In the House of Representatives, U. S.,

October 7, 1994.

Resolved, That the House agree to the amendments of

the Senate to the bill (H.R. 3313) entitled ‘‘An Act to amend

title 38, United States Code, to improve health care services

of the Department of Veterans Affairs relating to women veterans, to extend and expand authority for the Secretary of

Veterans Affairs to provide priority health care to veterans

who were exposed to ionizing radiation or to Agent Orange,

to expand the scope of services that may be provided to veterans through Vet Centers, and for other purposes’’, with the

following

AMENDMENTS:

In lieu of the matter proposed to be inserted by said

amendment to the text, insert:

1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

2 (a) SHORT TITLE.—This Act may be cited as the ‘‘Vet3 erans Health Programs Extension Act of 1994’’.

4 (b) TABLE OF CONTENTS.—The table of contents of this

5 Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. References to title 38, United States Code.

TITLE I—GENERAL MEDICAL AUTHORITIES

Sec. 101. Sexual trauma counseling and services.

Sec. 102. Research relating to women veterans.

Sec. 103. Extension of expiring authorities.

Sec. 104. Facilities in Republic of the Philippines.

Sec. 105. Savings provision.
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TITLE II—CONSTRUCTION AUTHORIZATION

Sec. 201. Authorization of major medical facility projects and major medical facility leases.

Sec. 202. Authorization of appropriations.

1 SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

2 Except as otherwise expressly provided, whenever in

3 this Act an amendment or repeal is expressed in terms of

4 an amendment to, or repeal of, a section or other provision,

5 the reference shall be considered to be made to a section or

6 other provision of title 38, United States Code.

7 TITLE I—GENERAL MEDICAL

8 AUTHORITIES

9 SEC. 101. SEXUAL TRAUMA COUNSELING AND SERVICES.

10 (a) AUTHORITY TO PROVIDE TREATMENT SERVICES

11 FOR SEXUAL TRAUMA; REPEAL OF LIMITATION ON TIME

12 TO SEEK SERVICES.—Subsection (a) of section 1720D is

13 amended—

14 (1) by striking out paragraph (2); and

15 (2) by inserting after paragraph (1) the follow16 ing new paragraph (2):

17 ‘‘(2) During the period referred to in paragraph (1),

18 the Secretary may provide appropriate care and services

19 to a veteran for an injury, illness, or other psychological

20 condition that the Secretary determines to be the result of

21 a physical assault, battery, or harassment referred to in

22 that paragraph.’’.
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1 (b) EXTENSION OF PERIOD OF AUTHORITY TO PRO2 VIDE SEXUAL TRAUMA SERVICES.—Such subsection is fur3 ther amended—

4 (1) in paragraph (1), by striking out ‘‘December

5 31, 1995,’’ and inserting in lieu thereof ‘‘December

6 31, 1998,’’; and

7 (2) in paragraph (3), by striking out ‘‘December

8 31, 1994,’’ and inserting in lieu thereof ‘‘December

9 31, 1998,’’.

10 (c) REPEAL OF LIMITATION ON PERIOD OF RECEIPT

11 OF SERVICES.—Such section is further amended—

12 (1) by striking out subsection (b); and

13 (2) by redesignating subsections (c), (d), and (e)

14 as subsections (b), (c), and (d), respectively.

15 (d) COORDINATION OF CARE.—Paragraph (1) of sub16 section (b) of such section, as redesignated by subsection

17 (c)(2), is amended to read as follows:

18 ‘‘(1) The Secretary shall give priority to the establish19 ment and operation of the program to provide counseling

20 and care and services under subsection (a). In the case of

21 a veteran eligible for counseling and care and services under

22 subsection (a), the Secretary shall ensure that the veteran

23 is furnished counseling and care and services under this

24 section in a way that is coordinated with the furnishing

25 of such care and services under this chapter.’’.
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1 (e) INCREASED PRIORITY OF CARE.—Section 1712(i)

2 is amended—

3 (1) in paragraph (1)—

4 (A) by inserting ‘‘(A)’’ after ‘‘To a veteran’’;

5 and

6 (B) by inserting ‘‘, or (B) who is eligible for

7 counseling and care and services under section

8 1720D of this title, for the purposes of such coun9 seling and care and services’’ before the period at

10 the end; and

11 (2) in paragraph (2)—

12 (A) by striking out ‘‘, (B)’’ and inserting in

13 lieu thereof ‘‘or (B)’’; and

14 (B) by striking out ‘‘, or (C)’’ and all that

15 follows through ‘‘such counseling’’.

16 (f) PROGRAM REVISION.—(1) Section 1720D is further

17 amended—

18 (A) by striking out ‘‘woman’’ in subsection

19 (a)(1);

20 (B) by striking out ‘‘women’’ in subsection

21 (b)(2)(C) and in the first sentence of subsection (c),

22 as redesignated by subsection (c); and

23 (C) by striking out ‘‘women’’ in subsection

24 (c)(2), as so redesignated, and inserting in lieu there25 of ‘‘individuals’’.
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1 (2)(A) The heading of such section is amended to read

2 as follows:

3 ‘‘§ 1720D. Counseling and treatment for sexual trau4 ma’’.

5 (B) The item relating to such section in the table of

6 sections at the beginning of chapter 17 is amended to read

7 as follows:

‘‘1720D. Counseling and treatment for sexual trauma.’’.

8 (g) INFORMATION BY TELEPHONE.—(1) Paragraph (1)

9 of section 1720D(c), as redesignated by subsection (c) of this

10 section, is amended to read as follows:

11 ‘‘(1) shall include availability of a toll-free tele12 phone number (commonly referred to as an 800 num13 ber); and’’.

14 (2) In providing information on counseling available

15 to veterans as required under section 1720D(c)(1) of title

16 38, United States Code (as amended by paragraph (1)), the

17 Secretary of Veterans Affairs shall ensure that the Depart18 ment of Veterans Affairs personnel who provide assistance

19 under such section are trained in the provision to persons

20 who have experienced sexual trauma of information about

21 the care and services relating to sexual trauma that are

22 available to veterans in the communities in which such vet23 erans reside, including care and services available under

24 programs of the Department (including the care and serv-
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1 ices available under section 1720D of such title) and from

2 non-Department agencies or organizations.

3 (3) The telephone assistance service shall be operated

4 in a manner that protects the confidentiality of persons who

5 place calls to the system.

6 (4) The Secretary shall ensure that information about

7 the availability of the telephone assistance service is visibly

8 posted in Department medical facilities and is advertised

9 through public service announcements, pamphlets, and

10 other means.

11 (5) Not later than 18 months after the date of the en12 actment of this Act, the Secretary shall submit to Congress

13 a report on the operation of the telephone assistance service

14 required under section 1720D(c)(1) of title 38, United

15 States Code (as amended by paragraph (1)). The report

16 shall set forth the following:

17 (A) The number of persons who sought informa18 tion during the period covered by the report through

19 a toll free telephone number regarding services avail20 able to veterans relating to sexual trauma, with a sep21 arate display of the number of such persons arrayed

22 by State (as such term is defined in section 101(20)

23 of title 38, United States Code).

24 (B) A description of the training provided to the

25 personnel who provide such assistance.
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1 (C) The recommendations and plans of the Sec2 retary for the improvement of the service.

3 (h) CONFORMING REPEAL.—Section 102(b) of the Vet4 erans Health Care Act of 1992 (Public Law 102–585; 106

5 Stat. 4946; 38 U.S.C. 1720D note) is repealed.

6 SEC. 102. RESEARCH RELATING TO WOMEN VETERANS.

7 (a) INCLUSION OF WOMEN AND MINORITIES IN CLINI8 CAL RESEARCH PROJECTS.—Section 7303 is amended—

9 (1) by transferring the text of subsection (c) to

10 the end of subsection (a)(1); and

11 (2) by striking out ‘‘(c)’’ and inserting in lieu

12 thereof the following:

13 ‘‘(c)(1) In conducting or supporting clinical research,

14 the Secretary shall ensure that, whenever possible and ap15 propriate—

16 ‘‘(A) women who are veterans are included as

17 subjects in each project of such research; and

18 ‘‘(B) members of minority groups who are veter19 ans are included as subjects of such research.

20 ‘‘(2) In the case of a project of clinical research in

21 which women or members of minority groups will under

22 paragraph (1) be included as subjects of the research, the

23 Secretary shall ensure that the project is designed and car24 ried out so as to provide for a valid analysis of whether

25 the variables being tested in the research affect women or
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1 members of minority groups, as the case may be, differently

2 than other persons who are subjects of the research.’’.

3 (b) HEALTH RESEARCH.—(1) Such section is further

4 amended by adding after subsection (c), as added by sub5 section (a), the following new subsection:

6 ‘‘(d)(1) The Secretary, in carrying out the Secretary’s

7 responsibilities under this section, shall foster and encour8 age the initiation and expansion of research relating to the

9 health of veterans who are women.

10 ‘‘(2) In carrying out this subsection, the Secretary

11 shall consult with the following to assist the Secretary in

12 setting research priorities:

13 ‘‘(A) Officials of the Department assigned re14 sponsibility for women’s health programs and sexual

15 trauma services.

16 ‘‘(B) The members of the Advisory Committee on

17 Women Veterans.

18 ‘‘(C) Members of appropriate task forces and

19 working groups within the Department (including the

20 Women Veterans Working Group and the Task Force

21 on Treatment of Women Who Suffer Sexual Abuse).’’.

22 (2) Section 109 of the Veterans Health Care Act of

23 1992 (Public Law 102–585; 38 U.S.C. 7303 note) is re24 pealed.
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1 (c) POPULATION STUDY.—Section 110(a) of the Veter2 ans Health Care Act of 1992 (Public Law 102–585; 106

3 Stat. 4948) is amended by adding at the end of paragraph

4 (3) the following: ‘‘If it is feasible to do so within the

5 amounts available for the conduct of the study, the Sec6 retary shall ensure that the sample referred to in paragraph

7 (1) constitutes a representative sampling (as determined by

8 the Secretary) of the ages, the ethnic, social and economic

9 backgrounds, the enlisted and officer grades, and the

10 branches of service of all veterans who are women.’’.

11 SEC. 103. EXTENSION OF EXPIRING AUTHORITIES.

12 (a) AUTHORITY TO PROVIDE PRIORITY HEALTH CARE

13 FOR VETERANS EXPOSED TO TOXIC SUBSTANCES.—Chap14 ter 17 is amended—

15 (1) in section 1710(e)(3)—

16 (A) by striking out ‘‘June 30, 1994’’ and

17 inserting in lieu thereof ‘‘June 30, 1995’’; and

18 (B) by striking out ‘‘December 31, 1994’’

19 and inserting in lieu thereof ‘‘December 31,

20 1995’’; and

21 (2) in section 1712(a)(1)(D), by striking out

22 ‘‘December 31, 1994’’ and inserting in lieu thereof

23 ‘‘December 31, 1995’’.
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1 (b) DRUG AND ALCOHOL ABUSE AND DEPENDENCE.—

2 Section 1720A(e) is amended by striking out ‘‘December 31,

3 1994’’ and inserting in lieu thereof ‘‘December 31, 1995’’.

4 (c) PILOT PROGRAM FOR NONINSTITUTIONAL ALTER5 NATIVES TO NURSING HOME CARE.—(1) Effective as of Oc6 tober 1, 1994, subsection (a) of section 1720C is amended

7 by striking out ‘‘During the four-year period beginning on

8 October 1, 1990,’’ and inserting in lieu thereof ‘‘During the

9 period through September 30, 1995,’’.

10 (2) Such subsection is further amended by striking out

11 ‘‘care and who—’’ and inserting in lieu thereof ‘‘care. The

12 Secretary shall give priority for participation in such pro13 gram to veterans who—’’.

14 (d) ENHANCED-USE LEASES OF REAL PROPERTY.—

15 Section 8169 is amended by striking out ‘‘December 31,

16 1994’’ and inserting in lieu thereof ‘‘December 31, 1995’’.

17 (e) AUTHORITY FOR COMMUNITY-BASED RESIDENTIAL

18 CARE FOR HOMELESS CHRONICALLY MENTALLY ILL VET19 ERANS AND OTHER VETERANS.—Section 115(d) of the Vet20 erans’ Benefits and Services Act of 1988 (38 U.S.C. 1712

21 note) is amended by striking out ‘‘September 30, 1994’’ and

22 inserting in lieu thereof ‘‘September 30, 1995’’.

23 (f) DEMONSTRATION PROGRAM OF COMPENSATED

24 WORK THERAPY.—Sction 7(a) of Public Law 102–54 (105
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1 Stat. 269; 38 U.S.C. 1718 note) is amended by striking out

2 ‘‘1994’’ and inserting in lieu thereof ‘‘1995’’.

3 (g) REPORT DEADLINES.—Section 201(b) of the De4 partment of Veterans Affairs Nurse Pay Act of 1990 (Public

5 Law 101–366; 38 U.S.C. 1720C note) is amended by strik6 ing out ‘‘February 1, 1994,’’ and inserting in lieu thereof

7 ‘‘February 1, 1995,’’.

8 SEC. 104. FACILITIES IN REPUBLIC OF THE PHILIPPINES.

9 Notwithstanding section 1724 of title 38, United States

10 Code, the Secretary of Veterans Affairs may contract with

11 facilities in the Republic of the Philippines other than the

12 Veterans Memorial Medical Center to furnish, during the

13 period from February 28, 1994, through June 1, 1994, hos14 pital care and medical services to veterans for nonservice15 connected disabilities if such veterans are unable to defray

16 the expenses of necessary hospital care. When the Secretary

17 determines it to be most feasible, the Secretary may provide

18 medical services under the preceding sentence to such veter19 ans at the Department of Veterans Affairs Outpatient Clin20 ic at Manila, Republic of the Philippines.

21 SEC. 105. RATIFICATION OF ACTIONS DURING PERIOD OF

22 LAPSED AUTHORITY.

23 Any action of the Secretary of Veterans Affairs under

24 section 1710(e) of title 38, United States Code, during the
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1 period beginning on July 1, 1994, and ending on the date

2 of the enactment of this Act is hereby ratified.

3 TITLE II—CONSTRUCTION

4 AUTHORIZATION

5 SEC. 201. AUTHORIZATION OF MAJOR MEDICAL FACILITY

6 PROJECTS AND MAJOR MEDICAL FACILITY

7 LEASES.

8 (a) PROJECTS AUTHORIZED.—The Secretary of Veter9 ans Affairs may carry out the major medical facility

10 projects for the Department of Veterans Affairs, and may

11 carry out the major medical facility leases for that Depart12 ment, for which funds are requested in the budget of the

13 President for fiscal year 1995. The authorization in the pre14 ceding sentence applies to projects and leases which have

15 not been authorized, or for which funds have not been ap16 propriated, in any fiscal year before fiscal year 1995 and

17 to projects and leases which have been authorized, or for

18 which funds were appropriated, in fiscal years before fiscal

19 year 1995.

20 (b) ADDITIONAL PROJECTS.—(1) In addition to the

21 projects authorized in subsection (a), the Secretary may

22 carry out the following major medical facility projects in

23 the amounts specified for such projects:

24 (A) The projects that are proposed in the docu25 ments submitted to Congress by the Secretary of Vet-
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1 erans Affairs in conjunction with the budget of the

2 President for fiscal year 1995 to be financed with

3 funds from the proposed Health Care Investment

4 Fund.

5 (B) Construction of a nursing home facility at

6 the Department of Veterans Affairs Medical Center in

7 Charleston, South Carolina, in the amount of

8 $7,300,000.

9 (C) Construction of an outpatient care addition

10 at the Department of Veterans Affairs medical center

11 in Phoenix, Arizona, in the amount of $50,000,000.

12 (D) A lease/purchase of a nursing home facility

13 near Fort Myers, Florida, in the amount of

14 $12,800,000.

15 (2) The authorizations in paragraph (1) apply to

16 projects which have not been authorized, or for which funds

17 have not been appropriated, in any fiscal year before fiscal

18 year 1995 and to projects which have been authorized, or

19 for which funds were appropriated, in fiscal years before

20 fiscal year 1995.

21 (c) PROJECTS FOR WHICH FUNDS APPROPRIATED.—

22 In addition to the projects authorized in subsections (a) and

23 (b), the Secretary may carry out the following major medi24 cal facility projects for which funds were appropriated in

25 chapter 7 of the Emergency Supplemental Appropriations
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1 Act of 1994 (title I of Public Law 103–211; 108 Stat. 10)

2 in the amounts specified:

3 (1) Construction of an ambulatory care/support

4 services facility at the Department of Veterans Affairs

5 Medical Center in Sepulveda, California, $53,700,000.

6 (2) Other major medical facility projects re7 quired to repair, restore, or replace earthquake-dam8 aged facilities at the Department of Veterans Affairs

9 Medical Center in Sepulveda, California, $50,000,000.

10 SEC. 202. AUTHORIZATION OF APPROPRIATIONS.

11 (a) IN GENERAL.—There are authorized to be appro12 priated to the Secretary of Veterans Affairs for fiscal year

13 1995—

14 (1) $379,370,000 for the major medical facility

15 projects authorized in subsections (a), (b), and (c) of

16 section 201; and

17 (2) $15,800,000 for the major medical facility

18 leases authorized in section 201(a).

19 (b) LIMITATION.—The projects authorized in sub20 sections (a) and (b) of section 201 may only be carried out

21 using—

22 (1) funds appropriated for fiscal year 1995 pur23 suant to the authorization of appropriations in sub24 section (a);
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1 (2) funds appropriated for Construction, Major

2 Projects for a fiscal year before fiscal year 1995 that

3 remain available for obligation; and

4 (3) funds appropriated for Construction, Major

5 Projects for fiscal year 1995 for a category of activity

6 not specific to a project.

7 (c) LIMITATION ON CERTAIN PROJECTS.—The projects

8 authorized in subsection (c) of section 201 may only be car9 ried out using—

10 (1) funds appropriated to the Construction,

11 Major Projects account under chapter 7 of the Emer12 gency Supplemental Appropriations Act of 1994 (title

13 I of Public Law 103–211; 108 Stat. 10) and funds

14 transferred by the President to the Construction,

15 Major Projects account pursuant to chapter 8 of that

16 Act (108 Stat. 14);

17 (2) funds appropriated to the Medical Care ac18 count by chapter 7 of the Emergency Supplemental

19 Appropriations Act of 1994 that are transferred to the

20 Construction, Major Projects account;

21 (3) funds appropriated to the Construction,

22 Major Projects account for a fiscal year before fiscal

23 year 1995 that remain available for obligation; and
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1 (4) funds appropriated to the Construction,

2 Major Projects account for fiscal year 1995 for a cat3 egory of activity not specific to a project.

Amend the title so as to read: ‘‘An Act to amend

title 38, United States Code, to extend certain expiring

veterans’ health care programs, and for other purposes’’.

Passed the House of Representatives October 7,

1994.

Attest:

Clerk.

103D CONGRESS

2D SESSION H. R. 3313

AMENDMENTS

TO

SENATE AMENDMENTS