[House Report 107-471]
[From the U.S. Government Publishing Office]



107th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     107-471

======================================================================



 
    DEPARTMENT OF VETERANS AFFAIRS EMERGENCY PREPAREDNESS RESEARCH, 
          EDUCATION, AND BIO-TERRORISM PREVENTION ACT OF 2002

                                _______
                                

  May 16, 2002.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

   Mr. Smith of New Jersey, from the Committee on Veterans' Affairs, 
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 3253]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Veterans' Affairs, to whom was referred the 
bill (H.R. 3253) to amend title 38, United States Code, to 
provide for the establishment of emergency medical preparedness 
centers in the Department of Veterans Affairs, having 
considered the same, reports favorably thereon with amendments 
and recommends that the bill as amended do pass.

  The amendments are as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Department of Veterans Affairs 
Emergency Preparedness Research, Education, and Bio-Terrorism 
Prevention Act of 2002''.

SEC. 2. ESTABLISHMENT OF EMERGENCY MEDICAL PREPAREDNESS CENTERS.

  (a) In General.--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 at 
least 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 pursuant to 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 for Veterans Affairs with responsibility for operations, 
preparedness, and security.
  ``(b) Mission.--The mission of the centers shall be--
          ``(1) to carry out research on and develop methods of 
        detection, diagnosis, vaccination, protection, and treatment 
        for chemical, biological, and radiological 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; and
          ``(3) to provide contingent rapid response laboratory 
        assistance and other assistance to local health care 
        authorities in the event of a national emergency.
  ``(c) Center Directors.--Each center shall have a Director with (1) 
expertise in managing organizations that deal with threats referred to 
in subsection (b), (2) expertise in providing care to populations 
exposed to toxic substances, or (3) significant research experience in 
those fields.
  ``(d) Selection of Centers.--(1) The Secretary shall select the sites 
for the centers on the basis of a competitive selection process and a 
finding under paragraph (2). The centers selected shall be located in 
different regions of the Nation, and any such center may be a 
consortium of efforts of more than one medical center. At least one of 
the centers shall be established to concentrate on chemical threats, at 
least one shall be established to concentrate on biological threats, 
and at least one shall be established to concentrate on radiological 
threats.
  ``(2) The finding 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, and security, 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 centers so as to provide those persons with 
        training in the diagnosis and treatment of illnesses induced by 
        exposures to toxins, including chemical and biological 
        substances and nuclear ionizing radiation.
          ``(B) An arrangement with an accredited graduate program of 
        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, vaccination, 
        protection, or treatment of persons exposed to chemical, 
        biological, or radiological substances.
  ``(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.
  ``(e) Funding.--(1) Amounts appropriated for the activities of the 
centers shall be appropriated separately from amounts appropriated for 
the Department for medical care.
  ``(2) There are authorized to be appropriated for the centers under 
this section $20,000,000 for each of fiscal years 2003 through 2007.
  ``(3) In addition to funds appropriated for a fiscal year pursuant to 
the authorization of appropriations in paragraph (2), 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. Any determination by the Under Secretary 
under the preceding sentence shall be made in consultation with the 
Assistant Secretary with responsibility for operations, preparedness, 
and security.
  ``(f) 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.
  ``(g) Peer Review Panel.--(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 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 centers under this section. The peer review shall be 
established in consultation with the Assistant Secretary with 
responsibility for operations, preparedness, and security.
  ``(2) The peer review panel shall include experts in the fields of 
toxicological research, bio-hazards management education and training, 
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.
  ``(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.).
  ``(h) Research Products.--(1) The Under Secretary for Health and the 
Assistant Secretary with responsibility for operations, preparedness, 
and security 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.
  ``(i) 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.
  ``(j) 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. The duration of any such assignment or 
detail shall be subject to approval by the Office of Personnel 
Management.''.
  (b) Clerical Amendment.--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:

``7325. Medical emergency preparedness centers.''.

SEC. 3. ESTABLISHMENT OF EMERGENCY MEDICAL EDUCATION PROGRAM.

  (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), the following new section:

``Sec. 7326. Emergency health and medical education: joint program with 
                    Department of Defense

  ``(a) Joint Education Program.--The Secretary and the Secretary of 
Defense shall carry out a joint program to develop and disseminate a 
series of model education and training programs on the medical 
responses to the consequences of terrorist activities. The Secretaries 
shall enter into an agreement for a partnership to implement the joint 
program.
  ``(b) Implementing Entities.--Within the Department of Veterans 
Affairs, the joint 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, and 
security. Within the Department of Defense, the joint program shall be 
carried out through the F. Edward Hebert School of Medicine of the 
Uniformed Services University of the Health Sciences.
  ``(c) Content of Programs.--The education and training programs 
developed under the joint program shall be based on programs 
established at the F. Edward Hebert School of Medicine and shall 
include, at a minimum, training for health care professionals in the 
following:
          ``(1) Recognition of chemical, biological, and radiological 
        agents that may be used in terrorist activities.
          ``(2) Identification of the potential symptoms of those 
        agents.
          ``(3) Understanding of the potential long-term health 
        consequences, including psychological effects, resulting from 
        exposure to those agents.
          ``(4) Emergency treatment for exposure to those agents.
          ``(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 to protect against contamination.
          ``(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 Secretaries shall ensure that 
different programs are designed for health-care professionals at 
various levels. 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 the joint education and training 
program under this section, the two Secretaries 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(b), the following new item:

``7326. Emergency health and medical education: joint program with 
Department of Defense.''.
  (b) Effective Date.--The Secretary of Veterans Affairs and the 
Secretary of Defense 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. 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) 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)''.

  Amend the title so as to read:

      A bill to amend title 38, United States Code, to provide 
for the establishment within the Department of Veterans Affairs 
of improved emergency medical preparedness, research, and 
education programs to combat terrorism, and for other purposes.

                              Introduction

    H.R. 3253, Department of Veterans Affairs Emergency 
Preparedness Research, Education, and Bio-terrorism Prevention 
Act of 2002, addresses issues reviewed by the Committee in 
hearings, meetings, and through other oversight mechanisms over 
the course of this Congress. This bill was introduced by the 
Honorable Christopher H. Smith on November 8, 2001.
    On October 15, 2001, the Committee held a hearing to 
receive testimony on emergency preparedness issues confronting 
the Department of Veterans Affairs in the wake of the terrorist 
attacks of September 11, 2002, on New York City and the 
Pentagon. Those testifying were Ms. Cynthia A. Bascetta, 
Director, Veterans' Health and Benefits Issues, U.S. General 
Accounting Office, accompanied by Mr. Steven L. Caldwell, 
Assistant Director, Defense Capabilities and Management Issues, 
U.S. General Accounting Office; Honorable Anthony J. Principi, 
Secretary, Department of Veterans Affairs, accompanied by 
Frances M. Murphy, M.D., Deputy Under Secretary for Health, 
Veterans Health Administration, Mr. James J. Farsetta, 
Director, VA New York-New Jersey Healthcare System, and Mr. 
John J. Donnellan, Jr., Director, VA New York Harbor Health 
Care System; the Honorable Claude A. Allen, Deputy Secretary, 
Department of Health and Human Services; Dr. Sue Bailey, former 
Assistant Secretary of Defense for Health Affairs; Mr. Kenneth 
S. Kasprisin, Associate Director, Readiness, Response and 
Recovery Division, Federal Emergency Management Agency; Mr. 
James Krueger, Executive Vice President, Chapter Services 
Network, American Red Cross; Ms. Annie W. Everett, Acting 
Regional Administrator for the National Capitol Region, General 
Services Administration; Dr. David S. C. Chu, Under Secretary 
of Defense for Personnel and Readiness, Department of Defense. 
The Committee also received testimony from: Mr. Thomas H. 
Corey, Vietnam Veterans of America; Ms. Jacqueline Garrick, 
Deputy Director, Health Care, National Veterans Affairs and 
Rehabilitation Commission, The American Legion; Mr. Paul A. 
Hayden, Associate Director, National Legislative Service, 
Veterans of Foreign Wars of the United States; Ms. Joy J. Ilem, 
Assistant National Legislative Director, Disabled American 
Veterans; Mr. Richard C. Schneider, Director of Veterans and 
State Affairs, Non-Commissioned Officers Association; and, Mr. 
Delatorro McNeal, Executive Director, Paralyzed Veterans of 
America.
    On November 14, 2001, the Subcommittee on Oversight and 
Investigations received testimony on the need to develop 
education and training programs on medical responses to 
consequences of terrorist acts, particularly after the outbreak 
of anthrax infections caused by a terrorist or terrorists, in 
New Jersey, New York City, Washington, DC and Florida. Those 
testifying at that hearing were: Honorable John Cooksey, Member 
of Congress from the State of Louisiana; Honorable Dave Weldon, 
Member of Congress from the State of Florida; Admiral John F. 
Eisold, Attending Physician to Congress; Dr. Susan J. Matcha, 
Mid-Atlantic Permanente Medical Group; Dr. Carlos Omenaca, 
Miami Heart Center, Miami, FL; Frances M. Murphy, M.D., Deputy 
Under Secretary for Health, Veterans Health Administration, 
Department of Veterans Affairs, accompanied by Dr. Susan 
Mather, Chief Officer, Public Health and Environmental Hazards, 
and Mr. Kenneth H. Mizrach, Director, VA New Jersey Health Care 
System; Dr. Val G. Hemming, Dean, F. Edward Hebert School of 
Medicine, Uniformed Services University of the Health Sciences, 
Department of Defense; Dr. J. Edward Hill, Chairman-Elect of 
the Board of Trustees, American Medical Association; Dr. Jordan 
J. Cohen, President, Association of American Medical Colleges; 
and Dr. Martin J. Blaser, M.D., Professor and Chairman, 
Department of Medicine, New York University School of Medicine.
    On April 10, 2002, the Subcommittee on Health held a 
hearing to consider the following bills: H.R. 3253, National 
Medical Emergency Preparedness Act of 2001; and H.R. 3254, 
Medical Education for National Defense in the 21st Century Act. 
Those testifying at that hearing were: Honorable Leo S. Mackay, 
Jr., Ph.D., Deputy Secretary, Department of Veterans Affairs, 
accompanied by Dr. Robert H. Roswell, Under Secretary for 
Health, and Dr. Kristi Koenig, Director, Emergency Management 
Strategic Healthcare Group; Dr. Kevin Yeskey, Director, Bio-
Terrorism Preparedness and Response Program, Centers for 
Disease Control and Prevention, Department of Health and Human 
Services; Dr. Deborah E. Powell, Executive Dean, University of 
Kansas School of Medicine; and Dr. Stephen F. Wintermeyer, 
Associate Professor of Clinical Medicine, Indiana University 
School of Medicine. Also, the Subcommittee received testimony 
from: Ms. Joy J. Ilem, Assistant National Legislative Director, 
Disabled American Veterans; Mr. Richard Jones, National 
Legislative Director, AMVETS; Mr. Thomas H. Corey, National 
President, Vietnam Veterans of America; Mr. James R. Fischl, 
Director, National Veterans Affairs and Rehabilitation 
Commission, The American Legion; Mr. Richard B. Fuller, 
Legislative Director, Paralyzed Veterans of America; and Mr. 
Paul A. Hayden, Associate Director, National Legislative 
Service, Veterans of Foreign Wars of the United States.
    On May 1, 2002, the Subcommittee on Health met and 
unanimously ordered H.R.3253, with an amendment in the nature 
of a substitute, reported favorably to the full Committee.
    The amendment to H.R. 3253 included the addition of H.R. 
3254, the Medical Education for National Defense in the 21st 
Century Act, introduced by Honorable Steve Buyer on November 8, 
2001 and H.R. 4559, the Department of Veterans Affairs 
Reorganization Act of 2002, introduced by Honorable Christopher 
H. Smith of New Jersey, on April 24, 2002, at the request of 
the Department of Veterans Affairs.
    On May 9, 2002, the full Committee met and ordered H.R. 
3253, with an amendment in the nature of a substitute, reported 
favorably to the House by unanimous voice vote.

                      Summary of the Reported Bill

    H.R. 3253, as amended, would:

    1. LEstablish four or more new National Medical Emergency 
Preparedness Centers at VA medical centers or a consortium of 
VA centers to:

         Conduct medical research on and develop 
            health care responses for chemical, biological and 
            radiological threats to the public;

         Provide related education, training and 
            advice to VA and community health care 
            professionals; and

         Provide rapid response laboratory assistance 
            to local health care authorities in the event of a 
            national emergency.

    2. LRequire the new centers to arrange the participation of 
medical schools and public health schools in the related 
education and training of health care professionals.

    3. LAuthorize $100 million over 5 years to fund the new 
centers.

    4. LRequire the Secretaries of VA and Defense to carry out 
a joint program to develop and disseminate model education and 
training programs on the medical responses to the consequences 
of terrorist activities.

    5. LRequire the training programs to be disseminated to 
health professions students, graduate medical education 
trainees, and health practitioners in a variety of fields.

    6. LAuthorize an additional Assistant Secretary in the 
Department of Veterans Affairs to perform operations, 
preparedness, security and law enforcement functions.

                       Background and Discussion

    With an increased public awareness of bio-terrorism threats 
and an urgent need for preventive measures against bio-
terrorism, the reported bill would provide a proactive approach 
to define new and specific roles for the Department of Veterans 
Affairs in helping the Nation to meet this challenge.
    The bill would establish, at a minimum, four national 
medical emergency preparedness centers in selected VA medical 
center locations to conduct research and develop diagnostic and 
treatment disciplines and standards to respond to biological, 
chemical, and radiological attacks. The centers would be funded 
from resources made available outside the normal funding 
streams available for the VA health care system for the direct 
delivery of health care to enrolled veterans; therefore, the 
new mission of these centers would not erode funding Congress 
provides for the direct delivery of VA health care.

    The missions of these Centers would be to conduct research 
and develop methods of detection, diagnosis, vaccination, 
protection and treatment for chemical, biological, and 
radiological threats to public safety, such as anthrax, 
smallpox, bubonic plague, nerve gas, radiation poisoning, and 
other hazards to human health which may arise as a result of 
acts of terrorism. The centers would engage in direct research, 
coordinate ongoing and new research and educational attainment 
in other public and private agencies, research universities, 
schools of medicine, and schools of public health. The centers 
would also act as clearinghouses for new discoveries, serve to 
disseminate the latest and most comprehensive medical 
information, and help to protect health care workers, emergency 
personnel, active duty military personnel, police officers, as 
well as the general public.
    Through its extensive medical and prosthetic research and 
clinical care programs, VA already has expertise in diagnosing 
and treating widespread viral or bacterial illnesses with 
devastating health consequences, such as the hepatitis C 
epidemic, the HIV pandemic, and in earlier generations, 
tuberculosis infections. In the early part of this century, a 
number of VA hospitals were created specifically to combat 
tuberculosis in the veteran population.
    As authorized by the Veterans Programs Enhancement Act of 
1998, VA operates two War-Related Illness Centers tasked with 
developing specialized treatments for those illnesses and 
injuries that may come from veterans' wartime exposures. 
Previously, the Department successfully launched new centers of 
expertise, education and special care in geriatrics and 
gerontology, mental illness and Parkinson's disease. Such 
initiatives show VA's ability to organize programs and solve 
difficult health problems. In essence, these new National 
Medical Preparedness Centers authorized by H.R. 3253, as 
amended, would study those illnesses and injuries likely to 
come from a terrorist attack using biological, chemical or 
radiation weapons, or from another national environmental or 
biological emergency with similar risks.
    The reported bill would also authorize VA and DoD to work 
with the Nation's schools of medicine to ensure that physicians 
in training receive targeted education in recognizing and 
treating the effects of exposures to biological, chemical and 
nuclear weapons. These training programs would then be made 
available to all health care professionals, students, graduate 
medical education trainees, and practitioners across the 
country in diagnosing and treating victims of biological, 
chemical, and radiological attacks or incidents.
    The Association of American Medical Colleges (AAMC) 
reported that military physicians, who should be more prepared 
than civilian doctors to deal with such threats, are not 
certain about their capability to handle them (Reporter, Volume 
8, Number 3, December 1998, USUHS Military Medicine Program: A 
Treatment for Terrorism). Moreover, Military Medicine reports 
that only 19 percent of military physicians were confident 
about providing care in nuclear, biological or chemical 
disaster situations (Military Medicine, Volume 163, Number 6, 
June 1998, Perceptions of Current and Recent Military Internal 
Medicine Residents on Operational Medicine, Managed Care, 
Graduate Medical Education, and Continued Military Service). 
The majority of those who were confident about their 
capabilities in this area, 53 percent, were graduates of the 
military medical school, the F. Edward Hebert School of 
Medicine of the Uniformed Services University of the Health 
Sciences. The combination of DoD's expertise in the fields of 
teaching and treating casualties resulting from an 
unconventional attack, and VA's infrastructure of 163 medical 
centers, 800 outpatient clinics, extensive satellite 
broadcasting capabilities and affiliations with 107 medical 
schools and teaching hospitals, would provide the needed 
education to current and future health and medical 
practitioners schooled in this country to diagnose and treat 
casualties in such situations.
    The suicide airliner attacks of September 11, 2001, and the 
anthrax attacks in mid-October, 2001, vividly demonstrated the 
vulnerability of the United States to a devastating biological, 
chemical, or radiological attack. Medical professionals have 
honestly acknowledged that they should be better prepared to 
respond effectively whatever the type of weapon a terrorist may 
choose to employ against the United States. This legislation 
recognizes that many diseases and toxins that terrorists might 
use are not seen in the normal course of civilian medical 
practice, and only rarely in the military environment.
    To carry out the intent of this legislation, the Department 
of Veterans Affairs would work with the Department of Health 
and Human Services, the Centers for Disease Control and 
Prevention, the Food and Drug Administration and the Federal 
Emergency Management Agency, as well as the Department of 
Defense. The events of September 11, 2001, have made many 
medical schools acutely aware of the gaps in curriculum and the 
need to fill those gaps. The Committee believes it is desirable 
that the Department of Veterans Affairs and the Department of 
Defense, in coordination with other agencies of government, 
take a more active role in partnering to address these gaps.
    The reported bill also would authorize the Department of 
Veterans Affairs to establish a new Assistant Secretary. The 
new Assistant Secretary would be made responsible for 
coordinating departmental operations, preparedness, security 
and law enforcement to coordinate and improve VA's abilities to 
protect itself, its patients and staff, and the general public 
in a future emergency.

                      Section-By-Section Analysis

    Section 1 of the bill would cite the bill as the Department 
of Veterans Affairs Emergency Preparedness Research, Education, 
and Bio-Terrorism Prevention Act of 2002.

    Section 2(a) of the bill would amend title 38, United 
States Code, chapter 73 by adding a new section 7325 entitled 
``Medical Emergency Preparedness Centers.''

    Section 7325 (a)(1) of title 38, United States Code would 
authorize the Secretary to establish at least four medical 
emergency preparedness centers at Department medical centers 
staffed by Department employees.

    Section 7325 (a)(2) would hold the Under Secretary for 
Health responsible for supervising the operation and provide 
ongoing evaluation of the centers.

    Section 7325 (a)(3) would require the Under Secretary for 
Health and the Assistant Secretary for Veterans Affairs, in 
carrying out the role of the centers, to consult in matters 
dealing with operations, preparedness, and security.

    Section 7325 (b) would define the mission of the centers.

    Section 7325 (b)(1) would require each center to carry out 
research on and develop methods of detection, diagnosis, 
vaccination, protection, and treatment for chemical biological, 
and radiological threats to public health and safety.

    Section 7325 (b)(2) would require each center to provide 
education, training, and advice to health care professionals, 
including health care professionals outside the Veterans Health 
Administration.

    Section 7325 (b)(3) would require each center to provide 
contingent rapid response laboratory assistance and other 
assistance to local health care authorities in the event of a 
national emergency.

    Section 7325 (c) would require the director of each center 
to have expertise in managing organizations that deal with 
chemical, biological, and radiological threats, providing care 
to populations exposed to toxic substances, or significant 
research experience in chemical, biological, and radiological 
fields.

    Section 7325 (d)(1) would authorize the Secretary of 
Veterans Affairs to select sites for the Centers on the basis 
of a competitive selection process. The centers would be 
located in different regions of the Nation with at least one 
center concentrating on chemical threats, at least one center 
concentrating on biological threats, and at least one center 
concentrating on radiological threats.

    Section 7325 (d)(2) would establish criteria for site 
locations by requiring the facility or facilities to meet 
certain guidelines.

    Section 7325 (d)(2)(A) would require the facility to have 
an arrangement with a qualifying medical school and school of 
public health, or a consortium of such schools, to provide 
training to physicians and other medical professionals in the 
diagnosis and treatment of illnesses induced by exposures to 
toxins, including chemical, biological, and nuclear ionizing 
radiation.
    Section 7325 (d)(2)(B) would require the facility to have 
an arrangement with an accredited graduate program of 
epidemiology to provide training in the epidemiology of 
contagious and infectious diseases, and chemical and radiation 
poisoning in an exposed population.

    Section 7325 (d)(2)(C) would require the facility to have 
an arrangement to provide training and education in recognizing 
and caring for conditions associated with exposures to toxins 
to nursing, social work, counseling, or allied health personnel 
and students.

    Section 7325 (d)(2)(D) would require the facility to have 
the ability to attract scientists who have made significant 
contributions to the development of innovative approaches to 
the detection, diagnosis, vaccination, protection, or treatment 
of persons exposed to chemical, biological, or radiological 
substances.

    Section 7325 (d)(3) defines a qualifying medical school and 
school of public health respectively.

    Section 7325 (e)(1) would authorize appropriations for the 
centers to be separated from medical care appropriations.

    Section 7325 (e)(2) would authorize $20,000,000 for the 
centers for fiscal years 2003 through 2007.

    Section 7325 (e)(3) would authorize the Under Secretary for 
Health, in consultation with the Assistant Secretary with 
responsibility for operations, preparedness, and security, to 
allocate additional funds from the medical care and medical and 
prosthetics research account necessary to carry out the 
purposes of the medical emergency preparedness centers.

    Section 7325 (f) would require each center to conduct 
research on improved medical preparedness and authorize the 
centers to seek research funds from public and private sources.

    Section 7325 (g)(1) would establish a peer review panel to 
provide advice to assist the Secretary and the Under Secretary 
for Health in assessing the scientific and clinical merit of 
proposals for the establishment of the four centers. The peer 
review panel is established in consultation with the Assistant 
Secretary with responsibility for operations, preparedness, and 
security.

    Section 7325 (g)(2) would require the peer review panel to 
include experts in relevant areas such as toxicology and 
radiology.

    Section 7325 (g)(3) would require the peer review panel to 
review and submit its views on the scientific and clinical 
merit of each proposal to establish a center.

    Section 7325 (g)(4) would exempt the peer review panel from 
the Federal Advisory Committee Act.

    Section 7325 (h)(1) would require the Under Secretary for 
Health and the Assistant Secretary with responsibility for 
operations, preparedness, and security to disseminate the 
information produced in the centers to health care providers in 
the United States.

    Section 7325 (h)(2) would authorize the Secretary to 
conduct the work of the centers in close coordination with 
other Federal departments and agencies and share such 
information with the departments and agencies.

    Section 7325 (i) would require the Secretary to provide 
assistance to Federal, state, or local authorities in 
investigations, inquiries, and data analyses in the areas of 
biological, chemical or radiological threats.

    Section 7325 (j) would allow the Director of a center, with 
the Secretary's approval, to request temporary assignment or 
detail of employees from other departments and agencies with 
expertise to further the mission of the center. The duration of 
assignment or detail would be subject to approval by the Office 
of Personnel Management.

    Section 2(b) of the bill would make clerical amendments.

    Section 3(a)(1) of the bill would amend chapter 73 of title 
38, United States Code, by adding a new section 7326 entitled 
``Emergency health and medical education: joint program with 
Department of Defense.''

    Section 7326 (a) of title 38, United States Code, would 
authorize the Department of Veterans Affairs and Department of 
Defense to develop and disseminate a series of model education 
and training programs on the medical responses to the 
consequences of terrorist activities.

    Section 7326 (b) would require the Under Secretary for 
Health, in consultation with the Assistant Secretary with 
responsibility for operations, preparedness and security, to 
carry out a joint program for the Department of Veterans 
Affairs; and the F. Edward Hebert School of Medicine of the 
Uniformed Services University of the Health Sciences for the 
Department of Defense.

    Section 7326 (c) would require that the content of the 
education and training program developed be based on programs 
established at the F. Edward Hebert School of Medicine.

    Section 7326 (c) would define the minimum training 
requirements for the joint program: 1) recognition of chemical, 
biological, and radiological agents; 2) identification of 
potential symptoms of those agents; 3) understanding the 
potential long-term health consequences; 4) emergency treatment 
for exposure; 5) appropriate course of follow-up treatment, 
supportive care, and referral; 6) preventive actions against 
contamination taken while providing care for exposure; and 7) 
information on reporting and seeking consultative support for 
the suspected or actual use of those agents.

    Section 7326 (d) would require that the programs be 
designed and disseminated to health professions students, 
graduate health and medical education trainees, and health 
practitioners in a variety of fields and of vaious levels of 
training.

    Section 7326 (e) would require the Secretaries to consult 
with representatives of accrediting, certifying and 
coordinating organizations in the field of health professions 
education in establishing the joint program.

    Section 3(a)(2) of the bill would make clerical amendments.

    Subsection (b) would require the implementation of this 
section to be no later than 90 days after the enactment of the 
Act.

    Section 4(a) would amend section 308(a) of title 38, United 
States Code, by increasing the number of Assistant Secretaries 
of Veterans Affairs from six to seven.

    Subsection (b) would add a new item to the list of 
functions which the seven Assistant Secretaries would be 
responsible for: operations, preparedness, security and law 
enforcement functions.

    Subsection (c) would make a conforming amendment.

                    Performance Goals and Objectives

    The Department of Veterans Affairs' performance goals and 
objectives are established in annual performance plans and are 
subject to the Committee's regular oversight and evaluation by 
the U.S. General Accounting Office.

              Statement of the Views of the Administration

    From the statement of the Honorable Leo S. MacKay, Jr., 
Ph.D., Deputy Secretary of Veterans Affairs, Department of 
Veterans Affairs, before the Subcommittee on Health, Committee 
on Veterans' Affairs, April 10, 2002:

          VA has the infrastructure and expertise to be a vital 
        and integral link in our Nation's Homeland Security 
        efforts. We are the largest integrated national health 
        care system with personnel and facilities in virtually 
        every community across the U.S. VA has a robust 
        research program and is already actively engaged in 
        numerous projects in the areas of bio-terrorism and 
        medical emergency preparedness. We have made tremendous 
        strides in improving our capacity to maintain 
        operations in the event of a medical emergency by 
        increasing our ability to protect our staff and by 
        providing education and training. VA currently sponsors 
        the largest medical education and health professions 
        training program in the United States. Last year, 
        approximately 85,000 health professionals trained in 
        our medical facilities. VA facilities are affiliated 
        with almost 1,400 medical and other allied health care 
        schools. It is imperative that not only VA but also 
        non-VA health care providers receive the education and 
        training needed to become highly adept at recognizing 
        and responding to both the immediate and potential 
        long-term medical needs of individuals exposed to 
        chemical, biological, radiological, and other 
        unconventional warfare agents.
          As you are aware, under the Federal Response Plan, 
        the Department of Health and Human Services (HHS) has 
        been designated as lead Federal agency for assessing 
        and providing health and medical services during 
        medical emergencies. VA may be, and has in fact been, 
        called upon to furnish needed medical assistance and 
        related services.
          The Executive Office of the President, through the 
        Office of Homeland Security (OHS), is currently 
        crafting a comprehensive coordinated federal policy on 
        Homeland Security. VA is actively participating in this 
        OHS effort. It is expected that OHS will deliver this 
        policy to the President this July. The precise role and 
        responsibilities VA will be assigned in the area of 
        Homeland Security will be reflected in that policy. We 
        expect that we will have much to contribute in this 
        area based on our depth of expertise and 
        infrastructure, as alluded to above.

          Because the President's Homeland Security policy is 
        forthcoming, we would like to work with the Committee 
        to ensure that the provisions of H.R. 3253 and H.R. 
        3254 are consistent with the comprehensive federal 
        plan.

          Finally, I am very concerned that carrying out the 
        proposed activities without dedicated funding could 
        unacceptably diminish VA's ability to fulfill its 
        primary mission-providing health care and services to 
        veterans and their families. These new activities 
        cannot be accommodated within our already stretched 
        medical care accounts. Dedicated funding appropriated 
        separately for this effort must be consistent with the 
        discretionary spending limits of the President's 
        budget.

          Having said this, I would like to address the bills 
        and provide a brief explanation of H.R. 3253 and H.R. 
        3254 and our views on their major provisions.

          Mr. Chairman, the first bill, H.R. 3254, would 
        require that the Secretaries of Veterans Affairs and 
        Defense jointly develop and distribute a series of 
        model education and training programs to prepare health 
        professionals to respond to consequences of terrorist 
        activities. The programs' content would emphasize 
        education and training in the recognition of chemical, 
        biological, and radiological agents that may be used in 
        terrorist activities and identification of the 
        potential symptoms related to use of those agents. They 
        would also focus on management of clinical consequences 
        of terrorist acts. The education and training programs 
        would also be required to address short-term and long-
        term health consequences, including psychological 
        effects that may result from exposure to such agents 
        and the appropriate treatment of those health 
        consequences. In addition, the programs must identify 
        measures to be taken by health care professionals to 
        prevent them from suffering secondary contamination or 
        infection while treating victims of a national medical 
        emergency. H.R. 3254 would also require that the 
        proposed joint education and training programs be 
        designed for health professions students, graduate 
        medical education trainees, and health practitioners in 
        a variety of fields.

          Initial funding for these programs would be 
        authorized from funds made available under the 
        Emergency Supplemental Appropriations Act (Public Law 
        107-38).

          VA strongly supports the goals of H.R. 3254. The 
        proposed training and education activities on national 
        medical emergencies would complement and strengthen the 
        current training and education efforts being carried 
        out by HHS through the Health Resources Administration 
        and the Centers for Disease Control and Prevention.

          As drafted, the bill provides that DoD would carry 
        out the joint program through the F. Edward Hebert 
        School of Medicine of the Uniformed Services University 
        of the Health Sciences. We recommend that the Committee 
        consider placing DoD responsibility for the joint 
        program in the Assistant Secretary of Defense (Health 
        Affairs), which is the appropriate policy-level 
        counterpart to the Under Secretary for Health. If 
        enacted, the Department projects the first-year costs 
        associated with H.R. 3254 to be $5,641,500, with ten-
        year costs estimated to be $55,065,000.
          Mr. Chairman, I next turn to H.R. 3253. This bill 
        would require the Secretary to establish four or more 
        Emergency Medical Preparedness Centers within the 
        Veterans Health Administration (VHA). Under the 
        proposal, VA employees would staff the proposed 
        Centers, and the VHA Headquarters official responsible 
        for medical preparedness would be responsible for 
        supervising and evaluating the Centers' operations. The 
        Centers would have three specific missions. First, they 
        would carry out research and develop methods in 
        detection, diagnosis, vaccination, protection, and 
        treatment for CBR threats to the public health and 
        safety. Second, they would provide education, training, 
        and advice to VA and non-VA healthcare professionals. 
        Third, the Centers would provide contingent rapid 
        response laboratory assistance and other assistance to 
        local health care authorities in the event of a 
        national emergency.
          H.R. 3253 would require that at least one of the 
        proposed Centers focus on chemical threats, another 
        concentrate on biological threats, and a third on 
        radiological threats. Each Center would be required to 
        conduct research on improved medical preparedness in 
        that Center's particular area of expertise. To carry 
        out this particular mandate, each Center would be 
        authorized to seek funding from both public and private 
        sources.
          Finally, the bill would authorize initial funding 
        from the Emergency Supplemental Appropriations Act 
        (Public Law 107-38). It would also authorize additional 
        appropriations and require the Under Secretary for 
        Health to allocate from funds appropriated for the 
        Medical Care Account and the Medical and Prosthetics 
        Research Accounts such amounts as the Under Secretary 
        for Health determines appropriate to carry out the 
        activities of the Centers.

          We strongly support the goals of H.R. 3253 and 
        believe that VA's expertise and infrastructure is 
        needed to help the nation respond to the health 
        consequences of terrorists' use, and potential use, of 
        CBR agents and other similar unconventional weapons. 
        However, H.R. 3253 would also authorize the Secretary 
        to assist Federal, State, and local civil and law 
        enforcement authorities with investigations to protect 
        the public safety and to prevent or obviate CBR-related 
        threats. Although we have the expertise to support such 
        activities, I believe we should limit our role to 
        support these needs on an expedited referral basis.

          We also note that the training mission of the Centers 
        is somewhat similar to the goals of H.R. 3254 addressed 
        earlier. We recommend that the Subcommittee work to 
        integrate the similar training provisions of the two 
        bills.

          ***
          I would underscore that any new role or 
        responsibilities must be consistent with the overall 
        comprehensive federal strategy on Homeland Security. 
        Moreover, a separate appropriation consistent with the 
        overall discretionary spending limits of the 
        President's budget must be provided. We welcome the 
        opportunity to work with the Committee to that end.

               Congressional Budget Office Cost Estimate

    The following letter was received from the Congressional 
Budget Office concerning the cost of the reported bill:

                                     U.S. Congress,
                               Congressional Budget Office,
                                      Washington, DC, May 10, 2002.
Hon. Christopher H. Smith
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.

    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 3253, the 
Department of Veterans Affairs Emergency Preparedness Research, 
Education, and Bio-Terrorism Prevention Act of 2002.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Sam 
Papenfuss, who can be reached at 226-2840.

            Sincerely,
                                            Dan L. Crippen,
                                                          Director.

    Enclosure.

Congressional Budget Office Cost Estimate              May 10, 2002     
                                         


H.R. 3253, Department of Veterans Affairs Emergency Preparedness 
  Research, Education, and Bio-Terrorism Prevention Act of 2002, As 
  ordered reported by the House Committee on Veterans' Affairs on 
  May 9, 2002

Summary

    H.R. 3253 would establish at least four medical emergency 
centers that would carry out research and development, provide 
education and training, and provide assistance in the case of a 
national emergency with regard to chemical, biological, and 
radiological threats. These emergency centers would be located 
in hospitals operated by the Department of Veterans Affairs 
(VA). H.R. 3253 would authorize appropriations of $20 million a 
year over the 2003-2007 period to operate these centers. As 
part of the requirement to provide education and training, the 
bill would require VA to carry out a joint program with the 
Department of Defense (DoD) to develop and disseminate a series 
of training programs on the medical responses to terrorist 
activities. Finally, H.R. 3253 would increase the number of 
Assistant Secretaries within the VA from six to seven with the 
new assistant secretary being responsible for operations, 
preparedness, security, and law enforcement functions.
    CBO estimates that implementing H.R. 3253 would cost $12 
million in 2003 and $87 million over the 2003-2007 period, 
assuming appropriation of the authorized amounts. Because the 
bill would not affect direct spending or receipts, pay-as-you-
go procedures would not apply.
    H.R. 3253 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would impose no costs on state, local, or tribal 
governments.

Estimated Cost to the Federal Government

    The estimated budgetary impact of H.R. 3253 is shown in the 
following table. The costs of this legislation fall within 
budget function 700 (veterans benefits and services).



----------------------------------------------------------------------------------------------------------------
                                                                 By Fiscal Year, in Millions of Dollars
                                                     -----------------------------------------------------------
                                                        2002      2003      2004      2005      2006      2007
----------------------------------------------------------------------------------------------------------------

                             CHANGES IN SPENDING SUBJECT TO APPROPRIATIONa

Spending for VA Medical Emergency Centers Under H.R.
 3253
  Authorization Level...............................         0        20        20        20        20        20
  Estimated Outlays.................................         0        12        16        19        20        20
----------------------------------------------------------------------------------------------------------------
a No funds were appropriated for these purposes in 2002.

Basis of Estimate

    VA has some limited responsibilities to provide assistance 
in the event of a chemical, biological, or radiological (CBR) 
threat under current law. Under H.R. 3253, VA would have 
expanded responsibility to assist with CBR threats with the 
creation of four medical emergency centers that would carry out 
VA's new responsibilities. H.R. 3253 would specifically 
authorize appropriations of $20 million a year over the 2003-
2007 period for the operation of these centers and would 
authorize the use of other appropriated funds to carry out the 
centers' activities. Assuming normal delays in beginning new 
programs and appropriation of the authorized amounts, CBO 
estimates that implementing H.R. 3253 would increase spending 
by $12 million in 2003 and by $87 million over the 2003-2007 
period.
    The bill would require that VA establish four medical 
emergency centers that would have three different 
responsibilities. The first would be to conduct research and 
development on detection, diagnosis, vaccination, protection, 
and treatment on CBR threats to the public health and safety. 
The second responsibility would be to provide training and 
advice to health care professionals outside of VA, in 
conjunction with DoD. The third responsibility would be to 
provide contingent rapid response assistance including 
laboratory assistance in the event of national emergencies.
    CBO estimates that all of these responsibilities could be 
carried out for the authorized $20 million a year. Although 
setup and operating costs would come from appropriated funds, 
the actual costs of the research and development would come 
from public and private research grants. Using information from 
VA, CBO estimates that the cost of providing education and 
training would be about $5 million a year. Barring any major 
national emergencies, CBO does not expect that VA would spend 
more than the $20 million in appropriations specifically 
authorized in H.R. 3253.

Pay-as-you-go Considerations: None.

Intergovernmental and Private-sector Impact

    H.R. 3253 contains no intergovernmental or private-sector 
mandates as defined in UMRA and would impose no costs on state, 
local, or tribal governments.

Estimate prepared by:

  Federal Costs: Sam Papenfuss
  Impact on State, Local, and Tribal Governments: Elyse Goldman
  Impact on the Private Sector: Sally Maxwell

Estimate approved by:

  Peter H. Fontaine
  Deputy Assistant Director for Budget Analysis

                     Statement of Federal Mandates

    The preceding Congressional Budget Office cost estimate 
states that the bill contains no intergovernmental or private 
sector mandates as defined in the Unfunded Mandates Reform Act.

                  Applicability to Legislative Branch

    The reported bill would not be applicable to the 
legislative branch under the Congressional Accountability Act, 
Public Law 104-1, because the bill would only affect or 
authorize certain Department of Veterans Affairs with 
Department of Defense programs or activities.

                 Statement of Constitutional Authority

    Pursuant to Article I, section 8 of the United States 
Constitution, the reported bill is authorized by Congress' 
power to ``provide for the common Defense and general Welfare 
of the United States.''

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, existing law in which no change 
is proposed is shown in roman):

                     TITLE 38, UNITED STATES CODE

           *       *       *       *       *       *       *


                      PART I--GENERAL PROVISIONS

           *       *       *       *       *       *       *


               CHAPTER 3--DEPARTMENT OF VETERANS AFFAIRS

           *       *       *       *       *       *       *


Sec. 308. Assistant Secretaries; Deputy Assistant Secretaries

  (a) There shall be in the Department not more than [six] 
seven Assistant Secretaries. Each Assistant Secretary shall be 
appointed by the President, by and with the advice and consent 
of the Senate.
  (b) The Secretary shall assign to the Assistant Secretaries 
responsibility for the administration of such functions and 
duties as the Secretary considers appropriate, including the 
following functions:
          (1) * * *

           *       *       *       *       *       *       *

          (11) Operations, preparedness, security, and law 
        enforcement functions.

           *       *       *       *       *       *       *


             PART V--BOARDS, ADMINISTRATIONS, AND SERVICES

           *       *       *       *       *       *       *


 CHAPTER 73--VETERANS HEALTH ADMINISTRATION--ORGANIZATION AND FUNCTIONS

                       SUBCHAPTER I--ORGANIZATION

Sec.
7301.    Functions of Veterans Health Administration: in general.
     * * * * * * *

           subchapter ii--general authority and administration

7311.    Quality assurance.
     * * * * * * *
7325.    Medical emergency preparedness centers.
7326.    Emergency health and medical education: joint program with 
          Department of Defense.

           *       *       *       *       *       *       *


          SUBCHAPTER II--GENERAL AUTHORITY AND ADMINISTRATION

           *       *       *       *       *       *       *


Sec. 7325. Medical emergency preparedness centers

  (a) Establishment of Centers.--(1) The Secretary shall 
establish at least 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 pursuant 
to 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 for Veterans Affairs with responsibility 
for operations, preparedness, and security.
  (b) Mission.--The mission of the centers shall be--
          (1) to carry out research on and develop methods of 
        detection, diagnosis, vaccination, protection, and 
        treatment for chemical, biological, and radiological 
        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; and
          (3) to provide contingent rapid response laboratory 
        assistance and other assistance to local health care 
        authorities in the event of a national emergency.
  (c) Center Directors.--Each center shall have a Director with 
(1) expertise in managing organizations that deal with threats 
referred to in subsection (b), (2) expertise in providing care 
to populations exposed to toxic substances, or (3) significant 
research experience in those fields.
  (d) Selection of Centers.--(1) The Secretary shall select the 
sites for the centers on the basis of a competitive selection 
process and a finding under paragraph (2). The centers selected 
shall be located in different regions of the Nation, and any 
such center may be a consortium of efforts of more than one 
medical center. At least one of the centers shall be 
established to concentrate on chemical threats, at least one 
shall be established to concentrate on biological threats, and 
at least one shall be established to concentrate on 
radiological threats.
  (2) The finding 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, and security, 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 
        centers so as to provide those persons with training in 
        the diagnosis and treatment of illnesses induced by 
        exposures to toxins, including chemical and biological 
        substances and nuclear ionizing radiation.
          (B) An arrangement with an accredited graduate 
        program of 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, 
        vaccination, protection, or treatment of persons 
        exposed to chemical, biological, or radiological 
        substances.
  (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.
  (e) Funding.--(1) Amounts appropriated for the activities of 
the centers shall be appropriated separately from amounts 
appropriated for the Department for medical care.
  (2) There are authorized to be appropriated for the centers 
under this section $20,000,000 for each of fiscal years 2003 
through 2007.
  (3) In addition to funds appropriated for a fiscal year 
pursuant to the authorization of appropriations in paragraph 
(2), 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. Any determination by the Under 
Secretary under the preceding sentence shall be made in 
consultation with the Assistant Secretary with responsibility 
for operations, preparedness, and security.
  (f) 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.
  (g) Peer Review Panel.--(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 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 centers under this 
section. The peer review shall be established in consultation 
with the Assistant Secretary with responsibility for 
operations, preparedness, and security.
  (2) The peer review panel shall include experts in the fields 
of toxicological research, bio-hazards management education and 
training, 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.
  (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.).
  (h) Research Products.--(1) The Under Secretary for Health 
and the Assistant Secretary with responsibility for operations, 
preparedness, and security 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.
  (i) 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.
  (j) 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. The duration of any such assignment or detail 
shall be subject to approval by the Office of Personnel 
Management.

Sec. 7326. Emergency health and medical education: joint program with 
                    Department of Defense

  (a) Joint Education Program.--The Secretary and the Secretary 
of Defense shall carry out a joint program to develop and 
disseminate a series of model education and training programs 
on the medical responses to the consequences of terrorist 
activities. The Secretaries shall enter into an agreement for a 
partnership to implement the joint program.
  (b) Implementing Entities.--Within the Department of Veterans 
Affairs, the joint 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, and security. Within the Department 
of Defense, the joint program shall be carried out through the 
F. Edward Hebert School of Medicine of the Uniformed Services 
University of the Health Sciences.
  (c) Content of Programs.--The education and training programs 
developed under the joint program shall be based on programs 
established at the F. Edward Hebert School of Medicine and 
shall include, at a minimum, training for health care 
professionals in the following:
          (1) Recognition of chemical, biological, and 
        radiological agents that may be used in terrorist 
        activities.
          (2) Identification of the potential symptoms of those 
        agents.
          (3) Understanding of the potential long-term health 
        consequences, including psychological effects, 
        resulting from exposure to those agents.
          (4) Emergency treatment for exposure to those agents.
          (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 to protect against 
        contamination.
          (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 Secretaries shall 
ensure that different programs are designed for health-care 
professionals at various levels. 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 the joint education and 
training program under this section, the two Secretaries shall 
consult with appropriate representatives of accrediting, 
certifying, and coordinating organizations in the field of 
health professions education.

           *       *       *       *       *       *       *

                              ----------                              


              SECTION 5315 OF TITLE 5, UNITED STATES CODE

Sec. 5315. Positions at level IV

  Level IV of the Executive Schedule applies to the following 
positions, for which the annual rate of basic pay shall be the 
rate determined with respect to such level under chapter 11 of 
title 2, as adjusted by section 5318 of this title:
          Deputy Administrator of General Services.

           *       *       *       *       *       *       *

          Assistant Secretaries, Department of Veterans Affairs 
        [(6)] (7).

           *       *       *       *       *       *       *


                                  
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