[Congressional Record (Bound Edition), Volume 148 (2002), Part 15]
[Senate]
[Pages 20714-20717]
[From the U.S. Government Publishing Office, www.gpo.gov]




   DEPARTMENT OF VETERANS AFFAIRS EMERGENCY PREPAREDNESS ACT OF 2002

  Mr. DASCHLE. Mr. President, I ask that the Chair lay before the 
Senate a message from the House on H.R. 3253.
  The Presiding Officer laid before the Senate the following message 
from the House of Representatives:
       House amendment to Senate amendments:
       In lieu of the matter proposed to be inserted by the 
     amendment of the Senate to the text of the bill, insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Department of Veterans 
     Affairs Emergency Preparedness Act of 2002''.

     SEC. 2. ESTABLISHMENT OF MEDICAL EMERGENCY PREPAREDNESS 
                   CENTERS AT DEPARTMENT OF VETERANS AFFAIRS 
                   MEDICAL CENTERS.

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

     ``Sec. 7325. Medical emergency preparedness centers

       ``(a) Establishment of Centers.--(1) The Secretary shall 
     establish four medical emergency preparedness centers in 
     accordance with this section. Each such center shall be 
     established at a Department medical center and shall be 
     staffed by Department employees.
       ``(2) The Under Secretary for Health shall be responsible 
     for supervising the operation of the centers established 
     under this section. The Under Secretary shall provide for 
     ongoing evaluation of the centers and their compliance with 
     the requirements of this section.
       ``(3) The Under Secretary shall carry out the Under 
     Secretary's functions under paragraph (2) in consultation 
     with the Assistant Secretary of Veterans Affairs with 
     responsibility for operations, preparedness, security, and 
     law enforcement functions.
       ``(b) Mission.--The mission of the centers shall be as 
     follows:
       ``(1) To carry out research on, and to develop methods of 
     detection, diagnosis, prevention, and treatment of injuries, 
     diseases, and illnesses arising from the use of chemical, 
     biological, radiological, incendiary or other explosive 
     weapons or devices posing threats to the public health and 
     safety.
       ``(2) To provide education, training, and advice to health 
     care professionals, including health care professionals 
     outside the Veterans Health Administration, through the 
     National Disaster Medical System established pursuant to 
     section 2811(b) of the Public Health Service Act (42 U.S.C. 
     300hh-11(b)) or through interagency agreements entered into 
     by the Secretary for that purpose.
       ``(3) In the event of a disaster or emergency referred to 
     in section 1785(b) of this title, to provide such laboratory, 
     epidemiological, medical, or other assistance as the 
     Secretary considers appropriate to Federal, State, and local 
     health care agencies and personnel involved in or responding 
     to the disaster or emergency.
       ``(c) Selection of Centers.--(1) The Secretary shall select 
     the sites for the centers on the basis of a competitive 
     selection process. The Secretary may not designate a site as 
     a location for a center under this section unless the 
     Secretary makes a finding under paragraph (2) with respect to 
     the proposal for the designation of such site. To the maximum 
     extent practicable, the Secretary shall ensure the geographic 
     dispersal of the sites throughout the United States. Any such 
     center may be a consortium of efforts of more than one 
     medical center.
       ``(2) A finding by the Secretary referred to in paragraph 
     (1) 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 recommendations of the Under Secretary 
     for Health and the Assistant Secretary with responsibility 
     for operations, preparedness, security, and law enforcement 
     functions, that the facility or facilities submitting the 
     proposal have developed (or may reasonably be anticipated to 
     develop) each of the following:
       ``(A) An arrangement with a qualifying medical school and a 
     qualifying school of public health (or a consortium of such 
     schools) under which physicians and other persons in the 
     health field receive education and training through the 
     participating Department medical facilities so as to provide 
     those persons with training in the detection, diagnosis, 
     prevention, and treatment of injuries, diseases, and 
     illnesses induced by exposures to chemical and biological 
     substances, radiation, and incendiary or other explosive 
     weapons or devices.
       ``(B) An arrangement with a graduate school specializing in 
     epidemiology under which students receive education and 
     training in epidemiology through the participating Department 
     facilities so as to provide such students with training in 
     the epidemiology of contagious and infectious diseases and 
     chemical and radiation poisoning in an exposed population.
       ``(C) An arrangement under which nursing, social work, 
     counseling, or allied health personnel and students receive 
     training and education in recognizing and caring for 
     conditions associated with exposures to toxins through the 
     participating Department facilities.
       ``(D) The ability to attract scientists who have made 
     significant contributions to the development of innovative 
     approaches to the detection, diagnosis, prevention, or 
     treatment of injuries, diseases, and illnesses arising from 
     the use of chemical, biological, radiological, incendiary or 
     other explosive weapons or devices posing threats to the 
     public health and safety.
       ``(3) For purposes of paragraph (2)(A)--
       ``(A) a qualifying medical school is an accredited medical 
     school that provides education and training in toxicology and 
     environmental health hazards and with which one or more of 
     the participating Department medical centers is affiliated; 
     and
       ``(B) a qualifying school of public health is an accredited 
     school of public health that provides education and training 
     in toxicology and environmental health hazards and with which 
     one or more of the participating Department medical centers 
     is affiliated.
       ``(d) Research Activities.--Each center shall conduct 
     research on improved medical preparedness to protect the 
     Nation from threats in the area of that center's expertise. 
     Each center may seek research funds from public and private 
     sources for such purpose.
       ``(e) Dissemination of Research Products.--(1) The Under 
     Secretary for Health and the Assistant Secretary with 
     responsibility for operations, preparedness, security, and 
     law enforcement functions shall ensure that information 
     produced by the research, education and training, and 
     clinical activities of centers established under this section 
     is made available, as appropriate, to health-care providers 
     in the United States. Dissemination of such information 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.
       ``(2) The Secretary shall ensure that the work of the 
     centers is conducted in close coordination with other Federal 
     departments and agencies and that research products or other 
     information of the centers shall be coordinated and shared 
     with other Federal departments and agencies.
       ``(f) Coordination of Activities.--The Secretary shall take 
     appropriate actions to ensure that the work of each center is 
     carried out--
       ``(1) in close coordination with the Department of Defense, 
     the Department of Health and Human Services, and other 
     departments, agencies, and elements of the Government charged 
     with coordination of plans for United States homeland 
     security; and
       ``(2) after taking into consideration applicable 
     recommendations of the working group on the prevention, 
     preparedness, and response to bioterrorism and other public 
     health emergencies established under section 319F(a) of the 
     Public Health Service Act (42 U.S.C. 247d-6(a)) or any other 
     joint interagency advisory group or committee designated by 
     the President or the President's designee to coordinate 
     Federal research on weapons of mass destruction.
       ``(g) Assistance to Other Agencies.--The Secretary may 
     provide assistance requested by appropriate Federal, State, 
     and local civil and criminal authorities in investigations, 
     inquiries, and data analyses as necessary to protect the 
     public safety and prevent or obviate biological, chemical, or 
     radiological threats.
       ``(h) Detail of Employees From Other Agencies.--Upon 
     approval by the Secretary, the Director of a center may 
     request the temporary assignment or detail to the center, on 
     a nonreimbursable basis, of employees from other departments 
     and agencies of the United States who have expertise that 
     would further the mission of the center. Any such employee 
     may be so assigned or detailed on a nonreimbursable basis 
     pursuant to such a request.
       ``(i) Funding.--(1) Amounts appropriated for the activities 
     of the centers under this section shall be appropriated 
     separately from amounts appropriated for the Department for 
     medical care.
       ``(2) In addition to funds appropriated for a fiscal year 
     specifically for the activities of the centers pursuant to 
     paragraph (1), the Under Secretary for Health shall allocate 
     to such centers from other funds appropriated for that fiscal 
     year generally for the Department medical care account and 
     the Department medical and prosthetics research account such 
     amounts as the Under Secretary determines appropriate to 
     carry out the purposes of this section. Any determination by 
     the Under Secretary under the preceding sentence shall be 
     made in consultation with the Assistant Secretary with 
     responsibility for operations, preparedness, security, and 
     law enforcement functions.
       ``(3) There are authorized to be appropriated for the 
     centers under this section $20,000,000 for each of fiscal 
     years 2003 through 2007.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     7324 the following new item:


[[Page 20715]]


``7325. Medical emergency preparedness centers.''.
       (b) Peer Review for Designation of Centers.--(1) In order 
     to assist the Secretary of Veterans Affairs and the Under 
     Secretary of Veterans Affairs for Health in selecting sites 
     for centers under section 7325 of title 38, United States 
     Code, as added by subsection (a), the Under Secretary 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 such centers. The peer 
     review panel shall be established in consultation with the 
     Assistant Secretary of Veterans Affairs with responsibility 
     for operations, preparedness, security, and law enforcement 
     functions.
       (2) The peer review panel shall include experts in the 
     fields of toxicological research, infectious diseases, 
     radiology, clinical care of patients exposed to such hazards, 
     and other persons as determined appropriate by the Secretary. 
     Members of the panel shall serve as consultants to the 
     Department of Veterans Affairs.
       (3) The panel shall review each proposal submitted to the 
     panel by the officials referred to in paragraph (1) and shall 
     submit to the Under Secretary for Health 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.).

     SEC. 3. EDUCATION AND TRAINING PROGRAMS ON MEDICAL RESPONSES 
                   TO CONSEQUENCES OF TERRORIST ACTIVITIES.

       (a) In General.--(1) Subchapter II of chapter 73 of title 
     38, United States Code, is amended by adding after section 
     7325, as added by section 2(a)(1), the following new section:

     ``Sec. 7326. Education and training programs on medical 
       response to consequences of terrorist activities

       ``(a) Education Program.--The Secretary shall carry out a 
     program to develop and disseminate a series of model 
     education and training programs on the medical responses to 
     the consequences of terrorist activities.
       ``(b) Implementing Official.--The program shall be carried 
     out through the Under Secretary for Health, in consultation 
     with the Assistant Secretary of Veterans Affairs with 
     responsibility for operations, preparedness, security, and 
     law enforcement functions.
       ``(c) Content of Programs.--The education and training 
     programs developed under the program shall be modelled after 
     programs established at the F. Edward Hebert School of 
     Medicine of the Uniformed Services University of the Health 
     Sciences and shall include, at a minimum, training for health 
     care professionals in the following:
       ``(1) Recognition of chemical, biological, radiological, 
     incendiary, or other explosive agents, weapons, or devices 
     that may be used in terrorist activities.
       ``(2) Identification of the potential symptoms of exposure 
     to those agents.
       ``(3) Understanding of the potential long-term health 
     consequences, including psychological effects, resulting from 
     exposure to those agents, weapons, or devices.
       ``(4) Emergency treatment for exposure to those agents, 
     weapons, or devices.
       ``(5) An appropriate course of followup treatment, 
     supportive care, and referral.
       ``(6) Actions that can be taken while providing care for 
     exposure to those agents, weapons, or devices to protect 
     against contamination, injury, or other hazards from such 
     exposure.
       ``(7) Information on how to seek consultative support and 
     to report suspected or actual use of those agents.
       ``(d) Potential Trainees.--In designing the education and 
     training programs under this section, the Secretary shall 
     ensure that different programs are designed for health-care 
     professionals in Department medical centers. The programs 
     shall be designed to be disseminated to health professions 
     students, graduate health and medical education trainees, and 
     health practitioners in a variety of fields.
       ``(e) Consultation.--In establishing education and training 
     programs under this section, the Secretary shall consult with 
     appropriate representatives of accrediting, certifying, and 
     coordinating organizations in the field of health professions 
     education.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     7325, as added by section 2(a)(2), the following new item:

``7326. Education and training programs on medical response to 
              consequences of terrorist activities.''.
       (b) Effective Date.--The Secretary of Veterans Affairs 
     shall implement section 7326 of title 38, United States Code, 
     as added by subsection (a), not later than the end of the 90-
     day period beginning on the date of the enactment of this 
     Act.

     SEC. 4. AUTHORITY TO FURNISH HEALTH CARE DURING MAJOR 
                   DISASTERS AND MEDICAL EMERGENCIES.

       (a) In General.--(1) Subchapter VIII of chapter 17 of title 
     38, United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 1785. Care and services during certain disasters and 
       emergencies

       ``(a) Authority To Provide Hospital Care and Medical 
     Services.--During and immediately following a disaster or 
     emergency referred to in subsection (b), the Secretary may 
     furnish hospital care and medical services to individuals 
     responding to, involved in, or otherwise affected by that 
     disaster or emergency.
       ``(b) Covered Disasters and Emergencies.--A disaster or 
     emergency referred to in this subsection is any disaster or 
     emergency as follows:
       ``(1) A major disaster or emergency declared by the 
     President under the Robert B. Stafford Disaster Relief and 
     Emergency Assistance Act (42 U.S.C. 5121 et seq.).
       ``(2) A disaster or emergency in which the National 
     Disaster Medical System established pursuant to section 
     2811(b) of the Public Health Service Act (42 U.S.C. 300hh-
     11(b)) is activated by the Secretary of Health and Human 
     Services under paragraph (3)(A) of that section or as 
     otherwise authorized by law.
       ``(c) Applicability to Eligible Individuals Who Are 
     Veterans.--The Secretary may furnish care and services under 
     this section to an individual described in subsection (a) who 
     is a veteran without regard to whether that individual is 
     enrolled in the system of patient enrollment under section 
     1705 of this title.
       ``(d) Reimbursement From Other Federal Departments and 
     Agencies.--(1) The cost of any care or services furnished 
     under this section to an officer or employee of a department 
     or agency of the United States other than the Department or 
     to a member of the Armed Forces shall be reimbursed at such 
     rates as may be agreed upon by the Secretary and the head of 
     such department or agency or the Secretary concerned, in the 
     case of a member of the Armed Forces, based on the cost of 
     the care or service furnished.
       ``(2) Amounts received by the Department under this 
     subsection shall be credited to the Medical Care Collections 
     Fund under section 1729A of this title.
       ``(e) Report to Congressional Committees.--Within 60 days 
     of the commencement of a disaster or emergency referred to in 
     subsection (b) in which the Secretary furnishes care and 
     services under this section (or as soon thereafter as is 
     practicable), the Secretary shall submit to the Committees on 
     Veterans' Affairs of the Senate and the House of 
     Representatives a report on the Secretary's allocation of 
     facilities and personnel in order to furnish such care and 
     services.
       ``(f) Regulations.--The Secretary shall prescribe 
     regulations governing the exercise of the authority of the 
     Secretary under this section.''.
       (2) The table of sections at the beginning of that chapter 
     is amended by adding at the end the following new item:

``1785. Care and services during certain disasters and emergencies.''.
       (b) Members of the Armed Forces on Active Duty.--Section 
     8111A(a) of such title is amended--
       (1) by redesignating paragraph (2) as paragraph (4);
       (2) by designating the second sentence of paragraph (1) as 
     paragraph (3); and
       (3) by inserting between paragraph (1) and paragraph (3), 
     as designated by paragraph (2) of this subsection, the 
     following new paragraph:
       ``(2)(A) During and immediately following a disaster or 
     emergency referred to in subparagraph (B), the Secretary may 
     furnish hospital care and medical services to members of the 
     Armed Forces on active duty responding to or involved in that 
     disaster or emergency.
       ``(B) A disaster or emergency referred to in this 
     subparagraph is any disaster or emergency as follows:
       ``(i) A major disaster or emergency declared by the 
     President under the Robert B. Stafford Disaster Relief and 
     Emergency Assistance Act (42 U.S.C. 5121 et seq.).
       ``(ii) A disaster or emergency in which the National 
     Disaster Medical System established pursuant to section 
     2811(b) of the Public Health Service Act (42 U.S.C. 300hh-
     11(b)) is activated by the Secretary of Health and Human 
     Services under paragraph (3)(A) of that section or as 
     otherwise authorized by law.''.

     SEC. 5. 10-YEAR EXTENSION OF EXPIRED AUTHORITY.

       Effective September 30, 2002, subsection (d) of section 
     1722A of title 38, United States Code, is amended by striking 
     ``September 30, 2002'' and inserting ``September 30, 2012''.

     SEC. 6. INCREASE IN NUMBER OF ASSISTANT SECRETARIES OF 
                   VETERANS AFFAIRS.

       (a) Increase.--Subsection (a) of section 308 of title 38, 
     United States Code, is amended by striking ``six'' in the 
     first sentence and inserting ``seven''.
       (b) Functions.--Subsection (b) of such section is amended 
     by adding at the end the following new paragraph:
       ``(11) Operations, preparedness, security, and law 
     enforcement functions.''.
       (c) Number of Deputy Assistant Secretaries.--Subsection 
     (d)(1) of such section is amended by striking ``18'' and 
     inserting ``19''.
       (d) Conforming Amendment.--Section 5315 of title 5, United 
     States Code, is amended by striking ``(6)'' after ``Assistant 
     Secretaries, Department of Veterans Affairs'' and inserting 
     ``(7)''.

     SEC. 7. CODIFICATION OF DUTIES OF SECRETARY OF VETERANS 
                   AFFAIRS RELATING TO EMERGENCY PREPAREDNESS.

       (a) In General.--(1) Subchapter I of chapter 81 of title 
     38, United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 8117. Emergency preparedness

       ``(a) Readiness of Department Medical Centers.--(1) The 
     Secretary shall take appropriate actions to provide for the 
     readiness of Department medical centers to protect the 
     patients

[[Page 20716]]

     and staff of such centers from chemical or biological attack 
     or otherwise to respond to such an attack so as to enable 
     such centers to fulfill their obligations as part of the 
     Federal response to public health emergencies.
       ``(2) Actions under paragraph (1) shall include--
       ``(A) the provision of decontamination equipment and 
     personal protection equipment at Department medical centers; 
     and
       ``(B) the provision of training in the use of such 
     equipment to staff of such centers.
       ``(b) Security at Department Medical and Research 
     Facilities.--(1) The Secretary shall take appropriate actions 
     to provide for the security of Department medical centers and 
     research facilities, including staff and patients at such 
     centers and facilities.
       ``(2) In taking actions under paragraph (1), the Secretary 
     shall take into account the results of the evaluation of the 
     security needs at Department medical centers and research 
     facilities required by section 154(b)(1) of the Public Health 
     Security and Bioterrorism Preparedness and Response Act of 
     2002 (Public Law 107-188; 116 Stat. 631), including the 
     results of such evaluation relating to the following needs:
       ``(A) Needs for the protection of patients and medical 
     staff during emergencies, including a chemical or biological 
     attack or other terrorist attack.
       ``(B) Needs, if any, for screening personnel engaged in 
     research relating to biological pathogens or agents, 
     including work associated with such research.
       ``(C) Needs for securing laboratories or other facilities 
     engaged in research relating to biological pathogens or 
     agents.
       ``(c) Tracking of Pharmaceuticals and Medical Supplies and 
     Equipment.--The Secretary shall develop and maintain a 
     centralized system for tracking the current location and 
     availability of pharmaceuticals, medical supplies, and 
     medical equipment throughout the Department health care 
     system in order to permit the ready identification and 
     utilization of such pharmaceuticals, supplies, and equipment 
     for a variety of purposes, including response to a chemical 
     or biological attack or other terrorist attack.
       ``(d) Training.--The Secretary shall ensure that the 
     Department medical centers, in consultation with the 
     accredited medical school affiliates of such medical centers, 
     develop and implement curricula to train resident physicians 
     and health care personnel in medical matters relating to 
     biological, chemical, or radiological attacks or attacks from 
     an incendiary or other explosive weapon.
       ``(e) Participation in National Disaster Medical System.--
     (1) The Secretary shall establish and maintain a training 
     program to facilitate the participation of the staff of 
     Department medical centers, and of the community partners of 
     such centers, in the National Disaster Medical System 
     established pursuant to section 2811(b) of the Public Health 
     Service Act (42 U.S.C. 300hh-11(b)).
       ``(2) The Secretary shall establish and maintain the 
     training program under paragraph (1) in accordance with the 
     recommendations of the working group on the prevention, 
     preparedness, and response to bioterrorism and other public 
     health emergencies established under section 319F(a) of the 
     Public Health Service Act (42 U.S.C. 247d-6(a)).
       ``(3) The Secretary shall establish and maintain the 
     training program under paragraph (1) in consultation with the 
     following:
       ``(A) The Secretary of Defense.
       ``(B) The Secretary of Health and Human Services.
       ``(C) The Director of the Federal Emergency Management 
     Agency.
       ``(f) Mental Health Counseling.--(1) With respect to 
     activities conducted by personnel serving at Department 
     medical centers, the Secretary shall develop and maintain 
     various strategies for providing mental health counseling and 
     assistance, including counseling and assistance for post-
     traumatic stress disorder, following a bioterrorist attack or 
     other public health emergency to the following persons:
       ``(A) Veterans.
       ``(B) Local and community emergency response providers.
       ``(C) Active duty military personnel.
       ``(D) Individuals seeking care at Department medical 
     centers.
       ``(2) The strategies under paragraph (1) shall include the 
     following:
       ``(A) Training and certification of providers of mental 
     health counseling and assistance.
       ``(B) Mechanisms for coordinating the provision of mental 
     health counseling and assistance to emergency response 
     providers referred to in paragraph (1).
       ``(3) The Secretary shall develop and maintain the 
     strategies under paragraph (1) in consultation with the 
     Secretary of Health and Human Services, the American Red 
     Cross, and the working group referred to in subsection 
     (e)(2).''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     8116 the following new item:

``8117. Emergency preparedness.''.

       (b) Repeal of Codified Provisions.--Subsections (a), 
     (b)(2), (c), (d), (e), and (f) of section 154 of the Public 
     Health Security and Bioterrorism Preparedness and Response 
     Act of 2002 (Public Law 107-188; 38 U.S.C. note prec. 8101) 
     are repealed.
       (c) Conforming Amendments.--Subsection (g) of such section 
     is amended--
       (1) in paragraph (1), by inserting ``of section 8117 of 
     title 38, United States Code'' after ``subsection (a)''; and
       (2) in paragraph (2), by striking ``subsections (b) through 
     (f)'' and inserting ``subsection (b)(1) of this section and 
     subsections (b) through (f) of section 8117 of title 38, 
     United States Code''.

  Mr. ROCKEFELLER. Mr. President, as Chairman of the Committee on 
Veterans Affairs, I urge my colleagues to pass H.R. 3253, the proposed 
``Department of Veterans Affairs Emergency Preparedness Act,'' as it 
will be modified by a manager's amendment.
  The pending measure represents a compromise agreement on an omnibus 
bill that would ensure that VA can capably fulfill its obligations to 
veterans, the military, and the entire Nation during disasters. H.R. 
3253 would not only preserve veterans services during national 
emergencies, but would take advantage of VA's expertise in the medical 
consequences of weapons of mass destruction to protect all Americans.
  This legislation would establish four medical emergency preparedness 
research centers within the VA health care system. Although my 
colleagues may not be surprised to learn about VA's research expertise 
in the long-term health consequences of biological, chemical, and 
radiological exposures, fewer may be aware of VA's unparalleled 
clinical management research program. The centers authorized by H.R. 
3253 would allow VA's experts to develop practices for managing or 
preventing mass casualties resulting from the use of terrorist weapons, 
and to do so within our evolving National strategy for homeland 
security research.
  H.R. 3253, as amended, would also authorize a new Assistant 
Secretary, requested by the administration, to coordinate VA's internal 
and interagency operations, security, preparedness, and law enforcement 
activities. This measure would also clarify the Secretary's 
preparedness duties, which would include ensuring that VA's 105,000 
healthcare professionals--and the additional 81,000 providers trained 
in VA facilities each year--receive the education and training that 
they need to protect themselves and their patients during disasters.
  Finally, this measure would recognize the role that VA--the largest 
integrated healthcare system in the Nation already plays during 
disasters. In 1982, Public Law 97-174 assigned a new duty to VA: 
serving as the contingency medical system to the Department of Defense 
during conflicts and emergencies, which Congress assumed would mean 
caring for wounded troops as they returned home from war. In 1982, no 
one anticipated that VA might be called upon to care for active duty 
military casualties during a domestic disaster.
  H.R. 3253 as amended acknowledges that we no longer have the luxury 
of ignoring that possibility, and authorizes VA to extend care to 
active duty military casualties injured while fulfilling their duties 
during a conflict or disaster on American soil as well as abroad.
  The legislation would also acknowledge VA's role in protecting public 
health during emergencies. As part of the Federal Response Plan for 
disasters and a cornerstone of the National Disaster Medical System, VA 
caregivers have aided overwhelmed communities during every major 
domestic disaster of the last two decades. After the Oklahoma City 
attack, after Hurricanes Andrew and Floyd, during Houston's disastrous 
floods, and in New York City on September 11 of last year, VA medical 
professionals stepped up to care for victims--not only veterans, but 
anyone in need.
  VA medical centers are more than just the backbone of the Federal 
clinical infrastructure, they are integral parts of communities, and 
those communities turn to them during crises. The compromise agreement 
highlights this mission, authorizing VA to provide medical care to 
those affected by or responding to declared disasters, or following 
activation of the National Disaster Medical System. I wish to stress to 
my colleagues that this reflects VA's already enormous contribution to 
public safety, a mission that VA will carry out in the future as part 
of the Nation's homeland security strategy.
  Following last year's attacks, Congress sought new tools and new 
strategies to protect the American people

[[Page 20717]]

from the suddenly evident threat posed by terrorists wielding weapons 
of mass destruction. We learned--at the price of five lives lost and 
months of fear, confusion, and the disruption of the Senate that our 
public health resources and our scientific expertise could be 
overwhelmed by a biological assault aimed at a handful of public 
figures.
  We must do more than bemoan the slow starvation of our public health 
care system, the chronic underfunding of the laboratories that detect 
outbreaks, and the managed care principles that have stripped away our 
hospitals' surge capacity. We must use the resources at hand as 
efficiently as possible to ready ourselves for whatever disasters may 
come.
  In conclusion, I want to thank Senator Specter and his staff Bill 
Tuerk, Bill Cahill, and David Goetz for diligently working with me and 
my staff Kim Lipsky and Julie Fischer to craft this legislation. I 
would also like to thank my colleagues on the House Committee on 
Veterans Affairs, particularly Chairman Christopher Smith and his staff 
Pat Ryan, Kingston Smith, Jeannie McNally, Peter Dickinson, Kathleen 
Greve, and John Bradley and Ranking Member Lane Evans and his staff, 
Michael Durishin and Susan Edgerton, for their essential contributions 
to this legislation.
  I urge my colleagues to support these preparedness improvements for 
veterans and VA. This bipartisan measure represents a vital step in 
ensuring VA's preparedness, with a potentially enormous pay-off in 
public safety.
  Mr. DASCHLE. I ask unanimous consent that the Senate concur in the 
House amendment with a further amendment, which is at the desk, that 
the amendment be agreed to and the motion to reconsider be laid upon 
the table, with no intervening action.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 4883) was agreed to.
  (The amendment is printed in today's Record under ``Text of 
Amendments.'')

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