[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3972 Introduced in House (IH)]







104th CONGRESS
  2d Session
                                H. R. 3972

To amend title 38, United States Code, to improve health care services 
   provided by the Department of Veterans Affairs to women veterans.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 2, 1996

   Ms. Waters (for herself and Ms. Brown of Florida) introduced the 
   following bill; which was referred to the Committee on Veterans' 
                                Affairs

_______________________________________________________________________

                                 A BILL


 
To amend title 38, United States Code, to improve health care services 
   provided by the Department of Veterans Affairs to women veterans.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Women Veterans' Health Act of 
1996''.

SEC. 2. WOMEN'S HEALTH SERVICES.

    (a) Women's Health Services.--Section 1701 of title 38, United 
States Code, is amended--
            (1) in paragraph (6)(A)(i), by inserting ``women's health 
        services,'' after ``preventive health services,''; and
            (2) by adding at the end the following:
    ``(10) The term `women's health services' means health care 
services provided to women. Such term includes counseling and services 
relating to the following:
            ``(A) Papanicolaou tests (pap smear).
            ``(B) Breast examinations and mammography.
            ``(C) The management and prevention of sexually transmitted 
        diseases.
            ``(D) Menopause, osteoporosis, and other conditions 
        relating to aging.
            ``(E) Cardiac care.
            ``(F) Physical and psychological conditions arising out of 
        acts of sexual violence.
            ``(G) Physical and psychological conditions that result 
        from homelessness.''.
    (b) Contracts for Women's Health Services.--Section 1703(a) of such 
title is amended by adding at the end the following:
            ``(9) Women's health services for veterans on an ambulatory 
        or outpatient basis.''.
    (c) Repeal of Superseded Authority.--Section 106 of the Veterans 
Health Care Act of 1992 (Public Law 102-585; 38 U.S.C. 1710 note) is 
amended--
            (1) by striking out subsection (a); and
            (2) by striking out ``(b) Responsibilities of Directors of 
        Facilities.--'' before ``The Secretary''.

SEC. 3. COUNSELING AND TREATMENT FOR SEXUAL TRAUMA.

    (a) Counseling.--Subsection (a)(1) of section 1720D of title 38, 
United States Code, is amended by striking out ``During the period 
through December 31, 1998, the Secretary'' and inserting in lieu 
thereof ``The Secretary''.
    (b) Treatment.--Subsection (a)(2) of such section is amended by 
striking out ``During the period referred to in paragraph (1), the 
Secretary'' and inserting in lieu thereof ``The Secretary''.
    (c) Contract Counseling.--Subsection (a)(3) of such section is 
amended by striking out ``, during the period through December 31, 
1998,''.

SEC. 4. REPORT ON WOMEN'S HEALTH CARE AND RESEARCH.

    (a) In General.--Not later than January 1, 1999, the Secretary of 
Veterans Affairs shall submit to the Committees on Veterans' Affairs of 
the Senate and House of Representatives a report on the provision of 
health care services and the conduct of research carried out by, or 
under the jurisdiction of, the Secretary relating to women veterans. 
The report shall be prepared through the Center for Women Veterans 
established under section 318 of title 38, United States Code, which 
shall prepare the report in consultation with the Advisory Committee on 
Women Veterans established under section 542 of that title.
    (b) Contents.--The report under subsection (a) shall include the 
following information:
            (1) The number of women veterans who have received women's 
        health services (as such term is defined in section 1701(10) of 
        title 38, United States Code) in facilities under the 
        jurisdiction of the Secretary (or the Secretary of Defense), 
        shown by reference to the Department facility which provided 
        (or, in the case of Department of Defense facilities, arranged 
        for) those services.
            (2) A description of--
                    (A) the services provided at each such facility;
                    (B) the type and amount of services provided by 
                such personnel, including information on the numbers of 
inpatient stays and the number of outpatient visits through which such 
services were provided; and
                    (C) the extent to which each such facility relies 
                on contractual arrangements under section 1703 or 8153 
                of title 38, United States Code, to furnish care to 
                women veterans in facilities which are not under the 
                jurisdiction of the Secretary where the provision of 
                such care is not furnished in a medical emergency.
            (3) The steps taken by each such facility to expand the 
        provision of services at such facility (or under arrangements 
        with the Department of Defense facility) to women veterans.
            (4) A description of the personnel of the Department who 
        provided such services to women veterans, including the number 
        of employees (including both the number of individual employees 
        and the number of full-time employee equivalents) and the 
        professional qualifications or specialty training of such 
        employees and the Department facilities to which such personnel 
        were assigned.
            (5) A description of any actions taken by the Secretary to 
        ensure the retention of the personnel described in paragraph 
        (4) and any actions undertaken to recruit such additional 
        personnel or personnel to replace such personnel.
            (6) An assessment by the Secretary of any difficulties 
        experienced by the Secretary in the furnishing of such services 
        and the actions taken by the Secretary to resolve such 
        difficulties.
            (7) A description (as of October 1 of the year preceding 
        the year in which the report is submitted) of the status of any 
        research relating to women veterans being carried out by or 
        under the jurisdiction of the Secretary.
            (8) A description of the actions taken by the Secretary to 
        foster and encourage the expansion of such research.

SEC. 5. EXPANSION OF RESEARCH RELATING TO WOMEN VETERANS.

    (a) Inclusion of Women and Minorities in Health Research.--Section 
7303(c) of title 38, United States Code, is amended--
            (1) in paragraph (1), by striking out ``that, whenever 
        possible and appropriate--'' and inserting in lieu thereof 
        ``that--''; and
            (2) by adding at the end the following new paragraph:
    ``(3) The requirement in paragraph (1) regarding women and members 
of minority groups who are veterans may be waived by the Secretary of 
Veterans Affairs with respect to a project of clinical research if the 
Secretary determines that the inclusion, as subjects in the project, of 
women and members of minority groups, respectively--
            ``(A) is inappropriate with respect to the health of the 
        subjects;
            ``(B) is inappropriate with respect to the purpose of the 
        research; or
            ``(C) is inappropriate under such other circumstances as 
        the Secretary may designate.''.
    (b) Health Research Relating to Women.--Section 7303(d) of such 
title is amended by adding at the end the following new paragraphs:
    ``(3) The Secretary shall foster and encourage research under this 
section on the following matters as they relate to women:
            ``(A) Breast cancer.
            ``(B) Gynecological and reproductive health, including 
        gynecological cancer, infertility, sexually-transmitted 
        diseases, and pregnancy.
            ``(C) Human Immunodeficiency Virus and Acquired Immune 
        Deficiency Syndrome.
            ``(D) Mental health, including post-traumatic stress 
        disorder, depression, combat related stress, and trauma.
            ``(E) Diseases related to aging, including menopause, 
        osteoporosis, and Alzheimer's disease.
            ``(F) Substance abuse.
            ``(G) Sexual violence and related trauma.
            ``(H) Exposure to toxic chemicals and other environmental 
        hazards.
            ``(I) Cardiac care.
    ``(4) The Secretary shall, to the maximum extent practicable, 
ensure that personnel of the Department of Veterans Affairs engaged in 
the research referred to in paragraph (1) include the following:
            ``(A) Personnel of the geriatric research, education, and 
        clinical centers designated pursuant to section 7314 of this 
        title.
            ``(B) Personnel of the National Center for Post-Traumatic 
        Stress Disorder established pursuant to section 110(c) of the 
        Veterans Health Care Act of 1984 (Public Law 98-528; 98 Stat. 
        2692).
    ``(5) The Secretary shall ensure that personnel of the Department 
engaged in research relating to the health of women veterans are 
advised and informed of such research engaged in by other personnel of 
the Department.''.

SEC. 6. POPULATION STUDY.

    (a) Study.--The Secretary of Veterans Affairs, subject to 
subsection (f), shall conduct a study to determine the needs of 
veterans who are women for health-care services. The study shall be 
carried out through the Center for Women Veterans.
    (b) Consultation.--Before carrying out the study, the Secretary 
shall request the advice of the Advisory Committee on Women Veterans on 
the conduct of the study.
    (c) Persons To Be Included in Sample of Veterans Studied.--(1) 
Subject to paragraph (2), the study shall be based on--
          (A) an appropriate sample of veterans who are women; and
            (B) an examination of the medical and demographic histories 
        of the women comprising such sample.
    (2) The sample referred to in paragraph (1) shall constitute a 
representative sampling (as determined by the Secretary) of the ages, 
the ethnic, social and economic backgrounds, the enlisted and officer 
grades, and the branches of service of all veterans who are women. The 
Secretary shall ensure that homeless Women Veterans are included in the 
sample.
    (3) In carrying out the examination referred to in paragraph 
(1)(B), the Secretary shall determine the number of women of the sample 
who have used medical facilities of the Department, nursing home 
facilities of or under the jurisdiction of the Department, and 
outpatient care facilities of or under the jurisdiction of the 
Department.
    (d) Reports.--The Secretary shall submit to the Committees on 
Veterans' Affairs of the Senate and House of Representatives reports 
relating to the study as follows:
            (1) Not later than nine months after the date of the 
        enactment of this Act, an interim report describing (A) the 
        information and advice obtained by the Secretary from the 
        Advisory Committee on Women Veterans, and (B) the status of the 
        study.
            (2) Not later than December 31, 1999, a final report 
        describing the results of the study.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to the General Operating Expenses account of the 
Department of Veterans Affairs $2,000,000 to carry out the purposes of 
this section. Amounts appropriated pursuant to this authorization of 
appropriations shall be available for obligation without fiscal year 
limitation.
    (f) Limitation.--No funds may be used to conduct the study 
described in subsection (a) unless expressly provided for in an 
appropriation Act.

SEC. 7. OUTREACH SERVICES FOR HOMELESS WOMEN VETERANS.

    Section 7722(e) of title 38, United States Code, is amended by 
adding at the end the following new sentence: ``In carrying out this 
subsection, the Secretary shall take such steps as may be necessary to 
ensure that homeless women veterans are included in such outreach 
programs and outreach services.''.

SEC. 8. SAFE AND EFFECTIVE TREATMENT FOR WOMEN PSYCHIATRIC PATIENTS.

    The Secretary of Veterans Affairs shall ensure that women veterans 
who receive psychiatric treatment from the Secretary, particularly in 
the case of women who are sexually traumatized, receive such treatment 
(on both an inpatient and outpatient basis) in a safe and effective 
manner that recognizes the privacy needs of such women.

SEC. 9. MAMMOGRAPHY QUALITY STANDARDS.

    (a) Applicability to Department of Veterans Affairs of Mammography 
Quality Standards Act of 1992.--Subsections (a) through (k) of section 
354 of the Public Health Service Act (42 U.S.C. 263b) shall apply with 
respect to facilities of the Department of Veterans Affairs without 
regard to the last sentence of subparagraph (A) of subsection (a)(3) of 
such section.
    (b) Extension of Deadlines.--Any deadline for the completion of any 
action prescribed under any provision referred to in subsection (a) 
shall be applied with respect to facilities of the Department of 
Veterans Affairs by extending such deadline so as to be two years after 
the date of the enactment of this Act or two years after the date which 
would otherwise be applicable under such provision, whichever is later.
    (c) Interagency Cooperation.--The Secretary of Veterans Affairs 
shall take appropriate steps to cooperate with the Secretary of Health 
and Human Services in the implementation of this section.

SEC. 10. CENTER FOR WOMEN VETERANS.

    Section 318(e) of title 38, United States Code, is amended--
            (1) by inserting ``(1)'' after ``(e)'';
            (2) by adding after the period the following: ``Such 
        resources shall include (subject to the availability of 
        appropriations) adequate clerical support (as determined by the 
        Director) to enable the Director to carry out the functions of 
        the Director under this section.''; and
            (3) by adding at the end the following:
    ``(2) There is in the Center an Associate Director, who shall be 
appointed from among individuals with appropriate education, 
experience, and training to assist the Director with the investigative, 
research, and reporting requirements under this section.''.
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