[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3376 Reported in House (RH)]





                                                 Union Calendar No. 282

104th CONGRESS

  2d Session

                               H. R. 3376

                          [Report No. 104-574]

_______________________________________________________________________

                                 A BILL

To authorize major medical facility projects and major medical facility 
leases for the Department of Veterans Affairs for fiscal year 1997, and 
                          for other purposes.

_______________________________________________________________________

                              May 14, 1996

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed





                                                 Union Calendar No. 282
104th CONGRESS
  2d Session
                                H. R. 3376

                          [Report No. 104-574]

To authorize major medical facility projects and major medical facility 
leases for the Department of Veterans Affairs for fiscal year 1997, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 1, 1996

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

                              May 14, 1996

   Additional sponsors: Mr. Smith of New Jersey, Mr. Bilirakis, Mr. 
Everett, Mr. Buyer, Mr. Stearns, Mr. Flanagan, Mr. Weller, Mr. Clement, 
                Mr. Filner, Mr. Bishop, and Mr. Mascara

                              May 14, 1996

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
  [Omit the part struck through and insert the part printed in italic]

_______________________________________________________________________

                                 A BILL


 
To authorize major medical facility projects and major medical facility 
leases for the Department of Veterans Affairs for fiscal year 1997, and 
                          for other purposes.

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

                 TITLE I--CONSTRUCTION AUTHORIZATION  

SEC. 101. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS.

    (a) Ambulatory Care Addition Projects.--The Secretary of Veterans 
Affairs may carry out the following ambulatory care addition major 
medical facility projects, with each project to be carried out in the 
amount specified for that project:
            (1) Addition of ambulatory care facilities for mental 
        health enhancements at the Department of Veterans Affairs 
        medical center in Dallas, Texas, $19,900,000.
            (2) Addition of ambulatory care facilities at the 
        Department of Veterans Affairs medical center in Brockton, 
        Massachusetts, $13,500,000.
            (3) Addition of ambulatory care facilities for outpatient 
        improvements at the Department of Veterans Affairs medical 
        center in Shreveport, Louisiana, $25,000,000.
            (4) Addition of ambulatory care facilities at the 
        Department of Veterans Affairs medical center in Lyons, New 
        Jersey, $21,100,000.
            (5) Addition of ambulatory care facilities at the 
        Department of Veterans Affairs medical center in Tomah, 
        Wisconsin, $12,700,000.
            (6) Addition of ambulatory care facilities at the 
        Department of Veterans Affairs medical center in Asheville, 
        North Carolina, in the amount of $28,800,000.
            (7) Addition of ambulatory care facilities at the 
        Department of Veterans Affairs medical center in Temple, Texas, 
        in the amount of $9,800,000.
            (8) Addition of ambulatory care facilities at the 
        Department of Veterans Affairs medical center in Tucson, 
        Arizona, in the amount of $35,500,000.
    (b) Environmental Improvement Projects.--The Secretary of Veterans 
Affairs may carry out the following environmental improvement major 
medical facility projects, with each project to be carried out in the 
amount specified for that project:
            (1) Environmental improvements for the renovation of 
        nursing home facilities at the Department of Veterans Affairs 
        medical center in Lebanon, Pennsylvania, in the amount of 
        $9,500,000.
            (2) Environmental improvements at the Department of 
        Veterans Affairs medical center in Marion, Illinois, in the 
        amount of $11,500,000.
            (3) Environmental improvements to modernize patient wards 
        at the Department of Veterans Affairs medical center in 
        Atlanta, Georgia, $28,200,000.
            (4) Environmental improvements for the replacement of a 
        psychiatric bed building at the Department of Veterans Affairs 
        medical center in Battle Creek, Michigan, $22,900,000.
            (5) Environmental improvements for ward renovation for 
        patient privacy at the Department of Veterans Affairs medical 
        center in Omaha, Nebraska, $7,700,000.
            (6) Environmental improvements at the Department of 
        Veterans Affairs medical center in Pittsburgh, Pennsylvania, 
        $17,400,000.
            (7) Environmental improvements for the renovation of 
        various buildings at the Department of Veterans Affairs medical 
        center in Waco, Texas, $26,000,000.
            (8) Environmental improvements for the replacement of 
        psychiatric beds at the Department of Veterans Affairs medical 
        center in Marion, Indiana, in the amount of $17,300,000.
            (9) Environmental improvements for the renovation of 
        psychiatric wards at the Department of Veterans Affairs medical 
        center in Perry Point, Maryland, in the amount of $15,100,000.
            (10) Environmental enhancement at the Department of 
        Veterans Affairs medical center in Salisbury, North Carolina, 
        in the amount of $18,200,000.
    (c) Seismic Correction Projects.--The Secretary of Veterans Affairs 
may carry out the following seismic correction major medical facility 
projects, with each project to be carried out in the amount specified 
for that project:
            (1) Seismic corrections at the Department of Veterans 
        Affairs medical center in Palo Alto, California, in the amount 
        of $36,000,000.
            (2) Seismic corrections at the Department of Veterans 
        Affairs medical center in Long Beach, California, in the amount 
        of $20,200,000.
            (3) Seismic corrections at the Department of Veterans 
        Affairs medical center in San Francisco, California, 
        $26,000,000.

SEC. 102. AUTHORIZATION OF MAJOR MEDICAL FACILITY LEASES.

    The Secretary of Veterans Affairs may enter into leases for medical 
facilities as follows:
            (1) Lease of a satellite outpatient clinic in Allentown, 
        Pennsylvania, in an amount not to exceed $2,159,000.
            (2) Lease of a satellite outpatient clinic in Beaumont, 
        Texas, in an amount not to exceed $1,940,000.
            (3) Lease of a satellite outpatient clinic in Boston, 
        Massachusetts, in an amount not to exceed $2,358,000.
            (4) Lease of a parking facility in Cleveland, Ohio, in an 
        amount not to exceed $1,300,000.
            (5) Lease of a satellite outpatient clinic and Veterans 
        Benefits Administration field office in San Antonio, Texas, in 
        an amount not to exceed $2,256,000.
            (6) Lease of a satellite outpatient clinic in Toledo, Ohio, 
        in an amount not to exceed $2,223,000.

SEC. 103. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated to the 
Secretary of Veterans Affairs for fiscal year 1997--
            (1) for the Construction, Major Projects, account, 
        $422,300,000 for the projects authorized in section 101; and
            (2) for the Medical Care account, $12,236,000 for the 
        leases authorized in section 102.
    (b) Limitation.--The projects authorized in section 101 may only be 
carried out using--
            (1) funds appropriated for fiscal year 1997 pursuant to the 
        authorization of appropriations in subsection (a);
            (2) funds appropriated for Construction, Major Projects for 
        a fiscal year before fiscal year 1997 that remain available for 
        obligation; and
            (3) funds appropriated for Construction, Major Projects for 
        fiscal year 1997 for a category of activity not specific to a 
        project.

SEC. 104. REPORT ON HEALTH CARE NEEDS OF VETERANS IN EAST CENTRAL 
              FLORIDA.

    (a) Report Required.--Not later than 60 days 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 on the health care needs of veterans in east 
central Florida. In preparing the report, the Secretary shall consider 
the needs of such veterans for psychiatric and long-term care. The 
Secretary shall include in the report the Secretary's views, based on 
the Secretary's determination of such needs, as to the best means of 
meeting such needs using the amounts appropriated pursuant to the 
authorization of appropriations in this Act and Public Law 103-452 for 
projects to meet the health care needs of such veterans. The Secretary 
may, subject to the availability of appropriations for such purpose, 
use an independent contractor to assist in the determination of such 
health care needs.
    (b) Limitation.--The Secretary may not obligate any funds, other 
than for design work, for the conversion of the former Orlando Naval 
Training Center Hospital in Orlando, Florida (now under the 
jurisdiction of the Secretary of Veterans Affairs), to a nursing home 
care unit until <DELETED>15 days</DELETED> 45 days after the date on 
which the report required by subsection (a) is submitted.

         TITLE II--STRATEGIC PLANNING FOR HEALTH CARE RESOURCES

SEC. 201. STRATEGIC PLANNING.

    Section 8107 of title 38, United States Code, is amended--
            (1) by redesignating subsection (b) as subsection (c);
            (2) by striking out subsection (a) and inserting in lieu 
        thereof the following new subsections:
    ``(a) In order to promote effective planning for the efficient 
provision of care to eligible veterans, the Secretary, based on the 
analysis and recommendations of the Under Secretary for Health, shall 
submit to each committee, not later than January 31 of each year, a 
report regarding long-range health planning of the Department.
    ``(b) Each report under subsection (a) shall include the following:
            ``(1) A five-year strategic plan for the provision of care 
        under chapter 17 of this title to eligible veterans through 
        coordinated networks of medical facilities operating within 
        prescribed geographic service-delivery areas, such plan to 
        include provision of services for the specialized treatment and 
        rehabilitative needs of disabled veterans (including veterans 
        with spinal cord dysfunction, blindness, amputations, and 
        mental illness) through distinct programs or facilities of the 
        Department dedicated to the specialized needs of those 
        veterans.
            ``(2) A description of how planning for the networks will 
        be coordinated.
            ``(3) A profile regarding each such network of medical 
        facilities which identifies--
                    ``(A) the mission of each existing or proposed 
                medical facility in the network;
                    ``(B) any planned change in the mission for any 
                such facility and the rationale for such planned 
                change;
                    ``(C) the population of veterans to be served by 
                the network and anticipated changes over a five-year 
                period and a ten-year period, respectively, in that 
                population and in the health-care needs of that 
                population;
                    ``(D) information relevant to assessing progress 
                toward the goal of achieving relative equivalency in 
                the level of resources per patient distributed to each 
                network, such information to include the plans for and 
                progress toward lowering the cost of care-delivery in 
                the network (by means such as changes in the mix in the 
                network of physicians, nurses, physician assistants, 
                and advance practice nurses);
                    ``(E) the capacity of non-Federal facilities in the 
                network to provide acute, long-term, and specialized 
                treatment and rehabilitative services (described in 
                section 7305 of this title), and determinations 
                regarding the extent to which services to be provided 
                in each service-delivery area and each facility in such 
area should be provided directly through facilities of the Department 
or through contract or other arrangements, including arrangements 
authorized under sections 8111 and 8153 of this title; and
                    ``(F) a five-year plan for construction, 
                replacement, or alteration projects in support of the 
                approved mission of each facility in the network and a 
                description of how those projects will improve access 
                to care, or quality of care, for patients served in the 
                network.
            ``(4) A status report for each facility on progress 
        toward--
                    ``(A) instituting planned mission changes 
                identified under paragraph (3)(B);
                    ``(B) implementing principles of managed care of 
                eligible veterans; and
                    ``(C) developing and instituting cost-effective 
                alternatives to provision of institutional care.''; and
            (3) by adding at the end the following new subsection:
    ``(d)(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. 202. REVISION TO PROSPECTUS REQUIREMENTS.

    (a) Additional Information.--Section 8104(b) of title 38, United 
States Code, 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, including 
        information on projected changes in the population of veterans 
        to be served by the project over a five-year period and a ten-
        year period.
            ``(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. 203. CONSTRUCTION AUTHORIZATION REQUIREMENTS.

    (a) Definition of Major Medical Facility Project.--Paragraph (3)(A) 
of section 8104(a) of title 38, United States Code, is amended by 
striking out ``$3,000,000'' and inserting ``$5,000,000''.
    (b) Applicability of Construction Authorization Requirement.--(1) 
Subsection (b) of section 301 of the Veterans' Medical Programs 
Amendments of 1992 (Public Law 102-405; 106 Stat. 1984) is repealed.
    (2) The amendments made by subsection (a) of such section shall 
apply with respect to any major medical facility project or any major 
medical facility lease of the Department of Veterans Affairs, 
regardless of when funds are first appropriated for that project or 
lease, except that in the case of a project for which funds were first 
appropriated before October 9, 1992, such amendments shall not apply 
with respect to amounts appropriated for that project for a fiscal year 
before fiscal year 1998.
    (c) Limitation on Obligations for Advance Planning.--Section 8104 
of title 38, United States Code, is amended by adding at the end the 
following new subsection:
    ``(f) The Secretary may not obligate funds in an amount in excess 
of $500,000 from the Advance Planning Fund of the Department toward 
design or development of a major medical facility project until--
            ``(1) the Secretary submits to the committees a report on 
        the proposed obligation; and
            ``(2) a period of 30 days has passed after the date on 
        which the report is received by the committees.''.

SEC. 204. TERMINOLOGY CHANGES.

    (a) Definition of ``Construct''.--Section 8101(2) of title 38, 
United States Code, is amended--
            (1) by striking out ``working drawings'' and inserting in 
        lieu thereof ``construction documents''; and
            (2) by striking out ``preliminary plans'' and inserting in 
        lieu thereof ``design development''.
    (b) Parking Facilities.--Section 8109(h)(3)(B) of such title is 
amended by striking out ``working drawings'' and inserting in lieu 
thereof ``construction documents''.

SEC. 205. VETERANS HEALTH ADMINISTRATION HEADQUARTERS.

    (a) Repeal of Statutory Specification of Organizational Services.--
The text of section 7305 of title 38, United States Code, is amended to 
read as follows:
    ``(a) The Veterans Health Administration shall include the Office 
of the Under Secretary for Health and such professional and auxiliary 
services as the Secretary may find to be necessary to carry out the 
functions of the Administration.
    ``(b) In organizing, and appointing persons to positions in, the 
Office, the Under Secretary shall ensure that the Office is staffed so 
as to provide the Under Secretary with appropriate expertise, including 
expertise in--
            ``(1) unique programs operated by the Administration to 
        provide for the specialized treatment and rehabilitation of 
        disabled veterans (including blind rehabilitation, spinal cord 
        dysfunction, mental illness, and geriatrics and long-term 
        care); and
            ``(2) appropriate clinical care disciplines.''.
    (b) Office of the Under Secretary.--Section 7306 of such title is 
amended--
            (1) in subsection (a)--
                    (A) by striking out ``and who shall be a qualified 
                doctor of medicine'' in paragraph (2);
                    (B) by striking out paragraphs (5), (6), and (7); 
                and
                    (C) by redesignating the succeeding two paragraphs 
                as paragraphs (5) and (6), respectively; and
            (2) in subsection (b)--
                    (A) by striking out ``subsection (a)(3)'' and all 
                that follows through ``two may be'' and inserting in 
                lieu thereof ``subsection (a)(3), not more than two may 
                be'';
                    (B) by striking out the semicolon after ``dental 
                medicines'' and inserting in lieu thereof a period; and
                    (C) by striking out paragraphs (2) and (3).

                        TITLE III--OTHER MATTERS

SEC. 301. NAME OF DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, 
              JACKSON, MISSISSIPPI.

    (a) Name.--The Department of Veterans Affairs medical center in 
Jackson, Mississippi, shall be known and designated as the ``G. V. 
Sonny Montgomery Department of Veterans Affairs Medical Center''. Any 
reference to such medical center in any law, regulation, map, document, 
record, or other paper of the United States shall be considered to be a 
reference to the G. V. Sonny Montgomery Department of Veterans Affairs 
Medical Center.
    (b) Effective Date.--Subsection (a) shall take effect at noon on 
January 3, 1997, or the first day on which G. V. Sonny Montgomery 
otherwise ceases to be a Member of the House of Representatives.

SEC 302. NAME OF DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, JOHNSON 
              CITY, TENNESSEE.

    (a) Name.--The Mountain Home Department of Veterans Affairs medical 
center in Johnson City, Tennessee, shall after the date of the 
enactment of this Act be known and designated as the ``James H. Quillen 
Department of Veterans Affairs Medical Center''. Any reference to such 
medical center in any law, regulation, map, document, record, or other 
paper of the United States shall be considered to be a reference to the 
James H. Quillen Department of Veterans Affairs Medical Center.
    (b) Effective Date.--Subsection (a) shall take effect at noon on 
January 3, 1997, or the first day on which James H. Quillen otherwise 
ceases to be a Member of the House of Representatives.

SEC. 303. NAME OF DEPARTMENT OF VETERANS AFFAIRS NURSING CARE CENTER, 
              ASPINWALL, PENNSYLVANIA.

    The Department of Veterans Affairs nursing care center at the 
Department of Veterans Affairs medical center in Aspinwall, 
Pennsylvania, shall after the date of the enactment of this Act be 
known and designated as the ``H. John Heinz, III Department of Veterans 
Affairs Nursing Care Center''. Any reference to such nursing care 
center in any law, regulation, map, document, record, or other paper of 
the United States shall be considered to be a reference to the H. John 
Heinz, III Department of Veterans Affairs Nursing Care Center.

SEC. 304. RESTORATION OF AUTHORITY FOR ESTABLISHMENT OF DEPARTMENT OF 
              VETERANS AFFAIRS RESEARCH CORPORATIONS.

    Section 7368 of title 38, United States Code, is amended by 
striking out ``December 31, 1992'' and inserting in lieu thereof 
``December 31, 2000''.