[Congressional Record Volume 142, Number 104 (Tuesday, July 16, 1996)]
[House]
[Pages H7546-H7552]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         EXTENDING BENEFITS TO VETERANS EXPOSED TO AGENT ORANGE

  Mr. STUMP. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 3643) to amend title 38, United States Code, to extend through 
December 31, 1998, the period during which the Secretary of Veterans 
Affairs is authorized to provide priority health care to certain 
veterans who were exposed to agent orange or who served in the Persian 
Gulf war and to make such authority permanent in the case of certain 
veterans exposed to ionizing radiation, and for other purposes, as 
amended.
  The Clerk read as follows:

                               H.R. 3643

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

     SECTION 1. AUTHORITY TO PROVIDE PRIORITY HEALTH CARE.

       (a) Authorized Inpatient Care.--Section 1710(e) of title 
     38, United States Code, is amended--
       (1) in paragraph (1), by striking out subparagraphs (A) and 
     (B) and inserting in lieu thereof the following:
       ``(e)(1)(A) A herbicide-exposed veteran is eligible for 
     hospital care and nursing home care under subsection 
     (a)(1)(G) for any disease suffered by the veteran that is--
       ``(i) among those diseases for which the National Academy 
     of Sciences, in a report issued in accordance with section 2 
     of the Agent Orange Act of 1991, has determined--
       ``(I) that there is sufficient evidence to conclude that 
     there is a positive association between occurrence of the 
     disease in humans and exposure to a herbicide agent;
       ``(II) that there is evidence which is suggestive of an 
     association between occurrence of the disease in humans and 
     exposure to a herbicide agent, but such evidence is limited 
     in nature; or
       ``(III) that available studies are insufficient to permit a 
     conclusion about the presence or absence of an association 
     between occurrence of the disease in humans and exposure to a 
     herbicide agent; or
       ``(ii) a disease for which the Secretary, pursuant to a 
     recommendation of the Under Secretary for Health on the basis 
     of a peer-reviewed research study or studies published within 
     20 months after the most recent report of the National 
     Academy under section 2 of the Agent Orange Act of 1991, 
     determines there is credible evidence suggestive of an 
     association between occurrence of the disease in humans and 
     exposure to a herbicide agent.
       ``(B) A radiation-exposed veteran is eligible for hospital 
     care and nursing home care under subsection (a)(1)(G) for any 
     disease suffered by the veteran that is--
       ``(i) a disease listed in section 1112(c)(2) of this title; 
     or
       ``(ii) any other disease for which the Secretary, based on 
     the advice of the Advisory Committee on Environmental 
     Hazards, determines that there is credible evidence of a 
     positive association between occurrence of the disease in 
     humans and exposure to ionizing radiation.'';
       (2) in paragraph (2)--
       (A) by striking out ``Hospital'' and inserting in lieu 
     thereof ``In the case of a veteran described in paragraph 
     (1)(C), hospital''; and
       (B) by striking out ``subparagraph'' and all that follows 
     through ``subsection'' and inserting in lieu thereof 
     ``paragraph (1)(C)'';
       (3) in paragraph (3), by striking out ``of this section 
     after December 31, 1996'' and inserting in lieu thereof 
     ``after December 31, 1998, in the case of care for a veteran 
     described in paragraph (1)(A) or paragraph (1)(C)''; and
       (4) by adding at the end the following new paragraph:
       ``(4) For purposes of this subsection and section 1712 of 
     this title:
       ``(A) The term `herbicide-exposed veteran' means a veteran 
     (i) who served on active duty in the Republic of Vietnam 
     during the Vietnam era, and (ii) who the Secretary finds may 
     have been exposed during such service to a herbicide agent.

[[Page H7547]]

       ``(B) The term `herbicide agent' has the meaning given that 
     term in section 1116(a)(4) of this title.
       ``(C) The term `radiation-exposed veteran' has the meaning 
     given that term in section 1112(c)(4) of this title.''.
       (b) Authorized Outpatient Care.--Section 1712 of such title 
     is amended--
       (1) in subsection (a)(1)--
       (A) by striking out ``and'' at the end of subparagraph (C);
       (B) in subparagraph (D)--
       (i) by striking out ``before December 31, 1996,'' and 
     inserting in lieu thereof ``before January 1, 1999,''; and
       (ii) by striking out the period at the end of subparagraph 
     (D) and inserting in lieu thereof a semicolon;
       (C) by adding at the end the following new subparagraphs:
       ``(E) during the period before January 1, 1999, to any 
     herbicide-exposed veteran (as defined in section 
     1710(e)(4)(A) of this title) for any disease specified in 
     section 1710(e)(1)(A) of this title; and
       ``(F) to any radiation-exposed veteran (as defined in 
     section 1112(c)(4) of this title) for any disease covered 
     under section 1710(e)(1)(B) of this title.''; and
       (2) in subsection (i)(3)--
       (A) by striking out ``(A)''; and
       (B) by striking out ``, or (B)'' and all that follows 
     through ``title''.
       (c) Savings Provisions.--The provisions of sections 1710(e) 
     and 1712(a) of title 38, United States Code, as in effect on 
     the day before the date of the enactment of this Act, shall 
     continue to apply on and after such date with respect to the 
     furnishing of hospital care, nursing home care, and medical 
     services for any veteran who was furnished such care or 
     services before such date of enactment on the basis of 
     presumed exposure to a substance or radiation under the 
     authority of those provisions, but only for treatment for a 
     disability for which such care or services were furnished 
     before such date.
       (d) Priority Health Care for Service in Israel or Turkey 
     During Persian Gulf War.--(1) Section 1710(e)(1)(C) of title 
     38, United States Code, is amended by inserting after 
     ``Southwest Asia theater of operations'' the following: ``, 
     or who may have been exposed while serving on active duty in 
     Israel or Turkey during the period beginning on August 2, 
     1990, and ending on July 31, 1991,''.
       (2) Section 1712(a)(1)(D) of such title is amended by 
     inserting after ``during the Persian Gulf War'' the 
     following: ``, or who served on active duty in Israel or 
     Turkey during the period beginning on August 2, 1990, and 
     ending on July 31, 1991,''.

     SEC. 2. DEPARTMENT COMMITTEE ON CARE OF SEVERELY CHRONICALLY 
                   MENTALLY ILL VETERANS.

       (a) Establishment.--Subchapter II of chapter 73 of title 
     38, United States Code, is amended by adding after section 
     7318 the following new section:

     ``Sec. 7319. Committee on Care of Severely Chronically 
       Mentally Ill Veterans

       ``(a) Establishment.--The Secretary, acting through the 
     Under Secretary for Health, shall establish in the Veterans 
     Health Administration a Committee on Care of Severely 
     Chronically Mentally Ill Veterans. The Under Secretary shall 
     appoint employees of the Department with expertise in the 
     care of the chronically mentally ill to serve on the 
     committee.
       ``(b) Duties.--The committee shall assess, and carry out a 
     continuing assessment of, the capability of the Veterans 
     Health Administration to meet effectively the treatment and 
     rehabilitation needs of mentally ill veterans whose mental 
     illness is severe and chronic and who are eligible for health 
     care furnished by the Department, including the needs of such 
     veterans who are women. In carrying out that responsibility, 
     the committee shall--
       ``(1) evaluate the care provided to such veterans through 
     the Veterans Health Administration;
       ``(2) identify systemwide problems in caring for such 
     veterans in facilities of the Veterans Health Administration;
       ``(3) identify specific facilities within the Veterans 
     Health Administration at which program enrichment is needed 
     to improve treatment and rehabilitation of such veterans; and
       ``(4) identify model programs which the committee considers 
     to have been successful in the treatment and rehabilitation 
     of such veterans and which should be implemented more widely 
     in or through facilities of the Veterans Health 
     Administration.
       ``(c) Advice and Recommendations.--The committee shall--
       ``(1) advise the Under Secretary regarding the development 
     of policies for the care and rehabilitation of severely 
     chronically mentally ill veterans; and
       ``(2) make recommendations to the Under Secretary--
       ``(A) for improving programs of care of such veterans at 
     specific facilities and throughout the Veterans Health 
     Administration;
       ``(B) for establishing special programs of education and 
     training relevant to the care of such veterans for employees 
     of the Veterans Health Administration;
       ``(C) regarding research needs and priorities relevant to 
     the care of such veterans; and
       ``(D) regarding the appropriate allocation of resources for 
     all such activities.
       ``(d) Annual Report.--(1) Not later than April 1, 1997, the 
     Secretary shall submit to the Committees on Veterans' Affairs 
     of the Senate and House of Representatives a report on the 
     implementation of this section. The report shall include the 
     following:
       ``(A) A list of the members of the committee.
       ``(B) The assessment of the Under Secretary for Health, 
     after review of the initial findings of the committee, 
     regarding the capability of the Veterans Health 
     Administration, on a systemwide and facility-by-facility 
     basis, to meet effectively the treatment and rehabilitation 
     needs of severely chronically mentally ill veterans who are 
     eligible for Department care.
       ``(C) The plans of the committee for further assessments.
       ``(D) The findings and recommendations made by the 
     committee to the Under Secretary for Health and the views of 
     the Under Secretary on such findings and recommendations.
       ``(E) A description of the steps taken, plans made (and a 
     timetable for their execution), and resources to be applied 
     toward improving the capability of the Veterans Health 
     Administration to meet effectively the treatment and 
     rehabilitation needs of severely chronically mentally ill 
     veterans who are eligible for Department care.
       ``(2) Not later than February 1, 1998, and February 1 of 
     each of the three following years, the Secretary shall submit 
     to the Committees on Veterans' Affairs of the Senate and 
     House of Representatives a report containing information 
     updating the reports submitted under this subsection before 
     the submission of such report.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 73 is amended by inserting after the 
     item relating to section 7318 the following new item:

``7319. Committee on Care of Severely Chronically Mentally Ill 
              Veterans.''.

     SEC. 3. CENTERS FOR MENTAL ILLNESS RESEARCH, EDUCATION, AND 
                   CLINICAL ACTIVITIES.

       (a) In General.--(1) Subchapter II of chapter 73 is amended 
     by adding after section 7319, as added by section 2(a), the 
     following new section:

     ``Sec. 7320. Centers for mental illness research, education, 
       and clinical activities

       ``(a) The purpose of this section is to provide for the 
     improvement of the provision of health-care services and 
     related counseling services to eligible veterans suffering 
     from mental illness (especially mental illness related to 
     service-related conditions) through--
       ``(1) the conduct of research (including research on 
     improving mental health service facilities of the Department 
     and on improving the delivery of mental health services by 
     the Department);
       ``(2) the education and training of health care personnel 
     of the Department; and
       ``(3) the development of improved models and systems for 
     the furnishing of mental health services by the Department.
       ``(b)(1) The Secretary shall establish and operate centers 
     for mental illness research, education, and clinical 
     activities. Such centers shall be established and operated by 
     collaborating Department facilities as provided in subsection 
     (c)(1). Each such center shall function as a center for--
       ``(A) research on mental health services;
       ``(B) the use by the Department of specific models for 
     furnishing services to treat serious mental illness;
       ``(C) education and training of health-care professionals 
     of the Department; and
       ``(D) the development and implementation of innovative 
     clinical activities and systems of care with respect to the 
     delivery of such services by the Department.
       ``(2) The Secretary shall, upon the recommendation of the 
     Under Secretary for Health, designate the centers under this 
     section. In making such designations, the Secretary shall 
     ensure that the centers designated are located in various 
     geographic regions of the United States. The Secretary may 
     designate a center under this section only if--
       ``(A) the proposal submitted for the designation of the 
     center meets the requirements of subsection (c);
       ``(B) the Secretary makes the finding described in 
     subsection (d); and
       ``(C) the peer review panel established under subsection 
     (e) makes the determination specified in subsection (e)(3) 
     with respect to that proposal.
       ``(3) Not more than five centers may be designated under 
     this section.
       ``(4) The authority of the Secretary to establish and 
     operate centers under this section is subject to the 
     appropriation of funds for that purpose.
       ``(c) A proposal submitted for the designation of a center 
     under this section shall--
       ``(1) provide for close collaboration in the establishment 
     and operation of the center, and for the provision of care 
     and the conduct of research and education at the center, by a 
     Department facility or facilities in the same geographic area 
     which have a mission centered on care of the mentally ill and 
     a Department facility in that area which has a mission of 
     providing tertiary medical care;
       ``(2) provide that no less than 50 percent of the funds 
     appropriated for the center for support of clinical care, 
     research, and education will be provided to the collaborating 
     facility or facilities that have a mission centered on care 
     of the mentally ill; and
       ``(3) provide for a governance arrangement between the 
     collaborating Department facilities which ensures that the 
     center will be established and operated in a manner aimed at

[[Page H7548]]

     improving the quality of mental health care at the 
     collaborating facility or facilities which have a mission 
     centered on care of the mentally ill.
       ``(d) The finding referred to in subsection (b)(2)(B) 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 recommendation of the Under Secretary for Health, 
     that the facilities submitting the proposal have developed 
     (or may reasonably be anticipated to develop) each of the 
     following:
       ``(1) An arrangement with an accredited medical school that 
     provides education and training in psychiatry and with which 
     one or more of the participating Department facilities is 
     affiliated under which medical residents receive education 
     and training in psychiatry through regular rotation through 
     the participating Department facilities so as to provide such 
     residents with training in the diagnosis and treatment of 
     mental illness.
       ``(2) An arrangement with an accredited graduate school of 
     psychology under which students receive education and 
     training in clinical, counseling, or professional psychology 
     through regular rotation through the participating Department 
     facilities so as to provide such students with training in 
     the diagnosis and treatment of mental illness.
       ``(3) An arrangement under which nursing, social work, or 
     allied health personnel receive training and education in 
     mental health care through regular rotation through the 
     participating Department facilities.
       ``(4) The ability to attract scientists who have 
     demonstrated achievement in research--
        ``(A) into the evaluation of innovative approaches to the 
     design of mental health services; or
       ``(B) into the causes, prevention, and treatment of mental 
     illness.
       ``(5) The capability to evaluate effectively the activities 
     of the center, including activities relating to the 
     evaluation of specific efforts to improve the quality and 
     effectiveness of mental health services provided by the 
     Department at or through individual facilities.
       ``(e)(1) In order to provide advice to assist the Secretary 
     and the Under Secretary for Health to carry out their 
     responsibilities under this section, the official within the 
     central office of the Veterans Health Administration 
     responsible for mental health and behavioral sciences matters 
     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 centers under this section.
       ``(2) The panel shall consist of experts in the fields of 
     mental health research, education and training, and clinical 
     care. Members of the panel shall serve as consultants to the 
     Department.
       ``(3) The panel shall review each proposal submitted to the 
     panel by the official referred to in paragraph (1) and shall 
     submit to that official 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.).
       ``(f) Clinical and scientific investigation activities at 
     each center established under this section--
       ``(1) may compete for the award of funding from amounts 
     appropriated for the Department of Veterans Affairs medical 
     and prosthetics research account; and
       ``(2) shall receive priority in the award of funding from 
     such account insofar as funds are awarded to projects and 
     activities relating to mental illness.
       ``(g) The Under Secretary for Health shall ensure that at 
     least three centers designated under this section emphasize 
     research into means of improving the quality of care for 
     veterans suffering from mental illness through the 
     development of community-based alternatives to institutional 
     treatment for such illness.
       ``(h) The Under Secretary for Health shall ensure that 
     information produced by the research, education and training, 
     and clinical activities of centers established under this 
     section that may be useful for other activities of the 
     Veterans Health Administration is disseminated throughout the 
     Veterans Health Administration. Such dissemination 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.
       ``(i) The official within the central office of the 
     Veterans Health Administration responsible for mental health 
     and behavioral sciences matters shall be responsible for 
     supervising the operation of the centers established pursuant 
     to this section and shall provide for ongoing evaluation of 
     the centers and their compliance with the requirements of 
     this section.
       ``(j)(1) There are authorized to be appropriated to the 
     Department of Veterans Affairs for the basic support of the 
     research and education and training activities of centers 
     established pursuant to this section amounts as follows:
       ``(A) $3,125,000 for fiscal year 1998.
       ``(B) $6,250,000 for each of fiscal years 1999 through 
     2001.
       ``(2) In addition to funds appropriated for a fiscal year 
     pursuant to the authorization of appropriations in paragraph 
     (1), the Under Secretary for Health shall allocate to such 
     centers from other funds appropriated for that fiscal year 
     generally for the Department of Veterans Affairs medical care 
     account and the Department of Veterans Affairs medical and 
     prosthetics research account such amounts as the Under 
     Secretary for Health determines appropriate to carry out the 
     purposes of this section.''.
       (2) The table of sections at the beginning of chapter 73 is 
     amended by inserting after the item relating to section 7319, 
     as added by section 2(b), the following new item:

``7320. Centers for mental illness research, education, and clinical 
              activities.''.

       (b) Annual Reports.--Not later than February 1 of each of 
     1998, 1999, and 2000, the Secretary of Veterans Affairs shall 
     submit to the Committees on Veterans' Affairs of the Senate 
     and House of Representatives a report on the status and 
     activities during the previous fiscal year of the centers for 
     mental illness, research, education, and clinical activities 
     established pursuant to section 7320 of title 38, United 
     States Code (as added by subsection (a)). Each such report 
     shall include the following:
       (1) A description of the activities carried out at each 
     center and the funding provided for such activities.
       (2) A description of the advances made at each of the 
     participating facilities of the center in research, education 
     and training, and clinical activities relating to mental 
     illness in veterans.
       (3) A description of the actions taken by the Under 
     Secretary for Health pursuant to subsection (h) of that 
     section (as so added) to disseminate information derived from 
     such activities throughout the Veterans Health 
     Administration.
       (4) The Secretary's evaluations of the effectiveness of the 
     centers in fulfilling the purposes of the centers.
       (c) Implementation.--The Secretary of Veterans Affairs 
     shall designate at least one center under section 7320 of 
     title 38, United States Code, not later than January 1, 1998.

     SEC. 4. DISBURSEMENT AGREEMENTS RELATING TO MEDICAL RESIDENTS 
                   AND INTERNS.

       Section 7406(c) of title 38, United States Code, is 
     amended--
       (1) by striking out ``Department hospital'' each place it 
     appears and inserting in lieu thereof ``Department facility 
     furnishing hospital care or medical services'';
       (2) by striking out ``participating hospital'' in paragraph 
     (4)(C) and inserting in lieu thereof ``participating 
     facility''; and
       (3) by striking out ``hospital'' both places it appears in 
     paragraph (5) and inserting in lieu thereof ``facility''.

     SEC. 5. AUTHORITY TO SUSPEND SPECIAL PAY AGREEMENTS FOR 
                   PHYSICIANS AND DENTISTS WHO ENTER RESIDENCY 
                   TRAINING PROGRAMS.

       Section 7432(b)(2) of title 38, United States Code, is 
     amended--
       (1) by inserting ``(A)'' after ``(2)''; and
       (2) by adding at the end the following:
       ``(B) The Secretary may suspend a special pay agreement 
     entered into under this section in the case of a physician or 
     dentist who, having entered into the special pay agreement, 
     enters a residency training program. Any such suspension 
     shall terminate when the physician or dentist completes, 
     withdraws from, or is no longer a participant in the program. 
     During the period of such a suspension, the physician or 
     dentist is not subject to the provisions of paragraph (1).''.

     SEC. 6. REPORTING REQUIREMENTS.

       (a) Extension of Annual Report Requirement.--Section 107(a) 
     of the Veterans Health Care Act of 1992 (Public Law 102-585; 
     38 U.S.C. 1710 note) is amended by striking out ``Not later 
     than January 1, 1993, January 1, 1994, and January 1, 1995'' 
     and inserting in lieu thereof ``Not later than January 1 of 
     1993 and each year thereafter through 1998''.
       (b) Report on Health Care and Research.--Section 107(b) of 
     such Act is amended--
       (1) in paragraph (2)(A), by inserting ``(including 
     information on the number of inpatient stays and the number 
     of outpatient visits through which such services were 
     provided)'' after ``facility''; and
       (2) by adding at the end the following new paragraph:
       ``(5) A description of the actions taken by the Secretary 
     to foster and encourage the expansion of such research.''.

     SEC. 7. ASSESSMENT OF USE BY WOMEN VETERANS OF DEPARTMENT 
                   HEALTH SERVICES.

       (a) Reports to Under Secretary for Health.--The Center for 
     Women Veterans of the Department of Veterans Affairs 
     (established under section 509 of Public Law 103-446), in 
     consultation with the Advisory Committee on Women Veterans, 
     shall assess the use by women veterans of health services 
     through the Department of Veterans Affairs, including 
     counseling for sexual trauma and mental health services. The 
     Center shall submit to the Under Secretary for Health of the 
     Department of Veterans Affairs a report not later than April 
     1, 1997, and April 1 of each of the two following years, on--
       (1) the extent to which women veterans described in section 
     1710(a)(1) of title 38, United States Code, fail to seek, or 
     face barriers in seeking, health services through the 
     Department, and the reasons therefor; and

[[Page H7549]]

       (2) recommendations, if indicated, for encouraging greater 
     use of such services, including (if appropriate) public 
     service announcements and other outreach efforts.
       (b) Reports to Congressional Committees.--Not later than 
     July 1, 1997, and July 1 of each of the two following years, 
     the Secretary of Veterans Affairs shall submit to the 
     Committees on Veterans' Affairs of the Senate and House of 
     Representatives a report containing--
       (1) the most recent report of the Center for Women Veterans 
     under subsection (a);
       (2) the views of the Under Secretary for Health on such 
     report's findings and recommendations; and
       (3) a description of the steps being taken by the Secretary 
     to remedy any problems described in the report.

     SEC. 8. MAMMOGRAPHY QUALITY STANDARDS.

       (a) In General.--(1) Subchapter II of chapter 73 of title 
     38, United States Code, is amended by adding after section 
     7320, as added by section 3(a), the following new section:

     ``Sec. 7321. Mammography quality standards

       ``(a) A mammogram may not be performed at a Department 
     facility unless that facility is accredited for that purpose 
     by a private nonprofit organization designated by the 
     Secretary. An organization designated by the Secretary under 
     this subsection shall meet the standards for accrediting 
     bodies established under section 354(e) of the Public Health 
     Service Act (42 U.S.C. 263b(e)).
       ``(b) The Secretary, in consultation with the Secretary of 
     Health and Human Services, shall prescribe quality assurance 
     and quality control standards relating to the performance and 
     interpretation of mammograms and use of mammogram equipment 
     and facilities of the Department of Veterans Affairs 
     consistent with the requirements of section 354(f)(1) of the 
     Public Health Service Act. Such standards shall be no less 
     stringent than the standards prescribed by the Secretary of 
     Health and Human Services under section 354(f) of the Public 
     Health Service Act.
       ``(c)(1) The Secretary, to ensure compliance with the 
     standards prescribed under subsection (b), shall provide for 
     an annual inspection of the equipment and facilities used by 
     and in Department health care facilities for the performance 
     of mammograms. Such inspections shall be carried out in a 
     manner consistent with the inspection of certified facilities 
     by the Secretary of Health and Human Services under section 
     354(g) of the Public Health Service Act.
       ``(2) The Secretary may not provide for an inspection under 
     paragraph (1) to be performed by a State agency.
       ``(d) The Secretary shall ensure that mammograms performed 
     for the Department under contract with any non-Department 
     facility or provider conform to the quality standards 
     prescribed by the Secretary of Health and Human Services 
     under section 354 of the Public Health Service Act.
       ``(e) For the purposes of this section, the term 
     `mammogram' has the meaning given such term in paragraph (5) 
     of section 354(a) of the Public Health Service Act (42 U.S.C. 
     263b(a)).''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     7320, as added by section 3(b), the following new item:

``7321. Mammography quality standards.''.

       (b) Deadline for Prescribing Standards.--The Secretary of 
     Veterans Affairs shall prescribe standards under subsection 
     (b) of section 7321 of title 38, United States Code, as added 
     by subsection (a), not later than the end of the 120-day 
     period beginning on the date of the enactment of this Act.
       (c) Implementation Report.--The Secretary of Veterans 
     Affairs shall submit to the Committees on Veterans' Affairs 
     of the Senate and House of Representatives a report on the 
     Secretary's implementation of section 7321 of title 38, 
     United States Code, as added by subsection (a). The report 
     shall be submitted not later than 120 days after the later of 
     (1) the date on which the Secretary prescribes the quality 
     standards required under subsection (b) of that section, or 
     (2) the date of the enactment of this Act.

     SEC. 9. PATIENT PRIVACY FOR WOMEN PATIENTS.

       (a) Identification of Deficiencies.--The Secretary of 
     Veterans Affairs shall conduct a survey of each medical 
     center under the jurisdiction of the Secretary to identify 
     deficiencies relating to patient privacy afforded to women 
     patients in the clinical areas at each such center which may 
     interfere with appropriate treatment of such patients.
       (b) Correction of Deficiencies.--The Secretary shall ensure 
     that plans and, where appropriate, interim steps, to correct 
     the deficiencies identified in the survey conducted under 
     subsection (a) are developed and are incorporated into the 
     Department's construction planning processes and given a high 
     priority.
       (c) Reports to Congress.--The Secretary shall compile an 
     annual inventory, by medical center, of deficiencies 
     identified under subsection (a) and of plans and, where 
     appropriate, interim steps, to correct such deficiencies. The 
     Secretary shall submit to the Committees on Veterans' Affairs 
     of the Senate and House of Representatives, not later than 
     October 1, 1997, and not later than October 1 each year 
     thereafter through 1999 a report on such deficiencies. The 
     Secretary shall include in such report the inventory compiled 
     by the Secretary, the proposed corrective plans, and the 
     status of such plans.

     SEC. 10. MODIFICATION OF RESTRICTIONS ON REAL PROPERTY, 
                   MILWAUKEE COUNTY, WISCONSIN.

       (a) Modification of Reversionary Interest.--The Secretary 
     of Veterans Affairs is authorized to execute such instruments 
     as may be necessary to modify the conditions under which the 
     land described in subsection (b) will revert to the United 
     States so as--
       (1) to permit Milwaukee County, Wisconsin, to grant all or 
     part of such land to another party with a condition on such 
     grant that the grantee use such land only for civic and 
     recreational purposes; and
       (2) to provide that the conditions under which title to all 
     or any part of such land reverts to the United States are 
     stated so that any such reversion would occur at the option 
     of the United States.
       (b) Description of Land.--The land covered by this section 
     is the tract of 28 acres of land, more or less, conveyed to 
     Milwaukee County, Wisconsin, pursuant to the Act entitled 
     ``An Act authorizing the Administrator of Veterans' Affairs 
     to convey certain property to Milwaukee County, Wisconsin'', 
     approved August 27, 1954 (68 Stat. 866).
       (c) General Authorities.--The Secretary may carry out this 
     section subject to such terms and conditions (including 
     reservations of rights for the United States) as the 
     Secretary considers necessary to protect the interests of the 
     United States. In carrying out this section, the Secretary 
     may eliminate any existing covenant or restriction with 
     respect to the tract of land described in subsection (b) 
     which the Secretary determines to be no longer necessary to 
     protect the interests of the United States.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Arizona [Mr. Stump] and the gentleman from Mississippi [Mr. Montgomery] 
will each control 20 minutes.
  The Chair recognizes the gentleman from Arizona, [Mr. Stump].
  (Mr. STUMP asked and was given permission to revise and extend his 
remarks.)


                             General Leave

  Mr. STUMP. Mr. Speaker, I ask unanimous consent all Members have 5 
legislative days to revise and extend their remarks and include 
extraneous material on H.R. 3643, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Arizona?
  There was no objection.
  Mr. STUMP. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, H.R. 3643 extends for 2 years expiring authorities for 
the VA to provide priority health care to Persian Gulf veterans and 
veterans exposed to agent orange.
  This bill makes VA's authority to provide priority care to veterans 
exposed to ionizing radiation permanent.
  It also contains additional provisions which will be explained by the 
subcommittee chairman momentarily, and I urge my colleagues to support 
this bill.
  I want to thank my good friend, Sonny Montgomery, the ranking 
minority members of the full committee for his work on this measure. 
Before yielding to him, I also want to thank Tim Hutchinson, chairman 
of the SubCommittee on Hospitals and Health Care, and Chet Edwards, the 
ranking minority member on the subcommittee.
  Additionally, Mr. Speaker, Corrine Brown and Jack Quinn, both members 
of the VA Committee, should be commended for their contributions to the 
bill.
  I also want to recognize Lane Evans for bringing provisions to the VA 
Committee's attention which are needed to modify the title restrictions 
in a 1954 VA land conveyance to the county of Milwaukee.
  Mr. Speaker, I yield such time as he may consume to the gentleman 
from Arkansas [Mr. Hutchinson].
  Mr. HUTCHINSON. Mr. Speaker, I rise in strong support of H.R. 3643, 
legislation to extend through December 31, 1998, the period which the 
Secretary of Veterans Affairs is authorized to provide priority health 
care to certain veterans who were exposed to agent orange or who served 
in the Persian Gulf war and to make such authority permanent in the 
case of certain veterans exposed to ionizing radiation.
  The Committee on Veterans' Affairs has demonstrated a long history of 
bipartisan support for those veterans who may have been exposed to 
chemical or environmental hazards during their service in the Southeast 
and Southwest Asian theaters of war. specifically, the bill extends 
priority health care to agent orange and Persian Gulf veterans to 
December 31, 1998.
  With regard to agent orange, this bill incorporates those provisions 
accepted by the full committee in the last session and were dropped out 
during conference with the Senate. As you may

[[Page H7550]]

remember, the provisions recognize the categorical list of diseases and 
their respective association with agent orange exposure to provide 
priority health care for veterans suffering from diseases in the first 
three of the five categories. The provisions neither alter nor have any 
bearing on the recent decision of the Secretary to presumptively 
service-connected veterans with prostate cancer and peripheral 
neuropathy.
  The bill also makes permanent priority health care for radiation-
exposed veterans and creates a VA committee on the care of severely 
chronically mentally ill veterans and centers for mental illness 
research, education, and clinical activities. This provision, 
originally introduced by subcommittee Ranking Member Chet Edwards, 
would require that committee members be VA employees with expertise in 
the care of the chronically mentally ill and that it submit annual 
reports to the House and Senate Veterans' Affairs Committees on ways of 
improving care to this priority treatment group. Over 40 percent of 
VA's patients are treated for mental health problems.
  The bill would also require the VA to establish centers of excellence 
in mental illness research and clinical activities with the acronym 
MIRECC. The purpose of the MIRECC's would be to facilitate the 
improvement of health care services for veterans suffering from mental 
illness, especially from conditions which are service-related, and to 
develop improved models for the furnishing of clinical services. 
MIRECC's would be modeled after the successful Geriatric Research, 
Education, and Clinical Centers [GRECC's].
  Under the provisions of this bill, the VA is authorized to 
appropriate the amount of $3,125 million for fiscal year 1998 and $6.25 
million for the fiscal years 1999-2001.
  The bill also makes technical changes to title 38 to facilitate the 
training of physicians and dentists in any VA facility and suspends 
special pay agreements for physicians and dentists who enter residency 
training programs.
  Two amendments which encompass the committee's bipartisan concern for 
veterans were added to the bill during the Subcommittee on Hospitals 
and Health care markup.
  The first amendment, offered by my friend and colleague Jack Quinn, 
provides that those veterans who served in Turkey and Israel during the 
time period of August 2, 1990, to July 31, 1991, be included in the 
definition of Persian Gulf veterans for the purpose of priority health 
care. The Department of Defense has estimated that approximately 8,145 
veterans served in Israel and Turkey during the 11-month period. Under 
the current definition of the gulf war theater, these veterans are 
excluded and therefore not eligible for priority health care as 
provided under this bill.
  Jack has also been a leader in the fight for mammography sceening at 
VA facilities, and has introduced legislation which has been 
incorporated into the second amendment, offered by Congresswoman 
Corrine Brown, which would reinstate reporting requirements through 
1998 on the number of women who receive VA health care services; 
requires VA to assess barriers that may prevent women veterans from 
receiving proper health care; and identifies patient privacy 
deficiencies and makes recommendations on the correction of existing 
deficiencies. It also requires VA to adopt the same mammography 
standards used by the private sector and HHS. Finally, it directs that 
the mental health needs of women veterans who are chronically mentally 
ill be addressed by the Committee on the Care of Severely Chronically 
Mentally Ill Veterans.
  The hard work of Mr. Quinn and Ms. Brown is invaluable and I 
appreciate all they did to strengthen this bill.
  I would also like to recognize the bipartisan efforts of Lane Evans 
and Gerald Kleczka, who have worked hard to ensure that language which 
would transfer VA land to the State of Wisconsin to facilitate the 
building of a new Milwaukee Brewers stadium is included in the bill.
  Finally, I would like to extend my heartfelt thanks to Committee 
Chairman Bob Stump, Ranking Member Sonny Montgomery, and subcommittee 
Ranking Member Chet Edwards for all the hard work they have done in 
ensuring that this bill is brought to the floor today.
  Mr. MONTGOMERY. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I would like to point out that the gentleman from New 
York [Mr. Gilman] is not a member of our committee but he always comes 
over when we have bills on the floor about veterans and makes some 
comments. The gentleman from Arizona [Mr. Stump] and I are very 
appreciative that he takes that time and interest.
  This bill is the result of the excellent work done by our 
Subcommittee on Hospitals and Health Care. At one time, the Honorable 
John Paul Hammerschmidt and I served as ranking member and chairman of 
this subcommittee. Today, Representative Tim Hutchinson, who serves in 
the seat which Mr. Hammerschmidt used to hold, is the chairman of the 
subcommittee, and Chet Edwards of Texas whose district includes the 
Olin E. Teague VA hospital, is the ranking member.
  The subcommittee oversees 173 medical centers, all of which provide 
outpatient care and inpatient care. At 131 of these medical centers, 
the Veterans Health Administration also operates a nursing home care 
unit. In addition to these facilities, there are 391 independent, 
satellite, community based, rural outreach or mobile clinics operated 
by VHA, and this number should grow in future years as VHA tries to 
make VA care more convenient for veterans.
  For my colleagues who may not know how important the VA health care 
system is to veterans, let me recite a few numbers from the most recent 
national survey of veterans.
  The VA treated 64 percent of the most seriously disabled service-
connected veterans who needed hospital care.
  Almost half of the veterans with no health insurance, and 44 percent 
of veterans with incomes below $10,000, were treated by VA if they 
needed hospital care.
  There are very significant changes taking place inside the veterans 
medical system. The Under Secretary for Health, Dr. Kenneth Kizer, is 
really shaking up the way things are done. He's trying to make sure the 
veterans are satisfied with the health care that VA provides them. Even 
at a time when the VA medical budget is under some pressure, Dr. Kizer 
assures us that he can serve the same number of veterans with fewer 
employees
  The chairman of the committee, my good friend Bob Stump, has been 
very supportive of the needs of veterans, and I wash to commend him for 
his leadership of the committee. He has continued to work with me and 
other members on both sides of the aisle to report legislation which 
will improve the services provided to veterans.
  This bill, H.R. 3643, as amended, is an example of the bipartisan 
work of our committee. It includes provisions to extend the authority 
to provide health care to Vietnam veterans and Persian Gulf veterans, 
and includes an expansion of that authority suggested by Mr. Quinn for 
service members who served in Israel or Turkey during the Persian Gulf 
war. The bill also includes several provisions authored by my colleague 
from Florida, Ms. Corinne Brown, dealing with the special health care 
needs of women veterans.
  Mr. Speaker, this bill also includes a provision which would resolve 
a technical problem clouding the future use of a 28-acre parcel of land 
conveyed by the VA to Milwaukee County, WI, as authorized by statute in 
1954, for recreational and other purposes. The terms of that conveyance 
provided that if the county were to attempt to transfer title to a 
third party, title would automatically revert back to the VA. Unlike 
two other adjacent parcels of land previously transferred from VA to 
the county, the deed of conveyance made no provision for reversion ``at 
the option of the United States''.
  A major league baseball stadium was constructed on the site made up 
of these three parcels of land. In October 1995, the State legislature 
of Wisconsin authorized financing and construction of a new stadium to 
replace the existing stadium on the site. That legislation requires 
Milwaukee County to convey all three tracts of land to the State.
  That proposed conveyance raised a question of law as to whether, 
under such a transfer, the three tracts would

[[Page H7551]]

revert back to the United States under the terms of the earlier 
conveyances. As described by the Department of Veterans Affairs' 
General Counsel, a ``reversionary interest is a property right that 
runs with the land* * *'' and the Secretary lacks the authority to 
waive or otherwise extinguish the right of reversion. With respect to 
the parcels VA conveyed in 1949, however, the deed of conveyance 
provides for reversion, in the event of alienation of any part of the 
tract, at the option of the United States. The General Counsel 
concluded, in a February 2, 1996, memorandum opinion, that ``the 
Secretary of the VA has authority to exercise the option of the right 
of reversion on behalf of the United States, and the concomitant 
discretion to decline the option.'' The General Counsel further 
concluded, however, with respect to the property conveyed in 1954, that 
the law gives VA no discretion and a reversion would be automatic.
  The Department of Veterans Affairs has advised, with respect to its 
authority to weigh the option of reversion regarding the two parcels, 
that it will not exercise the option in favor of reversion back to the 
United States so long as the existing statutory restrictions on use are 
followed. The Department has further advised that in the event that 
legislation is introduced to modify the deed restrictions, the VA would 
not object to releasing the properties from the restriction against 
alienation.
  While recent press reports indicate success in developing other 
elements of a financing plan for the proposed new stadium, legislation 
is clearly needed to enable the county to transfer the 28-acre tract, 
which would otherwise revert to the United States, to the State of 
Wisconsin.
  Section 10 of the amended bill would authorize the Secretary of 
Veterans Affairs to execute such instruments as may be needed to modify 
the conditions under which VA conveyed the 28-acre tract to Milwaukee 
County in 1954. Such authorization would permit the county to grant all 
or part of the land to another party, subject to the condition that the 
land be used only for civic and recreational purposes, and to provide 
that any reversion to the United States would occur at the option of 
the United States. The measure would also provide that the Secretary 
may carry out this provision subject to such terms and conditions as 
the Secretary considers necessary to protect the interests of the 
United States.
  Also included, are provisions suggested by the ranking member, Mr. 
Edwards, which would improve the VA's treatment of mentally ill 
veterans.
  Mr. Speaker, veterans with mental illness are five times more likely 
to use VA for health care services than the rest of the veteran 
population. This bill calls for VA to establish a committee of experts 
to assess its mental health programs and make recommendations for 
improvement. It also authorizes the establishment of up to five centers 
of excellence that would provide mental health research, education and 
clinical care.

                              {time}  1330

  Mr. Speaker, I yield 2 minutes to the gentleman from Illinois [Mr. 
Evans].
  Mr. EVANS. Mr. Speaker, the extension of priority care for veterans 
who were exposed to agent orange reflects the compromise reached in the 
Veterans' Affairs Committee last year on this issue. I must admit that 
I was not completely satisfied with the legislation and I still have 
reservations. Specifically, I still believe that we should be covering 
all of the categories in the Agent Orange Act of 1991.
  However, I still believe, as I did last year, that this is a solid 
compromise which will ensure that the health care needs of deserving 
Vietnam veterans will be met. The recent release of the Institute of 
Medicine's report on agent orange only reaffirms that we must continue 
to honor the health care needs of our Vietnam veterans.
  I would again like to thank Chairman Stump, Mr. Edwards, Mr. 
Hutchinson, and Mr. Montgomery for their efforts last year to work out 
legislation which I feel protects the rights of veterans. The rest of 
legislation, which also provides for our Persian Gulf war and atomic 
veterans, is right on target and should be supported by all of my 
colleagues.
  Mr. STUMP. Mr. Speaker, I yield 3 minutes to the gentleman from New 
York [Mr. Gilman], the chairman of the Committee on International 
Relations.
  (Mr. GILMAN asked and was given permission to revise and extend his 
remarks.)
  Mr. GILMAN. Mr. Speaker, I am pleased today to rise in support of 
H.R. 3643, extending benefits to veterans who have been exposed to 
agent orange, and I commend the gentleman from Arizona, the 
distinguished chairman of our Committee on Veterans' Affairs, and the 
gentleman from Mississippi, the distinguished ranking minority member, 
Mr. Montgomery, for bringing this measure to the floor at this time, 
and I thank the gentleman from Mississippi for his kind remarks.
  This legislation provides for the extension of much needed assistance 
to those veterans who have contracted health problems due to their 
exposure to radiation in World War II, to exposure to agent orange in 
Vietnam or to their service in the Persian Gulf.
  Mr. Speaker, specifically, this measure extends through December 31, 
1998, health care benefits to veterans suffering long-term side effects 
of exposure to agent orange as well as for those veterans suffering 
health problems from their service in the Persian Gulf.
  Most important, it also recognizes the National Academy of Sciences 
categorical list of diseases and their respective association to agent 
orange exposure and provides priority health care for veterans from 
diseases in the first three categories.
  In doing this, this bill gives the veterans the benefit of the doubt, 
allowing treatment for any disease conceivably related to wartime 
herbicide exposure unless scientific evidence clearly shows that no 
association exists. Additional conditions may be added for coverage at 
the VA secretary's discretion, if based upon credible evidence of an 
association.
  This legislation also extends through 1997 the VA policy of offering 
care to veterans suffering from ailments that may have been caused by 
exposure to ionized radiation during atomic weapons testing after World 
War II.
  Finally, this bill extends the authority of the VA to provide health 
care on a priority basis for Persian Gulf veterans through December 31, 
1998, and extends coverage to those veterans serving in Israel and 
Turkey during the conflict.
  Mr. Speaker, this legislation addresses many longstanding critical 
issues in veterans' health care and is a fitting response to the 
service provided by these dedicated veterans on behalf of their 
country.
  Mr. MONTGOMERY. Mr. Speaker, I yield 2 minutes to the gentleman from 
Wisconsin [Mr. Kleczka].
  Mr. KLECZKA. Mr. Speaker, let me thank the gentleman from Mississippi 
[Mr. Montgomery] for yielding time to me.
  Let me echo the remarks of my friend, the gentleman from New York 
[Mr. Gilman], in support of H.R. 3643. Not only does the bill provide 
priority health care for those veterans who were exposed to a agent 
orange, but also broadens the definition for the veterans who served in 
the Persian Gulf.
  I think a more important portion of the bill requires the Veterans' 
Administration to promulgate mammography quality standards for our 
service men and women.
  The last portion of the bill, which I asked be inserted, and I want 
to thank the gentleman from Arizona [Mr. Stump] and the minority 
leaders, the gentleman from Mississippi [Mr. Montgomery] and the 
gentleman from Illinois [Mr. Evans], my friends, for helping me out on 
this; the situation is that in Milwaukee County the current baseball 
stadium lies on three parcels of land owned by the Veterans' 
Administration. Two of the parcels were transferred way back in 1948, 
and the third was transferred in 1954.
  Now there is a new stadium being contemplated, the financing is 
almost put together on the new ball park, and we found that two of the 
parcels already have been transferred by the Secretary's authority. The 
third needed congressional legislation.
  The provision in the bill today provides that since the use is going 
to be the same, for a public purpose, that the Veterans' Administration 
Secretary, at his authority or on his authority, can

[[Page H7552]]

transfer the land. I want to thank the chairman for helping us out on 
this situation.
  Mr. STEARNS. Mr. Speaker, the legislation we consider today, H.R. 
3643, is a credit to the Veterans Committee. I want to compliment both 
Chairman Bob Stump and ranking minority member Representative Sonny 
Montgomery for the bipartisan spirit they have shown in getting this 
bill to the House floor. This bill extends priority health care for 
veterans exposed to agent orange and those who served in the Persian 
Gulf war through December 31, 1998.
  Mr. Speaker, my commitment to providing priority health care to the 
Vietnam veterans who were exposed to agent orange and to those who 
served in gulf war is longstanding. As you know, I have long supported 
efforts to find a link between exposure to agent orange and the 
plethora of illnesses which have occurred in Vietnam veterans.
  With respect to what has been known as the gulf war syndrome, I took 
a deep interest in requesting that we aggressively seek answers to the 
many unexplained illnesses experienced by gulf war veterans. One of 
first casualties of this mysterious group of disease was a constituent 
of mine, Michael C. Adcock of Ocala, FL, who died at the age of 22 
after serving in Operation Desert Storm.
  After returning home from the gulf war, Michael suffered from a 
number of symptoms which had befallen many other gulf war veterans, 
including persistent nausea, skin rashes, aching joints, hair loss, 
bleeding gums, blurred vision, and lack of energy, among others.
  Michael died in 1993, 3 years after coming home from the Desert Storm 
operation. We are still looking for answers to the causes of this 
mysterious syndrome which appears to be indigenous to those who served 
in the gulf war.
  I think we all know how terribly urgent it is that we continue with 
our research efforts until we find the answer to the cause for this 
syndrome which is so ubiquitous to veterans of Desert Storm.
  In light of the controversy surrounding unexplained illnesses Desert 
Storm veterans are experiencing, the VA, DOD, NIH, and HHS have been 
conducting extensive research into possible causes of the unexplained 
illnesses associated with this military campaign.
  On March 19, 1995, Dr. Kizer testified that the VA would be 
initiating a national survey of Persian Gulf veterans and that this 
study that would involve selecting a random sample of 15,000 Persian 
Gulf veterans and 15,000 contemporaneous non-Persian Gulf era veterans. 
The survey would include a mail-in health questionnaire as well as 
physical examinations for a subgroup of those veterans included in a 
broader survey. Hopefully, the data collected will shed further light 
and provide us with additional clues surrounding the various illnesses 
being experienced by the men and women who served in Desert Storm.
  I believe the results of the VA mortality followup study comparing 
Persian Gulf veterans with a control group of Persian-Gulf-era veterans 
could produce some answers to several troubling questions.
  I am optimistic that through such efforts we might find the missing 
link that will explain this rash of perplexing illnesses which seem to 
be indigenous to these particular veterans. We all know how invaluable 
the research being conducted is and the need to find answers as to what 
is causing thousands of gulf war veterans to be plagued by a rash of 
unexplained symptoms.
  I hope that the DOD and the VA will continue to both aggressively 
treat symptoms associated with Desert Storm syndrome and investigate 
its cause or causes.
  My reason for sounding skeptical is that the medical follow up agency 
of medicine [IOM] made an independent study of the collective efforts 
to date. The IOM was rather harsh in its evaluation of the piecemeal 
study and the duplication of efforts between DOD, VA, and HHS. The IOM 
made several suggestions regarding the data and databases, the 
coordination process, and the consideration of study design needs. 
Hopefully, implementation of these suggestions will prove beneficial.
  I also noted that the IOM concluded that it could not find any 
reliable intelligence of medical or biological justification for 
allegations that U.S. troops were exposed to chemical warfare agencies. 
Unfortunately, this seems to be at odds with statements from our troops 
both then and now.
  On March 14, 1996, ``Veterans and Agent Orange: Update 1996'' found 
sufficient evidence between herbicide exposure and soft tissue sarcoma, 
non-Hodgkin's lymphoma, Hodgkin's disease, chloracne, and porphyria 
cutanea tarda. The primary focus in these updated studies was whether 
or not there is a connection between birth defects of children of those 
servicemen who were sprayed with herbicides while serving in Vietnam. 
Previous studies conducted by the National Academy of Sciences for the 
Department of Veterans Affairs at the direction of Congress found a 
link between agent orange and that at certain levels it caused a 
plethora of cancers and other health hazards.
  It is my hope that further studies may be conducted so that we have a 
final pronouncement as to whether or not agent orange is culpable for 
causing such deformities in children born to Vietnam veterans. This 
bill would also establish five centers of excellence for mental 
illness, research, education and clinical activities [MIRECC]. I have 
long advocated that we provide our veterans with access to mental 
health services and care. In fact, I proposed a 120-bed psychiatric 
unit be a component of the ambulatory care addition in Gainesville. 
While I am gratified by the fact the VA in Gainesville just received a 
$19.8 million grant for this ambulatory care center, I suggest here 
today that one of these proposed centers, be housing in the VA in 
Gainesville, FL.
  Another important component of this bill is that it requires VA to 
promulgate mammography quality standards, and it also directs the VA to 
report to Congress and efforts being made by the Department to ensure 
privacy and safety for women veterans who require hospitalization for 
psychiatric reasons.
  Mr. Speaker, I strongly support this important legislation and urge 
my colleagues to give it their full support and pass this bill today.
  Mrs. SMITH of Washington. Mr. Speaker, I rise today in strong support 
of H.R. 3643. This legislation will provide priority health care for 
Persian Gulf veterans suffering from the gulf war syndrome. In 
addition, this bill ensures our commitment to these veterans by 
providing funding to establish five centers for mental illness 
research, education and clinical activities, and improve VA health care 
services for women veterans.
  Mr. Speaker, I recently had the opportunity to read some disturbing 
testimony from the Department of Defense at the House Government Reform 
and Oversight Committee hearing on the gulf war syndrome. The Pentagon 
admitted that when an Army unit blew up an Iraqi ammunition depot, 
soldiers might have been exposed to nerve gas. This announcement may 
help explain some of the mysterious illnesses reported by Americans who 
served in the gulf.
  I will continue to do all that I can to ensure that VA resources are 
focused and coordinated to yield answers for Persian Gulf veterans. I 
will not tolerate the Federal Government dragging its feet for the fear 
of the financial consequences as it did with agent orange. This bill 
sends a message that we will not abandon our soldiers when they get in 
harm's way. Mr. Speaker, I urge my colleagues to support this important 
legislation.
  Mr. EDWARDS. Mr. Speaker, H.R. 3643, as amended, is an omnibus health 
care bill which tackles a broad spectrum of issues affecting special 
veteran populations--women, veterans exposed to toxic and hazardous 
substances, and veterans suffering with chronic mental illness.
  Mr. Speaker, I'm very pleased that this bill includes two provisions 
I introduced last year. One calls for VA to establish a committee of 
experts to assess its mental health programs and make recommendations 
for improvements. The other authorizes appropriations for VA to 
establish up to five centers of excellence that would provide mental 
health research, education, and clinical care.
  Mr. Speaker, I think it's important to appreciate that more than 50 
percent of all eligible veterans who suffer from severe mental illness 
rely on VA for care; that's more than five times the proportion of 
veterans in the general population who use VA for any health care. The 
Department reports that 64 percent of those veterans are service-
connected for a psychiatric condition. I believe these data underscore 
the importance of VA mental health programs, and the need for this 
legislation.
  I urge Members to support H.R. 3643.
  Mr. MONTGOMERY. Mr. Speaker, I have no more requests for time and I 
yield back the balance of my time.
  Mr. STUMP. Mr. Speaker, I have no further requests for time, and I, 
too, yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Gutknecht). The question is on the 
motion offered by the gentleman from Arizona [Mr. Stump] that the House 
suspend the rules and pass the bill, H.R. 3643, as amended.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended, and the bill, as amended, was 
passed.
  A motion to reconsider was laid on the table.

                          ____________________