I
103D CONGRESS
1ST SESSION
H. R. 2797
To improve programs of the Department of Veterans Affairs relating to
women’s health, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JULY 29, 1993
Mrs. SCHROEDER (for herself, Mrs. LLOYD, Mr. EVANS, Mr. FILNER, Mr. ED-
WARDS of California, Mr. KENNEDY, Mrs. MEEK, Mr. MCDERMOTT, Ms.
DELAURO, Ms. DANNER, Mr. DELLUMS, Mr. LIPINSKI, Ms. KAPTUR, Mr.
PETERSON of Minnesota, Mr. WAXMAN, Ms. NORTON, Ms. SLAUGHTER,
Mr. BILBRAY, Mr. KOPETSKI, Mr. TORRES, Mr. DEUTSCH, Ms.
MARGOLIES-MEZVINSKY, Ms. VELA´ZQUEZ, Mrs. MORELLA, Mr. GENE
GREEN of Texas, Mr. HUGHES, Mr. SLATTERY, Mr. BOUCHER, Ms.
PELOSI, Ms. WOOLSEY, and Mr. INSLEE) introduced the following bill;
which was referred to the Committee on Veterans’ Affairs
A BILL
To improve programs of the Department of Veterans Affairs
relating to women’s health, and for other purposes.
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 ‘‘Veteran Women’s
Health Improvement Act of 1993’’.
(c) REPEAL OF SUPERSEDED AUTHORITY.—Section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’’.
(d) REPORT ON HEALTH CARE AND RESEARCH.—
Section 107(b) of such Act (38 U.S.C. 1710 note) is
amended—
(1) in paragraph (1), by inserting ‘‘and wom-
en’s health services (as such term is defined in sec-
tion 1701(10) of title 38, United States Code)’’ after
‘‘section 106 of this Act’’;
(2) in paragraph (2), by striking out ‘‘and (B)’’
and inserting in lieu thereof ‘‘(B) the type and
amount of services provided by such personnel, in-
cluding information on the numbers of inpatient
stays and the number of outpatient visits through
which such services were provided, and (C)’’;
(3) by redesignating paragraph (4) as para-
graph (7);
(4) by adding after paragraph (3) the following
new paragraphs:
‘‘(4) A description of the personnel of the De-
partment who provided such services to women vet-
erans, including the number of employees (including
both the number of individual employees and the
number of full-time employee equivalents) and the
professional qualifications or specialty training of
such employees and the Department facilities to
which such personnel were assigned.
‘‘(5) A description of any actions taken by the
Secretary to ensure the retention of the personnel
described in paragraph (4) and any actions under-
taken to recruit additional such 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.’’; and
(5) by adding after paragraph (7), as redesig-
nated by paragraph (3) of this subsection, the fol-
lowing:
‘‘(8) A description of the actions taken by the
Secretary to foster and encourage the expansion of
such research.’’.
SEC. 3. EXPANSION OF RESEARCH RELATING TO WOMEN
VETERANS.
(a) HEALTH RESEARCH.—Section 109(a) of the Vet-
erans Health Care Act of 1992 (Public Law 102–585; 38
U.S.C. 7303 note) is amended—
(1) by inserting ‘‘(1)’’ before ‘‘The Secretary’’;
(2) in paragraph (1), as so designated, by strik-
ing out ‘‘veterans who are women’’ and inserting in
lieu thereof ‘‘women veterans’’; and
(3) by adding at the end the following:
‘‘(2) In carrying out this section, the Secretary shall
consult with the following:
‘‘(A) The Director of the Nursing Service.
‘‘(B) Officials of the Central Office assigned re-
sponsibility for women’s health programs and sexual
trauma services.
‘‘(C) The members of the Advisory Committee
on Women Veterans established under section 542 of
title 38, United States Code.
‘‘(D) Members of appropriate task forces and
working groups within the Department of Veterans
Affairs (including the Women Veterans Working
Group and the Task Force on Treatment of Women
Who Suffer Sexual Abuse).
‘‘(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.
‘‘(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 title 38, United States Code.
‘‘(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.’’.
(b) INCLUSION
OF WOMEN
AND MINORITIES
IN
CLINICAL RESEARCH PROJECTS.—(1) In conducting or
supporting clinical research, the Secretary of Veterans Af-
fairs shall ensure that—
(A) women who are veterans are included as
subjects in each project of such research; and
(B) members of minority groups who are veter-
ans are included as subjects of such research.
(2) 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 purpose
of the research; or
(C) is inappropriate under such other cir-
cumstances as the Secretary of Veterans Affairs may
designate.
(3) In the case of a project of clinical research in
which women or members of minority groups will under
paragraph (1) be included as subjects of the research, the
Secretary of Veterans Affairs shall ensure that the project
is designed and carried out so as to provide for a valid
analysis of whether the variables being tested in the re-
search affect women or members of minority groups, as
the case may be, differently than other persons who are
subjects of the research.
(c) POPULATION STUDY.—Section 110(a) of such Act
(38 U.S.C. 1710 note) is amended—
(1) in paragraph (1), by striking out the second
sentence; and
(2) by amending paragraph (3) to read as fol-
lows:
‘‘(3)(A) Subject to subparagraph (B), the study shall
be based on—
‘‘(i) an appropriate sample of veterans who are
women; and
‘‘(ii) an examination of the medical and demo-
graphic histories of the women comprising such sam-
ple.
‘‘(B) The sample referred to in subparagraph (A)
shall constitute a representative sampling (as determined
by the Secretary) of the ages, the ethnic, social and eco-
nomic backgrounds, the enlisted and officer grades, and
the branches of service of all veterans who are women.
‘‘(C) In carrying out the examination referred to in
subparagraph (A)(ii), the Secretary shall determine the
number of women of the sample who have used medical
facilities 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 Depart-
ment.’’.
SEC. 4. 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.
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