[Congressional Record Volume 140, Number 65 (Monday, May 23, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: May 23, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
  DEPARTMENT OF VETERANS AFFAIRS MEDICAL CONSTRUCTION AUTHORIZATION, 
                            FISCAL YEAR 1995

  Mr. MONTGOMERY. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4425) to authorize major medical facility construction 
projects for the Department of Veterans Affairs for fiscal year 1995, 
to revise and improve veterans' health programs, and for other 
purposes.
  The Clerk read as follows:

                               H.R. 4425

       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 
                   AND MAJOR MEDICAL FACILITY LEASES.

       (a) Projects in President's Budget.--(1) Except as provided 
     in paragraph (2), the Secretary of Veterans Affairs may carry 
     out the major medical facility projects for the Department of 
     Veterans Affairs, and may carry out the major medical 
     facility leases for that Department, for which funds are 
     requested in the budget of the President for fiscal year 
     1995.
       (2) The Secretary is not authorized to carry out--
       (A) the project described in the budget of the President 
     for fiscal year 1995 for the construction of a research 
     addition at Huntington, West Virginia; or
       (B) the project described in the budget of the President 
     for fiscal year 1995 for the construction of a research 
     addition at Portland, Oregon.
       (b) Additional Projects.--In addition to the projects 
     authorized in subsection (a), the Secretary may carry out the 
     following major medical facility projects, in the amounts 
     specified:
       (1) The projects for ambulatory care facilities that are 
     proposed in the budget for fiscal year 1995 to be financed 
     with funds from the Health Care Investment Fund.
       (2) Construction of a nursing home facility at the 
     Department of Veterans Affairs Medical Center in Charleston, 
     South Carolina, $7,300,000.
       (3) A lease/purchase of a nursing home facility near Ft. 
     Myers, Florida, $18,630,000.
       (4) Construction of an outpatient care addition at the 
     Department of Veterans Affairs medical center in Phoenix, 
     Arizona, in the amount of $50,000,000.
       (c) Projects for Which Funds Appropriated.--In addition to 
     the projects authorized in subsections (a) and (b), the 
     Secretary may carry out the following major medical facility 
     projects for which funds were appropriated in the Emergency 
     Supplemental Appropriations Act of 1994 (Public Law 103-211) 
     in the amounts specified:
       (1) Construction of an ambulatory care/support services 
     facility at the Department of Veterans Affairs Medical Center 
     in Sepulveda, California, $53,700,000.
       (2) Other major medical facility projects required to 
     repair, restore, or replace earthquake-damaged facilities at 
     the Department of Veterans Affairs Medical Center in 
     Sepulveda, California, $50,000,000.

     SEC. 102. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There is hereby authorized to be 
     appropriated to the Secretary of Veterans Affairs for fiscal 
     year 1995--
       (1) $343,800,000 for the major medical facility projects 
     authorized in subsections (a) and (b) of section 101; and
       (2) $15,800,000 for the major medical facility leases 
     authorized in section 101(a).
       (b) Limitation.--The projects authorized in subsections (a) 
     and (b) of section 101 may only be carried out using--
       (1) funds appropriated for fiscal year 1995 pursuant to the 
     authorization of appropriations in subsection (a);
       (2) funds appropriated for Construction, Major Projects for 
     a fiscal year before fiscal year 1995 that remain available 
     for obligation; and
       (3) funds appropriated for Construction, Major Projects for 
     fiscal year 1995 for a category of activity not specific to a 
     project.
       (c) Limitation on Certain Projects.--The projects 
     authorized in subsection (c) of section 101 may only be 
     carried out using--
       (1) funds appropriated, as well as funds transferred by the 
     President, to the Construction, Major Projects account 
     pursuant to the Emergency Supplemental Appropriations Act of 
     1994 (Public Law 103-211);
       (2) funds appropriated to the Medical Care account by the 
     Emergency Supplemental Appropriations Act of 1994 (Public Law 
     103-211) that are transferred by law to the Construction, 
     Major Projects account;
       (3) funds appropriated to the Construction, Major Projects 
     account for a fiscal year before fiscal year 1994 that remain 
     available for obligation; and
       (4) funds appropriated to the Construction, Major Projects 
     account for fiscal year 1994 for a category of activity not 
     specific to a project.
              TITLE II--HEALTH CARE PLANNING AND PROGRAMS

     SEC. 201. HEALTH CARE FACILITIES MISSIONS.

       (a) In General.--The Secretary of Veterans Affairs shall 
     prescribe a specific, detailed statement of the mission of, 
     and the clinical programs to be operated at, each health care 
     facility of the Department, determined based upon a 
     requirement that each such facility operate within a network 
     of Department facilities in the same geographic area which, 
     taken together, provide a full range of services for 
     veterans.
       (b) Purposes of Mission Statements.--The mission statements 
     shall be designed so as to permit--
       (1) effective planning;
       (2) reduction in duplication of services and programs in 
     the same geographic area;
       (3) realignment of services among facilities within each 
     network;
       (4) improved means of resource distribution; and
       (5) more efficient delivery of needed services.
       (c) Review of Current Missions.--In preparing the mission 
     statements under subsection (a), the Secretary shall review 
     the existing missions and clinical programs at each health 
     care facility of the Department.
       (d) Deadline and Report.--The Secretary, not later than 
     nine months after the date of the enactment of this Act, 
     shall--
       (1) prescribe the mission statements required by subsection 
     (a); and
       (2) submit to the Committees on Veterans' Affairs of the 
     Senate and House of Representatives a report on the 
     implementation of this section and on the timetable and 
     projected milestones for implementing actions to enable each 
     such facility to carry out fully its prescribed missions.

     SEC. 202. PILOT PROGRAM FOR NONINSTITUTIONAL ALTERNATIVES TO 
                   NURSING HOME CARE.

       (a) Extension of Program.--Subsection (a) of section 1720C 
     of title 38, United States Code, is amended by striking out 
     ``During the four-year period beginning on October 1, 1990,'' 
     and inserting in lieu thereof ``During the period through 
     September 30, 1997,''.
       (b) Veterans Eligible To Participate in Program.--Such 
     subsection is further amended by striking out ``care and 
     who--'' and inserting in lieu thereof ``care. The Secretary 
     shall give priority for participation in such program to 
     veterans who--''.
       (c) Report Deadlines.--Section 201(b) of the Department of 
     Veterans Affairs Nurse Pay Act of 1990 (Public Law 101-366; 
     104 Stat. 438) is amended--
       (1) by striking out ``February 1, 1994,'' and inserting in 
     lieu thereof ``February 1, 1997,''; and
       (2) by striking out ``September 30, 1993,'' and inserting 
     in lieu thereof ``September 30, 1996,''.
               TITLE III--MEDICAL FACILITIES ACQUISITION

     SEC. 301. 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:'';
       (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) The relationship between the mission of the facility 
     and the missions and capabilities of other nearby Department 
     facilities and, as applicable, the availability or lack of 
     availability of alternative sources of service in the 
     community and the cost-effectiveness of using such 
     alternative sources.
       ``(7) Current and projected operating costs of the 
     facility.
       ``(8) The raw score assigned to the proposal under the 
     Department's prioritization methodology and, if the project 
     is being proposed for funding ahead of a project with a 
     higher score, a comprehensive explanation of the specific 
     factors on the basis of which the project is being proposed 
     for funding ahead of each such higher-scored project.
       ``(9) 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. 302. PRIORITIZATION METHODOLOGY.

       (a) Review of Methodology.--The Secretary of Veterans 
     Affairs shall conduct a review of the methodology used by the 
     Department for establishing the relative priority for major 
     construction projects under consideration in the Department.
       (b) Revision.--Based upon the review under subsection (a), 
     the Secretary shall revise the prioritization methodology so 
     as to give additional weight, as determined appropriate by 
     the Secretary taking into consideration particularly the 
     needs of the aging veteran population, to projects intended 
     to expand long-term care and ambulatory care programs.
       (c) Report.--Not later than 120 days 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 actions of the Secretary in 
     carrying out this section.

     SEC. 303. SEMIANNUAL COMPILATION OF CONSTRUCTION PRIORITIES.

       Section 8107 of title 38, United States Code, is amended by 
     adding at the end the following new subsection:
       ``(c)(1) The Secretary shall submit to each committee, not 
     later than January 31 and July 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. 304. DEFINITION OF MAJOR MEDICAL FACILITY PROJECT.

       Subparagraph (A) of section 8104(a)(3) of title 38, United 
     States Code, 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 IV--STATE HOME PROGRAM

     SEC. 401. PER DIEM FOR ADULT DAY HEALTH CARE.

       (a) In General.--Subsection (a) of section 1741 of title 
     38, United States Code, 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 rate to be paid under this subsection is 
     as follows:
       ``(A) For domiciliary care, $15.11 for each day.
       ``(B) For nursing home care and hospital care, $35.37 for 
     each day.
       ``(C) For adult day health care, $16.28 for each day.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply with respect to adult day health care provided in 
     a State home after September 30, 1994.

     SEC. 402. CONSTRUCTION ASSISTANCE PROGRAM.

       (a) In General.--Subchapter III of chapter 81 of title 38, 
     United States Code, 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 ``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 ``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.
                         TITLE V--MISCELLANEOUS

     SEC. 501. DEPARTMENT OF VETERANS AFFAIRS RESEARCH ADVISORY 
                   COMMITTEES.

       (a) Statutory Basis for Research Advisory Committees.--
     Chapter 5 of title 38, United States Code, is amended by 
     adding at the end of subchapter III the following new 
     section:

     ``Sec. 544. 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 March 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 congressional veterans' affairs 
     committees 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 
     March 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 Evaluation Board for Health 
     Services Research and Development.
       ``(18) The Scientific Review Evaluation Board for 
     Rehabilitation Research and Development.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 543 the following new item:

``544. Veterans research advisory committees.''.

     SEC. 502. CHILD CARE SERVICES.

       (a) Revised Child Care Authority.--Chapter 81 of title 38, 
     United States Code, 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 unfeasible; 
     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 of such title is 
     repealed.
       (c) Clerical Amendments.--(1) The table of sections at the 
     beginning of chapter 81 of such title 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 of 
     such title is amended by striking out the item relating to 
     section 7809.

     SEC. 503. CONTRACTS FOR UTILITIES, AUDIE L. MURPHY MEMORIAL 
                   HOSPITAL.

       (a) Authority To Contact.--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 and in the amount provided in advance 
     in appropriations Acts.
       (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. 504. FACILITIES IN REPUBLIC OF THE PHILIPPINES.

       Notwithstanding section 1724 of title 38, United States 
     Code, the Secretary of Veterans Affairs, during the period 
     from February 28, 1994, through June 1, 1994, may contract 
     with facilities in the Republic of the Philippines other than 
     the Veterans Memorial Medical Center to furnish hospital care 
     and medical services to veterans for nonservice-connected 
     disabilities if such veterans are unable to defray the 
     expenses of necessary hospital care. When the Secretary 
     determines it to be most feasible, the Secretary may provide 
     medical services to such veterans at the Department of 
     Veterans Affairs Outpatient Clinic at Manila, Republic of the 
     Philippines.

     SEC. 505. WAIVER OF CONGRESSIONAL WAITING PERIOD REQUIREMENT 
                   FOR A SPECIFIED ADMINISTRATIVE REORGANIZATION.

       (a) Waiver.--The Secretary of Veterans Affairs may 
     undertake the administrative reorganization described in 
     subsection (b) of this section without regard to the waiting 
     period requirement of section 510(b) of title 38, United 
     States Code.
       (b) Covered Administrative Reorganization.--The 
     administrative reorganization referred to in subsection (a) 
     of this section is a reorganization at the Department of 
     Veterans Affairs Medical Center in Sepulveda, California, 
     necessitated by the January 1994 earthquake damage at that 
     location, as described in the letters dated April 25, 1994, 
     and the accompanying detailed plan and justification, 
     submitted by the Secretary of Veterans Affairs to the 
     chairmen of the House and Senate Committees on Veterans' 
     Affairs pursuant to section 510(b) of title 38, United States 
     Code.

     SEC. 506. TECHNICAL AMENDMENT.

       Section 7363(c) of title 38, United States Code, is amended 
     by striking out ``section 501(c)(3) of''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Mississippi [Mr. Montgomery] will be recognized for 20 minutes, and the 
gentleman from Arizona [Mr. Stump] will be recognized for 20 minutes.
  The Chair recognizes the gentleman from Mississippi [Mr. Montgomery].


                             general leave

  Mr. MONTGOMERY. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Mississippi.
  There was no objection.
  Mr. MONTGOMERY. Mr. Speaker, I yield myself such time as I may 
consume.
  (Mr. MONTGOMERY asked and was given permission to revise and extend 
his remarks.)
  Mr. MONTGOMERY. Mr. Speaker, H.R. 4425 authorizes various VA 
construction projects during the next fiscal year. Under current law, 
VA cannot proceed with any construction project costing $3 million or 
more, unless the project has been authorized by the Congress. The law 
also applies to any lease agreement that exceeds $300,000 per year.
  The bill also contains several provisions that would improve VA's 
construction planning process--a process that has been subject to much 
criticism for the past several years. The enactment of this bill would 
require VA to establish specific missions for each of its health care 
facilities.
  Several provisions contained in H.R. 4425 were originally part of 
H.R. 2034, which passed the House on May 18 last year. Unfortunately, 
the Senate failed to act on those provisions. We hope the other body 
will work with us on these important provisions before we adjourn this 
session.
  Given the current Federal budget deficit and the limited amount of 
construction funds available to VA, the Department must do a better job 
of evaluating proposed construction projects and deciding which ones 
have the highest priority.

  Mr. Speaker, the distinguished chairman of the subcommittee, Dr. Roy 
Rowland, is on his way back from Georgia and, in his absence, I will 
briefly explain the major provisions of the bill.
  The bill authorizes most of the construction projects proposed by the 
President in his fiscal year 1995 budget, including all of the projects 
requiring authorization that the President proposes be financed with 
funds from the Health Care Investment Fund.
  The bill authorizes the construction of a nursing home facility at 
the VA Medical Center in Charleston, SC. This project was not included 
in the President's budget, although VA has rated Charleston as one of 
the areas in the country most in need of VA nursing home beds.
  The bill authorizes the lease-purchase of a nursing home facility 
near Ft. Myers, FL, a project which is also badly needed.
  Finally, the bill authorizes the construction of an outpatient care 
addition at the VA medical center in Phoenix, AZ, which State is 
receiving more veterans each year.
  Mr. Speaker, all of the projects contained in this bill are rated 
high priority by the Department of Veterans Affairs and I am pleased to 
support the committee bill.
  I want to express my appreciation to Chairman J. Roy Rowland and 
ranking minority member, the Honorable Chris Smith of New Jersey, for 
their work on the bill.
  In addition, I want to thank my good friend, the Honorable Bob Stump, 
ranking minority member of the full committee, for his leadership and 
support of the bill.
  I urge my colleagues to support H.R. 4425.
  Mr. Speaker, I reserve the balance of my time.
  Mr. STUMP. Mr. Speaker, I yield myself such time as I may consume.
  (Mr. STUMP asked and was given permission to revise and extend his 
remarks.)
  Mr. STUMP. Mr. Speaker, I want to state my strong support for this 
legislation and I would like to commend the chairman of the full 
committee, Sonny Montgomery, and the chairman and ranking minority 
member of the Subcommittee on Hospitals and Health Care, Roy Rowland 
and Chris Smith, for the bipartisan manner with which this bill was 
drafted.
  H.R. 4425 more than doubles the administration's proposal which would 
have effectively gutted VA's construction program for fiscal year 1995. 
Once again this committee has demonstrated its willingness to be an 
advocate on behalf of veterans rather than simply making decisions 
based on the budget bottom-line.
  I am especially pleased that this authorization bill includes 
provisions from H.R. 2034 which passed the House last year, but were 
held up in the other body. These provisions will provide the 
cornerstone for future VA construction planning.
  I believe it is essential that VA revise its planning methods in 
order to adequately prepare to meet the changing needs and demographic 
trends of veterans.
  Mr. Speaker, I urge my colleagues to support this bill.
  Mr. Speaker, I yield such time as he may consume to the gentleman 
from New Jersey [Mr. Smith], the ranking member of the Subcommittee on 
Hospitals and Health Care.
  Mr. SMITH of New Jersey. Mr. Speaker, I thank the gentleman for 
yielding time to me.
  First of all, let me compliment the gentleman from Mississippi [Mr. 
Montgomery] and the gentleman from Georgia [Mr. ROWLAND] and the 
ranking Republican member, the gentleman from Arizona [Mr. Stump] for 
their great work on this important legislation.
  As usual, we bring to the full House of Representatives a bipartisan 
bill. The details have been worked out painstakingly. This is an 
excellent bill that will very significantly help our veterans in 
America.
  Mr. Speaker, this bill was carefully crafted to ensure that VA health 
care in our country remains the best that we can possibly offer, and 
this is especially vital as we move to reform health care from top to 
bottom in the United States. The VA must be competitive, Mr. Speaker, 
and they must offer top quality if we are to attract the kind of people 
that we hope especially during health care reform to keep this system 
viable.
  I am also very pleased, Mr. Speaker, that our bill focuses on 
ambulatory care for veterans whose treatment may only require 
outpatients therapy. For too many years, veterans have been forced to 
wait for inpatient services when in fact they could be treated just as 
effectively on an outpatients basis. This legislation requests the VA 
to review its methodology for prioritizing major construction projects, 
giving added weight to ambulatory care projects.
  I am also pleased, Mr. Speaker, that this legislation nearly triples 
President Clinton's funding request for major construction projects. 
Our committee approved a $343 million budget, as opposed to the paltry 
$115 million request from the administration. The President, in my 
view, has obviously miscalculated the need for increased funding for 
the delivery of health care. And as in the past, we have moved in a 
bipartisan way to redress those underfunding requests.
  Mr. Speaker, I fully support this legislation and am very proud to be 
one of the sponsors of it. I hope the full House will give its assent 
to it.
  Mr. MONTGOMERY. Mr. Speaker, this is a fine bill. It has been well 
crafted. I hope we will get a unanimous consent on this bill.
  Mr. ROWLAND. Mr. Speaker, I rise in support of H.R. 4425.
  The Veterans' Affairs Committee's Subcommittee on Hospitals and 
Health Care recently adopted an amendment in the nature of a substitute 
to title VIII of H.R. 3600, the proposed Health Security Act. Our 
recent discussions about VA's role under health care reform makes 
consideration of H.R. 4425 particularly timely. The VA's ability to 
seize on the challenge of health care reform and mobilize itself 
depends on many factors. One of those factors is the Department's 
ability to modernize its health care system's infrastructure.
  Under the leadership of Chairman Sonny Montgomery, the Veterans' 
Affairs Committee has taken very seriously its role of charting the 
course for the VA construction program. Significantly, H.R. 4425, which 
was adopted unanimously by our committee, not only authorizes needed 
construction projects, but improves the construction planning process 
and our tools for overseeing the VA's construction program.
  H.R. 4425 requires VA to establish specific missions for each of its 
health care facilities. Requiring VA to identify the specific role each 
of its facilities will play in delivering care to veterans will provide 
a reliable base for facility planning. Taking such action will help 
assure that proposed construction activity dovetails with sound 
planning. Improving strategic planning at our medical facilities will 
also encourage needed streamlining within the VA system.
  In addition to fostering better planning, H.R. 4425 aims to improve 
the system through which VA evaluates and ranks proposed construction 
projects. With a dramatic decline in VA major construction budgets in 
recent years, VA and the Congress are critically in need of a reliable 
means of distinguishing objectively among competing construction 
projects.

  H.R. 4425 addresses this concern in two ways. It requires more 
frequent and detailed VA reporting as to which projects constitute its 
highest construction priorities and directs VA to document the factors 
accounting for those rankings. It also calls for increasing the 
priority given projects that expand VA's capacity to provide ambulatory 
care and long-term care, areas of greatest need.
  That priority is reflected in this bill, which authorizes a series of 
much-needed ambulatory care projects, including those proposed for 
funding through the administration's so-called investment fund, as well 
as several urgently needed nursing home care projects.
  H.R. 4425 authorizes $17.2 million in design funds for a medical 
center and nursing home for Brevard County, FL, as part of a joint 
venture with Patrick Air Force Base; $62.3 million for seismic 
corrections and construction of upper floors to the bed tower, VAMC, 
Memphis, TN; $28.20 million for a satellite outpatient clinic and 
nursing home in Ft. Myers, FL; $48 million for an ambulatory care 
addition at the VAMC, Boston, MA; $14 million for a satellite 
outpatient clinic/nursing home in Orlando, FL; $22.9 million for an 
ambulatory care addition at the VAMC, Columbia, MO; $29.2 million for 
an ambulatory care addition at the VAMC, Hampton, VA; $48.6 million for 
an ambulatory care addition at VAMC, West Haven, CT; $50 million for an 
ambulatory care addition at VAMC, Phoenix, AZ; $7.3 million for a 
nursing home at VAMC, Charleston, SC; and construction funding in the 
amount of $103.7 million, already appropriated in the 1994 emergency 
supplemental, in connection with earthquake damage at the VAMC's in 
Sepulveda and Los Angeles. H.R. 4425 also authorizes $8.5 million for a 
facility lease for a satellite outpatient clinic in Ponce, PR, and $7.3 
million for a facility lease for satellite outpatient clinic in 
Winston-Salem, NC.
  The bill also aims to encourage VA to convert numbers of its hospital 
wards into ambulatory care clinics. It would facilitate VA medical 
center efforts to make those changes through targeted use of its minor 
construction appropriation--by increasing the threshold on the use of 
minor construction funding for such projects from the current $3 
million to $5 million.
  Finally, this bill incorporates a number of provisions from last 
year's House-passed construction authorization bill on which the Senate 
failed to act.
  I urge my colleagues to support H.R. 4425.
  Mr. de la GARZA. Mr. Speaker, today we consider H.R. 4425, a bill to 
authorize a total of $344 million in fiscal year 1995 for the 
construction of major VA medical facility projects. This is a sound 
investment--one which evidences our commitment to seeing the needs of 
our Nation's veterans met.
  Let me take this opportunity, however, to say I feel there is one 
region of the Nation which remains woefully underserved and that is 
south Texas. I cannot emphasize too strongly just how badly a VA 
hospital is needed there. I am well aware of the criteria for building 
a hospital--it is to demonstrate that the need exists. The voices of 
the veterans and the veterans organizations in south Texas evidence 
that there is such a need. In fact, statistics show the number of 
veterans continues to grow and that the number of veterans retiring to 
Sun Belt States such as Texas is rapidly on the rise. This is why I 
must say, as I have before in the past--improving access to health care 
for veterans must be a priority concern. It certainly is for me.
  Currently there are approximately 40,000 veterans in the Rio Grande 
Valley of Texas. In winter months approximately 80,000 winter Texans 
come to our area and of that total 50 easier are veterans. It is true 
we have an expanded outpatient clinic, but the clinic refers countless 
patients to San Antonio every day--the nearest hospital--and for 
veterans to have to travel distances of approximately 200 miles to 
reach the closest hospital is something that I simply do not feel is 
acceptable. The solution is to afford serious consideration to 
addressing the health care needs of our veterans by pushing for and 
building a hospital.
  Let me close by saying we certainly appreciate the committee's work 
on projects such as those being considered today, and we ask them to 
include south Texas in the next round of planned additions to the VA 
system.

                              {time}  1220

  Mr. MONTGOMERY. Mr. Speaker, I yield back the balance of my time.
  Mr. STUMP. Mr. Speaker, I have no further requests for time, and I 
yield back the balance of my time.
  Mr. MONTGOMERY. Mr. Speaker, I have no further requests for time, and 
I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Richardson). The question is on the 
motion offered by the gentleman from Mississippi [Mr. Montgomery] that 
the House suspend the rules and pass the bill, H.R. 4425.
  The question was taken; and (two-thirds having voted in favor 
thereof), the rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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