H.R. 2259, Sam Farr and Nick Castle Peace Corps Enhancement Act

Floor Situation

On Tuesday, July 10, 2018, the House will consider H.R. 2259, the Sam Farr and Nick Castle Peace Corps Enhancement Act, under suspension of the rules. This bill was introduced on May 1, 2017 by Rep. Ted Poe (R-TX) and was referred to the House Committee on Foreign Affairs, which ordered the bill reported by voice vote on May 17, 2018.

Summary

H.R. 2259 enhances the transparency and accountability of the Peace Corps in an effort to improve operations and better protect volunteers. It amends the Peace Corps Act to ensure that appropriate medical services are accessible to volunteers from the point of recruitment through return to the United States. It specifies qualifying criteria for medical officers serving in the field, enhances coordination with the Centers for Disease Control and Prevention (CDC) in prescribing medications, and provides a 120-day bridging mechanism for injured volunteers seeking to access care. It requires the Peace Corps to disclose information on the risk environment volunteers face in each country and to publish volunteer surveys, updates and extends the Office of Victim Advocacy and the Sexual Assault Advisory Council, allows Peace Corps to extend the term of service for critical staff for up to 5 years, and requires the agency to notify Congress prior to opening, closing, or significantly modifying a country program.

Background

Founded in 1961, the Peace Corps has sought to meet its legislative mandate of promoting world peace and friendship by sending American volunteers to serve at the grassroots level in villages and towns in all corners of the globe. As of the end of September 2017, about 7,376 volunteers were serving in 65 nations.[1]

Periodically, concerns have been raised regarding the quality of health care provided to volunteers during service as well as health care benefits offered to returned Peace Corps volunteers (RPCVs) who have illnesses connected to their service.[2]

The Peace Corps provides serving volunteers with comprehensive health care—routine care provided by a medical officer at each post and emergency care provided as deemed advisable, including medical evacuation to the United States. The agency has taken a number of steps in recent years to improve the quality of this care—providing direct communication between volunteers and medical professionals at headquarters, improving the supervision and hiring of medical officers, initiating electronic medical records, and strengthening malaria prevention and treatment efforts, among other measures. The 2017 Volunteer Survey found 71% of volunteers satisfied or very satisfied with medical support provided by the Peace Corps.[3]

One concern of serving volunteers has been the use of mefloquine, an antimalarial medication that may incur serious side effects. In March 2015, a former volunteer sued the Peace Corps for providing the drug without appropriate warnings. The Peace Corps disputes this point and further notes that its policy is to monitor closely for tolerance and to offer changes in medication if requested.[4]

RPCVs with maladies attributable to their Peace Corps service have long complained of inadequate support from Peace Corps and considerable frustration trying to obtain the health services for which they are eligible. RPCVs  with service-related health problems are supposed to file claims under the Federal Employees' Compensation Act (FECA) and work with the Department of Labor (DOL) Office of Workers' Compensation Programs (OWCP) to have those claims adjudicated. The Peace Corps itself is responsible for reimbursing DOL. The length and complexity of the established process, compounded by OWCP's perceived lack of understanding of volunteer service and the types of illnesses characteristic of work in developing nations, are particular concerns of affected RPCVs.[5]

To address these concerns, the Peace Corps in recent years has hired staff to assist volunteers with their claims and attempted to strengthen communication with DOL and shorten the claims process. In November 2015, a Healthcare Task Force, established by the Peace Corps, offered a proposed set of actions based on 28 recommendations previously made by GAO, Peace Corps, and nongovernment interest groups. Among other steps, the Task Force suggested that the Peace Corps seek legislation to raise the ceiling on disability compensation, improve explanation of post-service health benefits to volunteers and RPCVs, and provide greater assistance to volunteers on post-service options regarding accessibility to insurance under the Affordable Care Act.[6]

After Nick Castle, a 23-year-old Peace Corps volunteer teaching in rural China, fell violently ill in January 2013, no one recognized the severity of his symptoms and he passed away. A 2014 Peace Corps Inspector General report found that Nick was the victim of medical negligence and exposed “failures and delays in treatment” that ultimately led to his death.[7]

According to the bill sponsor, “After Nick’s death, it became clear that the Peace Corps staff was not properly trained or equipped and failed to respond. When young American Peace Corps volunteers head overseas, they must know that the U.S. government has their back. In 2011, Congress took a historic step in passing the Kate Puzey Peace Corps Volunteer Protection Act, but there is more work to be done. This bill will go even further to both keep volunteers healthy and to ensure that those who have experienced sexual assault have the assistance and protection that they need.”[8]

Cost

The Congressional Budget Office (CBO) estimates that implementing the bill would cost less than $500,000 over the 2018-2023 period, subject to the availability of appropriated funds.

Staff Contact

For questions or further information please contact Ryan Hofmann with the House Republican Policy Committee by email or at 2-6674.