[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3253 Engrossed Amendment House (EAH)]


  2d Session

                               H.R. 3253

_______________________________________________________________________

                  HOUSE AMENDMENT TO SENATE AMENDMENTS
                In the House of Representatives, U. S.,

                                                    September 17, 2002.

    Resolved, That the House agree to the amendments of the Senate to the bill 
(H.R. 3253) entitled ``An Act to amend title 38, United States Code, to provide 
for the establishment within the Department of Veterans Affairs of improved 
emergency medical preparedness, research, and education programs to combat 
terrorism, and for other purposes'', with the following

                 HOUSE AMENDMENT TO SENATE AMENDMENTS:

            In lieu of the matter proposed to be inserted by the 
      amendment of the Senate to the text of the bill, insert the 
      following:

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Department of Veterans Affairs 
Emergency Preparedness Act of 2002''.

SEC. 2. ESTABLISHMENT OF MEDICAL EMERGENCY PREPAREDNESS CENTERS AT 
              DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTERS.

    (a) In General.--(1) Subchapter II of chapter 73 of title 38, 
United States Code, is amended by adding at the end the following new 
section:
``Sec. 7325. Medical emergency preparedness centers
    ``(a) Establishment of Centers.--(1) The Secretary shall establish 
four medical emergency preparedness centers in accordance with this 
section. Each such center shall be established at a Department medical 
center and shall be staffed by Department employees.
    ``(2) The Under Secretary for Health shall be responsible for 
supervising the operation of the centers established under this 
section. The Under Secretary shall provide for ongoing evaluation of 
the centers and their compliance with the requirements of this section.
    ``(3) The Under Secretary shall carry out the Under Secretary's 
functions under paragraph (2) in consultation with the Assistant 
Secretary of Veterans Affairs with responsibility for operations, 
preparedness, security, and law enforcement functions.
    ``(b) Mission.--The mission of the centers shall be as follows:
            ``(1) To carry out research on, and to develop methods of 
        detection, diagnosis, prevention, and treatment of injuries, 
        diseases, and illnesses arising from the use of chemical, 
        biological, radiological, incendiary or other explosive weapons 
        or devices posing threats to the public health and safety.
            ``(2) To provide education, training, and advice to health 
        care professionals, including health care professionals outside 
        the Veterans Health Administration, through the National 
        Disaster Medical System established pursuant to section 2811(b) 
        of the Public Health Service Act (42 U.S.C. 300hh-11(b)) or 
        through interagency agreements entered into by the Secretary 
        for that purpose.
            ``(3) In the event of a disaster or emergency referred to 
        in section 1785(b) of this title, to provide such laboratory, 
        epidemiological, medical, or other assistance as the Secretary 
        considers appropriate to Federal, State, and local health care 
        agencies and personnel involved in or responding to the 
        disaster or emergency.
    ``(c) Selection of Centers.--(1) The Secretary shall select the 
sites for the centers on the basis of a competitive selection process. 
The Secretary may not designate a site as a location for a center under 
this section unless the Secretary makes a finding under paragraph (2) 
with respect to the proposal for the designation of such site. To the 
maximum extent practicable, the Secretary shall ensure the geographic 
dispersal of the sites throughout the United States. Any such center 
may be a consortium of efforts of more than one medical center.
    ``(2) A finding by the Secretary referred to in paragraph (1) with 
respect to a proposal for designation of a site as a location of a 
center under this section is a finding by the Secretary, upon the 
recommendations of the Under Secretary for Health and the Assistant 
Secretary with responsibility for operations, preparedness, security, 
and law enforcement functions, that the facility or facilities 
submitting the proposal have developed (or may reasonably be 
anticipated to develop) each of the following:
            ``(A) An arrangement with a qualifying medical school and a 
        qualifying school of public health (or a consortium of such 
        schools) under which physicians and other persons in the health 
        field receive education and training through the participating 
        Department medical facilities so as to provide those persons 
        with training in the detection, diagnosis, prevention, and 
        treatment of injuries, diseases, and illnesses induced by 
        exposures to chemical and biological substances, radiation, and 
        incendiary or other explosive weapons or devices.
            ``(B) An arrangement with a graduate school specializing in 
        epidemiology under which students receive education and 
        training in epidemiology through the participating Department 
        facilities so as to provide such students with training in the 
        epidemiology of contagious and infectious diseases and chemical 
        and radiation poisoning in an exposed population.
            ``(C) An arrangement under which nursing, social work, 
        counseling, or allied health personnel and students receive 
        training and education in recognizing and caring for conditions 
        associated with exposures to toxins through the participating 
        Department facilities.
            ``(D) The ability to attract scientists who have made 
        significant contributions to the development of innovative 
        approaches to the detection, diagnosis, prevention, or 
        treatment of injuries, diseases, and illnesses arising from the 
        use of chemical, biological, radiological, incendiary or other 
        explosive weapons or devices posing threats to the public 
        health and safety.
    ``(3) For purposes of paragraph (2)(A)--
            ``(A) a qualifying medical school is an accredited medical 
        school that provides education and training in toxicology and 
        environmental health hazards and with which one or more of the 
        participating Department medical centers is affiliated; and
            ``(B) a qualifying school of public health is an accredited 
        school of public health that provides education and training in 
        toxicology and environmental health hazards and with which one 
        or more of the participating Department medical centers is 
        affiliated.
    ``(d) Research Activities.--Each center shall conduct research on 
improved medical preparedness to protect the Nation from threats in the 
area of that center's expertise. Each center may seek research funds 
from public and private sources for such purpose.
    ``(e) Dissemination of Research Products.--(1) The Under Secretary 
for Health and the Assistant Secretary with responsibility for 
operations, preparedness, security, and law enforcement functions shall 
ensure that information produced by the research, education and 
training, and clinical activities of centers established under this 
section is made available, as appropriate, to health-care providers in 
the United States. Dissemination of such information shall be made 
through publications, through programs of continuing medical and 
related education provided through regional medical education centers 
under subchapter VI of chapter 74 of this title, and through other 
means. Such programs of continuing medical education shall receive 
priority in the award of funding.
    ``(2) The Secretary shall ensure that the work of the centers is 
conducted in close coordination with other Federal departments and 
agencies and that research products or other information of the centers 
shall be coordinated and shared with other Federal departments and 
agencies.
    ``(f) Coordination of Activities.--The Secretary shall take 
appropriate actions to ensure that the work of each center is carried 
out--
            ``(1) in close coordination with the Department of Defense, 
        the Department of Health and Human Services, and other 
        departments, agencies, and elements of the Government charged 
        with coordination of plans for United States homeland security; 
        and
            ``(2) after taking into consideration applicable 
        recommendations of the working group on the prevention, 
        preparedness, and response to bioterrorism and other public 
        health emergencies established under section 319F(a) of the 
        Public Health Service Act (42 U.S.C. 247d-6(a)) or any other 
        joint interagency advisory group or committee designated by the 
        President or the President's designee to coordinate Federal 
        research on weapons of mass destruction.
    ``(g) Assistance to Other Agencies.--The Secretary may provide 
assistance requested by appropriate Federal, State, and local civil and 
criminal authorities in investigations, inquiries, and data analyses as 
necessary to protect the public safety and prevent or obviate 
biological, chemical, or radiological threats.
    ``(h) Detail of Employees From Other Agencies.--Upon approval by 
the Secretary, the Director of a center may request the temporary 
assignment or detail to the center, on a nonreimbursable basis, of 
employees from other departments and agencies of the United States who 
have expertise that would further the mission of the center. Any such 
employee may be so assigned or detailed on a nonreimbursable basis 
pursuant to such a request.
    ``(i) Funding.--(1) Amounts appropriated for the activities of the 
centers under this section shall be appropriated separately from 
amounts appropriated for the Department for medical care.
    ``(2) In addition to funds appropriated for a fiscal year 
specifically for the activities of the centers pursuant to paragraph 
(1), the Under Secretary for Health shall allocate to such centers from 
other funds appropriated for that fiscal year generally for the 
Department medical care account and the Department medical and 
prosthetics research account such amounts as the Under Secretary 
determines appropriate to carry out the purposes of this section. Any 
determination by the Under Secretary under the preceding sentence shall 
be made in consultation with the Assistant Secretary with 
responsibility for operations, preparedness, security, and law 
enforcement functions.
    ``(3) There are authorized to be appropriated for the centers under 
this section $20,000,000 for each of fiscal years 2003 through 2007.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 7324 the 
following new item:

``7325. Medical emergency preparedness centers.''.
    (b) Peer Review for Designation of Centers.--(1) In order to assist 
the Secretary of Veterans Affairs and the Under Secretary of Veterans 
Affairs for Health in selecting sites for centers under section 7325 of 
title 38, United States Code, as added by subsection (a), the Under 
Secretary shall establish a peer review panel to assess the scientific 
and clinical merit of proposals that are submitted to the Secretary for 
the designation of such centers. The peer review panel shall be 
established in consultation with the Assistant Secretary of Veterans 
Affairs with responsibility for operations, preparedness, security, and 
law enforcement functions.
    (2) The peer review panel shall include experts in the fields of 
toxicological research, infectious diseases, radiology, clinical care 
of patients exposed to such hazards, and other persons as determined 
appropriate by the Secretary. Members of the panel shall serve as 
consultants to the Department of Veterans Affairs.
    (3) The panel shall review each proposal submitted to the panel by 
the officials referred to in paragraph (1) and shall submit to the 
Under Secretary for Health its views on the relative scientific and 
clinical merit of each such proposal. The panel shall specifically 
determine with respect to each such proposal whether that proposal is 
among those proposals which have met the highest competitive standards 
of scientific and clinical merit.
    (4) The panel shall not be subject to the Federal Advisory 
Committee Act (5 U.S.C. App.).

SEC. 3. EDUCATION AND TRAINING PROGRAMS ON MEDICAL RESPONSES TO 
              CONSEQUENCES OF TERRORIST ACTIVITIES.

    (a) In General.--(1) Subchapter II of chapter 73 of title 38, 
United States Code, is amended by adding after section 7325, as added 
by section 2(a)(1), the following new section:
``Sec. 7326. Education and training programs on medical response to 
              consequences of terrorist activities
    ``(a) Education Program.--The Secretary shall carry out a program 
to develop and disseminate a series of model education and training 
programs on the medical responses to the consequences of terrorist 
activities.
    ``(b) Implementing Official.--The program shall be carried out 
through the Under Secretary for Health, in consultation with the 
Assistant Secretary of Veterans Affairs with responsibility for 
operations, preparedness, security, and law enforcement functions.
    ``(c) Content of Programs.--The education and training programs 
developed under the program shall be modelled after programs 
established at the F. Edward Hebert School of Medicine of the Uniformed 
Services University of the Health Sciences and shall include, at a 
minimum, training for health care professionals in the following:
            ``(1) Recognition of chemical, biological, radiological, 
        incendiary, or other explosive agents, weapons, or devices that 
        may be used in terrorist activities.
            ``(2) Identification of the potential symptoms of exposure 
        to those agents.
            ``(3) Understanding of the potential long-term health 
        consequences, including psychological effects, resulting from 
        exposure to those agents, weapons, or devices.
            ``(4) Emergency treatment for exposure to those agents, 
        weapons, or devices.
            ``(5) An appropriate course of followup treatment, 
        supportive care, and referral.
            ``(6) Actions that can be taken while providing care for 
        exposure to those agents, weapons, or devices to protect 
        against contamination, injury, or other hazards from such 
        exposure.
            ``(7) Information on how to seek consultative support and 
        to report suspected or actual use of those agents.
    ``(d) Potential Trainees.--In designing the education and training 
programs under this section, the Secretary shall ensure that different 
programs are designed for health-care professionals in Department 
medical centers. The programs shall be designed to be disseminated to 
health professions students, graduate health and medical education 
trainees, and health practitioners in a variety of fields.
    ``(e) Consultation.--In establishing education and training 
programs under this section, the Secretary shall consult with 
appropriate representatives of accrediting, certifying, and 
coordinating organizations in the field of health professions 
education.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 7325, as added 
by section 2(a)(2), the following new item:

``7326. Education and training programs on medical response to 
                            consequences of terrorist activities.''.
    (b) Effective Date.--The Secretary of Veterans Affairs shall 
implement section 7326 of title 38, United States Code, as added by 
subsection (a), not later than the end of the 90-day period beginning 
on the date of the enactment of this Act.

SEC. 4. AUTHORITY TO FURNISH HEALTH CARE DURING MAJOR DISASTERS AND 
              MEDICAL EMERGENCIES.

    (a) In General.--(1) Subchapter VIII of chapter 17 of title 38, 
United States Code, is amended by adding at the end the following new 
section:
``Sec. 1785. Care and services during certain disasters and emergencies
    ``(a) Authority To Provide Hospital Care and Medical Services.--
During and immediately following a disaster or emergency referred to in 
subsection (b), the Secretary may furnish hospital care and medical 
services to individuals responding to, involved in, or otherwise 
affected by that disaster or emergency.
    ``(b) Covered Disasters and Emergencies.--A disaster or emergency 
referred to in this subsection is any disaster or emergency as follows:
            ``(1) A major disaster or emergency declared by the 
        President under the Robert B. Stafford Disaster Relief and 
        Emergency Assistance Act (42 U.S.C. 5121 et seq.).
            ``(2) A disaster or emergency in which the National 
        Disaster Medical System established pursuant to section 2811(b) 
        of the Public Health Service Act (42 U.S.C. 300hh-11(b)) is 
        activated by the Secretary of Health and Human Services under 
        paragraph (3)(A) of that section or as otherwise authorized by 
        law.
    ``(c) Applicability to Eligible Individuals Who Are Veterans.--The 
Secretary may furnish care and services under this section to an 
individual described in subsection (a) who is a veteran without regard 
to whether that individual is enrolled in the system of patient 
enrollment under section 1705 of this title.
    ``(d) Reimbursement From Other Federal Departments and Agencies.--
(1) The cost of any care or services furnished under this section to an 
officer or employee of a department or agency of the United States 
other than the Department or to a member of the Armed Forces shall be 
reimbursed at such rates as may be agreed upon by the Secretary and the 
head of such department or agency or the Secretary concerned, in the 
case of a member of the Armed Forces, based on the cost of the care or 
service furnished.
    ``(2) Amounts received by the Department under this subsection 
shall be credited to the Medical Care Collections Fund under section 
1729A of this title.
    ``(e) Report to Congressional Committees.--Within 60 days of the 
commencement of a disaster or emergency referred to in subsection (b) 
in which the Secretary furnishes care and services under this section 
(or as soon thereafter as is practicable), the Secretary shall submit 
to the Committees on Veterans' Affairs of the Senate and the House of 
Representatives a report on the Secretary's allocation of facilities 
and personnel in order to furnish such care and services.
    ``(f) Regulations.--The Secretary shall prescribe regulations 
governing the exercise of the authority of the Secretary under this 
section.''.
    (2) The table of sections at the beginning of that chapter is 
amended by adding at the end the following new item:

``1785. Care and services during certain disasters and emergencies.''.
    (b) Members of the Armed Forces on Active Duty.--Section 8111A(a) 
of such title is amended--
            (1) by redesignating paragraph (2) as paragraph (4);
            (2) by designating the second sentence of paragraph (1) as 
        paragraph (3); and
            (3) by inserting between paragraph (1) and paragraph (3), 
        as designated by paragraph (2) of this subsection, the 
        following new paragraph:
    ``(2)(A) During and immediately following a disaster or emergency 
referred to in subparagraph (B), the Secretary may furnish hospital 
care and medical services to members of the Armed Forces on active duty 
responding to or involved in that disaster or emergency.
    ``(B) A disaster or emergency referred to in this subparagraph is 
any disaster or emergency as follows:
            ``(i) A major disaster or emergency declared by the 
        President under the Robert B. Stafford Disaster Relief and 
        Emergency Assistance Act (42 U.S.C. 5121 et seq.).
            ``(ii) A disaster or emergency in which the National 
        Disaster Medical System established pursuant to section 2811(b) 
        of the Public Health Service Act (42 U.S.C. 300hh-11(b)) is 
        activated by the Secretary of Health and Human Services under 
        paragraph (3)(A) of that section or as otherwise authorized by 
        law.''.

SEC. 5. 10-YEAR EXTENSION OF EXPIRED AUTHORITY.

    Effective September 30, 2002, subsection (d) of section 1722A of 
title 38, United States Code, is amended by striking ``September 30, 
2002'' and inserting ``September 30, 2012''.

SEC. 6. INCREASE IN NUMBER OF ASSISTANT SECRETARIES OF VETERANS 
              AFFAIRS.

    (a) Increase.--Subsection (a) of section 308 of title 38, United 
States Code, is amended by striking ``six'' in the first sentence and 
inserting ``seven''.
    (b) Functions.--Subsection (b) of such section is amended by adding 
at the end the following new paragraph:
            ``(11) Operations, preparedness, security, and law 
        enforcement functions.''.
    (c) Number of Deputy Assistant Secretaries.--Subsection (d)(1) of 
such section is amended by striking ``18'' and inserting ``19''.
    (d) Conforming Amendment.--Section 5315 of title 5, United States 
Code, is amended by striking ``(6)'' after ``Assistant Secretaries, 
Department of Veterans Affairs'' and inserting ``(7)''.

SEC. 7. CODIFICATION OF DUTIES OF SECRETARY OF VETERANS AFFAIRS 
              RELATING TO EMERGENCY PREPAREDNESS.

    (a) In General.--(1) Subchapter I of chapter 81 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 8117. Emergency preparedness
    ``(a) Readiness of Department Medical Centers.--(1) The Secretary 
shall take appropriate actions to provide for the readiness of 
Department medical centers to protect the patients and staff of such 
centers from chemical or biological attack or otherwise to respond to 
such an attack so as to enable such centers to fulfill their 
obligations as part of the Federal response to public health 
emergencies.
    ``(2) Actions under paragraph (1) shall include--
            ``(A) the provision of decontamination equipment and 
        personal protection equipment at Department medical centers; 
        and
            ``(B) the provision of training in the use of such 
        equipment to staff of such centers.
    ``(b) Security at Department Medical and Research Facilities.--(1) 
The Secretary shall take appropriate actions to provide for the 
security of Department medical centers and research facilities, 
including staff and patients at such centers and facilities.
    ``(2) In taking actions under paragraph (1), the Secretary shall 
take into account the results of the evaluation of the security needs 
at Department medical centers and research facilities required by 
section 154(b)(1) of the Public Health Security and Bioterrorism 
Preparedness and Response Act of 2002 (Public Law 107-188; 116 Stat. 
631), including the results of such evaluation relating to the 
following needs:
            ``(A) Needs for the protection of patients and medical 
        staff during emergencies, including a chemical or biological 
        attack or other terrorist attack.
            ``(B) Needs, if any, for screening personnel engaged in 
        research relating to biological pathogens or agents, including 
        work associated with such research.
            ``(C) Needs for securing laboratories or other facilities 
        engaged in research relating to biological pathogens or agents.
    ``(c) Tracking of Pharmaceuticals and Medical Supplies and 
Equipment.--The Secretary shall develop and maintain a centralized 
system for tracking the current location and availability of 
pharmaceuticals, medical supplies, and medical equipment throughout the 
Department health care system in order to permit the ready 
identification and utilization of such pharmaceuticals, supplies, and 
equipment for a variety of purposes, including response to a chemical 
or biological attack or other terrorist attack.
    ``(d) Training.--The Secretary shall ensure that the Department 
medical centers, in consultation with the accredited medical school 
affiliates of such medical centers, develop and implement curricula to 
train resident physicians and health care personnel in medical matters 
relating to biological, chemical, or radiological attacks or attacks 
from an incendiary or other explosive weapon.
    ``(e) Participation in National Disaster Medical System.--(1) The 
Secretary shall establish and maintain a training program to facilitate 
the participation of the staff of Department medical centers, and of 
the community partners of such centers, in the National Disaster 
Medical System established pursuant to section 2811(b) of the Public 
Health Service Act (42 U.S.C. 300hh-11(b)).
    ``(2) The Secretary shall establish and maintain the training 
program under paragraph (1) in accordance with the recommendations of 
the working group on the prevention, preparedness, and response to 
bioterrorism and other public health emergencies established under 
section 319F(a) of the Public Health Service Act (42 U.S.C. 247d-6(a)).
    ``(3) The Secretary shall establish and maintain the training 
program under paragraph (1) in consultation with the following:
            ``(A) The Secretary of Defense.
            ``(B) The Secretary of Health and Human Services.
            ``(C) The Director of the Federal Emergency Management 
        Agency.
    ``(f) Mental Health Counseling.--(1) With respect to activities 
conducted by personnel serving at Department medical centers, the 
Secretary shall develop and maintain various strategies for providing 
mental health counseling and assistance, including counseling and 
assistance for post-traumatic stress disorder, following a bioterrorist 
attack or other public health emergency to the following persons:
            ``(A) Veterans.
            ``(B) Local and community emergency response providers.
            ``(C) Active duty military personnel.
            ``(D) Individuals seeking care at Department medical 
        centers.
    ``(2) The strategies under paragraph (1) shall include the 
following:
            ``(A) Training and certification of providers of mental 
        health counseling and assistance.
            ``(B) Mechanisms for coordinating the provision of mental 
        health counseling and assistance to emergency response 
        providers referred to in paragraph (1).
    ``(3) The Secretary shall develop and maintain the strategies under 
paragraph (1) in consultation with the Secretary of Health and Human 
Services, the American Red Cross, and the working group referred to in 
subsection (e)(2).''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 8116 the 
following new item:

``8117. Emergency preparedness.''.
    (b) Repeal of Codified Provisions.--Subsections (a), (b)(2), (c), 
(d), (e), and (f) of section 154 of the Public Health Security and 
Bioterrorism Preparedness and Response Act of 2002 (Public Law 107-188; 
38 U.S.C. note prec. 8101) are repealed.
    (c) Conforming Amendments.--Subsection (g) of such section is 
amended--
            (1) in paragraph (1), by inserting ``of section 8117 of 
        title 38, United States Code'' after ``subsection (a)''; and
            (2) in paragraph (2), by striking ``subsections (b) through 
        (f)'' and inserting ``subsection (b)(1) of this section and 
        subsections (b) through (f) of section 8117 of title 38, United 
        States Code''.
            Attest:

                                                                 Clerk.