[Congressional Record Volume 140, Number 145 (Friday, October 7, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: October 7, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
 REQUEST TO CONCUR IN SENATE AMENDMENTS TO H.R. 3313, VETERANS HEALTH 
               IMPROVEMENTS ACT OF 1993, WITH AMENDMENTS

  Mr. MONTGOMERY. Mr. Speaker, I ask unanimous consent to take from the 
Speaker's table the bill (H.R. 3313) to amend title 38, United States 
Code, to improve health care services of the Department of Veterans 
Affairs relating to women veterans, to extend and expand authority for 
the Secretary of Veterans Affairs to provide priority health care to 
veterans who were exposed to ionizing radiation or to Agent Orange, to 
expand the scope of services that may be provided to veterans through 
Vet Centers, and for other purposes, with Senate amendments thereto and 
concur in the Senate amendments with amendments that are at the desk.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. The Clerk will report the proposed 
amendments.
  The Clerk read the House amendments to the Senate amendments, as 
follows:

       House Amendments to the Senate Amendments:   In lieu of the 
     matter proposed to be inserted by the amendment of the Senate 
     to the text of the bill, insert the following:

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Veterans 
     Health Improvements Act of 1994''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.

              TITLE I--WOMEN VETERANS HEALTH IMPROVEMENTS

Sec. 101. Short title.
Sec. 102. Health care services for women.
Sec. 103. Women's health services.
Sec. 104. Mammography quality standards.
Sec. 105. Research relating to women veterans.
Sec. 106. Sexual trauma counseling and services.
Sec. 107. Coordinators of women's services.
Sec. 108. Patient privacy for women patients.

        TITLE II--CARE FOR VETERANS EXPOSED TO TOXIC SUBSTANCES

Sec. 201. Authority to provide priority health care.
Sec. 202. Savings provision.

                    TITLE III--READJUSTMENT SERVICES

Sec. 301. Scope of services provided in vet centers.
Sec. 302. Advisory committee on the readjustment of veterans.
Sec. 303. Plan for expansion of Vietnam veteran resource centers pilot 
              program.
Sec. 304. Organizational autonomy of the Readjustment Counseling 
              Service.
Sec. 305. Report on collocation of vet centers and Department of 
              Veterans Affairs outpatient clinics.
Sec. 306. Bereavement counseling for deaths on active duty.

              TITLE IV--SERVICES FOR MENTALLY ILL VETERANS

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

            TITLE V--CONSTRUCTION PLANNING AND AUTHORIZATION

Sec. 501. Authorization of major medical facility projects and major 
              medical facility leases.
Sec. 502. Authorization of appropriations.
Sec. 503. Revision to prospectus requirements.
Sec. 504. Annual compilation of construction priorities.

    TITLE VI--GENERAL MEDICAL AUTHORITIES AND MEDICAL ADMINISTRATION

Sec. 601. Assistance in the payment of education debts incurred by 
              certain Veterans Health Administration employees.
Sec. 602. Pilot program for noninstitutional alternatives to nursing 
              home care.
Sec. 603. Per diem for adult day health care.
Sec. 604. State home construction assistance program.
Sec. 605. Department of Veterans Affairs research advisory committees.
Sec. 606. Child care services.
Sec. 607. Contracts for utilities, Audie L. Murphy Memorial Hospital.
Sec. 608. Facilities in Republic of the Philippines.
Sec. 609. Technical amendments.
Sec. 610. Center for Minority Veterans and Center for Women Veterans.
Sec. 611. Advisory Committee for Minority Veterans.
Sec. 612. Authority to enter into agreement for use of property at 
              Edward Hines, Jr., Department of Veterans Affairs 
              Hospital.
Sec. 613. Counseling services for POW/MIA family members.
Sec. 614. Revision of authority on use of tobacco products in 
              Department facilities.
Sec. 615. Extension of certain expiring authorities.
Sec. 616. Protection against certain prohibited personnel practices.
Sec. 617. Permanent authority for waiver of reduction of retirement pay 
              for registered-nurse positions.
Sec. 618. Submittal date for report on annual analysis of 
              departmentwide admissions policies.
Sec. 619. Health care resources.

             TITLE VII--HEALTH CARE DELIVERY PILOT PROGRAM

Sec. 701. Pilot program authority.
Sec. 702. Conditions of participation.
Sec. 703. Operation of pilot programs.
Sec. 704. Provision of benefits.
Sec. 705. Funding.
Sec. 706. Annual reports to congress.
Sec. 707. Expiration of authority.

     SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

       Except as otherwise expressly provided, whenever in this 
     Act an amendment or repeal is expressed in terms of an 
     amendment to, or repeal of, a section or other provision, the 
     reference shall be considered to be made to a section or 
     other provision of title 38, United States Code.
              TITLE I--WOMEN VETERANS HEALTH IMPROVEMENTS

     SEC. 101. SHORT TITLE.

       This title may be cited as the ``Women Veterans Health 
     Improvements Act of 1994''.

     SEC. 102. HEALTH CARE SERVICES FOR WOMEN.

       (a) Ensured Provision of Services.--The Secretary of 
     Veterans Affairs shall ensure that each health-care facility 
     under the direct jurisdiction of the Secretary is able, 
     through services made available either by individuals 
     appointed to positions in the Veterans Health Administration 
     or under contracts or other agreements made under section 
     7409, 8111, or 8153 of title 38, United States Code, or title 
     II of Public Law 102-585, to provide in a timely and 
     appropriate manner women's health services (as defined in 
     section 1701(10) of title 38, United States Code (as added by 
     section 103)) to any veteran described in section 1710(a)(1) 
     of title 38, United States Code, who is eligible for such 
     services.
       (b) Health Care Services To Be Provided Directly When Cost 
     Effective.--(1) The Secretary shall ensure that each health-
     care facility under the direct jurisdiction of the Secretary 
     shall provide women's health services directly (rather than 
     by contract or other agreement) when it is cost effective to 
     do so.
       (2) The Secretary shall ensure that each such facility is 
     provided appropriate equipment, treatment facilities, and 
     staff to carry out paragraph (1) and to ensure that the 
     quality of care provided under that paragraph is in 
     accordance with professional standards.
       (c) Conforming Repeal.--Section 302 of the Veterans' Health 
     Care Amendments of 1983 (Public Law 98-160; 97 Stat. 1004; 38 
     U.S.C. 1701 note) is repealed.

     SEC. 103. WOMEN'S HEALTH SERVICES.

       (a) Women's Health Services.--Section 1701 is amended--
       (1) in paragraph (6)(A)(i), by inserting ``women's health 
     services,'' after ``preventive health services,''; and
       (2) by adding at the end the following:
       ``(10) The term `women's health services' means--
       ``(A) health care services to prevent diseases specific to 
     women and to treat disabilities specific to women, 
     including--
       ``(i) papanicolaou tests (pap smears);
       ``(ii) breast examinations and mammography;
       ``(iii) management of menopause; and
       ``(iv) management and treatment of osteoporosis; and
       ``(B) prenatal care, delivery, and postpartum care.''.
       (b) Extension of Annual Report Requirement.--Section 107(a) 
     of the Veterans Health Care Act of 1992 (Public Law 102-585; 
     38 U.S.C. 1710 note) is amended by striking out ``Not later 
     than January 1, 1993, January 1, 1994, and January 1, 1995'' 
     and inserting in lieu thereof ``Not later than January 1 of 
     1993 and each year thereafter through 1998''.
       (c) Report on Health Care and Research.--Section 107(b) of 
     such Act is amended--
       (1) in paragraph (1), by striking out ``services described 
     in section 106 of this Act'' and inserting in lieu thereof 
     ``women's health services (as such term is defined in section 
     1701(10) of title 38, United States Code)'';
       (2) in paragraph (2)(A), by inserting ``(including 
     information on the number of inpatient stays and the number 
     of outpatient visits through which such services were 
     provided)'' after ``facility''; and
       (3) by adding at the end the following new paragraph:
       ``(5) A description of the actions taken by the Secretary 
     to foster and encourage the expansion of such research.''.

     SEC. 104. MAMMOGRAPHY QUALITY STANDARDS.

       (a) In General.--(1) Subchapter II of chapter 73 is amended 
     by adding at the end the following new section:

     ``Sec. 7319. Mammography quality standards

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

``7319. Mammography quality standards.''.

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

     SEC. 105. RESEARCH RELATING TO WOMEN VETERANS.

       (a) Inclusion of Women and Minorities in Clinical Research 
     Projects.--Section 7303 is amended--
       (1) by transferring the text of subsection (c) to the end 
     of subsection (a); and
       (2) by striking out subsection (c) and inserting in lieu 
     thereof the following new subsection (c):
       ``(c)(1) In conducting or supporting clinical research, the 
     Secretary shall ensure that, whenever possible and 
     appropriate--
       ``(A) women who are veterans are included as subjects in 
     each project of such research; and
       ``(B) members of minority groups who are veterans are 
     included as subjects of such research.
       ``(2) In the case of a project of clinical research in 
     which women or members of minority groups will under 
     paragraph (1) be included as subjects of the research, the 
     Secretary shall ensure that the project is designed and 
     carried out so as to provide for a valid analysis of whether 
     the variables being tested in the research affect women or 
     members of minority groups, as the case may be, differently 
     than other persons who are subjects of the research.''.
       (b) Health Research.--(1) Such section is further amended 
     by adding after subsection (c), as added by subsection (a), 
     the following new subsection:
       ``(d)(1) The Secretary, in carrying out the Secretary's 
     responsibilities under this section, shall foster and 
     encourage the initiation and expansion of research relating 
     to the health of veterans who are women.
       ``(2) In carrying out this subsection, the Secretary shall 
     consult with the following to assist the Secretary in setting 
     research priorities:
       ``(A) Officials of the Department assigned responsibility 
     for women's health programs and sexual trauma services.
       ``(B) The members of the Advisory Committee on Women 
     Veterans.
       ``(C) Members of appropriate task forces and working groups 
     within the Department (including the Women Veterans Working 
     Group and the Task Force on Treatment of Women Who Suffer 
     Sexual Abuse).''.
       (2) Section 109 of the Veterans Health Care Act of 1992 
     (Public Law 102-585; 38 U.S.C. 7303 note) is repealed.
       (c) Population Study.--Section 110(a) of the Veterans 
     Health Care Act of 1992 (Public Law 102-585; 106 Stat. 4948) 
     is amended by adding at the end of paragraph (3) the 
     following: ``If it is feasible to do so within the amounts 
     available for the conduct of the study, the Secretary shall 
     ensure that the sample referred to in paragraph (1) 
     constitutes a representative sampling (as determined by the 
     Secretary) of the ages, the ethnic, social and economic 
     backgrounds, the enlisted and officer grades, and the 
     branches of service of all veterans who are women.''.

     SEC. 106. SEXUAL TRAUMA COUNSELING AND SERVICES.

       (a) Authority To Provide Treatment Services for Sexual 
     Trauma; Repeal of Limitation on Time To Seek Services.--
     Subsection (a) of section 1720D is amended--
       (1) by striking out paragraph (2); and
       (2) by inserting after paragraph (1) the following new 
     paragraph (2):
       ``(2) During the period referred to in paragraph (1), the 
     Secretary may provide appropriate care and services to a 
     veteran for an injury, illness, or other psychological 
     condition that the Secretary determines to be the result of a 
     physical assault, battery, or harassment referred to in that 
     paragraph.''.
       (b) Extension of Period of Authority To Provide Sexual 
     Trauma Services.--Such subsection is further amended--
       (1) in paragraph (1), by striking out ``December 31, 
     1995,'' and inserting in lieu thereof ``December 31, 1998,''; 
     and
       (2) in paragraph (3), by striking out ``December 31, 
     1994,'' and inserting in lieu thereof ``December 31, 1998,''.
       (c) Repeal of Limitation on Period of Receipt of 
     Services.--Such section is further amended--
       (1) by striking out subsection (b); and
       (2) by redesignating subsections (c), (d), and (e) as 
     subsections (b), (c), and (d), respectively.
       (d) Coordination of Care.--Paragraph (1) of subsection (b) 
     of such section, as redesignated by subsection (c)(2), is 
     amended to read as follows:
       ``(1) The Secretary shall give priority to the 
     establishment and operation of the program to provide 
     counseling and care and services under subsection (a). In the 
     case of a veteran eligible for counseling and care and 
     services under subsection (a)(1), the Secretary shall ensure 
     that the veteran is furnished counseling and care and 
     services under this section in a way that is coordinated with 
     the furnishing of such care and services under this 
     chapter.''.
       (e) Increased Priority of Care.--Section 1712(i) is 
     amended--
       (1) in paragraph (1)--
       (A) by inserting ``(A)'' after ``To a veteran''; and
       (B) by inserting ``, or (B) who is eligible for counseling 
     and care and services under section 1720D of this title, for 
     the purposes of such counseling and care and services'' 
     before the period at the end; and
       (2) in paragraph (2)--
       (A) by striking out ``, (B)'' and inserting in lieu thereof 
     ``or (B)''; and
       (B) by striking out ``, or (C)'' and all that follows 
     through ``such counseling''.
       (f) Program Revision.--(1) Section 1720D is further 
     amended--
       (A) by striking out ``woman'' in subsection (a)(1);
       (B) by striking out ``women'' in subsection (b)(2)(C) and 
     in the first sentence of subsection (c), as redesignated by 
     subsection (c); and
       (C) by striking out ``women'' in subsection (c)(2), as so 
     redesignated, and inserting in lieu thereof ``individuals''.
       (2)(A) The heading of such section is amended to read as 
     follows:

     ``Sec. 1720D. Counseling and treatment for sexual trauma''.

       (B) The item relating to such section in the table of 
     sections at the beginning of chapter 17 is amended to read as 
     follows:

``1720D. Counseling and treatment for sexual trauma.''.

       (g) Information by Telephone.--(1) Paragraph (1) of section 
     1720D(c), as redesignated by subsection (c) of this section, 
     is amended to read as follows:
       ``(1) shall include availability of a toll-free telephone 
     number (commonly referred to as an 800 number); and''.
       (2) In providing information on counseling available to 
     veterans as required under section 1720D(c)(1) of title 38, 
     United States Code (as amended by paragraph (1)), the 
     Secretary of Veterans Affairs shall ensure that the 
     Department of Veterans Affairs personnel who provide 
     assistance under such section are trained in the provision to 
     persons who have experienced sexual trauma of information 
     about the care and services relating to sexual trauma that 
     are available to veterans in the communities in which such 
     veterans reside, including care and services available under 
     programs of the Department (including the care and services 
     available under section 1720D of such title) and from non-
     Department agencies or organizations.
       (3) The telephone assistance service shall be operated in a 
     manner that protects the confidentiality of persons who place 
     calls to the system.
       (4) The Secretary shall ensure that information about the 
     availability of the telephone assistance service is visibly 
     posted in Department medical facilities and is advertised 
     through public service announcements, pamphlets, and other 
     means.
       (5) Not later than 18 months after the date of the 
     enactment of this Act, the Secretary shall submit to Congress 
     a report on the operation of the telephone assistance service 
     required under section 1720D(c)(1) of title 38, United States 
     Code (as amended by paragraph (1)). The report shall set 
     forth the following:
       (A) The number of persons who sought information during the 
     period covered by the report through a toll free telephone 
     number regarding services available to veterans relating to 
     sexual trauma, with a separate display of the number of such 
     persons arrayed by State (as such term is defined in section 
     101(20) of title 38, United States Code).
       (B) A description of the training provided to the personnel 
     who provide such assistance.
       (C) The recommendations and plans of the Secretary for the 
     improvement of the service.
       (h) Conforming Repeal.--Section 102(b) of the Veterans 
     Health Care Act of 1992 (Public Law 102-585; 106 Stat. 4946; 
     38 U.S.C. 1720D note) is repealed.

     SEC. 107. COORDINATORS OF WOMEN'S SERVICES.

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

     SEC. 108. PATIENT PRIVACY FOR WOMEN PATIENTS.

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

     SEC. 201. AUTHORITY TO PROVIDE PRIORITY HEALTH CARE.

       (a) Authorized Inpatient Care.--Section 1710(e) is amended 
     to read as follows:
       ``(e)(1)(A) A herbicide-exposed veteran is eligible for 
     hospital care and nursing home care under subsection 
     (a)(1)(G)--
       ``(i) during the period before January 1, 1996, for any 
     disability, notwithstanding that there is insufficient 
     medical evidence to conclude that such disability may be 
     associated with such exposure, except in the case of a 
     disability that is found, in accordance with guidelines 
     issued by the Under Secretary for Health, to have resulted 
     from a cause other than an exposure to a herbicide agent; and
       ``(ii) during the period beginning on January 1, 1996, and 
     ending on the date specified in paragraph (3), for any 
     disease specified in paragraph (2).
       ``(B) A radiation-exposed veteran is eligible for hospital 
     care and nursing home care under subsection (a)(1)(G) for any 
     disease--
       ``(i) which is listed in section 1112(c)(2) of this title; 
     and
       ``(ii) for which the Secretary, based on the advice of the 
     Advisory Committee on Environmental Hazards or other relevant 
     scientific research, determines that a significant 
     statistical association exists between the disease and 
     exposure to ionizing radiation.
       ``(C) Subject to paragraph (3), a veteran who the Secretary 
     finds may have been exposed while serving on active duty in 
     the Southwest Asia theater of operations during the Persian 
     Gulf War to a toxic substance or environmental hazard is 
     eligible for hospital care and nursing home care under 
     subsection (a)(1)(G) of this section for any disability, 
     notwithstanding that there is insufficient medical evidence 
     to conclude that such disability may be associated with such 
     exposure.
       ``(2) The diseases referred to in paragraph (1)(A) are 
     those for which the National Academy of Sciences, in the most 
     recent report issued in accordance with section 3(g) of the 
     Agent Orange Act of 1991 (Public Law 102-4), has determined--
       ``(A) that there is sufficient evidence to conclude that 
     there is a positive association between occurrence of the 
     disease in humans and exposure to a herbicide agent;
       ``(B) that there is evidence which is suggestive of an 
     association between occurrence of the disease in humans and 
     exposure to a herbicide agent, but such evidence is limited 
     in nature; or
       ``(C) that available studies are insufficient to permit a 
     conclusion about the presence or absence of an association 
     between occurrence of the disease in humans and exposure to a 
     herbicide agent.
       ``(3) Hospital and nursing home care may not be provided 
     under or by virtue of paragraph (1)(A) after September 30, 
     2003, and may not be provided under or by virtue of paragraph 
     (1)(C) after September 30, 1998.
       ``(4) For purposes of this subsection and section 1712 of 
     this title--
       ``(A) the term `herbicide-exposed veteran' means a veteran 
     (i) who served on active duty in the Republic of Vietnam 
     during the Vietnam era, and (ii) who the Secretary finds may 
     have been exposed during such service to a herbicide agent;
       ``(B) the term `herbicide agent' has the meaning given that 
     term in section 1116(a)(4) of this title; and
       ``(C) the term `radiation-exposed veteran' has the meaning 
     given that term in section 1112(c)(3) of this title.''.
       (b) Authorized Outpatient Care.--(1) Subsection (a)(1) of 
     section 1712 is amended--
       (A) by striking out ``and'' at the end of subparagraph (C);
       (B) in subparagraph (D)--
       (i) by striking out ``December 31, 1994'' and inserting in 
     lieu thereof ``September 30, 1998''; and
       (ii) by striking out the period at the end and inserting in 
     lieu thereof a semicolon; and
       (C) by adding at the end the following:
       ``(E) during the period beginning on January 1, 1996, and 
     ending on the date specified in section 1710(e)(3) of this 
     title, to any herbicide-exposed veteran for any disease 
     specified in section 1710(e)(2) of this title; and
       ``(F) to any radiation-exposed veteran for any disease 
     covered under section 1710(e)(1)(B) of this title.''.
       (2) Subsection (i)(3) of such section is amended--
       (A) by striking out ``(A)''; and
       (B) by striking out ``, or (B)'' and all that follows 
     through ``title''.

     SEC. 202. SAVINGS PROVISION.

       (a) Preservation of Earlier Eligibility.--The provisions of 
     sections 1710(e) and 1712(a) of title 38, United States Code, 
     as in effect on the day before the date of the enactment of 
     this Act, shall continue to apply on and after such date with 
     respect to the furnishing of hospital care, nursing home 
     care, and medical services for any veteran who was furnished 
     such care or services before such date of enactment on the 
     basis of presumed exposure to a substance or radiation under 
     the authority of those provisions, but only for treatment for 
     a disability for which such care or services were furnished 
     before such date.
       (b) Ratification of Actions During Period of Lapsed 
     Authority.--Any action of the Secretary of Veterans Affairs 
     under section 1710(e) of title 38, United States Code, during 
     the period beginning on July 1, 1994, and ending on the date 
     of the enactment of this Act is hereby ratified.
                    TITLE III--READJUSTMENT SERVICES

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

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

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

       (a) In General.--(1) Subchapter III of chapter 5 is amended 
     by adding at the end the following new section:

     ``Sec. 544. Advisory Committee on Veterans Readjustment 
       Counseling

       ``(a)(1) There is in the Department the Advisory Committee 
     on Veterans Readjustment Counseling (hereinafter in this 
     section referred to as the `Committee').
       ``(2) The Committee shall consist of 18 members. The 
     members of the Committee shall be appointed by the Secretary 
     and shall include individuals who are recognized authorities 
     in fields pertinent to the social, psychological, economic, 
     or educational readjustment of veterans. An officer or 
     employee of the United States may not be appointed as a 
     member of the Committee. At least 12 members of the Committee 
     shall be veterans of the Vietnam era or other period of war. 
     Appointments of members of the Committee shall be made from 
     among individuals who have experience with the provision of 
     veterans benefits and services by the Department or who are 
     otherwise familiar with programs of the Department.
       ``(3) The Secretary shall seek to ensure that members 
     appointed to the Committee include persons from a wide 
     variety of geographic areas and ethnic backgrounds, persons 
     from veterans service organizations, minorities, and women.
       ``(4) The Secretary shall determine the terms of service 
     and pay and allowances of the members of the Committee, 
     except that a term of service may not exceed two years. The 
     Secretary may reappoint any member for additional terms of 
     service.
       ``(b)(1) The Secretary shall, on a regular basis, consult 
     with and seek the advice of the Committee with respect to the 
     provision by the Department of benefits and services to 
     veterans in order to assist veterans in the readjustment to 
     civilian life.
       ``(2) In providing advice to the Secretary under this 
     subsection, the Committee shall--
       ``(A) assemble and review information relating to the needs 
     of veterans in readjusting to civilian life;
       ``(B) provide information relating to the nature and 
     character of psychological problems arising from military 
     service;
       ``(C) provide an on-going assessment of the effectiveness 
     of the policies, organizational structures, and services of 
     the Department in assisting veterans in readjusting to 
     civilian life; and
       ``(D) provide on-going advice on the most appropriate means 
     of responding to the readjustment needs of future veterans.
       ``(3) In carrying out its duties under paragraph (2), the 
     Committee shall take into special account veterans of the 
     Vietnam era and the readjustment needs of those veterans.
       ``(c)(1) Not later than March 31 of each year, the 
     Committee shall submit to the Secretary a report on the 
     programs and activities of the Department that relate to the 
     readjustment of veterans to civilian life. Each such report 
     shall include--
       ``(A) an assessment of the needs of veterans with respect 
     to readjustment to civilian life;
       ``(B) a review of the programs and activities of the 
     Department designed to meet such needs; and
       ``(C) such recommendations (including recommendations for 
     administrative and legislative action) as the Committee 
     considers appropriate.
       ``(2) Not later than 90 days after the receipt of each 
     report under paragraph (1), the Secretary shall transmit to 
     the Committees on Veterans' Affairs of the Senate and House 
     of Representatives a copy of the report, together with any 
     comments and recommendations concerning the report that the 
     Secretary considers appropriate.
       ``(3) The Committee may also submit to the Secretary such 
     other reports and recommendations as the Committee considers 
     appropriate.
       ``(4) The Secretary shall submit with each annual report 
     submitted to the Congress pursuant to section 529 of this 
     title a summary of all reports and recommendations of the 
     Committee submitted to the Secretary since the previous 
     annual report of the Secretary submitted pursuant to that 
     section.''.
       (2) The table of sections at the beginning of chapter 5 is 
     amended by adding at the end the following new item:

``544. Advisory Committee on Veterans Readjustment Counseling.''.

       (b) Original Members.--(1) Notwithstanding subsection 
     (a)(2) of section 544 of title 38, United States Code (as 
     added by subsection (a)), the members of the Advisory 
     Committee on the Readjustment of Vietnam and Other War 
     Veterans on the date of the enactment of this Act shall be 
     the original members of the advisory committee established 
     under that section.
       (2) The original members shall so serve until the Secretary 
     of Veterans Affairs carries out appointments under such 
     subsection (a)(2). The Secretary shall carry out such 
     appointments as soon as is practicable. The Secretary may 
     make such appointments from among such original members.

     SEC. 303. PLAN FOR EXPANSION OF VIETNAM VETERAN RESOURCE 
                   CENTERS PILOT PROGRAM.

       (a) Plan.--The Secretary of Veterans Affairs shall submit 
     to the Committees on Veterans' Affairs of the Senate and 
     House of Representatives a plan for expansion of the Vietnam 
     Veteran Resource Centers program established by section 105 
     of Public Law 99-166. The plan submitted shall be a plan 
     which the Secretary would implement if resources for such 
     implementation were available.
       (b) Submission of Plan.--The plan, together with an 
     analysis setting forth in detail the resources required for 
     the implementation of the plan, shall be submitted under 
     subsection (a) not later than four months after the date of 
     the enactment of this Act.

     SEC. 304. ORGANIZATIONAL AUTONOMY OF THE READJUSTMENT 
                   COUNSELING SERVICE.

       (a) Establishment of RCS By Law.--Section 7305 is amended--
       (1) by redesignating paragraph (7) as paragraph (8); and
       (2) by inserting after paragraph (6) the following new 
     paragraph (7):
       ``(7) A Readjustment Counseling Service.''.
       (b) Director of RCS.--Section 7306(a) is amended by 
     inserting after paragraph (5) the following:
       ``(6) A Director of Readjustment Counseling Service.''.
       (c) Administration of RCS.--(1) Subchapter II of chapter 73 
     is amended by adding after section 7319, as added by section 
     104(a), the following new section:

     ``Sec. 7320. Readjustment Counseling Service: administration

       ``(a) Except as provided in subsection (b), the Secretary 
     shall administer the Readjustment Counseling Service through 
     an organization which involves a direct line of authority 
     from centers described in section 1712A of this title through 
     an official charged with administration and oversight of the 
     provision of readjustment counseling services within a 
     geographic region, to the Director of the Readjustment 
     Counseling Service.
       ``(b)(1) The Secretary may not alter or revise the 
     organizational structure of the readjustment counseling 
     service from one which involves a direct line of authority as 
     described in subsection (a) until--
       ``(A) the Secretary submits to the Committees on Veterans' 
     Affairs of the Senate and House of Representatives a report 
     containing a full and complete statement of the proposed 
     alteration or revision; and
       ``(B) a period of 45 days has elapsed after the date on 
     which the report is received by the committees.
       ``(2) In the computation of the 45-day period under 
     paragraph (1)(B), there shall be excluded any day on which 
     either House of Congress is not in session because of an 
     adjournment of more than three calendar days to a day 
     certain.
       ``(c) Budget Autonomy.--Each budget submitted to Congress 
     by the President under section 1105 of title 31 shall set 
     forth the amount requested in the budget for the operation of 
     the Readjustment Counseling Service in the fiscal year 
     covered by the budget.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     7319, as added by section 104(a), the following new item:

``7320. Readjustment Counseling Service: administration.''.

     SEC. 305. REPORT ON COLLOCATION OF VET CENTERS AND DEPARTMENT 
                   OF VETERANS AFFAIRS OUTPATIENT CLINICS.

       (a) Requirement.--The Secretary of Veterans Affairs shall 
     submit to the Committees on Veterans' Affairs of the Senate 
     and House of Representatives a report on the feasibility and 
     desirability of the collocation of Vet Centers and outpatient 
     clinics of the Department of Veterans Affairs as current 
     leases for such centers and clinics expire. The report shall 
     be submitted not later than one year after the date of the 
     enactment of this Act.
       (b) Covered Matters.--The report under this section shall 
     include an assessment of the following:
       (1) The results of any collocation of Vet Centers and 
     outpatient clinics carried out by the Secretary before the 
     date of the enactment of this Act, including the effects of 
     such collocation on the quality of care provided at such 
     centers and clinics.
       (2) The effect of such collocation on the capacity of such 
     centers to carry out their primary missions.
       (3) The extent to which such collocation might impair the 
     operational independence or administrative integrity of such 
     centers.
       (4) The feasibility of combining the services provided by 
     such centers and clinics in the course of the collocation of 
     such centers and clinics.
       (5) The advisability of the collocation of centers and 
     clinics of significantly different size.
       (6) The effect of the locations (including urban and rural 
     locations) of the centers and clinics on the feasibility and 
     desirability of such collocation.
       (7) The amount of any costs savings to be achieved by 
     Department as a result of such collocation.
       (8) The desirability of such collocation in light of plans 
     for the provision of health care services by the Department 
     under national health care reform.
       (9) Any other matter that the Secretary determines 
     appropriate.
       (c) Definition.--For purposes of this section, the term 
     ``Vet Centers'' means centers which are operated by the 
     Secretary of Veterans Affairs for the provision of services 
     under section 1712A of title 38, United States Code.

     SEC. 306. BEREAVEMENT COUNSELING FOR DEATHS ON ACTIVE DUTY.

       (a) Statutory Reorganization.--Subchapter I of chapter 17 
     is amended--
       (1) in section 1701(6) (as amended by section 103(a)(1))--
       (A) by striking out subparagraph (B) and the sentence 
     following that subparagraph; and
       (B) by striking out subparagraph (A) and inserting in lieu 
     thereof the following:
       ``(A) surgical services;
       ``(B) dental services and appliances as described in 
     sections 1710 and 1712 of this title;
       ``(C) optometric and podiatric services;
       ``(D) preventive health services (in the case of a person 
     otherwise receiving care or services under this chapter);
       ``(E) women's health services;
       ``(F) except under the conditions described in section 
     1712(a)(5)(A) of this title, wheelchairs, artificial limbs, 
     trusses, and similar appliances;
       ``(G) special clothing made necessary by the wearing of 
     prosthetic appliances;
       ``(H) such other supplies or services as the Secretary 
     determines to be reasonable and necessary; and
       ``(I) travel and incidental expenses pursuant to the 
     provisions of section 111 of this title.''; and
       (2) by adding at the end of such subchapter the following 
     new section:

     ``Sec. 1705. Counseling, training, and mental health services 
       for immediate family members; bereavement counseling

       ``(a)(1) In the case of a veteran who is receiving 
     treatment for a service-connected disability pursuant to 
     section 1712(a) of this title, the Secretary shall provide to 
     individuals described in paragraph (3) such consultation, 
     professional counseling, training, and mental health services 
     as are necessary in connection with that treatment.
       ``(2) In the case of a veteran who is eligible to receive 
     treatment for a non-service-connected disability under the 
     conditions described in section 1712(a)(5)(B) of this title, 
     the Secretary may, in the discretion of the Secretary, 
     provide to individuals described in paragraph (3) such 
     consultation, professional counseling, training, and mental 
     health services as are necessary in connection with that 
     treatment if--
       ``(A) those services were initiated during the veteran's 
     hospitalization; and
       ``(B) the continued provision of those services on an 
     outpatient basis is essential to permit the discharge of the 
     veteran from the hospital.
       ``(3) Individuals who may be provided services under this 
     subsection are--
       ``(A) the members of the immediate family or the legal 
     guardian of a veteran; or
       ``(B) the individual in whose household such veteran 
     certifies an intention to live.
       ``(b)(1) In the case of an individual who was a recipient 
     of services under subsection (a) at the time of the death of 
     the veteran, the Secretary may provide bereavement counseling 
     to that individual in the case of a death--
       ``(A) that was unexpected; or
       ``(B) that occurred while the veteran was participating in 
     a hospice program (or a similar program) conducted by the 
     Secretary.
       ``(2) The Secretary may provide bereavement counseling to 
     an individual who is a member of the immediate family of a 
     member of the Armed Forces who dies in the active military, 
     naval, or air service in the line of duty and under 
     circumstances not due to the person's own misconduct.
       ``(3) For purposes of this subsection, the term 
     `bereavement counseling' means such counseling services, for 
     a limited period, as the Secretary determines to be 
     reasonable and necessary to assist an individual with the 
     emotional and psychological stress accompanying the death of 
     another individual.
       ``(c) Services provided under subsection (a) may include, 
     under the terms and conditions set forth in section 111 of 
     this title, travel and incidental expenses of individuals 
     described in subsection (a)(3) in the case of--
       ``(1) a veteran who is receiving care for a service-
     connected disability; and
       ``(2) a dependent or survivor receiving care under the last 
     sentence of section 1713(b) of this title.''.
       (b) Conforming Amendment.--Section 1713(b) is amended by 
     adding at the end the following new sentence: ``A dependent 
     or survivor receiving care under the preceding sentence shall 
     be eligible for the same medical services as a veteran.''.
       (c) Clerical Amendment.--The table of sections at the 
     beginning of chapter 17 is amended by inserting after the 
     item relating to section 1704 the following new item:

``1705. Counseling, training, and mental health services for immediate 
              family members; bereavement counseling.''.
              TITLE IV--SERVICES FOR MENTALLY ILL VETERANS

     SEC. 401. AUTHORITY TO ESTABLISH NONPROFIT CORPORATIONS.

       (a) In General.--Chapter 17 is amended by inserting after 
     section 1718 the following new section:

     ``Sec. 1718A. Nonprofit corporations

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

``1718A. Nonprofit corporations.''.

     SEC. 402. EXTENSION OF DEMONSTRATION PROGRAM.

       Section 7(a) of Public Law 102-54 (105 Stat. 269; 38 U.S.C. 
     1718 note) is amended by striking out ``1994'' and inserting 
     in lieu thereof ``1998''.

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

       (a) Establishment.--Subchapter II of chapter 73 is amended 
     by adding after section 7320, as added by section 304(c), the 
     following new section:

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

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

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

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

       (a) In General.--(1) Subchapter II of chapter 73 is amended 
     by adding after section 7321, as added by section 403(a), the 
     following new section:

     ``Sec. 7322. Centers for mental illness research, education, 
       and clinical activities

       ``(a) The purpose of this section is to provide for the 
     improvement of the provision of health-care services and 
     related counseling services to eligible veterans suffering 
     from serious mental illness (especially mental illness 
     related to service-related conditions) through--
       ``(1) the conduct of research (including research on 
     improving mental health service facilities of the Department 
     and on improving the delivery of mental health services by 
     the Department);
       ``(2) the education and training of health care personnel 
     of the Department; and
       ``(3) the development of improved models and systems for 
     the furnishing of mental health services by the Department.
       ``(b)(1) The Secretary shall establish and operate centers 
     for mental illness research, education, and clinical 
     activities. Such centers shall be established and operated by 
     collaborating Department facilities as provided in subsection 
     (c)(1). Each such center shall function as a center for--
       ``(A) research on mental health services;
       ``(B) the use by the Department of specific models for 
     furnishing services to treat serious mental illness;
       ``(C) education and training of health-care professionals 
     of the Department; and
       ``(D) the development and implementation of innovative 
     clinical activities and systems of care with respect to the 
     delivery of such services by the Department.
       ``(2) The Secretary shall, upon the recommendation of the 
     Under Secretary for Health, designate the centers under this 
     section. In making such designations, the Secretary shall 
     ensure that the centers designated are located in various 
     geographic regions of the United States. The Secretary may 
     designate a center under this section only if--
       ``(A) the proposal submitted for the designation of the 
     center meets the requirements of subsection (c);
       ``(B) the Secretary makes the finding described in 
     subsection (d); and
       ``(C) the peer review panel established under subsection 
     (e) makes the determination specified in subsection (e)(3) 
     with respect to that proposal.
       ``(3) Not more than five centers may be designated under 
     this section.
       ``(4) The authority of the Secretary to establish and 
     operate centers under this section is subject to the 
     appropriation of funds for that purpose.
       ``(c) A proposal submitted for the designation of a center 
     under this section shall--
       ``(1) provide for close collaboration in the establishment 
     and operation of the center, and for the provision of care 
     and the conduct of research and education at the center, by a 
     Department facility or facilities in the same geographic area 
     which have a mission centered on care of the mentally ill and 
     a Department facility in that area which has a mission of 
     providing tertiary medical care;
       ``(2) provide that no less than 50 percent of the funds 
     appropriated for the center for support of clinical care, 
     research, and education will be provided to the collaborating 
     facility or facilities that have a mission centered on care 
     of the mentally ill; and
       ``(3) provide for a governance arrangement between the 
     collaborating Department facilities which ensures that the 
     center will be established and operated in a manner aimed at 
     improving the quality of mental health care at the 
     collaborating facility or facilities which have a mission 
     centered on care of the mentally ill.
       ``(d) The finding referred to in subsection (b)(2)(B) with 
     respect to a proposal for designation of a site as a location 
     of a center under this section is a finding by the Secretary, 
     upon the recommendation of the Under Secretary for Health, 
     that the facilities submitting the proposal have developed 
     (or may reasonably be anticipated to develop) each of the 
     following:
       ``(1) An arrangement with an accredited medical school that 
     provides education and training in psychiatry and with which 
     one or more of the participating Department facilities is 
     affiliated under which medical residents receive education 
     and training in psychiatry through regular rotation through 
     the participating Department facilities so as to provide such 
     residents with training in the diagnosis and treatment of 
     mental illness.
       ``(2) An arrangement with an accredited graduate school of 
     psychology under which students receive education and 
     training in clinical, counseling, or professional psychology 
     through regular rotation through the participating Department 
     facilities so as to provide such students with training in 
     the diagnosis and treatment of mental illness.
       ``(3) An arrangement under which nursing, social work, or 
     allied health personnel receive training and education in 
     mental health care through regular rotation through the 
     participating Department facilities.
       ``(4) The ability to attract scientists who have 
     demonstrated creativity and achievement in research--
        ``(A) into the evaluation of innovative approaches to the 
     design of mental health services; or
       ``(B) into the causes, prevention, and treatment of mental 
     illness.
       ``(5) The capability to evaluate effectively the activities 
     of the center, including activities relating to the 
     evaluation of specific efforts to improve the quality and 
     effectiveness of mental health services provided by the 
     Department at or through individual facilities.
       ``(e)(1) In order to provide advice to assist the Secretary 
     and the Under Secretary for Health to carry out their 
     responsibilities under this section, the official within the 
     central office of the Veterans Health Administration 
     responsible for mental health and behavioral sciences matters 
     shall establish a peer review panel to assess the scientific 
     and clinical merit of proposals that are submitted to the 
     Secretary for the designation of centers under this section.
       ``(2) The panel shall consist of experts in the fields of 
     mental health research, education and training, and clinical 
     care. Members of the panel shall serve as consultants to the 
     Department.
       ``(3) The panel shall review each proposal submitted to by 
     the official referred to in paragraph (1) and shall submit to 
     that official its views on the relative scientific and 
     clinical merit of each such proposal. The panel shall 
     specifically determine with respect to each such proposal 
     whether that proposal is among those proposals which have met 
     the highest competitive standards of scientific and clinical 
     merit.
       ``(4) The panel shall not be subject to the Federal 
     Advisory Committee Act (5 U.S.C. App.).
       ``(f) Clinical and scientific investigation activities at 
     each center established under this section--
       ``(1) may compete for the award of funding from amounts 
     appropriated for the Department of Veterans Affairs medical 
     and prosthetics research account; and
       ``(2) shall receive priority in the award of funding from 
     such account insofar as funds are awarded to projects and 
     activities relating to serious mental illness.
       ``(g) The Under Secretary for Health shall ensure that at 
     least three centers designated under this section emphasize 
     research into means of improving the quality of care for 
     veterans suffering from serious and persistent mental illness 
     through the development of community-based alternatives to 
     institutional treatment for such illness.
       ``(h) The Under Secretary for Health shall ensure that 
     information produced by the research, education and training, 
     and clinical activities of centers established under this 
     section that may be useful for other activities of the 
     Veterans Health Administration is disseminated throughout the 
     Veterans Health Administration. Such dissemination shall be 
     made through publications, through programs of continuing 
     medical and related education provided through regional 
     medical education centers under subchapter VI of chapter 74 
     of this title, and through other means. Such programs of 
     continuing medical education shall receive priority in the 
     award of funding.
       ``(i) The official within the central office of the 
     Veterans Health Administration responsible for mental health 
     and behavioral sciences matters shall be responsible for 
     supervising the operation of the centers established pursuant 
     to this section and shall provide for ongoing evaluation of 
     the centers and their compliance with the requirements of 
     this section.
       ``(j)(1) There are authorized to be appropriated to the 
     Department of Veterans Affairs for the basic support of the 
     research and education and training activities of centers 
     established pursuant to this section amounts as follows:
       ``(A) $3,125,000 for fiscal year 1996.
       ``(B) $6,250,000 for each of fiscal years 1997 through 
     1999.
       ``(2) In addition to funds appropriated for a fiscal year 
     pursuant to the authorization of appropriations in paragraph 
     (1), the Under Secretary for Health shall allocate to such 
     centers from other funds appropriated for that fiscal year 
     generally for the Department of Veterans Affairs medical care 
     account and the Department of Veterans Affairs medical and 
     prosthetics research account such amounts as the Under 
     Secretary for Health determines appropriate to carry out the 
     purposes of this section.''.
       (2) The table of sections at the beginning of chapter 73 is 
     amended by inserting after the item relating to section 7321, 
     as added by section 403(b), the following new item:

``7322. Centers for mental illness research, education, and clinical 
              activities.''.

       (b) Annual Reports.--Not later than February 1 of each of 
     1996, 1997, and 1998, the Secretary of Veterans Affairs shall 
     submit to the Committees on Veterans' Affairs of the Senate 
     and House of Representatives a report on the status and 
     activities during the previous fiscal year of the centers for 
     mental illness, research, education, and clinical activities 
     established pursuant to section 7322 of title 38, United 
     States Code (as added by subsection (a)). Each such report 
     shall include the following:
       (1) A description of the activities carried out at each 
     center and the funding provided for such activities.
       (2) A description of the advances made at each of the 
     participating facilities of the center in research, education 
     and training, and clinical activities relating to serious 
     mental illness in veterans.
       (3) A description of the actions taken by the Under 
     Secretary for Health pursuant to subsection (h) of that 
     section (as so added) to disseminate information derived from 
     such activities throughout the Veterans Health 
     Administration.
       (4) The Secretary's evaluations of the effectiveness of the 
     centers in fulfilling the purposes of the centers.
       (c) Implementation.--The Secretary of Veterans Affairs 
     shall designate at least one center under section 7322 of 
     title 38, United States Code, not later than January 1, 1996.

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

       (a) In General.--Subchapter II of chapter 17 is amended by 
     adding at the end the following:

     ``Sec. 1720E. Community-based residential care: homeless 
       chronically mentally ill veterans and other veterans

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

``1720E. Community-based residential care: homeless chronically 
              mentally ill veterans and other veterans.''.

       (c) Repeal of Superseded Authority.--Section 115 of the 
     Veterans' Benefits and Services Act of 1988 (38 U.S.C. 1712 
     note) is repealed.
            TITLE V--CONSTRUCTION PLANNING AND AUTHORIZATION

     SEC. 501. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS 
                   AND MAJOR MEDICAL FACILITY LEASES.

       (a) Projects Authorized.--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. The authorization in the preceding sentence applies to 
     projects and leases which have not been authorized, or for 
     which funds have not been appropriated, in any fiscal year 
     before fiscal year 1995 and to projects and leases which have 
     been authorized, or for which funds were appropriated, in 
     fiscal years before fiscal year 1995.
       (b) Additional Projects.--(1) In addition to the projects 
     authorized in subsection (a), the Secretary may carry out the 
     following major medical facility projects in the amounts 
     specified for such projects:
       (A) The projects that are proposed in the documents 
     submitted to Congress by the Secretary of Veterans Affairs in 
     conjunction with the budget of the President for fiscal year 
     1995 to be financed with funds from the proposed Health Care 
     Investment Fund.
       (B) Construction of a nursing home facility at the 
     Department of Veterans Affairs Medical Center in Charleston, 
     South Carolina, in the amount of $7,300,000.
       (C) Construction of an outpatient care addition at the 
     Department of Veterans Affairs medical center in Phoenix, 
     Arizona, in the amount of $50,000,000.
       (D) A lease/purchase of a nursing home facility near Fort 
     Myers, Florida, in the amount of $12,800,000.
       (2) The authorizations in paragraph (1) apply to projects 
     which have not been authorized, or for which funds have not 
     been appropriated, in any fiscal year before fiscal year 1995 
     and to projects which have been authorized, or for which 
     funds were appropriated, in fiscal years before fiscal year 
     1995.
       (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 chapter 7 of 
     the Emergency Supplemental Appropriations Act of 1994 (title 
     I of Public Law 103-211; 108 Stat. 10) 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. 502. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There are authorized to be appropriated to 
     the Secretary of Veterans Affairs for fiscal year 1995--
       (1) $379,370,000 for the major medical facility projects 
     authorized in subsections (a), (b), and (c) of section 501; 
     and
       (2) $15,800,000 for the major medical facility leases 
     authorized in section 501(a).
       (b) Limitation.--The projects authorized in subsections (a) 
     and (b) of section 501 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 501 may only be 
     carried out using--
       (1) funds appropriated to the Construction, Major Projects 
     account under chapter 7 of the Emergency Supplemental 
     Appropriations Act of 1994 (title I of Public Law 103-211; 
     108 Stat. 10) and funds transferred by the President to the 
     Construction, Major Projects account pursuant to chapter 8 of 
     that Act (108 Stat. 14);
       (2) funds appropriated to the Medical Care account by 
     chapter 7 of the Emergency Supplemental Appropriations Act of 
     1994 that are transferred to the Construction, Major Projects 
     account;
       (3) funds appropriated to the Construction, Major Projects 
     account for a fiscal year before fiscal year 1995 that remain 
     available for obligation; and
       (4) funds appropriated to the Construction, Major Projects 
     account for fiscal year 1995 for a category of activity not 
     specific to a project.

     SEC. 503. REVISION TO PROSPECTUS REQUIREMENTS.

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

     SEC. 504. ANNUAL COMPILATION OF CONSTRUCTION PRIORITIES.

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

     SEC. 601. ASSISTANCE IN THE PAYMENT OF EDUCATION DEBTS 
                   INCURRED BY CERTAIN VETERANS HEALTH 
                   ADMINISTRATION EMPLOYEES.

       (a) Program.--(1) Chapter 76 is amended by adding at the 
     end the following new subchapter:

           ``SUBCHAPTER VI--EDUCATION DEBT REDUCTION PROGRAM

     ``Sec. 7661. Authority for program

       ``(a) The Secretary shall carry out an education debt 
     reduction program under this subchapter. The program shall be 
     known as the Department of Veterans Affairs Education Debt 
     Reduction Program. The purpose of the program is to assist 
     individuals serving in health-care positions in the Veterans 
     Health Administration in reducing the amount of debt incurred 
     by such individuals in completing educational programs that 
     qualify those individuals for such service.
       ``(b)(1) Subject to paragraph (2), assistance under the 
     Education Debt Reduction Program shall be in addition to the 
     assistance available to individuals under the Educational 
     Assistance Program established under this chapter.
       ``(2) An individual may not receive assistance under both 
     the Education Debt Reduction Program and the Educational 
     Assistance Program for the same period of service in the 
     Department.

     ``Sec. 7662. Eligibility; application

       ``(a) An individual eligible to participate in the 
     Education Debt Reduction Program is any individual (other 
     than a physician or dentist) who--
       ``(1) serves in a position in the Veterans Health 
     Administration under an appointment under section 7402(b) of 
     this title;
       ``(2) serves in an occupation, specialty, or geographic 
     area for which the recruitment or retention of an adequate 
     supply of qualified health-care personnel is especially 
     difficult (as determined by the Secretary);
       ``(3) has pursued or is pursuing, as the case may be--
       ``(A) a two-year or four-year course of education or 
     training at a qualifying undergraduate institution which 
     course qualified or will qualify, as the case may be, the 
     individual for appointment in a position referred to in 
     paragraph (1); or
       ``(B) a course of education at a qualifying graduate 
     institution which course qualified or will qualify, as the 
     case may be, the individual for appointment in such a 
     position; and
       ``(4) owes any amount of principal or interest under a loan 
     or other obligation the proceeds of which were used or are 
     being used, as the case may be, by or on behalf of the 
     individual to pay tuition or other costs incurred by the 
     individual in the pursuit of a course of education or 
     training referred to in paragraph (3).
       ``(b) Any eligible individual seeking to participate in the 
     Education Debt Reduction Program shall submit an application 
     to the Secretary relating to such participation.

     ``Sec. 7663. Agreement

       ``(a) The Secretary shall enter into an agreement with each 
     individual selected to participate in the Education Debt 
     Reduction Program. The Secretary and the individual shall 
     enter into such an agreement at the beginning of each year 
     for which the individual is selected to so participate.
       ``(b) An agreement between the Secretary and an individual 
     selected to participate in the Education Debt Reduction 
     Program shall be in writing, shall be signed by the 
     individual, and shall include the following provisions:
       ``(1) The Secretary's agreement to provide assistance on 
     behalf of the individual under the program upon the 
     completion by the individual of a one-year period of service 
     in a position referred to in section 7662(a) of this title 
     which period begins on the date of the signing of the 
     agreement (or such later date as is jointly agreed upon by 
     the Secretary and the individual).
       ``(2) The individual's agreement that the Secretary shall 
     pay any assistance provided under the program to the holder 
     (as designated by the individual) of any loan or other 
     obligation of the individual referred to in section 
     7662(a)(4) of this title in order to reduce or satisfy the 
     unpaid balance (including principal and interest) due on such 
     loan or other obligation.
       ``(3) The individual's agreement that assistance shall not 
     be paid on behalf of the individual under the program for a 
     year unless and until the individual completes the one-year 
     period of service referred to in paragraph (1).
       ``(4) The individual's agreement that assistance shall not 
     be paid on behalf of the individual under the program for a 
     year unless the individual maintains (as determined by the 
     Secretary) an acceptable level of performance during the 
     service referred to in paragraph (3).

     ``Sec. 7664. Amount of assistance

       ``(a) Subject to subsection (b), the amount of assistance 
     provided to an individual under the Education Debt Reduction 
     Program for a year may not exceed $4,000 (adjusted in 
     accordance with section 7631 of this title).
       ``(b) The total amount of assistance received by an 
     individual under the Education Debt Reduction Program may not 
     exceed $12,000 (as so adjusted).''.
       (2) The table of sections at the beginning of such chapter 
     is amended by adding at the end the following:

           ``SUBCHAPTER VI--EDUCATION DEBT REDUCTION PROGRAM

``7661. Authority for program.
``7662. Eligibility; application.
``7663. Agreement.
``7664. Amount of assistance.''.

       (b) Conforming Amendments.--Section 7631 is amended--
       (1) in subsection (a), by striking out ``and the maximum 
     Selected Reserve member stipend amount'' and inserting in 
     lieu thereof ``the maximum Selected Reserve stipend amount, 
     and the education debt reduction amount and limitation''; and
       (2) in subsection (b)--
       (A) by redesignating paragraph (4) as paragraph (5); and
       (B) by inserting after paragraph (3) the following new 
     paragraph (4):
       ``(4) The term `education debt reduction amount and 
     limitation' means the maximum amount of assistance, and the 
     limitation applicable to such assistance, for a person 
     receiving assistance under subchapter VI of this chapter, as 
     specified in section 7663 of this title and as previously 
     adjusted (if at all) in accordance with this subsection.''.
       (c) Regulations.--The Secretary of Veterans Affairs shall 
     prescribe regulations necessary to carry out the Education 
     Debt Reduction Program established under subchapter VI of 
     chapter 76 of title 38, United States Code (as added by 
     subsection (a)). Such regulations shall be prescribed not 
     later than 90 days after the date of the enactment of this 
     Act.
       (d) Report.--Section 7632 is amended--
       (1) in the matter preceding paragraph (1), by inserting 
     ``and the Education Debt Reduction Program'' before the 
     period at the end;
       (2) in paragraph (1)--
       (A) by inserting ``and the Education Debt Reduction 
     Program'' after ``Educational Assistance Program'';
       (B) by striking out ``Program and'' and inserting in lieu 
     thereof ``Program,''; and
       (C) by inserting ``, and the Education Debt Reduction 
     Program'' before ``separately'';
       (3) in paragraph (3), by striking out ``the Educational 
     Assistance Program (or predecessor program) has'' and 
     inserting in lieu thereof ``each of the Educational 
     Assistance Program (or predecessor program) and the Education 
     Debt Reduction Program have''; and
       (4) in paragraph (4)--
       (A) by striking out ``and per'' and inserting in lieu 
     thereof ``, per''; and
       (B) by inserting ``, and per participant in the Education 
     Debt Reduction Program'' before the period at the end.
       (e) Authorization of Appropriations.--(1) There is 
     authorized to be appropriated for the Department of Veterans 
     Affairs the amount of $10,000,000 for each of fiscal years 
     1994 through 1998 to carry out the Education Debt Reduction 
     Program.
       (2) No funds may be used to provide assistance under the 
     program unless expressly provided for in an appropriations 
     law.
       (f) Exemption From Limitation.--Section 523(b) of the 
     Veterans Health Care Act of 1992 (Public Law 102-585; 38 
     U.S.C. 7601 note) shall not apply to the Education Debt 
     Reduction Program.

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

       (a) Extension of Program.--Effective on October 1, 1994, 
     subsection (a) of section 1720C 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; 
     38 U.S.C. 1720C note) 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,''.

     SEC. 603. PER DIEM FOR ADULT DAY HEALTH CARE.

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

     SEC. 604. STATE HOME CONSTRUCTION ASSISTANCE PROGRAM.

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

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

       (b) Clerical Amendment.--The item relating to subchapter 
     III in the table of sections at the beginning of such chapter 
     is amended to read as follows:


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

       (c) Effective Date.--The amendments made by subsection (a) 
     shall apply with respect to grants made to States using funds 
     appropriated after the date of the enactment of this Act.

     SEC. 605. DEPARTMENT OF VETERANS AFFAIRS RESEARCH ADVISORY 
                   COMMITTEES.

       (a) Statutory Basis for Research Advisory Committees.--
     Subchapter III of chapter 5 is amended by adding after 
     section 544, as added by section 302(a), the following new 
     section:

     ``Sec. 545. Veterans research advisory committees

       ``(a) Congress declares that each of the veterans research 
     advisory committees specified in subsection (c) (previously 
     established by the Secretary in carrying out the duties of 
     the Secretary under section 7303 of this title) has a 
     continuing, ongoing function that is integrally related to 
     the successful completion by the Department of its statutory 
     duties. Each such committee shall, for all purposes, operate 
     as though such committee had been established by, and 
     chartered pursuant to, law. The objectives and scope of the 
     activities of each such committee and the duties for which 
     the committee is responsible, as specified by the Secretary 
     as of September 1, 1993, shall be those in effect as of that 
     date.
       ``(b) The Secretary may not terminate a veterans' research 
     advisory committee specified in subsection (c) unless the 
     Secretary finds that the committee is no longer needed. Not 
     less than 120 days before terminating such a committee, the 
     Secretary shall submit to the Committees on Veterans' Affairs 
     of the Senate and House of Representatives a report on the 
     proposed termination. The report shall include an explanation 
     of (1) the basis for the Secretary's determination that such 
     committee is no longer needed, and (2) the manner in which 
     the Secretary will carry out the Secretary's responsibilities 
     under section 7303 of this title in the absence of the 
     committee.
       ``(c) For purposes of this section, each of the following 
     committees and boards, as established by the Secretary as of 
     September 1, 1993, shall be considered to be a veterans' 
     research advisory committee:
       ``(1) The Career Development Committee.
       ``(2) The Department of Veterans Affairs Cooperative 
     Studies Evaluation Committee.
       ``(3) The Merit Review Board for Basic Sciences Programs.
       ``(4) The Merit Review Board for Cardiovascular Programs.
       ``(5) The Merit Review Board for Clinical Pharmacology, 
     Alcoholism, and Drug Dependence Programs.
       ``(6) The Merit Review Board for Endocrinology Programs.
       ``(7) The Merit Review Board for Gastroenterology Programs.
       ``(8) The Merit Review Board for Hematology Programs.
       ``(9) The Merit Review Board for Immunology Programs.
       ``(10) The Merit Review Board for Infectious Diseases 
     Programs.
       ``(11) The Merit Review Board for Mental Health and 
     Behavioral Sciences Programs.
       ``(12) The Merit Review Board for Nephrology Programs.
       ``(13) The Merit Review Board for Neurobiology Programs.
       ``(14) The Merit Review Board for Oncology Programs.
       ``(15) The Merit Review Board for Respiration Programs.
       ``(16) The Merit Review Board for Surgery Programs.
       ``(17) The Scientific Review and Evaluation Board for 
     Health Services Research and Development.
       ``(18) The Scientific Review and Evaluation Board for 
     Rehabilitation Research and Development.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 5 is amended by inserting after the item 
     relating to section 544, as added by section 302(a), the 
     following new item:

``545. Veterans research advisory committees.''.

     SEC. 606. CHILD CARE SERVICES.

       (a) Revised Child Care Authority.--Chapter 81 is amended by 
     inserting after section 8116 the following new section:

     ``Sec. 8117. Child care centers

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

``8117. Child care centers.''.

       (2) The table of sections at the beginning of chapter 78 is 
     amended by striking out the item relating to section 7809.

     SEC. 607. CONTRACTS FOR UTILITIES, AUDIE L. MURPHY MEMORIAL 
                   HOSPITAL.

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

     SEC. 608. FACILITIES IN REPUBLIC OF THE PHILIPPINES.

       Notwithstanding section 1724 of title 38, United States 
     Code, the Secretary of Veterans Affairs may contract with 
     facilities in the Republic of the Philippines other than the 
     Veterans Memorial Medical Center to furnish, during the 
     period from February 28, 1994, through June 1, 1994, 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 under the preceding sentence to such 
     veterans at the Department of Veterans Affairs Outpatient 
     Clinic at Manila, Republic of the Philippines.

     SEC. 609. TECHNICAL AMENDMENTS.

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

     SEC. 610. CENTER FOR MINORITY VETERANS AND CENTER FOR WOMEN 
                   VETERANS.

       (a) In General.--Chapter 3 is amended by striking out 
     section 317 and inserting in lieu thereof the following new 
     sections:

     ``Sec. 317. Center for Minority Veterans

       ``(a) There is in the Department a Center for Minority 
     Veterans. There is at the head of the Center a Director.
       ``(b) The Director shall be a noncareer appointee in the 
     Senior Executive Service. The Director shall be appointed for 
     a term of six years.
       ``(c) The Director reports directly to the Secretary or the 
     Deputy Secretary concerning the activities of the Center.
       ``(d) The Director shall perform the following functions 
     with respect to veterans who are minorities:
       ``(1) Serve as principal adviser to the Secretary on the 
     adoption and implementation of policies and programs 
     affecting veterans who are minorities.
       ``(2) Make recommendations to the Secretary, the Under 
     Secretary for Health, the Under Secretary for Benefits, and 
     other Department officials for the establishment or 
     improvement of programs in the Department for which veterans 
     who are minorities are eligible.
       ``(3) Promote the use of benefits authorized by this title 
     by veterans who are minorities and the conduct of outreach 
     activities to veterans who are minorities, in conjunction 
     with outreach activities carried out under chapter 77 of this 
     title.
       ``(4) Disseminate information and serve as a resource 
     center for the exchange of information regarding innovative 
     and successful programs which improve the services available 
     to veterans who are minorities.
       ``(5) Conduct and sponsor appropriate social and 
     demographic research on the needs of veterans who are 
     minorities and the extent to which programs authorized under 
     this title meet the needs of those veterans, without regard 
     to any law concerning the collection of information from the 
     public.
       ``(6) Analyze and evaluate complaints made by or on behalf 
     of veterans who are minorities about the adequacy and 
     timeliness of services provided by the Department and advise 
     the appropriate official of the Department of the results of 
     such analysis or evaluation.
       ``(7) Consult with, and provide assistance and information 
     to, officials responsible for administering Federal, State, 
     local, and private programs that assist veterans, to 
     encourage those officials to adopt policies which promote the 
     use of those programs by veterans who are minorities.
       ``(8) Advise the Secretary when laws or policies have the 
     effect of discouraging the use of benefits by veterans who 
     are minorities.
       ``(9) Publicize the results of medical research which are 
     of particular significance to veterans who are minorities.
       ``(10) Perform such other duties consistent with this 
     section as the Secretary shall prescribe.
       ``(e) The Secretary shall ensure that the Director is 
     furnished sufficient resources to enable the Director to 
     carry out the functions of the Center in a timely manner.
       ``(f) The Secretary shall include in documents submitted to 
     Congress by the Secretary in support of the President's 
     budget for each fiscal year--
       ``(1) detailed information on the budget for the Center;
       ``(2) the Secretary's opinion as to whether the resources 
     (including the number of employees) proposed in the budget 
     for that fiscal year are adequate to enable the Center to 
     comply with its statutory and regulatory duties; and
       ``(3) a report on the activities and significant 
     accomplishments of the Center during the preceding fiscal 
     year.

     ``Sec. 318. Center for Women Veterans

       ``(a) There is in the Department a Center for Women 
     Veterans. There is at the head of the Center a Director.
       ``(b) The Director shall be a noncareer appointee in the 
     Senior Executive Service. The Director shall be appointed for 
     a term of six years.
       ``(c) The Director reports directly to the Secretary or the 
     Deputy Secretary concerning the activities of the Center.
       ``(d) The Director shall perform the following functions 
     with respect to veterans who are women:
       ``(1) Serve as principal adviser to the Secretary on the 
     adoption and implementation of policies and programs 
     affecting veterans who are women.
       ``(2) Make recommendations to the Secretary, the Under 
     Secretary for Health, the Under Secretary for Benefits, and 
     other Department officials for the establishment or 
     improvement of programs in the Department for which veterans 
     who are women are eligible.
       ``(3) Promote the use of benefits authorized by this title 
     by veterans who are women and the conduct of outreach 
     activities to veterans who are women, in conjunction with 
     outreach activities carried out under chapter 77 of this 
     title.
       ``(4) Disseminate information and serve as a resource 
     center for the exchange of information regarding innovative 
     and successful programs which improve the services available 
     to veterans who are women.
       ``(5) Conduct and sponsor appropriate social and 
     demographic research on the needs of veterans who are women 
     and the extent to which programs authorized under this title 
     meet the needs of those veterans, without regard to any law 
     concerning the collection of information from the public.
       ``(6) Analyze and evaluate complaints made by or on behalf 
     of veterans who are women about the adequacy and timeliness 
     of services provided by the Department and advise the 
     appropriate official of the Department of the results of such 
     analysis or evaluation.
       ``(7) Consult with, and provide assistance and information 
     to, officials responsible for administering Federal, State, 
     local, and private programs that assist veterans, to 
     encourage those officials to adopt policies which promote the 
     use of those programs by veterans who are women.
       ``(8) Advise the Secretary when laws or policies have the 
     effect of discouraging the use of benefits by veterans who 
     are women.
       ``(9) Publicize the results of medical research which are 
     of particular significance to veterans who are women.
       ``(10) Advise the Secretary and other appropriate officials 
     on the effectiveness of the Department's efforts to 
     accomplish the goals of section 492B of the Public Health 
     Service Act (relating to the inclusion of women and 
     minorities in clinical research) and of particular health 
     conditions affecting womens' health which should be studied 
     as part of the Department's medical research program and 
     promote cooperation between the Department and other sponsors 
     of medical research of potential benefit to veterans who are 
     women.
       ``(11) Provide support and administrative services to the 
     Advisory Committee on Women Veterans established under 
     section 542 of this title.
       ``(12) Perform such other duties consistent with this 
     section as the Secretary shall prescribe.
       ``(e) The Secretary shall ensure that the Director is 
     furnished sufficient resources to enable the Director to 
     carry out the functions of the Center in a timely manner.
       ``(f) The Secretary shall include in documents submitted to 
     Congress by the Secretary in support of the President's 
     budget for each fiscal year--
       ``(1) detailed information on the budget for the Center;
       ``(2) the Secretary's opinion as to whether the resources 
     (including the number of employees) proposed in the budget 
     for that fiscal year are adequate to enable the Center to 
     comply with its statutory and regulatory duties; and
       ``(3) a report on the activities and significant 
     accomplishments of the Center during the preceding fiscal 
     year.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by striking out the item 
     relating to section 317 and and inserting in lieu thereof the 
     following new items:

``317. Center for Minority Veterans.
``318. Center for Women Veterans.''.

     SEC. 611. ADVISORY COMMITTEE ON MINORITY VETERANS.

       (a) Establishment.--Subchapter III of chapter 5 is amended 
     by adding after section 545, as added by section 605(a), the 
     following new section:

     ``Sec. 546. Advisory Committee on Minority Veterans

       ``(a)(1) The Secretary shall establish an advisory 
     committee to be known as the Advisory Committee on Minority 
     Veterans (hereinafter in this section referred to as `the 
     Committee').
       ``(2)(A) The Committee shall consist of members appointed 
     by the Secretary from the general public, including--
       ``(i) representatives of veterans who are minority group 
     members;
       ``(ii) individuals who are recognized authorities in fields 
     pertinent to the needs of veterans who are minority group 
     members;
       ``(iii) veterans who are minority group members and who 
     have experience in a military theater of operations; and
       ``(iv) veterans who are minority group members and who do 
     not have such experience.
       ``(B) The Committee shall include, as ex officio members, 
     the following:
       ``(i) The Secretary of Labor (or a representative of the 
     Secretary of Labor designated by the Secretary after 
     consultation with the Assistant Secretary of Labor for 
     Veterans' Employment).
       ``(ii) The Secretary of Defense (or a representative of the 
     Secretary of Defense designated by the Secretary of Defense).
       ``(iii) The Secretary of the Interior (or a representative 
     of the Secretary of the Interior designated by the Secretary 
     of the Interior).
       ``(iv) The Secretary of Commerce (or a representative of 
     the Secretary of Commerce designated by the Secretary of 
     Commerce).
       ``(v) The Secretary of Health and Human Services (or a 
     representative of the Secretary of Health and Human Services 
     designated by the Secretary of Health and Human Services).
       ``(vi) The Under Secretary for Health and the Under 
     Secretary for Benefits, or their designees.
       ``(C) The Secretary may invite representatives of other 
     departments and agencies of the United States to participate 
     in the meetings and other activities of the Committee.
       ``(3) The Secretary shall determine the number, terms of 
     service, and pay and allowances of members of the Committee 
     appointed by the Secretary, except that a term of service of 
     any such member may not exceed three years. The Secretary may 
     reappoint any such member for additional terms of service.
       ``(4) The Committee shall meet as often as the Secretary 
     considers necessary or appropriate, but not less often than 
     twice each fiscal year.
       ``(b) The Secretary shall, on a regular basis, consult with 
     and seek the advice of the Committee with respect to the 
     administration of benefits by the Department for veterans who 
     are minority group members, reports and studies pertaining to 
     such veterans and the needs of such veterans with respect to 
     compensation, health care, rehabilitation, outreach, and 
     other benefits and programs administered by the Department.
       ``(c)(1) Not later than July 1 of each year, the Committee 
     shall submit to the Secretary a report on the programs and 
     activities of the Department that pertain to veterans who are 
     minority group members. Each such report shall include--
       ``(A) an assessment of the needs of veterans who are 
     minority group members with respect to compensation, health 
     care, rehabilitation, outreach, and other benefits and 
     programs administered by the Department;
       ``(B) a review of the programs and activities of the 
     Department designed to meet such needs; and
       ``(C) such recommendations (including recommendations for 
     administrative and legislative action) as the Committee 
     considers appropriate.
       ``(2) The Secretary shall, within 60 days after receiving 
     each report under paragraph (1), submit to Congress a copy of 
     the report, together with any comments concerning the report 
     that the Secretary considers appropriate.
       ``(3) The Committee may also submit to the Secretary such 
     other reports and recommendations as the Committee considers 
     appropriate.
       ``(4) The Secretary shall submit with each annual report 
     submitted to the Congress pursuant to section 529 of this 
     title a summary of all reports and recommendations of the 
     Committee submitted to the Secretary since the previous 
     annual report of the Secretary submitted pursuant to such 
     section.
       ``(d) In this section, the term `minority group member' 
     means an individual who is--
       ``(1) Asian American;
       ``(2) Black;
       ``(3) Hispanic;
       ``(4) Native American (including American Indian, Alaskan 
     Native, and Native Hawaiian); or
       ``(5) Pacific-Islander American.
       ``(e) The Committee shall cease to exist December 31, 
     1997.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by adding after the item 
     relating to section 545, as added by section 605(b), the 
     following new item:

``546. Advisory Committee on Minority Veterans.''.

     SEC. 612. AUTHORITY TO ENTER INTO AGREEMENT FOR USE OF 
                   PROPERTY AT EDWARD HINES, JR., DEPARTMENT OF 
                   VETERANS AFFAIRS HOSPITAL.

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

     SEC. 613. COUNSELING SERVICES FOR POW/MIA FAMILY MEMBERS.

       (a) Authority.--The Secretary of Veterans Affairs may, in 
     accordance with arrangements described in subsection (c), 
     provide counseling services to the members of the immediate 
     family of a member of the Armed Forces who is a prisoner of 
     war or missing in action or who is an unaccounted-for POW/
     MIA.
       (b) Services Authorized.--Services authorized under this 
     section are such counseling services as the Secretary of 
     Veterans Affairs determines to be appropriate to assist 
     family members with the mental or psychological problems 
     associated with the status of the member as a prisoner of 
     war, missing in action, or an unaccounted-for POW/MIA.
       (c) Arrangements With Department of Defense.--Counseling 
     services under this section shall be provided in accordance 
     with arrangements between the Secretary of Veterans Affairs 
     and the Secretary of Defense. Such arrangements shall provide 
     for reimbursement in accordance with the methodology 
     described in section 8111(e) of title 38, United States Code. 
     The Secretary of Veterans Affairs may waive reimbursement 
     under this subsection if the Secretary determines that it 
     would not be cost-effective to attempt to secure such 
     reimbursement.
       (d) Definition.--For purposes of this section, the term 
     ``unaccounted-for POW/MIA'' means an individual who, as a 
     result of service in the Armed Forces, was at any time 
     classified as a prisoner of war or missing-in-action and 
     whose person or remains have not been returned to United 
     States control and who remains unaccounted for.

     SEC. 614. REVISION OF AUTHORITY ON USE OF TOBACCO PRODUCTS IN 
                   DEPARTMENT FACILITIES.

       Subsection (a) of section 526 of the Veterans Health Care 
     Act of 1992 (Public Law 102-585; 38 U.S.C. 1715 note) is 
     amended to read as follows:
       ``(a) In General.--(1) The Secretary of Veterans Affairs 
     shall ensure that each facility of the Department of Veterans 
     Affairs described in subsection (b) may establish and 
     maintain a smoking area for patients or residents of the 
     facility. Any such area shall be--
       ``(A) a suitable indoor area which is ventilated in a 
     manner that, to the maximum extent feasible, prevents smoke 
     from entering other areas of the facility; or
       ``(B) an area in a building that is detached from the 
     facility but that is accessible to patients or residents of 
     the facility and has appropriate heating and air 
     conditioning.
       ``(2) The Secretary shall ensure that access to a smoking 
     area established and maintained under paragraph (1) at a 
     Department facility is provided, consistent with medical 
     requirements and limitations, for patients or residents of 
     the facility who are receiving care or services at the 
     facility and who desire to use tobacco products.
       ``(3) The Secretary shall ensure that the establishment and 
     maintenance of smoking areas under paragraph (1) is carried 
     out in a manner consistent with medical requirements and 
     limitations.
       ``(4) The Secretary shall ensure that any facility that as 
     of the date of the enactment of the Veterans Health 
     Improvements Act of 1994 has established a smoking area under 
     this section shall continue to maintain such a smoking 
     area.''.

     SEC. 615. EXTENSION OF CERTAIN EXPIRING AUTHORITIES.

       (a) Drug and Alcohol Abuse and Dependence.--Section 
     1720A(e) is amended by striking out ``December 31, 1994'' and 
     inserting in lieu thereof ``December 31, 1997''.
       (b) Enhanced-Use Leases of Real Property.--Section 8169 is 
     amended by striking out ``December 31, 1994'' and inserting 
     in lieu thereof ``December 31, 1997''.

     SEC. 616. PROTECTION AGAINST CERTAIN PROHIBITED PERSONNEL 
                   PRACTICES.

       (a) In General.--Subchapter II of chapter 74 is amended by 
     adding at the end the following:

     ``Sec. 7427. Protection from prohibited personnel practices

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

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

     SEC. 617. PERMANENT AUTHORITY FOR WAIVER OF REDUCTION OF 
                   RETIREMENT PAY FOR REGISTERED-NURSE POSITIONS.

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

     SEC. 618. SUBMITTAL DATE FOR REPORT ON ANNUAL ANALYSIS OF 
                   DEPARTMENTWIDE ADMISSIONS POLICIES.

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

     SEC. 619. HEALTH CARE RESOURCES.

       (a) Section 8123 is amended--
       (1) by inserting ``(a)'' at the beginning of the text;
       (2) by inserting after subsection (a) the following:
       ``(b)(1) The director of a Department health care facility 
     located in a State that has established a State health care 
     reform plan may, without regard to section 1703 of this 
     title, or any other law or regulation pertaining to 
     competitive procedures, acquisition procedures, or policies 
     (other than contract dispute procedures), or bid protests, 
     contract with any entity or individual to procure or furnish 
     any health care resource, as that term is defined in section 
     8152 of this title. The references in this subsection to laws 
     or regulations shall not be construed to apply to any 
     provision of title XVIII or XIX of the Social Security Act.
       ``(2) A director may contract to furnish services under 
     this subsection to individuals who are not veterans or 
     enrollees in a health plan operated by the Secretary only if 
     the director has determined that a contract to furnish such 
     services--
       ``(A) is necessary to maintain an acceptable level and 
     quality of service to veterans at that facility;
       ``(B) will result in the improvement of services to 
     eligible veterans at that facility; and
       ``(C) will not result in the denial of, or a delay in 
     providing access to, care to any veteran at that facility.
       ``(3) In entering into a contract to provide services under 
     this subsection, the director shall require payment to the 
     Department in accordance with rates of payment sufficient to 
     recover the cost of the Department in providing services 
     under the contract. Any proceeds to the Government received 
     therefrom shall be credited to the applicable appropriation 
     of the Department and to funds that have been allotted to the 
     facility that furnished the care or services.
       ``(4) For purposes of this subsection, a State health care 
     reform plan shall be considered to have been established in a 
     State if the Secretary determines that the State has enacted 
     legislation that is intended, at least in part, to provide 
     residents of that State who lack, or have inadequate, health 
     insurance coverage access to health care services.
       ``(c) A provision of law enacted after the date of 
     enactment of this subsection shall not be construed as 
     applicable to purchases of prosthetic appliances or health 
     care resources by the Department unless that provision of law 
     specifically refers to this section and specifically states 
     that such provision of law modifies or supersedes this 
     section.
       ``(d) The authority to enter into a contract under 
     subsection (b) shall expire upon the expiration of the 
     authority of the Secretary to conduct pilot programs under 
     title VII of the Veterans Health Improvements Act of 1994.''.
       (b) Clerical Amendments.--
       (1) The heading of section 8123 is amended to read:

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

       (2) The table of sections at the beginning of chapter 81 is 
     amended by striking out the item relating to section 8123 and 
     inserting in lieu thereof the following:

``8123. Procurement of prosthetic appliances and health care 
              resources.''.
             TITLE VII--HEALTH CARE DELIVERY PILOT PROGRAM

     SEC. 701. PILOT PROGRAM AUTHORITY.

       (a) In General.--Subject to section 702, the Secretary of 
     Veterans Affairs may establish and operate a pilot program 
     under this title in any State that has established a State 
     comprehensive health benefit plan. Such a pilot program may 
     not be established in more than five States.
       (b) State Comprehensive Health Benefit Plan.--For purposes 
     of this title, a State comprehensive health benefit plan 
     shall be considered to have been established in a State if 
     the Secretary determines that the State has enacted 
     legislation which establishes a plan or program that is 
     intended to ensure access to comprehensive basic health care 
     benefits to all residents of the State who otherwise lack 
     such health care coverage.
       (c) Authorities Under Pilot Program.--Subject to subsection 
     (d), the Secretary, in carrying out a pilot program in a 
     State under this title, may--
       (1) establish and operate health plans, either 
     independently or through a joint venture with any health care 
     plan, insurer, or any other entity--
       (A) in accordance with the statutory requirements 
     applicable to the establishment and operation of a health 
     plan under the comprehensive health benefit plan of the State 
     in which the pilot program is carried out, and
       (B) through the provision of the required benefits to 
     persons eligible for such benefits under subsection (f) by 
     Department of Veterans Affairs health care facilities or by 
     contract;
       (2) conduct the pilot program in some or all Department of 
     Veterans Affairs health care facilities located in the State; 
     and
       (3) establish such coverage areas for participation in the 
     pilot programs as the Secretary determines appropriate.
       (d) Compliance With State Law.--In carrying out subsection 
     (c), the Secretary shall comply with applicable provisions of 
     State law, except that a State may not impose on a health 
     plan established under this section any standard or 
     requirement that--
       (1) would prevent the Secretary from establishing and 
     operating a plan solely because it is not open to all 
     residents of the State;
       (2) would require particular health care personnel employed 
     by the Secretary to be licensed in that State;
       (3) imposes reserve or reinsurance requirements, 
     requirements to purchase reinsurance coverage or financial 
     reporting requirements based on such requirements;
       (4) is based on a professional practice act of such State;
       (5) would limit the number of beds which the Secretary may 
     operate at any health care facility under the jurisdiction of 
     the Secretary;
       (6) would limit or restrict the Secretary from procuring 
     equipment or carrying out any construction work at a health 
     care facility under the jurisdiction of the Secretary; or
       (7) would require payment of any tax which is not based on 
     revenues generated from operating a health plan or which 
     imposes a discriminatory burden on a Department health plan.
       (e) Designation of States as Locations for Pilot 
     Programs.--(1) Not later than 45 days after the date of the 
     enactment of this Act, the Secretary shall (subject to 
     section 702) designate not less than two States as locations 
     for pilot programs under this title. The Secretary may 
     (subject to section 702) designate additional States (not in 
     excess of three) for locations for a pilot program under this 
     title. The Secretary shall seek to make any such designation 
     not later than the end of the 90-day period beginning on such 
     date of enactment. After the end of such period, the 
     Secretary may make such a designation of an additional State 
     only after--
       (A) the Secretary submits to the Committees on Veterans' 
     Affairs of the Senate and House of Representatives a report 
     stating that the Secretary intends to make such a designation 
     and setting forth the rationale for each proposed 
     designation; and
       (B) a period of 30 days of continuous session of Congress 
     has elapsed after the submission of the report under 
     subparagraph (A).
     For purposes of subparagraph (B), continuity of a session of 
     Congress is broken only by adjournment sine die, and there 
     shall be excluded from the computation of such 30-day period 
     any day during which either House of Congress is not in 
     session during an adjournment of more than three days to a 
     day certain.
       (2) In designating locations for pilot programs from among 
     States other than States described in paragraph (3), the 
     Secretary shall give preference to States with respect to 
     which the Secretary determines that the establishment and 
     operation of a pilot program in those States would result in 
     substantial collections by the United States under section 
     705(e) from sources such as employer contributions and 
     premium subsidy payments.
       (3)(A) In carrying out this title, the Secretary shall 
     (subject to subparagraph (C)) designate as a location for a 
     pilot program each State with respect to which the Secretary 
     has determined, based on factors that the Secretary considers 
     relevant (which shall include the factors specified in 
     subparagraph (B)) that a failure to establish a Department of 
     Veterans Affairs plan in that State would result in a decline 
     in the projected workload in one or more Department of 
     Veterans Affairs health care facilities in that State to such 
     an extent that the decline--
       (i) would threaten to impair the capability of those 
     facilities to meet one or more assigned missions; or
       (ii) would result in a deterioration in the quality of 
     service-delivery to a degree that it would not be reasonable 
     to continue to provide a needed service or services in such 
     facility or facilities.
       (B) Factors considered by the Secretary for purposes of 
     subparagraph (A) shall include--
       (i) the scope of benefits offered under the State 
     comprehensive health benefit plan; and
       (ii) the extent of financing supporting that plan.
       (C) If the Secretary makes a determination described in 
     subparagraph (A) with respect to more than five States, the 
     requirement in that subparagraph that each such State be 
     designated as a location for a pilot program shall not apply 
     and the Secretary shall designate five (rather than all) of 
     such States as locations for a pilot program.
       (f) Eligible Persons.--A person eligible for health care 
     benefits under a pilot program is any person residing within 
     the coverage area (as established by the Secretary under 
     subsection (c)(3)) of a Department health care facility which 
     the Secretary has designated for participation in the pilot 
     program as follows:
       (1) Any veteran.
       (2) Any spouse or child of a veteran who enrolls in a 
     Department of Veterans Affairs health plan.
       (3) Any individual eligible for care under paragraph (2) or 
     (3) of section 1713(a) of title 38, United States Code.
       (g) Copayments and Other Charges.--(1) Except as provided 
     in paragraph (2), the Secretary may collect from or on behalf 
     of any individual receiving health care benefits from the 
     Secretary under a pilot program under this title a premium, 
     deductible, copayment, or other charge with respect to the 
     provision of a benefit under the pilot program.
       (2) The following individuals who receive health care 
     benefits from the Secretary under a pilot program incur no 
     liability to pay a premium, deductible, copayment, or other 
     charge in connection with receiving such benefits:
       (A) A veteran with a compensable service-connected 
     disability.
       (B) A veteran whose discharge or release from active 
     military, naval, or air service was for a compensable 
     disability that was incurred or aggravated in the line of 
     duty.
       (C) A veteran who is in receipt of, or who, but for a 
     suspension pursuant to section 1151 of title 38, United 
     States Code (or both a suspension and the receipt of retired 
     pay), would be entitled to disability compensation, but only 
     to the extent that such veteran's continuing eligibility for 
     such care is provided for in the judgment or settlement 
     provided for in such section.
       (D) A veteran who is a former prisoner of war.
       (E) A veteran of the Mexican border period or of World War 
     I.
       (F) A veteran who is unable to defray the expenses of 
     necessary care, as determined in accordance with section 
     1722(a) of such title.
       (3) In no case shall an enrollee under a health plan 
     operated under this title be liable for unsatisfied claims 
     against such plan.

     SEC. 702. CONDITIONS OF PARTICIPATION.

       (a) In General.--The Secretary may establish and operate a 
     pilot program in a State under section 701 only if the 
     Secretary has done each of the following:
       (1) Taken action to ensure that in designing and 
     establishing a health plan under the pilot program, 
     provisions are made, to the extent feasible, for the 
     applicability and compatibility of data collection, services, 
     and other aspects of medical care and administration with 
     those of other Department health care facilities that are not 
     participants in the pilot program in that State.
       (2) Provided for an evaluation of the pilot program to 
     assess--
       (A) access to care;
       (B) cost of care;
       (C) patient satisfaction;
       (D) quality of care;
       (E) the ability of health plans under the pilot program to 
     attract enrollees; and
       (F) such other matters as the Secretary determines 
     appropriate.
       (3) Required the director of each medical center that is to 
     participate in the pilot program to establish, and to consult 
     regularly with, a committee, which shall include veteran and 
     other patient representatives, regarding the delivery of 
     services and the conduct of the pilot program.
       (b) Submission of Plan to Congress.--The Secretary may 
     implement a pilot program under section 701 only after the 
     Secretary submits to the Committees on Veterans' Affairs of 
     the Senate and House of Representatives a report on the 
     proposed plan.
       (c) Matters To Be Included in Report.--Each report under 
     subsection (b) shall include the following:
       (1) A detailed description of the rationale for proposed 
     participation in the State comprehensive health benefit plan.
       (2) A detailed business plan for the Department's 
     participation under the State comprehensive health benefits 
     plan.
       (3) A description of the actions the Secretary has taken to 
     consult with veterans on the Department's proposed 
     participation in the State comprehensive health benefit plan.
       (4) A description of the provisions the Secretary has made 
     to ensure the fiscal solvency of the proposed pilot programs.
       (d) Retention of Specialized Capacities.--In carrying out 
     the pilot programs, the Secretary shall ensure that the 
     Department maintains its capacity to provide for the 
     specialized treatment and rehabilitative needs of disabled 
     veterans described in section 1710(a) of title 38, United 
     States Code, including veterans with spinal cord dysfunction, 
     blindness, and mental illness.

     SEC. 703. OPERATION OF PILOT PROGRAMS.

       (a) Delegation of Authority.--Not later than 30 days after 
     the date of the enactment of this Act, the Secretary, with 
     respect to the authority of the Secretary to operate pilot 
     programs under this title in those States in which pilot 
     program are established--
       (1) shall delegate, to the maximum extent feasible, 
     authority for the operation of that pilot program to an 
     official described in subsection (e)(1);
       (2) shall delegate in full the authority of the Secretary 
     under subsection (f)(2); and
       (3) shall delegate so much of the authority of the 
     Secretary under subsection (f)(1) as is applicable to an 
     administrative reorganization concerning a medical facility 
     of the Department in that State which does not result--
       (A) in a mission change to, or closure of, that medical 
     facility; or
       (B) in a reduction during any fiscal year in the number of 
     full-time equivalent employees with permanent duty stations 
     at that facility by 20 percent or more.
       (b) Development of Contract Provisions.--Not later than 30 
     days after the date of the enactment of this Act, the 
     Secretary shall, in connection with the development of 
     contracts relating to the establishment and operation of 
     pilot programs, prescribe the following:
       (1) Procedures which--
       (A) identify classes of contracts, other than contracts 
     described in subsection (e)(2), which shall not be subject to 
     prior Central Office review; and
       (B) provide for expedited review and consideration of 
     proposed contracts which the Secretary determines require 
     such review.
       (2) Accountability mechanisms to ensure that such 
     procedures are implemented.
       (c) Implementation Report.--Not later than 30 days after 
     the date of the enactment of this Act, the Secretary shall 
     submit to the Committee on Veterans' Affairs of the Senate 
     and House of Representatives a report on the implementation 
     of this section. The report shall--
       (1) describe the delegations of authority prescribed under 
     subsection (a) and identify and describe the areas of 
     responsibility for which the Secretary proposes to retain 
     decisionmaking authority with respect to the operation of the 
     pilot program and the rationale for such proposed retention 
     in each instance; and
       (2) in connection with contracts relating to the 
     establishment and operation of the pilot programs, identify--
       (A) the classes of proposed contracts which are subject to 
     prior Central Office review;
       (B) the procedures and accountability mechanisms for 
     expediting review and consideration of such proposed 
     contracts; and
       (C) the mechanism or mechanisms by which such expedited 
     review and decisionmaking will take place.
       (d) Timely Central Office Review.--The accountability 
     mechanisms described in subsection (b)(2) shall include a 
     requirement that any required prior review of a contract by 
     Central Office be completed within 30 days of its submittal 
     and a requirement that the failure to approve or reject a 
     contract described in subsection (b)(1)(B) within such 30-day 
     period result in the contract being deemed approved.
       (e) Administration.--In carrying out pilot programs under 
     section 701, the Secretary shall--
       (1) designate a health system director for each State in 
     which a pilot program is carried out under this title;
       (2) ensure that contracts for health care services may be 
     entered into without prior review by the Central Office of 
     the Department; and
       (3) provide for training Department personnel in each State 
     in which a pilot program will be carried out in the 
     negotiation and development of managed care contracts and for 
     ensuring that an attorney employed by the Department and a 
     warranted contracting officer employed by the Department 
     participate in negotiation and development of all such 
     contracts.
       (f) Administrative Flexibility.--The Secretary, when the 
     Secretary considers it necessary in carrying out a pilot 
     program under section 701, may--
       (1) carry out administrative reorganizations, subject to 
     section 702(d), without regard to section 510(b) of title 38, 
     United States Code;
       (2) appoint personnel to positions in the health care 
     system of the Department in the State in which the pilot 
     program is carried out in accordance with such standards for 
     such positions as the Secretary may establish and promote and 
     advance personnel serving in such positions in accordance 
     with such standards as the Secretary may establish;
       (3) enter into contracts, including contracts under the 
     terms and conditions described in section 8123(b) of title 
     38, United Sates Code, as added by this Act, without regard 
     to the provisions of section 8110(c) or 8125 of title 38, 
     United States Code; and
       (4) carry out consumer-survey, promotional, advertising, 
     and marketing activities related to establishing and 
     operating a health plan.

     SEC. 704. PROVISION OF BENEFITS.

       In the case of care and services that may be provided under 
     chapter 17 of title 38, United States Code, and that are not 
     included among the comprehensive basic health care benefits 
     provided for under a State comprehensive health benefit plan 
     in a State in which the Secretary operates a pilot program 
     under this title, the Secretary shall provide to any veteran 
     (whether or not enrolled in a Department of Veterans Affairs 
     health plan under the pilot program in that State) the care 
     and services authorized under that chapter in accordance with 
     the terms and conditions applicable to that veteran and that 
     care under that chapter.

     SEC. 705. FUNDING.

       (a) Establishment of Revolving Fund.--There is established 
     in the Treasury of the United States a revolving fund for 
     conduct of the pilot programs under this title. Subject to 
     subsection (e), amounts in the revolving funds are available 
     without fiscal year limitation for all expenses necessary to 
     carry out the purposes of the pilot program.
       (b) Authorization of Appropriations.--There is authorized 
     to be appropriated to the revolving fund such sums as may be 
     necessary for each of fiscal years 1995 through 2000 for 
     conduct and evaluation of the pilot programs.
       (c) Authorization To Transfer Certain Funds.--In addition 
     to funds appropriated pursuant to subsection (b), the 
     Secretary may transfer to the revolving fund authorized by 
     subsection (a) funds from the Medical Care Appropriation 
     Account of the Department when the Secretary determines that 
     such transfer is necessary to carry out the purposes of the 
     pilot program. The Secretary shall include in budget 
     documents of the Department for any fiscal year the 
     Secretary's estimate of the amount to be transferred pursuant 
     to this subsection.
       (d) Authorized Disbursements.--(1) The Secretary, subject 
     to paragraph (2) and to subsection (e), may make such 
     disbursements from the revolving fund established under 
     subsection (a) as the Secretary considers necessary to carry 
     out the purposes of the pilot programs and their evaluation. 
     Such disbursements may be made to cover any expense, both 
     direct and indirect, related to the establishment and 
     operation of a health plan, including the following:
       (A) The furnishing of medical care and services.
       (B) The acquisition of information systems.
       (C) Acquisition, construction, repair, and renovation of 
     facilities (including the land on which facilities are 
     located or to be constructed) necessary to carry out the 
     pilot program.
       (D) Legal services provided in support of the pilot program 
     by the General Counsel of the Department of Veterans Affairs.
       (E) Conduct of consumer surveys and printing, marketing, 
     and advertising (including contracts for such services).
       (2) Funds in the revolving fund shall not be available for 
     a major medical facility project, or a major medical facility 
     lease, as defined in section 8104(a)(3) of title 38, United 
     States Code, unless funds for such project or lease have been 
     specifically authorized by law.
       (e) Receipt of Certain Funds.--(1) The Secretary, subject 
     to section 701(g)(2), may collect premiums, deductibles, 
     copayments, and other charges with respect to health care 
     services furnished by the Secretary under a pilot program 
     authorized under section 701 from any party obligated to pay 
     such expenses.
       (2) Any funds received under paragraph (1), other than 
     funds for which recovery could have been accomplished under 
     section 1710(f), 1712(f), 1722A, or 1729(a) of title 38, 
     United States Code, shall be deposited in the revolving fund. 
     Funds for which recovery could have been accomplished under 
     any of those sections shall be deposited in the Medical-Care 
     Cost Recovery Fund established under section 1729(g) of that 
     title.
       (3) Funds deposited in the Medical-Care Cost Recovery Fund 
     during any fiscal year in an amount in excess of the 
     Congressional Budget Office baseline (as of the date of the 
     enactment of this Act) for deposits in that fund for that 
     fiscal year shall not be subject to paragraph (4) of section 
     1710(f), 1712(f), or 1729(g) (as the case may be) of that 
     title, but shall be transferred to the revolving fund. Such 
     transfer for any fiscal year shall be made at any time that 
     the total of amounts so received less amounts estimated to 
     cover the expenses, payments, and costs described in 
     paragraph (3) of section 1729(g) of that title is in excess 
     of the applicable Congressional Budget Office baseline.
       (f) Transfer of Excess Funds.--If the Secretary determines 
     that moneys in the revolving fund established under 
     subsection (a) are in excess of the needs of the pilot 
     program, the Secretary shall transfer the excess funds to the 
     Medical Care Appropriation account of the Department.
       (g) Reimbursement Required for Veterans Enrolled with 
     Health Plans Outside Department.--(1) A veteran who is 
     residing in a State in which the Secretary operates a pilot 
     program under this title and who is enrolled in a health plan 
     other than a health plan operated by the Secretary under that 
     pilot program may be provided the items and services in the 
     comprehensive basic health benefits package in effect in that 
     State by a VA health plan operating in that State only if 
     (except as provided in paragraph (2)) the plan is reimbursed 
     for the cost of the care provided.
       (2) The Secretary may not impose on or collect from a 
     veteran described in paragraph (1) a cost-share charge of any 
     kind in the case of treatment for a service-connected 
     disability that (as determined by the Secretary) requires a 
     specialized treatment capacity for which the Department has 
     particular expertise.

     SEC. 706. ANNUAL REPORTS TO CONGRESS.

       Not later than 14 months after the completion of the 
     designation of States as locations for pilot programs under 
     this title and not later than November 30 of each year from 
     1997 through the expiration of all pilot programs under this 
     title, the Secretary shall submit to the Committees on 
     Veterans' Affairs of the Senate and House of Representatives 
     a report of the Department's experience in carrying out the 
     provisions of this title and the findings or interim findings 
     or evaluations carried out in accordance with section 
     702(a)(2). Each such report shall include information 
     regarding the effect on Department health care delivery and 
     operations in each State in which a State comprehensive 
     health benefit plan has been implemented and shall 
     specifically identify each transfer of funds under section 
     705(c) and account specifically for the use of such funds.

     SEC. 707. EXPIRATION OF AUTHORITY.

       The authority to conduct a pilot program under this title 
     shall expire on the earlier of (1) the date that is five 
     years after the date of the commencement of the provision of 
     benefits under the pilot program, or (2) the effective date 
     of a Federal health-care reform statute which has the effect 
     of superseding State laws establishing reformed systems.
     In lieu of the amendment of the Senate to the title of the 
     bill, amend the title so as to read: ``An Act to amend title 
     38, United States Code, to revise and improve veterans' 
     health care programs, and for other purposes.''.
  Mr. MONTGOMERY (during the reading). Mr. Speaker, I ask unanimous 
consent the House amendments to the Senate amendments be considered as 
read and printed in the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Mississippi?
  There was no objection.
  The SPEAKER pro tempore. Is there objection to the initial request of 
the gentleman from Mississippi [Mr. Montgomery]?
  Mr. SMITH of New Jersey. Mr. Speaker, I object to the original 
request.
  The SPEAKER pro tempore. Objection is heard.

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