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S. HRG. 98-1211

VETERANS' ADMINISTRATION HEALTH

CARE AMENDMENTS OF 1984

HEARING

BEFORE THE

COMMITTEE ON VETERANS' AFFAIRS

UNITED STATES SENATE

NINETY-EIGHTH CONGRESS

SECOND SESSION

ON

S. 2210, S. 2269, Amendment No. 2850 to S. 2269,

S. 2278, S. 2514 and Related Bills

APRIL 11, 1984

Printed for the use of the Committee on Veterans' Affairs

U.S. GOVERNMENT PRINTING OFFICE

37-524 O

WASHINGTON : 1985

COMMITTEE ON VETERANS' AFFAIRS

ALAN K. SIMPSON, Wyoming, Chairman STROM THURMOND, South Carolina

ALAN CRANSTON, California ROBERT T. STAFFORD, Vermont

JENNINGS RANDOLPH, West Virginia FRANK H. MURKOWSKI, Alaska

SPARK M. MATSUNAGA, Hawaii ARLEN SPECTER, Pennsylvania

DENNIS DECONCINI, Arizona JEREMIAH DENTON, Alabama

GEORGE J. MITCHELL, Maine
RUDY BOSCHWITZ, Minnesota

ANTHONY J. PRINCIPI, Chief Counsel/Staff Director
JONATHAN R. STEINBERG, Minority Chief Counsel/Staff Director

(1)

CONTENTS

Page

32

33

37

56

57

70

72

Opening statement of Hon. Alan K. Simpson, chairman of the Senate Com-

mittee on Veterans' Affairs....

Bill S. 2210, as referred to the Committee on Veterans' Affairs:

Text of.

Agency report of the Veterans' Administration (No. 75, May 7, 1984).

Bill S. 2269, as referred to the Committee on Veterans' Affairs:

Text of

Introductory statement of the author, Hon. Alan Cranston, excerpts from

the Congressional Record, vol. 130, No. 12, pp. S1084-S1089–Senate,

February 7, 1984..

Amendment No. 2850, excerpts from the Congressional Record, vol. 130,

No. 37, pp. S3248-53252–Senate, March 27, 1984..

Bill S. 2278, as referred to the Committee on Veterans' Affairs:

Text of.

Introductory statement of the author, Hon. Rudy Boschwitz, excerpts

from the Congressional Record, vol. 130, No. 13, pp. S1185-S1186—

Senate, February 8, 1984....

Agency report of the Veterans' Administration (No. 79, May 21, 1984)...

Bill S. 2514, as referred to the Committee on Veterans' Affairs:

Text of .

Introductory statement of the author, Hon. Alan K. Simpson, excerpts

from the Congressional Record, vol. 130, No. 40, pp. $3533-S3536-

Senate, March 30, 1984...

Agency report of the Veterans' Administration (No. 85, July 16, 1984).......

Testimony of:

A panel consisting of: Donald L. Custis, M.D., Chief Medical Director,

Veterans' Administration, accompanied by D. Earl Brown, Jr., M.D.,

Associate Deputy Chief Medical Director; A. Audley Hendricks, Assist-

ant General Counsel; and Marjorie R. Quandt, Assistant Chief Medical

Director for Administration

A panel consisting of: Ewald W. Busse, M.D., dean emeritus, Duke Uni-

versity Medical Center, Durham, NC, and Chairman of the Geriatrics

and Gerontology Advisory Committee to the Veterans' Administration;

and Terrie Wetle, Ph.D., assistant professor, Division of Health Policy

Research and Education, Harvard University Medical School, Cam-

bridge, MA.

A panel consisting of: Leonard Saxe, Ph.D., psychologist, Boston Universi-

ty, accompanied by Denise Dougherty, Office of Technology Assess-

ment; Sandra K. Hill, R.N., C.A.Č., M.B.A., director, Suburban Hospi-

tals' Alcoholism Treatment Services, Bethesda, MD, and president,

board of trustees, Baltimore Alcoholism Treatment Center, Baltimore,

MD; and Leo Ruffing, member of the board of directors, Association of

Halfway House Alcoholism Programs of North America, Inc., St. Paul,

MN, accompanied by Donald Anderson, director, Serenity House Alco-

holism Recovery Program, Newport News, VA.......

John R. Smith, M.A., Clinical Program Director appointee, Center for

Trauma Recovery, Brecksville Division, VA Medical Center, Cleveland,

ОН.

A panel consisting of: Martin H. Cohen, M.D., Chief, Oncology Section,

Veterans' Administration Medical Center, Washington, DC; and Shar-

ron Dreyer, B.S.N., assistant administrator, Patient Care Services, Hos-

pice of Northern Virginia, Inc., Arlington, VA.

233

288

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