[Congressional Record Volume 141, Number 14 (Tuesday, January 24, 1995)]
[Senate]
[Pages S1472-S1473]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                         ADDITIONAL STATEMENTS

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                  NATCHEZ BLUFFS STABILIZATION--S. 255

 Mr. LOTT. Mr. President, I ask unanimous consent that S. 255 
be printed in the Congressional Record. S. 255, a bill to authorize the 
Corps of Engineers to stabilize the bluffs at Natchez, MS, was 
introduced on January 20, 1995, along with accompanying statements from 
myself and Senator Cochran. Due to an inadvertent omission at the time, 
the bill was not printed in the Record.

                                 S. 255

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

     SECTION 1. STABILIZATION OF NATCHEZ BLUFFS.

       (a) In General.--In accordance with the recommendations of 
     the reports prepared by the Army Corps of Engineers entitled 
     ``The Natchez Bluff Study'', ``The Natchez Bluff Study: 
     Supplement I'', and ``The Natchez Bluff Study: Supplement 
     II'', dated September 1985, June 1990, and December 1993, 
     respectively, the Secretary of the Army shall carry out such 
     activities as are necessary to stabilize the portions of the 
     bluffs along the Mississippi River in the vicinity of 
     Natchez, Mississippi, designated in figure 4 of the December 
     1993 report as--
       (1) Clifton Avenue, area 3;
       (2) the bluff above Natchez Under-the-Hill, area 7;
       (3) the bluff above Silver Street, area 6; and
       (4) Madison Street to State Street, area 4.
       (b) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Department of the Army such sums as 
     are necessary to carry out this section.
                  VETERANS' HEALTH ADMINISTRATION ACT

 Mr. INOUYE. Mr. President, I am introducing legislation today 
to amend chapter 74 of title 38, United States Code, to revise certain 
provisions relating to the appointment of clinical and counseling 
psychologists in the Veterans Health Administration [VHA].
  The VHA has a long history of maintaining a staff of the very best 
health care professionals to provide care to those men and women who 
have served their country in the Armed Forces. It is certainly fitting 
that this should be done.
  Recently a quite distressing situation regarding the care of our 
veterans has come to my attention. In particular, the recruitment and 
retention of psychologists in the VHA of the Department of Veterans 
Affairs has become a significant problem.
  The Congress has recognized the important contribution of the 
behavioral sciences in the treatment of several conditions from which a 
significant portion of our veterans suffer. For example, programs 
related to homelessness, substance abuse, and post traumatic stress 
disorder [PTSD] have received funding from the Congress in recent 
years.
  Certainly, psychologists, as behavioral science experts, are 
essential to the successful implementation of these programs. However, 
the high vacancy and turnover rates for psychologists in the VHA--over 
11 and 18 percent, respectively, as reported in one recent survey--
might seriously jeopardize these programs and will negatively impact 
overall patient care in the VHA.
  Recruitment of psychologists by the VHA is hindered by a number of 
factors including a pay scale not commensurate with private sector 
rates of pay as well as by the low number of clinical and counseling 
psychologists appearing on the register of the Office of Personnel 
Management [OPM]. Most new hires have no postdoctoral experience and 
are hired immediately after a VA internship. Recruitment, when 
successful, takes up to 6 months or more.
  Retention of psychologists in the VA system poses an even more 
significant problem. I have been informed that almost 40 percent of VHA 
psychologists had 5 years or less of postdoctoral experience. Without 
doubt, our veterans would benefit from a higher percentage of senior 
staff who are more experienced in working with veterans and their 
particular concerns. My bill provides
 incentives for psychologists to continue their work with the VHA and 
seek additional education and training.

  Several factors are associated with the difficulties in retention of 
VHA psychologists including low salaries and lack of career advancement 
opportunities. It seems that psychologists are apt to leave the VA 
system after 5 years because they have almost reached peak levels for 
salary and professional development in the VHA. Furthermore, under the 
present system 
[[Page S1473]] psychologists cannot be recognized nor appropriately 
compensated for excellence or for taking on additional responsibilities 
such as running treatment programs.
  In effect, the current system for hiring psychologists in the VHA 
supports mediocrity, not excellence and mastery. Our veterans with 
behavioral disorders and mental health problems are deserving of better 
psychological care from more experienced professionals than they are 
currently receiving.
  A hybrid title 38 appointment authority for psychologists would help 
ameliorate the recruitment and retention problems in several ways. The 
length of time it takes to recruit psychologists could be abbreviated 
by eliminating the requirement for applicants to be rated by the Office 
of Personnel Management. This would also facilitate the recruitment of 
applicants who are not recent VA interns by reducing the amount of time 
between identifying a desirable applicant and being able to offer that 
applicant a position.
  It is expected that problems in retention of behavioral science 
experts will be greatly alleviated with the implementation of a hybrid 
title 38 system for VA psychologists, primarily through offering 
financial incentives for psychologists to pursue professional 
development with the VHA. Achievements that would merit salary 
increases under title 38 should include such activities as assuming 
supervisory responsibilities for clinical programs, implementing 
innovative clinical treatments that improve the effectiveness and/or 
efficiency of patient care, making significant contributions to the 
science of psychology, earning the ABPP diplomate status, and becoming 
a fellow of the American Psychological Association.
  Currently, psychologists are the only doctoral level health care 
providers in the VHA who are not included in title 38. This is, without 
question, a significant factor in the recruitment and retention 
difficulties that I have addressed. Ultimately, an across-the-board 
salary increase might be necessary. However, the conversion of 
psychologists to a hybrid title 38, as proposed by this amendment, 
would provide relief for these difficulties and enhance the quality of 
care for our Nations' veterans and their families.
  Mr. President, I ask unanimous consent that the text of this bill be 
printed in the Congressional Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 82

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

     SECTION 1. REVISION OF AUTHORITY RELATING TO THE APPOINTMENT 
                   OF CLINICAL AND COUNSELING PSYCHOLOGISTS IN THE 
                   VETERANS HEALTH ADMINISTRATION.

       (a) In General.--Section 7401(3) of title 38, United States 
     Code, is amended by striking out ``who hold diplomas as 
     diplomates in psychology from an accrediting authority 
     approved by the Secretary''.
       (b) Certain Other Appointments.--Section 7405(a) of such 
     title is amended--
       (1) in paragraph (1)(B), by striking out ``Certified or'' 
     and inserting in lieu thereof ``Clinical or counseling 
     psychologists, certified or''; and
       (2) in paragraph (2)(B), by striking out ``Certified or'' 
     and inserting in lieu thereof ``Clinical or counseling 
     psychologists, certified or''.
       (c) Effective Date.--The amendments made by subsections (a) 
     and (b) shall take effect on the date of the enactment of 
     this Act.
       (d) Appointment Requirement.--Notwithstanding any other 
     provision of law, the Secretary of Veterans Affairs shall 
     begin to make appointments of clinical and counseling 
     psychologists in the Veterans Health Administration under 
     section 7401(3) of title 38, United States Code (as amended 
     by subsection (a)), not later than 1 year after the date of 
     the enactment of this Act.
     

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