[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1468 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 1468

To amend title 38, United States Code, to revise and improve veterans' 
             health care programs, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 7, 1995

 Mr. Edwards (for himself and Mr. Montgomery) introduced the following 
     bill; which was referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
To amend title 38, United States Code, to revise and improve veterans' 
             health care programs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans Health 
Improvements Act of 1995''.
    (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--WOMEN VETERANS HEALTH IMPROVEMENTS

Sec. 101. Short title.
Sec. 102. Health care services for women.
Sec. 103. Women's health services.
Sec. 104. Mammography quality standards.
Sec. 105. Coordinators of women's services.
Sec. 106. Patient privacy for women patients.
        TITLE II--CARE FOR VETERANS EXPOSED TO TOXIC SUBSTANCES

Sec. 201. Authority to provide priority health care.
Sec. 202. Savings provision.
                    TITLE III--READJUSTMENT SERVICES

Sec. 301. Scope of services provided in vet centers.
Sec. 302. Advisory committee on the readjustment of veterans.
              TITLE IV--SERVICES FOR MENTALLY ILL VETERANS

Sec. 401. Authority to establish nonprofit corporations.
Sec. 402. Extension of demonstration program.
Sec. 403. Department committee on care of severely chronically mentally 
                            ill veterans.
Sec. 404. Centers for mental illness research, education, and clinical 
                            activities.
Sec. 405. Codification and extension of authority for community-based 
                            residential care for homeless chronically 
                            mentally ill veterans and other veterans.
                     TITLE V--CONSTRUCTION PLANNING

Sec. 501. Strategic planning.
Sec. 502. Revision to prospectus requirements.
Sec. 503. Annual compilation of construction priorities.
Sec. 504. Definition of major medical facility project.
                TITLE VI--GENERAL HEALTH ADMINISTRATION

                 Subtitle A--Health Care Administration

Sec. 601. Overnight lodging in Department facilities when necessary for 
                            outpatient care.
Sec. 602. Pilot program for noninstitutional alternatives to nursing 
                            home care.
Sec. 603. Drug and alcohol abuse and dependence.
Sec. 604. Per diem for adult day health care.
Sec. 605. State home construction assistance program.
                  Subtitle B--Personnel Administration

Sec. 611. Limitation on reduction in full-time equivalent positions.
Sec. 612. Permanent authority for waiver of reduction of retirement pay 
                            for registered-nurse positions.
Sec. 613. Staffing flexibility.
Sec. 614. Protection against certain prohibited personnel practices.
Sec. 615. Extension of Health Scholarship Program.
              Subtitle C--Health Care Resource Agreements

Sec. 621. Repeal of termination of authority for expanded sharing 
                            arrangements.
Sec. 622. Acquisition of health care resources.
Sec. 623. Sharing agreements for specialized medical resources.
                       Subtitle D--Miscellaneous

Sec. 631. Department of Veterans Affairs research advisory committees.
Sec. 632. Technical amendments.
Sec. 633. Submittal date for report on annual analysis of 
                            departmentwide admissions policies.
Sec. 634. Child care services.
Sec. 635. Contracts for utilities, Audie L. Murphy Memorial Hospital.
Sec. 636. Authority to enter into agreement for use of property at 
                            Edward Hines, Jr., Department of Veterans 
                            Affairs Hospital.

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--WOMEN VETERANS HEALTH IMPROVEMENTS

SEC. 101. SHORT TITLE.

    This title may be cited as the ``Women Veterans Health Improvements 
Act of 1995''.

SEC. 102. HEALTH CARE SERVICES FOR WOMEN.

    (a) Ensured Provision of Services.--The Secretary of Veterans 
Affairs shall ensure that each health-care facility under the direct 
jurisdiction of the Secretary is able, through services made available 
either by individuals appointed to positions in the Veterans Health 
Administration or under contracts or other agreements made under 
section 7409, 8111, or 8152 of title 38, United States Code, or title 
II of Public Law 102-585, to provide in a timely and appropriate manner 
women's health services (as defined in section 1701(10) of title 38, 
United States Code (as added by section 103)) to any veteran described 
in section 1710(a)(1) of title 38, United States Code, who is eligible 
for such services.
    (b) Health Care Services To Be Provided Directly When Cost 
Effective.--(1) The Secretary shall ensure that each health-care 
facility under the direct jurisdiction of the Secretary shall provide 
women's health services directly (rather than by contract or other 
agreement) when it is cost effective to do so.
    (2) The Secretary shall ensure that each such facility is provided 
appropriate equipment, treatment facilities, and staff to carry out 
paragraph (1) and to ensure that the quality of care provided under 
that paragraph is in accordance with professional standards.
    (c) Conforming Repeal.--Section 302 of the Veterans' Health Care 
Amendments of 1983 (Public Law 98-160; 97 Stat. 1004; 38 U.S.C. 1701 
note) is repealed.

SEC. 103. WOMEN'S HEALTH SERVICES.

    (a) Women's Health Services.--Section 1701 is amended--
            (1) in paragraph (6)(A)(i), by inserting ``women's health 
        services,'' after ``preventive health services,''; and
            (2) by adding at the end the following:
    ``(10) The term `women's health services' means--
            ``(A) health care services to prevent diseases specific to 
        women, including--
                    ``(i) papanicolaou tests (pap smears); and
                    ``(ii) breast examinations and mammography;
            ``(B) health care services to treat disabilities specific 
        to women, including management and treatment of osteoporosis;
            ``(C) health care services for management of menopause;
            ``(D) health care services for the management and 
        prevention of sexually-transmitted diseases in women;
            ``(F) counseling and treatment of women for physical or 
        psychological conditions arising out of acts of sexual 
        violence;
            ``(G) early detection, management, and treatment for 
        cardiac disease, in the case of women who are determined to be 
        at risk of cardiac disease; and
            ``(H) health care authorized by paragraph (3) of section 
        106(a) of Public Law 102-585 (38 U.S.C. 1710 note), subject to 
        the limitations in that paragraph.''.
    (b) Extension of Annual Report Requirement.--Section 107(a) of the 
Veterans Health Care Act of 1992 (Public Law 102-585; 38 U.S.C. 1710 
note) is amended by striking out ``Not later than January 1, 1993, 
January 1, 1994, and January 1, 1995'' and inserting in lieu thereof 
``Not later than January 1 of 1993 and each year thereafter through 
1998''.
    (c) Report on Health Care and Research.--Section 107(b) of such Act 
is amended--
            (1) in paragraph (1), by striking out ``services described 
        in section 106 of this Act'' and inserting in lieu thereof 
        ``women's health services (as such term is defined in section 
        1701(10) of title 38, United States Code)'';
            (2) in paragraph (2)(A), by inserting ``(including 
        information on the number of inpatient stays and the number of 
        outpatient visits through which such services were provided)'' 
        after ``facility''; and
            (3) by adding at the end the following new paragraph:
            ``(5) A description of the actions taken by the Secretary 
        to foster and encourage the expansion of such research.''.

SEC. 104. MAMMOGRAPHY QUALITY STANDARDS.

    (a) In General.--(1) Subchapter II of chapter 73 is amended by 
adding at the end the following new section:
``Sec. 7319. Mammography quality standards
    ``(a) A mammogram may not be performed at a Department facility 
unless that facility is accredited for that purpose by a private 
nonprofit organization designated by the Secretary. An organization 
designated by the Secretary under this subsection shall meet the 
standards for accrediting bodies established under section 354(e) of 
the Public Health Service Act (42 U.S.C. 263b(e)).
    ``(b) The Secretary, in consultation with the Secretary of Health 
and Human Services, shall prescribe quality assurance and quality 
control standards relating to the performance and interpretation of 
mammograms and use of mammogram equipment and facilities of the 
Department of Veterans Affairs consistent with the requirements of 
section 354(f)(1) of the Public Health Service Act. Such standards 
shall be no less stringent than the standards prescribed by the 
Secretary of Health and Human Services under section 354(f) of the 
Public Health Service Act.
    ``(c)(1) The Secretary, to ensure compliance with the standards 
prescribed under subsection (b), shall provide for an annual inspection 
of the equipment and facilities used by and in Department health care 
facilities for the performance of mammograms. Such inspections shall be 
carried out in a manner consistent with the inspection of certified 
facilities by the Secretary of Health and Human Services under section 
354(g) of the Public Health Service Act.
    ``(2) The Secretary may not provide for an inspection under 
paragraph (1) to be performed by a State agency.
    ``(d) The Secretary shall ensure that mammograms performed for the 
Department under contract with any non-Department facility or provider 
conform to the quality standards prescribed by the Secretary of Health 
and Human Services under section 354 of the Public Health Service Act.
    ``(e) For the purposes of this section, the term `mammogram' has 
the meaning given such term in paragraph (5) of section 354(a) of the 
Public Health Service Act (42 U.S.C. 263b(a)).''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 7318 the 
following new item:

``7319. Mammography quality standards.''.
    (b) Deadline for Prescribing Standards.--The Secretary of Veterans 
Affairs shall prescribe standards under subsection (b) of section 7319 
of title 38, United States Code, as added by subsection (a), not later 
than the end of the 120-day period beginning on the later of--
            (1) the date on which the Secretary of Health and Human 
        Services prescribes quality standards under section 354(f) of 
        the Public Health Service Act (42 U.S.C. 263b(f)); or
            (2) the date of the enactment of this Act.
    (c) Transition.--(1) Subsection (a) of section 7319 of title 38, 
United States Code, as added by subsection (a), shall take effect on 
the date on which standards are prescribed by the Secretary of Veterans 
Affairs under subsection (b) of that section.
    (2) During the transition period, the Secretary of Veterans Affairs 
may waive the requirement of subsection (a) of section 7319 of title 
38, United States Code, as added by subsection (a), to any facility of 
the Department. The Secretary may provide such a waiver in the case of 
any facility only if the Secretary determines, based upon the 
recommendation of the Under Secretary for Health of the Department of 
Veterans Affairs, that during the period such a waiver is in effect for 
such facility (including any extension of the waiver under paragraph 
(3)) the facility will be operated in accordance with standards 
prescribed by the Secretary under subsection (b) of such section to 
assure the safety and accuracy of mammography services provided.
    (3) The transition period for purposes of this section is the six-
month period beginning on the date specified in paragraph (1). The 
Secretary may extend such period for a period not to exceed 90 days in 
the case of any Department facility. Any such extension may be made 
only if the Under Secretary for Health determines that--
            (A) without the extension access of veterans to mammography 
        services in the geographic area served by the facility would be 
        significantly reduced; and
            (B) appropriate steps will be taken before the end of the 
        transition period (as extended) to obtain accreditation of the 
        facility as required by subsection (a) of section 7319 of title 
        38, United States Code, as added by subsection (a).
    (d) Implementation Report.--The Secretary of Veterans Affairs shall 
submit to the Committees on Veterans' Affairs of the Senate and House 
of Representatives a report on the Secretary's implementation of 
section 7319 of title 38, United States Code, as added by subsection 
(a). The report shall be submitted not later than 120 days after the 
date on which the Secretary prescribes the quality standards required 
under subsection (b) of that section.

SEC. 105. COORDINATORS OF WOMEN'S SERVICES.

    (a) Full-Time Status.--Section 108 of the Veterans Health Care Act 
of 1992 (Public Law 102-585; 106 Stat. 4948; 38 U.S.C. 1710 note) is 
amended--
            (1) by inserting ``(a)'' before ``The Secretary''; and
            (2) by adding at the end the following:
    ``(b) Each official who serves in the position of coordinator of 
women's services under subsection (a) shall serve in such position on a 
full-time basis.''.
    (b) Support for Women's Services Coordinators.--The Secretary of 
Veterans Affairs shall take appropriate actions to ensure--
            (1) that sufficient funding is provided to each Department 
        of Veterans Affairs facility in order to permit the coordinator 
        of women's services assigned to that facility to carry out the 
        responsibilities of the coordinator at the facility; and
            (2) that each such coordinator has direct access to the 
        Director or Chief of Staff of the facility to which the 
        coordinator is assigned.

SEC. 106. PATIENT PRIVACY FOR WOMEN PATIENTS.

    (a) Identification of Deficiencies.--The Secretary of Veterans 
Affairs shall conduct a survey of each medical center under the 
jurisdiction of the Secretary to identify deficiencies relating to 
patient privacy afforded to women patients in the clinical areas at 
each such center which may interfere with appropriate treatment of such 
patients.
    (b) Correction of Deficiencies.--The Secretary shall ensure that 
plans and, where appropriate, interim steps, to correct the 
deficiencies identified in the survey conducted under subsection (a) 
are developed and are incorporated into the Department's construction 
planning processes and given a high priority.
    (c) Reports to Congress.--The Secretary shall compile an annual 
inventory, by medical center, of deficiencies identified under 
subsection (a) and of plans and, where appropriate, interim steps, to 
correct such deficiencies. The Secretary shall submit to the Committees 
on Veterans' Affairs of the Senate and House of Representatives, not 
later than October 1, 1995, and not later than October 1 each year 
thereafter through 1997 a report on such deficiencies. The Secretary 
shall include in such report the inventory compiled by the Secretary, 
the proposed corrective plans, and the status of such plans.

        TITLE II--CARE FOR VETERANS EXPOSED TO TOXIC SUBSTANCES

SEC. 201. AUTHORITY TO PROVIDE PRIORITY HEALTH CARE.

    (a) Authorized Inpatient Care.--Section 1710(e) of title 38, United 
States Code, is amended to read as follows:
    ``(e)(1)(A) Subject to paragraph (2), a herbicide-exposed veteran 
is eligible for hospital care and nursing home care under subsection 
(a)(1)(G) for any disease specified in subparagraph (B).
    ``(B) The diseases referred to in subparagraph (A) are those for 
which the National Academy of Sciences, in a report issued in 
accordance with section 2 of the Agent Orange Act of 1991, has 
determined--
            ``(i) that there is sufficient evidence to conclude that 
        there is a positive association between occurrence of the 
        disease in humans and exposure to a herbicide agent;
            ``(ii) that there is evidence which is suggestive of an 
        association between occurrence of the disease in humans and 
        exposure to a herbicide agent, but such evidence is limited in 
        nature; or
            ``(iii) that available studies are insufficient to permit a 
        conclusion about the presence or absence of an association 
        between occurrence of the disease in humans and exposure to a 
        herbicide agent.
    ``(C) A radiation-exposed veteran is eligible for hospital care and 
nursing home care under subsection (a)(1)(G) for--
            ``(i) any disease listed in section 1112(c)(2) of this 
        title; and
            ``(ii) any other disease for which the Secretary, based on 
        the advice of the Advisory Committee on Environmental Hazards, 
        determines that there is credible evidence of a positive 
        association between occurrence of the disease in humans and 
        exposure to ionizing radiation.
    ``(D) Subject to paragraph (2), a veteran who the Secretary finds 
may have been exposed while serving on active duty in the Southwest 
Asia theater of operations during the Persian Gulf War to a toxic 
substance or environmental hazard is eligible for hospital care and 
nursing home care under subsection (a)(1)(G) of this section for any 
disability which becomes manifest before October 1, 1996, 
notwithstanding that there is insufficient medical evidence to conclude 
that such disability may be associated with such exposure.
    ``(2) Hospital and nursing home care may not be provided under or 
by virtue of paragraph (1)(A) after December 31, 1996, and may not be 
provided under or by virtue of paragraph (1)(D) after December 31, 
1998.
    ``(3) For purposes of this subsection and section 1712 of this 
title--
            ``(A) the term `herbicide-exposed veteran' means a veteran 
        (i) who served on active duty in the Republic of Vietnam during 
        the Vietnam era, and (ii) who the Secretary finds may have been 
        exposed during such service to a herbicide agent;
            ``(B) the term `herbicide agent' has the meaning given that 
        term in section 1116(a)(4) of this title; and
            ``(C) the term `radiation-exposed veteran' has the meaning 
        given that term in section 1112(c)(4) of this title.''.
    (b) Authorized Outpatient Care.--Section 1712 of such title is 
amended--
            (1) in subsection (a)(1)--
                    (A) by striking out ``and'' at the end of 
                subparagraph (C);
                    (B) in subparagraph (D)--
                            (i) by striking out ``December 31, 1995'' 
                        and inserting in lieu thereof ``December 31, 
                        1998''; and
                            (ii) by striking out the period at the end 
                        and inserting in lieu thereof a semicolon; and
                    (C) by adding at the end the following:
                    ``(E) during the period before January 1, 1997, to 
                any herbicide-exposed veteran for any disease listed in 
                section 1710(e)(1)(B) of this title; and
                    ``(F) to any radiation-exposed veteran for any 
                disease covered under section 1710(e)(1)(C) of this 
                title.''; and
            (2) in subsection (i)(3)--
                    (A) by striking out ``(A)''; and
                    (B) by striking out ``, or (B)'' and all that 
                follows through ``title''.

SEC. 202. SAVINGS PROVISION.

    The provisions of sections 1710(e) and 1712(a) of title 38, United 
States Code, as in effect on the day before the date of the enactment 
of this Act, shall continue to apply on and after such date with 
respect to the furnishing of hospital care, nursing home care, and 
medical services for any veteran who was furnished such care or 
services before such date of enactment on the basis of presumed 
exposure to a substance or radiation under the authority of those 
provisions, but only for treatment for a disability for which such care 
or services were furnished before such date.

                    TITLE III--READJUSTMENT SERVICES

SEC. 301. SCOPE OF SERVICES PROVIDED IN VET CENTERS.

    (a) Expansion of Services.--Section 1712A is amended--
            (1) in subsection (a)(1) by inserting ``and, to the extent 
        otherwise authorized by law, may furnish such additional needed 
        services as described in subsection (i)'' in the first sentence 
        after ``life'';
            (2) by redesignating subsection (i) as subsection (j); and
            (3) by inserting after subsection (g) the following new 
        subsections:
    ``(h) The Secretary may, to the extent resources and facilities are 
available, furnish to any veteran who served in combat during World War 
II or the Korean conflict counseling in a center to assist such veteran 
in overcoming the effects of the veteran's combat experience.
    ``(i) In operating centers under this section, the Secretary may 
provide (1) preventive health care services, (2) medical services 
reasonably necessary in preparation for hospital admission or to 
complete treatment furnished under section 1710 or 1712(a) of this 
title, and (3) referral services to assist in obtaining specialized 
care. The Secretary shall provide such services through such health 
care personnel as the Secretary determines appropriate.''.
    (b) Report.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to the Committees on Veterans' Affairs of the Senate and House of 
Representatives a report relating to the implementation of the 
amendments made by subsection (a). The report shall include the 
following:
            (1) The number of veterans provided services described in 
        section 1712A(i) of title 38, United States Code, as added by 
        subsection (a).
            (2) The number of centers which provided services described 
        in that section.
            (3) An assessment of the effect providing such services has 
        had on access to and timeliness of service delivery, both for 
        veterans to whom services described in that section were 
        provided and for other veterans.

SEC. 302. ADVISORY COMMITTEE ON THE READJUSTMENT OF VETERANS.

    (a) In General.--(1) Subchapter III of chapter 5 is amended by 
adding at the end the following new section:
``Sec. 545. Advisory Committee on Veterans Readjustment Counseling
    ``(a)(1) There is in the Department the Advisory Committee on 
Veterans Readjustment Counseling (hereinafter in this section referred 
to as the `Committee').
    ``(2) The members of the Committee shall be appointed by the 
Secretary and shall include individuals who are recognized authorities 
in fields pertinent to the social, psychological, economic, or 
educational readjustment of veterans. At least two-thirds of the 
members of the Committee shall be veterans of the Vietnam era or other 
period of war. Appointments of members of the Committee shall be made 
from among individuals who have experience with the provision of 
veterans benefits and services by the Department or who are otherwise 
familiar with programs of the Department.
    ``(3) The Secretary shall seek to ensure that members appointed to 
the Committee include persons from a wide variety of geographic areas, 
persons from veterans service organizations, minorities, and women.
    ``(4) The Secretary shall determine the terms of service and pay 
and allowances of the members of the Committee, except that a term of 
service may not exceed two years. The Secretary may reappoint any 
member for additional terms of service.
    ``(b)(1) The Secretary shall, on a regular basis, consult with and 
seek the advice of the Committee with respect to the provision by the 
Department of benefits and services to veterans in order to assist 
veterans in the readjustment to civilian life.
    ``(2) In providing advice to the Secretary under this subsection, 
the Committee shall--
            ``(A) assemble and review information relating to the needs 
        of veterans in readjusting to civilian life;
            ``(B) provide information relating to the nature and 
        character of psychological problems arising from military 
        service;
            ``(C) provide an on-going assessment of the effectiveness 
        of the policies, organizational structures, and services of the 
        Department in assisting veterans in readjusting to civilian 
        life; and
            ``(D) provide on-going advice on the most appropriate means 
        of responding to the readjustment needs of future veterans.
    ``(3) In carrying out its duties under paragraph (2), the Committee 
shall take into special account veterans of the Vietnam era and the 
readjustment needs of those veterans.
    ``(c)(1) Not later than March 31 of each year, the Committee shall 
submit to the Secretary a report on the programs and activities of the 
Department that relate to the readjustment of veterans to civilian 
life. Each such report shall include--
            ``(A) an assessment of the needs of veterans with respect 
        to readjustment to civilian life;
            ``(B) a review of the programs and activities of the 
        Department designed to meet such needs; and
            ``(C) such recommendations (including recommendations for 
        administrative and legislative action) as the Committee 
        considers appropriate.
    ``(2) Not later than 90 days after the receipt of each report under 
paragraph (1), the Secretary shall transmit to the Committees on 
Veterans' Affairs of the Senate and House of Representatives a copy of 
the report, together with any comments and recommendations concerning 
the report that the Secretary considers appropriate.
    ``(3) The Committee may also submit to the Secretary such other 
reports and recommendations as the Committee considers appropriate.
    ``(4) The Secretary shall submit with each annual report submitted 
to the Congress pursuant to section 529 of this title a summary of all 
reports and recommendations of the Committee submitted to the Secretary 
since the previous annual report of the Secretary submitted pursuant to 
that section.''.
    (2) The table of sections at the beginning of chapter 5 is amended 
by adding at the end the following new item:

``545. Advisory Committee on Veterans Readjustment Counseling.''.
    (b) Original Members.--(1) Notwithstanding subsection (a)(2) of 
section 545 of title 38, United States Code (as added by subsection 
(a)), the members of the Advisory Committee on the Readjustment of 
Vietnam and Other War Veterans on the date of the enactment of this Act 
shall be the original members of the advisory committee established 
under that section.
    (2) The original members shall so serve until the Secretary of 
Veterans Affairs carries out appointments under such subsection (a)(2). 
The Secretary shall carry out such appointments as soon as is 
practicable. The Secretary may make such appointments from among such 
original members.

              TITLE IV--SERVICES FOR MENTALLY ILL VETERANS

SEC. 401. AUTHORITY TO ESTABLISH NONPROFIT CORPORATIONS.

    (a) In General.--Chapter 17 is amended by inserting after section 
1718 the following new section:
``Sec. 1718A. Nonprofit corporations
    ``(a) The Secretary may authorize the establishment at any Veterans 
Health Administration facility of a nonprofit corporation (1) to 
arrange for therapeutic work for patients of such facility or patients 
of other such Department facilities pursuant to section 1718(b) of this 
title, and (2) to provide a funding mechanism to achieve the purposes 
of section 1718 of this title.
    ``(b) The Secretary shall provide for the appointment of a board of 
directors for any corporation established under this section and shall 
determine the number of directors and the composition of the board of 
directors. The board of directors shall include--
            ``(1) the director of the facility and other officials or 
        employees of the facility; and
            ``(2) members appointed from among individuals who are not 
        officers or employees of the Department.
    ``(c) Each such corporation shall have an executive director who 
shall be appointed by the board of directors with concurrence of the 
Under Secretary for Health. The executive director of a corporation 
shall be responsible for the operations of the corporation and shall 
have such specific duties and responsibilities as the board may 
prescribe.
    ``(d)(1) A corporation established under this section shall arrange 
with the Department under section 1718(b)(2) of this title to provide 
for therapeutic work for patients.
    ``(2) Such a corporation may--
            ``(A) accept gifts and grants from, and enter into 
        contracts with, individuals and public and private entities 
        solely to carry out the purposes of this section; and
            ``(B) employ such employees as it considers necessary for 
        such purposes and fix the compensation of such employees.
    ``(e)(1) Except as provided in paragraph (2), any funds received by 
a corporation established under this section through arrangements 
authorized under subsection (d)(1) in excess of amounts reasonably 
required to carry out this section (including expenditures under 
subsection (d)(3)) shall be deposited in or credited to the fund 
established under section 1718(c) of this title.
    ``(2) The Secretary, in consultation with the Inspector General, 
shall prescribe regulations to govern the administration of funds 
received by a corporation established under this section. Such 
regulations may authorize a corporation to retain funds derived from 
arrangements authorized under subsection (d)(1).
    ``(3) Any funds received by a corporation established under this 
section through arrangements authorized under subsection (d)(2) may be 
transferred to the fund established under section 1718(c) of this 
title.
    ``(f) A corporation established under this section shall be 
established in accordance with the nonprofit corporation laws of the 
State in which the applicable medical facility is located and shall, to 
the extent not inconsistent with Federal law, be subject to the laws of 
such State.
    ``(g)(1)(A) The records of a corporation established under this 
section shall be available to the Secretary.
    ``(B) For the purposes of sections 4(a)(1) and 6(a)(1) of the 
Inspector General Act of 1978, the programs and operations of such a 
corporation shall be considered to be programs and operations of the 
Department with respect to which the Inspector General of the 
Department has responsibilities under such Act.
    ``(2) Such a corporation shall be considered an agency for the 
purposes of section 716 of title 31 (relating to availability of 
information and inspection of records by the Comptroller General).
    ``(3) Each such corporation shall submit to the Secretary an annual 
report providing a detailed statement of its operations, activities, 
and accomplishments during that year. The corporation shall obtain a 
report of independent auditors concerning the receipts and expenditures 
of funds by the corporation during that year and shall include that 
report in the corporation's report to the Secretary for that year.
    ``(4) Each member of the board of directors of a corporation 
established under this section, each employee of such corporation, and 
each employee of the Department who is involved in the functions of the 
corporation during any year shall--
            ``(A) be subject to Federal laws and regulations applicable 
        to Federal employees with respect to conflicts of interest in 
        the performance of official functions; and
            ``(B) submit to the Secretary an annual statement signed by 
        the director or employee certifying that the director or 
        employee is aware of, and has complied with, such laws and 
        regulations in the same manner as Federal employees are 
        required to.
    ``(h) The Secretary shall submit to the Committees on Veterans' 
Affairs of the Senate and House of Representatives an annual report on 
the number and location of corporations established and the amount of 
the contributions made to each such corporation.
    ``(i) No corporation may be established under this section after 
September 30, 1999.
    ``(j) If by the end of the four-year period beginning on the date 
of the establishment of a corporation under this section the 
corporation is not recognized as an entity the income of which is 
exempt from taxation under the Internal Revenue Code of 1986, the 
Secretary shall dissolve the corporation.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1718 the following new item:

``1718A. Nonprofit corporations.''.

SEC. 402. EXTENSION OF DEMONSTRATION PROGRAM.

    Section 7(a) of Public Law 102-54 (105 Stat. 269; 38 U.S.C. 1718 
note) is amended by striking out ``1995'' and inserting in lieu thereof 
``1998''.

SEC. 403. DEPARTMENT COMMITTEE ON CARE OF SEVERELY CHRONICALLY MENTALLY 
              ILL VETERANS.

    (a) Establishment.--Subchapter II of chapter 73 is amended by 
adding after section 7320, as added by section 304(c), the following 
new section:
``Sec. 7321. Committee on Care of Severely Chronically Mentally Ill 
              Veterans
    ``(a) Establishment.--The Secretary, acting through the Under 
Secretary for Health, shall establish in the Veterans Health 
Administration a Committee on Care of Severely Chronically Mentally Ill 
Veterans. The Under Secretary shall appoint employees of the Department 
with expertise in the care of the chronically mentally ill to serve on 
the committee.
    ``(b) Duties.--The committee shall assess, and carry out a 
continuing assessment of, the capability of the Veterans Health 
Administration to meet effectively the treatment and rehabilitation 
needs of mentally ill veterans whose mental illness is severe and 
chronic and who are eligible for health care furnished by the 
Department. In carrying out that responsibility, the committee shall--
            ``(1) evaluate the care provided to such veterans through 
        the Veterans Health Administration;
            ``(2) identify systemwide problems in caring for such 
        veterans in facilities of the Veterans Health Administration;
            ``(3) identify specific facilities within the Veterans 
        Health Administration at which program enrichment is needed to 
        improve treatment and rehabilitation of such veterans; and
            ``(4) identify model programs which the committee considers 
        to have been successful in the treatment and rehabilitation of 
        such veterans and which should be implemented more widely in or 
        through facilities of the Veterans Health Administration.
    ``(c) Advice and Recommendations.--The committee shall--
            ``(1) advise the Under Secretary regarding the development 
        of policies for the care and rehabilitation of severely 
        chronically mentally ill veterans; and
            ``(2) make recommendations to the Under Secretary--
                    ``(A) for improving programs of care of such 
                veterans at specific facilities and throughout the 
                Veterans Health Administration;
                    ``(B) for establishing special programs of 
                education and training relevant to the care of such 
                veterans for employees of the Veterans Health 
                Administration;
                    ``(C) regarding research needs and priorities 
                relevant to the care of such veterans; and
                    ``(D) regarding the appropriate allocation of 
                resources for all such activities.
    ``(d) Annual Report.--(1) Not later than April 1, 1996, the 
Secretary shall submit to the Committees on Veterans' Affairs of the 
Senate and House of Representatives a report on the implementation of 
this section. The report shall include the following:
            ``(A) A list of the members of the committee.
            ``(B) The assessment of the Under Secretary for Health, 
        after review of the initial findings of the committee, 
        regarding the capability of the Veterans Health Administration, 
        on a systemwide and facility-by-facility basis, to meet 
        effectively the treatment and rehabilitation needs of severely 
        chronically mentally ill veterans who are eligible for 
        Department care.
            ``(C) The plans of the committee for further assessments.
            ``(D) The findings and recommendations made by the 
        committee to the Under Secretary for Health and the views of 
        the Under Secretary on such findings and recommendations.
            ``(E) A description of the steps taken, plans made (and a 
        timetable for their execution), and resources to be applied 
        toward improving the capability of the Veterans Health 
        Administration to meet effectively the treatment and 
        rehabilitation needs of severely chronically mentally ill 
        veterans who are eligible for Department care.
    ``(2) Not later than February 1, 1997, and February 1 of each of 
the three following years, the Secretary shall submit to the Committees 
on Veterans' Affairs of the Senate and House of Representatives a 
report containing information updating the reports submitted under this 
subsection before the submission of such report.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 is amended by inserting after the item relating to section 
7320, as added by section 304(b), the following new item:

``7321. Committee on Care of Severely Chronically Mentally Ill 
                            Veterans.''.

SEC. 404. CENTERS FOR MENTAL ILLNESS RESEARCH, EDUCATION, AND CLINICAL 
              ACTIVITIES.

    (a) In General.--(1) Subchapter II of chapter 73 is amended by 
adding after section 7321, as added by section 403(a), the following 
new section:
``Sec. 7322. Centers for mental illness research, education, and 
              clinical activities
    ``(a) The purpose of this section is to provide for the improvement 
of the provision of health-care services and related counseling 
services to eligible veterans suffering from mental illness (especially 
mental illness related to service-related conditions) through--
            ``(1) the conduct of research (including research on 
        improving mental health service facilities of the Department 
        and on improving the delivery of mental health services by the 
        Department);
            ``(2) the education and training of health care personnel 
        of the Department; and
            ``(3) the development of improved models and systems for 
        the furnishing of mental health services by the Department.
    ``(b)(1) The Secretary shall establish and operate centers for 
mental illness research, education, and clinical activities. Such 
centers shall be established and operated by collaborating Department 
facilities as provided in subsection (c)(1). Each such center shall 
function as a center for--
            ``(A) research on mental health services;
            ``(B) the use by the Department of specific models for 
        furnishing services to treat serious mental illness;
            ``(C) education and training of health-care professionals 
        of the Department; and
            ``(D) the development and implementation of innovative 
        clinical activities and systems of care with respect to the 
        delivery of such services by the Department.
    ``(2) The Secretary shall, upon the recommendation of the Under 
Secretary for Health, designate the centers under this section. In 
making such designations, the Secretary shall ensure that the centers 
designated are located in various geographic regions of the United 
States. The Secretary may designate a center under this section only 
if--
            ``(A) the proposal submitted for the designation of the 
        center meets the requirements of subsection (c);
            ``(B) the Secretary makes the finding described in 
        subsection (d); and
            ``(C) the peer review panel established under subsection 
        (e) makes the determination specified in subsection (e)(3) with 
        respect to that proposal.
    ``(3) Not more than five centers may be designated under this 
section.
    ``(4) The authority of the Secretary to establish and operate 
centers under this section is subject to the appropriation of funds for 
that purpose.
    ``(c) A proposal submitted for the designation of a center under 
this section shall--
            ``(1) provide for close collaboration in the establishment 
        and operation of the center, and for the provision of care and 
        the conduct of research and education at the center, by a 
        Department facility or facilities in the same geographic area 
        which have a mission centered on care of the mentally ill and a 
        Department facility in that area which has a mission of 
        providing tertiary medical care;
            ``(2) provide that no less than 50 percent of the funds 
        appropriated for the center for support of clinical care, 
        research, and education will be provided to the collaborating 
        facility or facilities that have a mission centered on care of 
        the mentally ill; and
            ``(3) provide for a governance arrangement between the 
        collaborating Department facilities which ensures that the 
        center will be established and operated in a manner aimed at 
        improving the quality of mental health care at the 
        collaborating facility or facilities which have a mission 
        centered on care of the mentally ill.
    ``(d) The finding referred to in subsection (b)(2)(B) 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 recommendation of 
the Under Secretary for Health, that the facilities submitting the 
proposal have developed (or may reasonably be anticipated to develop) 
each of the following:
            ``(1) An arrangement with an accredited medical school that 
        provides education and training in psychiatry and with which 
        one or more of the participating Department facilities is 
        affiliated under which medical residents receive education and 
        training in psychiatry through regular rotation through the 
        participating Department facilities so as to provide such 
        residents with training in the diagnosis and treatment of 
        mental illness.
            ``(2) An arrangement with an accredited graduate school of 
        psychology under which students receive education and training 
        in clinical, counseling, or professional psychology through 
        regular rotation through the participating Department 
        facilities so as to provide such students with training in the 
        diagnosis and treatment of mental illness.
            ``(3) An arrangement under which nursing, social work, or 
        allied health personnel receive training and education in 
        mental health care through regular rotation through the 
        participating Department facilities.
            ``(4) The ability to attract scientists who have 
        demonstrated achievement in research--
                     ``(A) into the evaluation of innovative approaches 
                to the design of mental health services; or
                    ``(B) into the causes, prevention, and treatment of 
                mental illness.
            ``(5) The capability to evaluate effectively the activities 
        of the center, including activities relating to the evaluation 
        of specific efforts to improve the quality and effectiveness of 
        mental health services provided by the Department at or through 
        individual facilities.
    ``(e)(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 official within the central office of the Veterans 
Health Administration responsible for mental health and behavioral 
sciences matters 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.
    ``(2) The panel shall consist of experts in the fields of mental 
health research, education and training, and clinical care. Members of 
the panel shall serve as consultants to the Department.
    ``(3) The panel shall review each proposal submitted to the panel 
by the official referred to in paragraph (1) and shall submit to that 
official 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.).
    ``(f) Clinical and scientific investigation activities at each 
center established under this section--
            ``(1) may compete for the award of funding from amounts 
        appropriated for the Department of Veterans Affairs medical and 
        prosthetics research account; and
            ``(2) shall receive priority in the award of funding from 
        such account insofar as funds are awarded to projects and 
        activities relating to mental illness.
    ``(g) The Under Secretary for Health shall ensure that at least 
three centers designated under this section emphasize research into 
means of improving the quality of care for veterans suffering from 
mental illness through the development of community-based alternatives 
to institutional treatment for such illness.
    ``(h) The Under Secretary for Health shall ensure that information 
produced by the research, education and training, and clinical 
activities of centers established under this section that may be useful 
for other activities of the Veterans Health Administration is 
disseminated throughout the Veterans Health Administration. Such 
dissemination 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.
    ``(i) The official within the central office of the Veterans Health 
Administration responsible for mental health and behavioral sciences 
matters shall be responsible for supervising the operation of the 
centers established pursuant to this section and shall provide for 
ongoing evaluation of the centers and their compliance with the 
requirements of this section.
    ``(j)(1) There are authorized to be appropriated to the Department 
of Veterans Affairs for the basic support of the research and education 
and training activities of centers established pursuant to this section 
amounts as follows:
            ``(A) $3,125,000 for fiscal year 1997.
            ``(B) $6,250,000 for each of fiscal years 1998 through 
        2000.
    ``(2) In addition to funds appropriated for a fiscal year pursuant 
to the authorization of appropriations in paragraph (1), 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.''.
    (2) The table of sections at the beginning of chapter 73 is amended 
by inserting after the item relating to section 7321, as added by 
section 403(b), the following new item:

``7322. Centers for mental illness research, education, and clinical 
                            activities.''.
    (b) Annual Reports.--Not later than February 1 of each of 1997, 
1998, and 1999, the Secretary of Veterans Affairs shall submit to the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives a report on the status and activities during the 
previous fiscal year of the centers for mental illness, research, 
education, and clinical activities established pursuant to section 7322 
of title 38, United States Code (as added by subsection (a)). Each such 
report shall include the following:
            (1) A description of the activities carried out at each 
        center and the funding provided for such activities.
            (2) A description of the advances made at each of the 
        participating facilities of the center in research, education 
        and training, and clinical activities relating to mental 
        illness in veterans.
            (3) A description of the actions taken by the Under 
        Secretary for Health pursuant to subsection (h) of that section 
        (as so added) to disseminate information derived from such 
        activities throughout the Veterans Health Administration.
            (4) The Secretary's evaluations of the effectiveness of the 
        centers in fulfilling the purposes of the centers.
    (c) Implementation.--The Secretary of Veterans Affairs shall 
designate at least one center under section 7322 of title 38, United 
States Code, not later than January 1, 1997.

SEC. 405. CODIFICATION AND EXTENSION OF AUTHORITY FOR COMMUNITY-BASED 
              RESIDENTIAL CARE FOR HOMELESS CHRONICALLY MENTALLY ILL 
              VETERANS AND OTHER VETERANS.

    (a) In General.--Subchapter II of chapter 17 is amended by adding 
at the end the following:
``Sec. 1720E. Community-based residential care: homeless chronically 
              mentally ill veterans and other veterans
  ``(a)(1) The Secretary may provide to homeless veterans suffering 
from chronic mental illness disabilities who are eligible for care 
under section 1710(a)(1) of this title care and treatment and 
rehabilitative services (directly or by contract) in--
            ``(A) halfway houses;
            ``(B) therapeutic communities;
            ``(C) psychiatric residential treatment centers; and
            ``(D) other community-based treatment facilities.
  ``(2) In providing care and treatment and rehabilitative services 
under paragraph (1), the Secretary may also provide such care and 
treatment and rehabilitative services--
          ``(A) to veterans being furnished hospital or nursing home 
        care by the Secretary for a chronic mental illness disability; 
        and
          ``(B) to veterans with service-connected chronic mental 
        illness disabilities.
  ``(b)(1) Before furnishing care and treatment and rehabilitative 
services by contract under subsection (a) to a veteran through a 
facility described in subsection (a), the Secretary shall approve the 
quality and effectiveness of the program operated by such facility for 
the purpose for which the veteran is to be furnished such care and 
services.
    ``(2) The Secretary shall prescribe criteria for the approval under 
paragraph (1) of the quality and effectiveness of programs.
  ``(c)(1) The Secretary may provide in-kind assistance (through the 
services of Department employees and the sharing of other Department 
resources) to a facility described in subsection (a) under this 
section. The Secretary shall provide such assistance to a facility 
under a contract between the Secretary and the facility.
    ``(2) The Secretary may provide assistance under paragraph (1)--
            ``(A) only for use solely in the furnishing of appropriate 
        care and services under this section; and
            ``(B) only if, under such contract, the Secretary receives 
        reimbursement for the full cost of such assistance, including 
        the cost of services and supplies and normal depreciation and 
        amortization of equipment.
    ``(3) Reimbursement under paragraph (2)(B) may be made by reduction 
in the charges to the United States or by payment to the United States.
    ``(4) Any funds received through reimbursement under paragraph (3) 
shall be credited to funds allotted to the Department facility that 
provided the assistance.
    ``(d) The Secretary may not provide care and treatment and 
rehabilitative services under this section after September 30, 1999.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1720D the following new item:

``1720E. Community-based residential care: homeless chronically 
                            mentally ill veterans and other 
                            veterans.''.
    (c) Repeal of Superseded Authority.--Section 115 of the Veterans' 
Benefits and Services Act of 1988 (38 U.S.C. 1712 note) is repealed.

                     TITLE V--CONSTRUCTION PLANNING

SEC. 501. STRATEGIC PLANNING.

    (a) Development of Plan.--The Secretary of Veterans Affairs shall 
develop and implement a plan to promote efficient delivery of health 
care services and to reduce unnecessary duplication of health care 
resources. The plan shall provide for delivering health care to 
veterans through a coordinated network of facilities operating within 
prescribed geographic areas. Each such area shall be referred to as a 
``service-delivery area''.
    (b) Implementation of Plan.--The Under Secretary for Health shall 
use the plan to--
            (1) determine and prescribe the specific mission of, and 
        clinical programs to be operated at, each health care facility 
        of the Department;
            (2) determine, with respect to each such service-delivery 
        area and each facility in such area, the extent to which 
        services provided under the auspices of the Secretary should be 
        provided directly through facilities of the Department or 
        through contract or other arrangements, including arrangements 
        authorized under sections 8111 and 8153 of title 38, United 
        States Code;
            (3) provide for a reduction in duplication of services and 
        programs within such service-delivery areas and a realignment 
        of services among facilities within such areas as necessary to 
        promote efficiency;
            (4) develop medical facility construction projects and 
        other capital projects;
            (5) carry out such other purposes as the Secretary shall 
        prescribe.
    (c) Report on Implementation.--Not later than 12 months after the 
date of the enactment of this Act, the Secretary shall submit to the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives a report on the implementation of this section. The 
report shall--
            (1) include the plan established pursuant to subsection 
        (a);
            (2) identify the service-delivery areas described in such 
        subsection and provide demographic data on the veteran 
        population in each such service area, including projections of 
        the number of veterans who are likely to avail themselves of 
        Department of Veterans Affairs care in each such area;
            (3) identify the specific missions required by subsection 
        (a)(1) and the projected timetable and milestones necessary for 
        each facility to carry out its prescribed mission; and
            (4) identify and assess the nature and impact of such plan, 
        including provision of an analysis of specific effects 
        nationally and within each service-delivery area, on the 
        health-professions education and training, research, and 
        contingency support functions of the Veterans Health 
        Administration.

SEC. 502. REVISION TO PROSPECTUS REQUIREMENTS.

    (a) Additional Information.--Section 8104(b) is amended--
            (1) by striking out ``shall include--'' and inserting in 
        lieu thereof ``shall include the following:'';
            (2) in paragraph (1)--
                    (A) by striking out ``a detailed'' and inserting in 
                lieu thereof ``A detailed''; and
                    (B) by striking out the semicolon at the end and 
                inserting in lieu thereof a period;
            (3) in paragraph (2)--
                    (A) by striking out ``an estimate'' and inserting 
                in lieu thereof ``An estimate''; and
                    (B) by striking out ``; and'' and inserting in lieu 
                thereof a period;
            (4) in paragraph (3), by striking out ``an estimate'' and 
        inserting in lieu thereof ``An estimate''; and
            (5) by adding at the end the following new paragraphs:
            ``(4) Demographic data applicable to the project.
            ``(5) Current and projected workload and utilization data.
            ``(6) Current and projected operating costs of the 
        facility, to include both recurring and non-recurring costs.
            ``(7) The priority score assigned to the project under the 
        Department's prioritization methodology and, if the project is 
        being proposed for funding ahead of a project with a higher 
        score, a specific explanation of the factors other than the 
        priority that were considered and the basis on which the 
        project is proposed for funding ahead of projects with higher 
        priority scores.
            ``(8) A listing of each alternative to construction of the 
        facility that has been considered.''.
    (b) Applicability.--The amendments made by subsection (a) shall 
apply with respect to any prospectus submitted by the Secretary of 
Veterans Affairs after the date of the enactment of this Act.

SEC. 503. ANNUAL COMPILATION OF CONSTRUCTION PRIORITIES.

    Section 8107 is amended--
            (1) in subsection (a)(2)--
                    (A) by inserting ``and'' at the end of subparagraph 
                (A);
                    (B) by striking out subparagraph (B); and
                    (C) by redesignating subparagraph (C) as 
                subparagraph (B); and
            (2) by adding at the end the following new subsection:
    ``(c)(1) The Secretary shall submit to each committee, not later 
than January 31 of each year, a report showing the current priorities 
of the Department for proposed major medical construction projects. 
Each such report shall identify the 20 projects, from within all the 
projects in the Department's inventory of proposed projects, that have 
the highest priority and, for those 20 projects, the relative priority 
and rank scoring of each such project. The 20 projects shall be 
compiled, and their relative rankings shall be shown, by category of 
project (including the categories of ambulatory care projects, nursing 
home care projects, and such other categories as the Secretary 
determines).
    ``(2) The Secretary shall include in each report, for each project 
listed, a description of the specific factors that account for the 
relative ranking of that project in relation to other projects within 
the same category.
    ``(3) In a case in which the relative ranking of a proposed project 
has changed since the last report under this subsection was submitted, 
the Secretary shall also include in the report a description of the 
reasons for the change in the ranking, including an explanation of any 
change in the scoring of the project under the Department's scoring 
system for proposed major medical construction projects.''.

SEC. 504. CONSTRUCTION AUTHORIZATION.

    (a) Congressional Approval of Design Work.--Paragraph (2) of 
section 8104(a) is amended by striking out ``and design''.
    (b) Definition of Major Medical Facility Project.--Paragraph (3)(A) 
of such section is amended by inserting before the period at the end 
the following: ``, and, in the case of a project which is principally 
for the alteration of a medical facility to provide additional space 
for provision of ambulatory care, such term means a project involving a 
total expenditure of more than $5,000,000''.

                TITLE VI--GENERAL HEALTH ADMINISTRATION

                 Subtitle A--Health Care Administration

SEC. 601. OVERNIGHT LODGING IN DEPARTMENT FACILITIES WHEN NECESSARY FOR 
              OUTPATIENT CARE.

    Section 1701(6)(A)(i) is amended by inserting ``overnight lodging 
in Department facilities when necessary for the provision of services 
on an outpatient basis,'' after ``prosthetic appliances,''.

SEC. 602. PILOT PROGRAM FOR NONINSTITUTIONAL ALTERNATIVES TO NURSING 
              HOME CARE.

    (a) Extension of Program.--Section 1720C(a) is amended by striking 
out ``September 30, 1995'' and inserting in lieu thereof ``September 
30, 1997''.
    (b) 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--
            (1) by striking out ``February 1, 1995,'' and inserting in 
        lieu thereof ``February 1, 1997,''; and
            (2) by striking out ``September 30, 1993,'' and inserting 
        in lieu thereof ``September 30, 1996,''.

SEC. 603. DRUG AND ALCOHOL ABUSE AND DEPENDENCE.

    Section 1720A(e) is amended by striking out ``December 31, 1995'' 
and inserting in lieu thereof ``December 31, 1997''.

SEC. 604. PER DIEM FOR ADULT DAY HEALTH CARE.

    (a) In General.--Subsection (a) of section 1741 is amended to read 
as follows:
    ``(a)(1) The Secretary shall pay to each State a per diem amount 
for each veteran receiving domiciliary care, nursing home care, 
hospital care, or adult day health care in a State home if the veteran 
is eligible to receive that care in a Department facility.
    ``(2) The per diem amount to be paid under this subsection is as 
follows:
            ``(A) For domiciliary care, $15.11.
            ``(B) For nursing home care and hospital care, $35.37.
            ``(C) For adult day health care, an amount to be prescribed 
        by the Secretary, not in excess of the amount under 
        subparagraph (A).''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to adult day health care provided in a State home 
after the date of the enactment of this Act.

SEC. 605. STATE HOME CONSTRUCTION ASSISTANCE PROGRAM.

    (a) In General.--Subchapter III of chapter 81 is amended as 
follows:
            (1) Section 8131(3) is amended by inserting ``or adult day 
        health care'' after ``hospital care''.
            (2) Section 8132 is amended by inserting ``or adult day 
        health care'' after ``hospital care''.
            (3) Section 8135(a)(4) is amended by inserting ``and, in 
        the case of adult day health care, not more than 25 percent of 
        the number of patients participating in that program,'' after 
        ``occupancy''.
            (4) Section 8135(b) is amended--
                    (A) in paragraph (2)(C), by inserting ``or adult 
                day health care facilities'' after ``domiciliary 
                beds''; and
                    (B) in paragraph (3)(A), by inserting ``, or would 
                involve expansion, remodeling, or alteration of 
                existing buildings for the furnishing of adult day 
                health care'' after ``buildings''.
            (5) Section 8136 is amended by inserting ``or adult day 
        health care'' after ``hospital care''.
            (6) The heading of such subchapter is amended to read as 
        follows:

  ``SUBCHAPTER III--STATE HOME FACILITIES FOR FURNISHING DOMICILIARY 
  CARE, NURSING HOME CARE, ADULT DAY HEALTH CARE, AND HOSPITAL CARE''.

    (b) Clerical Amendment.--The item relating to subchapter III in the 
table of sections at the beginning of such chapter is amended to read 
as follows:
  ``subchapter iii--state home facilities for furnishing domiciliary 
  care, nursing home care, adult day health care, and hospital care''.
    (c) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to grants made to States using funds appropriated 
after the date of the enactment of this Act.

                  Subtitle B--Personnel Administration

SEC. 611. LIMITATION ON REDUCTION IN FULL-TIME EQUIVALENT POSITIONS.

    Section 712(b)(2) is amended--
            (1) by striking out ``the sum of--'' and inserting in lieu 
        thereof ``the sum of the following:'';
            (2) by capitalizing the first letter of the first word of 
        each of subparagraphs (A) and (B);
            (3) by striking out ``; and'' at the end of subparagraph 
        (A) and inserting in lieu thereof a period; and
            (4) by adding at the end the following:
            ``(C) The number of such positions in the Department during 
        that fiscal year held by persons involved in providing medical 
        resources under section 8111 or 8152 of this title, reduced by 
        the number of persons (as determined by the Secretary) involved 
        in furnishing medical resources to the Department under those 
        sections.''.

SEC. 612. PERMANENT AUTHORITY FOR WAIVER OF REDUCTION OF RETIREMENT PAY 
              FOR REGISTERED-NURSE POSITIONS.

    Section 7426(c) is amended by striking out the second sentence.

SEC. 613. STAFFING FLEXIBILITY.

    (a) Authority To Convert Position to Hybrid Title 38 Personnel 
System.--Section 7401(3) is amended by striking out ``and occupational 
therapists'' and inserting in lieu thereof ``occupational therapists, 
and such other persons in health care occupations as the Secretary 
considers necessary''.
    (b) Contracting Flexibility.--(1) Section 7409 is amended by 
striking out ``scarce'' in subsections (a) and (b)(3).
    (2)(A) The heading of such section, and the item relating to such 
section in the table of sections at the beginning of chapter 74, are 
each amended by striking out the third word.

SEC. 614. PROTECTION AGAINST CERTAIN PROHIBITED PERSONNEL PRACTICES.

    (a) In General.--Subchapter II of chapter 74 is amended by adding 
at the end the following:
``Sec. 7427. Protection from prohibited personnel practices
    ``(a)(1) The provisions of law specified in paragraph (2) apply to 
any individual appointed as an employee of the Veterans Health 
Administration under chapter 73 of this title or under this chapter.
    ``(2) The provisions of law referred to in paragraph (1) are 
sections 1212, 1213, 1214, 1215, 1216, 1221, 1222, and 2302 of title 5.
    ``(b) The authority of the Merit Systems Protection Board and of 
the Office of Special Counsel to review any personnel action under the 
authority provided for under a provision of law specified in subsection 
(a)(2) shall apply only to the extent specified in that provision of 
law.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
7426 the following new item:

``7427. Protection from prohibited personnel practices.''.

SEC. 615. EXTENSION OF HEALTH SCHOLARSHIP PROGRAM.

    Section 7618 is amended by striking out ``December 31, 1995'' and 
inserting in lieu thereof ``December 31, 1998''.

              Subtitle C--Health Care Resource Agreements

SEC. 621. REPEAL OF TERMINATION OF AUTHORITY FOR EXPANDED SHARING 
              ARRANGEMENTS.

    Section 204 of the Veterans Health Care Act of 1992 (Public Law 
102-585; 106 Stat. 4950) is repealed.

SEC. 622. ACQUISITION OF HEALTH CARE RESOURCES.

    (a) Authority in States With Health Care Reform Plans.--Section 
8123 is amended--
            (1) by inserting ``(a)'' at the beginning of the text;
            (2) by inserting after subsection (a) the following:
    ``(b)(1) The director of a Department health care facility located 
in a State that has established a State health care reform plan may, 
without regard to section 1703 of this title, or any other law or 
regulation pertaining to competitive procedures, acquisition 
procedures, or policies (other than contract dispute procedures), or 
bid protests, contract with any entity or individual to procure or 
furnish any health care resource, as that term is defined in section 
8151 of this title. The references in this subsection to laws or 
regulations shall not be construed to apply to any provision of title 
XVIII or XIX of the Social Security Act.
    ``(2) A director may contract to furnish services under this 
subsection to individuals who are not veterans only if the director 
determines that a contract to furnish such services--
            ``(A) is necessary to maintain an acceptable level and 
        quality of service to veterans at that facility;
            ``(B) will result in the improvement of services to 
        eligible veterans at that facility; and
            ``(C) will not result in the denial of, or a delay in 
        providing access to, care to any veteran at that facility.
    ``(3) In entering into a contract to provide services under this 
subsection, the director may provide for payment to the Department in 
accordance with procedures that provide appropriate flexibility to 
negotiate an appropriate rate of reimbursement. Any proceeds to the 
Government received therefrom shall be credited to the applicable 
appropriation of the Department and to funds that have been allotted to 
the facility that furnished the care or services.
    ``(4) For purposes of this subsection, a State health care reform 
plan shall be considered to have been established in a State if the 
Secretary determines that the State has enacted legislation that is 
intended, at least in part, to provide residents of that State who 
lack, or have inadequate, health insurance coverage access to health 
care services.
    ``(c) A provision of law enacted after the date of enactment of 
this subsection shall not be construed as applicable to purchases of 
prosthetic appliances or health care resources by the Department unless 
that provision of law specifically refers to this section and 
specifically states that such provision of law modifies or supersedes 
this section.
    ``(d) The authority to enter into a contract under subsection (b) 
shall expire on September 30, 2000.''.
    (b) Clerical Amendments.--(1) The heading of section 8123 is 
amended to read:
``Sec. 8123. Procurement of prosthetic appliances and health care 
              resources''.
    (2) The table of sections at the beginning of chapter 81 is amended 
by striking out the item relating to section 8123 and inserting in lieu 
thereof the following:

``8123. Procurement of prosthetic appliances and health care 
                            resources.''.

SEC. 623. SHARING AGREEMENTS FOR SPECIALIZED MEDICAL RESOURCES.

    (a) Repeal of Section 8151.--(1) Subchapter IV of chapter 81 is 
amended--
            (A) by striking out section 8151; and
            (B) by redesignating sections 8152, 8153, 8154, 8155, 8156, 
        8157, and 8158 as sections 8151, 8152, 8153, 8154, 8155, 8156, 
        and 8157, respectively.
    (2) The table of sections at the beginning of chapter 81 is 
amended--
            (A) by striking out the item relating to section 8151; and
            (B) by revising the items relating to sections 8152, 8153, 
        8154, 8155, and 8156 to reflect the redesignations by paragraph 
        (1)(B).
    (b) Revised Authority for Sharing Agreements.--Section 8152, as 
redesignated by subsection (a)(1)(B), is amended--
            (1) in subsection (a)--
                    (A) by striking out ``certain specialized medical'' 
                and inserting in lieu thereof ``health care'';
                    (B) by striking out ``clauses (i)'' and all that 
                follows through ``medical schools:'' and inserting in 
                lieu thereof ``paragraphs (1) and (2), between 
                Department health-care facilities and any medical 
                school, health care provider, health care plan, 
                insurer, or other entity or individual:'';
                    (C) by striking out ``specialized medical'' in 
                paragraphs (1) and (2) and inserting in lieu thereof 
                ``health care''; and
                    (D) by striking out ``have been justified on the 
                basis of veterans' care, but which are not utilized'' 
                in paragraph (2) and inserting in lieu thereof ``are 
                not, or would not be, used'';
            (2) in subsection (b), by striking out ``reciprocal 
        reimbursement'' in the first sentence and all that follows 
        through the period at the end of that sentence and inserting in 
        lieu thereof ``payment to the Department in accordance with 
        procedures that provide appropriate flexibility to negotiate 
        payment which is in the best interest of the Government.'';
            (3) in subsection (d), by striking out ``preclude such 
        payment, in accordance with--'' and all that follows through 
        ``to such facility therefor'' and inserting in lieu thereof 
        ``preclude such payment to such facility for such care or 
        services'';
            (4) by redesignating subsection (e) as subsection (f); and
            (5) by inserting after subsection (d) the following new 
        subsection (e):
    ``(e) The Secretary may make an arrangement that authorizes the 
furnishing of services by the Secretary under this section to 
individuals who are not veterans only if the Secretary determines that 
such an arrangment--
            ``(1) is necessary to maintain an acceptable level and 
        quality of service to veterans at that facility;
            ``(2) will result in the improvement of services to 
        eligible veterans at that facility; and
            ``(3) will not result in the denial of, or a delay in 
        providing access to, care to any veteran at that facility.''.
    (c) Cross-Reference Amendments.--(1) Section 8110(c)(3)(A) is 
amended by striking out ``8153'' and inserting in lieu thereof 
``8152''.
    (2) Subsection (b) of section 8154 (as redesignated by subsection 
(a)(1)(B)) is amended by striking out ``section 8154'' and inserting in 
lieu thereof ``section 8153''.
    (3) Section 8156 (as redesignated by subsection (a)(1)(B)) is 
amended--
            (A) in subsection (a), by striking out ``section 8153(a)'' 
        and inserting in lieu thereof ``section 8152(a)''; and
            (B) in subsection (b)(3), by striking out ``section 8153'' 
        and inserting in lieu thereof ``section 8152''.
    (4) Subsection (a) of section 8157 (as redesignated by subsection 
(a)(1)(B)) is amended--
            (A) in the matter preceding paragraph (1), by striking out 
        ``section 8157'' and ``section 8153(a)'' and inserting in lieu 
        thereof ``section 8156'' and ``section 8152(a)'', respectively; 
        and
            (B) in paragraph (1), by striking out ``section 
        8157(b)(4)'' and inserting in lieu thereof ``section 
        8156(b)(4)''.

                       Subtitle D--Miscellaneous

SEC. 631. DEPARTMENT OF VETERANS AFFAIRS RESEARCH ADVISORY COMMITTEES.

    (a) Statutory Basis for Research Advisory Committees.--Subchapter 
III of chapter 5 is amended by adding after section 545, as added by 
section 302(a), the following new section:
``Sec. 546. Veterans research advisory committees
    ``(a) Congress declares that each of the veterans research advisory 
committees specified in subsection (c) (previously established by the 
Secretary in carrying out the duties of the Secretary under section 
7303 of this title) has a continuing, ongoing function that is 
integrally related to the successful completion by the Department of 
its statutory duties. Each such committee shall, for all purposes, 
operate as though such committee had been established by, and chartered 
pursuant to, law. The objectives and scope of the activities of each 
such committee and the duties for which the committee is responsible, 
as specified by the Secretary as of September 1, 1993, shall be those 
in effect as of that date.
    ``(b) The Secretary may not terminate a veterans' research advisory 
committee specified in subsection (c) unless the Secretary finds that 
the committee is no longer needed. Not less than 120 days before 
terminating such a committee, the Secretary shall submit to the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives a report on the proposed termination. The report shall 
include an explanation of (1) the basis for the Secretary's 
determination that such committee is no longer needed, and (2) the 
manner in which the Secretary will carry out the Secretary's 
responsibilities under section 7303 of this title in the absence of the 
committee.
    ``(c) For purposes of this section, each of the following 
committees and boards, as established by the Secretary as of September 
1, 1993, shall be considered to be a veterans' research advisory 
committee:
            ``(1) The Career Development Committee.
            ``(2) The Department of Veterans Affairs Cooperative 
        Studies Evaluation Committee.
            ``(3) The Merit Review Board for Basic Sciences Programs.
            ``(4) The Merit Review Board for Cardiovascular Programs.
            ``(5) The Merit Review Board for Clinical Pharmacology, 
        Alcoholism, and Drug Dependence Programs.
            ``(6) The Merit Review Board for Endocrinology Programs.
            ``(7) The Merit Review Board for Gastroenterology Programs.
            ``(8) The Merit Review Board for Hematology Programs.
            ``(9) The Merit Review Board for Immunology Programs.
            ``(10) The Merit Review Board for Infectious Diseases 
        Programs.
            ``(11) The Merit Review Board for Mental Health and 
        Behavioral Sciences Programs.
            ``(12) The Merit Review Board for Nephrology Programs.
            ``(13) The Merit Review Board for Neurobiology Programs.
            ``(14) The Merit Review Board for Oncology Programs.
            ``(15) The Merit Review Board for Respiration Programs.
            ``(16) The Merit Review Board for Surgery Programs.
            ``(17) The Scientific Review and Evaluation Board for 
        Health Services Research and Development.
            ``(18) The Scientific Review and Evaluation Board for 
        Rehabilitation Research and Development.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 5 is amended by inserting after the item relating to section 
545, as added by section 302(a), the following new item:

``546. Veterans research advisory committees.''.

SEC. 632. TECHNICAL AMENDMENTS.

    (a) In General.--Sections 7361(b) and 7363(c) are each amended by 
striking out ``section 501(c)(3) of''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect as of May 20, 1988.

SEC. 633. SUBMITTAL DATE FOR REPORT ON ANNUAL ANALYSIS OF 
              DEPARTMENTWIDE ADMISSIONS POLICIES.

    Section 8110(a)(3)(B) is amended by striking out ``December 1'' and 
inserting in lieu thereof ``April 1''.

SEC. 634. CHILD CARE SERVICES.

    (a) Revised Child Care Authority.--Chapter 81 is amended by 
inserting after section 8116 the following new section:
``Sec. 8117. Child care centers
    ``(a) The Secretary may provide for the operation of child care 
centers at Department facilities. The operation of such centers under 
this section shall be carried out to the extent that the Secretary 
determines, based on the demand of employees of the Department for the 
care involved, that such operation is in the best interest of the 
Department and that it is practicable to do so.
    ``(b)(1) In offering child care services under this section, the 
Secretary shall give priority (in the following order) to employees 
of--
            ``(A) the Department;
            ``(B) other departments and agencies of the Federal 
        Government; and
            ``(C) schools affiliated with the Department and 
        corporations created under section 7361 of this title.
    ``(2) To the extent that space is available, the Secretary may 
provide child care services to members of the public at a child care 
center operated under this section if the Secretary determines that to 
do so is necessary to assure the financial success of that center.
    ``(c)(1) The Secretary shall establish reasonable charges for child 
care services provided at each child care center operated under this 
section. Such charges may be established at different rates for 
different centers.
    ``(2) In establishing charges for child care services provided at a 
center, the Secretary--
            ``(A) shall (except as provided in paragraph (3)) establish 
        the charges so as to ensure that the sum of all charges for 
        child care services at that center is sufficient to meet the 
        staffing expenses of that center; and
            ``(B) may also consider the expenses of constructing or 
        acquiring space for the center, the expenses of converting 
        existing space into the center, and the expenses of equipment 
        and services furnished to the center under subsection (d)(2).
    ``(3) The Secretary may establish charges for child care services 
provided at a center at rates less than those necessary to ensure that 
the sum of all charges for child care services at that center is 
sufficient to meet the staffing expenses of that center if the 
Secretary determines (with respect to a particular facility of the 
Department) that--
            ``(A) the operation of a child care center at that facility 
        would help overcome serious recruitment or retention problems;
            ``(B) adherence to the requirement to establish charges for 
        child care services at that center at rates sufficient to meet 
        the staffing expenses of that center would make the operation 
        of a child care center at that facility infeasible; and
            ``(C) there are no other practical alternatives to meeting 
        the needs of employees at that facility for child care 
        services.
    ``(4) Proceeds from charges for child care services shall be 
credited to the applicable Department of Veterans Affairs account and 
shall be allotted to the facility served by the child care center and 
shall remain available until expended.
    ``(d) In connection with the establishment and operation of a child 
care center under this section, the Secretary--
            ``(1) may construct or alter space in any Department 
        facility, and may lease space in a non-Department facility for 
        a term not to exceed 20 years, for use as a child care center;
            ``(2) may provide, out of operating funds, other items and 
        services necessary for the operation of the center, including 
        furniture, office machines and equipment, utility and custodial 
        services, and other necessary services and amenities;
            ``(3) shall provide for the participation (directly or 
        through a parent advisory committee) of parents of children 
        receiving care in the center in the establishment of policies 
        to govern the operation of the center and in the oversight of 
        the implementation of such policies;
            ``(4) shall require the development and use of a process 
        for determining the fitness and suitability of prospective 
        employees of or volunteers at the center; and
            ``(5) shall require in connection with the operation of the 
        center compliance with all State and local laws, ordinances, 
        and regulations relating to health and safety and the operation 
        of child care centers.
    ``(e) The Secretary shall prescribe guidelines to carry out this 
section.
    ``(f) For the purpose of this section, the term `parent advisory 
committee' means a committee comprised of, and selected by, the parents 
of children receiving care in a child care center operated under this 
section.''.
    (b) Conforming Repeal.--Section 7809 is repealed.
    (c) Clerical Amendments.--(1) The table of sections at the 
beginning of chapter 81 is amended by inserting after the item relating 
to section 8116 the following new item:

``8117. Child care centers.''.
    (2) The table of sections at the beginning of chapter 78 is amended 
by striking out the item relating to section 7809.

SEC. 635. CONTRACTS FOR UTILITIES, AUDIE L. MURPHY MEMORIAL HOSPITAL.

    (a) Authority To Contract.--Subject to subsection (b), the 
Secretary of Veterans Affairs may enter into contracts for the 
provision of utilities (including steam and chilled water) to the Audie 
L. Murphy Memorial Hospital in San Antonio, Texas. Each such contract 
may--
            (1) be for a period not to exceed 35 years;
            (2) provide for the construction and operation of a 
        production facility on or near property under the jurisdiction 
        of the Secretary;
            (3) require capital contributions by the parties involved 
        for the construction of such a facility, such contribution to 
        be in the form of cash, equipment, or other in-kind 
        contribution; and
            (4) provide for a predetermined formula to compute the cost 
        of providing such utilities to the parties for the duration of 
        the contract.
    (b) Funds.--A contract may be entered into under subsection (a) 
only to the extent that appropriations are available.
    (c) Additional Terms.--The Secretary may include in a contract 
under subsection (a) such additional provisions as the Secretary 
considers necessary to secure the provision of utilities and to protect 
the interests of the United States.

SEC. 636. AUTHORITY TO ENTER INTO AGREEMENT FOR USE OF PROPERTY AT 
              EDWARD HINES, JR., DEPARTMENT OF VETERANS AFFAIRS 
              HOSPITAL.

    (a) In General.--The Secretary of Veterans Affairs may enter into a 
long-term lease or similar agreement with the organization known as The 
Caring Place at Loyola, Inc., a not-for-profit organization operating 
under the laws of the State of Illinois, to permit that organization to 
establish on the grounds of the Edward Hines, Jr., Department of 
Veterans Affairs Hospital, Hines, Illinois, a facility to provide 
temporary accommodations for family members of severely ill children 
who are being treated at the Loyola University of Chicago Medical 
Center and other hospitals.
    (b) Conditions.--An agreement under subsection (a)--
            (1) shall ensure that there shall be no cost to the United 
        States as a result of the property use authorized by that 
        subsection;
            (2) may permit the use of the property without rent; and
            (3) shall, to the extent practicable, ensure that one room 
        of the facility is available for the use of a veteran (at no 
        cost to the veteran) as temporary accommodations for the 
        veteran while a severely ill child of the veteran is treated at 
        the Loyola University of Chicago Medical Center or other 
        hospitals.
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