[Congressional Record Volume 140, Number 145 (Friday, October 7, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: October 7, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
 VETERANS BENEFITS AND SERVICES AMENDMENTS OF 1994--MESSAGES FROM THE 
                                 HOUSE

  Mr. FEINGOLD. Mr. President, I ask that the Chair lay before the 
Senate a message from the House of Representatives on a bill (H.R. 
3313) to amend title 38, United States Code, to improve health care 
services of the Department of Veterans Affairs relating to women 
veterans, to extend and expand authority for the Secretary of Veterans 
Affairs to provide priority health care to veterans who were exposed to 
ionizing radiation or to Agent Orange, to expand the scope of services 
that may be provided to veterans through Vet Centers, and for other 
purposes.
  The PRESIDING OFFICER laid before the Senate the following message 
from the House of Representatives:

       Resolved, That the House agree to the amendments of the 
     Senate to the bill (H.R. 3313) entitled ``An Act to amend 
     title 38, United States Code, to improve health care services 
     of the Department of Veterans Affairs relating to women 
     veterans, to extend and expand authority for the Secretary of 
     Veterans Affairs to provide priority health care to veterans 
     who were exposed to ionizing radiation or to Agent Orange, to 
     expand the scope of services that may be provided to veterans 
     through Vet Centers, and for other purposes'', with the 
     following amendments:
       In lieu of the matter proposed to be inserted by said 
     amendment to the text, insert:

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Veterans 
     Health Programs Extension Act of 1994''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.

                  TITLE I--GENERAL MEDICAL AUTHORITIES

Sec. 101. Sexual trauma counseling and services.
Sec. 102. Research relating to women veterans.
Sec. 103. Extension of expiring authorities.
Sec. 104. Facilities in Republic of the Philippines.
Sec. 105. Savings provision.

                  TITLE II--CONSTRUCTION AUTHORIZATION

Sec. 201. Authorization of major medical facility projects and major 
              medical facility leases.
Sec. 202. Authorization of appropriations.

     SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

       Except as otherwise expressly provided, whenever in this 
     Act an amendment or repeal is expressed in terms of an 
     amendment to, or repeal of, a section or other provision, the 
     reference shall be considered to be made to a section or 
     other provision of title 38, United States Code.
                  TITLE I--GENERAL MEDICAL AUTHORITIES

     SEC. 101. SEXUAL TRAUMA COUNSELING AND SERVICES.

       (a) Authority To Provide Treatment Services for Sexual 
     Trauma; Repeal of Limitation on Time To Seek Services.--
     Subsection (a) of section 1720D is amended--
       (1) by striking out paragraph (2); and
       (2) by inserting after paragraph (1) the following new 
     paragraph (2):
       ``(2) During the period referred to in paragraph (1), the 
     Secretary may provide appropriate care and services to a 
     veteran for an injury, illness, or other psychological 
     condition that the Secretary determines to be the result of a 
     physical assault, battery, or harassment referred to in that 
     paragraph.''.
       (b) Extension of Period of Authority To Provide Sexual 
     Trauma Services.--Such subsection is further amended--
       (1) in paragraph (1), by striking out ``December 31, 
     1995,'' and inserting in lieu thereof ``December 31, 1998,''; 
     and
       (2) in paragraph (3), by striking out ``December 31, 
     1994,'' and inserting in lieu thereof ``December 31, 1998,''.
       (c) Repeal of Limitation on Period of Receipt of 
     Services.--Such section is further amended--
       (1) by striking out subsection (b); and
       (2) by redesignating subsections (c), (d), and (e) as 
     subsections (b), (c), and (d), respectively.
       (d) Coordination of Care.--Paragraph (1) of subsection (b) 
     of such section, as redesignated by subsection (c)(2), is 
     amended to read as follows:
       ``(1) The Secretary shall give priority to the 
     establishment and operation of the program to provide 
     counseling and care and services under subsection (a). In the 
     case of a veteran eligible for counseling and care and 
     services under subsection (a), the Secretary shall ensure 
     that the veteran is furnished counseling and care and 
     services under this section in a way that is coordinated with 
     the furnishing of such care and services under this 
     chapter.''.
       (e) Increased Priority of Care.--Section 1712(i) is 
     amended--
       (1) in paragraph (1)--
       (A) by inserting ``(A)'' after ``To a veteran''; and
       (B) by inserting ``, or (B) who is eligible for counseling 
     and care and services under section 1720D of this title, for 
     the purposes of such counseling and care and services'' 
     before the period at the end; and
       (2) in paragraph (2)--
       (A) by striking out ``, (B)'' and inserting in lieu thereof 
     ``or (B)''; and
       (B) by striking out ``, or (C)'' and all that follows 
     through ``such counseling''.
       (f) Program Revision.--(1) Section 1720D is further 
     amended--
       (A) by striking out ``woman'' in subsection (a)(1);
       (B) by striking out ``women'' in subsection (b)(2)(C) and 
     in the first sentence of subsection (c), as redesignated by 
     subsection (c); and
       (C) by striking out ``women'' in subsection (c)(2), as so 
     redesignated, and inserting in lieu thereof ``individuals''.
       (2)(A) The heading of such section is amended to read as 
     follows:

     ``Sec. 1720D. Counseling and treatment for sexual trauma''.

       (B) The item relating to such section in the table of 
     sections at the beginning of chapter 17 is amended to read as 
     follows:

``1720D. Counseling and treatment for sexual trauma.''.
       (g) Information by Telephone.--(1) Paragraph (1) of section 
     1720D(c), as redesignated by subsection (c) of this section, 
     is amended to read as follows:
       ``(1) shall include availability of a toll-free telephone 
     number (commonly referred to as an 800 number); and''.
       (2) In providing information on counseling available to 
     veterans as required under section 1720D(c)(1) of title 38, 
     United States Code (as amended by paragraph (1)), the 
     Secretary of Veterans Affairs shall ensure that the 
     Department of Veterans Affairs personnel who provide 
     assistance under such section are trained in the provision to 
     persons who have experienced sexual trauma of information 
     about the care and services relating to sexual trauma that 
     are available to veterans in the communities in which such 
     veterans reside, including care and services available under 
     programs of the Department (including the care and services 
     available under section 1720D of such title) and from non-
     Department agencies or organizations.
       (3) The telephone assistance service shall be operated in a 
     manner that protects the confidentiality of persons who place 
     calls to the system.
       (4) The Secretary shall ensure that information about the 
     availability of the telephone assistance service is visibly 
     posted in Department medical facilities and is advertised 
     through public service announcements, pamphlets, and other 
     means.
       (5) Not later than 18 months after the date of the 
     enactment of this Act, the Secretary shall submit to Congress 
     a report on the operation of the telephone assistance service 
     required under section 1720D(c)(1) of title 38, United States 
     Code (as amended by paragraph (1)). The report shall set 
     forth the following:
       (A) The number of persons who sought information during the 
     period covered by the report through a toll free telephone 
     number regarding services available to veterans relating to 
     sexual trauma, with a separate display of the number of such 
     persons arrayed by State (as such term is defined in section 
     101(20) of title 38, United States Code).
       (B) A description of the training provided to the personnel 
     who provide such assistance.
       (C) The recommendations and plans of the Secretary for the 
     improvement of the service.
       (h) Conforming Repeal.--Section 102(b) of the Veterans 
     Health Care Act of 1992 (Public Law 102-585; 106 Stat. 4946; 
     38 U.S.C. 1720D note) is repealed.

     SEC. 102. RESEARCH RELATING TO WOMEN VETERANS.

       (a) Inclusion of Women and Minorities in Clinical Research 
     Projects.--Section 7303 is amended--
       (1) by transferring the text of subsection (c) to the end 
     of subsection (a)(1); and
       (2) by striking out ``(c)'' and inserting in lieu thereof 
     the following:
       ``(c)(1) In conducting or supporting clinical research, the 
     Secretary shall ensure that, whenever possible and 
     appropriate--
       ``(A) women who are veterans are included as subjects in 
     each project of such research; and
       ``(B) members of minority groups who are veterans are 
     included as subjects of such research.
       ``(2) In the case of a project of clinical research in 
     which women or members of minority groups will under 
     paragraph (1) be included as subjects of the research, the 
     Secretary shall ensure that the project is designed and 
     carried out so as to provide for a valid analysis of whether 
     the variables being tested in the research affect women or 
     members of minority groups, as the case may be, differently 
     than other persons who are subjects of the research.''.
       (b) Health Research.--(1) Such section is further amended 
     by adding after subsection (c), as added by subsection (a), 
     the following new subsection:
       ``(d)(1) The Secretary, in carrying out the Secretary's 
     responsibilities under this section, shall foster and 
     encourage the initiation and expansion of research relating 
     to the health of veterans who are women.
       ``(2) In carrying out this subsection, the Secretary shall 
     consult with the following to assist the Secretary in setting 
     research priorities:
       ``(A) Officials of the Department assigned responsibility 
     for women's health programs and sexual trauma services.
       ``(B) The members of the Advisory Committee on Women 
     Veterans.
       ``(C) Members of appropriate task forces and working groups 
     within the Department (including the Women Veterans Working 
     Group and the Task Force on Treatment of Women Who Suffer 
     Sexual Abuse).''.
       (2) Section 109 of the Veterans Health Care Act of 1992 
     (Public Law 102-585; 38 U.S.C. 7303 note) is repealed.
       (c) Population Study.--Section 110(a) of the Veterans 
     Health Care Act of 1992 (Public Law 102-585; 106 Stat. 4948) 
     is amended by adding at the end of paragraph (3) the 
     following: ``If it is feasible to do so within the amounts 
     available for the conduct of the study, the Secretary shall 
     ensure that the sample referred to in paragraph (1) 
     constitutes 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.''.

     SEC. 103. EXTENSION OF EXPIRING AUTHORITIES.

       (a) Authority To Provide Priority Health Care for Veterans 
     Exposed to Toxic Substances.--Chapter 17 is amended--
       (1) in section 1710(e)(3)--
       (A) by striking out ``June 30, 1994'' and inserting in lieu 
     thereof ``June 30, 1995''; and
       (B) by striking out ``December 31, 1994'' and inserting in 
     lieu thereof ``December 31, 1995''; and
       (2) in section 1712(a)(1)(D), by striking out ``December 
     31, 1994'' and inserting in lieu thereof ``December 31, 
     1995''.
       (b) Drug and Alcohol Abuse and Dependence.--Section 
     1720A(e) is amended by striking out ``December 31, 1994'' and 
     inserting in lieu thereof ``December 31, 1995''.
       (c) Pilot Program for Noninstitutional Alternatives to 
     Nursing Home Care.--(1) Effective as of October 1, 1994, 
     subsection (a) of section 1720C is amended by striking out 
     ``During the four-year period beginning on October 1, 1990,'' 
     and inserting in lieu thereof ``During the period through 
     September 30, 1995,''.
       (2) Such subsection is further amended by striking out 
     ``care and who--'' and inserting in lieu thereof ``care. The 
     Secretary shall give priority for participation in such 
     program to veterans who--''.
       (d) Enhanced-Use Leases of Real Property.--Section 8169 is 
     amended by striking out ``December 31, 1994'' and inserting 
     in lieu thereof ``December 31, 1995''.
       (e) Authority for Community-based Residential Care for 
     Homeless Chronically Mentally Ill Veterans and Other 
     Veterans.--Section 115(d) of the Veterans' Benefits and 
     Services Act of 1988 (38 U.S.C. 1712 note) is amended by 
     striking out ``September 30, 1994'' and inserting in lieu 
     thereof ``September 30, 1995''.
       (f) Demonstration Program of Compensated Work Therapy.--
     Sction 7(a) of Public Law 102-54 (105 Stat. 269; 38 U.S.C. 
     1718 note) is amended by striking out ``1994'' and inserting 
     in lieu thereof ``1995''.
       (g) Report Deadlines.--Section 201(b) of the Department of 
     Veterans Affairs Nurse Pay Act of 1990 (Public Law 101-366; 
     38 U.S.C. 1720C note) is amended by striking out ``February 
     1, 1994,'' and inserting in lieu thereof ``February 1, 
     1995,''.

     SEC. 104. FACILITIES IN REPUBLIC OF THE PHILIPPINES.

       Notwithstanding section 1724 of title 38, United States 
     Code, the Secretary of Veterans Affairs may contract with 
     facilities in the Republic of the Philippines other than the 
     Veterans Memorial Medical Center to furnish, during the 
     period from February 28, 1994, through June 1, 1994, hospital 
     care and medical services to veterans for nonservice-
     connected disabilities if such veterans are unable to defray 
     the expenses of necessary hospital care. When the Secretary 
     determines it to be most feasible, the Secretary may provide 
     medical services under the preceding sentence to such 
     veterans at the Department of Veterans Affairs Outpatient 
     Clinic at Manila, Republic of the Philippines.

     SEC. 105. RATIFICATION OF ACTIONS DURING PERIOD OF LAPSED 
                   AUTHORITY.

       Any action of the Secretary of Veterans Affairs under 
     section 1710(e) of title 38, United States Code, during the 
     period beginning on July 1, 1994, and ending on the date of 
     the enactment of this Act is hereby ratified.
                  TITLE II--CONSTRUCTION AUTHORIZATION

     SEC. 201. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS 
                   AND MAJOR MEDICAL FACILITY LEASES.

       (a) Projects Authorized.--The Secretary of Veterans Affairs 
     may carry out the major medical facility projects for the 
     Department of Veterans Affairs, and may carry out the major 
     medical facility leases for that Department, for which funds 
     are requested in the budget of the President for fiscal year 
     1995. The authorization in the preceding sentence applies to 
     projects and leases which have not been authorized, or for 
     which funds have not been appropriated, in any fiscal year 
     before fiscal year 1995 and to projects and leases which have 
     been authorized, or for which funds were appropriated, in 
     fiscal years before fiscal year 1995.
       (b) Additional Projects.--(1) In addition to the projects 
     authorized in subsection (a), the Secretary may carry out the 
     following major medical facility projects in the amounts 
     specified for such projects:
       (A) The projects that are proposed in the documents 
     submitted to Congress by the Secretary of Veterans Affairs in 
     conjunction with the budget of the President for fiscal year 
     1995 to be financed with funds from the proposed Health Care 
     Investment Fund.
       (B) Construction of a nursing home facility at the 
     Department of Veterans Affairs Medical Center in Charleston, 
     South Carolina, in the amount of $7,300,000.
       (C) Construction of an outpatient care addition at the 
     Department of Veterans Affairs medical center in Phoenix, 
     Arizona, in the amount of $50,000,000.
       (D) A lease/purchase of a nursing home facility near Fort 
     Myers, Florida, in the amount of $12,800,000.
       (2) The authorizations in paragraph (1) apply to projects 
     which have not been authorized, or for which funds have not 
     been appropriated, in any fiscal year before fiscal year 1995 
     and to projects which have been authorized, or for which 
     funds were appropriated, in fiscal years before fiscal year 
     1995.
       (c) Projects for Which Funds Appropriated.--In addition to 
     the projects authorized in subsections (a) and (b), the 
     Secretary may carry out the following major medical facility 
     projects for which funds were appropriated in chapter 7 of 
     the Emergency Supplemental Appropriations Act of 1994 (title 
     I of Public Law 103-211; 108 Stat. 10) in the amounts 
     specified:
       (1) Construction of an ambulatory care/support services 
     facility at the Department of Veterans Affairs Medical Center 
     in Sepulveda, California, $53,700,000.
       (2) Other major medical facility projects required to 
     repair, restore, or replace earthquake-damaged facilities at 
     the Department of Veterans Affairs Medical Center in 
     Sepulveda, California, $50,000,000.

     SEC. 202. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There are authorized to be appropriated to 
     the Secretary of Veterans Affairs for fiscal year 1995--
       (1) $379,370,000 for the major medical facility projects 
     authorized in subsections (a), (b), and (c) of section 201; 
     and
       (2) $15,800,000 for the major medical facility leases 
     authorized in section 201(a).
       (b) Limitation.--The projects authorized in subsections (a) 
     and (b) of section 201 may only be carried out using--
       (1) funds appropriated for fiscal year 1995 pursuant to the 
     authorization of appropriations in subsection (a);
       (2) funds appropriated for Construction, Major Projects for 
     a fiscal year before fiscal year 1995 that remain available 
     for obligation; and
       (3) funds appropriated for Construction, Major Projects for 
     fiscal year 1995 for a category of activity not specific to a 
     project.
       (c) Limitation on Certain Projects.--The projects 
     authorized in subsection (c) of section 201 may only be 
     carried out using--
       (1) funds appropriated to the Construction, Major Projects 
     account under chapter 7 of the Emergency Supplemental 
     Appropriations Act of 1994 (title I of Public Law 103-211; 
     108 Stat. 10) and funds transferred by the President to the 
     Construction, Major Projects account pursuant to chapter 8 of 
     that Act (108 Stat. 14);
       (2) funds appropriated to the Medical Care account by 
     chapter 7 of the Emergency Supplemental Appropriations Act of 
     1994 that are transferred to the Construction, Major Projects 
     account;
       (3) funds appropriated to the Construction, Major Projects 
     account for a fiscal year before fiscal year 1995 that remain 
     available for obligation; and
       (4) funds appropriated to the Construction, Major Projects 
     account for fiscal year 1995 for a category of activity not 
     specific to a project.
       Amend the amendment of the title so as to read: ``An Act to 
     amend title 38, United States Code, to extend certain 
     expiring veterans' health care programs, and for other 
     purposes.''.

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