[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5109 Reported in House (RH)]







                                                 Union Calendar No. 519
106th CONGRESS
  2d Session
                                H. R. 5109

                          [Report No. 106-863]

To amend title 38, United States Code, to improve the personnel system 
     of the Veterans Health Administration, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 6, 2000

  Mr. Stearns (for himself, Mr. Gutierrez, Mr. Stump, and Mr. Evans) 
 introduced the following bill; which was referred to the Committee on 
                           Veterans' Affairs

                           September 18, 2000

  Additional sponsors: Mr. LaTourette, Mr. Snyder, Mr. Jenkins, Mrs. 
 Capps, Mr. Weldon of Florida, Mr. Rush, Ms. Carson, Mrs. Emerson, Mr. 
   Simpson, Mr. Hansen, Mr. Peterson of Minnesota, Mr. Gibbons, Ms. 
 Berkley, Mrs. Jones of Ohio, Ms. Hooley of Oregon, Mr. Whitfield, Mr. 
Bilirakis, Mr. Cooksey, Mr. Buyer, Mr. Hinojosa, Mr. Tiahrt, Mr. Smith 
   of New Jersey, Ms. Baldwin, Mr. Reyes, Mr. Oberstar, Mr. Hill of 
 Montana, Ms. Brown of Florida, Mr. Wamp, Mr. Jones of North Carolina, 
 Mr. Green of Texas, Mr. Hayworth, Mr. LaHood, Mr. Sawyer, Mr. Gekas, 
  Mr. Lewis of Kentucky, Mr. Hall of Texas, Mr. Deal of Georgia, Mr. 
 Hilleary, Mr. Isakson, Mr. Gallegly, Mr. Rodriguez, Mr. Udall of New 
                         Mexico, and Mr. Baker

                           September 18, 2000

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
    [For text of introduced bill, see copy of bill as introduced on 
                           September 6, 2000]

_______________________________________________________________________

                                 A BILL


 
To amend title 38, United States Code, to improve the personnel system 
     of the Veterans Health Administration, 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 ``Department of 
Veterans Affairs Health Care Personnel Act of 2000''.
    (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--PERSONNEL MATTERS

Sec. 101. Annual national pay comparability adjustment for nurses 
                            employed by Department of Veterans Affairs.
Sec. 102. Special pay for dentists.
Sec. 103. Exemption for pharmacists from ceiling on special salary 
                            rates.
Sec. 104. Physician assistant adviser to Under Secretary for Health.
Sec. 105. Temporary full-time appointments of certain medical 
                            personnel.
Sec. 106. Qualifications of social workers.
Sec. 107. Extension of voluntary separation incentive payments.

                  TITLE II--CONSTRUCTION AUTHORIZATION

Sec. 201. Authorization of major medical facility projects.
Sec. 202. Authorization of appropriations.

                   TITLE III--MILITARY SERVICE ISSUES

Sec. 301. Military service history.
Sec. 302. Study of post-traumatic stress disorder in Vietnam veterans.

                    TITLE IV--MEDICAL ADMINISTRATION

Sec. 401. Pilot program for coordination of hospital benefits.
Sec. 402. Benefits for persons disabled by participation in compensated 
                            work therapy program.
Sec. 403. Extension of authority to establish research and education 
                            corporations.
Sec. 404. Department of Veterans Affairs Fisher Houses.
Sec. 405. Extension of annual report of Committee on Mentally Ill 
                            Veterans.
Sec. 406. Exception to recapture rule.
Sec. 407. Change to enhanced use lease congressional notification 
                            period.
Sec. 408. Technical and conforming changes.
Sec. 409. Release of reversionary interest of the United States in 
                            certain real property previously conveyed 
                            to the State of Tennessee.

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--PERSONNEL MATTERS

SEC. 101. ANNUAL NATIONAL PAY COMPARABILITY ADJUSTMENT FOR NURSES 
              EMPLOYED BY DEPARTMENT OF VETERANS AFFAIRS.

    (a) Revised Pay Adjustment Procedures.--Section 7451 is amended--
            (1) in subsection (d)--
                    (A) in paragraph (1)--
                            (i) by striking ``The rates'' and inserting 
                        ``Subject to subsection (e), the rates''; and
                            (ii) in subparagraph (A), by inserting 
                        ``and to be by the same percentage'' after ``to 
                        have the same effective date'';
                    (B) in paragraph (2), by striking ``Such'' in the 
                second sentence and inserting ``Except as provided in 
                paragraph (1)(A), such'';
                    (C) in paragraph (3)(B)--
                            (i) by inserting after the first sentence 
                        the following new sentence: ``To the extent 
                        practicable, the director shall use third-party 
                        industry wage surveys to meet the requirements 
                        of the preceding sentence.'';
                            (ii) by inserting before the penultimate 
                        sentence the following new sentence: ``To the 
                        extent practicable, all surveys conducted 
                        pursuant to this subparagraph or subparagraph 
                        (A) shall include the collection of salary 
                        midpoints, actual salaries, lowest and highest 
                        salaries, average salaries, bonuses, incentive 
                        pays, differential pays, actual beginning rates 
                        of pay and such other information needed to 
                        meet the purpose of this section.''; and
                            (iii) in the penultimate sentence, by 
                        inserting ``or published'' after ``completed'';
                    (D) by striking clause (iii) of paragraph (3)(C);
            (2) by striking subsection (e) and inserting the following:
    ``(e)(1) An adjustment in a rate of basic pay under subsection (d) 
may not reduce the rate of basic pay applicable to any grade of a 
covered position.
    ``(2) The director of a Department health-care facility, in 
determining whether to carry out a wage survey under subsection (d)(3) 
with respect to rates of basic pay for a grade of a covered position, 
may not consider as a factor in such determination the absence of a 
current recruitment or retention problem for personnel in that grade of 
that position. The director shall make such a determination based upon 
whether, in accordance with criteria established by the Secretary, 
there is a significant pay-related staffing problem at that facility in 
any grade for a position. If the director determines that there is such 
a problem, or that such a problem is likely to exist in the near 
future, the Director shall provide for a wage survey in accordance with 
paragraph (3) of subsection (d).
    ``(3) The Under Secretary for Health may, to the extent necessary 
to carry out the purposes of subsection (d), modify any determination 
made by the director of a Department health-care facility with respect 
to adjusting the rates of basic pay applicable to covered positions. 
Upon such action by the Under Secretary, any adjustment shall take 
effect on the first day of the first pay period beginning after such 
action. The Secretary shall ensure that the Under Secretary establishes 
a mechanism for the exercise of the authority in the preceding 
sentence.
    ``(4) Each director of a Department health-care facility shall 
provide to the Secretary, not later than July 31 each year, a report on 
staffing for covered positions at that facility. The report shall 
include the following:
            ``(A) Information on turnover rates and vacancy rates for 
        each grade in a covered position, including a comparison of 
those rates with the rates for the preceding three years.
            ``(B) The director's findings concerning the review and 
        evaluation of the facility's staffing situation, including 
        whether there is, or is likely to be, in accordance with 
        criteria established by the Secretary, a significant pay-
        related staffing problem at that facility for any grade of a 
        covered position and, if so, whether a wage survey was 
        conducted, or will be conducted with respect to that grade.
            ``(C) In any case in which the director conducts such a 
        wage survey during the period covered by the report, 
        information describing the survey and any actions taken or not 
        taken based on the survey, and the reasons for taking (or not 
        taking) such actions.
            ``(D) In any case in which the director, after finding that 
        there is, or is likely to be, in accordance with criteria 
        established by the Secretary, a significant pay-related 
        staffing problem at that facility for any grade of a covered 
        position, determines not to conduct a wage survey with respect 
        to that position, a statement of the reasons why the director 
        did not conduct such a survey.
    ``(5) Not later than September 30 of each year, the Secretary shall 
submit to the Committees on Veterans' Affairs of the Senate and House 
of Representatives a report on staffing for covered positions at 
Department healthcare facilities. Each such report shall include the 
following:
            ``(A) A summary and analysis of the information contained 
        in the most recent reports submitted by facility directors 
        under paragraph (4).
            ``(B) The information for each such facility specified in 
        paragraph (4).'';
            (3) in subsection (f)--
                    (A) by striking ``February 1 of 1991, 1992, and 
                1993'' and inserting ``March 1 of each year''; and
                    (B) by striking ``subsection (d)(1)(A)'' and 
                inserting ``subsection (d)''; and
            (4) by striking subsection (g) and redesignating subsection 
        (h) as subsection (g).
    (b) Required Consultations With Nurses.--(1) Subchapter II of 
chapter 73 is amended by adding at the end the following new section:
``Sec. 7323. Required consultations with nurses
    ``The Under Secretary for Health shall ensure that--
            ``(1) the director of a geographic service area, in 
        formulating policy relating to the provision of patient care, 
        shall consult regularly with a senior nurse executive or senior 
        nurse executives; and
            ``(2) the director of a medical center shall, to the extent 
        feasible, include a registered nurse as a member of any 
        committee used at that medical center to provide 
        recommendations or decisions on medical center operations or 
        policy affecting clinical services, clinical outcomes, budget, 
        or resources.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 7322 the 
following new item:

``7323. Required consultations with nurses.''.

SEC. 102. SPECIAL PAY FOR DENTISTS.

    (a) Full-Time Status Pay.--Paragraph (1) of section 7435(b) is 
amended by striking ``$3,500'' and inserting ``$9,000''.
    (b) Special Pay for Post-Graduate Training.--Such section is 
amended by adding at the end the following new paragraph:
            ``(8) For a dentist who has successfully completed a post-
        graduate year of hospital-based training in a program 
        accredited by the American Dental Association, an annual rate 
        of $2,000 for each of the first two years of service after 
        successful completion of that training.''.
    (c) Tenure Pay.--The table in paragraph (2)(A) of that section is 
amended to read as follows:


------------------------------------------------------------------------
                                                          Rate
              ``Length of Service              -------------------------
                                                  Minimum      Maximum
------------------------------------------------------------------------
1 year but less than 2 years..................       $1,000       $2,000
2 years but less than 4 years.................        4,000        5,000
4 years but less than 8 years.................        5,000        8,000
8 years but less than 12 years................        8,000       12,000
12 years but less than 20 years...............       12,000       15,000
20 years or more..............................       15,000   18,000.''.
------------------------------------------------------------------------

    (d) Scarce Specialty Pay.--Paragraph (3)(A) of that section is 
amended by striking ``$20,000'' and inserting ``$30,000''.
    (e) Geographic Pay.--Paragraph (6) of that section is amended by 
striking ``$5,000'' and inserting ``$12,000''.
    (f) Responsibility Pay.--(1) The table in paragraph (4)(A) of that 
section is amended to read as follows:


------------------------------------------------------------------------
                                                          Rate
                  ``Position                   -------------------------
                                                  Minimum      Maximum
------------------------------------------------------------------------
Chief of Staff or in an Executive Grade.......      $14,500      $25,000
Director Grade................................            0       25,000
Service Chief (or in a comparable position as         4,500   15,000.''.
 determined by the Secretary).................
------------------------------------------------------------------------

    (2) The table in paragraph (4)(B) of that section is amended to 
read as follows:

------------------------------------------------------------------------
                         ``Position                              Rate
------------------------------------------------------------------------
Deputy Service Director....................................      $20,000
Service Director...........................................       25,000
Deputy Assistant Under Secretary for Health................       27,500
Assistant Under Secretary for Health (or in a comparable      30,000.''.
 position as determined by the Secretary)..................
------------------------------------------------------------------------

    (g) Crediting of Increased Tenure Pay for Civil Service 
Retirement.--Section 7438(b) is amended--
            (1) by redesignating paragraph (5) as paragraph (6); and
            (2) by inserting after paragraph (4) the following new 
        paragraph:
    ``(5) Notwithstanding paragraphs (1) and (2), a dentist employed as 
a dentist in the Veterans Health Administration on the effective date 
of section 102 of the Department of Veterans Affairs Health Care 
Personnel Act of 2000 shall be entitled to have special pay paid to the 
dentist under section 7435(b)(2)(A) of this title (referred to as 
`tenure pay') considered basic pay for the purposes of chapter 83 or 
84, as appropriate, of title 5 only as follows:
            ``(A) In an amount equal to the amount that would have been 
        so considered under such section on the day before such 
        effective date based on the rates of special pay the dentist 
        was entitled to receive under that section on the day before 
        such effective date.
            ``(B) With respect to any amount of special pay received 
        under that section in excess of the amount such dentist was 
        entitled to receive under such section on the day before such 
        effective date, in an amount equal to 25 percent of such excess 
        amount for each two years that the physician or dentist has 
completed as a physician or dentist in the Veterans Health 
Administration after such effective date.''.
    (h) Effective Date.--The amendments made by this section shall 
apply with respect to agreements entered into by dentists under 
subchapter III of chapter 74 of title 38, United States Code, on or 
after the later of--
            (1) the date of the enactment of this Act; and
            (2) October 1, 2000.
    (i) Transition.--(1) In the case of an agreement entered into by a 
dentist under subchapter III of chapter 74 of title 38, United States 
Code, before the date of the enactment of this Act that expires after 
the effective date specified in subsection (h), the Secretary of 
Veterans Affairs and the dentist concerned may agree to terminate that 
agreement as of that effective date in order to permit a new agreement 
in accordance with section 7435 of such title, as amended by this 
section, to take effect as of that effective date.
    (2) In the case of an agreement entered into under such subchapter 
before the date of the enactment of this Act that expires during the 
period beginning on the date of the enactment of this Act and ending on 
the effective date specified in subsection (h)(2), an extension or 
renewal of that agreement may not extend beyond that effective date.
    (3) In the case of a dentist who begins employment with the 
Department of Veterans Affairs during the period beginning on the date 
of the enactment of this Act and ending on the effective date specified 
in subsection (h)(2) who is eligible for an agreement under subchapter 
III of chapter 74 of title 38, United States Code, any such agreement 
may not extend beyond that effective date.

SEC. 103. EXEMPTION FOR PHARMACISTS FROM CEILING ON SPECIAL SALARY 
              RATES.

    Section 7455(c)(1) is amended by inserting ``, pharmacists,'' after 
``anesthetists''.

SEC. 104. PHYSICIAN ASSISTANT ADVISER TO UNDER SECRETARY FOR HEALTH.

    Section 7306(f) is amended--
            (1) by striking ``and'' at the end of paragraph (1);
            (2) by striking the period at the end of paragraph (2) and 
        inserting ``; and''; and
            (3) by adding at the end the following new paragraph:
            ``(3) a physician assistant with appropriate experience 
        (who may have a permanent duty station at a Department medical 
        care facility in reasonable proximity to Washington, DC) 
        advises the Under Secretary on all matters relating to the 
        utilization and employment of physician assistants in the 
        Administration.''.

SEC. 105. TEMPORARY FULL-TIME APPOINTMENTS OF CERTAIN MEDICAL 
              PERSONNEL.

    (a) Physician Assistants Awaiting Certification or Licensure.--
Paragraph (2) of section 7405(c) is amended to read as follows:
    ``(2) A temporary full-time appointment may not be made for a 
period in excess of two years in the case of a person who--
            ``(A) has successfully completed--
                    ``(i) a full course of nursing in a recognized 
                school of nursing, approved by the Secretary; or
                    ``(ii) a full course of training for any category 
                of personnel described in paragraph (3) of section 7401 
                of this title, or as a physician assistant, in a 
                recognized education or training institution approved 
                by the Secretary; and
            ``(B) is pending registration or licensure in a State or 
        certification by a national board recognized by the 
        Secretary.''.
    (b) Medical Support Personnel.--That section is further amended--
            (1) by redesignating paragraph (3) as paragraph (4); and
            (2) by inserting after paragraph (2) the following new 
        paragraph (3):
    ``(3)(A) Temporary full-time appointments of persons in positions 
referred to in subsection (a)(1)(D) shall not exceed three years.
    ``(B) Temporary full-time appointments under this paragraph may be 
renewed for one or more additional periods not in excess of three years 
each.''.

SEC. 106. QUALIFICATIONS OF SOCIAL WORKERS.

    Section 7402(b)(9) is amended by striking ``a person must'' and all 
that follows and inserting ``a person must--
            ``(A) hold a master's degree in social work from a college 
        or university approved by the Secretary; and
            ``(B) be licensed or certified to independently practice 
        social work in a State, except that the Secretary may waive the 
        requirement of licensure or certification for an individual 
        social worker for a reasonable period of time recommended by 
        the Under Secretary for Health.''.

SEC. 107. EXTENSION OF VOLUNTARY SEPARATION INCENTIVE PAYMENTS.

    The Department of Veterans Affairs Employment Reduction Assistance 
Act of 1999 (title XI of Public Law 106-117; 5 U.S.C. 5597 note) is 
amended as follows:
            (1) Section 1102(c) is amended to read as follows:
    ``(c) Limitation.--The plan under subsection (a) shall be limited 
to 8,110 positions within the Department.''.
            (2) Section 1105(a) is amended by striking ``26 percent'' 
        and inserting ``15 percent''.
            (3) Section 1109(a) is amended by striking ``December 31, 
        2000'' and inserting ``December 31, 2002''.

                  TITLE II--CONSTRUCTION AUTHORIZATION

SEC. 201. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS.

    (a) Fiscal Year 2001 Projects.--The Secretary of Veterans Affairs 
may carry out the following major medical facility projects, with each 
project to be carried out in the amount specified for that project:
            (1) Construction of a psychogeriatric care building at the 
        Department of Veterans Affairs Medical Center, Palo Alto, 
        California, in an amount not to exceed $26,600,000.
            (2) Construction of a utility plant and electrical vault at 
        the Department of Veterans Affairs Medical Center, Miami, 
        Florida, in an amount not to exceed $23,600,000.
            (3) Seismic corrections, clinical consolidation, and other 
        improvements at the Department of Veterans Affairs Medical 
        Center, Long Beach, California, in an amount not to exceed 
        $51,700,000.
    (b) Additional Fiscal Year 2000 Project.--The Secretary is 
authorized to carry out a project for the renovation of psychiatric 
nursing units at the Department of Veterans Affairs Medical Center, 
Murfreesboro, Tennessee, in an amount not to exceed $14,000,000.

SEC. 202. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated to the 
Secretary of Veterans Affairs for fiscal years 2001 and 2002 for the 
Construction, Major Projects, account, $101,900,000 for the projects 
authorized in section 101(a).
    (b) Limitation.--The projects authorized in section 101(a) may only 
be carried out using--
            (1) funds appropriated for fiscal year 2001 or 2002 
        pursuant to the authorization of appropriations in subsection 
        (a);
            (2) funds appropriated for Construction, Major Projects for 
        a fiscal year before fiscal year 2001 that remain available for 
        obligation; and
            (3) funds appropriated for Construction, Major Projects for 
        fiscal year 2001 or 2002 for a category of activity not 
        specific to a project.

                   TITLE III--MILITARY SERVICE ISSUES

SEC. 301. MILITARY SERVICE HISTORY.

    (a) Military Histories.--The Secretary of Veterans Affairs, in 
carrying out the responsibilities of the Secretary under chapter 17 of 
title 38, United States Code, shall ensure that--
            (1) during at least one clinical evaluation of a patient in 
        a facility of the Department, a protocol is used to identify 
        pertinent military experiences and exposures of the patient 
        that may contribute to the health status of the patient; and
            (2) pertinent information relating to the military history 
        of the patient is included in the Department's medical records 
        of the patient.
    (b) Report.--Not later than nine 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 feasibility and desirability of using a computer-based system in 
conducting clinical evaluations referred to in subsection (a)(1).

SEC. 302. STUDY OF POST-TRAUMATIC STRESS DISORDER IN VIETNAM VETERANS.

    (a) Study on Post-Traumatic Stress Disorder.--Not later than 10 
months after the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall enter into a contract with an appropriate entity 
to carry out a study on post-traumatic stress disorder.
    (b) Follow-Up Study.--The contract under subsection (a) shall 
provide for a follow-up study to the study conducted in accordance with 
section 102 of the Veterans Health Care Amendments of 1983 (Public Law 
98-160). Such follow-up study shall use the data base and sample of the 
previous study.
    (c) Information To Be Included.--The study conducted pursuant to 
this section shall be designed to yield information on--
            (1) the long-term course of post-traumatic stress disorder;
            (2) any long-term medical consequences of post-traumatic 
        stress disorder;
            (3) whether particular subgroups of veterans are at greater 
        risk of chronic or more severe problems with such disorder; and
            (4) the services used by veterans who have post-traumatic 
        stress disorder and the effect of those services on the course 
        of the disorder.
    (d) Report.--The Secretary shall submit to the Committees of 
Veterans' Affairs of the Senate and House of Representatives a report 
on the results of the study under this section. The report shall be 
submitted no later than October 1, 2004.

                    TITLE IV--MEDICAL ADMINISTRATION

SEC. 401. PILOT PROGRAM FOR COORDINATION OF HOSPITAL BENEFITS.

    (a) In General.--Chapter 17 is amended by inserting after section 
1725 the following new section:
``Sec. 1725A. Coordination of hospital benefits: pilot program
    ``(a) The Secretary may carry out a pilot program in not more than 
four geographic areas of the United States to improve access to, and 
coordination of, inpatient care of eligible veterans. Under the pilot 
program, the Secretary, subject to subsection (b), may pay certain 
costs described in subsection (b) for which an eligible veteran would 
otherwise be personally liable. The authority to carry out the pilot 
program shall expire on September 30, 2005.
    ``(b) In carrying out the program described in subsection (a), the 
Secretary may pay the costs authorized under this section for hospital 
care and medical services furnished on an inpatient basis in a non-
Department hospital to an eligible veteran participating in the 
program. Such payment may cover the costs for applicable plan 
deductibles and coinsurance and the reasonable costs of such inpatient 
care and medical services not covered by any applicable health-care 
plan of the veteran, but only to the extent such care and services are 
of the kind authorized under this chapter. The Secretary shall limit 
the care and services for which payment may be made under the program 
to general medical and surgical services and shall require that such 
services may be provided only upon preauthorization by the Secretary.
    ``(c)(1) A veteran described in paragraph (1) or (2) of section 
1710(a) of this title is eligible to participate in the pilot program 
if the veteran--
            ``(A) is enrolled to receive medical services from an 
        outpatient clinic operated by the Secretary which is (i) within 
        reasonable proximity to the principal residence of the veteran, 
        and (ii) located within the geographic area in which the 
        Secretary is carrying out the program described in subsection 
        (a);
            ``(B) has received care under this chapter within the 24-
        month period preceding the veteran's application for enrollment 
        in the pilot program;
            ``(C) as determined by the Secretary before the 
        hospitalization of the veteran (i) requires such hospital care 
        and services for a non-service-connected condition, and (ii) 
        could not receive such services from a clinic operated by the 
        Secretary; and
            ``(D) elects to receive such care under a health-care plan 
        (other than under this title) under which the veteran is 
        entitled to receive such care.
    ``(2) Nothing in this section shall be construed to reduce the 
authority of the Secretary to contract with non-Department facilities 
for care of a service-connected disability of a veteran.
    ``(3) Notwithstanding subparagraph (D) of paragraph (1), the 
Secretary shall ensure that not less than 15 percent of the veterans 
participating in the program are veterans who do not have a health-care 
plan.
    ``(d) As part of the program under this section, the Secretary 
shall, through provision of case-management, coordinate the care being 
furnished directly by the Secretary and care furnished under the 
program in non-Department hospitals to veterans participating in the 
program.
    ``(e)(1) In designating geographic areas in which to establish the 
program under subsection (a), the Secretary shall ensure that--
            ``(A) the areas designated are geographically dispersed;
            ``(B) at least 70 percent of the veterans who reside in a 
        designated area reside at least two hours driving distance from 
        the closest medical center operated by the Secretary which 
        provides medical and surgical hospital care; and
            ``(C) the establishment of the program in any such area 
        would not result in jeopardizing the critical mass of patients 
        needed to maintain a Department medical center that serves that 
        area.
    ``(2) Notwithstanding paragraph (1)(B), the Secretary may designate 
for participation in the program at least one area which is in 
proximity to a Department medical center which, as a result of a change 
in mission of that center, does not provide hospital care.
    ``(f)(1) Not later than September 30, 2002, the Secretary shall 
submit to the Committees on Veterans' Affairs of the Senate and House 
of Representatives a report on the experience in implementing the pilot 
program under subsection (a).
    ``(2) Not later than September 30, 2004, the Secretary shall submit 
to those committees a report on the experience in operating the pilot 
program during the first two full fiscal years during which the pilot 
program is conducted. That report shall include--
            ``(A) a comparison of the costs incurred by the Secretary 
        under the program and the cost experience for the calendar year 
        preceding establishment of the program at each site at which 
        the program is operated;
            ``(B) an assessment of the satisfaction of the participants 
        in the program; and
            ``(C) an analysis of the effect of the program on access 
        and quality of care for veterans.
    ``(g) The total amount expended for the pilot program in any fiscal 
year (including amounts for administrative costs) may not exceed 
$50,000,000.
    ``(h) For purposes of this section, the term `health-care plan' has 
the meaning given that term in section 1725(f)(3) of this title.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1725 the following new item:

``1725A. Coordination of hospital benefits: pilot program.''.

SEC. 402. BENEFITS FOR PERSONS DISABLED BY PARTICIPATION IN COMPENSATED 
              WORK THERAPY PROGRAM.

    Section 1151(a)(2) is amended--
            (1) by inserting ``(A)'' after ``proximately caused''; and
            (2) by inserting before the period at the end the 
        following: ``, or (B) by participation in a program (known as a 
        `compensated work therapy program') under section 1718 of this 
        title''.

SEC. 403. EXTENSION OF AUTHORITY TO ESTABLISH RESEARCH AND EDUCATION 
              CORPORATIONS.

    Section 7368 is amended by striking ``December 31, 2000'' and 
inserting ``December 31, 2005''.

SEC. 404. DEPARTMENT OF VETERANS AFFAIRS FISHER HOUSES.

    (a) Authority.--Subchapter I of chapter 17 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 1708. Temporary lodging
    ``(a) The Secretary may furnish persons described in subsection (b) 
with temporary lodging in a Fisher house or other appropriate facility 
in connection with the examination, treatment, or care of a veteran 
under this chapter or, as provided for under subsection (e)(5), in 
connection with benefits administered under this title.
    ``(b) Persons to whom the Secretary may provide lodging under 
subsection (a) are the following:
            ``(1) A veteran who must travel a significant distance to 
        receive care or services under this title.
            ``(2) A member of the family of a veteran and others who 
        accompany a veteran and provide the equivalent of familial 
        support for such veteran.
    ``(c) In this section, the term `Fisher house' means a housing 
facility that--
            ``(1) is located at, or in proximity to, a Department 
        medical facility;
            ``(2) is available for residential use on a temporary basis 
        by patients of that facility and others described in subsection 
        (b)(2); and
            ``(3) is constructed by, and donated to the Secretary by, 
        the Zachary and Elizabeth M. Fisher Armed Services Foundation.
    ``(d) The Secretary may establish charges for providing lodging 
under this section. The proceeds from such charges shall be credited to 
the medical care account and shall be available until expended for the 
purposes of providing such lodging.
    ``(e) The Secretary shall prescribe regulations to carry out this 
section. Such regulations shall include provisions--
            ``(1) limiting the duration of such lodging;
            ``(2) establishing standards and criteria under which 
        medical facilities may set charges for such lodging;
            ``(3) establishing criteria for persons considered to be 
        accompanying a veteran;
            ``(4) establishing criteria for the use of such premises; 
        and
            ``(5) any other limitations, conditions, and priorities 
        that the Secretary considers appropriate with respect to 
        temporary lodging under this section.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1707 the following new item:

``1708. Temporary lodging.''.

SEC. 405. EXTENSION OF ANNUAL REPORT OF COMMITTEE ON MENTALLY ILL 
              VETERANS.

    Section 7321(d)(2) is amended by striking ``three'' and inserting 
``six''.

SEC. 406. EXCEPTION TO RECAPTURE RULE.

    Section 8136 is amended--
            (1) by inserting ``(a)'' at the beginning of the text of 
        the section; and
            (2) by adding at the end the following new subsection:
    ``(b) The establishment and operation by the Secretary of an 
outpatient clinic in facilities described in subsection (a) shall not 
constitute grounds entitling the United States to any recovery under 
that subsection.''.

SEC. 407. CHANGE TO ENHANCED USE LEASE CONGRESSIONAL NOTIFICATION 
              PERIOD.

    Paragraph (2) of section 8163(c) is amended to read as follows:
    ``(2) The Secretary may not enter into an enhanced use lease until 
the end of the 90-day period beginning on the date of the submission of 
notice under paragraph (1).''.

SEC. 408. TECHNICAL AND CONFORMING CHANGES.

    (a) Requirement To Provide Care.--Section 1710A(a) is amended by 
inserting ``(subject to section 1710(a)(4) of this title)'' after 
``Secretary'' the first place it appears.
    (b) Conforming Amendment.--Section 1710(a)(4) is amended by 
striking ``requirement in'' and inserting ``requirements in section 
1710A(a) and''.

SEC. 409. RELEASE OF REVERSIONARY INTEREST OF THE UNITED STATES IN 
              CERTAIN REAL PROPERTY PREVIOUSLY CONVEYED TO THE STATE OF 
              TENNESSEE.

    (a) Release of Interest.--The Secretary of Veterans Affairs shall 
execute such legal instruments as necessary to release the reversionary 
interest of the United States described in subsection (b) in a certain 
parcel of real property conveyed to the State of Tennessee pursuant to 
the Act entitled ``An Act authorizing the transfer of certain property 
of the Veterans' Administration (in Johnson City, Tennessee) to the 
State of Tennessee'', approved June 6, 1953 (67 Stat. 54).
    (b) Specified Reversionary Interest.--Subsection (a) applies to the 
reversionary interest of the United States required under section 2 of 
the Act referred to in subsection (a), requiring use of the property 
conveyed pursuant to that Act to be primarily for training of the 
National Guard and for other military purposes.
    (c) Conforming Amendment.--Section 2 of such Act is repealed.




                                                 Union Calendar No. 519

106th CONGRESS

  2d Session

                               H. R. 5109

                          [Report No. 106-863]

_______________________________________________________________________

                                 A BILL

To amend title 38, United States Code, to improve the personnel system 
     of the Veterans Health Administration, and for other purposes.

_______________________________________________________________________

                           September 18, 2000

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