Summary: S.2344 — 102nd Congress (1991-1992)All Information (Except Text)

Bill summaries are authored by CRS.

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Conference report filed in House (09/17/1992)

Veterans' Medical Programs Amendments of 1992 - Title I: Health Care - Part A: General Health Care - Increases the amount authorized to be expended per veteran for improvements and structural alterations necessary to assure the continuation of treatment for a disability or to provide access to the home or to lavatory and sanitary facilities. Makes such rates effective for veterans who first apply for such benefits on or after January 1, 1990, making ineligible for such increases any veterans who received the maximum amount authorized before such date.

Requires the Geriatrics and Gerontology Advisory Committee to submit to the appropriate congressional committees a copy of any report submitted to the Secretary of Veterans Affairs on all appropriate matters of geriatrics and gerontology.

Authorizes the Secretary to enter into agreements for the joint acquisition of medical equipment. Outlines conditions to such joint acquisition, including payment of no more than one half of the purchase price of such equipment by the Secretary, the exchange of use of such equipment between the joint holders, and provision by the institution involved of its share of the purchase price. Authorizes the Secretary to transfer to the other joint holder its interest in the equipment if the Secretary determines that such transfer would be justified by compelling clinical considerations or the economic interest of the Department of Veterans Affairs. Authorizes the Secretary to purchase the interest of the joint holder of such equipment under similar conditions. Authorizes the Secretary to enter into escrow agreements with institutions to facilitate the procurement of medical equipment. Outlines escrow agreement requirements. Requires the Secretary to report on the implementation of such joint acquisition under these provisions.

States that Department quality assurance activities shall be deemed to be part of the operation of hospitals, nursing homes, and domiciliary facilities of the Department, without regard to the location of the duty stations of employees carrying out such activities.

Renames the Prosthetics Service Advisory Committee as the Advisory Committee on Prosthetics and Special-Disabilities Programs and provides that such committee shall operate as if established by law. Requires the Advisory Committee's activities to relate to: (1) prosthetics and special-disabilities programs of the Department; (2) coordination of programs which develop and test prosthetic devices; and (3) the adequacy of funding for such programs within the Department. Requires the Advisory Committee to report to the Secretary and the Senate and House Veterans' Affairs Committees (veterans' committees) on the effectiveness of the prosthetics and special-disabilities programs administered by the Secretary during the preceding fiscal year.

Directs the Secretary to report to the veterans' committees concerning the backlog that occurred in the procurement of prosthetic appliances in FY 1989 and on actions to be taken to prevent a recurrence of backlogs and failures to furnish such appliances on a priority basis.

Directs the Secretary to assess all programs developed by Department facilities to assist homeless veterans. Requires the director of each medical center or regional benefits office of the Department to assess the needs of homeless veterans living within their area, identifying needs with respect to health care, education and training, employment, shelter, counseling, and outreach services. Outlines further requirements of each such director with respect to homeless veterans. Authorizes the Secretary to accept the donation of funds and services in order to provide one-stop, nonresidential services and mobile support teams and for expanding the medical services furnished to eligible homeless veterans by the Department.

Amends the: (1) Stewart B. McKinney Homeless Assistance Amendments Act of 1988 to extend through FY 1993 a program for furnishing domiciliary care to homeless veterans through Department facilities; and (2) Veterans' Benefits and Services Act of 1988 to extend through FY 1994 a pilot program of community-based residential care for homeless chronically mentally ill and other veterans. Requires a report.

Part B: Mental Health Provisions - Directs the Secretary to conduct a program for furnishing marriage and family counseling services to veterans who were awarded a campaign medal for active-duty service during the Persian Gulf War, to reservists who were called or ordered to active duty during such War, and to their spouses and children. Authorizes the Secretary to provide marriage and family counseling services that the Secretary determines, based on an assessment by a mental health professional, are necessary for the amelioration of psychological, marital, or familial difficulties resulting from such service. Outlines provisions concerning the manner in which such services will be furnished, as well as qualifications required of the marriage and family counselors performing such services. Outlines provisions concerning counseling services provided by mental health professionals pursuant to Department contracts, including the length of marriage and counseling services to be performed under the program. Prohibits the same person who performs the counseling needs assessment from furnishing the marriage and counseling services under the program, with a waiver of such prohibition under specified circumstances. Directs the Secretary to reimburse the mental health professionals for the reasonable costs of such counseling services. Provides cost recovery provisions. Authorizes appropriations for FY 1993 and 1994. Requires the Secretary to report to the Congress on such program.

Directs the Secretary, in carrying out medical research and awarding grants, to designate a level of funding support for, and assign a priority to, the conduct of research on mental illness, including research regarding post-traumatic stress disorder (PTSD), PTSD in association with substance abuse, and the treatment of those disorders. Requires the Special Committee on Post-Traumatic Stress Disorder to submit in 1992 and 1993 additional reports updating earlier reports on PTSD as required under the Veterans' Health Care Act of 1984.

Directs the Secretary to develop a plan to: (1) ensure that veterans suffering from active-duty PTSD are provided timely and appropriate treatment and rehabilitation for such condition; (2) expand and improve the services available for PTSD victims; (3) eliminate waiting lists for inpatient treatment; (4) enhance PTSD outreach activities; and (5) ensure the existence of Department PTSD treatment units in readily accessible locations for veterans residing in rural areas. Requires a plan report from the Secretary to the veterans' committees.

Title II: Health-Care Personnel - Prohibits the amount of increased pay for certain Department health care personnel furnishing direct patient care or incidental services from exceeding by two times (currently, only exceeding) the amount by which the maximum for such pay grade exceeds the minimum for such pay grade.

Requires a minimum two-year service requirement in the Department for graduates of the Department of Veterans Affairs Health Professional Scholarship Program.

Authorizes the Secretary to purchase promotional items of nominal value for recruitment purposes.

Includes board certification pay within certain other categories of special pay under Federal provisions guaranteeing that full and part-time physicians and dentists receiving special pay will continue to receive special pay of at least such amount after changes made to special pay provisions under the Department of Veterans Affairs Health-Care Personnel Act of 1991.

Authorizes the Department to appoint and pay nonphysician directors of clinical support services within the VHA of the Department, as opposed to payment under a Federal employees schedule.

Title III: Miscellaneous - Prohibits funds from being appropriated for any fiscal year, and prohibits the Secretary from obligating or expending funds, for any major medical project or major medical facility lease unless funds have been specifically authorized by law. Defines a "major medical facility lease" as a lease having an average annual rental amount of more than $300,000 (currently $500,000).

Redesignates within the Department the positions of Chief Medical Director and Chief Benefits Director as the Under Secretary for Health and the Under Secretary for Benefits, respectively.

Allows attorneys to charge veterans a reasonable fee for representation in any case arising out of a loan made, guaranteed, or insured by the Department. Requires a fee agreement to be entered and filed with the Secretary.