II

103D CONGRESS

1ST SESSION S. 1226

To amend title 38, United States Code, to provide for the organization

and administration of the Readjustment Counseling Service, to improve

eligibility for readjustment counseling and related counseling, and for

other purposes.

IN THE SENATE OF THE UNITED STATES

JULY 14 (legislative day, JUNE 30), 1993

Mr. AKAKA introduced the following bill; which was read twice and referred

to the Committee on Veterans’ Affairs

A BILL

To amend title 38, United States Code, to provide for the

organization and administration of the Readjustment

Counseling Service, to improve eligibility for readjustment counseling and related counseling, and for other

purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Readjustment Counsel5 ing Service Amendments of 1993’’.
2

•S 1226 IS

1 SEC. 2. ORGANIZATION OF THE READJUSTMENT COUNSEL2 ING SERVICE IN THE DEPARTMENT OF VET3 ERANS AFFAIRS.

4 (a) IN GENERAL.—Section 7305 of title 38, United

5 States Code, is amended—

6 (1) by redesignating paragraph (7) as para7 graph (8); and

8 (2) by inserting after paragraph (6) the follow9 ing new paragraph (7):

10 ‘‘(7) A Readjustment Counseling Service.’’.

11 (b) ORGANIZATION.—The Readjustment Counseling

12 Service shall have the organizational structure and admin13 istrative structure of that service as such structures were

14 in existence on January 1, 1993.

15 (c) REVISION OF ORGANIZATIONAL STRUCTURE.—

16 (1) The Secretary of Veterans Affairs may not alter or

17 revise the organizational structure or the administrative

18 structure of the Readjustment Counseling Service until—

19 (A) the Secretary has submitted to the Commit20 tees on Veterans’ Affairs of the Senate and House

21 of Representatives a report containing a full and

22 complete statement of the proposed alteration or re23 vision; and

24 (B) a period of 60 days has elapsed after the

25 date on which the report is received by the commit26 tees.
3

•S 1226 IS

1 (2) In the computation of the 60-day period under

2 paragraph (1)(B), there shall be excluded any day on

3 which either House of Congress is not in session because

4 of an adjournment of more than 3 calendar days to a day

5 certain.

6 (d) BUDGET INFORMATION RELATING TO THE SERV7 ICE.—Each budget submitted to the Congress by the

8 President under section 1105 of title 31, United States

9 Code, shall set forth the amount requested in the budget

10 for the operation of the Readjustment Counseling Service

11 in the fiscal year covered by the budget and shall set forth

12 separately the amount requested for administrative over13 sight of the activities of the service (including the amount

14 requested for funding of the Advisory Committee on Vet15 eran Readjustment Counseling).

16 SEC. 3. DIRECTOR OF THE READJUSTMENT COUNSELING

17 SERVICE.

18 (a) DIRECTOR.—Section 7306(b) of title 38, United

19 States Code, is amended—

20 (1) by striking out ‘‘and’’ at the end of para21 graph (2);

22 (2) by striking out the period at the end of

23 paragraph (3) and inserting in lieu thereof ‘‘; and’’;

24 and

25 (3) by adding at the end the following:
4

•S 1226 IS

1 ‘‘(4) one shall be a person who (A)(i) is a quali2 fied psychiatrist, (ii) is a qualified psychologist hold3 ing a diploma as a doctorate in clinical or counseling

4 psychology from an authority approved by the Amer5 ican Psychological Association and has successfully

6 undergone an internship approved by that associa7 tion, (iii) is a qualified holder of a master in social

8 work degree, or (iv) is a registered nurse holding a

9 master of science in nursing degree in psychiatric

10 nursing or any other mental-health related degree

11 approved by the Secretary, and (B) has at least 3

12 years of clinical experience and 2 years of adminis13 trative experience in the Readjustment Counseling

14 Service or other comparable mental health care

15 counseling service (as determined by the Secretary),

16 who shall be the director of the Readjustment Coun17 seling Service.’’.

18 (b) ORGANIZATIONAL REQUIREMENT.—The Director

19 of the Readjustment Counseling Service shall report to the

20 Under Secretary for Health through the Associate Deputy

21 Under Secretary for Health for Clinical Programs.
5

•S 1226 IS

1 SEC. 4. EXPANSION OF ELIGIBILITY FOR READJUSTMENT

2 COUNSELING AND CERTAIN RELATED COUN3 SELING SERVICES.

4 (a) READJUSTMENT COUNSELING.—(1) Subsection

5 (c) of section 1712A of title 38, United States Code, is

6 amended to read as follows:

7 ‘‘(a) Upon the request of any veteran, the Secretary

8 shall, within the limits of Department facilities, furnish

9 counseling to such veteran to assist such veteran in re10 adjusting to civilian life. Such counseling shall include a

11 general mental and psychological assessment to ascertain

12 whether such veteran has mental or psychological prob13 lems associated with readjustment to civilian life.’’.

14 (2) Subsection (c) of such section is repealed.

15 (b) OTHER COUNSELING.—Such section is further

16 amended by inserting after subsection (b) the following

17 new subsection (c):

18 ‘‘(c) The Secretary may provide the counseling serv19 ices described in section 1701(6)(B)(ii) of this title to the

20 surviving parents, spouse, and children of any member of

21 the Armed Forces who dies while serving on active duty

22 or from a condition (as determined by the Secretary) in23 curred in or aggravated by such service.’’.

24 (c) AUTHORITY TO CONTRACT FOR COUNSELING

25 SERVICES.—Subsection (e) of such section is amended by

26 striking out ‘‘subsections (a) and (b)’’ each place it ap-
6

•S 1226 IS

1 pears and inserting in lieu thereof ‘‘subsections (a), (b),

2 and (c)’’.

3 SEC. 5. CONFIDENTIALITY OF PATIENT RECORDS IN THE

4 READJUSTMENT COUNSELING SERVICE.

5 (a) IN GENERAL.—Notwithstanding any other provi6 sion of law, the records of the identity, diagnosis, progno7 sis, or treatment of any patient or subject of the Readjust8 ment Counseling Service of the Department of Veterans

9 Affairs, or of any patient or subject provided readjustment

10 counseling services under a contract with the Department,

11 may be disclosed only as follows:

12 (1) By written consent of the patient or subject,

13 only for the purpose for which such consent is

14 granted.

15 (2) To medical personnel to the extent nec16 essary to meet a bona fide medical emergency.

17 (3) To personnel of the Department other than

18 personnel of the service, if such disclosure is deter19 mined by an appropriate member of the service to be

20 necessary to avert an imminent danger to the pa21 tient or subject, or to another person.

22 (4) If authorized by an appropriate order of a

23 court of competent jurisdiction granted after appli24 cation showing good cause therefor (with such cause

25 to be determined according to the elements set forth
7

•S 1226 IS

1 in section 7332(b)(2)(D) of title 38, United States

2 Code).

3 (b) FINES.—Any person who violates a provision of

4 subsection (a) shall be fined in accordance with sub5 sections (f) and (g) of section 7332 of title 38, United

6 States Code.

7 SEC. 6. ADVISORY COMMITTEE ON THE READJUSTMENT OF

8 VETERANS.

9 (a) IN GENERAL.—(1) Subchapter II of chapter 17

10 of title 38, United States Code, is amended by inserting

11 after section 1712B the following:

12 ‘‘§ 1712C. Advisory Committee on Veteran Readjust13 ment Counseling

14 ‘‘(a)(1) There is in the Department the Advisory

15 Committee on Veteran Readjustment Counseling (herein16 after in this section referred to as the ‘Committee’).

17 ‘‘(2) The Committee shall consist of 18 members ap18 pointed by the Secretary from among veterans—

19 ‘‘(A) who have demonstrated significant civic or

20 professional achievement;

21 ‘‘(B) at least 12 of whom are veterans of the

22 Vietnam era or other period of war; and

23 ‘‘(C) who have experience with the provision of

24 veterans benefits and services by the Department.
8

•S 1226 IS

1 ‘‘(3) The Secretary shall seek to ensure that members

2 appointed to the Committee include persons from a wide

3 variety of geographic areas and ethnic backgrounds, per4 sons from veterans service organizations, and women.

5 ‘‘(4) The Secretary shall determine the terms of serv6 ice and pay and allowances of the members of the Commit7 tee, except that a term of service may not exceed 2 years.

8 The Secretary may reappoint any member for additional

9 terms of service.

10 ‘‘(b)(1) The Secretary shall, on a regular basis, con11 sult with and seek the advice of the Committee with re12 spect to the provision by the Department of benefits and

13 services to veterans in order to assist veterans in the re14 adjustment to civilian life.

15 ‘‘(2)(A) In providing advice to the Secretary under

16 this subsection, the Committee shall—

17 ‘‘(i) assemble and review information relating to

18 the needs of veterans in readjusting to civilian life;

19 ‘‘(ii) provide information relating to the nature

20 and character of psychological problems arising from

21 military service;

22 ‘‘(iii) provide an on-going assessment of the ef23 fectiveness of the policies, organizational structures,

24 and services of the Department in assisting veterans

25 in readjusting to civilian life; and
9

•S 1226 IS

1 ‘‘(iv) provide on-going advice on the most ap2 propriate means of responding to the readjustment

3 needs of future veterans.

4 ‘‘(B) In carrying out its duties under subparagraph

5 (A), the Committee shall take into special account veter6 ans of the Vietnam era, and the readjustment needs of

7 such veterans.

8 ‘‘(c)(1) Not later than March 31 of each year, the

9 Committee shall submit to the Secretary a report on the

10 programs and activities of the Department that relate to

11 the readjustment of veterans to civilian life. Each such

12 report shall include—

13 ‘‘(A) an assessment of the needs of veterans

14 with respect to readjustment to civilian life;

15 ‘‘(B) a review of the programs and activities of

16 the Department designed to meet such needs; and

17 ‘‘(C) such recommendations (including rec18 ommendations for administrative and legislative ac19 tion) as the Committee considers appropriate.

20 ‘‘(2) Not later than 90 days after the receipt of each

21 report under paragraph (1), the Secretary shall transmit

22 to the Committees on Veterans’ Affairs of the Senate and

23 House of Representatives a copy of the report, together

24 with any comments and recommendations concerning the

25 report that the Secretary considers appropriate.
10

•S 1226 IS

1 ‘‘(3) The Committee may also submit to the Sec2 retary such other reports and recommendations as the

3 Committee considers appropriate.

4 ‘‘(4) The Secretary shall submit with each annual re5 port submitted to the Congress pursuant to section 529

6 of this title a summary of all reports and recommendations

7 of the Committee submitted to the Secretary since the pre8 vious annual report of the Secretary submitted pursuant

9 to that section.

10 ‘‘(d)(1) Except as provided in paragraph (2), the pro11 visions of the Federal Advisory Committee Act (5 U.S.C.

12 App.) shall apply to the activities of the Committee under

13 this section.

14 ‘‘(2) Section 14 of such Act shall not apply to the

15 Committee.’’.

16 (2) The table of sections at the beginning of chapter

17 17 of such title is amended by inserting after the item

18 relating to section 1712B the following:

‘‘1712C. Advisory Committee on Veteran Readjustment Counseling.’’.

19 (b) ORIGINAL MEMBERS.—(1) Notwithstanding sub20 section (a)(2) of section 1712C(a)(2) of such title (as

21 added by subsection (a)), the members of the Advisory

22 Committee on the Readjustment of Vietnam and Other

23 War Veterans on the date of the enactment of this Act

24 shall be the original members of the advisory committee

25 recognized under such section.
11

•S 1226 IS

1 (2) The original members shall so serve until the Sec2 retary of Veterans Affairs carries out appointments under

3 such subsection (a)(2). The Secretary shall carry out such

4 appointments as soon after such date as is practicable.

5 The Secretary may make such appointments from among

6 such original members.

7 SEC. 7. PLAN FOR EXPANSION OF VIETNAM VETERAN RE8 SOURCE CENTER PILOT PROGRAM.

9 (a) REQUIREMENT.—(1) The Secretary of Veterans

10 Affairs shall submit to the Committees on Veterans’ Af11 fairs of the Senate and House of Representatives a plan

12 for the expansion of the Vietnam Veteran Resource Center

13 program established pursuant to the amendment made by

14 section 105 of the Veterans’ Administration Health-Care

15 Amendments of 1985 (Public Law 99–166; 99 Stat. 944).

16 The plan shall include a schedule for the implementation

17 of the program at or through all Department of Veterans

18 Affairs readjustment counseling centers.

19 (2) The Secretary shall submit the plan not later

20 than 4 months after the date of the enactment of this Act.

21 (b) DEFINITION.—In this section the term ‘‘Depart22 ment of Veterans Affairs readjustment counseling cen23 ters’’ has the same meaning given the term ‘‘center’’ in

24 section 1712A(i)(1) of title 38, United States Code.
12

•S 1226 IS

1 SEC. 8. VETERAN CENTER HEALTH-CARE PILOT PROGRAM.

2 (a) PROGRAM.—(1) Subchapter II of chapter 17 of

3 title 38, United States Code, is amended by adding at the

4 end the following:

5 ‘‘§ 1720E. Veteran center health-care pilot program

6 ‘‘(a) The Secretary shall carry out a pilot program

7 for the provision of health-related services to eligible veter8 ans at readjustment counseling centers. The Secretary

9 shall carry out the pilot program in accordance with this

10 section.

11 ‘‘(b)(1) In carrying out the pilot program, the Sec12 retary shall—

13 ‘‘(A) identify not less than 12 or more than 15

14 readjustment counseling centers at which to provide

15 health-related services under the pilot program; and

16 ‘‘(B) provide such services to eligible veterans

17 at such centers in accordance with paragraph (2).

18 ‘‘(2)(A) The Secretary shall provide health-related

19 services under the pilot program as follows:

20 ‘‘(i) At 5 or more readjustment counseling cen21 ters identified under paragraph (1)(A), by providing

22 not less than 20 hours per week of basic ambulatory

23 services and health-care screening through qualified

24 personnel.
13

•S 1226 IS

1 ‘‘(ii) At 5 or more such centers, by providing

2 not less than 40 hours per week of full-range ambu3 latory services through qualified personnel.

4 ‘‘(iii) At 2 or more such centers, by providing

5 not less than 120 hours per week of physician serv6 ices through qualified personnel.

7 ‘‘(B) In determining the location of the readjustment

8 counseling centers at which to provide health-related serv9 ices under the pilot program, the Secretary shall select

10 centers that are located in a variety of geographic areas

11 and that serve veterans of a variety of economic, social,

12 and ethnic backgrounds.

13 ‘‘(c)(1) The Secretary shall commence the provision

14 of health-related services at readjustment counseling cen15 ters under this section not later than 6 months after the

16 date of the enactment of the Readjustment Counseling

17 Service Amendments of 1993.

18 ‘‘(2) The pilot program shall terminate 2 years after

19 the date on which the Secretary commences the provision

20 of services under paragraph (1).

21 ‘‘(d) For the purposes of this section—

22 ‘‘(1) The term ‘Department general health-care

23 facility’ has the meaning given such term in section

24 1712A(i)(2) of this title.
14

•S 1226 IS

1 ‘‘(2) The term ‘eligible veteran’ means any vet2 eran eligible for outpatient services under paragraph

3 (1), (2), or (3) of section 1712(a) of this title.

4 ‘‘(3) The term ‘readjustment counseling center’

5 has the same meaning given the term ‘center’ in sec6 tion 1712A(i)(1) of this title.’’.

7 (2) The table of sections at the beginning of such

8 chapter is amended by inserting after the item relating

9 to section 1720D the following:

‘‘1720E. Veteran center health-care pilot program.’’.

10 (b) REPORT.—(1) The Secretary of Veterans Affairs

11 shall submit to Congress a report on the veteran center

12 health-care pilot program established under section 1720E

13 of title 38, United States Code (as added by subsection

14 (a)). The report shall include the following:

15 (A) A description of the program, including in16 formation on—

17 (i) the number of veterans provided health18 related services under the program;

19 (ii) the number of such veterans referred

20 to Department of Veterans Affairs general

21 health-care facilities in order to provide health

22 care services to such veterans; and

23 (iii) the cost to the Department of the pro24 gram.
15

•S 1226 IS

1 (B) An analysis of the effectiveness of the

2 health-related services provided to veterans under

3 the program.

4 (C) The recommendations of the Secretary for

5 means of improving the program, and an estimate of

6 the cost to the Department of implementing such

7 recommendations.

8 (D) Such other information as the Secretary

9 considers appropriate.

10 (2) The Secretary shall submit the report not later

11 than 3 months after the termination of the pilot program.

Æ