Veterans Health Programs Extension Act of 1994

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans Health 
Programs Extension Act of 1994''.
    (b) Table of Contents.--The table of contents of this 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.

                  TITLE II--CONSTRUCTION AUTHORIZATION

Sec. 201. Authorization of major medical facility projects and major 
          medical facility leases.
Sec. 202. Authorization of appropriations.

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

    Except as otherwise expressly provided, whenever in this Act an 
amendment or repeal is expressed in terms of an amendment to, or repeal 
of, a section or other provision, the reference shall be considered to 
be made to a section or other provision of title 38, United States 
Code.

                  TITLE I--GENERAL MEDICAL AUTHORITIES

SEC. 101. SEXUAL TRAUMA COUNSELING AND SERVICES.

    (a) Authority To Provide Treatment Services for Sexual Trauma; 
Repeal of Limitation on Time To Seek Services.--Subsection (a) of 
section 1720D is amended--
        (1) by striking out paragraph (2); and
        (2) by inserting after paragraph (1) the following new 
    paragraph (2):
    ``(2) During the period referred to in paragraph (1), the Secretary 
may provide appropriate care and services to a veteran for an injury, 
illness, or other psychological condition that the Secretary determines 
to be the result of a physical assault, battery, or harassment referred 
to in that paragraph.''.
    (b) Extension of Period of Authority To Provide Sexual Trauma 
Services.--Such subsection is further amended--
        (1) in paragraph (1), by striking out ``December 31, 1995,'' 
    and inserting in lieu thereof ``December 31, 1998,''; and
        (2) in paragraph (3), by striking out ``December 31, 1994,'' 
    and inserting in lieu thereof ``December 31, 1998,''.
    (c) Repeal of Limitation on Period of Receipt of Services.--Such 
section is further amended--
        (1) by striking out subsection (b); and
        (2) by redesignating subsections (c), (d), and (e) as 
    subsections (b), (c), and (d), respectively.
    (d) Coordination of Care.--Paragraph (1) of subsection (b) of such 
section, as redesignated by subsection (c)(2), is amended to read as 
follows:
    ``(1) The Secretary shall give priority to the establishment and 
operation of the program to provide counseling and care and services 
under subsection (a). In the case of a veteran eligible for counseling 
and care and services under subsection (a), the Secretary shall ensure 
that the veteran is furnished counseling and care and services under 
this section in a way that is coordinated with the furnishing of such 
care and services under this chapter.''.
    (e) Increased Priority of Care.--Section 1712(i) is amended--
        (1) in paragraph (1)--
            (A) by inserting ``(A)'' after ``To a veteran''; and
            (B) by inserting ``, or (B) who is eligible for counseling 
        and care and services under section 1720D of this title, for 
        the purposes of such counseling and care and services'' before 
        the period at the end; and
        (2) in paragraph (2)--
            (A) by striking out ``, (B)'' and inserting in lieu thereof 
        ``or (B)''; and
            (B) by striking out ``, or (C)'' and all that follows 
        through ``such counseling''.
    (f) Program Revision.--(1) Section 1720D is further amended--
        (A) by striking out ``woman'' in subsection (a)(1);
        (B) by striking out ``women'' in subsection (b)(2)(C) and in 
    the first sentence of subsection (c), as redesignated by subsection 
    (c); and
        (C) by striking out ``women'' in subsection (c)(2), as so 
    redesignated, and inserting in lieu thereof ``individuals''.
    (2)(A) The heading of such section is amended to read as follows:

``Sec. 1720D. Counseling and treatment for sexual trauma''.

    (B) The item relating to such section in the table of sections at 
the beginning of chapter 17 is amended to read as follows:
``1720D. Counseling and treatment for sexual trauma.''.

    (g) Information by Telephone.--(1) Paragraph (1) of section 
1720D(c), as redesignated by subsection (c) of this section, is amended 
to read as follows:
        ``(1) shall include availability of a toll-free telephone 
    number (commonly referred to as an 800 number); and''.
    (2) In providing information on counseling available to veterans as 
required under section 1720D(c)(1) of title 38, United States Code (as 
amended by paragraph (1)), the Secretary of Veterans Affairs shall 
ensure that the Department of Veterans Affairs personnel who provide 
assistance under such section are trained in the provision to persons 
who have experienced sexual trauma of information about the care and 
services relating to sexual trauma that are available to veterans in 
the communities in which such veterans reside, including care and 
services available under programs of the Department (including the care 
and services available under section 1720D of such title) and from non-
Department agencies or organizations.
    (3) The telephone assistance service shall be operated in a manner 
that protects the confidentiality of persons who place calls to the 
system.
    (4) The Secretary shall ensure that information about the 
availability of the telephone assistance service is visibly posted in 
Department medical facilities and is advertised through public service 
announcements, pamphlets, and other means.
    (5) Not later than 18 months after the date of the enactment of 
this Act, the Secretary shall submit to Congress a report on the 
operation of the telephone assistance service required under section 
1720D(c)(1) of title 38, United States Code (as amended by paragraph 
(1)). The report shall set forth the following:
        (A) The number of persons who sought information during the 
    period covered by the report through a toll-free telephone number 
    regarding services available to veterans relating to sexual trauma, 
    with a separate display of the number of such persons arrayed by 
    State (as such term is defined in section 101(20) of title 38, 
    United States Code).
        (B) A description of the training provided to the personnel who 
    provide such assistance.
        (C) The recommendations and plans of the Secretary for the 
    improvement of the service.
    (h) Conforming Repeal.--Section 102(b) of the Veterans Health Care 
Act of 1992 (Public Law 102-585; 106 Stat. 4946; 38 U.S.C. 1720D note) 
is repealed.

SEC. 102. RESEARCH RELATING TO WOMEN VETERANS.

    (a) Inclusion of Women and Minorities in Clinical Research 
Projects.--Section 7303 is amended--
        (1) by transferring the text of subsection (c) to the end of 
    subsection (a)(1); and
        (2) by striking out ``(c)'' and inserting in lieu thereof the 
    following:
    ``(c)(1) In conducting or supporting clinical research, the 
Secretary shall ensure that, whenever possible and appropriate--
        ``(A) women who are veterans are included as subjects in each 
    project of such research; and
        ``(B) members of minority groups who are veterans are included 
    as subjects of such research.
    ``(2) 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 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 research affect women or 
members of minority groups, as the case may be, differently than other 
persons who are subjects of the research.''.
    (b) Health Research.--(1) Such section is further amended by adding 
after subsection (c), as added by subsection (a), the following new 
subsection:
    ``(d)(1) The Secretary, in carrying out the Secretary's 
responsibilities under this section, shall foster and encourage the 
initiation and expansion of research relating to the health of veterans 
who are women.
    ``(2) In carrying out this subsection, the Secretary shall consult 
with the following to assist the Secretary in setting research 
priorities:
        ``(A) Officials of the Department assigned responsibility for 
    women's health programs and sexual trauma services.
        ``(B) The members of the Advisory Committee on Women Veterans.
        ``(C) Members of appropriate task forces and working groups 
    within the Department (including the Women Veterans Working Group 
    and the Task Force on Treatment of Women Who Suffer Sexual 
    Abuse).''.
    (2) Section 109 of the Veterans Health Care Act of 1992 (Public Law 
102-585; 38 U.S.C. 7303 note) is repealed.
    (c) Population Study.--Section 110(a) of the Veterans Health Care 
Act of 1992 (Public Law 102-585; 106 Stat. 4948) is amended by adding 
at the end of paragraph (3) the following: ``If it is feasible to do so 
within the amounts available for the conduct of the study, the 
Secretary shall ensure that the sample referred to in paragraph (1) 
constitutes 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.''.

SEC. 103. EXTENSION OF EXPIRING AUTHORITIES.

    (a) Authority To Provide Priority Health Care for Veterans Exposed 
to Toxic Substances.--Chapter 17 is amended--
        (1) in section 1710(e)(3)--
            (A) by striking out ``June 30, 1994'' and inserting in lieu 
        thereof ``June 30, 1995''; and
            (B) by striking out ``December 31, 1994'' and inserting in 
        lieu thereof ``December 31, 1995''; and
        (2) in section 1712(a)(1)(D), by striking out ``December 31, 
    1994'' and inserting in lieu thereof ``December 31, 1995''.
    (b) Drug and Alcohol Abuse and Dependence.--Section 1720A(e) is 
amended by striking out ``December 31, 1994'' and inserting in lieu 
thereof ``December 31, 1995''.
    (c) Pilot Program for Noninstitutional Alternatives to Nursing Home 
Care.--(1) Effective as of October 1, 1994, subsection (a) of section 
1720C is amended by striking out ``During the four-year period 
beginning on October 1, 1990,'' and inserting in lieu thereof ``During 
the period through September 30, 1995,''.
    (2) Such subsection is further amended by striking out ``care and 
who--'' and inserting in lieu thereof ``care. The Secretary shall give 
priority for participation in such program to veterans Pwho--''.
    (d) Enhanced-Use Leases of Real Property.--Section 8169 is amended 
by striking out ``December 31, 1994'' and inserting in lieu thereof 
``December 31, 1995''.
    (e) Authority for Community-based Residential Care for Homeless 
Chronically Mentally Ill Veterans and Other Veterans.--Section 115(d) 
of the Veterans' Benefits and Services Act of 1988 (38 U.S.C. 1712 
note) is amended by striking out ``September 30, 1994'' and inserting 
in lieu thereof ``September 30, 1995''.
    (f) Demonstration Program of Compensated Work Therapy.--Section 
7(a) of Public Law 102-54 (105 Stat. 269; 38 U.S.C. 1718 note) is 
amended by striking out ``1994'' and inserting in lieu thereof 
``1995''.
    (g) Report Deadlines.--Section 201(b) of the Department of Veterans 
Affairs Nurse Pay Act of 1990 (Public Law 101-366; 38 U.S.C. 1720C 
note) is amended by striking out ``February 1, 1994,'' and inserting in 
lieu thereof ``February 1, 1995,''.

SEC. 104. FACILITIES IN REPUBLIC OF THE PHILIPPINES.

    Notwithstanding section 1724 of title 38, United States Code, the 
Secretary of Veterans Affairs may contract with facilities in the 
Republic of the Philippines other than the Veterans Memorial Medical 
Center to furnish, during the period from February 28, 1994, through 
June 1, 1994, hospital care and medical services to veterans for 
nonservice-connected disabilities if such veterans are unable to defray 
the expenses of necessary hospital care. When the Secretary determines 
it to be most feasible, the Secretary may provide medical services 
under the preceding sentence to such veterans at the Department of 
Veterans Affairs Outpatient Clinic at Manila, Republic of the 
Philippines.
    SEC. 105. RATIFICATION OF ACTIONS DURING PERIOD OF LAPSED 
      AUTHORITY.
    Any action of the Secretary of Veterans Affairs under section 
1710(e) of title 38, United States Code, during the period beginning on 
July 1, 1994, and ending on the date of the enactment of this Act is 
hereby ratified.

                  TITLE II--CONSTRUCTION AUTHORIZATION

    SEC. 201. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS AND 
      MAJOR MEDICAL FACILITY LEASES.
    (a) Projects Authorized.--The Secretary of Veterans Affairs may 
carry out the major medical facility projects for the Department of 
Veterans Affairs, and may carry out the major medical facility leases 
for that Department, for which funds are requested in the budget of the 
President for fiscal year 1995. The authorization in the preceding 
sentence applies to projects and leases which have not been authorized, 
or for which funds have not been appropriated, in any fiscal year 
before fiscal year 1995 and to projects and leases which have been 
authorized, or for which funds were appropriated, in fiscal years 
before fiscal year 1995.
    (b) Additional Projects.--(1) In addition to the projects 
authorized in subsection (a), the Secretary may carry out the following 
major medical facility projects in the amounts specified for such 
projects:
        (A) The projects that are proposed in the documents submitted 
    to Congress by the Secretary of Veterans Affairs in conjunction 
    with the budget of the President for fiscal year 1995 to be 
    financed with funds from the proposed Health Care Investment Fund.
        (B) Construction of a nursing home facility at the Department 
    of Veterans Affairs Medical Center in Charleston, South Carolina, 
    in the amount of $7,300,000.
        (C) Construction of an outpatient care addition at the 
    Department of Veterans Affairs medical center in Phoenix, Arizona, 
    in the amount of $50,000,000.
        (D) A lease/purchase of a nursing home facility near Fort 
    Myers, Florida, in the amount of $12,800,000.
    (2) The authorizations in paragraph (1) apply to projects which 
have not been authorized, or for which funds have not been 
appropriated, in any fiscal year before fiscal year 1995 and to 
projects which have been authorized, or for which funds were 
appropriated, in fiscal years before fiscal year 1995.
    (c) Projects for Which Funds Appropriated.--In addition to the 
projects authorized in subsections (a) and (b), the Secretary may carry 
out the following major medical facility projects for which funds were 
appropriated in chapter 7 of the Emergency Supplemental Appropriations 
Act of 1994 (title I of Public Law 103-211; 108 Stat. 10) in the 
amounts specified:
        (1) Construction of an ambulatory care/support services 
    facility at the Department of Veterans Affairs Medical Center in 
    Sepulveda, California, $53,700,000.
        (2) Other major medical facility projects required to repair, 
    restore, or replace earthquake-damaged facilities at the Department 
    of Veterans Affairs Medical Center in Sepulveda, California, 
    $50,000,000.

SEC. 202. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated to the 
Secretary of Veterans Affairs for fiscal year 1995--
        (1) $379,370,000 for the major medical facility projects 
    authorized in subsections (a), (b), and (c) of section 201; and
        (2) $15,800,000 for the major medical facility leases 
    authorized in section 201(a).
    (b) Limitation.--The projects authorized in subsections (a) and (b) 
of section 201 may only be carried out using--
        (1) funds appropriated for fiscal year 1995 pursuant to the 
    authorization of appropriations in subsection (a);
        (2) funds appropriated for Construction, Major Projects for a 
    fiscal year before fiscal year 1995 that remain available for 
    obligation; and
        (3) funds appropriated for Construction, Major Projects for 
    fiscal year 1995 for a category of activity not specific to a 
    project.
    (c) Limitation on Certain Projects.--The projects authorized in 
subsection (c) of section 201 may only be carried out using--
        (1) funds appropriated to the Construction, Major Projects 
    account under chapter 7 of the Emergency Supplemental 
    Appropriations Act of 1994 (title I of Public Law 103-211; 108 
    Stat. 10) and funds transferred by the President to the 
    Construction, Major Projects account pursuant to chapter 8 of that 
    Act (108 Stat. 14);
        (2) funds appropriated to the Medical Care account by chapter 7 
    of the Emergency Supplemental Appropriations Act of 1994 that are 
    transferred to the Construction, Major Projects account;
        (3) funds appropriated to the Construction, Major Projects 
    account for a fiscal year before fiscal year 1995 that remain 
    available for obligation; and
        (4) funds appropriated to the Construction, Major Projects 
    account for fiscal year 1995 for a category of activity not 
    specific to a project.







                               Speaker of the House of Representatives.







                            Vice President of the United States and    
                                               President of the Senate.

Summary: TABLE OF CONTENTS: 
     Title I:  General Medical Authorization 
     Title II:  Construction Authorities 
Veterans Health Programs Extension Act of 1994 - 
Title I:  General Medical Authorities
 - Repeals a Federal provision requiring a veteran, in order to be eligible for counseling for sexual trauma from the Department 111Veterans Affairs, to seek such counseling within two years after release from active military service.  Extends through December 31, 1998, the authority of the Department to provide such counseling services. Repeals a provision limiting to one year the authorized length of such counseling.  Provides a priority for such care in furnishing medical services with funds appropriated for the medical care of veterans.  Allows any veteran (currently, only women) to receive such counseling.  Requires with respect to such counseling:  (1) the availability of a toll-free telephone number; (2) appropriate training to Department personnel who provide counseling assistance; and (3) a report to the Congress on the operation of the telephone assistance service. 
(Sec. 102) Requires the Secretary of Veterans Affairs, in conducting or supporting clinical research, to ensure that women and minority veterans are included as subjects in such research.  Directs the Secretary to foster and encourage the initiation and expansion of research relating to the health of women veterans, requiring specified consultation during such research. 
Amends the Veterans Health Care Act of 1992 to:  (1) repeal a provision requiring the expansion of research relating to women veterans; and (2) require an appropriate test sample of age, background, rank, and service branch under a provision requiring a population study concerning women veterans. 
(Sec. 103) Extends for an additional year the authority:  (1) to provide priority health care to veterans exposed to toxic substances during their military service; (2) for a pilot program for noninstitutional alternatives to nursing home care; (3) of the Secretary to enter into enhanced-use leases of real property; (4) for community-based residential care for homeless chronically mentally ill veterans and other veterans under the Veterans' Benefits and Services Act of 1988; and (5) for a demonstration program of compensated work therapy and therapeutic transitional housing for certain veterans. Amends the Department of Veterans Affairs Nurse Pay Act of 1990 to extend until February 1, 1995, the deadline of a required report on the findings of a study concerning noninstitutional alternatives to nursing home care. 
(Sec. 104) Authorizes the Secretary, from February 28, 1994, through June 1, 1994, to contract with facilities in the Republic of the Philippines other than the Veterans Memorial Medical Center to furnish hospital care and medical services to veterans for nonservice-connected connected disabilities if such veterans are unable to defray the cost of such care. 
(Sec. 105) Ratifies certain action taken by the Secretary during the period between July 1, 1994, and the date of enactment of this Act with respect to the furnishing of hospital and nursing home care to eligible veterans. 
Title II:  Construction Authorization
 - Authorizes the Secretary to carry out the major medical facility projects and leases for the Department for which funds are requested in the FY 1995 budget, as well as certain prior year projects and leases.  Authorizes the Secretary to carry out certain additional major medical facility construction projects, each with a cost limitation.  Authorizes appropriations for such projects and leases, with limitations.