[Congressional Record Volume 148, Number 44 (Thursday, April 18, 2002)]
[Senate]
[Pages S2963-S2965]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ROCKEFELLER:
  S. 2205. A bill to amend title 38, United States Code, to clarify the 
entitlement to disability compensation of women veterans who have 
service-connected mastectomies, to provide permanent authority for 
counseling and treatment for sexual trauma, and for other purposes; to 
the Committee on Veterans' Affairs.
  Mr. ROCKEFELLER. Madam President, I introduce legislation today that 
would help VA continue to meet the needs of veterans who experienced 
sexual trauma while serving in the military. This legislation would 
also extend special compensation to women veterans whose service led to 
the loss of all or part of a breast, and would help us understand 
better how well VA is meeting the health care needs of women veterans.
  Almost a decade ago, the Committee on Veterans Affairs took a hard 
look at

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the growing needs of women veterans in a hearing that helped VA improve 
its women's health care and services. Many studies grew from this 
hearing, including investigations that showed that women veterans are 
eight times more likely to report having experienced sexual assault 
during military service than women civilians of the same age.
  In 1992, Congress authorized VA to provide counseling to women who 
experienced sexual trauma during active military service. Two years 
later, recognizing that sexual trauma is not limited to women, Congress 
expanded VA's mandate to offer counseling and treatment to victims of 
sexual harassment or sexual assault without regard to gender. The 
Veterans Millennium Health Care and Benefits Act of 1999 broadened VA's 
responsibilities toward victims of sexual trauma even farther, 
strengthening outreach efforts and extending the programs through 
December 2004.
  VA has worked, internally and with the Department of Defense, to 
educate health care professionals about the physical and emotional 
legacies of military sexual trauma. Those who have endured such trauma 
need counseling and appropriate treatment, both during and following 
service. Although we must hope that education will eliminate sexual 
violence from our forces, the sad reality is that the programs that VA 
has established will continue to be needed. The legislation I introduce 
today would authorize VA to continue its counseling and treatment 
programs for veterans who have experienced military sexual trauma 
beyond 2004, so that veterans and health care professionals can depend 
upon these critical services.
  The Committee on Veterans Affairs continues to await VA's report on 
rates of military sexual trauma among National Guard and Reservists, 
mandated in the Millennium Act and due in March 2001, to make a sound 
decision on the need for counseling services among these forces who 
might have experienced sexual trauma while on active duty for training.
  Last year, Congress authorized VA to offer special monthly 
compensation to women who had lost one or both breasts, including 
through surgical treatment, as a result of their military service. VA 
recently issued regulations addressing this, which would require 
complete loss of a breast through simple or radical mastectomy in order 
to make a woman eligible for benefits. The intent of Congress in 
passing this legislation was to acknowledge that women who undergo such 
procedures face physical, emotional, and financial challenges in 
returning to health. The need for increased medical attention, and 
concomitant impairment in daily activities, remains consistent, whether 
the loss of a breast is complete or partial. Therefore, the legislation 
that I offer here would extend benefits to women veterans who have lost 
half or more of a breast's tissue as a result of military service, 
rather than drawing an arbitrary clinical line for compensation.
  According to the Veterans Health Administration, women veterans now 
make up about 5 percent of enrolled veterans, a percentage that is 
expected to double over the next two decades. We must ensure that women 
veterans enjoy access to the best possible health care, including for 
gender-specific medical conditions, in the most appropriate setting. 
One of the challenges that Congress and VA face in assessing how well 
the needs of women veterans are being met is understanding exactly what 
services women veterans require, and whether these are being offered by 
VA's medical facilities.
  Many of the advances VA has made in improving women's care and 
services has resulted from the hard work of the Women Veterans 
Coordinators who work within VA's medical centers. These coordinators 
assist women veterans who seek VA medical care, and help VA understand 
which needs still go unmet, frequently as a collateral portion of their 
jobs, while facing many competing demands on their time. As VA health 
care evolves from a primarily hospital-based system to a network of 
outpatient clinics, women veterans coordinators face an even more 
complex set of tasks and a shifting geography of care.
  Women veterans increasingly receive care within general outpatient 
clinics rather than in women's clinics, an issue of special concern as 
women may comprise only a tiny part of the caseload for VA's general 
practitioners, unlike the private sector where women make up half or 
more of a doctor's patients, resulting in less expertise in women's 
health. The legislation I offer here would request a report on how many 
clinics and health care teams remain dedicated specifically to the 
needs of women veterans, and how many hours per week Women Veterans 
Coordinators can allocate to serving women veterans.
  In 1983, Congress responded to the needs of the growing number of 
women veterans by establishing the Advisory Committee on Women 
Veterans. This committee advises the Secretary of VA on the adequacy of 
programs for women veterans, and helps ensure that women veterans have 
the same access to services and benefits as their male counterparts. 
Early this year, the Secretary renewed the charter for the Advisory 
Committee on Women Veterans. I hope my colleagues will join me in 
acknowledging both the Secretary's decision to foster this essential 
voice, and the service of the men and women who share their time and 
experience with VA on behalf of all women veterans. Together, VA and 
the advisory committee have worked to be sure that VA can offer women 
veterans the services they need and the respect they have earned.
  I ask that the text of the bill and a list of the membership of the 
Advisory Committee on Women Veterans be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 2205

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

     SECTION 1. CLARIFICATION OF ENTITLEMENT TO WARTIME DISABILITY 
                   COMPENSATION FOR WOMEN VETERANS WHO HAVE 
                   SERVICE-CONNECTED MASTECTOMIES.

       (a) In General.--Section 1114(k) of title 38, United States 
     Code, is amended by inserting ``of half or more of the 
     tissue'' after ``anatomical loss'' the second place it 
     appears.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect on the date of the enactment of this Act, 
     and shall apply with respect to months that begin on or after 
     that date.

     SEC. 2. PERMANENT AUTHORITY FOR COUNSELING AND TREATMENT FOR 
                   SEXUAL TRAUMA.

       Section 1720D of title 38, United States Code, is amended--
       (1) in subsection (a)--
       (A) in paragraph (1), by striking ``During the period 
     through December 31, 2004, the Secretary'' and inserting 
     ``The Secretary''; and
       (B) in paragraph (2), by striking ``, during the period 
     through December 31, 2004,''; and
       (2) in subsection (b)--
       (A) in paragraph (1), by striking ``establishment and''; 
     and
       (B) in paragraph (2), by striking ``establishing a 
     program'' and inserting ``operating a program''.

     SEC. 3. REPORT ON FURNISHING OF HEALTH CARE TO WOMEN VETERANS 
                   BY VETERANS HEALTH ADMINISTRATION.

       (a) Report Required.--Not later than 180 days after the 
     date of the enactment of this Act, the Secretary of Veterans 
     Affairs shall submit to the Committees on Veterans' Affairs 
     of the Senate and the House of Representatives a report on 
     the furnishing by the Veterans Health Administration of 
     health care for women veterans.
       (b) Report Elements.--The report under subsection (a) shall 
     set forth the following:
       (1) A list of each Women Veterans' Comprehensive Health 
     Center within the Veterans Health Administration, including 
     whether such Center is located in a Department of Veterans 
     Affairs medical center or outpatient clinic.
       (2) For each Center listed under paragraph (1)--
       (A) the staffing level of such Center, expressed in terms 
     of number of full-time equivalent employees (FTEEs);
       (B) the health care services furnished by such Center to 
     women veterans, including the health care services (including 
     breast cancer screening and cervical cancer screening) that 
     are furnished only for women; and
       (C) the number of women veterans furnished health care 
     services by such Center during the last fiscal year ending 
     before the date of the report.
       (3) A list of each facility without a Women Veterans' 
     Comprehensive Health Center that furnishes health care 
     services to women veterans through a full-service womens' 
     primary care team, including whether such facility is located 
     in a Department medical center or outpatient clinic.
       (4) For each facility listed under paragraph (3)--
       (A) the staffing level of such facility for the furnishing 
     of health care services to women veterans, expressed in terms 
     of number of full-time equivalent employees (FTEEs);

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       (B) the health care services furnished by such facility to 
     women veterans, including the health care services (including 
     breast cancer screening and cervical cancer screening) that 
     are furnished only for women; and
       (C) the number of women veterans furnished health care 
     services by such facility during the last fiscal year ending 
     before the date of the report.
       (5) For each Veterans Integrated Service Network and 
     Department medical center, the number of hours per week that 
     the Women Veterans' Coordinator of such network or medical 
     center, as the case may be, is authorized to perform duties 
     relating to the furnishing of health care services to women 
     veterans.
                                  ____


 Current Membership of the VA Advisory Committee on Women Veterans (as 
                            of January 2002)

       Karen L. Ray, RN, MSN, Chair 2000-2002, Colonel, USA 
     (Retired).
       Constance G. Evans, RN, ARNP, Co-Chair 2000-2002, 
     Commander, USPHS (Retired).
       Marsha Tansey Four, USA.
       Bertha Cruz Hall, USAF.
       Marcelite J. Harris, Major General, USAF (Retired).
       Edward E. Hartman, USA.
       Consuelo C. Kickbusch, Lieutenant Colonel, USA (Retired).
       Kathy LaSauce, Lieutenant Colonel, USAF (Retired).
       M Joy Mann, Captain, US Air Force Reserve.
       Lory Manning, Captain, USN (Retired).
       Michele (Mitzi) Manning, Colonel, USMC (Retired).
       Kahleen A. Morrissey, RN, BSN, Colonel, NJ. Army National 
     Guard.
       Joan O'Connor, Commander, Naval Reserve (Retired).
       Sheryl Schmidt, USAF.
                                 ______