[House Report 107-471]
[From the U.S. Government Publishing Office]
107th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 107-471
======================================================================
DEPARTMENT OF VETERANS AFFAIRS EMERGENCY PREPAREDNESS RESEARCH,
EDUCATION, AND BIO-TERRORISM PREVENTION ACT OF 2002
_______
May 16, 2002.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Smith of New Jersey, from the Committee on Veterans' Affairs,
submitted the following
R E P O R T
[To accompany H.R. 3253]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred the
bill (H.R. 3253) to amend title 38, United States Code, to
provide for the establishment of emergency medical preparedness
centers in the Department of Veterans Affairs, having
considered the same, reports favorably thereon with amendments
and recommends that the bill as amended do pass.
The amendments are as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Department of Veterans Affairs
Emergency Preparedness Research, Education, and Bio-Terrorism
Prevention Act of 2002''.
SEC. 2. ESTABLISHMENT OF EMERGENCY MEDICAL PREPAREDNESS CENTERS.
(a) In General.--Subchapter II of chapter 73 of title 38, United
States Code, is amended by adding at the end the following new section:
``Sec. 7325. Medical emergency preparedness centers
``(a) Establishment of Centers.--(1) The Secretary shall establish at
least four medical emergency preparedness centers in accordance with
this section. Each such center shall be established at a Department
medical center and shall be staffed by Department employees.
``(2) The Under Secretary for Health shall be responsible for
supervising the operation of the centers established pursuant to this
section. The Under Secretary shall provide for ongoing evaluation of
the centers and their compliance with the requirements of this section.
``(3) The Under Secretary shall carry out the Under Secretary's
functions under paragraph (2) in consultation with the Assistant
Secretary for Veterans Affairs with responsibility for operations,
preparedness, and security.
``(b) Mission.--The mission of the centers shall be--
``(1) to carry out research on and develop methods of
detection, diagnosis, vaccination, protection, and treatment
for chemical, biological, and radiological threats to the
public health and safety;
``(2) to provide education, training, and advice to health-
care professionals, including health-care professionals outside
the Veterans Health Administration; and
``(3) to provide contingent rapid response laboratory
assistance and other assistance to local health care
authorities in the event of a national emergency.
``(c) Center Directors.--Each center shall have a Director with (1)
expertise in managing organizations that deal with threats referred to
in subsection (b), (2) expertise in providing care to populations
exposed to toxic substances, or (3) significant research experience in
those fields.
``(d) Selection of Centers.--(1) The Secretary shall select the sites
for the centers on the basis of a competitive selection process and a
finding under paragraph (2). The centers selected shall be located in
different regions of the Nation, and any such center may be a
consortium of efforts of more than one medical center. At least one of
the centers shall be established to concentrate on chemical threats, at
least one shall be established to concentrate on biological threats,
and at least one shall be established to concentrate on radiological
threats.
``(2) The finding referred to in paragraph (1) with respect to a
proposal for designation of a site as a location of a center under this
section is a finding by the Secretary, upon the recommendations of the
Under Secretary for Health and the Assistant Secretary with
responsibility for operations, preparedness, and security, that the
facility or facilities submitting the proposal have developed (or may
reasonably be anticipated to develop) each of the following:
``(A) An arrangement with a qualifying medical school and a
qualifying school of public health (or a consortium of such
schools) under which physicians and other persons in the health
field receive education and training through the participating
Department medical centers so as to provide those persons with
training in the diagnosis and treatment of illnesses induced by
exposures to toxins, including chemical and biological
substances and nuclear ionizing radiation.
``(B) An arrangement with an accredited graduate program of
epidemiology under which students receive education and
training in epidemiology through the participating Department
facilities so as to provide such students with training in the
epidemiology of contagious and infectious diseases and chemical
and radiation poisoning in an exposed population.
``(C) An arrangement under which nursing, social work,
counseling, or allied health personnel and students receive
training and education in recognizing and caring for conditions
associated with exposures to toxins through the participating
Department facilities.
``(D) The ability to attract scientists who have made
significant contributions to the development of innovative
approaches to the detection, diagnosis, vaccination,
protection, or treatment of persons exposed to chemical,
biological, or radiological substances.
``(3) For purposes of paragraph (2)(A)--
``(A) a qualifying medical school is an accredited medical
school that provides education and training in toxicology and
environmental health hazards and with which one or more of the
participating Department medical centers is affiliated; and
``(B) a qualifying school of public health is an accredited
school of public health that provides education and training in
toxicology and environmental health hazards and with which one
or more of the participating Department medical centers is
affiliated.
``(e) Funding.--(1) Amounts appropriated for the activities of the
centers shall be appropriated separately from amounts appropriated for
the Department for medical care.
``(2) There are authorized to be appropriated for the centers under
this section $20,000,000 for each of fiscal years 2003 through 2007.
``(3) In addition to funds appropriated for a fiscal year pursuant to
the authorization of appropriations in paragraph (2), the Under
Secretary for Health shall allocate to such centers from other funds
appropriated for that fiscal year generally for the Department of
Veterans Affairs medical care account and the Department of Veterans
Affairs medical and prosthetics research account such amounts as the
Under Secretary for Health determines appropriate to carry out the
purposes of this section. Any determination by the Under Secretary
under the preceding sentence shall be made in consultation with the
Assistant Secretary with responsibility for operations, preparedness,
and security.
``(f) Research Activities.--Each center shall conduct research on
improved medical preparedness to protect the Nation from threats in the
area of that center's expertise. Each center may seek research funds
from public and private sources for such purpose.
``(g) Peer Review Panel.--(1) In order to provide advice to assist
the Secretary and the Under Secretary for Health to carry out their
responsibilities under this section, the Under Secretary shall
establish a peer review panel to assess the scientific and clinical
merit of proposals that are submitted to the Secretary for the
designation of centers under this section. The peer review shall be
established in consultation with the Assistant Secretary with
responsibility for operations, preparedness, and security.
``(2) The peer review panel shall include experts in the fields of
toxicological research, bio-hazards management education and training,
radiology, clinical care of patients exposed to such hazards, and other
persons as determined appropriate by the Secretary. Members of the
panel shall serve as consultants to the Department.
``(3) The panel shall review each proposal submitted to the panel by
the officials referred to in paragraph (1) and shall submit to the
Under Secretary for Health its views on the relative scientific and
clinical merit of each such proposal. The panel shall specifically
determine with respect to each such proposal whether that proposal is
among those proposals which have met the highest competitive standards
of scientific and clinical merit.
``(4) The panel shall not be subject to the Federal Advisory
Committee Act (5 U.S.C. App.).
``(h) Research Products.--(1) The Under Secretary for Health and the
Assistant Secretary with responsibility for operations, preparedness,
and security shall ensure that information produced by the research,
education and training, and clinical activities of centers established
under this section is made available, as appropriate, to health-care
providers in the United States. Dissemination of such information shall
be made through publications, through programs of continuing medical
and related education provided through regional medical education
centers under subchapter VI of chapter 74 of this title, and through
other means. Such programs of continuing medical education shall
receive priority in the award of funding.
``(2) The Secretary shall ensure that the work of the centers is
conducted in close coordination with other Federal departments and
agencies and that research products or other information of the centers
shall be coordinated and shared with other Federal departments and
agencies.
``(i) Assistance to Other Agencies.--The Secretary may provide
assistance requested by appropriate Federal, State, and local civil and
criminal authorities in investigations, inquiries, and data analyses as
necessary to protect the public safety and prevent or obviate
biological, chemical, or radiological threats.
``(j) Detail of Employees From Other Agencies.--Upon approval by the
Secretary, the Director of a center may request the temporary
assignment or detail to the center, on a nonreimbursable basis, of
employees from other Departments and agencies of the United States who
have expertise that would further the mission of the center. Any such
employee may be so assigned or detailed on a nonreimbursable basis
pursuant to such a request. The duration of any such assignment or
detail shall be subject to approval by the Office of Personnel
Management.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by inserting after the item relating to section
7324 the following new item:
``7325. Medical emergency preparedness centers.''.
SEC. 3. ESTABLISHMENT OF EMERGENCY MEDICAL EDUCATION PROGRAM.
(a) In General.--(1) Subchapter II of chapter 73 of title 38, United
States Code, is amended by adding after section 7325, as added by
section 2(a), the following new section:
``Sec. 7326. Emergency health and medical education: joint program with
Department of Defense
``(a) Joint Education Program.--The Secretary and the Secretary of
Defense shall carry out a joint program to develop and disseminate a
series of model education and training programs on the medical
responses to the consequences of terrorist activities. The Secretaries
shall enter into an agreement for a partnership to implement the joint
program.
``(b) Implementing Entities.--Within the Department of Veterans
Affairs, the joint program shall be carried out through the Under
Secretary for Health, in consultation with the Assistant Secretary of
Veterans Affairs with responsibility for operations, preparedness, and
security. Within the Department of Defense, the joint program shall be
carried out through the F. Edward Hebert School of Medicine of the
Uniformed Services University of the Health Sciences.
``(c) Content of Programs.--The education and training programs
developed under the joint program shall be based on programs
established at the F. Edward Hebert School of Medicine and shall
include, at a minimum, training for health care professionals in the
following:
``(1) Recognition of chemical, biological, and radiological
agents that may be used in terrorist activities.
``(2) Identification of the potential symptoms of those
agents.
``(3) Understanding of the potential long-term health
consequences, including psychological effects, resulting from
exposure to those agents.
``(4) Emergency treatment for exposure to those agents.
``(5) An appropriate course of followup treatment, supportive
care, and referral.
``(6) Actions that can be taken while providing care for
exposure to those agents to protect against contamination.
``(7) Information on how to seek consultative support and to
report suspected or actual use of those agents.
``(d) Potential Trainees.--In designing the education and training
programs under this section, the Secretaries shall ensure that
different programs are designed for health-care professionals at
various levels. The programs shall be designed to be disseminated to
health professions students, graduate health and medical education
trainees, and health practitioners in a variety of fields.
``(e) Consultation.--In establishing the joint education and training
program under this section, the two Secretaries shall consult with
appropriate representatives of accrediting, certifying, and
coordinating organizations in the field of health professions
education.''.
(2) The table of sections at the beginning of such chapter is amended
by inserting after the item relating to section 7325, as added by
section 2(b), the following new item:
``7326. Emergency health and medical education: joint program with
Department of Defense.''.
(b) Effective Date.--The Secretary of Veterans Affairs and the
Secretary of Defense shall implement section 7326 of title 38, United
States Code, as added by subsection (a), not later than the end of the
90-day period beginning on the date of the enactment of this Act.
SEC. 4. INCREASE IN NUMBER OF ASSISTANT SECRETARIES OF VETERANS
AFFAIRS.
(a) Increase.--Subsection (a) of section 308 of title 38, United
States Code, is amended by striking ``six'' in the first sentence and
inserting ``seven''.
(b) Functions.--subsection (b) of such section is amended by adding
at the end the following new paragraph:
``(11) Operations, preparedness, security, and law
enforcement functions.''.
(c) Conforming Amendment.--Section 5315 of title 5, United States
Code, is amended by striking ``(6)'' after ``Assistant Secretaries,
Department of Veterans Affairs'' and inserting ``(7)''.
Amend the title so as to read:
A bill to amend title 38, United States Code, to provide
for the establishment within the Department of Veterans Affairs
of improved emergency medical preparedness, research, and
education programs to combat terrorism, and for other purposes.
Introduction
H.R. 3253, Department of Veterans Affairs Emergency
Preparedness Research, Education, and Bio-terrorism Prevention
Act of 2002, addresses issues reviewed by the Committee in
hearings, meetings, and through other oversight mechanisms over
the course of this Congress. This bill was introduced by the
Honorable Christopher H. Smith on November 8, 2001.
On October 15, 2001, the Committee held a hearing to
receive testimony on emergency preparedness issues confronting
the Department of Veterans Affairs in the wake of the terrorist
attacks of September 11, 2002, on New York City and the
Pentagon. Those testifying were Ms. Cynthia A. Bascetta,
Director, Veterans' Health and Benefits Issues, U.S. General
Accounting Office, accompanied by Mr. Steven L. Caldwell,
Assistant Director, Defense Capabilities and Management Issues,
U.S. General Accounting Office; Honorable Anthony J. Principi,
Secretary, Department of Veterans Affairs, accompanied by
Frances M. Murphy, M.D., Deputy Under Secretary for Health,
Veterans Health Administration, Mr. James J. Farsetta,
Director, VA New York-New Jersey Healthcare System, and Mr.
John J. Donnellan, Jr., Director, VA New York Harbor Health
Care System; the Honorable Claude A. Allen, Deputy Secretary,
Department of Health and Human Services; Dr. Sue Bailey, former
Assistant Secretary of Defense for Health Affairs; Mr. Kenneth
S. Kasprisin, Associate Director, Readiness, Response and
Recovery Division, Federal Emergency Management Agency; Mr.
James Krueger, Executive Vice President, Chapter Services
Network, American Red Cross; Ms. Annie W. Everett, Acting
Regional Administrator for the National Capitol Region, General
Services Administration; Dr. David S. C. Chu, Under Secretary
of Defense for Personnel and Readiness, Department of Defense.
The Committee also received testimony from: Mr. Thomas H.
Corey, Vietnam Veterans of America; Ms. Jacqueline Garrick,
Deputy Director, Health Care, National Veterans Affairs and
Rehabilitation Commission, The American Legion; Mr. Paul A.
Hayden, Associate Director, National Legislative Service,
Veterans of Foreign Wars of the United States; Ms. Joy J. Ilem,
Assistant National Legislative Director, Disabled American
Veterans; Mr. Richard C. Schneider, Director of Veterans and
State Affairs, Non-Commissioned Officers Association; and, Mr.
Delatorro McNeal, Executive Director, Paralyzed Veterans of
America.
On November 14, 2001, the Subcommittee on Oversight and
Investigations received testimony on the need to develop
education and training programs on medical responses to
consequences of terrorist acts, particularly after the outbreak
of anthrax infections caused by a terrorist or terrorists, in
New Jersey, New York City, Washington, DC and Florida. Those
testifying at that hearing were: Honorable John Cooksey, Member
of Congress from the State of Louisiana; Honorable Dave Weldon,
Member of Congress from the State of Florida; Admiral John F.
Eisold, Attending Physician to Congress; Dr. Susan J. Matcha,
Mid-Atlantic Permanente Medical Group; Dr. Carlos Omenaca,
Miami Heart Center, Miami, FL; Frances M. Murphy, M.D., Deputy
Under Secretary for Health, Veterans Health Administration,
Department of Veterans Affairs, accompanied by Dr. Susan
Mather, Chief Officer, Public Health and Environmental Hazards,
and Mr. Kenneth H. Mizrach, Director, VA New Jersey Health Care
System; Dr. Val G. Hemming, Dean, F. Edward Hebert School of
Medicine, Uniformed Services University of the Health Sciences,
Department of Defense; Dr. J. Edward Hill, Chairman-Elect of
the Board of Trustees, American Medical Association; Dr. Jordan
J. Cohen, President, Association of American Medical Colleges;
and Dr. Martin J. Blaser, M.D., Professor and Chairman,
Department of Medicine, New York University School of Medicine.
On April 10, 2002, the Subcommittee on Health held a
hearing to consider the following bills: H.R. 3253, National
Medical Emergency Preparedness Act of 2001; and H.R. 3254,
Medical Education for National Defense in the 21st Century Act.
Those testifying at that hearing were: Honorable Leo S. Mackay,
Jr., Ph.D., Deputy Secretary, Department of Veterans Affairs,
accompanied by Dr. Robert H. Roswell, Under Secretary for
Health, and Dr. Kristi Koenig, Director, Emergency Management
Strategic Healthcare Group; Dr. Kevin Yeskey, Director, Bio-
Terrorism Preparedness and Response Program, Centers for
Disease Control and Prevention, Department of Health and Human
Services; Dr. Deborah E. Powell, Executive Dean, University of
Kansas School of Medicine; and Dr. Stephen F. Wintermeyer,
Associate Professor of Clinical Medicine, Indiana University
School of Medicine. Also, the Subcommittee received testimony
from: Ms. Joy J. Ilem, Assistant National Legislative Director,
Disabled American Veterans; Mr. Richard Jones, National
Legislative Director, AMVETS; Mr. Thomas H. Corey, National
President, Vietnam Veterans of America; Mr. James R. Fischl,
Director, National Veterans Affairs and Rehabilitation
Commission, The American Legion; Mr. Richard B. Fuller,
Legislative Director, Paralyzed Veterans of America; and Mr.
Paul A. Hayden, Associate Director, National Legislative
Service, Veterans of Foreign Wars of the United States.
On May 1, 2002, the Subcommittee on Health met and
unanimously ordered H.R.3253, with an amendment in the nature
of a substitute, reported favorably to the full Committee.
The amendment to H.R. 3253 included the addition of H.R.
3254, the Medical Education for National Defense in the 21st
Century Act, introduced by Honorable Steve Buyer on November 8,
2001 and H.R. 4559, the Department of Veterans Affairs
Reorganization Act of 2002, introduced by Honorable Christopher
H. Smith of New Jersey, on April 24, 2002, at the request of
the Department of Veterans Affairs.
On May 9, 2002, the full Committee met and ordered H.R.
3253, with an amendment in the nature of a substitute, reported
favorably to the House by unanimous voice vote.
Summary of the Reported Bill
H.R. 3253, as amended, would:
1. LEstablish four or more new National Medical Emergency
Preparedness Centers at VA medical centers or a consortium of
VA centers to:
Conduct medical research on and develop
health care responses for chemical, biological and
radiological threats to the public;
Provide related education, training and
advice to VA and community health care
professionals; and
Provide rapid response laboratory assistance
to local health care authorities in the event of a
national emergency.
2. LRequire the new centers to arrange the participation of
medical schools and public health schools in the related
education and training of health care professionals.
3. LAuthorize $100 million over 5 years to fund the new
centers.
4. LRequire the Secretaries of VA and Defense to carry out
a joint program to develop and disseminate model education and
training programs on the medical responses to the consequences
of terrorist activities.
5. LRequire the training programs to be disseminated to
health professions students, graduate medical education
trainees, and health practitioners in a variety of fields.
6. LAuthorize an additional Assistant Secretary in the
Department of Veterans Affairs to perform operations,
preparedness, security and law enforcement functions.
Background and Discussion
With an increased public awareness of bio-terrorism threats
and an urgent need for preventive measures against bio-
terrorism, the reported bill would provide a proactive approach
to define new and specific roles for the Department of Veterans
Affairs in helping the Nation to meet this challenge.
The bill would establish, at a minimum, four national
medical emergency preparedness centers in selected VA medical
center locations to conduct research and develop diagnostic and
treatment disciplines and standards to respond to biological,
chemical, and radiological attacks. The centers would be funded
from resources made available outside the normal funding
streams available for the VA health care system for the direct
delivery of health care to enrolled veterans; therefore, the
new mission of these centers would not erode funding Congress
provides for the direct delivery of VA health care.
The missions of these Centers would be to conduct research
and develop methods of detection, diagnosis, vaccination,
protection and treatment for chemical, biological, and
radiological threats to public safety, such as anthrax,
smallpox, bubonic plague, nerve gas, radiation poisoning, and
other hazards to human health which may arise as a result of
acts of terrorism. The centers would engage in direct research,
coordinate ongoing and new research and educational attainment
in other public and private agencies, research universities,
schools of medicine, and schools of public health. The centers
would also act as clearinghouses for new discoveries, serve to
disseminate the latest and most comprehensive medical
information, and help to protect health care workers, emergency
personnel, active duty military personnel, police officers, as
well as the general public.
Through its extensive medical and prosthetic research and
clinical care programs, VA already has expertise in diagnosing
and treating widespread viral or bacterial illnesses with
devastating health consequences, such as the hepatitis C
epidemic, the HIV pandemic, and in earlier generations,
tuberculosis infections. In the early part of this century, a
number of VA hospitals were created specifically to combat
tuberculosis in the veteran population.
As authorized by the Veterans Programs Enhancement Act of
1998, VA operates two War-Related Illness Centers tasked with
developing specialized treatments for those illnesses and
injuries that may come from veterans' wartime exposures.
Previously, the Department successfully launched new centers of
expertise, education and special care in geriatrics and
gerontology, mental illness and Parkinson's disease. Such
initiatives show VA's ability to organize programs and solve
difficult health problems. In essence, these new National
Medical Preparedness Centers authorized by H.R. 3253, as
amended, would study those illnesses and injuries likely to
come from a terrorist attack using biological, chemical or
radiation weapons, or from another national environmental or
biological emergency with similar risks.
The reported bill would also authorize VA and DoD to work
with the Nation's schools of medicine to ensure that physicians
in training receive targeted education in recognizing and
treating the effects of exposures to biological, chemical and
nuclear weapons. These training programs would then be made
available to all health care professionals, students, graduate
medical education trainees, and practitioners across the
country in diagnosing and treating victims of biological,
chemical, and radiological attacks or incidents.
The Association of American Medical Colleges (AAMC)
reported that military physicians, who should be more prepared
than civilian doctors to deal with such threats, are not
certain about their capability to handle them (Reporter, Volume
8, Number 3, December 1998, USUHS Military Medicine Program: A
Treatment for Terrorism). Moreover, Military Medicine reports
that only 19 percent of military physicians were confident
about providing care in nuclear, biological or chemical
disaster situations (Military Medicine, Volume 163, Number 6,
June 1998, Perceptions of Current and Recent Military Internal
Medicine Residents on Operational Medicine, Managed Care,
Graduate Medical Education, and Continued Military Service).
The majority of those who were confident about their
capabilities in this area, 53 percent, were graduates of the
military medical school, the F. Edward Hebert School of
Medicine of the Uniformed Services University of the Health
Sciences. The combination of DoD's expertise in the fields of
teaching and treating casualties resulting from an
unconventional attack, and VA's infrastructure of 163 medical
centers, 800 outpatient clinics, extensive satellite
broadcasting capabilities and affiliations with 107 medical
schools and teaching hospitals, would provide the needed
education to current and future health and medical
practitioners schooled in this country to diagnose and treat
casualties in such situations.
The suicide airliner attacks of September 11, 2001, and the
anthrax attacks in mid-October, 2001, vividly demonstrated the
vulnerability of the United States to a devastating biological,
chemical, or radiological attack. Medical professionals have
honestly acknowledged that they should be better prepared to
respond effectively whatever the type of weapon a terrorist may
choose to employ against the United States. This legislation
recognizes that many diseases and toxins that terrorists might
use are not seen in the normal course of civilian medical
practice, and only rarely in the military environment.
To carry out the intent of this legislation, the Department
of Veterans Affairs would work with the Department of Health
and Human Services, the Centers for Disease Control and
Prevention, the Food and Drug Administration and the Federal
Emergency Management Agency, as well as the Department of
Defense. The events of September 11, 2001, have made many
medical schools acutely aware of the gaps in curriculum and the
need to fill those gaps. The Committee believes it is desirable
that the Department of Veterans Affairs and the Department of
Defense, in coordination with other agencies of government,
take a more active role in partnering to address these gaps.
The reported bill also would authorize the Department of
Veterans Affairs to establish a new Assistant Secretary. The
new Assistant Secretary would be made responsible for
coordinating departmental operations, preparedness, security
and law enforcement to coordinate and improve VA's abilities to
protect itself, its patients and staff, and the general public
in a future emergency.
Section-By-Section Analysis
Section 1 of the bill would cite the bill as the Department
of Veterans Affairs Emergency Preparedness Research, Education,
and Bio-Terrorism Prevention Act of 2002.
Section 2(a) of the bill would amend title 38, United
States Code, chapter 73 by adding a new section 7325 entitled
``Medical Emergency Preparedness Centers.''
Section 7325 (a)(1) of title 38, United States Code would
authorize the Secretary to establish at least four medical
emergency preparedness centers at Department medical centers
staffed by Department employees.
Section 7325 (a)(2) would hold the Under Secretary for
Health responsible for supervising the operation and provide
ongoing evaluation of the centers.
Section 7325 (a)(3) would require the Under Secretary for
Health and the Assistant Secretary for Veterans Affairs, in
carrying out the role of the centers, to consult in matters
dealing with operations, preparedness, and security.
Section 7325 (b) would define the mission of the centers.
Section 7325 (b)(1) would require each center to carry out
research on and develop methods of detection, diagnosis,
vaccination, protection, and treatment for chemical biological,
and radiological threats to public health and safety.
Section 7325 (b)(2) would require each center to provide
education, training, and advice to health care professionals,
including health care professionals outside the Veterans Health
Administration.
Section 7325 (b)(3) would require each center to provide
contingent rapid response laboratory assistance and other
assistance to local health care authorities in the event of a
national emergency.
Section 7325 (c) would require the director of each center
to have expertise in managing organizations that deal with
chemical, biological, and radiological threats, providing care
to populations exposed to toxic substances, or significant
research experience in chemical, biological, and radiological
fields.
Section 7325 (d)(1) would authorize the Secretary of
Veterans Affairs to select sites for the Centers on the basis
of a competitive selection process. The centers would be
located in different regions of the Nation with at least one
center concentrating on chemical threats, at least one center
concentrating on biological threats, and at least one center
concentrating on radiological threats.
Section 7325 (d)(2) would establish criteria for site
locations by requiring the facility or facilities to meet
certain guidelines.
Section 7325 (d)(2)(A) would require the facility to have
an arrangement with a qualifying medical school and school of
public health, or a consortium of such schools, to provide
training to physicians and other medical professionals in the
diagnosis and treatment of illnesses induced by exposures to
toxins, including chemical, biological, and nuclear ionizing
radiation.
Section 7325 (d)(2)(B) would require the facility to have
an arrangement with an accredited graduate program of
epidemiology to provide training in the epidemiology of
contagious and infectious diseases, and chemical and radiation
poisoning in an exposed population.
Section 7325 (d)(2)(C) would require the facility to have
an arrangement to provide training and education in recognizing
and caring for conditions associated with exposures to toxins
to nursing, social work, counseling, or allied health personnel
and students.
Section 7325 (d)(2)(D) would require the facility to have
the ability to attract scientists who have made significant
contributions to the development of innovative approaches to
the detection, diagnosis, vaccination, protection, or treatment
of persons exposed to chemical, biological, or radiological
substances.
Section 7325 (d)(3) defines a qualifying medical school and
school of public health respectively.
Section 7325 (e)(1) would authorize appropriations for the
centers to be separated from medical care appropriations.
Section 7325 (e)(2) would authorize $20,000,000 for the
centers for fiscal years 2003 through 2007.
Section 7325 (e)(3) would authorize the Under Secretary for
Health, in consultation with the Assistant Secretary with
responsibility for operations, preparedness, and security, to
allocate additional funds from the medical care and medical and
prosthetics research account necessary to carry out the
purposes of the medical emergency preparedness centers.
Section 7325 (f) would require each center to conduct
research on improved medical preparedness and authorize the
centers to seek research funds from public and private sources.
Section 7325 (g)(1) would establish a peer review panel to
provide advice to assist the Secretary and the Under Secretary
for Health in assessing the scientific and clinical merit of
proposals for the establishment of the four centers. The peer
review panel is established in consultation with the Assistant
Secretary with responsibility for operations, preparedness, and
security.
Section 7325 (g)(2) would require the peer review panel to
include experts in relevant areas such as toxicology and
radiology.
Section 7325 (g)(3) would require the peer review panel to
review and submit its views on the scientific and clinical
merit of each proposal to establish a center.
Section 7325 (g)(4) would exempt the peer review panel from
the Federal Advisory Committee Act.
Section 7325 (h)(1) would require the Under Secretary for
Health and the Assistant Secretary with responsibility for
operations, preparedness, and security to disseminate the
information produced in the centers to health care providers in
the United States.
Section 7325 (h)(2) would authorize the Secretary to
conduct the work of the centers in close coordination with
other Federal departments and agencies and share such
information with the departments and agencies.
Section 7325 (i) would require the Secretary to provide
assistance to Federal, state, or local authorities in
investigations, inquiries, and data analyses in the areas of
biological, chemical or radiological threats.
Section 7325 (j) would allow the Director of a center, with
the Secretary's approval, to request temporary assignment or
detail of employees from other departments and agencies with
expertise to further the mission of the center. The duration of
assignment or detail would be subject to approval by the Office
of Personnel Management.
Section 2(b) of the bill would make clerical amendments.
Section 3(a)(1) of the bill would amend chapter 73 of title
38, United States Code, by adding a new section 7326 entitled
``Emergency health and medical education: joint program with
Department of Defense.''
Section 7326 (a) of title 38, United States Code, would
authorize the Department of Veterans Affairs and Department of
Defense to develop and disseminate a series of model education
and training programs on the medical responses to the
consequences of terrorist activities.
Section 7326 (b) would require the Under Secretary for
Health, in consultation with the Assistant Secretary with
responsibility for operations, preparedness and security, to
carry out a joint program for the Department of Veterans
Affairs; and the F. Edward Hebert School of Medicine of the
Uniformed Services University of the Health Sciences for the
Department of Defense.
Section 7326 (c) would require that the content of the
education and training program developed be based on programs
established at the F. Edward Hebert School of Medicine.
Section 7326 (c) would define the minimum training
requirements for the joint program: 1) recognition of chemical,
biological, and radiological agents; 2) identification of
potential symptoms of those agents; 3) understanding the
potential long-term health consequences; 4) emergency treatment
for exposure; 5) appropriate course of follow-up treatment,
supportive care, and referral; 6) preventive actions against
contamination taken while providing care for exposure; and 7)
information on reporting and seeking consultative support for
the suspected or actual use of those agents.
Section 7326 (d) would require that the programs be
designed and disseminated to health professions students,
graduate health and medical education trainees, and health
practitioners in a variety of fields and of vaious levels of
training.
Section 7326 (e) would require the Secretaries to consult
with representatives of accrediting, certifying and
coordinating organizations in the field of health professions
education in establishing the joint program.
Section 3(a)(2) of the bill would make clerical amendments.
Subsection (b) would require the implementation of this
section to be no later than 90 days after the enactment of the
Act.
Section 4(a) would amend section 308(a) of title 38, United
States Code, by increasing the number of Assistant Secretaries
of Veterans Affairs from six to seven.
Subsection (b) would add a new item to the list of
functions which the seven Assistant Secretaries would be
responsible for: operations, preparedness, security and law
enforcement functions.
Subsection (c) would make a conforming amendment.
Performance Goals and Objectives
The Department of Veterans Affairs' performance goals and
objectives are established in annual performance plans and are
subject to the Committee's regular oversight and evaluation by
the U.S. General Accounting Office.
Statement of the Views of the Administration
From the statement of the Honorable Leo S. MacKay, Jr.,
Ph.D., Deputy Secretary of Veterans Affairs, Department of
Veterans Affairs, before the Subcommittee on Health, Committee
on Veterans' Affairs, April 10, 2002:
VA has the infrastructure and expertise to be a vital
and integral link in our Nation's Homeland Security
efforts. We are the largest integrated national health
care system with personnel and facilities in virtually
every community across the U.S. VA has a robust
research program and is already actively engaged in
numerous projects in the areas of bio-terrorism and
medical emergency preparedness. We have made tremendous
strides in improving our capacity to maintain
operations in the event of a medical emergency by
increasing our ability to protect our staff and by
providing education and training. VA currently sponsors
the largest medical education and health professions
training program in the United States. Last year,
approximately 85,000 health professionals trained in
our medical facilities. VA facilities are affiliated
with almost 1,400 medical and other allied health care
schools. It is imperative that not only VA but also
non-VA health care providers receive the education and
training needed to become highly adept at recognizing
and responding to both the immediate and potential
long-term medical needs of individuals exposed to
chemical, biological, radiological, and other
unconventional warfare agents.
As you are aware, under the Federal Response Plan,
the Department of Health and Human Services (HHS) has
been designated as lead Federal agency for assessing
and providing health and medical services during
medical emergencies. VA may be, and has in fact been,
called upon to furnish needed medical assistance and
related services.
The Executive Office of the President, through the
Office of Homeland Security (OHS), is currently
crafting a comprehensive coordinated federal policy on
Homeland Security. VA is actively participating in this
OHS effort. It is expected that OHS will deliver this
policy to the President this July. The precise role and
responsibilities VA will be assigned in the area of
Homeland Security will be reflected in that policy. We
expect that we will have much to contribute in this
area based on our depth of expertise and
infrastructure, as alluded to above.
Because the President's Homeland Security policy is
forthcoming, we would like to work with the Committee
to ensure that the provisions of H.R. 3253 and H.R.
3254 are consistent with the comprehensive federal
plan.
Finally, I am very concerned that carrying out the
proposed activities without dedicated funding could
unacceptably diminish VA's ability to fulfill its
primary mission-providing health care and services to
veterans and their families. These new activities
cannot be accommodated within our already stretched
medical care accounts. Dedicated funding appropriated
separately for this effort must be consistent with the
discretionary spending limits of the President's
budget.
Having said this, I would like to address the bills
and provide a brief explanation of H.R. 3253 and H.R.
3254 and our views on their major provisions.
Mr. Chairman, the first bill, H.R. 3254, would
require that the Secretaries of Veterans Affairs and
Defense jointly develop and distribute a series of
model education and training programs to prepare health
professionals to respond to consequences of terrorist
activities. The programs' content would emphasize
education and training in the recognition of chemical,
biological, and radiological agents that may be used in
terrorist activities and identification of the
potential symptoms related to use of those agents. They
would also focus on management of clinical consequences
of terrorist acts. The education and training programs
would also be required to address short-term and long-
term health consequences, including psychological
effects that may result from exposure to such agents
and the appropriate treatment of those health
consequences. In addition, the programs must identify
measures to be taken by health care professionals to
prevent them from suffering secondary contamination or
infection while treating victims of a national medical
emergency. H.R. 3254 would also require that the
proposed joint education and training programs be
designed for health professions students, graduate
medical education trainees, and health practitioners in
a variety of fields.
Initial funding for these programs would be
authorized from funds made available under the
Emergency Supplemental Appropriations Act (Public Law
107-38).
VA strongly supports the goals of H.R. 3254. The
proposed training and education activities on national
medical emergencies would complement and strengthen the
current training and education efforts being carried
out by HHS through the Health Resources Administration
and the Centers for Disease Control and Prevention.
As drafted, the bill provides that DoD would carry
out the joint program through the F. Edward Hebert
School of Medicine of the Uniformed Services University
of the Health Sciences. We recommend that the Committee
consider placing DoD responsibility for the joint
program in the Assistant Secretary of Defense (Health
Affairs), which is the appropriate policy-level
counterpart to the Under Secretary for Health. If
enacted, the Department projects the first-year costs
associated with H.R. 3254 to be $5,641,500, with ten-
year costs estimated to be $55,065,000.
Mr. Chairman, I next turn to H.R. 3253. This bill
would require the Secretary to establish four or more
Emergency Medical Preparedness Centers within the
Veterans Health Administration (VHA). Under the
proposal, VA employees would staff the proposed
Centers, and the VHA Headquarters official responsible
for medical preparedness would be responsible for
supervising and evaluating the Centers' operations. The
Centers would have three specific missions. First, they
would carry out research and develop methods in
detection, diagnosis, vaccination, protection, and
treatment for CBR threats to the public health and
safety. Second, they would provide education, training,
and advice to VA and non-VA healthcare professionals.
Third, the Centers would provide contingent rapid
response laboratory assistance and other assistance to
local health care authorities in the event of a
national emergency.
H.R. 3253 would require that at least one of the
proposed Centers focus on chemical threats, another
concentrate on biological threats, and a third on
radiological threats. Each Center would be required to
conduct research on improved medical preparedness in
that Center's particular area of expertise. To carry
out this particular mandate, each Center would be
authorized to seek funding from both public and private
sources.
Finally, the bill would authorize initial funding
from the Emergency Supplemental Appropriations Act
(Public Law 107-38). It would also authorize additional
appropriations and require the Under Secretary for
Health to allocate from funds appropriated for the
Medical Care Account and the Medical and Prosthetics
Research Accounts such amounts as the Under Secretary
for Health determines appropriate to carry out the
activities of the Centers.
We strongly support the goals of H.R. 3253 and
believe that VA's expertise and infrastructure is
needed to help the nation respond to the health
consequences of terrorists' use, and potential use, of
CBR agents and other similar unconventional weapons.
However, H.R. 3253 would also authorize the Secretary
to assist Federal, State, and local civil and law
enforcement authorities with investigations to protect
the public safety and to prevent or obviate CBR-related
threats. Although we have the expertise to support such
activities, I believe we should limit our role to
support these needs on an expedited referral basis.
We also note that the training mission of the Centers
is somewhat similar to the goals of H.R. 3254 addressed
earlier. We recommend that the Subcommittee work to
integrate the similar training provisions of the two
bills.
***
I would underscore that any new role or
responsibilities must be consistent with the overall
comprehensive federal strategy on Homeland Security.
Moreover, a separate appropriation consistent with the
overall discretionary spending limits of the
President's budget must be provided. We welcome the
opportunity to work with the Committee to that end.
Congressional Budget Office Cost Estimate
The following letter was received from the Congressional
Budget Office concerning the cost of the reported bill:
U.S. Congress,
Congressional Budget Office,
Washington, DC, May 10, 2002.
Hon. Christopher H. Smith
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 3253, the
Department of Veterans Affairs Emergency Preparedness Research,
Education, and Bio-Terrorism Prevention Act of 2002.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Sam
Papenfuss, who can be reached at 226-2840.
Sincerely,
Dan L. Crippen,
Director.
Enclosure.
Congressional Budget Office Cost Estimate May 10, 2002
H.R. 3253, Department of Veterans Affairs Emergency Preparedness
Research, Education, and Bio-Terrorism Prevention Act of 2002, As
ordered reported by the House Committee on Veterans' Affairs on
May 9, 2002
Summary
H.R. 3253 would establish at least four medical emergency
centers that would carry out research and development, provide
education and training, and provide assistance in the case of a
national emergency with regard to chemical, biological, and
radiological threats. These emergency centers would be located
in hospitals operated by the Department of Veterans Affairs
(VA). H.R. 3253 would authorize appropriations of $20 million a
year over the 2003-2007 period to operate these centers. As
part of the requirement to provide education and training, the
bill would require VA to carry out a joint program with the
Department of Defense (DoD) to develop and disseminate a series
of training programs on the medical responses to terrorist
activities. Finally, H.R. 3253 would increase the number of
Assistant Secretaries within the VA from six to seven with the
new assistant secretary being responsible for operations,
preparedness, security, and law enforcement functions.
CBO estimates that implementing H.R. 3253 would cost $12
million in 2003 and $87 million over the 2003-2007 period,
assuming appropriation of the authorized amounts. Because the
bill would not affect direct spending or receipts, pay-as-you-
go procedures would not apply.
H.R. 3253 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA)
and would impose no costs on state, local, or tribal
governments.
Estimated Cost to the Federal Government
The estimated budgetary impact of H.R. 3253 is shown in the
following table. The costs of this legislation fall within
budget function 700 (veterans benefits and services).
----------------------------------------------------------------------------------------------------------------
By Fiscal Year, in Millions of Dollars
-----------------------------------------------------------
2002 2003 2004 2005 2006 2007
----------------------------------------------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATIONa
Spending for VA Medical Emergency Centers Under H.R.
3253
Authorization Level............................... 0 20 20 20 20 20
Estimated Outlays................................. 0 12 16 19 20 20
----------------------------------------------------------------------------------------------------------------
a No funds were appropriated for these purposes in 2002.
Basis of Estimate
VA has some limited responsibilities to provide assistance
in the event of a chemical, biological, or radiological (CBR)
threat under current law. Under H.R. 3253, VA would have
expanded responsibility to assist with CBR threats with the
creation of four medical emergency centers that would carry out
VA's new responsibilities. H.R. 3253 would specifically
authorize appropriations of $20 million a year over the 2003-
2007 period for the operation of these centers and would
authorize the use of other appropriated funds to carry out the
centers' activities. Assuming normal delays in beginning new
programs and appropriation of the authorized amounts, CBO
estimates that implementing H.R. 3253 would increase spending
by $12 million in 2003 and by $87 million over the 2003-2007
period.
The bill would require that VA establish four medical
emergency centers that would have three different
responsibilities. The first would be to conduct research and
development on detection, diagnosis, vaccination, protection,
and treatment on CBR threats to the public health and safety.
The second responsibility would be to provide training and
advice to health care professionals outside of VA, in
conjunction with DoD. The third responsibility would be to
provide contingent rapid response assistance including
laboratory assistance in the event of national emergencies.
CBO estimates that all of these responsibilities could be
carried out for the authorized $20 million a year. Although
setup and operating costs would come from appropriated funds,
the actual costs of the research and development would come
from public and private research grants. Using information from
VA, CBO estimates that the cost of providing education and
training would be about $5 million a year. Barring any major
national emergencies, CBO does not expect that VA would spend
more than the $20 million in appropriations specifically
authorized in H.R. 3253.
Pay-as-you-go Considerations: None.
Intergovernmental and Private-sector Impact
H.R. 3253 contains no intergovernmental or private-sector
mandates as defined in UMRA and would impose no costs on state,
local, or tribal governments.
Estimate prepared by:
Federal Costs: Sam Papenfuss
Impact on State, Local, and Tribal Governments: Elyse Goldman
Impact on the Private Sector: Sally Maxwell
Estimate approved by:
Peter H. Fontaine
Deputy Assistant Director for Budget Analysis
Statement of Federal Mandates
The preceding Congressional Budget Office cost estimate
states that the bill contains no intergovernmental or private
sector mandates as defined in the Unfunded Mandates Reform Act.
Applicability to Legislative Branch
The reported bill would not be applicable to the
legislative branch under the Congressional Accountability Act,
Public Law 104-1, because the bill would only affect or
authorize certain Department of Veterans Affairs with
Department of Defense programs or activities.
Statement of Constitutional Authority
Pursuant to Article I, section 8 of the United States
Constitution, the reported bill is authorized by Congress'
power to ``provide for the common Defense and general Welfare
of the United States.''
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, existing law in which no change
is proposed is shown in roman):
TITLE 38, UNITED STATES CODE
* * * * * * *
PART I--GENERAL PROVISIONS
* * * * * * *
CHAPTER 3--DEPARTMENT OF VETERANS AFFAIRS
* * * * * * *
Sec. 308. Assistant Secretaries; Deputy Assistant Secretaries
(a) There shall be in the Department not more than [six]
seven Assistant Secretaries. Each Assistant Secretary shall be
appointed by the President, by and with the advice and consent
of the Senate.
(b) The Secretary shall assign to the Assistant Secretaries
responsibility for the administration of such functions and
duties as the Secretary considers appropriate, including the
following functions:
(1) * * *
* * * * * * *
(11) Operations, preparedness, security, and law
enforcement functions.
* * * * * * *
PART V--BOARDS, ADMINISTRATIONS, AND SERVICES
* * * * * * *
CHAPTER 73--VETERANS HEALTH ADMINISTRATION--ORGANIZATION AND FUNCTIONS
SUBCHAPTER I--ORGANIZATION
Sec.
7301. Functions of Veterans Health Administration: in general.
* * * * * * *
subchapter ii--general authority and administration
7311. Quality assurance.
* * * * * * *
7325. Medical emergency preparedness centers.
7326. Emergency health and medical education: joint program with
Department of Defense.
* * * * * * *
SUBCHAPTER II--GENERAL AUTHORITY AND ADMINISTRATION
* * * * * * *
Sec. 7325. Medical emergency preparedness centers
(a) Establishment of Centers.--(1) The Secretary shall
establish at least four medical emergency preparedness centers
in accordance with this section. Each such center shall be
established at a Department medical center and shall be staffed
by Department employees.
(2) The Under Secretary for Health shall be responsible for
supervising the operation of the centers established pursuant
to this section. The Under Secretary shall provide for ongoing
evaluation of the centers and their compliance with the
requirements of this section.
(3) The Under Secretary shall carry out the Under Secretary's
functions under paragraph (2) in consultation with the
Assistant Secretary for Veterans Affairs with responsibility
for operations, preparedness, and security.
(b) Mission.--The mission of the centers shall be--
(1) to carry out research on and develop methods of
detection, diagnosis, vaccination, protection, and
treatment for chemical, biological, and radiological
threats to the public health and safety;
(2) to provide education, training, and advice to
health-care professionals, including health-care
professionals outside the Veterans Health
Administration; and
(3) to provide contingent rapid response laboratory
assistance and other assistance to local health care
authorities in the event of a national emergency.
(c) Center Directors.--Each center shall have a Director with
(1) expertise in managing organizations that deal with threats
referred to in subsection (b), (2) expertise in providing care
to populations exposed to toxic substances, or (3) significant
research experience in those fields.
(d) Selection of Centers.--(1) The Secretary shall select the
sites for the centers on the basis of a competitive selection
process and a finding under paragraph (2). The centers selected
shall be located in different regions of the Nation, and any
such center may be a consortium of efforts of more than one
medical center. At least one of the centers shall be
established to concentrate on chemical threats, at least one
shall be established to concentrate on biological threats, and
at least one shall be established to concentrate on
radiological threats.
(2) The finding referred to in paragraph (1) with respect to
a proposal for designation of a site as a location of a center
under this section is a finding by the Secretary, upon the
recommendations of the Under Secretary for Health and the
Assistant Secretary with responsibility for operations,
preparedness, and security, that the facility or facilities
submitting the proposal have developed (or may reasonably be
anticipated to develop) each of the following:
(A) An arrangement with a qualifying medical school
and a qualifying school of public health (or a
consortium of such schools) under which physicians and
other persons in the health field receive education and
training through the participating Department medical
centers so as to provide those persons with training in
the diagnosis and treatment of illnesses induced by
exposures to toxins, including chemical and biological
substances and nuclear ionizing radiation.
(B) An arrangement with an accredited graduate
program of epidemiology under which students receive
education and training in epidemiology through the
participating Department facilities so as to provide
such students with training in the epidemiology of
contagious and infectious diseases and chemical and
radiation poisoning in an exposed population.
(C) An arrangement under which nursing, social work,
counseling, or allied health personnel and students
receive training and education in recognizing and
caring for conditions associated with exposures to
toxins through the participating Department facilities.
(D) The ability to attract scientists who have made
significant contributions to the development of
innovative approaches to the detection, diagnosis,
vaccination, protection, or treatment of persons
exposed to chemical, biological, or radiological
substances.
(3) For purposes of paragraph (2)(A)--
(A) a qualifying medical school is an accredited
medical school that provides education and training in
toxicology and environmental health hazards and with
which one or more of the participating Department
medical centers is affiliated; and
(B) a qualifying school of public health is an
accredited school of public health that provides
education and training in toxicology and environmental
health hazards and with which one or more of the
participating Department medical centers is affiliated.
(e) Funding.--(1) Amounts appropriated for the activities of
the centers shall be appropriated separately from amounts
appropriated for the Department for medical care.
(2) There are authorized to be appropriated for the centers
under this section $20,000,000 for each of fiscal years 2003
through 2007.
(3) In addition to funds appropriated for a fiscal year
pursuant to the authorization of appropriations in paragraph
(2), the Under Secretary for Health shall allocate to such
centers from other funds appropriated for that fiscal year
generally for the Department of Veterans Affairs medical care
account and the Department of Veterans Affairs medical and
prosthetics research account such amounts as the Under
Secretary for Health determines appropriate to carry out the
purposes of this section. Any determination by the Under
Secretary under the preceding sentence shall be made in
consultation with the Assistant Secretary with responsibility
for operations, preparedness, and security.
(f) Research Activities.--Each center shall conduct research
on improved medical preparedness to protect the Nation from
threats in the area of that center's expertise. Each center may
seek research funds from public and private sources for such
purpose.
(g) Peer Review Panel.--(1) In order to provide advice to
assist the Secretary and the Under Secretary for Health to
carry out their responsibilities under this section, the Under
Secretary shall establish a peer review panel to assess the
scientific and clinical merit of proposals that are submitted
to the Secretary for the designation of centers under this
section. The peer review shall be established in consultation
with the Assistant Secretary with responsibility for
operations, preparedness, and security.
(2) The peer review panel shall include experts in the fields
of toxicological research, bio-hazards management education and
training, radiology, clinical care of patients exposed to such
hazards, and other persons as determined appropriate by the
Secretary. Members of the panel shall serve as consultants to
the Department.
(3) The panel shall review each proposal submitted to the
panel by the officials referred to in paragraph (1) and shall
submit to the Under Secretary for Health its views on the
relative scientific and clinical merit of each such proposal.
The panel shall specifically determine with respect to each
such proposal whether that proposal is among those proposals
which have met the highest competitive standards of scientific
and clinical merit.
(4) The panel shall not be subject to the Federal Advisory
Committee Act (5 U.S.C. App.).
(h) Research Products.--(1) The Under Secretary for Health
and the Assistant Secretary with responsibility for operations,
preparedness, and security shall ensure that information
produced by the research, education and training, and clinical
activities of centers established under this section is made
available, as appropriate, to health-care providers in the
United States. Dissemination of such information shall be made
through publications, through programs of continuing medical
and related education provided through regional medical
education centers under subchapter VI of chapter 74 of this
title, and through other means. Such programs of continuing
medical education shall receive priority in the award of
funding.
(2) The Secretary shall ensure that the work of the centers
is conducted in close coordination with other Federal
departments and agencies and that research products or other
information of the centers shall be coordinated and shared with
other Federal departments and agencies.
(i) Assistance to Other Agencies.--The Secretary may provide
assistance requested by appropriate Federal, State, and local
civil and criminal authorities in investigations, inquiries,
and data analyses as necessary to protect the public safety and
prevent or obviate biological, chemical, or radiological
threats.
(j) Detail of Employees From Other Agencies.--Upon approval
by the Secretary, the Director of a center may request the
temporary assignment or detail to the center, on a
nonreimbursable basis, of employees from other Departments and
agencies of the United States who have expertise that would
further the mission of the center. Any such employee may be so
assigned or detailed on a nonreimbursable basis pursuant to
such a request. The duration of any such assignment or detail
shall be subject to approval by the Office of Personnel
Management.
Sec. 7326. Emergency health and medical education: joint program with
Department of Defense
(a) Joint Education Program.--The Secretary and the Secretary
of Defense shall carry out a joint program to develop and
disseminate a series of model education and training programs
on the medical responses to the consequences of terrorist
activities. The Secretaries shall enter into an agreement for a
partnership to implement the joint program.
(b) Implementing Entities.--Within the Department of Veterans
Affairs, the joint program shall be carried out through the
Under Secretary for Health, in consultation with the Assistant
Secretary of Veterans Affairs with responsibility for
operations, preparedness, and security. Within the Department
of Defense, the joint program shall be carried out through the
F. Edward Hebert School of Medicine of the Uniformed Services
University of the Health Sciences.
(c) Content of Programs.--The education and training programs
developed under the joint program shall be based on programs
established at the F. Edward Hebert School of Medicine and
shall include, at a minimum, training for health care
professionals in the following:
(1) Recognition of chemical, biological, and
radiological agents that may be used in terrorist
activities.
(2) Identification of the potential symptoms of those
agents.
(3) Understanding of the potential long-term health
consequences, including psychological effects,
resulting from exposure to those agents.
(4) Emergency treatment for exposure to those agents.
(5) An appropriate course of followup treatment,
supportive care, and referral.
(6) Actions that can be taken while providing care
for exposure to those agents to protect against
contamination.
(7) Information on how to seek consultative support
and to report suspected or actual use of those agents.
(d) Potential Trainees.--In designing the education and
training programs under this section, the Secretaries shall
ensure that different programs are designed for health-care
professionals at various levels. The programs shall be designed
to be disseminated to health professions students, graduate
health and medical education trainees, and health practitioners
in a variety of fields.
(e) Consultation.--In establishing the joint education and
training program under this section, the two Secretaries shall
consult with appropriate representatives of accrediting,
certifying, and coordinating organizations in the field of
health professions education.
* * * * * * *
----------
SECTION 5315 OF TITLE 5, UNITED STATES CODE
Sec. 5315. Positions at level IV
Level IV of the Executive Schedule applies to the following
positions, for which the annual rate of basic pay shall be the
rate determined with respect to such level under chapter 11 of
title 2, as adjusted by section 5318 of this title:
Deputy Administrator of General Services.
* * * * * * *
Assistant Secretaries, Department of Veterans Affairs
[(6)] (7).
* * * * * * *