I
104TH CONGRESS
2D SESSION
H. R. 3972
To amend title 38, United States Code, to improve health care services
provided by the Department of Veterans Affairs to women veterans.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 2, 1996
Ms. WATERS (for herself and Ms. BROWN of Florida) introduced the following
bill; which was referred to the Committee on Veterans’ Affairs
A BILL
To amend title 38, United States Code, to improve health
care services provided by the Department of Veterans
Affairs to women veterans.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Women Veterans’
Health Act of 1996’’.
SEC. 2. WOMEN’S HEALTH SERVICES.
(a) WOMEN’S HEALTH SERVICES.—Section 1701 of
title 38, United States Code, is amended—
(1) in paragraph (6)(A)(i), by inserting ‘‘wom-
en’s health services,’’ after ‘‘preventive health serv-
ices,’’; and
(2) by adding at the end the following:
‘‘(10) The term ‘women’s health services’ means
health care services provided to women. Such term in-
cludes counseling and services relating to the following:
‘‘(A) Papanicolaou tests (pap smear).
‘‘(B) Breast examinations and mammography.
‘‘(C) The management and prevention of sexu-
ally transmitted diseases.
‘‘(D) Menopause, osteoporosis, and other condi-
tions relating to aging.
‘‘(E) Cardiac care.
‘‘(F) Physical and psychological conditions aris-
ing out of acts of sexual violence.
‘‘(G) Physical and psychological conditions that
result from homelessness.’’.
(b) CONTRACTS FOR WOMEN’S HEALTH SERVICES.—
Section 1703(a) of such title is amended by adding at the
end the following:
‘‘(9) Women’s health services for veterans on
an ambulatory or outpatient basis.’’.
(c) REPEAL OF SUPERSEDED AUTHORITY.—Section
106 of the Veterans Health Care Act of 1992 (Public Law
102–585; 38 U.S.C. 1710 note) is amended—
(1) by striking out subsection (a); and
(2) by striking out ‘‘(b) RESPONSIBILITIES OF
DIRECTORS
OF FACILITIES.—’’ before ‘‘The Sec-
retary’’.
SEC. 3. COUNSELING AND TREATMENT FOR SEXUAL TRAU-
MA.
(a) COUNSELING.—Subsection (a)(1) of section
1720D of title 38, United States Code, is amended by
striking out ‘‘During the period through December 31,
1998, the Secretary’’ and inserting in lieu thereof ‘‘The
Secretary’’.
(b) TREATMENT.—Subsection (a)(2) of such section
is amended by striking out ‘‘During the period referred
to in paragraph (1), the Secretary’’ and inserting in lieu
thereof ‘‘The Secretary’’.
(c) CONTRACT COUNSELING.—Subsection (a)(3) of
such section is amended by striking out ‘‘, during the pe-
riod through December 31, 1998,’’.
SEC. 4. REPORT ON WOMEN’S HEALTH CARE AND RE-
SEARCH.
(a) IN GENERAL.—Not later than January 1, 1999,
the Secretary of Veterans Affairs shall submit to the Com-
taken to recruit such additional personnel or person-
nel to replace such personnel.
(6) An assessment by the Secretary of any dif-
ficulties experienced by the Secretary in the furnish-
ing of such services and the actions taken by the
Secretary to resolve such difficulties.
(7) A description (as of October 1 of the year
preceding the year in which the report is submitted)
of the status of any research relating to women vet-
erans being carried out by or under the jurisdiction
of the Secretary.
(8) A description of the actions taken by the
Secretary to foster and encourage the expansion of
such research.
SEC. 5. EXPANSION OF RESEARCH RELATING TO WOMEN
VETERANS.
(a) INCLUSION
OF WOMEN
AND MINORITIES
IN
HEALTH RESEARCH.—Section 7303(c) of title 38, United
States Code, is amended—
(1) in paragraph (1), by striking out ‘‘that,
whenever possible and appropriate—’’ and inserting
in lieu thereof ‘‘that—’’; and
(2) by adding at the end the following new
paragraph:
‘‘(3) The requirement in paragraph (1) regarding
women and members of minority groups who are veterans
may be waived by the Secretary of Veterans Affairs with
respect to a project of clinical research if the Secretary
determines that the inclusion, as subjects in the project,
of women and members of minority groups, respectively—
‘‘(A) is inappropriate with respect to the health
of the subjects;
‘‘(B) is inappropriate with respect to the pur-
pose of the research; or
‘‘(C) is inappropriate under such other cir-
cumstances as the Secretary may designate.’’.
(b) HEALTH RESEARCH RELATING TO WOMEN.—
Section 7303(d) of such title is amended by adding at the
end the following new paragraphs:
‘‘(3) The Secretary shall foster and encourage re-
search under this section on the following matters as they
relate to women:
‘‘(A) Breast cancer.
‘‘(B) Gynecological and reproductive health, in-
cluding gynecological cancer, infertility, sexually-
transmitted diseases, and pregnancy.
‘‘(C) Human Immunodeficiency Virus and Ac-
quired Immune Deficiency Syndrome.
‘‘(D) Mental health, including post-traumatic
stress disorder, depression, combat related stress,
and trauma.
‘‘(E) Diseases related to aging, including meno-
pause, osteoporosis, and Alzheimer’s disease.
‘‘(F) Substance abuse.
‘‘(G) Sexual violence and related trauma.
‘‘(H) Exposure to toxic chemicals and other en-
vironmental hazards.
‘‘(I) Cardiac care.
‘‘(4) The Secretary shall, to the maximum extent
practicable, ensure that personnel of the Department of
Veterans Affairs engaged in the research referred to in
paragraph (1) include the following:
‘‘(A) Personnel of the geriatric research, edu-
cation, and clinical centers designated pursuant to
section 7314 of this title.
‘‘(B) Personnel of the National Center for Post-
Traumatic Stress Disorder established pursuant to
section 110(c) of the Veterans Health Care Act of
1984 (Public Law 98–528; 98 Stat. 2692).
‘‘(5) The Secretary shall ensure that personnel of the
Department engaged in research relating to the health of
women veterans are advised and informed of such research
engaged in by other personnel of the Department.’’.
SEC. 6. POPULATION STUDY.
(a) STUDY.—The Secretary of Veterans Affairs, sub-
ject to subsection (f), shall conduct a study to determine
the needs of veterans who are women for health-care serv-
ices. The study shall be carried out through the Center
for Women Veterans.
(b) CONSULTATION.—Before carrying out the study,
the Secretary shall request the advice of the Advisory
Committee on Women Veterans on the conduct of the
study.
(c) PERSONS TO BE INCLUDED IN SAMPLE OF VET-
ERANS STUDIED.—(1) Subject to paragraph (2), the study
shall be based on—
(A) an appropriate sample of veterans who are
women; and
(B) an examination of the medical and demo-
graphic histories of the women comprising such sam-
ple.
(2) The sample referred to in paragraph (1) shall
constitute a representative sampling (as determined by the
Secretary) of the ages, the ethnic, social and economic
backgrounds, the enlisted and officer grades, and the
branches of service of all veterans who are women. The
Secretary shall ensure that homeless Women Veterans are
included in the sample.
(3) In carrying out the examination referred to in
paragraph (1)(B), the Secretary shall determine the num-
ber of women of the sample who have used medical facili-
ties of the Department, nursing home facilities of or under
the jurisdiction of the Department, and outpatient care
facilities of or under the jurisdiction of the Department.
(d) REPORTS.—The Secretary shall submit to the
Committees on Veterans’ Affairs of the Senate and House
of Representatives reports relating to the study as follows:
(1) Not later than nine months after the date
of the enactment of this Act, an interim report de-
scribing (A) the information and advice obtained by
the Secretary from the Advisory Committee on
Women Veterans, and (B) the status of the study.
(2) Not later than December 31, 1999, a final
report describing the results of the study.
(e) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated to the General Operating
Expenses account of the Department of Veterans Affairs
$2,000,000 to carry out the purposes of this section.
Amounts appropriated pursuant to this authorization of
appropriations shall be available for obligation without fis-
cal year limitation.
(f) LIMITATION.—No funds may be used to conduct
the study described in subsection (a) unless expressly pro-
vided for in an appropriation Act.
SEC. 7. OUTREACH SERVICES FOR HOMELESS WOMEN VET-
ERANS.
Section 7722(e) of title 38, United States Code, is
amended by adding at the end the following new sentence:
‘‘In carrying out this subsection, the Secretary shall take
such steps as may be necessary to ensure that homeless
women veterans are included in such outreach programs
and outreach services.’’.
SEC. 8. SAFE AND EFFECTIVE TREATMENT FOR WOMEN
PSYCHIATRIC PATIENTS.
The Secretary of Veterans Affairs shall ensure that
women veterans who receive psychiatric treatment from
the Secretary, particularly in the case of women who are
sexually traumatized, receive such treatment (on both an
inpatient and outpatient basis) in a safe and effective
manner that recognizes the privacy needs of such women.
SEC. 9. MAMMOGRAPHY QUALITY STANDARDS.
(a) APPLICABILITY TO DEPARTMENT OF VETERANS
AFFAIRS OF MAMMOGRAPHY QUALITY STANDARDS ACT
OF 1992.—Subsections (a) through (k) of section 354 of
the Public Health Service Act (42 U.S.C. 263b) shall
apply with respect to facilities of the Department of Veter-
ans Affairs without regard to the last sentence of subpara-
graph (A) of subsection (a)(3) of such section.
(b) EXTENSION OF DEADLINES.—Any deadline for
the completion of any action prescribed under any provi-
sion referred to in subsection (a) shall be applied with re-
spect to facilities of the Department of Veterans Affairs
by extending such deadline so as to be two years after
the date of the enactment of this Act or two years after
the date which would otherwise be applicable under such
provision, whichever is later.
(c) INTERAGENCY COOPERATION.—The Secretary of
Veterans Affairs shall take appropriate steps to cooperate
with the Secretary of Health and Human Services in the
implementation of this section.
SEC. 10. CENTER FOR WOMEN VETERANS.
Section 318(e) of title 38, United States Code, is
amended—
(1) by inserting ‘‘(1)’’ after ‘‘(e)’’;
(2) by adding after the period the following:
‘‘Such resources shall include (subject to the avail-
ability of appropriations) adequate clerical support
(as determined by the Director) to enable the Direc-
tor to carry out the functions of the Director under
this section.’’; and
(3) by adding at the end the following:
‘‘(2) There is in the Center an Associate Director,
who shall be appointed from among individuals with ap-
propriate education, experience, and training to assist the
Director with the investigative, research, and reporting
requirements under this section.’’.
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