[Congressional Record Volume 140, Number 36 (Friday, March 25, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: March 25, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
  UNDER SECRETARY FOR HEALTH IN THE DEPARTMENT OF VETERANS AFFAIRS ACT

  Mr. FORD. Mr. President, I ask that the Chair lay before the Senate a 
message from the House of Representatives on (S. 1534), a bill to amend 
title 38, United States Code, to repeal a requirement that the Under 
Secretary for Health in the Department of Veterans Affairs be a doctor 
of medicine.
  The PRESIDENT pro tempore laid before the Senate the following 
message from the House of Representatives:

       Resolved, That the bill from the Senate (S. 1534) entitled 
     ``An Act to amend title 38, United States Code, to repeal a 
     requirement that the Under Secretary for Health in the 
     Department of Veterans Affairs be a doctor of medicine'', do 
     pass with the following amendments:
       Strike out all after the enacting clause and insert:

     SECTION 1. MODIFICATION TO PHYSICIAN REQUIREMENT FOR CERTAIN 
                   SENIOR VETERANS HEALTH ADMINISTRATION 
                   OFFICIALS.

       (a) Under Secretary.--Section 305 of title 38, United 
     States Code, is amended--
       (1) in subsection (a)(2), by striking out ``shall be a 
     doctor of medicine and shall be'' an inserting in lieu 
     thereof ``shall (except as provided in subsection (d)(1)) be 
     a doctor of medicine. The Under Secretary shall be'';
       (2) in subsection (d)--
       (A) by adding at the end of paragraph (1) the following: 
     ``If at the time such a commission is established both the 
     position of Deputy Under Secretary for Health and the 
     position of Associate Deputy Under Secretary for Health are 
     held by individuals who are doctors of medicine, the 
     individual appointed by the President as Under Secretary for 
     Health may be someone who is not a doctor of medicine. In any 
     case, the Secretary shall develop, and shall furnish to the 
     commission, specific criteria which the commission shall use 
     in evaluating individuals for recommendations under paragraph 
     (3).'';
       (B) by redesignating paragraph (4) as paragraph (5);
       (C) by inserting after the first sentence of paragraph (3) 
     the following: ``In a case in which, pursuant to paragraph 
     (1), the individual to be appointed as Under Secretary does 
     not have to be a doctor of medicine, the commission may make 
     recommendations without regard to the requirement in 
     subsection (a)(2)(A) that the Under Secretary be appointed on 
     the basis of demonstrated ability in the medical profession, 
     but in such a case the commission shall accord a priority to 
     the selection of a doctor of medicine over an individual who 
     is not a doctor of medicine.''; and
       (D) by designating the sentence beginning ``The commission 
     shall submit'' as paragraph (4).
       (b) Deputy and Associate Deputy Under Secretary.--Section 
     7306 of such title is amended--
       (1) in subsection (a), by inserting ``(except as provided 
     in subsection (c))'' in paragraphs (1) and (2) after ``and 
     who shall'';
       (2) in subsection (c)--
       (A) by inserting ``(1)'' after ``(c)''; and
       (B) by adding at the end the following:
       ``(2) If at the time of the appointment of the Deputy Under 
     Secretary for Health under subsection (a)(1), both the 
     position of Under Secretary for Health and the position of 
     Associate Deputy Under Secretary for Health are held by 
     individuals who are doctors of medicine, the individual 
     appointed as Deputy Under Secretary for Health may be someone 
     who is not a doctor of medicine.
       ``(3) If at the time of the appointment of the Associate 
     Deputy Under Secretary for Health under subsection (a)(2), 
     both the position of Under Secretary for Health and the 
     position of Deputy Under Secretary for Health are held by 
     individuals who are doctors of medicine, the individual 
     appointed as Associate Deputy Under Secretary for Health may 
     be someone who is not a doctor of medicine.''.
       Amend the title so as to read: ``An Act to amend title 38, 
     United States Code, to allow one of the three senior citizens 
     in the Veterans Health Administration of the Department of 
     Veterans Affairs to be an individual who is not a doctor of 
     medicine.''.


                           AMENDMENT NO. 1604

                   (Purpose: To provide a substitute)

  Mr. FORD. Mr. President, I ask unanimous consent that the Senate 
concur in the amendment of the House to the bill with an amendment that 
I now send to the desk.
  The PRESIDENT pro tempore. Without objection, it is so ordered. The 
clerk will state the amendment.
  The legislative clerk read as follows:

       The Senator from Kentucky [Mr. Ford], for Mr. Rockefeller, 
     proposes an amendment numbered 1604.

  Mr. FORD. Mr. President, I ask unanimous consent that the reading of 
the amendment be dispensed with.
  The PRESIDENT pro tempore. Without objection, it is so ordered.
  The amendment is as follows:

       Strike out all after the enacting clause and insert in lieu 
     thereof the following:

     SECTION 1. MODIFICATION TO PHYSICIAN REQUIREMENT FOR CERTAIN 
                   SENIOR VETERANS HEALTH ADMINISTRATION 
                   OFFICIALS.

       (a) Under Secretary.--Section 305 of title 38, United 
     States Code, is amended--
       (1) in subsection (a)(2), by striking out ``shall be a 
     doctor of medicine and shall be'' and inserting in lieu 
     thereof ``shall (except as provided in subsection (d)(1)) be 
     a doctor of medicine. The Under Secretary shall be'';
       (2) in subsection (d)--
       (A) by adding at the end of paragraph (1) the following: 
     ``If at the time such a commission is established both the 
     position of Deputy Under Secretary for Health and the 
     position of Associate Deputy Under Secretary for Health are 
     held by individuals who are doctors of medicine, the 
     individual appointed by the President as Under Secretary for 
     health may be someone who is not a doctor of medicine. In any 
     case, the Secretary shall develop, and shall furnish to the 
     commission, specific criteria which the commission shall use 
     in evaluating individuals for recommendations under paragraph 
     (3).'';
       (B) by redesignating paragraph (4) as paragraph (5);
       (C) by inserting after the first sentence of paragraph (3) 
     the following: ``In a case in which, pursuant to paragraph 
     (1), the individual to be appointed as Under Secretary does 
     not have to be a doctor of medicine, the commission may make 
     recommendations without regard to the requirement in 
     subsection (a)(2)(A) that the Under Secretary be appointed on 
     the basis of demonstrated ability in the medical 
     profession''; and
       (D) by designating the sentence beginning ``The commission 
     shall submit'' as paragraph (4).
       (b) Deputy and Associate Deputy Under Secretary.--Section 
     7306 of such title is amended--
       (1) in subsection (a), by inserting ``(except as provided 
     in subsection (c))'' in paragraphs (1) and (2) after ``and 
     who shall'';
       (2) in subsection (c)--
       (A) by inserting ``(1)'' after ``(c)''; and
       (B) by adding at the end of the following:
       ``(2) If at the time of the appointment of the Deputy Under 
     Secretary for Health under subsection (a)(1), both the 
     position of Under Secretary for Health and the position of 
     Associate Deputy Under Secretary for Health are held by 
     individuals who are doctors of medicine, the individual 
     appointed as Deputy Under Secretary for Health may be someone 
     who is not a doctor of medicine.
       ``(3) If at the time of the appointment of the Associate 
     Deputy Under Secretary for Health under subsection (a)(2), 
     both the position of Under Secretary for Health and a 
     position of Deputy Under Secretary for Health are held by 
     individuals who are doctors of medicine, the individual 
     appointed as Associate Deputy Under Secretary for Health 
     may be someone who is not a doctor of medicine.''.

     SEC. 2. REQUIREMENT RELATING TO MEMBERS OF COMMISSION TO 
                   RECOMMENDED APPOINTEES.

       Section 305(d)(2) of title 38, United States Code, is 
     amended--
       (1) by striking out ``A commission'' and inserting in lieu 
     thereof ``(A) Subject to subparagraph (B), a commission'';
       (2) by redesignating subparagraphs (A), (B), (C), (D), (E), 
     and (F) as clauses (i), (ii), (iii), (iv), (v), and (vi), 
     respectively; and
       (3) by adding at the end the following new subparagraph 
     (B):
       ``(B) Not less than five of the members of the commission 
     shall be doctors of medicine.''.
       Amend the title so as to read: ``An Act to amend title 38, 
     United States Code, to allow one of the three senior 
     officials in the Veterans Health Administration of the 
     Department of Veterans Affairs to be an individual who is not 
     a doctor of medicine, and for other purposes.''.

  Mr. ROCKEFELLER. Mr. President, I am delighted that the Senate is 
acting on my amendment to the pending legislation, S. 1534, which 
relates to the qualifications of the Under Secretary for Health of the 
Department of Veterans Affairs.
  Under current law, section 305 of title 38, United States Code, which 
dates from 1946, the Under Secretary for Health must be a doctor of 
medicine. I originally introduced this bill, along with my good friend, 
the ranking minority member on the Committee on Veterans' Affairs, 
Senator Murkowski, last fall, and the Senate passed it on October 7, 
1993. As introduced and passed by the Senate, the legislation would 
have modified current law so as to allow the Under Secretary to be 
other than a medical doctor. I refer my colleagues and others with an 
interest in the background of this legislation to my remarks at the 
time of Senate action, which begin on page S 13253 of the Record for 
October 7, 1993.
  Mr. President, following Senate passage of this legislation, the 
House Committee on Veterans' Affairs developed--after significant 
debate and activity, including a defeat for the provision as passed by 
the Senate in a subcommittee markup--an amendment that would allow one 
of the top three positions within the Veterans Health Administration--
the Under Secretary for Health, the Deputy Under Secretary for Health, 
or the Associate Deputy Under Secretary--to be a nonphysician. The full 
House passed this amendment on November 16, 1993. The House amendment 
also would require the Secretary to develop specific criteria for the 
evaluation of candidates for the position of Under Secretary and would 
provide that, in the event a commission established under the law to 
select a new Under Secretary was considering individuals who were not 
physicians, the commission would be required to accord a priority to 
physician candidates over nonphysician candidates.
  Mr. President, the amendment that I am proposing today would further 
amend the House amendment in two ways--first, in response to concerns 
raised by some members of our Committee, it would delete the 
requirement that a commission give a priority to physician candidates, 
and second, it would provide that any such commissions established in 
the future have physicians as at least one-half of their membership. 
With reference to this second element of the membership. With reference 
to this second element of the membership of a search commission, in 
light of the qualifications that are set forth in the law for such 
membership, this would not be a difficult standard to meet.
  Mr. President, as I noted last fall, there was an immediate reason 
for making the change to the qualifications of the Under Secretary--
namely, the compelling need to find a highly qualified candidate to 
fill the currently vacant position of Under Secretary for Health. 
However, that process has gone forward in the interim, and I am hopeful 
that a decision will be made in the near future on a candidate for the 
position. Thus, this change in the law will not have any immediate 
effect. I nevertheless believe that this is an important change, and I 
urge my colleagues support for it.
  The PRESIDENT pro tempore. The question is on the adoption of the 
amendment.
  Without objection, the amendment is agreed to.
  So the amendment (No. 1604) was agreed to.
  Mr. FORD. Mr. President, I ask unanimous consent the Senate concur in 
the amendment of the House to the title.
  The PRESIDENT pro tempore. Is there objection? Without objection, it 
is so ordered.

                          ____________________