making determinations under this 
provision, the medical facility director or designee will consider:
    (i) The special transportation needs of the child, if any;
    (ii) The ability to transport the child safely using the available 
resources;
    (iii) The availability of services at the facility to accommodate 
the needs of the child;
    (iv) The appropriateness of transporting the child; and
    (v) Any other relevant factors.

(Authority: 38 U.S.C. 111A, 1714, 1720G, 1781, 1782, 501)

Sec.  70.72  Types of transportation.

    The following types of transportation may be provided by VA 
facilities through VTS:
    (a) Door-to-door service. VA facilities may use VTS to transport, 
on a scheduled or unscheduled basis, eligible persons between a VA or 
VA-authorized facility and their residence or a place where the person 
is staying. VA facilities may use VTS to transport eligible persons to 
and from a VA or VA-authorized facility and another location identified 
by the person when it is financially favorable to the government to do 
so.
    (b) Travel to and from designated locations. VA facilities may use 
VTS to provide transportation between a VA or VA-authorized facility 
and a designated location in the community on a scheduled basis.
    (c) Service between VA facilities. VA facilities may use VTS to 
provide scheduled or unscheduled transportation between VA or VA-
authorized health care facilities. This includes travel from one 
building to another within a single VA campus.
    (d) Other locations. VA facilities may use VTS to provide scheduled 
or unscheduled transportation to and/or from a VA or VA-authorized 
facility or other places when a VA clinician has determined that such 
transportation of the veteran, servicemember, their attendant(s), or 
CHAMPVA beneficiary receiving benefits through the CITI program would 
be needed to promote, preserve, or restore the health of the individual 
and is in accord with generally accepted standards of medical practice, 
as defined in 38 CFR 17.38(b).

(Authority: 38 U.S.C. 111A, 501, 1718, 7301)

Sec.  70.73  Arranging transportation services.

    (a) Requesting VTS. An eligible person may request transportation 
services by contacting the facility director or designee at the VA 
facility providing or authorizing the examination, treatment, or care 
to be delivered. The person must provide the facility director or 
designee with information necessary to arrange these services, 
including the name of the person, the basis for eligibility, the name 
of the veteran or servicemember they are accompanying (if applicable), 
the time of the appointment (if known), the eligible person's departure 
location and destination, any special needs that must be accommodated 
to allow for transportation (e.g. wheelchair, oxygen tank, or service 
animal as defined in 38 CFR 1.218(a)(11)(viii)), and other relevant 
information. Transportation services generally will be provided on a 
first come, first served basis.
    (b) Travel without a reservation. Eligible persons who have 
provided the facility director or designee with the information 
referred to in the previous paragraph may travel without a reservation 
for the purpose of examination, treatment, or care when, for example:
    (1) The person is being discharged from inpatient care;
    (2) The person is traveling for an unscheduled visit, pursuant to a 
recommendation for such a visit by an attending VA clinician; or
    (3) The person is being transported to another VA or VA-authorized 
facility.
    (c) Determining priority for transportation. When the facility 
director or designee determines there are insufficient resources to 
transport all persons requesting transportation services, he or she 
will assist any person denied VTS in identifying and accessing other 
transportation options. VTS resources will be allocated using the 
following criteria, which are to be assessed in the context of the 
totality of the circumstances, so that no one factor is determinative:

[[Page 10508]]

    (1) The eligible person's basis for eligibility. Enrolled veterans 
will receive first priority, followed in order by non-enrolled 
veterans; servicemembers; Family Caregivers; persons receiving 
counseling, training, or mental health services under 38 U.S.C. 1782 
and 38 CFR 71.50; CITI beneficiaries; and guests. Persons eligible 
under more than one designation will be considered in the highest 
priority category for which that trip permits. VA will provide 
transportation to any attendant accompanying a veteran or servicemember 
who is approved for transportation.
    (2) First in time request.
    (3) An eligible person's clinical need.
    (4) An eligible person's inability to transport him or herself 
(e.g., visual impairment, immobility, etc.).
    (5) An eligible person's eligibility for other transportation 
services or benefits.
    (6) The availability of other transportation services (e.g., common 
carriers, veterans' service organizations, etc.).
    (7) The VA facility's ability to maximize the use of available 
resources.
    (The Office of Management and Budget has approved the information 
collection requirements in this section under control number 2900-
0838.)

(Authority: 38 U.S.C. 111A, 501)


[FR Doc. 2016-04281 Filed 2-29-16; 8:45 am]
 BILLING CODE 8320-01-P