[Congressional Record Volume 145, Number 162 (Tuesday, November 16, 1999)]
[House]
[Pages H11976-H12002]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  CONFERENCE REPORT ON H.R. 2116, VETERANS MILLENNIUM HEALTH CARE AND 
                              BENEFITS ACT

  Mr. STUMP submitted the following conference report and statement on 
the bill (H.R. 2116) to amend title 38, United States Code, to 
establish a program of extended care services for veterans and to make 
other improvements in health care programs of the Department of 
Veterans Affairs:

                  Conference Report (H. Rept. 106-470)

       The committee of conference on the disagreeing votes of the 
     two Houses on the amendments of the Senate to the bill (H.R. 
     2116), to amend title 38, United States Code,

[[Page H11977]]

     to establish a program of extended care services for veterans 
     and to make other improvements in health care programs of the 
     Department of Veterans Affairs, having met, after full and 
     free conference, have agreed to recommend and do recommend to 
     their respective Houses as follows:
       That the House recede from its disagreement to the 
     amendment of the Senate to the text of the bill and agree to 
     the same with an amendment as follows:
       In lieu of the matter proposed to be inserted by the Senate 
     amendment, insert the following:

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Veterans 
     Millennium Health Care and Benefits Act''.
       (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.
Sec. 3. Secretary and Department defined.

                        TITLE I--ACCESS TO CARE

                       Subtitle A--Long-Term Care

Sec. 101. Requirement to provide extended care services.
Sec. 102. Pilot programs relating to long-term care.
Sec. 103. Pilot program relating to assisted living.

                Subtitle B--Other Access-to-Care Matters

Sec. 111. Reimbursement for emergency treatment in non-Department of 
              Veterans Affairs facilities.
Sec. 112. Eligibility for care of combat-injured veterans.
Sec. 113. Access to care for TRICARE-eligible military retirees.
Sec. 114. Treatment and services for drug or alcohol dependency.
Sec. 115. Counseling and treatment for veterans who have experienced 
              sexual trauma.
Sec. 116. Specialized mental health services.

                TITLE II--MEDICAL PROGRAM ADMINISTRATION

Sec. 201. Medical care collections.
Sec. 202. Health Services Improvement Fund.
Sec. 203. Allocation to health care facilities of amounts made 
              available from Medical Care Collections Fund.
Sec. 204. Authority to accept funds for education and training.
Sec. 205. Extension of certain authorities.
Sec. 206. Reestablishment of Committee on Post-Traumatic Stress 
              Disorder.
Sec. 207. State home grant program.
Sec. 208. Expansion of enhanced-use lease authority.
Sec. 209. Ineligibility for employment by Veterans Health 
              Administration of health care professionals who have lost 
              license to practice in one jurisdiction while still 
              licensed in another jurisdiction.
Sec. 210. Report on coordination of procurement of pharmaceuticals and 
              medical supplies by the Department of Veterans Affairs 
              and the Department of Defense.
Sec. 211. Reimbursement of medical expenses of veterans located in 
              Alaska.

              TITLE III--MISCELLANEOUS MEDICAL PROVISIONS

Sec. 301. Review of proposed changes to operation of medical 
              facilities.
Sec. 302. Patient services at Department facilities.
Sec. 303. Chiropractic treatment.
Sec. 304. Designation of hospital bed replacement building at Ioannis 
              A. Lougaris Department of Veterans Affairs Medical 
              Center, Reno, Nevada.

             TITLE IV--CONSTRUCTION AND FACILITIES MATTERS

Sec. 401. Authorization of major medical facility projects.
Sec. 402. Authorization of major medical facility leases.
Sec. 403. Authorization of appropriations.

                TITLE V--BENEFITS AND EMPLOYMENT MATTERS

                    Subtitle A--Compensation and DIC

Sec. 501. Dependency and indemnity compensation for surviving spouses 
              of former prisoners of war.
Sec. 502. Reinstatement of certain benefits for remarried surviving 
              spouses of veterans upon termination of their remarriage.
Sec. 503. Presumption that bronchiolo-alveolar carcinoma is service-
              connected.

                         Subtitle B--Employment

Sec. 511. Clarification of veterans' civil service employment 
              opportunities.

                   TITLE VI--MEMORIAL AFFAIRS MATTERS

            Subtitle A--American Battle Monuments Commission

Sec. 601. Codification and expansion of authority for World War II 
              memorial.
Sec. 602. General authority to solicit and receive contributions.
Sec. 603. Intellectual property and related items.
Sec. 604. Technical amendments.

                    Subtitle B--National Cemeteries

Sec. 611. Establishment of additional national cemeteries.
Sec. 612. Use of flat grave markers at Santa Fe National Cemetery, New 
              Mexico.
Sec. 613. Independent study on improvements to veterans' cemeteries.

                      Subtitle C--Burial Benefits

Sec. 621. Independent study on improvements to veterans' burial 
              benefits.

                TITLE VII--EDUCATION AND HOUSING MATTERS

                     Subtitle A--Education Matters

Sec. 701. Availability of Montgomery GI Bill benefits for preparatory 
              courses for college and graduate school entrance exams.
Sec. 702. Determination of eligibility period for members of the Armed 
              Forces commissioned following completion of officer 
              training school.
Sec. 703. Report on veterans' education and vocational training 
              benefits provided by the States.
Sec. 704. Technical amendments.

                      Subtitle B--Housing Matters

Sec. 711. Extension of authority for housing loans for members of the 
              Selected Reserve.
Sec. 712. Technical amendment relating to transitional housing loan 
              guarantee program.

   TITLE VIII--DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATIVE MATTERS

Sec. 801. Enhanced quality assurance program within the Veterans 
              Benefits Administration.
Sec. 802. Extension of authority to maintain a regional office in the 
              Republic of the Philippines.
Sec. 803. Extension of Advisory Committee on Minority Veterans.
Sec. 804. Technical amendment to automobile assistance program.

                  TITLE IX--HOMELESS VETERANS PROGRAMS

Sec. 901. Homeless veterans' reintegration programs.
Sec. 902. Extension of program of housing assistance for homeless 
              veterans.
Sec. 903. Homeless veterans programs.
Sec. 904. Plan for evaluation of performance of programs to assist 
              homeless veterans.

      TITLE X--UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

Sec. 1001. Short title.
Sec. 1002. Definition.

     Subtitle A--Transitional Provisions To Stagger Terms of Judges

Sec. 1011. Early retirement authority for current judges.
Sec. 1012. Modified terms for next two judges appointed to the Court.

          Subtitle B--Other Matters Relating to Retired Judges

Sec. 1021. Recall of retired judges.
Sec. 1022. Judges' retired pay.
Sec. 1023. Survivor annuities.
Sec. 1024. Limitation on activities of retired judges.

 Subtitle C--Rotation of Service of Judges as Chief Judge of the Court

Sec. 1031. Repeal of separate appointment of chief judge.
Sec. 1032. Designation and term of chief judge of Court.
Sec. 1033. Salary.
Sec. 1034. Precedence of judges.
Sec. 1035. Conforming amendments.
Sec. 1036. Applicability of amendments.

            TITLE XI--VOLUNTARY SEPARATION INCENTIVE PROGRAM

Sec. 1101. Short title.
Sec. 1102. Plan for payment of voluntary separation incentive payments.
Sec. 1103. Voluntary separation incentive payments.
Sec. 1104. Effect of subsequent employment with the Government.
Sec. 1105. Additional agency contributions to Civil Service Retirement 
              and Disability Fund.
Sec. 1106. Continued health insurance coverage.
Sec. 1107. Prohibition of reduction of full-time equivalent employment 
              level.
Sec. 1108. Regulations.
Sec. 1109. Limitation; savings clause.
Sec. 1110. Eligible employees.

     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.

     SEC. 3. SECRETARY AND DEPARTMENT DEFINED.

       For purposes of this Act--
       (1) the term ``Secretary'' means the Secretary of Veterans 
     Affairs; and
       (2) the term ``Department'' means the Department of 
     Veterans Affairs.
                        TITLE I--ACCESS TO CARE
                       Subtitle A--Long-Term Care

     SEC. 101. REQUIREMENT TO PROVIDE EXTENDED CARE SERVICES.

       (a) Required Nursing Home Care.--(1) Chapter 17 is amended 
     by inserting after section 1710 the following new section:

     ``Sec. 1710A. Required nursing home care

       ``(a) The Secretary shall provide nursing home care which 
     the Secretary determines is needed (1) to any veteran in need 
     of such care for a service-connected disability, and (2) to 
     any veteran who is in need of such care and who has a 
     service-connected disability rated at 70 percent or more.
       ``(b)(1) The Secretary shall ensure that a veteran 
     described in subsection (a) who continues to need nursing 
     home care is not, after placement in a Department nursing 
     home, transferred from the facility without the consent of 
     the veteran, or, in the event the veteran cannot provide 
     informed consent, the representative of the veteran.

[[Page H11978]]

       ``(2) Nothing in subsection (a) may be construed as 
     authorizing or requiring that a veteran who is receiving 
     nursing home care in a Department nursing home on the date of 
     the enactment of this section be displaced, transferred, or 
     discharged from the facility.
       ``(c) The provisions of subsection (a) shall terminate on 
     December 31, 2003.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     1710 the following new item:

``1710A. Required nursing home care.''.

       (b) Required Noninstitutional Extended Care Services.--
     Section 1701 is amended by adding at the end the following 
     new paragraph:
       ``(10)(A) During the period beginning on the date of the 
     enactment of the Veterans Millennium Health Care and Benefits 
     Act and ending on December 31, 2003, the term `medical 
     services' includes noninstitutional extended care 
     services.
       ``(B) For the purposes of subparagraph (A), the term 
     `noninstitutional extended care services' means such 
     alternatives to institutional extended care which the 
     Secretary may furnish (i) directly, (ii) by contract, or 
     (iii) (through provision of case management) by another 
     provider or payor.''.
       (c) Program of Extended Care Services.--(1) Chapter 17 is 
     amended by inserting after section 1710A, as added by 
     subsection (a), the following new section:

     ``Sec. 1710B. Extended care services

       ``(a) The Secretary (subject to section 1710(a)(4) of this 
     title and subsection (c) of this section) shall operate and 
     maintain a program to provide extended care services to 
     eligible veterans in accordance with this section. Such 
     services shall include the following:
       ``(1) Geriatric evaluation.
       ``(2) Nursing home care (A) in facilities operated by the 
     Secretary, and (B) in community-based facilities through 
     contracts under section 1720 of this title.
       ``(3) Domiciliary services under section 1710(b) of this 
     title.
       ``(4) Adult day health care under section 1720(f) of this 
     title.
       ``(5) Such other noninstitutional alternatives to nursing 
     home care as the Secretary may furnish as medical services 
     under section 1701(10) of this title.
       ``(6) Respite care under section 1720B of this title.
       ``(b) The Secretary shall ensure that the staffing and 
     level of extended care services provided by the Secretary 
     nationally in facilities of the Department during any fiscal 
     year is not less than the staffing and level of such services 
     provided nationally in facilities of the Department during 
     fiscal year 1998.
       ``(c)(1) Except as provided in paragraph (2), the Secretary 
     may not furnish extended care services for a non-service-
     connected disability other than in the case of a veteran who 
     has a compensable service-connected disability unless the 
     veteran agrees to pay to the United States a copayment 
     (determined in accordance with subsection (d)) for any period 
     of such services in a year after the first 21 days of such 
     services provided that veteran in that year.
       ``(2) Paragraph (1) shall not apply--
       ``(A) to a veteran whose annual income (determined under 
     section 1503 of this title) is less than the amount in effect 
     under section 1521(b) of this title; or
       ``(B) with respect to an episode of extended care services 
     that a veteran is being furnished by the Department on the 
     date of the enactment of the Veterans Millennium Health Care 
     and Benefits Act.
       ``(d)(1) A veteran who is furnished extended care services 
     under this chapter and who is required under subsection (c) 
     to pay an amount to the United States in order to be 
     furnished such services shall be liable to the United States 
     for that amount.
       ``(2) In implementing subsection (c), the Secretary shall 
     develop a methodology for establishing the amount of the 
     copayment for which a veteran described in subsection (c) is 
     liable. That methodology shall provide for--
       ``(A) establishing a maximum monthly copayment (based on 
     all income and assets of the veteran and the spouse of such 
     veteran);
       ``(B) protecting the spouse of a veteran from financial 
     hardship by not counting all of the income and assets of the 
     veteran and spouse (in the case of a spouse who resides in 
     the community) as available for determining the copayment 
     obligation; and
       ``(C) allowing the veteran to retain a monthly personal 
     allowance.
       ``(e)(1) There is established in the Treasury of the United 
     States a revolving fund known as the Department of Veterans 
     Affairs Extended Care Fund (hereinafter in this section 
     referred to as the `fund'). Amounts in the fund shall be 
     available, without fiscal year limitation and without further 
     appropriation, exclusively for the purpose of providing 
     extended care services under subsection (a).
       ``(2) All amounts received by the Department under this 
     section shall be deposited in or credited to the fund.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     1710A, as added by subsection (a)(2), the following new item:

``1710B. Extended care services.''.

       (d) Adult Day Health Care.--Section 1720(f)(1)(A) is 
     amended to read as follows:
       ``(f)(1)(A) The Secretary may furnish adult day health care 
     services to a veteran enrolled under section 1705(a) of this 
     title who would otherwise require nursing home care.''.
       (e) Respite Care Program.--Section 1720B is amended--
       (1) in subsection (a), by striking ``eligible'' and 
     inserting ``enrolled'';
       (2) in subsection (b)--
       (A) by striking ``the term `respite care' means hospital or 
     nursing home care'' and inserting ``the term `respite care 
     services' means care and services'';
       (B) by striking ``is'' at the beginning of each of 
     paragraphs (1), (2), and (3) and inserting ``are''; and
       (C) by striking ``in a Department facility'' in paragraph 
     (2); and
       (3) by adding at the end the following new subsection:
       ``(c) In furnishing respite care services, the Secretary 
     may enter into contract arrangements.''.
       (f) Conforming Amendments.--Section 1710(a) is amended--
       (1) in paragraph (1), by striking ``, and may furnish 
     nursing home care,'';
       (2) in paragraph (2)(A), by inserting ``or, with respect to 
     nursing home care during any period during which the 
     provisions of section 1710A(a) of this title are in effect, a 
     compensable service-connected disability rated less than 70 
     percent'' after ``50 percent'';
       (3) in paragraph (4), by inserting ``, and the requirement 
     in section 1710B of this title that the Secretary provide a 
     program of extended care services,'' after ``medical 
     services''; and
       (4) by adding at the end the following new paragraph:
       ``(5) During any period during which the provisions of 
     section 1710A(a) of this title are not in effect, the 
     Secretary may furnish nursing home care which the Secretary 
     determines is needed to any veteran described in paragraph 
     (1), with the priority for such care on the same basis as if 
     provided under that paragraph.''.
       (g) State Homes.--Section 1741(a)(2) is amended by striking 
     ``adult day health care in a State home'' and inserting 
     ``extended care services described in any of paragraphs (4) 
     through (6) of section 1710B(a) of this title under a program 
     administered by a State home''.
       (h) Effective Date.--(1) Except as provided in paragraph 
     (2), the amendments made by this section shall take effect on 
     the date of the enactment of this Act.
       (2) Subsection (c) of section 1710B of title 38, United 
     States Code (as added by subsection (b)), shall take effect 
     on the effective date of regulations prescribed by the 
     Secretary of Veterans Affairs under subsections (c) and (d) 
     of such section. The Secretary shall publish the effective 
     date of such regulations in the Federal Register.
       (3) The provisions of section 1710(f) of title 38, United 
     States Code, shall not apply to any day of nursing home care 
     on or after the effective date of regulations under paragraph 
     (2).
       (i) Report.--Not later than January 1, 2003, the Secretary 
     shall submit to the Committees on Veterans' Affairs of the 
     Senate and House of Representatives a report on the operation 
     of this section (including the amendments made by this 
     section). The Secretary shall include in the report--
       (1) the Secretary's assessment of the experience of the 
     Department under the provisions of this section;
       (2) the costs incurred by the Department under the 
     provisions of this section and a comparison of those costs 
     with the Secretary's estimate of the costs that would have 
     been incurred by the Secretary for extended care services if 
     this section had not been enacted; and
       (3) the Secretary's recommendations, with respect to the 
     provisions of section 1710A(a) of title 38, United States 
     Code, as added by subsection (a), and with respect to the 
     provisions of section 1701(10) of such title, as added by 
     subsection (b), as to--
       (A) whether those provisions should be extended or made 
     permanent; and
       (B) what modifications, if any, should be made to those 
     provisions.

     SEC. 102. PILOT PROGRAMS RELATING TO LONG-TERM CARE.

       (a) Pilot Programs.--The Secretary shall carry out three 
     pilot programs for the purpose of determining the 
     effectiveness of different models of all-inclusive care-
     delivery in reducing the use of hospital and nursing home 
     care by frail, elderly veterans.
       (b) Locations of Pilot Programs.--In selecting locations in 
     which the pilot programs will be carried out, the Secretary 
     may not select more than one location in any given health 
     care region of the Veterans Health Administration.
       (c) Scope of Services Under Pilot Programs.--Each of the 
     pilot programs under this section shall be designed to 
     provide participating veterans with integrated, comprehensive 
     services which include the following:
       (1) Adult-day health care services on an eight-hour per 
     day, five-day per week basis.
       (2) Medical services (including primary care, preventive 
     services, and nursing home care, as needed).
       (3) Coordination of needed services.
       (4) Transportation services.
       (5) Home care services.
       (6) Respite care.
       (d) Program Requirements.--In carrying out the pilot 
     programs under this section, the Secretary shall--
       (1) employ the use of interdisciplinary care-management 
     teams to provide the required array of services;
       (2) determine the appropriate number of patients to be 
     enrolled in each program and the criteria for enrollment; and
       (3) ensure that funding for each program is based on the 
     complex care category under the resource allocation system 
     (known as the Veterans Equitable Resource Allocation system) 
     established pursuant to section 429 of Public Law 104-204 
     (110 Stat. 2929).
       (e) Design of Pilot Programs.--To the maximum extent 
     feasible, the Secretary shall use the following three models 
     in designing the three pilot programs under this section:
       (1) Under one of the pilot programs, the Secretary shall 
     provide services directly through facilities and personnel of 
     the Department.

[[Page H11979]]

       (2) Under one of the pilot programs, the Secretary shall 
     provide services through a combination of--
       (A) services provided under contract with appropriate 
     public and private entities; and
       (B) services provided through facilities and personnel of 
     the Department.
       (3) Under one of the pilot programs, the Secretary shall 
     arrange for the provision of services through a combination 
     of--
       (A) services provided through cooperative arrangements with 
     appropriate public and private entities; and
       (B) services provided through facilities and personnel of 
     the Department.
       (f) In-Kind Assistance.--In providing for the furnishing of 
     services under a contract in carrying out the pilot program 
     described in subsection (e)(2), the Secretary may, subject to 
     reimbursement, provide in-kind assistance (through the 
     services of Department employees and the sharing of other 
     Department resources) to a facility furnishing care to 
     veterans. Such reimbursement may be made by reduction in the 
     charges to the Secretary under such contract.
       (g) Limitation.--In providing for the furnishing of 
     services in carrying out a pilot program described in 
     subsection (e)(2) or (e)(3), the Secretary shall make payment 
     for services only to the extent that payment for such 
     services is not otherwise covered (notwithstanding any 
     provision of title XVIII or XIX of the Social Security Act) 
     by another government or nongovernment entity or program.
       (h) Duration of Programs.--The authority of the Secretary 
     to provide services under a pilot program under this section 
     shall cease on the date that is three years after the date of 
     the commencement of that pilot program.
       (i) Report.--(1) Not later than nine months after the 
     completion of all of the pilot programs under this section, 
     the Secretary shall submit to the Committees on Veterans' 
     Affairs of the Senate and the House of Representatives a 
     report on those programs.
       (2) The report shall include the following:
       (A) A description of the implementation and operation of 
     each such program.
       (B) An analysis comparing use of institutional care and use 
     of other services among enrollees in each of the pilot 
     programs with the experience of comparable patients who are 
     not enrolled in one of the pilot programs.
       (C) An assessment of the satisfaction of participating 
     veterans with each of those programs.
       (D) An assessment of the health status of participating 
     veterans in each of those programs and of the ability of 
     those veterans to function independently.
       (E) An analysis of the costs and benefits under each of 
     those programs.

     SEC. 103. PILOT PROGRAM RELATING TO ASSISTED LIVING.

       (a) Program Authority.--The Secretary may carry out a pilot 
     program for the purpose of determining the feasibility and 
     practicability of enabling eligible veterans to secure needed 
     assisted living services as an alternative to nursing home 
     care.
       (b) Location of Pilot Program.--The pilot program shall be 
     carried out in a designated health care region of the 
     Department selected by the Secretary for purposes of this 
     section.
       (c) Scope of Program.--In carrying out the pilot program, 
     the Secretary may enter into contracts with appropriate 
     facilities for the provision for a period of up to six months 
     of assisted living services on behalf of eligible veterans in 
     the region where the program is carried out.
       (d) Eligible Veterans.--A veteran is an eligible veteran 
     for purposes of this section if the veteran--
       (1) is eligible for placement assistance by the Secretary 
     under section 1730(a) of title 38, United States Code;
       (2) is unable to manage routine activities of daily living 
     without supervision and assistance; and
       (3) could reasonably be expected to receive ongoing 
     services after the end of the contract period under another 
     government program or through other means.
       (e) Report.--(1) Not later than 90 days before the end of 
     the pilot program under this section, the Secretary shall 
     submit to the Committees on Veterans' Affairs of the Senate 
     and the House of Representatives a report on the program.
       (2) The report under paragraph (1) shall include the 
     following:
       (A) A description of the implementation and operation of 
     the program.
       (B) An analysis comparing use of institutional care among 
     participants in the program with the experience of comparable 
     patients who are not enrolled in the program.
       (C) A comparison of assisted living services provided by 
     the Department through the pilot program with domiciliary 
     care provided by the Department.
       (D) The Secretary's recommendations, if any, regarding an 
     extension of the program.
       (f) Duration.--The authority of the Secretary to provide 
     services under the pilot program shall cease on the date that 
     is three years after the date of the commencement of the 
     pilot program.
       (g) Definition.--For purposes of this section, the term 
     ``assisted living services'' means services in a facility 
     that provides room and board and personal care for and 
     supervision of residents as necessary for the health, safety, 
     and welfare of residents.
       (h) Standards.--The Secretary may not enter into a contract 
     with a facility under this section unless the facility meets 
     the standards established in regulations prescribed under 
     section 1730 of title 38, United States Code.
                Subtitle B--Other Access-to-Care Matters

     SEC. 111. REIMBURSEMENT FOR EMERGENCY TREATMENT IN NON-
                   DEPARTMENT OF VETERANS AFFAIRS FACILITIES.

       (a) Authority To Provide Reimbursement.--Chapter 17 is 
     amended by inserting after section 1724 the following new 
     section:

     ``Sec. 1725. Reimbursement for emergency treatment

       ``(a) General Authority.--(1) Subject to subsections (c) 
     and (d), the Secretary may reimburse a veteran described in 
     subsection (b) for the reasonable value of emergency 
     treatment furnished the veteran in a non-Department facility.
       ``(2) In any case in which reimbursement is authorized 
     under subsection (a)(1), the Secretary, in the Secretary's 
     discretion, may, in lieu of reimbursing the veteran, make 
     payment of the reasonable value of the furnished emergency 
     treatment directly--
       ``(A) to a hospital or other health care provider that 
     furnished the treatment; or
       ``(B) to the person or organization that paid for such 
     treatment on behalf of the veteran.
       ``(b) Eligibility.--(1) A veteran referred to in subsection 
     (a)(1) is an individual who is an active Department health-
     care participant who is personally liable for emergency 
     treatment furnished the veteran in a non-Department facility.
       ``(2) A veteran is an active Department health-care 
     participant if--
       ``(A) the veteran is enrolled in the health care system 
     established under section 1705(a) of this title; and
       ``(B) the veteran received care under this chapter within 
     the 24-month period preceding the furnishing of such 
     emergency treatment.
       ``(3) A veteran is personally liable for emergency 
     treatment furnished the veteran in a non-Department facility 
     if the veteran--
       ``(A) is financially liable to the provider of emergency 
     treatment for that treatment;
       ``(B) has no entitlement to care or services under a 
     health-plan contract (determined, in the case of a health-
     plan contract as defined in subsection (f)(2)(B) or 
     (f)(2)(C), without regard to any requirement or limitation 
     relating to eligibility for care or services from any 
     department or agency of the United States);
       ``(C) has no other contractual or legal recourse against a 
     third party that would, in whole or in part, extinguish such 
     liability to the provider; and
       ``(D) is not eligible for reimbursement for medical care or 
     services under section 1728 of this title.
       ``(c) Limitations on Reimbursement.--(1) The Secretary, in 
     accordance with regulations prescribed by the Secretary, 
     shall--
       ``(A) establish the maximum amount payable under subsection 
     (a);
       ``(B) delineate the circumstances under which such payments 
     may be made, to include such requirements on requesting 
     reimbursement as the Secretary shall establish; and
       ``(C) provide that in no event may a payment under that 
     subsection include any amount for which the veteran is not 
     personally liable.
       ``(2) Subject to paragraph (1), the Secretary may provide 
     reimbursement under this section only after the veteran or 
     the provider of emergency treatment has exhausted without 
     success all claims and remedies reasonably available to the 
     veteran or provider against a third party for payment of such 
     treatment.
       ``(3) Payment by the Secretary under this section on behalf 
     of a veteran to a provider of emergency treatment shall, 
     unless rejected and refunded by the provider within 30 days 
     of receipt, extinguish any liability on the part of the 
     veteran for that treatment. Neither the absence of a contract 
     or agreement between the Secretary and the provider nor any 
     provision of a contract, agreement, or assignment to the 
     contrary shall operate to modify, limit, or negate the 
     requirement in the preceding sentence.
       ``(d) Independent Right of Recovery.--(1) In accordance 
     with regulations prescribed by the Secretary, the United 
     States shall have the independent right to recover any amount 
     paid under this section when, and to the extent that, a third 
     party subsequently makes a payment for the same emergency 
     treatment.
       ``(2) Any amount paid by the United States to the veteran 
     (or the veteran's personal representative, successor, 
     dependents, or survivors) or to any other person or 
     organization paying for such treatment shall constitute a 
     lien in favor of the United States against any recovery the 
     payee subsequently receives from a third party for the same 
     treatment.
       ``(3) Any amount paid by the United States to the provider 
     that furnished the veteran's emergency treatment shall 
     constitute a lien against any subsequent amount the provider 
     receives from a third party for the same emergency treatment 
     for which the United States made payment.
       ``(4) The veteran (or the veteran's personal 
     representative, successor, dependents, or survivors) shall 
     ensure that the Secretary is promptly notified of any payment 
     received from any third party for emergency treatment 
     furnished to the veteran. The veteran (or the veteran's 
     personal representative, successor, dependents, or survivors) 
     shall immediately forward all documents relating to such 
     payment, cooperate with the Secretary in the investigation of 
     such payment, and assist the Secretary in enforcing the 
     United States right to recover any payment made under 
     subsection (c)(3).
       ``(e) Waiver.--The Secretary, in the Secretary's 
     discretion, may waive recovery of a payment made to a veteran 
     under this section that is otherwise required by subsection 
     (d)(1) when the Secretary determines that such waiver would 
     be in the best interest of the United States, as defined by 
     regulations prescribed by the Secretary.
       ``(f) Definitions.--For purposes of this section:
       ``(1) The term `emergency treatment' means medical care or 
     services furnished, in the judgment of the Secretary--

[[Page H11980]]

       ``(A) when Department or other Federal facilities are not 
     feasibly available and an attempt to use them beforehand 
     would not be reasonable;
       ``(B) when such care or services are rendered in a medical 
     emergency of such nature that a prudent layperson reasonably 
     expects that delay in seeking immediate medical attention 
     would be hazardous to life or health; and
       ``(C) until such time as the veteran can be transferred 
     safely to a Department facility or other Federal facility.
       ``(2) The term `health-plan contract' includes any of the 
     following:
       ``(A) An insurance policy or contract, medical or hospital 
     service agreement, membership or subscription contract, or 
     similar arrangement under which health services for 
     individuals are provided or the expenses of such services are 
     paid.
       ``(B) An insurance program described in section 1811 of the 
     Social Security Act (42 U.S.C. 1395c) or established by 
     section 1831 of that Act (42 U.S.C. 1395j).
       ``(C) A State plan for medical assistance approved under 
     title XIX of such Act (42 U.S.C. 1396 et seq.).
       ``(D) A workers' compensation law or plan described in 
     section 1729(a)(2)(A) of this title.
       ``(E) A law of a State or political subdivision described 
     in section 1729(a)(2)(B) of this title.
       ``(3) The term `third party' means any of the following:
       ``(A) A Federal entity.
       ``(B) A State or political subdivision of a State.
       ``(C) An employer or an employer's insurance carrier.
       ``(D) An automobile accident reparations insurance carrier.
       ``(E) A person or entity obligated to provide, or to pay 
     the expenses of, health services under a health-plan 
     contract.''.
       (b) Conforming Amendments.--(1) Section 1729A(b) is 
     amended--
       (A) by redesignating paragraphs (5) and (6) as paragraphs 
     (6) and (7), respectively; and
       (B) by inserting after paragraph (4) the following new 
     paragraph:
       ``(5) Section 1725 of this title.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     1724 the following new item:

``1725. Reimbursement for emergency treatment.''.

       (c) Effective Date.--The amendments made by this section 
     shall take effect 180 days after the date of the enactment of 
     this Act.
       (d) Implementation Reports.--The Secretary shall include 
     with the budget justification materials submitted to Congress 
     in support of the Department of Veterans Affairs budget for 
     fiscal year 2002 and for fiscal year 2003 a report on the 
     implementation of section 1725 of title 38, United States 
     Code, as added by subsection (a). Each such report shall 
     include information on the experience of the Department under 
     that section and the costs incurred, and expected to be 
     incurred, under that section.

     SEC. 112. ELIGIBILITY FOR CARE OF COMBAT-INJURED VETERANS.

       Chapter 17 is amended--
       (1) in section 1710(a)(2)(D), by inserting ``or who was 
     awarded the Purple Heart'' after ``former prisoner of war''; 
     and
       (2) in section 1705(a)(3), by inserting ``or who were 
     awarded the Purple Heart'' after ``former prisoners of war''.

     SEC. 113. ACCESS TO CARE FOR TRICARE-ELIGIBLE MILITARY 
                   RETIREES.

       (a) Interagency Agreement.--(1) The Secretary of Defense 
     shall enter into an agreement (characterized as a memorandum 
     of understanding or otherwise) with the Secretary of Veterans 
     Affairs with respect to the provision of medical care by the 
     Secretary of Veterans Affairs to eligible military retirees 
     in accordance with the provisions of subsection (c). That 
     agreement shall include provisions for reimbursement of the 
     Secretary of Veterans Affairs by the Secretary of Defense for 
     medical care provided by the Secretary of Veterans Affairs to 
     an eligible military retiree and may include such other 
     provisions with respect to the terms and conditions of such 
     care as may be agreed upon by the two Secretaries.
       (2) Reimbursement under the agreement under paragraph (1) 
     shall be in accordance with rates agreed upon by the 
     Secretary of Defense and the Secretary of Veterans Affairs. 
     Such reimbursement may be made by the Secretary of Defense or 
     by the appropriate TRICARE Managed Care Support contractor, 
     as determined in accordance with that agreement.
       (3) In entering into the agreement under paragraph (1), 
     particularly with respect to determination of the rates of 
     reimbursement under paragraph (2), the Secretary of Defense 
     shall consult with TRICARE Managed Care Support 
     contractors.
       (4) The Secretary of Veterans Affairs may not enter into an 
     agreement under paragraph (1) for the provision of care in 
     accordance with the provisions of subsection (c) with respect 
     to any geographic service area, or a part of any such area, 
     of the Veterans Health Administration unless--
       (A) in the judgment of that Secretary, the Department of 
     Veterans Affairs will recover the costs of providing such 
     care to eligible military retirees; and
       (B) that Secretary has certified and documented, with 
     respect to any geographic service area in which the Secretary 
     proposes to provide care in accordance with the provisions of 
     subsection (c), that such geographic service area, or 
     designated part of any such area, has adequate capacity 
     (consistent with the requirements in section 1705(b)(1) of 
     title 38, United States Code, that care to enrollees shall be 
     timely and acceptable in quality) to provide such care.
       (5) The agreement under paragraph (1) shall be entered into 
     by the Secretaries not later than nine months after the date 
     of the enactment of this Act. If the Secretaries are unable 
     to reach agreement, they shall jointly report, by that date 
     or within 30 days thereafter, to the Committees on Armed 
     Services and the Committees on Veterans' Affairs of the 
     Senate and House of Representatives on the reasons for their 
     inability to reach an agreement and their mutually agreed 
     plan for removing any impediments to final agreement.
       (b) Depositing of Reimbursements.--Amounts received by the 
     Secretary of Veterans Affairs under the agreement under 
     subsection (a) shall be deposited in the Department of 
     Veterans Affairs Health Services Improvement Fund established 
     under section 1729B of title 38, United States Code, as added 
     by section 202.
       (c) Copayment Requirement.--The provisions of subsections 
     (f)(1) and (g)(1) of section 1710 of title 38, United States 
     Code, shall not apply in the case of an eligible military 
     retiree who is covered by the agreement under subsection (a).
       (d) Phased Implementation.--(1) The Secretary of Defense 
     shall include in each TRICARE contract entered into after the 
     date of the enactment of this Act provisions to implement the 
     agreement under subsection (a).
       (2) The provisions of the agreement under subsection (a)(2) 
     and the provisions of subsection (c) shall apply to the 
     furnishing of medical care by the Secretary of Veterans 
     Affairs in any area of the United States only if that area is 
     covered by a TRICARE contract that was entered into after the 
     date of the enactment of this Act.
       (e) Eligible Military Retirees.--For purposes of this 
     section, an eligible military retiree is a member of the 
     Army, Navy, Air Force, or Marine Corps who--
       (1) has retired from active military, naval, or air 
     service;
       (2) is eligible for care under the TRICARE program 
     established by the Secretary of Defense;
       (3) has enrolled for care under section 1705 of title 38, 
     United States Code; and
       (4) is not described in paragraph (1) or (2) of section 
     1710(a) of such title.

     SEC. 114. TREATMENT AND SERVICES FOR DRUG OR ALCOHOL 
                   DEPENDENCY.

       (a) Authority To Provide Treatment and Services for Members 
     on Active Duty.--Section 1720A(c) is amended in the first 
     sentence of paragraph (1)--
       (1) by striking ``may not be transferred'' and inserting 
     ``may be transferred''; and
       (2) by striking ``unless such transfer is during the last 
     thirty days of such member's enlistment or tour of duty''.
       (b) Conforming Amendment.--The first sentence of paragraph 
     (2) of that section is amended by striking ``during the last 
     thirty days of such person's enlistment period or tour of 
     duty''.

     SEC. 115. COUNSELING AND TREATMENT FOR VETERANS WHO HAVE 
                   EXPERIENCED SEXUAL TRAUMA.

       (a) Extension of Period of Program.--Subsection (a) of 
     section 1720D is amended--
       (1) in paragraph (1), by striking ``December 31, 2001'' and 
     inserting ``December 31, 2004''; and
       (2) in paragraph (3), by striking ``December 31, 2001'' and 
     inserting ``December 31, 2004''.
       (b) Mandatory Nature of Program.--(1) Subsection (a)(1) of 
     such section is further amended by striking ``may provide 
     counseling to a veteran who the Secretary determines requires 
     such counseling'' and inserting ``shall operate a program 
     under which the Secretary provides counseling and appropriate 
     care and services to veterans who the Secretary determines 
     require such counseling and care and services''.
       (2) Subsection (a) of such section is further amended--
       (A) by striking paragraph (2); and
       (B) by redesignating paragraph (3) (as amended by 
     subsection (a)(2)) as paragraph (2).
       (c) Outreach Efforts.--Subsection (c) of such section is 
     amended--
       (1) by inserting ``and treatment'' in the first sentence 
     and in paragraph (2) after ``counseling'';
       (2) by striking ``and'' at the end of paragraph (1);
       (3) by redesignating paragraph (2) as paragraph (3); and
       (4) by inserting after paragraph (1) the following new 
     paragraph (2):
       ``(2) shall ensure that information about the counseling 
     and treatment available to veterans under this section--
       ``(A) is revised and updated as appropriate;
       ``(B) is made available and visibly posted at appropriate 
     facilities of the Department; and
       ``(C) is made available through appropriate public 
     information services; and''.
       (d) Report on Implementation of Outreach Activities.--Not 
     later than six months after the date of the enactment of this 
     Act, the Secretary of Veterans Affairs shall submit to the 
     Committees on Veterans' Affairs of the Senate and House of 
     Representatives a report on the Secretary's implementation of 
     paragraph (2) of section 1720D(c) of title 38, United States 
     Code, as added by subsection (c). Such report shall include 
     examples of the documents and other means of communication 
     developed for compliance with that paragraph.
       (e) Study of Expanding Eligibility for Counseling and 
     Treatment.--(1) The Secretary of Veterans Affairs, in 
     consultation with the Secretary of Defense, shall conduct a 
     study to determine--
       (A) the extent to which former members of the reserve 
     components of the Armed Forces experienced physical assault 
     of a sexual nature or battery of a sexual nature while 
     serving on active duty for training;
       (B) the extent to which such former members have sought 
     counseling from the Department of Veterans Affairs relating 
     to those incidents; and

[[Page H11981]]

       (C) the additional resources that, in the judgment of the 
     Secretary, would be required to meet the projected need of 
     those former members for such counseling.
       (2) Not later than 16 months after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to the Committees on Veterans' Affairs of the 
     Senate and House of Representatives a report on the results 
     of the study conducted under paragraph (1).
       (f) Oversight of Outreach Activities.--Not later than 14 
     months after the date of the enactment of this Act, the 
     Secretary of Veterans Affairs and the Secretary of Defense 
     shall submit to the appropriate congressional committees a 
     joint report describing in detail the collaborative efforts 
     of the Department of Veterans Affairs and the Department of 
     Defense to ensure that members of the Armed Forces, upon 
     separation from active military, naval, or air service, are 
     provided appropriate and current information about programs 
     of the Department of Veterans Affairs to provide counseling 
     and treatment for sexual trauma that may have been 
     experienced by those members while in the active military, 
     naval, or air service, including information about 
     eligibility requirements for, and procedures for applying 
     for, such counseling and treatment. The report shall include 
     proposed recommendations from both the Secretary of Veterans 
     Affairs and the Secretary of Defense for the improvement of 
     their collaborative efforts to provide such information.
       (g) Report on Implementation of Sexual Trauma Treatment 
     Program.--Not later than 14 months after the date of the 
     enactment of this Act, the Secretary shall submit to the 
     Committees on Veterans' Affairs of the Senate and House of 
     Representatives a report on the use made of the authority 
     provided under section 1720D of title 38, United States Code, 
     as amended by this section. The report shall include the 
     following with respect to activities under that section since 
     the enactment of this Act:
       (1) The number of veterans who have received counseling 
     under that section.
       (2) The number of veterans who have been referred to non-
     Department mental health facilities and providers in 
     connection with sexual trauma counseling and treatment.

     SEC. 116. SPECIALIZED MENTAL HEALTH SERVICES.

       (a) Improvement to Specialized Mental Health Services.--The 
     Secretary, in furtherance of the responsibilities of the 
     Secretary under section 1706(b) of title 38, United States 
     Code, shall carry out a program to expand and improve the 
     provision of specialized mental health services to veterans. 
     The Secretary shall establish the program in consultation 
     with the Committee on Care of Severely Chronically Mentally 
     Ill Veterans established pursuant to section 7321 of title 
     38, United States Code.
       (b) Covered Programs.--For purposes of this section, the 
     term ``specialized mental health services'' includes programs 
     relating to--
       (1) the treatment of post-traumatic stress disorder; and
       (2) substance use disorders.
       (c) Funding.--(1) In carrying out the program described in 
     subsection (a), the Secretary shall identify, from funds 
     available to the Department for medical care, an amount of 
     not less than $15,000,000 to be available to carry out the 
     program and to be allocated to facilities of the Department 
     pursuant to subsection (d).
       (2) In identifying available amounts pursuant to paragraph 
     (1), the Secretary shall ensure that, after the allocation of 
     those funds under subsection (d), the total expenditure for 
     programs relating to (A) the treatment of post-traumatic 
     stress disorder, and (B) substance use disorders is not less 
     than $15,000,000 in excess of the baseline amount.
       (3) For purposes of paragraph (2), the baseline amount is 
     the amount of the total expenditures on such programs for the 
     most recent fiscal year for which final expenditure amounts 
     are known, adjusted to reflect any subsequent increase in 
     applicable costs to deliver such services in the Veterans 
     Health Administration, as determined by the Committee on Care 
     of Severely Chronically Mentally Ill Veterans.
       (d) Allocation of Funds to Department Facilities.--The 
     Secretary shall allocate funds identified pursuant to 
     subsection (c)(1) to individual medical facilities of the 
     Department as the Secretary determines appropriate based upon 
     proposals submitted by those facilities for the use of those 
     funds for improvements to specialized mental health services.
       (e) Report.--Not later than 12 months after the date of the 
     enactment of this Act, the Secretary shall submit to the 
     Committees on Veterans' Affairs of the Senate and House of 
     Representatives a report describing the implementation of 
     this section. The Secretary shall include in the report 
     information on the allocation of funds to facilities of the 
     Department under the program and a description of the 
     improvements made with those funds to specialized mental 
     health services for veterans.
                TITLE II--MEDICAL PROGRAM ADMINISTRATION

     SEC. 201. MEDICAL CARE COLLECTIONS.

       (a) Limited Authority To Set Copayments.--Section 1722A is 
     amended--
       (1) by redesignating subsections (b) and (c) as subsections 
     (c) and (d), respectively;
       (2) by inserting after subsection (a) the following new 
     subsection (b):
       ``(b) The Secretary, pursuant to regulations which the 
     Secretary shall prescribe, may--
       ``(1) increase the copayment amount in effect under 
     subsection (a); and
       ``(2) establish a maximum monthly and a maximum annual 
     pharmaceutical copayment amount under subsection (a) for 
     veterans who have multiple outpatient prescriptions.''; and
       (3) in subsection (c), as redesignated by paragraph (1)--
       (A) by striking ``this section'' and inserting ``subsection 
     (a)''; and
       (B) by adding at the end the following new sentence: 
     ``Amounts collected through use of the authority under 
     subsection (b) shall be deposited in the Department of 
     Veterans Affairs Health Services Improvement Fund.''.
       (b) Outpatient Treatment.--Section 1710(g) is amended--
       (1) in paragraph (1), by striking ``the amount determined 
     under paragraph (2) of this subsection'' and inserting ``in 
     the case of each outpatient visit the applicable amount or 
     amounts established by the Secretary by regulation''; and
       (2) in paragraph (2), by striking all after ``for an 
     amount'' and inserting ``which the Secretary shall establish 
     by regulation.''.

     SEC. 202. HEALTH SERVICES IMPROVEMENT FUND.

       (a) Establishment of Fund.--Chapter 17 is amended by 
     inserting after section 1729A the following new section:

     ``Sec. 1729B. Health Services Improvement Fund

       ``(a) There is established in the Treasury of the United 
     States a fund to be known as the Department of Veterans 
     Affairs Health Services Improvement Fund.
       ``(b) Amounts received or collected after the date of the 
     enactment of this section under any of the following 
     provisions of law shall be deposited in the fund:
       ``(1) Section 1713A of this title.
       ``(2) Section 1722A(b) of this title.
       ``(3) Section 8165(a) of this title.
       ``(4) Section 113 of the Veterans Millennium Health Care 
     and Benefits Act.
       ``(c) Amounts in the fund are hereby available, without 
     fiscal year limitation, to the Secretary for the purposes 
     stated in subparagraphs (A) and (B) of section 1729A(c)(1) of 
     this title.
       ``(d) The Secretary shall allocate amounts in the fund in 
     the same manner as applies under subsection (d) of section 
     1729A of this title with respect to amounts made available 
     from the fund under that section.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 1729A the following new item:

``1729B. Health Services Improvement Fund.''.

     SEC. 203. ALLOCATION TO HEALTH CARE FACILITIES OF AMOUNTS 
                   MADE AVAILABLE FROM MEDICAL CARE COLLECTIONS 
                   FUND.

       Section 1729A(d) is amended--
       (1) by striking ``(1)'';
       (2) by striking ``each designated health care region'' and 
     inserting ``each Department health care facility'';
       (3) by striking ``each region'' and inserting ``each 
     facility'';
       (4) by striking ``such region'' both places it appears and 
     inserting ``such facility''; and
       (5) by striking paragraph (2).

     SEC. 204. AUTHORITY TO ACCEPT FUNDS FOR EDUCATION AND 
                   TRAINING.

       (a) Establishment of Nonprofit Corporations at Medical 
     Centers.--Section 7361(a) is amended--
       (1) by inserting ``and education'' after ``research''; and
       (2) by adding at the end the following: ``Such a 
     corporation may be established to facilitate either research 
     or education or both research and education.''.
       (b) Purpose of Corporations.--Section 7362 is amended--
       (1) in the first sentence--
       (A) by inserting ``(a)'' before ``Any corporation''; and
       (B) by inserting ``and education and training as described 
     in sections 7302, 7471, 8154, and 1701(6)(B) of this title'' 
     after ``of this title'';
       (2) in the second sentence--
       (A) by inserting ``or education'' after ``research''; and
       (B) by striking ``that purpose'' and inserting ``these 
     purposes''; and
       (3) by adding at the end the following new subsection:
       ``(b) For purposes of this section, the term `education and 
     training' means the following:
       ``(1) In the case of employees of the Veterans Health 
     Administration, such term means work-related instruction or 
     other learning experiences to--
       ``(A) improve performance of current duties;
       ``(B) assist employees in maintaining or gaining 
     specialized proficiencies; and
       ``(C) expand understanding of advances and changes in 
     patient care, technology, and health care administration.
     Such term includes (in the case of such employees) education 
     and training conducted as part of a residency or other 
     program designed to prepare an individual for an occupation 
     or profession.
       ``(2) In the case of veterans under the care of the 
     Veterans Health Administration, such term means instruction 
     or other learning experiences related to improving and 
     maintaining the health of veterans to patients and to the 
     families and guardians of patients.''.
       (c) Board of Directors.--Section 7363(a) is amended--
       (1) in subsection (a)(1), by striking all after ``medical 
     center, and'' and inserting ``as appropriate, the assistant 
     chief of staff for research for the medical center and the 
     assistant chief of staff for education for the medical 
     center, or, in the case of a facility at which such positions 
     do not exist, those officials who are responsible for 
     carrying out the responsibilities of the medical center 
     director, chief of staff, and, as appropriate, the assistant 
     chief of staff for research and the assistant chief of staff 
     for education; and'';
       (2) in subsection (a)(2), by inserting ``or education, as 
     appropriate'' after ``research''; and
       (3) in subsection (c), by inserting ``or education'' after 
     ``research''.

[[Page H11982]]

       (d) Approval of Expenditures.--Section 7364 is amended by 
     adding at the end the following new subsection:
       ``(c)(1) A corporation established under this subchapter 
     may not spend funds for an education activity unless the 
     activity is approved in accordance with procedures prescribed 
     by the Under Secretary for Health.
       ``(2) The Under Secretary for Health shall prescribe 
     policies and procedures to guide the expenditure of funds by 
     corporations under paragraph (1) consistent with the purpose 
     of such corporations as flexible funding mechanisms.''.
       (e) Accountability and Oversight.--Section 7366(d) is 
     amended--
       (1) in paragraph (2)(B), by inserting ``for research and 
     the amount received from governmental entities for 
     education'' after ``entities'';
       (2) in paragraph (2)(C), by inserting ``for research and 
     the amount received from all other sources for education'' 
     after ``sources'';
       (3) in paragraph (2)(D), by striking ``the'' and inserting 
     ``a'';
       (4) in paragraph (3)(A), by striking ``and'' and inserting 
     ``, the amount expended for salary for education staff, and 
     the amount expended'';
       (5) in paragraph (3)(B), by inserting ``and the amount 
     expended for direct support of education'' after 
     ``research''; and
       (6) by adding at the end the following new paragraph:
       ``(4) The amount expended by each corporation during the 
     year for travel conducted in conjunction with research and 
     the amount expended for travel in conjunction with 
     education.''.

     SEC. 205. EXTENSION OF CERTAIN AUTHORITIES.

       (a) Readjustment Counseling.--Section 1712A(a)(1)(B)(ii) is 
     amended by striking ``January 1, 2000'' and inserting 
     ``January 1, 2004''.
       (b) Newsletter on Medical Care for Persian Gulf Veterans.--
     Section 105(b)(2) of the Persian Gulf War Veterans' Benefits 
     Act (title I of Public Law 103-446; 108 Stat. 4659; 38 U.S.C. 
     1117 note) is amended by striking ``December 31, 1999'' and 
     inserting ``December 31, 2003''.
       (c) Evaluation of Health of Spouses and Children of Persian 
     Gulf Veterans.--Section 107(b) of that Act is amended by 
     striking ``December 31, 1999'' and inserting ``December 31, 
     2003''.

     SEC. 206. REESTABLISHMENT OF COMMITTEE ON POST-TRAUMATIC 
                   STRESS DISORDER.

       Section 110 of the Veterans' Health Care Act of 1984 (38 
     U.S.C. 1712A note) is amended--
       (1) by striking ``Chief Medical Director'' each place it 
     appears and inserting ``Under Secretary for Health'';
       (2) by striking ``Veterans' Administration'' each place it 
     appears (other than in subsection (a)(1)) and inserting 
     ``Department'';
       (3) by striking ``Veterans' Administration'' in subsection 
     (a)(1) and inserting ``Department of Veterans Affairs'';
       (4) by striking ``Department of Medicine and Surgery'' each 
     place it appears and inserting ``Veterans Health 
     Administration'';
       (5) by striking ``section 612A'' in subsection (a)(2) and 
     inserting ``section 1712A'';
       (6) by striking ``Department'' in the second sentence of 
     subsection (b)(1) and inserting ``Veterans Health 
     Administration'';
       (7) by striking ``Department of Veterans' Benefits'' in 
     subsection (b)(4)(E) and inserting ``Veterans Benefits 
     Administration'';
       (8) in subsection (e)(1), by striking ``Not later than 
     March 1, 1985, the Administrator'' and inserting ``Not later 
     than March 1, 2000, the Secretary''; and
       (9) in subsection (e)(2)--
       (A) by striking ``Not later than February 1, 1986'' and 
     inserting ``Not later than February 1, 2001'';
       (B) by striking ``Administrator'' and inserting 
     ``Secretary''; and
       (C) by striking ``before the submission of such report'' 
     and inserting ``since the enactment of the Veterans 
     Millennium Health Care and Benefits Act''.

     SEC. 207. STATE HOME GRANT PROGRAM.

       (a) General Regulations.--Section 8134 is amended--
       (1) by redesignating subsection (b) as subsection (c);
       (2) by striking the matter in subsection (a) preceding 
     paragraph (2) and inserting the following:
       ``(a)(1) The Secretary shall prescribe regulations for the 
     purposes of this subchapter.
       ``(2) In those regulations, the Secretary shall prescribe 
     for each State the number of nursing home and domiciliary 
     beds for which assistance under this subchapter may be 
     furnished. Such regulations shall be based on projected 
     demand for such care 10 years after the date of the enactment 
     of the Veterans Millennium Health Care and Benefits Act by 
     veterans who at such time are 65 years of age or older and 
     who reside in that State. In determining such projected 
     demand, the Secretary shall take into account travel 
     distances for veterans and their families.
       ``(3)(A) In those regulations, the Secretary shall 
     establish criteria under which the Secretary shall determine, 
     with respect to an application for assistance under this 
     subchapter for a project described in subparagraph (B) which 
     is from a State that has a need for additional beds as 
     determined under subsections (a)(2) and (d)(1), whether the 
     need for such beds is most aptly characterized as great, 
     significant, or limited. Such criteria shall take into 
     account the availability of beds already operated by the 
     Secretary and other providers which appropriately serve the 
     needs which the State proposes to meet with its 
     application.
       ``(B) This paragraph applies to a project for the 
     construction or acquisition of a new State home facility, a 
     project to increase the number of beds available at a State 
     home facility, and a project to replace beds at a State home 
     facility.
       ``(4) The Secretary shall review and, as necessary, revise 
     regulations prescribed under paragraphs (2) and (3) not less 
     often than every four years.
       ``(b) The Secretary shall prescribe the following by 
     regulation:'';
       (3) by redesignating paragraphs (2) and (3) of subsection 
     (b), as designated by paragraph (2), as paragraphs (1) and 
     (2);
       (4) in subsection (c), as redesignated by paragraph (1), by 
     striking ``subsection (a)(3)'' and inserting ``subsection 
     (b)(2)''; and
       (5) by adding at the end the following new subsection:
       ``(d)(1) In prescribing regulations to carry out this 
     subchapter, the Secretary shall provide that in the case of a 
     State that seeks assistance under this subchapter for a 
     project described in subsection (a)(3)(B), the determination 
     of the unmet need for beds for State homes in that State 
     shall be reduced by the number of beds in all previous 
     applications submitted by that State under this subchapter, 
     including beds which have not been recognized by the 
     Secretary under section 1741 of this title.
       ``(2)(A) Financial assistance under this subchapter for a 
     renovation project may only be provided for a project for 
     which the total cost of construction is in excess of $400,000 
     (as adjusted from time to time in such regulations to reflect 
     changes in costs of construction).
       ``(B) For purposes of this paragraph, a renovation project 
     is a project to remodel or alter existing buildings for which 
     financial assistance under this subchapter may be provided 
     and does not include maintenance and repair work which is the 
     responsibility of the State.''.
       (b) Applications With Respect to Projects.--Section 8135 is 
     amended--
       (1) in subsection (a)--
       (A) by striking ``set forth--'' in the matter preceding 
     paragraph (1) and inserting ``set forth the following:'';
       (B) by capitalizing the first letter of the first word in 
     each of paragraphs (1) through (9);
       (C) by striking the comma at the end of each of paragraphs 
     (1) through (7) and inserting a period; and
       (D) by striking ``, and'' at the end of paragraph (8) and 
     inserting a period;
       (2) by redesignating subsections (b), (c), (d), and (e) as 
     subsections (c), (d), (e), and (f), respectively;
       (3) by inserting after subsection (a) the following new 
     subsection (b):
       ``(b)(1) Any State seeking to receive assistance under this 
     subchapter for a project that would involve construction or 
     acquisition of either nursing home or domiciliary facilities 
     shall include with its application under subsection (a) the 
     following:
       ``(A) Documentation (i) that the site for the project is in 
     reasonable proximity to a sufficient concentration and 
     population of veterans who are 65 years of age and older, and 
     (ii) that there is a reasonable basis to conclude that the 
     facilities when complete will be fully occupied.
       ``(B) A financial plan for the first three years of 
     operation of such facilities.
       ``(C) A five-year capital plan for the State home program 
     for that State.
       ``(2) Failure to provide adequate documentation under 
     paragraph (1)(A) or to provide an adequate financial plan 
     under paragraph (1)(B) shall be a basis for disapproving the 
     application.''; and
       (4) in subsection (c), as redesignated by paragraph (2)--
       (A) in paragraph (1), by striking ``for a grant under 
     subsection (a) of this section'' in the matter preceding 
     subparagraph (A) and inserting ``under subsection (a) for 
     financial assistance under this subchapter'';
       (B) in paragraph (2)--
       (i) by striking ``the construction or acquisition of'' in 
     subparagraph (A); and
       (ii) by striking subparagraphs (B), (C), and (D) and 
     inserting the following:
       ``(B) An application from a State for a project at an 
     existing facility to remedy a condition or conditions that 
     have been cited by an accrediting institution, by the 
     Secretary, or by a local licensing or approving body of the 
     State as being threatening to the lives or safety of the 
     patients in the facility.
       ``(C) An application from a State that has not previously 
     applied for award of a grant under this subchapter for 
     construction or acquisition of a State nursing home.
       ``(D) An application for construction or acquisition of a 
     nursing home or domiciliary from a State that the Secretary 
     determines, in accordance with regulations under this 
     subchapter, has a great need for the beds to be established 
     at such home or facility.
       ``(E) An application from a State for renovations to a 
     State home facility other than renovations described in 
     subparagraph (B).
       ``(F) An application for construction or acquisition of a 
     nursing home or domiciliary from a State that the Secretary 
     determines, in accordance with regulations under this 
     subchapter, has a significant need for the beds to be 
     established at such home or facility.
       ``(G) An application that meets other criteria as the 
     Secretary determines appropriate and has established in 
     regulations.
       ``(H) An application for construction or acquisition of a 
     nursing home or domiciliary from a State that the Secretary 
     determines, in accordance with regulations under this 
     subchapter, has a limited need for the beds to be established 
     at such home or facility.''; and
       (C) in paragraph (3), by striking subparagraph (A) and 
     inserting the following:
       ``(A) may not accord any priority to a project for the 
     construction or acquisition of a hospital; and''.
       (c) Transition.--(1) The provisions of sections 8134 and 
     8135 of title 38, United States Code, as in effect on 
     November 10, 1999, shall continue in effect after that date 
     with respect to applications described in section 
     8135(b)(2)(A) of such

[[Page H11983]]

     title, as in effect on that date, that are identified in 
     paragraph (2) (and to projects and grants pursuant to those 
     applications). The Secretary shall accord priority among 
     those applications in the order listed in paragraph (2).
       (2) Applications covered by paragraph (1) are the 
     following:
       (A) Any application for a fiscal year 1999 priority one 
     project.
       (B) Any application for a fiscal year 2000 priority one 
     project that was submitted by a State that (i) did not 
     receive grant funds from amounts appropriated for fiscal year 
     1999 under the State home grant program, and (ii) does not 
     have any fiscal year 1999 priority one projects.
       (3) For purposes of this subsection--
       (A) the term ``fiscal year 1999 priority one project'' 
     means a project on the list of approved projects established 
     by the Secretary on October 29, 1998, under section 
     8135(b)(4) of title 38, United States Code, as in effect on 
     that date that (pursuant to section 8135(b)(2)(A) of that 
     title) is in the grouping of projects on that list designated 
     as Priority Group 1;
       (B) the term ``fiscal year 2000 priority one project'' 
     means a project on the list of approved projects established 
     by the Secretary on November 3, 1999, under section 
     8135(b)(4) of title 38, United States Code, as in effect on 
     that date that (pursuant to section 8135(b)(2)(A) of that 
     title) is in the grouping of projects on that list designated 
     as Priority Group 1; and
       (C) the term ``State home grant program'' means the grant 
     program under subchapter III of chapter 81 of title 38, 
     United States Code.
       (d) Effective Date for Initial Regulations.--The Secretary 
     shall prescribe the initial regulations under subsection (a) 
     of section 8134 of title 38, United States Code, as added by 
     subsection (a), not later than April 30, 2000.

     SEC. 208. EXPANSION OF ENHANCED-USE LEASE AUTHORITY.

       (a) Authority.--Section 8162(a)(2) is amended--
       (1) by striking ``only if the Secretary'' and inserting 
     ``only if--
       ``(A) the Secretary'';
       (2) by redesignating subparagraphs (A), (B), and (C) as 
     clauses (i), (ii), and (iii), respectively, and realigning 
     those clauses so as to be four ems from the left margin;
       (3) by striking the period at the end of clause (iii), as 
     so redesignated, and inserting ``; or''; and
       (4) by adding at the end the following:
       ``(B) the Secretary determines that the implementation of a 
     business plan proposed by the Under Secretary for Health for 
     applying the consideration under such a lease to the 
     provision of medical care and services would result in a 
     demonstrable improvement of services to eligible veterans in 
     the geographic service-delivery area within which the 
     property is located.''.
       (b) Term of Enhanced-Use Lease.--Section 8162(b) is 
     amended--
       (1) in paragraph (2), by striking ``may not exceed--'' and 
     all that follows and inserting ``may not exceed 75 years.''; 
     and
       (2) by striking paragraph (4) and inserting the following:
       ``(4) The terms of an enhanced-use lease may provide for 
     the Secretary to--
       ``(A) obtain facilities, space, or services on the leased 
     property; and
       ``(B) use minor construction funds for capital contribution 
     payments.''.
       (c) Designation of Property Proposed To Be Leased.--(1) 
     Subsection (b) of section 8163 is amended--
       (A) by striking ``include--'' and inserting ``include the 
     following:'';
       (B) by capitalizing the first letter of the first word of 
     each of paragraphs (1), (2), (3), (4), and (5);
       (C) by striking the semicolon at the end of paragraphs (1), 
     (2), and (3) and inserting a period; and
       (D) by striking subparagraphs (A), (B), and (C) of 
     paragraph (4) and inserting the following:
       ``(A) would--
       ``(i) contribute in a cost-effective manner to the mission 
     of the Department;
       ``(ii) not be inconsistent with the mission of the 
     Department;
       ``(iii) not adversely affect the mission of the Department; 
     and
       ``(iv) affect services to veterans; or
       ``(B) would result in a demonstrable improvement of 
     services to eligible veterans in the geographic service-
     delivery area within which the property is located.''.
       (2) Subparagraph (E) of subsection (c)(1) of that section 
     is amended by striking clauses (i), (ii), and (iii) and 
     inserting the following:
       ``(i) would--
       ``(I) contribute in a cost-effective manner to the mission 
     of the Department;
       ``(II) not be inconsistent with the mission of the 
     Department;
       ``(III) not adversely affect the mission of the Department; 
     and
       ``(IV) affect services to veterans; or
       ``(ii) would result in a demonstrable improvement of 
     services to eligible veterans in the geographic service-
     delivery area within which the property is located.''.
       (d) Use of Proceeds.--Section 8165(a) is amended by 
     striking paragraph (1) and inserting the following:
       ``(a)(1) Funds received by the Department under an 
     enhanced-use lease and remaining after any deduction from 
     those funds under subsection (b) shall be deposited in the 
     Department of Veterans Affairs Health Services Improvement 
     Fund established under section 1729B of this title.''.
       (e) Extension of Authority.--Section 8169 is amended by 
     striking ``December 31, 2001'' and inserting ``December 31, 
     2011''.
       (f) Training and Outreach Regarding Authority.--The 
     Secretary shall take appropriate actions to provide training 
     and outreach to personnel at Department medical centers 
     regarding the enhanced-use lease authority under subchapter V 
     of chapter 81 of title 38, United States Code. The training 
     and outreach shall address methods of approaching potential 
     lessees in the medical or commercial sectors regarding the 
     possibility of entering into leases under that authority and 
     other appropriate matters.
       (g) Independent Analysis of Opportunities for Use of 
     Authority.--(1) The Secretary shall take appropriate actions 
     to secure from an appropriate entity (or entities) 
     independent of the Department an analysis (or analyses) of 
     opportunities for the use of the enhanced-use lease authority 
     under subchapter V of chapter 81 of title 38, United States 
     Code.
       (2) An analysis under paragraph (1) shall include--
       (A) a survey of facilities of the Department for purposes 
     of identifying Department property that presents an 
     opportunity for lease under the enhanced-use lease authority;
       (B) an assessment of the feasibility of entering into 
     enhanced-use leases under that authority in the case of any 
     property identified under subparagraph (A) as presenting an 
     opportunity for such lease; and
       (C) an assessment of the resources required at the 
     Department facilities concerned, and at the Department 
     Central Office, in order to facilitate the entering into of 
     enhanced-used leases in the case of property so identified.
       (3) If as a result of a survey under paragraph (2)(A) an 
     entity carrying out an analysis under this subsection 
     determines that a particular Department property presents no 
     opportunities for lease under the enhanced-use lease 
     authority, the analysis shall include the entity's 
     explanation of that determination.
       (4) If as a result of such a survey an entity carrying out 
     an analysis under this subsection determines that certain 
     Department property presents an opportunity for lease under 
     the enhanced-use lease authority, the analysis shall include 
     a single integrated business plan, developed by the entity, 
     that addresses the strategy and resources necessary to 
     implement the plan for all property determined to present an 
     opportunity for such lease.

     SEC. 209. INELIGIBILITY FOR EMPLOYMENT BY VETERANS HEALTH 
                   ADMINISTRATION OF HEALTH CARE PROFESSIONALS WHO 
                   HAVE LOST LICENSE TO PRACTICE IN ONE 
                   JURISDICTION WHILE STILL LICENSED IN ANOTHER 
                   JURISDICTION.

       Section 7402 is amended by adding at the end the following 
     new subsection:
       ``(f) A person may not be employed in a position under 
     subsection (b) (other than under paragraph (4) of that 
     subsection) if--
       ``(1) the person is or has been licensed, registered, or 
     certified (as applicable to such position) in more than one 
     State; and
       ``(2) either--
       ``(A) any of those States has terminated such license, 
     registration, or certification for cause; or
       ``(B) the person has voluntarily relinquished such license, 
     registration, or certification in any of those States after 
     being notified in writing by that State of potential 
     termination for cause.''.

     SEC. 210. REPORT ON COORDINATION OF PROCUREMENT OF 
                   PHARMACEUTICALS AND MEDICAL SUPPLIES BY THE 
                   DEPARTMENT OF VETERANS AFFAIRS AND THE 
                   DEPARTMENT OF DEFENSE.

       (a) Requirement.--Not later than July 31, 2000, the 
     Secretary of Veterans Affairs and the Secretary of Defense 
     shall jointly submit to the Committees on Veterans' Affairs 
     and Armed Services of the Senate and the Committees on 
     Veterans' Affairs and Armed Services of the House of 
     Representatives a report on the cooperation between the 
     Department of Veterans Affairs and the Department of Defense 
     in the procurement of pharmaceuticals and medical supplies.
       (b) Report Elements.--The report under subsection (a) shall 
     include the following:
       (1) A description of the current cooperation between the 
     Department of Veterans Affairs and the Department of Defense 
     in the procurement of pharmaceuticals and medical supplies.
       (2) An assessment of the means by which cooperation between 
     the departments in such procurement could be enhanced or 
     improved.
       (3) A description of any existing memoranda of agreement 
     between the Department of Veterans Affairs and the Department 
     of Defense that provide for the cooperation referred to in 
     subsection (a).
       (4) A description of the effects, if any, such agreements 
     will have on current staffing levels at the Defense Supply 
     Center in Philadelphia, Pennsylvania, and the Department of 
     Veterans Affairs National Acquisition Center in Hines, 
     Illinois.
       (5) A description of the effects, if any, of such 
     cooperation on military readiness.
       (6) A comprehensive assessment of cost savings realized and 
     projected over the five fiscal year period beginning in 
     fiscal year 1999 for the Department of Veterans Affairs and 
     the Department of Defense as a result of such cooperation, 
     and the overall savings to the Treasury of the United States 
     as a result of such cooperation.
       (7) A list of the types of medical supplies and 
     pharmaceuticals for which cooperative agreements would not be 
     appropriate and the reason or reasons therefor.
       (8) An assessment of the extent to which cooperative 
     agreements could be expanded to include medical equipment, 
     major systems, and durable goods used in the delivery of 
     health care by the Department of Veterans Affairs and the 
     Department of Defense.
       (9) A description of the effects such agreements might have 
     on distribution of items purchased cooperatively by the 
     Department of Veterans Affairs and the Department of Defense, 
     particularly outside the continental United States.

[[Page H11984]]

       (10) An assessment of the potential to establish common 
     pharmaceutical formularies between the Department of Veterans 
     Affairs and the Department of Defense.
       (11) An explanation of the current Uniform Product Number 
     (UPN) requirements of each Department and of any planned 
     standardization of such requirements between the Departments 
     for medical equipment and durable goods manufacturers.

     SEC. 211. REIMBURSEMENT OF MEDICAL EXPENSES OF VETERANS 
                   LOCATED IN ALASKA.

       (a) Preservation of Current Reimbursement Rates.--
     Notwithstanding any other provision of law, the Secretary 
     shall, for purposes of reimbursing veterans in Alaska for 
     medical expenses under section 1728 of title 38, United 
     States Code, during the one-year period beginning on the 
     date of the enactment of this Act, use the fee-for-service 
     payment schedule in effect for such purposes on July 31, 
     1999, rather than the Participating Physician Fee Schedule 
     under the Medicare program.
       (b) Report.--(1) Not later than 180 days after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     and the Secretary of Health and Human Services shall jointly 
     submit to the Committees on Veterans' Affairs of the Senate 
     and the House of Representatives a report and recommendation 
     on the use of the Participating Physician Fee Schedule under 
     the Medicare program as a means of calculating reimbursement 
     rates for medical expenses of veterans located in Alaska 
     under section 1728 of title 38, United States Code.
       (2) The report shall--
       (A) assess the differences between health care costs in 
     Alaska and health care costs in the continental United 
     States;
       (B) describe any differences between the costs of providing 
     health care in Alaska and the reimbursement rates for the 
     provision of health care under the Participating Physician 
     Fee Schedule; and
       (C) assess the effects on health care for veterans in 
     Alaska of implementing the Participating Physician Fee 
     Schedule as a means of calculating reimbursement rates for 
     medical expenses of veterans located in Alaska under section 
     1728 of title 38, United States Code.
              TITLE III--MISCELLANEOUS MEDICAL PROVISIONS

     SEC. 301. REVIEW OF PROPOSED CHANGES TO OPERATION OF MEDICAL 
                   FACILITIES.

       Section 8110 is amended by adding at the end the following 
     new subsections:
       ``(d) The Secretary may not in any fiscal year close more 
     than 50 percent of the beds within a bed section (of 20 or 
     more beds) of a Department medical center unless the 
     Secretary first submits to the Committees on Veterans' 
     Affairs of the Senate and the House of Representatives a 
     report providing a justification for the closure. No action 
     to carry out such closure may be taken after the submission 
     of such report until the end of the 21-day period beginning 
     on the date of the submission of the report.
       ``(e) The Secretary shall submit to the Committees on 
     Veterans' Affairs of the Senate and the House of 
     Representatives, not later than January 20 of each year, a 
     report documenting by network for the preceding fiscal year 
     the following:
       ``(1) The number of medical service and surgical service 
     beds, respectively, that were closed during that fiscal year 
     and, for each such closure, a description of the changes in 
     delivery of services that allowed such closure to occur.
       ``(2) The number of nursing home beds that were the subject 
     of a mission change during that fiscal year and the nature of 
     each such mission change.
       ``(f) For purposes of this section:
       ``(1) The term `closure', with respect to beds in a medical 
     center, means ceasing to provide staffing for, and to 
     operate, those beds. Such term includes converting the 
     provision of such bed care from care in a Department facility 
     to care under contract arrangements.
       ``(2) The term `bed section', with respect to a medical 
     center, means psychiatric beds (including beds for treatment 
     of substance abuse and post-traumatic stress disorder), 
     intermediate, neurology, and rehabilitation medicine beds, 
     extended care (other than nursing home) beds, and domiciliary 
     beds.
       ``(3) The term `justification', with respect to closure of 
     beds, means a written report that includes the following:
       ``(A) An explanation of the reasons for the determination 
     that the closure is appropriate and advisable.
       ``(B) A description of the changes in the functions to be 
     carried out and the means by which such care and services 
     would continue to be provided to eligible veterans.
       ``(C) A description of the anticipated effects of the 
     closure on veterans and on their access to care.''.

     SEC. 302. PATIENT SERVICES AT DEPARTMENT FACILITIES.

       Section 7803 is amended--
       (1) in subsection (a)--
       (A) by striking ``(a)'' before ``The canteens''; and
       (B) by striking ``in this subsection;'' and all that 
     follows through ``the premises'' and inserting ``in this 
     section''; and
       (2) by striking subsection (b).

     SEC. 303. CHIROPRACTIC TREATMENT.

       (a) Establishment of Program.--Not later than 120 days 
     after the date of the enactment of this Act, the Under 
     Secretary for Health of the Department of Veterans 
     Affairs, after consultation with chiropractors, shall 
     establish a policy for the Veterans Health Administration 
     regarding the role of chiropractic treatment in the care 
     of veterans under chapter 17 of title 38, United States 
     Code.
       (b) Definitions.--For purposes of this section:
       (1) The term ``chiropractic treatment'' means the manual 
     manipulation of the spine performed by a chiropractor for the 
     treatment of such musculo-skeletal conditions as the 
     Secretary considers appropriate.
       (2) The term ``chiropractor'' means an individual who--
       (A) is licensed to practice chiropractic in the State in 
     which the individual performs chiropractic services; and
       (B) holds the degree of doctor of chiropractic from a 
     chiropractic college accredited by the Council on 
     Chiropractic Education.

     SEC. 304. DESIGNATION OF HOSPITAL BED REPLACEMENT BUILDING AT 
                   IOANNIS A. LOUGARIS DEPARTMENT OF VETERANS 
                   AFFAIRS MEDICAL CENTER, RENO, NEVADA.

       The hospital bed replacement building under construction at 
     the Ioannis A. Lougaris Department of Veterans Affairs 
     Medical Center in Reno, Nevada, is hereby designated as the 
     ``Jack Streeter Building''. Any reference to that building in 
     any law, regulation, map, document, record, or other paper of 
     the United States shall be considered to be a reference to 
     the Jack Streeter Building.
             TITLE IV--CONSTRUCTION AND FACILITIES MATTERS

     SEC. 401. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS.

       The Secretary of Veterans Affairs may carry out the 
     following major medical facility projects, with each project 
     to be carried out in the amount specified for that project:
       (1) Construction of a long term care facility at the 
     Department of Veterans Affairs Medical Center, Lebanon, 
     Pennsylvania, in an amount not to exceed $14,500,000.
       (2) Renovations and environmental improvements at the 
     Department of Veterans Affairs Medical Center, Fargo, North 
     Dakota, in an amount not to exceed $12,000,000.
       (3) Construction of a surgical suite and post-anesthesia 
     care unit at the Department of Veterans Affairs Medical 
     Center, Kansas City, Missouri, in an amount not to exceed 
     $13,000,000.
       (4) Renovations and environmental improvements at the 
     Department of Veterans Affairs Medical Center, Atlanta, 
     Georgia, in an amount not to exceed $12,400,000.
       (5) Demolition of buildings at the Dwight D. Eisenhower 
     Department of Veterans Affairs Medical Center, Leavenworth, 
     Kansas, in an amount not to exceed $5,600,000.
       (6) Renovation to provide a domiciliary at Orlando, 
     Florida, in a total amount not to exceed $2,400,000, to be 
     derived only from funds appropriated for Construction, Major 
     Projects, for a fiscal year before fiscal year 2000 that 
     remain available for obligation.

     SEC. 402. AUTHORIZATION OF MAJOR MEDICAL FACILITY LEASES.

       The Secretary of Veterans Affairs may enter into leases for 
     medical facilities as follows:
       (1) Lease of an outpatient clinic, Lubbock, Texas, in an 
     amount not to exceed $1,112,000.
       (2) Lease of a research building, San Diego, California, in 
     an amount not to exceed $1,066,500.

     SEC. 403. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There are authorized to be appropriated to 
     the Secretary of Veterans Affairs for fiscal year 2000 and 
     for fiscal year 2001--
       (1) for the Construction, Major Projects, account 
     $57,500,000 for the projects authorized in paragraphs (1) 
     through (5) of section 401; and
       (2) for the Medical Care account, $2,178,500 for the leases 
     authorized in section 402.
       (b) Limitation.--The projects authorized in paragraphs (1) 
     through (5) of section 401 may only be carried out using--
       (1) funds appropriated for fiscal year 2000 or fiscal year 
     2001 pursuant to the authorization of appropriations in 
     subsection (a);
       (2) funds appropriated for Construction, Major Projects, 
     for a fiscal year before fiscal year 2000 that remain 
     available for obligation; and
       (3) funds appropriated for Construction, Major Projects, 
     for fiscal year 2000 for a category of activity not specific 
     to a project.
                TITLE V--BENEFITS AND EMPLOYMENT MATTERS
                    Subtitle A--Compensation and DIC

     SEC. 501. DEPENDENCY AND INDEMNITY COMPENSATION FOR SURVIVING 
                   SPOUSES OF FORMER PRISONERS OF WAR.

       (a) Short Title.--This section may be cited as the ``John 
     William Rolen Act''.
       (b) Eligibility.--Section 1318(b) is amended--
       (1) by striking ``that either--'' in the matter preceding 
     paragraph (1) and inserting ``rated totally disabling if--'';
       (2) in paragraph (1)--
       (A) by inserting ``the disability'' after ``(1)''; and
       (B) by striking ``or'' after ``death;'';
       (3) in paragraph (2)--
       (A) by striking ``if so rated for a lesser period, was so 
     rated continuously'' and inserting ``the disability was 
     continuously rated totally disabling''; and
       (B) by striking the period at the end and inserting ``; 
     or''; and
       (4) by adding at the end the following new paragraph:
       ``(3) the veteran was a former prisoner of war who died 
     after September 30, 1999, and the disability was continuously 
     rated totally disabling for a period of not later than one 
     year immediately preceding death.''.

     SEC. 502. REINSTATEMENT OF CERTAIN BENEFITS FOR REMARRIED 
                   SURVIVING SPOUSES OF VETERANS UPON TERMINATION 
                   OF THEIR REMARRIAGE.

       (a) Restoration of Prior Eligibility.--Section 103(d) is 
     amended--

[[Page H11985]]

       (1) by inserting ``(1)'' after ``(d)''; and
       (2) by adding at the end the following:
       ``(2) The remarriage of the surviving spouse of a veteran 
     shall not bar the furnishing of benefits specified in 
     paragraph (5) to such person as the surviving spouse of the 
     veteran if the remarriage has been terminated by death or 
     divorce unless the Secretary determines that the divorce was 
     secured through fraud or collusion.
       ``(3) If the surviving spouse of a veteran ceases living 
     with another person and holding himself or herself out openly 
     to the public as that person's spouse, the bar to granting 
     that person benefits as the surviving spouse of the veteran 
     shall not apply in the case of the benefits specified in 
     paragraph (5).
       ``(4) The first month of eligibility for benefits for a 
     surviving spouse by reason of this subsection shall be the 
     month after--
       ``(A) the month of the termination of such remarriage, in 
     the case of a surviving spouse described in paragraph (2); or
       ``(B) the month of the cessation described in paragraph 
     (3), in the case of a surviving spouse described in that 
     paragraph.
       ``(5) Paragraphs (2) and (3) apply with respect to benefits 
     under the following provisions of this title:
       ``(A) Section 1311, relating to dependency and indemnity 
     compensation.
       ``(B) Section 1713, relating to medical care for survivors 
     and dependents of certain veterans.
       ``(C) Chapter 35, relating to educational assistance.
       ``(D) Chapter 37, relating to housing loans.''.
       (b) Conforming Amendment.--Section 1311 is amended by 
     striking subsection (e).
       (c) Effective Date.--The amendments made by subsections (a) 
     and (b) shall take effect on the first day of the first month 
     beginning after the month in which this Act is enacted.
       (d) Limitation.--No payment may be made to a person by 
     reason of paragraphs (2) and (3) of section 103(d) of title 
     38, United States Code, as added by subsection (a), for any 
     period before the effective date specified in subsection (c).

     SEC. 503. PRESUMPTION THAT BRONCHIOLO-ALVEOLAR CARCINOMA IS 
                   SERVICE-CONNECTED.

       Section 1112(c)(2) is amended by adding at the end the 
     following new subparagraph:
       ``(P) Bronchiolo-alveolar carcinoma.''.
                         Subtitle B--Employment

     SEC. 511. CLARIFICATION OF VETERANS' CIVIL SERVICE EMPLOYMENT 
                   OPPORTUNITIES.

       (a) Coordination of Amendments.--If the Federal Reserve 
     Board Retirement Portability Act is enacted before this Act, 
     the amendments made by subsection (b) shall be made and the 
     amendments made by subsection (c) shall not be made. 
     Otherwise, the amendments made by subsection (c) shall be 
     made and the amendments made by subsection (b) and the 
     amendments made by section 204 of the Federal Reserve Board 
     Retirement Portability Act shall not be made.
       (b) Clarification of Civil Service Employment 
     Opportunities.--Subject to subsection (a), section 3304(f) of 
     title 5, United States Code, as amended by section 204 of the 
     Federal Reserve Board Retirement Portability Act, is 
     amended--
       (1) in paragraph (2), as added by such section, by striking 
     ``shall acquire competitive status and''; and
       (2) by adding at the end the following new paragraph:
       ``(5) The Office of Personnel Management shall prescribe 
     regulations necessary for the administration of this 
     subsection. The regulations shall ensure that an individual 
     who has completed an initial tour of active duty is not 
     excluded from the application of this subsection because of 
     having been released from such tour of duty shortly before 
     completing 3 years of active service, having been honorably 
     released from such duty.''.
       (c) Clarification of Civil Service Employment 
     Opportunities.--Subject to subsection (a), section 3304(f) of 
     title 5, United States Code, is amended--
       (1) by striking paragraph (4);
       (2) by redesignating paragraphs (2) and (3) as paragraphs 
     (3) and (4), respectively;
       (3) by inserting after paragraph (1) the following new 
     paragraph (2):
       ``(2) If selected, a preference eligible or veteran 
     described in paragraph (1) shall receive a career or career-
     conditional appointment, as appropriate.''; and
       (4) by adding at the end the following new paragraph:
       ``(5) The Office of Personnel Management shall prescribe 
     regulations necessary for the administration of this 
     subsection. The regulations shall ensure that an individual 
     who has completed an initial tour of active duty is not 
     excluded from the application of this subsection because of 
     having been released from such tour of duty shortly before 
     completing 3 years of active service, having been honorably 
     released from such duty.''.
       (d) Effective Date.--(1) If pursuant to subsection (a) the 
     amendments specified in subsection (b) are made, those 
     amendments shall apply as if included in section 204 of the 
     Federal Reserve Board Retirement Portability Act.
       (2) If pursuant to subsection (a) the amendments specified 
     in subsection (c) are made, those amendments shall take 
     effect as of October 31, 1998, as if included in subsection 
     (f) of section 3304 of title 5, United States Code, as 
     enacted by section 2 of the Veterans Employment Opportunities 
     Act of 1998 (Public Law 105-339; 112 Stat. 3182).
                   TITLE VI--MEMORIAL AFFAIRS MATTERS
            Subtitle A--American Battle Monuments Commission

     SEC. 601. CODIFICATION AND EXPANSION OF AUTHORITY FOR WORLD 
                   WAR II MEMORIAL.

       (a) Codification of Existing Authority; Expansion of 
     Authority.--(1) Chapter 21 of title 36, United States Code, 
     is amended by adding at the end the following new section:

     ``Sec. 2113. World War II memorial in the District of 
       Columbia

       ``(a) Solicitation and Acceptance of Contributions.--(1) 
     Consistent with its authority under section 2103(e) of this 
     title, the American Battle Monuments Commission shall solicit 
     and accept contributions for the World War II memorial.
       ``(2) In this section, the term `World War II memorial' 
     means the memorial authorized by Public Law 103-32 (40 U.S.C. 
     1003 note) to be established by the Commission on Federal 
     land in the District of Columbia or its environs to honor 
     members of the Armed Forces who served in World War II and to 
     commemorate the participation of the United States in that 
     war.
       ``(b) Creation of Memorial Fund.--(1) There is hereby 
     created in the Treasury a fund for the World War II memorial, 
     which shall consist of the following:
       ``(A) Amounts deposited, and interest and proceeds 
     credited, under paragraph (2).
       ``(B) Obligations obtained under paragraph (3).
       ``(C) The amount of surcharges paid to the Commission for 
     the World War II memorial under the World War II 50th 
     Anniversary Commemorative Coins Act (31 U.S.C. 5112 note).
       ``(D) Amounts borrowed using the authority provided under 
     subsection (d).
       ``(E) Any funds received by the Commission under section 
     2114 of this title in exchange for use of, or the right to 
     use, any mark, copyright or patent.
       ``(2) The Chairman of the Commission shall deposit in the 
     fund the amounts accepted as contributions under subsection 
     (a). The Secretary of the Treasury shall credit to the fund 
     the interest on, and the proceeds from sale or redemption of, 
     obligations held in the fund.
       ``(3) The Secretary of the Treasury shall invest any 
     portion of the fund that, as determined by the Chairman, is 
     not required to meet current expenses. Each investment shall 
     be made in an interest-bearing obligation of the United 
     States or an obligation guaranteed as to principal and 
     interest by the United States that, as determined by the 
     Chairman, has a maturity suitable for the fund.
       ``(c) Use of Fund.--The fund shall be available to the 
     Commission--
       ``(1) for the expenses of establishing the World War II 
     memorial, including the maintenance and preservation amount 
     provided for in section 8(b) of the Commemorative Works Act 
     (40 U.S.C. 1008(b));
       ``(2) for such other expenses, other than routine 
     maintenance, with respect to the World War II memorial as the 
     Commission considers warranted; and
       ``(3) to secure, obtain, register, enforce, protect, and 
     license any mark, copyright, or patent that is owned by, 
     assigned to, or licensed to the Commission under section 2114 
     of this title to aid or facilitate the construction of the 
     World War II memorial.
       ``(d) Special Borrowing Authority.--(1) To assure that 
     groundbreaking, construction, and dedication of the World War 
     II memorial are carried out on a timely basis, the Commission 
     may borrow money from the Treasury of the United States in 
     such amounts as the Commission considers necessary, but not 
     to exceed a total of $65,000,000. Borrowed amounts shall bear 
     interest at a rate determined by the Secretary of the 
     Treasury, taking into consideration the average market yield 
     on outstanding marketable obligations of the United States 
     of comparable maturities during the month preceding the 
     month in which the obligations of the Commission are 
     issued. The interest payments on such obligations may be 
     deferred with the approval of the Secretary, but any 
     interest payment so deferred shall also bear interest.
       ``(2) The borrowing of money by the Commission under 
     paragraph (1) shall be subject to such maturities, terms, and 
     conditions as may be agreed upon by the Commission and the 
     Secretary, except that the maturities may not exceed 20 years 
     and such borrowings may be redeemable at the option of the 
     Commission before maturity.
       ``(3) The obligations of the Commission shall be issued in 
     amounts and at prices approved by the Secretary. The 
     authority of the Commission to issue obligations under this 
     subsection shall remain available without fiscal year 
     limitation. The Secretary of the Treasury shall purchase any 
     obligations of the Commission to be issued under this 
     subsection, and for such purpose the Secretary of the 
     Treasury may use as a public debt transaction of the United 
     States the proceeds from the sale of any securities issued 
     under chapter 31 of title 31. The purposes for which 
     securities may be issued under such chapter are extended to 
     include any purchase of the Commission's obligations under 
     this subsection.
       ``(4) Repayment of the interest and principal on any funds 
     borrowed by the Commission under paragraph (1) shall be made 
     from amounts in the fund. The Commission may not use for such 
     purpose any funds appropriated for any other activities of 
     the Commission.
       ``(e) Treatment of Borrowing Authority.--In determining 
     whether the Commission has sufficient funds to complete 
     construction of the World War II memorial, as required by 
     section 8 of the Commemorative Works Act (40 U.S.C. 1008), 
     the Secretary of the Interior shall consider the funds that 
     the Commission may borrow from the Treasury under subsection 
     (d) as funds available to complete construction of the 
     memorial, whether or not the Commission has actually 
     exercised the authority to borrow such funds.
       ``(f) Voluntary Services.--(1) Notwithstanding section 1342 
     of title 31, the Commission may accept from any person 
     voluntary services

[[Page H11986]]

     to be provided in furtherance of the fund-raising activities 
     of the Commission relating to the World War II memorial.
       ``(2) A person providing voluntary services under this 
     subsection shall be considered to be a Federal employee for 
     purposes of chapter 81 of title 5, relating to compensation 
     for work-related injuries, and chapter 171 of title 28, 
     relating to tort claims. A volunteer who is not otherwise 
     employed by the United States shall not be considered to be a 
     Federal employee for any other purpose by reason of the 
     provision of such voluntary service, except that any 
     volunteer given responsibility for the handling of funds or 
     the carrying out of a Federal function is subject to the 
     conflict of interest laws contained in chapter 11 of title 18 
     and the administrative standards of conduct contained in part 
     2635 of title 5 of the Code of Federal Regulations.
       ``(3) The Commission may provide for reimbursement of 
     incidental expenses that are incurred by a person providing 
     voluntary services under this subsection. The Commission 
     shall determine those expenses that are eligible for 
     reimbursement under this paragraph.
       ``(4) Nothing in this subsection shall be construed to 
     require any Federal employee to work without compensation or 
     to allow the use of volunteer services to displace or replace 
     any Federal employee.
       ``(g) Treatment of Certain Contracts.--A contract entered 
     into by the Commission for the design or construction of the 
     World War II memorial is not a funding agreement as that term 
     is defined in section 201 of title 35.
       ``(h) Extension of Authority To Establish Memorial.--
     Notwithstanding section 10 of the Commemorative Works Act (40 
     U.S.C. 1010), the authority for the construction of the World 
     War II memorial provided by Public Law 103-32 (40 U.S.C. 1003 
     note) expires on December 31, 2005.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by adding at the end the following new item:

``2113. World War II memorial in the District of Columbia.''.

       (b) Conforming Amendments.--Public Law 103-32 (40 U.S.C. 
     1003 note) is amended by striking sections 3, 4, and 5.
       (c) Effect of Repeal of Current Memorial Fund.--Upon the 
     enactment of this Act, the Secretary of the Treasury shall 
     transfer amounts in the fund created by section 4(a) of 
     Public Law 103-32 (40 U.S.C. 1003 note) to the fund created 
     by section 2113(b) of title 36, United States Code, as added 
     by subsection (a).

     SEC. 602. GENERAL AUTHORITY TO SOLICIT AND RECEIVE 
                   CONTRIBUTIONS.

       Subsection (e) of section 2103 of title 36, United States 
     Code, is amended to read as follows:
       ``(e) Solicitation and Receipt of Contributions.--(1) The 
     Commission may solicit and receive funds and in-kind 
     donations and gifts from any State, municipal, or private 
     source to carry out the purposes of this chapter. The 
     Commission shall deposit such funds in a separate account in 
     the Treasury. Funds from that account shall be disbursed upon 
     vouchers approved by the Chairman of the Commission.
       ``(2) The Commission shall establish written guidelines 
     setting forth the criteria to be used in determining whether 
     the acceptance of funds and in-kind donations and gifts under 
     paragraph (1) would--
       ``(A) reflect unfavorably on the ability of the Commission, 
     or any member or employee of the Commission, to carry out the 
     responsibilities or official duties of the Commission in a 
     fair and objective manner; or
       ``(B) compromise the integrity or the appearance of the 
     integrity of the programs of the Commission or any official 
     involved in those programs.''.

     SEC. 603. INTELLECTUAL PROPERTY AND RELATED ITEMS.

       (a) In General.--Chapter 21 of title 36, United States 
     Code, as amended by section 601(a)(1), is further amended by 
     adding at the end the following new section:

     ``Sec. 2114. Intellectual property and related items

       ``(a) Authority To Use and Register Intellectual 
     Property.--The American Battle Monuments Commission may--
       ``(1) adopt, use, register, and license trademarks, service 
     marks, and other marks;
       ``(2) obtain, use, register, and license the use of 
     copyrights consistent with section 105 of title 17;
       ``(3) obtain, use, and license patents; and
       ``(4) accept gifts of marks, copyrights, patents, and 
     licenses for use by the Commission.
       ``(b) Authority To Grant Licenses.--The Commission may 
     grant exclusive and nonexclusive licenses in connection with 
     any mark, copyright, patent, or license for the use of such 
     mark, copyright or patent, except to the extent the grant of 
     such license by the Commission would be contrary to any 
     contract or license by which the use of the mark, copyright, 
     or patent was obtained.
       ``(c) Enforcement Authority.--The Commission may enforce 
     any mark, copyright, or patent by an action in the district 
     courts under any law providing for the protection of such 
     marks, copyrights, or patents.
       ``(d) Legal Representation.--The Attorney General shall 
     furnish the Commission with such legal representation as the 
     Commission may require under subsection (c). The Secretary of 
     Defense shall provide representation for the Commission in 
     administrative proceedings before the Patent and Trademark 
     Office and Copyright Office.
       ``(e) Irrevocability of Transfers of Copyrights to 
     Commission.--Section 203 of title 17 shall not apply to any 
     copyright transferred in any manner to the Commission.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter, as amended by section 601(a)(2), 
     is further amended by adding at the end the following new 
     item:

``2114. Intellectual property and related items.''.

     SEC. 604. TECHNICAL AMENDMENTS.

       Chapter 21 of title 36, United States Code, is amended as 
     follows:
       (1) Section 2101(b) is amended--
       (A) by striking ``title 37, United States Code,'' in 
     paragraph (2) and inserting ``title 37''; and
       (B) by striking ``title 5, United States Code,'' in 
     paragraph (3) and inserting ``title 5''.
       (2) Section 2102(a)(1) is amended, by striking ``title 5, 
     United States Code'' and inserting ``title 5''.
       (3) Section 2103 is amended--
       (A) by striking ``title 31, United States Code'' in 
     subsection (h)(2)(A)(i) and inserting ``title 31'';
       (B) by striking ``title 44, United States Code'' in 
     subsection (i) and inserting ``title 44''; and
       (C) by striking ``chairman'' each place it appears and 
     inserting ``Chairman''.
                    Subtitle B--National Cemeteries

     SEC. 611. ESTABLISHMENT OF ADDITIONAL NATIONAL CEMETERIES.

       (a) Establishment.--The Secretary shall establish, in 
     accordance with chapter 24 of title 38, United States Code, a 
     national cemetery in each of the six areas in the United 
     States that the Secretary determines to be most in need of 
     such a cemetery to serve the needs of veterans and their 
     families.
       (b) Obligation of Funds in Fiscal Year 2000.--The Secretary 
     shall obligate, from the advance planning fund in the 
     Construction, Major Projects account appropriated to the 
     Department for fiscal year 2000, such amounts for costs that 
     the Secretary estimates are required for the planning and 
     commencement of the establishment of national cemeteries 
     under this section.
       (c) Reports.--(1) Not later than 120 days after the date of 
     the enactment of this Act, the Secretary shall submit to 
     Congress a report on the establishment of the national 
     cemeteries under subsection (a). The report shall set forth 
     the following:
       (A) The six areas of the United States determined by the 
     Secretary to be most in need of the establishment of a new 
     national cemetery.
       (B) A schedule for such establishment.
       (C) An estimate of the costs associated with such 
     establishment.
       (D) The amount obligated from the advance planning fund 
     under subsection (b).
       (2) Not later than one year after the date on which the 
     report described in paragraph (1) is submitted, and annually 
     thereafter until the establishment of the national cemeteries 
     under subsection (a) is complete, the Secretary shall submit 
     to Congress a report that updates the information included in 
     the report described in paragraph (1).

     SEC. 612. USE OF FLAT GRAVE MARKERS AT SANTA FE NATIONAL 
                   CEMETERY, NEW MEXICO.

       Notwithstanding section 2404(c)(2) of title 38, United 
     States Code, the Secretary may provide for flat grave markers 
     at the Santa Fe National Cemetery, New Mexico.

     SEC. 613. INDEPENDENT STUDY ON IMPROVEMENTS TO VETERANS' 
                   CEMETERIES.

       (a) Study.--Not later than 180 days after the date of the 
     enactment of this Act, the Secretary shall enter into a 
     contract with one or more qualified organizations to conduct 
     a study of national cemeteries described in subsection (b). 
     For purposes of this section, an entity of Federal, State, or 
     local government is not a qualified organization.
       (b) Matters Studied.--(1) The study conducted pursuant to 
     the contract entered into under subsection (a) shall include 
     an assessment of each of the following:
       (A) The one-time repairs required at each national cemetery 
     under the jurisdiction of the National Cemetery 
     Administration of the Department of Veterans Affairs to 
     ensure a dignified and respectful setting appropriate to such 
     cemetery, taking into account the variety of age, climate, 
     and burial options at individual national cemeteries.
       (B) The feasibility of making standards of appearance of 
     active national cemeteries, and the feasibility of making 
     standards of appearance of closed national cemeteries, 
     commensurate with standards of appearance of the finest 
     cemeteries in the world.
       (C) The number of additional national cemeteries that will 
     be required for the interment and memorialization in such 
     cemeteries of individuals qualified under chapter 24 of title 
     38, United States Code, who die after 2005.
       (D) The advantages and disadvantages of the use by the 
     National Cemetery Administration of flat grave markers and 
     upright grave markers.
       (E) The current condition of flat grave marker sections at 
     each of the national cemeteries.
       (2) In presenting the assessment of additional national 
     cemeteries required under paragraph (1)(C), the report shall 
     identify by five-year period, beginning with 2005 and ending 
     with 2020, the following:
       (A) The number of additional national cemeteries required 
     during each such five-year period.
       (B) With respect to each such five-year period, the areas 
     in the United States with the greatest concentration of 
     veterans whose needs are not served by national cemeteries or 
     State veterans' cemeteries.
       (c) Report.--(1) Not later than one year after the date on 
     which a qualified organization enters into a contract under 
     subsection (a), the organization shall submit to the 
     Secretary a report setting forth the results of the study 
     conducted and conclusions of the organization with respect to 
     such results.
       (2) Not later than 120 days after the date on which a 
     report is submitted under paragraph (1), the Secretary shall 
     transmit to the Committees on Veterans' Affairs of the House 
     of Representatives and the Senate a copy of the report,

[[Page H11987]]

     together with any comments on the report that the Secretary 
     considers appropriate.
                      Subtitle C--Burial Benefits

     SEC. 621. INDEPENDENT STUDY ON IMPROVEMENTS TO VETERANS' 
                   BURIAL BENEFITS.

       (a) Study.--Not later than 60 days after the date of the 
     enactment of this Act, the Secretary shall enter into a 
     contract with one or more qualified organizations to conduct 
     a study of burial benefits under chapter 23 of title 38, 
     United States Code. For purposes of this section, an entity 
     of Federal, State, or local government is not a qualified 
     organization.
       (b) Matters Studied.--The study conducted pursuant to the 
     contract entered into under subsection (a) shall include 
     consideration of the following:
       (1) An assessment of the adequacy and effectiveness of the 
     burial benefits administered by the Secretary under chapter 
     23 of title 38, United States Code, in meeting the burial 
     needs of veterans and their families.
       (2) Options to better serve the burial needs of veterans 
     and their families, including modifications to burial benefit 
     amounts and eligibility, together with the estimated cost for 
     each such modification.
       (3) Expansion of the authority of the Secretary to provide 
     burial benefits for burials in private-sector cemeteries and 
     to make grants to private-sector cemeteries.
       (c) Report.--(1) Not later than 120 days after the date on 
     which a qualified organization enters into a contract under 
     subsection (a), the organization shall submit to the 
     Secretary a report setting forth the results of the study 
     conducted and conclusions of the organization with respect to 
     those results.
       (2) Not later than 60 days after the date on which a report 
     is submitted 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 on the report that the Secretary considers 
     appropriate.
                TITLE VII--EDUCATION AND HOUSING MATTERS
                     Subtitle A--Education Matters

     SEC. 701. AVAILABILITY OF MONTGOMERY GI BILL BENEFITS FOR 
                   PREPARATORY COURSES FOR COLLEGE AND GRADUATE 
                   SCHOOL ENTRANCE EXAMS.

       Section 3002(3) is amended--
       (1) by striking ``, and'' at the end of subparagraph (A) 
     and inserting a semicolon;
       (2) by redesignating subparagraph (B) as subparagraph (C); 
     and
       (3) by inserting after subparagraph (A) the following new 
     subparagraph (B):
       ``(B) includes--
       ``(i) a preparatory course for a test that is required or 
     used for admission to an institution of higher education; and
       ``(ii) a preparatory course for a test that is required or 
     used for admission to a graduate school; and''.

     SEC. 702. DETERMINATION OF ELIGIBILITY PERIOD FOR MEMBERS OF 
                   THE ARMED FORCES COMMISSIONED FOLLOWING 
                   COMPLETION OF OFFICER TRAINING SCHOOL.

       (a) Measurement of Period Counted for GI Bill 
     Eligibility.--Section 3011(f) is amended--
       (1) in paragraph (1), by striking ``paragraph (2)'' and 
     inserting ``paragraph (2) or (3); and
       (2) by adding at the end the following new paragraph:
       ``(3) This subsection applies to a member who after a 
     period of continuous active duty as an enlisted member or 
     warrant officer, and following successful completion of 
     officer training school, is discharged in order to accept, 
     without a break in service, a commission as an officer in the 
     Armed Forces for a period of active duty.''.
       (b) Conforming Amendments for Time Limitation for Use of 
     Eligibility and Entitlement.--Section 3031 is amended--
       (1) by redesignating subsection (g) as subsection (h);
       (2) in subsection (a)--
       (A) by striking ``through (e)'' and inserting ``through 
     (g)''; and
       (B) by striking ``subsection (g)'' and inserting 
     ``subsection (h)''; and
       (3) by inserting after subsection (f) the following new 
     subsection:
       ``(g) In the case of an individual described in section 
     3011(f)(3) of this title, the period during which that 
     individual may use the individual's entitlement to 
     educational assistance allowance expires on the last day of 
     the 10-year period beginning on the date of the enactment of 
     the Veterans Millennium Health Care and Benefits Act if that 
     date is later than the date that would otherwise be 
     applicable to that individual under this section.''.
       (c) Effective Date.--The amendments made by subsection (a) 
     shall take effect on the date of the enactment of this Act 
     and apply with respect to an individual first appointed as a 
     commissioned officer on or after July 1, 1985.

     SEC. 703. REPORT ON VETERANS' EDUCATION AND VOCATIONAL 
                   TRAINING BENEFITS PROVIDED BY THE STATES.

       (a) Report.--(1) Not later than six months after the date 
     of the enactment of this Act, the Secretary shall submit to 
     the Committees on Veterans' Affairs of the Senate and the 
     House of Representatives a report on veterans education and 
     vocational training benefits provided by the States.
       (2) Benefits to be considered to be veterans education and 
     vocational training benefits for the purpose of this section 
     include any education or vocational training benefit provided 
     by a State (including any political subdivision of a State) 
     for which persons are eligible by reason of service in the 
     Armed Forces, including, in the case of persons who died in 
     the Armed Forces or as a result of a disease or disability 
     incurred in the Armed Forces, benefits provided by reason of 
     the service of those persons to their survivors or 
     dependents.
       (3) For purposes of this section, the term ``veteran'' 
     includes a person serving on active duty or in one of the 
     reserve components and a person who died while in the active 
     military, naval, or air service.
       (b) Matters To Be Included.--The report under this section 
     shall include the following:
       (1) A description, by State, of the veterans education and 
     vocational training benefits provided, including--
       (A) identification of benefits that are provided 
     specifically for disabled veterans or for which disabled 
     veterans receive benefits in a different amount; and
       (B) identification of benefits for which survivors of 
     persons who died in the Armed Forces (or as a result of a 
     disease or disability incurred in the Armed Forces) or who 
     were disabled in the Armed Forces are eligible.
       (2) For each State that provides a veterans education 
     benefit consisting of full or partial tuition assistance for 
     post-secondary education, a description of that benefit, 
     including whether the benefit is limited to tuition for 
     attendance at an institution of higher education in that 
     State or to tuition for attendance at a public institution of 
     higher education in that State.
       (3) A description of actions and programs of the Department 
     of Veterans Affairs, the Department of Defense, the 
     Department of Education, and the Department of Labor to 
     encourage the States to provide benefits designed to assist 
     veterans in securing post-secondary education and vocational 
     training.
       (c) Consultation.--The report under this section shall be 
     prepared in consultation with the Secretary of Education, the 
     Secretary of Defense, and the Secretary of Labor.
       (d) State Defined.--For purposes of this section, the term 
     ``State'' has the meaning given that term in section 101(20) 
     of title 38, United States Code.

     SEC. 704. TECHNICAL AMENDMENTS.

       Sections 3011(i) and 3012(g)(1) are amended by striking 
     ``Federal''.
                      Subtitle B--Housing Matters

     SEC. 711. EXTENSION OF AUTHORITY FOR HOUSING LOANS FOR 
                   MEMBERS OF THE SELECTED RESERVE.

       Section 3702(a)(2)(E) is amended by striking ``September 
     30, 2003,'' and inserting `September 30, 2007,''.

     SEC. 712. TECHNICAL AMENDMENT RELATING TO TRANSITIONAL 
                   HOUSING LOAN GUARANTEE PROGRAM.

       Section 3775 is amended--
       (1) by inserting ``(a)'' before ``During each''; and
       (2) by adding at the end the following new subsection:
       ``(b) After the first three years of operation of such a 
     multifamily transitional housing project, the Secretary may 
     provide for periodic audits of the project.''.
   TITLE VIII--DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATIVE MATTERS

     SEC. 801. ENHANCED QUALITY ASSURANCE PROGRAM WITHIN THE 
                   VETERANS BENEFITS ADMINISTRATION.

       (a) In General.--(1) Chapter 77 is amended by adding at the 
     end the following new subchapter:

                  ``SUBCHAPTER III--QUALITY ASSURANCE

     ``Sec. 7731. Establishment

       ``(a) The Secretary shall carry out a quality assurance 
     program in the Veterans Benefits Administration. The program 
     may be carried out through a single quality assurance 
     division in the Administration or through separate quality 
     assurance entities for each of the principal organizational 
     elements (known as `services') of the Administration.
       ``(b) The Secretary shall ensure that any quality assurance 
     entity established and operated under subsection (a) is 
     established and operated so as to meet generally applicable 
     governmental standards for independence and internal controls 
     for the performance of quality reviews of Government 
     performance and results.

     ``Sec. 7732. Functions

       ``The Under Secretary for Benefits, acting through the 
     quality assurance entities established under section 7731(a), 
     shall on an ongoing basis perform and oversee quality reviews 
     of the functions of each of the principal organizational 
     elements of the Veterans Benefits Administration.

     ``Sec. 7733. Personnel

       ``The Secretary shall ensure that the number of full-time 
     employees of the Veterans Benefits Administration assigned to 
     quality assurance functions under this subchapter is adequate 
     to perform the quality assurance functions for which they 
     have responsibility.

     ``Sec. 7734. Annual report to Congress

       ``The Secretary shall include in the annual report to the 
     Congress required by section 529 of this title a report on 
     the quality assurance activities carried out under this 
     subchapter. Each such report shall include--
       ``(1) an appraisal of the quality of services provided by 
     the Veterans Benefits Administration, including--
       ``(A) the number of decisions reviewed;
       ``(B) a summary of the findings on the decisions reviewed;
       ``(C) the number of full-time equivalent employees assigned 
     to quality assurance in each division or entity;
       ``(D) specific documentation of compliance with the 
     standards for independence and internal control required by 
     section 7731(b) of this title; and
       ``(E) actions taken to improve the quality of services 
     provided and the results obtained;
       ``(2) information with respect to the accuracy of 
     decisions, including trends in that information; and

[[Page H11988]]

       ``(3) such other information as the Secretary considers 
     appropriate.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by adding at the end the following new items:

                  ``SUBCHAPTER III--QUALITY ASSURANCE

``7731. Establishment.
``7732. Functions.
``7733. Personnel.
``7734. Annual report to Congress.''.
       (b) Effective Date.--Subchapter III of chapter 77 of title 
     38, United States Code, as added by subsection (a), shall 
     take effect at the end of the 60-day period beginning on the 
     date of the enactment of this Act.

     SEC. 802. EXTENSION OF AUTHORITY TO MAINTAIN A REGIONAL 
                   OFFICE IN THE REPUBLIC OF THE PHILIPPINES.

       Section 315(b) is amended by striking ``December 31, 1999'' 
     and inserting ``December 31, 2003''.

     SEC. 803. EXTENSION OF ADVISORY COMMITTEE ON MINORITY 
                   VETERANS.

       Section 544(e) is amended by striking ``December 31, 1999'' 
     and inserting ``December 31, 2003''.

     SEC. 804. TECHNICAL AMENDMENT TO AUTOMOBILE ASSISTANCE 
                   PROGRAM.

       Section 3903(e)(2) is amended by striking ``(not owned by 
     the Government)''.
                  TITLE IX--HOMELESS VETERANS PROGRAMS

     SEC. 901. HOMELESS VETERANS' REINTEGRATION PROGRAMS.

       (a) In General.--Chapter 41 is amended by adding at the end 
     the following new section:

     ``Sec. 4111. Homeless veterans' reintegration programs

       ``(a) In General.--The Secretary, acting through the 
     Assistant Secretary of Labor for Veterans' Employment and 
     Training, shall conduct, directly or through grant or 
     contract, such programs as the Secretary determines 
     appropriate to expedite the reintegration of homeless 
     veterans into the labor force.
       ``(b) Authority To Monitor Expenditure of Funds.--The 
     Secretary may collect such information as the Secretary 
     considers appropriate to monitor and evaluate the 
     distribution and expenditure of funds appropriated to carry 
     out this section, and such information shall be furnished to 
     the Secretary in such form as the Secretary determines 
     appropriate.
       ``(c) Definition.--For purposes of this section, the term 
     `homeless veteran' has the meaning given that term by section 
     3771(2) of this title.
       ``(d) Authorization of Appropriations.--(1) There are 
     authorized to be appropriated to carry out this section 
     amounts as follows:
       ``(A) $10,000,000 for fiscal year 2000.
       ``(B) $15,000,000 for fiscal year 2001.
       ``(C) $20,000,000 for fiscal year 2002.
       ``(D) $20,000,000 for fiscal year 2003.
       ``(2) Funds obligated for any fiscal year to carry out this 
     section may be expended in that fiscal year and the 
     succeeding fiscal year.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by adding at the end the 
     following new item:

``4111. Homeless veterans' reintegration programs.''.

     SEC. 902. EXTENSION OF PROGRAM OF HOUSING ASSISTANCE FOR 
                   HOMELESS VETERANS.

       Section 3735(c) is amended by striking ``December 31, 
     1999'' and inserting ``December 31, 2003''.

     SEC. 903. HOMELESS VETERANS PROGRAMS.

       The Homeless Veterans Comprehensive Service Programs Act of 
     1992 (38 U.S.C. 7721 note) is amended as follows:
       (1) Section 3(a)(1) is amended by inserting ``, and 
     expanding existing programs for furnishing,'' after ``new 
     programs to furnish''.
       (2) Section 3(a)(2) is amended by striking ``September 30, 
     1999'' and inserting ``September 30, 2003''.
       (3) Section 3(b)(2) is amended by striking ``and no more 
     than 20 programs which incorporate the procurement of vans as 
     described in paragraph (1)''.
       (4) Section 12 is amended in the first sentence by 
     inserting ``and $50,000,000 for each of fiscal years 2000 and 
     2001'' after ``for fiscal years 1993 through 1997''.

     SEC. 904. PLAN FOR EVALUATION OF PERFORMANCE OF PROGRAMS TO 
                   ASSIST HOMELESS VETERANS.

       (a) Report.--Not later than 90 days after the date of the 
     enactment of this Act, the Secretary shall submit to the 
     Committees on Veterans' Affairs of the Senate and the House 
     of Representatives a report containing a detailed plan for 
     the evaluation by the Department of Veterans Affairs of the 
     effectiveness of programs to assist homeless veterans. The 
     plan shall be prepared in consultation with the Secretary of 
     Housing and Urban Development and the Secretary of Labor.
       (b) Inclusion of Outcome Measures.--The plan shall include 
     outcome measures to show whether veterans for whom housing or 
     employment is secured through one or more of those programs 
     continue to be housed or employed, as the case may be, after 
     six months.
      TITLE X--UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

     SEC. 1001. SHORT TITLE.

       This title may be cited as the ``Court of Appeals for 
     Veterans Claims Amendments of 1999''.

     SEC. 1002. DEFINITION.

       In this title, the term ``Court'' means the United States 
     Court of Appeals for Veterans Claims.
     Subtitle A--Transitional Provisions To Stagger Terms of Judges

     SEC. 1011. EARLY RETIREMENT AUTHORITY FOR CURRENT JUDGES.

       (a) Retirement Authorized.--One eligible judge may retire 
     in accordance with this section in 2000 or 2001, and one 
     additional eligible judge may retire in accordance with this 
     section in 2001.
       (b) Eligible Judges.--For purposes of this section, an 
     eligible judge is a judge of the Court (other than the chief 
     judge) who--
       (1) has at least 10 years of service creditable under 
     section 7296 of title 38, United States Code;
       (2) has made an election to receive retired pay under 
     section 7296 of such title;
       (3) has at least 20 years of service described in section 
     7297(l) of such title; and
       (4) is at least 55 years of age.
       (c) Multiple Eligible Judges.--If for any year specified in 
     subsection (a) more than one eligible judge provides notice 
     in accordance with subsection (d), the judge who has the 
     greatest seniority as a judge of the Court shall be the judge 
     who is eligible to retire in accordance with this section in 
     that year.
       (d) Notice.--An eligible judge who desires to retire in 
     accordance with this section with respect to any year covered 
     by subsection (a) shall provide to the President and the 
     chief judge of the Court written notice to that effect and 
     stating that the judge agrees to the temporary service 
     requirements of subsection (j). Such notice shall be provided 
     not later than April 1 of that year and shall specify the 
     retirement date in accordance with subsection (e). Notice 
     provided under this subsection shall be irrevocable.
       (e) Date of Retirement.--A judge who is eligible to retire 
     in accordance with this section shall be retired during the 
     calendar year as to which notice is provided pursuant to 
     subsection (d), but not earlier than 30 days after the date 
     on which that notice is provided pursuant to subsection (d).
       (f) Applicable Provisions.--Except as provided in 
     subsections (g) and (j), a judge retired in accordance with 
     this section shall be considered for all purposes to be 
     retired under section 7296(b)(1) of title 38, United States 
     Code.
       (g) Applicability of Recall Status Authority.--The 
     provisions of section 7257 of this title shall apply to a 
     judge retired in accordance with this section as if the judge 
     is a judge specified in subsection (a)(2)(A) of that section.
       (h) Rate of Retired Pay.--The rate of retired pay for a 
     judge retiring in accordance with this section is--
       (1) the rate applicable to that judge under section 
     7296(c)(1) of title 38, United States Code, multiplied by
       (2) the fraction (not in excess of 1) in which--
       (A) the numerator is the number of years of service of the 
     judge as a judge of the Court creditable under section 7296 
     of such title; and
       (B) the denominator is 15.
       (i) Adjustments in Retired Pay for Judges Available for 
     Recall.--Subject to section 7296(f)(3)(B) of title 38, United 
     States Code, an adjustment provided by law in annuities 
     payable under civil service retirement laws shall apply to 
     retired pay under this section in the case of a judge who is 
     a recall-eligible retired judge under section 7257 of such 
     title or who was a recall-eligible retired judge under that 
     section and was removed from recall status under subsection 
     (b)(4) of that section by reason of disability.
       (j) Duty of Actuary.--Section 7298(e)(2) is amended--
       (1) by redesignating subparagraph (C) as subparagraph (D); 
     and
       (2) by inserting after subparagraph (B) the following new 
     subparagraph:
       ``(C) For purposes of subparagraph (B), the term `present 
     value' includes a value determined by an actuary with respect 
     to a payment that may be made under subsection (b) from the 
     retirement fund within the contemplation of law.''.
       (k) Transitional Service of Judge Retired Under This 
     Section.--(1) A judge who retires under this section shall 
     continue to serve on the Court during the period beginning on 
     the effective date of the judge's retirement under subsection 
     (e) and ending on the earlier of--
       (A) the date on which a person is appointed to the position 
     on the Court vacated by the judge's retirement; and
       (B) the date on which the judge's original appointment to 
     the court would have expired.
       (2) Subsections (f) and (g) of section 7253 of title 38, 
     United States Code, shall apply with respect to the service 
     of a judge on the Court under this section.
       (3) Notwithstanding any other provision of law, a person 
     whose service as a judge of the Court continues under this 
     section shall be paid for the period of service under this 
     subsection at the rate that is the difference between the 
     current rate of pay for a judge of the Court and the rate 
     of the judge's retired pay under subsection (g).
       (4) Amounts paid under paragraph (3)--
       (A) shall not be treated as--
       (i) compensation for employment with the United States for 
     purposes of section 7296(e) of title 38, United States Code, 
     or any provision of title 5, United States Code, relating to 
     the receipt or forfeiture of retired pay or retirement 
     annuities by a person accepting compensation for employment 
     with the United States; or
       (ii) pay for purposes of deductions or contributions for or 
     on behalf of the person to retired pay under subchapter V of 
     chapter 72 of title 38, United States Code, or under chapter 
     83 or 84 of title 5, United States Code, as applicable; but
       (B) may, at the election of the person, be treated as pay 
     for purposes of deductions or contributions for or on behalf 
     of the person to a retirement or other annuity, or both, 
     under subchapter V of chapter 72 of title 38, United States 
     Code, or under chapter 83 or 84 of title 5, United States 
     Code, as applicable.
       (5) Amounts paid under paragraph (3) shall be derived from 
     amounts available for payment of salaries and benefits of 
     judges of the Court.

[[Page H11989]]

       (6) The service as a judge of the Court under this 
     subsection of a person who makes an election provided for 
     under paragraph (4)(B) shall constitute creditable service 
     toward the judge's years of judicial service for purposes of 
     section 7297 of title 38, United States Code, with such 
     service creditable at a rate equal to the rate at which such 
     service would be creditable for such purposes if served by a 
     judge of the Court under chapter 72 of that title. For 
     purposes of subsection (k)(3) of that section, the average 
     annual pay for such service shall be the sum of the judge's 
     retired pay and the amount paid under paragraph (3) of this 
     subsection.
       (7) In the case of such a person who makes an election 
     provided for under paragraph (4)(B), upon the termination of 
     the service of that person as a judge of the Court under this 
     subsection, the retired pay of that person under subsection 
     (g) shall be recomputed to reflect the additional period of 
     service served under this subsection.
       (l) Treatment of Political Party Membership.--For purposes 
     of determining compliance with the last sentence of section 
     7253(b) of title 38, United States Code, the political party 
     membership of a judge serving on the Court under subsection 
     (j) shall not be taken into account.

     SEC. 1012. MODIFIED TERMS FOR NEXT TWO JUDGES APPOINTED TO 
                   THE COURT.

       (a) Modified Terms.--The term of office of the first two 
     judges appointed to the Court after the date of the enactment 
     of this Act shall be 13 years (rather than the period 
     specified in section 7253(c) of title 38, United States 
     Code).
       (b) Eligibility for Retirement.--(1) For purposes of 
     determining the eligibility to retire under section 7296 of 
     title 38, United States Code, of the two judges of the Court 
     whose term of office is determined under subsection (a)--
       (A) the age and service requirements in the table in 
     paragraph (2) shall apply to those judges rather than the 
     otherwise applicable age and service requirements specified 
     in the table in subsection (b)(1) of that section; and
       (B) the minimum years of service applicable to those judges 
     for eligibility to retire under the first sentence of 
     subsection (b)(2) of that section shall be 13 years instead 
     of 15 years.
       (2) The age and service requirements in this paragraph are 
     as follows:

And the years of service as a judge are at least
  65.............................................................13    
  66.............................................................13    
  67.............................................................13    
  68.............................................................12    
  69.............................................................11    
  70.............................................................10    
          Subtitle B--Other Matters Relating to Retired Judges

     SEC. 1021. RECALL OF RETIRED JUDGES.

       (a) Authority To Recall Retired Judges.--Chapter 72 is 
     amended by inserting after section 7256 the following new 
     section:

     ``Sec. 7257. Recall of retired judges

       ``(a)(1) A retired judge of the Court may be recalled for 
     further service on the Court in accordance with this section. 
     To be eligible to be recalled for such service, a retired 
     judge must at the time of the judge's retirement provide to 
     the chief judge of the Court (or, in the case of the chief 
     judge, to the clerk of the Court) notice in writing that the 
     retired judge is available for further service on the Court 
     in accordance with this section and is willing to be recalled 
     under this section. Such a notice provided by a retired judge 
     is irrevocable.
       ``(2) For the purposes of this section--
       ``(A) a retired judge is a judge of the Court of Appeals 
     for Veterans Claims who retires from the Court under section 
     7296 of this title or under chapter 83 or 84 of title 5; and
       ``(B) a recall-eligible retired judge is a retired judge 
     who has provided a notice under paragraph (1).
       ``(b)(1) The chief judge may recall for further service on 
     the Court a recall-eligible retired judge in accordance with 
     this section. Such a recall shall be made upon written 
     certification by the chief judge that substantial service is 
     expected to be performed by the retired judge for such 
     period, not to exceed 90 days (or the equivalent), as 
     determined by the chief judge to be necessary to meet the 
     needs of the Court.
       ``(2) A recall-eligible retired judge may not be recalled 
     for more than 90 days (or the equivalent) during any calendar 
     year without the judge's consent or for more than a total of 
     180 days (or the equivalent) during any calendar year.
       ``(3) If a recall-eligible retired judge is recalled by the 
     chief judge in accordance with this section and (other than 
     in the case of a judge who has previously during that 
     calendar year served at least 90 days (or the equivalent) of 
     recalled service on the court) declines (other than by reason 
     of disability) to perform the service to which recalled, the 
     chief judge shall remove that retired judge from the status 
     of a recall-eligible judge.
       ``(4) A recall-eligible retired judge who becomes 
     permanently disabled and as a result of that disability is 
     unable to perform further service on the Court shall be 
     removed from the status of a recall-eligible judge. 
     Determination of such a disability shall be made pursuant to 
     section 7253(g) or 7296(g) of this title.
       ``(c) A retired judge who is recalled under this section 
     may exercise all of the judicial powers and duties of the 
     office of a judge in active service.
       ``(d)(1) The pay of a recall-eligible retired judge who 
     retired under section 7296 of this title is specified in 
     subsection (c) of that section.
       ``(2) A judge who is recalled under this section who 
     retired under chapter 83 or 84 of title 5 shall be paid, 
     during the period for which the judge serves in recall 
     status, pay at the rate of pay in effect under section 
     7253(e) of this title for a judge performing active service, 
     less the amount of the judge's annuity under the applicable 
     provisions of chapter 83 or 84 of title 5.
       ``(e)(1) Except as provided in subsection (d), a judge who 
     is recalled under this section who retired under chapter 83 
     or 84 of title 5 shall be considered to be a reemployed 
     annuitant under that chapter.
       ``(2) Nothing in this section affects the right of a judge 
     who retired under chapter 83 or 84 of title 5 to serve as a 
     reemployed annuitant in accordance with the provisions of 
     title 5.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 7256 the following new item:

``7257. Recall of retired judges.''.

     SEC. 1022. JUDGES' RETIRED PAY.

       (a) In General.--Subsection (c)(1) of section 7296 is 
     amended by striking ``at the rate of pay in effect at the 
     time of retirement.'' and inserting the following: ``as 
     follows:
       ``(A) In the case of a judge who is a recall-eligible 
     retired judge under section 7257 of this title or who was a 
     recall-eligible retired judge under that section and was 
     removed from recall status under subsection (b)(4) of that 
     section by reason of disability, the retired pay of the judge 
     shall be the pay of a judge of the court.
       ``(B) In the case of a judge who at the time of retirement 
     did not provide notice under section 7257 of this title of 
     availability for service in a recalled status, the retired 
     pay of the judge shall be the rate of pay applicable to that 
     judge at the time of retirement.
       ``(C) In the case of a judge who was a recall-eligible 
     retired judge under section 7257 of this title and was 
     removed from recall status under subsection (b)(3) of that 
     section, the retired pay of the judge shall be the pay of the 
     judge at the time of the removal from recall status.''.
       (b) Cost-of-Living Adjustments.--Subsection (f) of such 
     section is amended by adding at the end the following new 
     paragraph:
       ``(3)(A) A cost-of-living adjustment provided by law in 
     annuities payable under civil service retirement laws shall 
     apply to retired pay under this section only in the case of 
     retired pay computed under paragraph (2) of subsection (c).
       ``(B) If such a cost-of-living adjustment would (but for 
     this subparagraph) result in the retired pay of a retired 
     judge being in excess of the annual rate of pay in effect for 
     judges of the Court as provided in section 7253(e) of this 
     title, such adjustment may be made only in such amount as 
     results in the retired pay of the retired judge being equal 
     to that annual rate of pay (as in effect on the effective 
     date of such adjustment).''.

     SEC. 1023. SURVIVOR ANNUITIES.

       (a) Surviving Spouse.--Subsection (a)(5) of section 7297 is 
     amended by striking ``two years'' and inserting ``one year''.
       (b) Election To Participate.--Subsection (b) of such 
     section is amended in the first sentence by inserting before 
     the period ``or within six months after the date on which the 
     judge marries if the judge has retired under section 7296 of 
     this title''.
       (c) Reduction in Contributions.--Subsection (c) of such 
     section is amended by striking ``3.5 percent of the judge's 
     pay'' and inserting ``that percentage of the judge's pay that 
     is the same as provided for the deduction from the salary or 
     retirement salary of a judge of the United States Court of 
     Federal Claims for the purpose of a survivor annuity under 
     section 376(b)(1)(B) of title 28''.
       (d) Interest Payments.--Subsection (d) of such section is 
     amended--
       (1) by inserting ``(1)'' after ``(d)''; and
       (2) by adding at the end the following new paragraph:
       ``(2) The interest required under the first sentence of 
     paragraph (1) shall not be required for any period--
       ``(A) during which a judge was separated from any service 
     described in section 376(d)(2) of title 28; and
       ``(B) during which the judge was not receiving retired pay 
     based on service as a judge or receiving any retirement 
     salary as described in section 376(d)(1) of title 28.''.
       (e) Service Eligibility.--(1) Subsection (f) of such 
     section is amended--
       (A) in paragraph (1), in the matter preceding subparagraph 
     (A)--
       (i) by striking ``at least 5 years'' and inserting ``at 
     least 18 months''; and
       (ii) by striking ``last 5 years'' and inserting ``last 18 
     months''; and
       (B) by adding at the end the following new paragraph:
       ``(5) If a judge dies as a result of an assassination and 
     leaves a survivor or survivors who are otherwise entitled to 
     receive annuity payments under this section, the 18-month 
     requirement in the matter in paragraph (1) preceding 
     subparagraph (A) shall not apply.''.
       (2) Subsection (a) of such section is further amended--
       (A) in paragraph (2), by inserting ``who is in active 
     service or who has retired under section 7296 of this title'' 
     after ``Court'';
       (B) in paragraph (3), by striking ``7296(c)'' and inserting 
     ``7296''; and
       (C) by adding at the end the following new paragraph:
       ``(8) The term `assassination' as applied to a judge shall 
     have the meaning provided that term in section 376(a)(7) of 
     title 28 as applied to a judicial official.''.
       (f) Age Requirement of Surviving Spouse.--Subsection (f) of 
     such section is further amended by striking ``or following 
     the surviving spouse's attainment of the age of 50 years, 
     whichever is the later'' in paragraph (1)(A).

     SEC. 1024. LIMITATION ON ACTIVITIES OF RETIRED JUDGES.

       (a) In General.--Chapter 72 is amended by adding at the end 
     the following new section:

[[Page H11990]]

     ``Sec. 7299. Limitation on activities of retired judges

       ``(a) A retired judge of the Court who is recall-eligible 
     under section 7257 of this title and who in the practice of 
     law represents (or supervises or directs the representation 
     of) a client in making any claim relating to veterans' 
     benefits against the United States or any agency thereof 
     shall, pursuant to such section, be considered to have 
     declined recall service and be removed from the status of a 
     recall-eligible judge. The pay of such a judge, pursuant to 
     section 7296 of this title, shall be the pay of the judge at 
     the time of the removal from recall status.
       ``(b) A recall-eligible judge shall be considered to be an 
     officer or employee of the United States, but only during 
     periods when the judge is serving in recall status. Any 
     prohibition, limitation, or restriction that would otherwise 
     apply to the activities of a recall-eligible judge shall 
     apply only during periods when the judge is serving in recall 
     status.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by adding at the end the 
     following new item:

``7299. Limitation on activities of retired judges.''.
 Subtitle C--Rotation of Service of Judges as Chief Judge of the Court

     SEC. 1031. REPEAL OF SEPARATE APPOINTMENT OF CHIEF JUDGE.

       Subsection (a) of section 7253 is amended to read as 
     follows:
       ``(a) Composition.--The Court of Appeals for Veterans 
     Claims is composed of at least three and not more than seven 
     judges, one of whom shall serve as chief judge in accordance 
     with subsection (d).''.

     SEC. 1032. DESIGNATION AND TERM OF CHIEF JUDGE OF COURT.

       (a) Rotation.--Subsection (d) of section 7253 is amended to 
     read as follows:
       ``(d) Chief Judge.--(1) The chief judge of the Court shall 
     be the judge of the Court in regular active service who is 
     senior in commission among the judges of the Court who--
       ``(A) have served for one or more years as judges of the 
     Court; and
       ``(B) have not previously served as chief judge.
       ``(2) In any case in which there is no judge of the Court 
     in regular active service who has served as a judge of the 
     Court for at least one year, the judge of the court in 
     regular active service who is senior in commission and has 
     not served previously as chief judge shall act as the chief 
     judge.
       ``(3) Except as provided in paragraph (4), a judge of the 
     Court shall serve as the chief judge under paragraph (1) for 
     a term of five years or until the judge becomes age 70, 
     whichever occurs first. If no other judge is eligible under 
     paragraph (1) to serve as chief judge upon the expiration of 
     that term, that judge shall continue to serve as chief judge 
     until another judge becomes eligible under that paragraph to 
     serve as chief judge.
       ``(4)(A) The term of a chief judge shall be terminated 
     before the end of the term prescribed by paragraph (3) if--
       ``(i) the chief judge leaves regular active service as a 
     judge of the court; or
       ``(ii) the chief judge notifies the other judges of the 
     court in writing that such judge desires to be relieved of 
     the duties of chief judge.
       ``(B) The effective date of a termination of the term under 
     subparagraph (A) shall be the date on which the chief judge 
     leaves regular active service or the date of the notification 
     under subparagraph (A)(ii), as the case may be.
       ``(5) If a chief judge is temporarily unable to perform the 
     duties of chief judge, those duties shall be performed by the 
     judge of the court in active service who is present, able and 
     qualified to act, and is next in precedence.
       ``(6) Judges who have the same seniority in commission 
     shall be eligible for service as chief judge in accordance 
     with their relative precedence.''.
       (b) Ineligibility of Judges on Temporary Service.--A person 
     serving as a judge of the Court under section 1011 may not 
     serve as chief judge of the Court.

     SEC. 1033. SALARY.

       Subsection (e) of section 7253 is amended to read as 
     follows:
       ``(e) Salary.--Each judge of the Court shall receive a 
     salary at the same rate as is received by judges of the 
     United States district courts.''.

     SEC. 1034. PRECEDENCE OF JUDGES.

       Subsection (d) of section 7254 is amended to read as 
     follows:
       ``(d) Precedence of Judges.--The chief judge of the Court 
     shall have precedence and preside at any session that the 
     chief judge attends. The other judges shall have precedence 
     and preside according to the seniority of their original 
     commissions. Judges whose commissions bear the same date 
     shall have precedence according to seniority in age.''.

     SEC. 1035. CONFORMING AMENDMENTS.

       Chapter 72 is amended as follows:
       (1) Section 7281(g) is amended to read as follows:
       ``(g) The chief judge of the Court may exercise the 
     authority of the Court under this section whenever there are 
     not at least two other judges of the Court.''.
       (2) Sections 7296(a)(2) and 7297(a)(2) are amended by 
     striking ``the chief judge or an associate judge'' and 
     inserting ``a judge''.

     SEC. 1036. APPLICABILITY OF AMENDMENTS.

       (a) Effective Date.--The amendments made by this subtitle 
     shall take effect on the date of the enactment of this Act.
       (b) Savings Provision for Incumbent Chief Judge.--The 
     amendments made by this subtitle shall not apply while the 
     individual who is chief judge of the Court on the date of the 
     enactment of this Act continues to serve as chief judge. If 
     that individual, upon termination of service as chief judge, 
     provides notice under section 7257 of title 38, United States 
     Code, of availability for service in a recalled status, the 
     rate of pay applicable to that individual under section 
     7296(c)(1)(A) of such title while serving in a recalled 
     status shall be at the rate of pay applicable to that 
     individual at the time of retirement, if greater than the 
     rate otherwise applicable under that section.
            TITLE XI--VOLUNTARY SEPARATION INCENTIVE PROGRAM

     SEC. 1101. SHORT TITLE.

       This title may be cited as the ``Department of Veterans 
     Affairs Employment Reduction Assistance Act of 1999''.

     SEC. 1102. PLAN FOR PAYMENT OF VOLUNTARY SEPARATION INCENTIVE 
                   PAYMENTS.

       (a) In General.--The Secretary of Veterans Affairs shall, 
     before obligating any funds for the payment of voluntary 
     separation incentive payments under this title, submit to the 
     Director of the Office of Management and Budget an 
     operational plan outlining the proposed use of such incentive 
     payments and a proposed organizational chart for the elements 
     of the Department of Veterans Affairs covered by the plan 
     once the payment of such incentive payments has been 
     completed.
       (b) Contents.--The plan under subsection (a) shall--
       (1) take into account the limitations on elements, and 
     personnel within elements, of the Department specified in 
     subsection (c);
       (2) specify the positions to be reduced or eliminated and 
     functions to be restructured or reorganized, identified by 
     element of the Department, geographic location, occupational 
     category, and grade level;
       (3) specify the manner in which the plan will improve 
     operating efficiency, or meet actual or anticipated levels of 
     budget or staffing resources, of each element covered by the 
     plan and of the Department generally; and
       (4) include a description of how each element of the 
     Department covered by the plan will operate without the 
     functions or positions affected by the implementation of the 
     plan.
       (c) Limitation on Elements and Personnel.--The plan under 
     subsection (a) shall be limited to the elements of the 
     Department, and the number of positions within such elements, 
     as follows:
       (1) The Veterans Health Administration, 4,400 positions.
       (2) The Veterans Benefits Administration, 240 positions.
       (3) Department of Veterans Affairs Staff Offices, 45 
     positions.
       (4) The National Cemetery Administration, 15 positions.
       (d) Approval.--(1) The Director of the Office of Management 
     and Budget shall approve or disapprove the plan submitted 
     under subsection (a).
       (2) In approving the plan, the Director may make such 
     modifications to the plan as the Director considers 
     appropriate with respect to the following:
       (A) The number and amounts of voluntary incentive payments 
     that may be paid under the plan.
       (B) Any other matter that the Director considers 
     appropriate.
       (3) In the event of the disapproval of a plan by the 
     Director under paragraph (1), the Secretary may modify and 
     resubmit the plan to the Director. The provisions of this 
     section shall apply to any plan submitted to the Director 
     under this paragraph as if such plan were the initial plan 
     submitted to the Director under subsection (a).

     SEC. 1103. VOLUNTARY SEPARATION INCENTIVE PAYMENTS.

       (a) Authority To Pay Voluntary Separation Incentive 
     Payments.--(1) The Secretary may pay a voluntary separation 
     incentive payment to an eligible employee only--
       (A) to the extent necessary to reduce or restructure the 
     positions and functions identified by the plan approved under 
     section 1102; and
       (B) if the Under Secretary concerned, or the head of the 
     staff office concerned, approves the payment of the voluntary 
     separation incentive payment to that employee.
       (2) In order to receive a voluntary separation incentive 
     payment under this title, an employee must separate from 
     service with the Department voluntarily (whether by 
     retirement or resignation) under the provisions of this 
     title.
       (b) Amount and Treatment of Payments.--A voluntary 
     separation incentive payment--
       (1) shall be paid in a lump sum after the employee's 
     separation under this title;
       (2) shall be in an amount equal to the lesser of--
       (A) an amount equal to the amount the employee would be 
     entitled to receive under section 5595(c) of title 5, United 
     States Code, if the employee were entitled to payment under 
     that section (without adjustment for any previous payment 
     made under that section); or
       (B) an amount determined by the Secretary, not to exceed 
     $25,000;
       (3) shall not be a basis for payment, and shall not be 
     included in the computation, of any other type of Government 
     benefit; and
       (4) shall not be taken into account in determining the 
     amount of severance pay to which an employee may be entitled 
     under section 5595 of title 5, United States Code, based on 
     any other separation.
       (c) Source of Funds.--Voluntary separation incentive 
     payments under this title shall be paid from the 
     appropriations or funds available for payment of the basic 
     pay of the employees of the Department.

     SEC. 1104. EFFECT OF SUBSEQUENT EMPLOYMENT WITH THE 
                   GOVERNMENT.

       (a) Repayment Upon Reemployment.--Except as provided in 
     subsection (b), an individual

[[Page H11991]]

     who is paid a voluntary separation incentive payment under 
     this title and who subsequently accepts employment with the 
     Government within five years after the date of the separation 
     on which the payment is based shall be required to repay to 
     the Secretary, before the individual's first day of such 
     employment, the entire amount of the voluntary separation 
     incentive payment paid to the individual under this title.
       (b) Waiver Authority for Certain Individuals.--(1) If the 
     employment of an individual under subsection (a) is with an 
     Executive agency (as defined by section 105 of title 5, 
     United States Code), the United States Postal Service, or the 
     Postal Rate Commission, the Director of the Office of 
     Personnel Management may, at the request of the head of such 
     agency, waive repayment by the individual under that 
     subsection if the individual possesses unique abilities and 
     is the only qualified applicant available for the position.
       (2) If the employment of an individual under subsection (a) 
     is with an entity in the legislative branch, the head of the 
     entity or the appointing official may waive repayment by the 
     individual under that subsection if the individual involved 
     possesses unique abilities and is the only qualified 
     applicant available for the position.
       (3) If the employment of an individual under subsection (a) 
     is with the judicial branch, the Director of the 
     Administrative Office of the United States Courts may waive 
     repayment by the individual under that subsection if the 
     individual involved possesses unique abilities and is the 
     only qualified applicant available for the position.
       (c) Employment Defined.--for purposes of this section, the 
     term ``employment'' includes--
       (1) for purposes of subsections (a) and (b), employment of 
     any length or under any type of appointment, but does not 
     include employment that is without compensation; and
       (2) for purposes of subsection (a), employment with any 
     agency of the Government through a personal services 
     contract.

     SEC. 1105. ADDITIONAL AGENCY CONTRIBUTIONS TO CIVIL SERVICE 
                   RETIREMENT AND DISABILITY FUND.

       (a) Requirement.--In addition to any other payments which 
     it is required to make under subchapter III of chapter 83 or 
     chapter 84 of title 5, United States Code, the Secretary 
     shall remit to the Office of Personnel Management for deposit 
     in the Treasury of the United States to the credit of the 
     Civil Service Retirement and Disability Fund an amount equal 
     to 26 percent of the final basic pay of each employee of the 
     Department who is covered under subchapter III of chapter 83 
     or chapter 84 of title 5, United States Code, to whom a 
     voluntary separation incentive is paid under this title.
       (b) Final Basic Pay Defined.--For purposes of this section, 
     the term ``final basic pay'', with respect to an employee, 
     means the total amount of basic pay that would be payable for 
     a year of service by the employee, computed using the 
     employee's final rate of basic pay, and, if last serving on 
     other than a full-time basis, with appropriate adjustment 
     therefor.

     SEC. 1106. CONTINUED HEALTH INSURANCE COVERAGE.

       Section 8905a(d) of title 5, United States Code, is 
     amended--
       (1) in paragraph (1)(A), by striking ``paragraph (4)'' and 
     inserting ``paragraphs (4) and (5)'';
       (2) in paragraph (2), by striking ``(1) or (4)'' and 
     inserting ``(1), (4), or (5)''; and
       (3) by adding at the end the following new paragraph:
       ``(5)(A) If the basis for continued coverage under this 
     section is an involuntary separation from a position in 
     or under the Department of Veterans Affairs due to a 
     reduction in force or a title 38 staffing readjustment--
       ``(i) the individual shall be liable for not more than the 
     employee contributions referred to in paragraph (1)(A)(i); 
     and
       ``(ii) the agency which last employed the individual shall 
     pay the remaining portion of the amount required under 
     paragraph (1)(A).
       ``(B) This paragraph shall only apply with respect to 
     individuals whose continued coverage is based on a separation 
     occurring on or after the date of the enactment of this 
     paragraph.''.

     SEC. 1107. PROHIBITION OF REDUCTION OF FULL-TIME EQUIVALENT 
                   EMPLOYMENT LEVEL.

       (a) Prohibition.--The total full-time equivalent employment 
     in the Department may not be reduced by reason of the 
     separation of an employee (or any combination of employees) 
     receiving a voluntary separation incentive payment under this 
     title.
       (b) Enforcement.--The President, through the Office of 
     Management and Budget, shall monitor the Department and take 
     any action necessary to ensure that the requirements of this 
     section are met.

     SEC. 1108. REGULATIONS.

       The Director of the Office of Personnel Management may 
     prescribe any regulations necessary to administer this title.

     SEC. 1109. LIMITATION; SAVINGS CLAUSE.

       (a) Limitation.--No voluntary separation incentive payment 
     may be paid under this title based on the separation of an 
     employee after December 31, 2000.
       (b) Relationship to Other Authority.--This title 
     supplements and does not supersede any other authority of the 
     Secretary to pay voluntary separation incentive payments to 
     employees of the Department.

     SEC. 1110. ELIGIBLE EMPLOYEES.

       For purposes of this title:
       (1) In general.--Except as provided in paragraph (2), the 
     term ``eligible employee'' means an employee (as defined by 
     section 2105 of title 5, United States Code) of the 
     Department of Veterans Affairs, who is serving under an 
     appointment without time limitation and has been employed by 
     the Department as of the date of separation under this title 
     for a continuous period of at least three years.
       (2) Exceptions.--Such term does not include the following:
       (A) A reemployed annuitant under subchapter III of chapter 
     83 or chapter 84 of title 5, United States Code, or another 
     retirement system for employees of the Government.
       (B) An employee having a disability on the basis of which 
     such employee is eligible for disability retirement under 
     subchapter III of chapter 83 or chapter 84 of title 5, United 
     States Code, or another retirement system for employees of 
     the Government.
       (C) An employee who is in receipt of a specific notice of 
     involuntary separation for misconduct or unacceptable 
     performance.
       (D) An employee who previously has received any voluntary 
     separation incentive payment by the Government under this 
     title or any other authority.
       (E) An employee covered by statutory reemployment rights 
     who is on transfer to another organization.
       (F) An employee who, during the 24-month period preceding 
     the date of separation, has received a recruitment or 
     relocation bonus under section 5753 of title 5, United States 
     Code, or a recruitment bonus under section 7458 of title 38, 
     United States Code.
       (G) An employee who, during the 12-month period preceding 
     the date of separation, received a retention allowance under 
     section 5754 of title 5, United States Code, or a retention 
     bonus under section 458 of title 38, United States Code.
       (H) An employee who, during the 24-month period preceding 
     the date of separation, was relocated at the expense of the 
     Federal Government.

       And the Senate agree to the same.
       That the House recede from its disagreement to the 
     amendment of the Senate to the title of the bill and agree to 
     the same with an amendment as follows:
       In lieu of the Senate amendment to the title of the bill, 
     amend the title so as to read: ``An Act to amend title 38, 
     United States Code, to establish a program of extended care 
     services for veterans, to make other improvements in health 
     care programs of the Department of Veterans Affairs, to 
     enhance compensation, memorial affairs, and housing programs 
     of the Department of Veterans Affairs, to improve retirement 
     authorities applicable to judges of the United States Court 
     of Appeals for Veterans Claims, and for other purposes.''.
       And the Senate agree to the same.

     Bob Stump,
     Chris Smith,
     Jack Quinn,
     Cliff Stearns,
     Lane Evans,
     Corrine Brown,
     Mike Doyle,
                                Managers on the Part of the House.

     Arlen Specter,
     Strom Thurmond,
     Jay Rockefeller,
                               Managers on the Part of the Senate.

       JOINT EXPLANATORY STATEMENT OF THE COMMITTEE OF CONFERENCE

       The managers on the part of the House and the Senate at the 
     conference on the disagreeing votes of the two Houses on the 
     amendments of the Senate to the bill (H.R. 2116) to amend 
     title 38, United States Code, to establish a program of 
     extended care services for veterans and to make other 
     improvements in health care programs of the Department of 
     Veterans Affairs, submit the following joint statement to the 
     House and the Senate in explanation of the effect of the 
     action agreed upon by the managers and recommended in the 
     accompanying conference report:
       The Senate amendment to the text of the bill struck all of 
     the House bill after the enacting clause and inserted a 
     substitute text.
       The House recedes from its disagreement to the amendment of 
     the Senate with an amendment that is a substitute for the 
     House bill and the Senate amendment. The differences between 
     the House bill, the Senate amendment, and the substitute 
     agreed to in conference are noted below, except for clerical 
     corrections, conforming changes made necessary by agreements 
     reached by the conferees, and minor drafting and clerical 
     changes.

                                OVERVIEW

       The House bill, H.R. 2116, as amended, consists of 
     provisions from the following House bills: H.R. 2280, which 
     passed the House on June 29, 1999, and H.R. 2116, which 
     passed the House on September 21, 1999.
       The Senate amendment consists of provisions from the 
     following Senate bills: S. 1402, which passed the Senate on 
     July 26, 1999; S. 695, which passed the Senate on August 4, 
     1999; and S. 1076, which passed the Senate on September 8, 
     1999.

                        TITLE I--ACCESS TO CARE

                       Subtitle A--Long-Term Care


                   EXTENDED CARE SERVICES (sec. 101)

     Current law
       Section 8110 of title 38, United States Code, states that 
     the Secretary ``shall operate and maintain a total of not 
     less than 90,000 hospital beds and nursing home beds'' and 
     ``shall maintain the bed and treatment capacities of all 
     Department medical facilities so as to ensure the 
     accessibility and availability of such beds and treatment 
     capacities to eligible veterans in all States and to minimize 
     delays in admissions and in the provision of hospital, 
     nursing home, and domiciliary care.'' Section 1710 of title 
     38, United States

[[Page H11992]]

     Code, establishes that all veterans (as delineated in that 
     section) are eligible for hospital care, medical services, 
     and nursing home care. The Secretary (to the extent 
     appropriations permit, and subject to an enrollment system 
     required under section 1706), ``shall'' furnish hospital care 
     and medical services to such veterans. ``Medical services'', 
     which are to be furnished to enrolled veterans, are defined 
     to include ``such . . . services as the Secretary determines 
     to be reasonable and necessary.'' Provisions of chapter 17 of 
     title 38, United States Code, also specifically authorize VA 
     to provide certain extended care services (VA and community-
     based nursing home care, domiciliary care, adult day health 
     care, respite care, and noninstitutional alternatives to 
     nursing home care), as needed, to eligible veterans.
     House Bill
       The House bill (H.R. 2116, section 101(a)) would direct VA, 
     subject to the availability of appropriations, to operate and 
     maintain extended care programs, to include geriatric 
     evaluations, VA and community-based nursing home care, 
     domiciliary care, adult day health care, respite care, and 
     such alternatives to institutional care as the Secretary 
     considers reasonable and appropriate. The measure would also 
     direct the Secretary to provide extended care services to any 
     veteran in need of such care (1) for a service-connected 
     condition, and (2) who is 50 percent or more service-
     connected disabled. Such veterans also would be afforded 
     highest priority for placements (and ongoing care) in VA 
     nursing homes. VA would be required to prescribe regulations 
     governing priorities for provision of VA nursing home care; 
     such regulations would ensure that priority is given for 
     patient rehabilitation, for clinically complex patient 
     populations, and for patients for whom there are not other 
     suitable placement options. The section would also proscribe 
     VA's furnishing extended care services (as defined) for care 
     of a nonservice-connected condition, other than for a 50 
     percent or more service-connected disabled veteran, unless 
     the veteran agrees to pay a copayment for extended care 
     services exceeding 21 days in any year. VA would be required 
     to develop a methodology for establishing the amount of such 
     copayments. That methodology would establish a maximum 
     monthly copayment based on all income and assets of the 
     veteran and spouse; protect the spouse who continues to 
     reside in the community from financial hardship; and allow 
     the veteran to retain a monthly personal allowance. 
     Copayments would be deposited into a new extended care 
     revolving fund to be used to expand extended care 
     programming.
       Section 101(b) would require VA (1) to develop and begin to 
     implement a plan to increase (above the level of extended 
     care services provided as of September 30, 1998) the 
     percentage of the budget dedicated to such care and the level 
     of services and variety of extended care programs; and (2) 
     ensure that the staffing and level of extended care services 
     provided in VA-operated facilities is not less than the level 
     of such services provided nationally during fiscal year 1998.
       Section 101(c) would authorize VA to furnish adult day 
     health care services to an enrolled veteran who would 
     otherwise require nursing home care, and would lift the 
     limitation on providing adult day health care services to a 
     veteran for more than six months. The measure would also 
     authorize VA to contract for provision of respite care  
     services, and lift the limitation that such services must 
     be provided in VA facilities. The measure would also 
     authorize VA to establish per diem payments to State homes 
     for respite care and noninstitutional care services.
     Senate bill
       The Senate bill (S. 1076, section 101) would amend the 
     definition in chapter 17 of title 38, United States Code, of 
     the term ``medical services'' to include the term 
     ``noninstitutional extended care services.'' This would 
     require the Secretary to provide home-based primary care, 
     adult day health care, respite care, palliative and end-of-
     life care, and home health aide visits to enrolled veterans. 
     It would further define respite care to provide that such 
     care could be furnished in the patient's home or in a VA 
     facility. The measure would also remove the six-month time 
     limitation on furnishing of adult day health care.
     Conference agreement
       The conference agreement incorporates provisions from both 
     the House and Senate bills. The Senate recedes to the House 
     on directing VA to operate and maintain an extended care 
     program (subject to funding), and to maintain in-house 
     extended care staffing and services at the FY 1998 level.
       The Senate recedes to the House provision mandating 
     extended care services, modified to limit the mandate for 
     nursing home care for nonservice-connected conditions to 
     veterans who are 70% or more service-connected disabled. The 
     House recedes to the Senate on adding to the definition of 
     the term ``medical services'' the term ``noninstitutional 
     extended care services,'' with a modified definition of that 
     term. VA would evaluate and report to the Committees within 
     three years after enactment on its experience in providing 
     services under these two provisions. Such evaluation would 
     assist the Committees in assessing whether at the end of four 
     years these provisions should be modified or extended. In the 
     event these provisions were to expire, veterans would 
     continue to be eligible for such services as under existing 
     law. With respect to the change in law governing nursing home 
     care, the conference agreement would also make clear that 
     patients currently receiving VA nursing home care who are not 
     service connected or are less than 70% service-connected may 
     not be discharged or transferred if they continue to need 
     such care.
       The Senate recedes to the House policy on copayments with a 
     modification which exempts compensably rated service-
     connected veterans and veterans with incomes below the 
     pension rate from such copayments. Such copayments would not 
     be applicable to patients who are currently in receipt of 
     long-term care services with respect to the current episode 
     of care.
       The Senate recedes to the House on authorization of VA 
     payments to State homes for noninstitutional care.
       The Senate recedes to the House on authorizing VA to 
     contract for respite care.


          PILOT PROGRAMS RELATING TO LONG-TERM CARE (sec. 102)

     Current law
       VA has broad general authority under which the Secretary 
     could establish health-delivery pilot programs not 
     inconsistent with law.
     Senate bill
       The Senate bill (S. 1076, section 102) would direct VA to 
     carry out three pilot programs over a three-year period to 
     determine the feasibility and practicability of different 
     models for providing long-term care. Each model would be 
     carried out in two VA regions (networks) designated by the 
     Secretary. No network could operate more than a single pilot. 
     The pilots would provide a comprehensive array of services to 
     include institutional and noninstitutional long-term care 
     services, and appropriate case-management. Under one pilot 
     model, VA would provide long-term care services directly 
     (through VA staff and facilities). A second model would 
     employ a mix of VA-provided care and care provided under 
     cooperative arrangements with other service providers (whom 
     VA reimbursed exclusively by providing in-kind services). 
     Under a third model, VA would serve as a case-manager to 
     ensure that veterans receive needed long-term care services 
     through arrangements with appropriate non-VA entities with VA 
     making payment for such services only when not otherwise 
     covered by another entity or program such as Medicare or 
     Medicaid. VA would collect data relevant to such programs 
     and, after the completion of the program, provide Congress a 
     report describing the services provided.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes to the Senate policy on establishing 
     pilot programs relating to long-term care, with a 
     modification that would direct the VA to conduct pilot 
     programs to determine the effectiveness of different models 
     of providing all-inclusive care to reduce use of hospital and 
     nursing home care.


                  ASSISTED LIVING SERVICES (sec. 103)

     Current law
       Under its domiciliary program, VA provides eligible 
     veterans room and board in a supervised setting. Through a 
     VA-supervised community residential care program (under 
     section 1730 of title 38, United States Code), VA assists 
     veterans in obtaining placement in facilities, which in some 
     states may be considered ``assisted living'' facilities. Both 
     of these programs respond to some needs that might be 
     appropriately addressed by assisted living facilities, yet VA 
     lacks authority to contract for, or to make payments to or on 
     behalf of, a veteran for assisted living services.
     House bill
       The House bill (H.R. 2116, section 303) would require the 
     VA Secretary to provide a comprehensive report no later than 
     April 1, 2000, to the House and Senate Committees on 
     Veterans' Affairs to determine the feasibility of 
     establishing a pilot program to veterans for assisted living 
     services. The report would contain the following information: 
     (1) services and staffing needed for such a program, (2) the 
     recommended design for such program, and (3) particular 
     issues that the program should address.
     Senate bill
       The Senate bill (S. 1076, section 103) would direct VA to 
     carry out a three-year pilot program to determine the 
     feasibility of providing veterans assisted living services. 
     Under this pilot, VA would provide services to any enrolled 
     veteran, but would charge a copayment equal to the amount 
     determined under section 1710(f) of title 38, United States 
     Code, in the case of ``category C'' veterans. VA would be 
     authorized to provide these services to the spouse of a 
     veteran receiving assisted living services if the spouse 
     agreed to pay for those services. VA would report to Congress 
     annually on the pilot and, in a final report, assess the 
     pilot and provide pertinent recommendations.
     Conference agreement
       The House recedes to the Senate policy on establishing a 
     pilot program relating to assisted living services with a 
     modification which would authorize the VA to provide for such 
     services through contract arrangements. The conferees further 
     recommend that VA establish the pilot in a State (or States) 
     that reimburses such a program through Medicaid.

[[Page H11993]]

                Subtitle B--Other Access-To-Care Matters


            REIMBURSEMENT FOR EMERGENCY TREATMENT (sec. 111)

     Current law
       Current law directs VA, subject to available resources, to 
     provide needed hospital care and medical services to veterans 
     who enroll for care. (VA is not generally required to furnish 
     emergency care services to enrolled veterans. It is, however, 
     authorized to pay for emergency care under particular 
     circumstances.) Section 1703(a)(3) of title 38, United States 
     Code, covers such non-VA care for the treatment of 
     emergencies (as defined) which arose in a VA facility or 
     community nursing home (requiring transfer to an emergency 
     care setting). Section 1728 of title 38, United States Code, 
     authorizes reimbursement of emergency care costs involving 
     principally care of a service-connected condition or a 
     veteran who has a total, permanent disability from a service-
     connected disability, in an emergency in which VA facilities 
     were not feasibly available, and trying to use them would be 
     unreasonable. VA also has authority to contract for emergency 
     hospital care (under section 1703(a)(1)(A) of title 38, 
     United States Code) for treatment of a medical emergency 
     involving a service-connected condition.
     House bill
       The House bill (H.R. 2116, section 102) would authorize VA 
     to make payments for the reasonable value of emergency 
     treatment for certain enrolled veterans who have no health 
     insurance or other health care coverage (including Medicare 
     and Medicaid); have no recourse against a third party to 
     cover their liability; and are not eligible for reimbursement 
     under section 1728 of title 38, United States Code. The 
     measure would cover only veterans in (enrollment) priority 
     groups one through six who have received VA medical care 
     within one year prior to the emergency treatment. It would 
     cover medical care furnished when (in VA's judgment) VA 
     facilities are not feasibly available; care was furnished in 
     a medical emergency of such nature that delay would have been 
     hazardous to life or health, and until such time that the 
     veteran could be safely transferred to a VA or other Federal 
     facility. Section 102 would require VA to promulgate 
     implementing regulations to set the maximum amount payable 
     for such treatment; set procedures for, and terms under 
     which, payment would be made; and require that VA payment to 
     a provider would extinguish any liability on the part of the 
     veteran.
     Senate bill
       The Senate bill (S. 1076, section 131) would amend the 
     definition in section 1701 of title 38, United States Code, 
     of the term ``medical services'' to provide that that term 
     would include emergency care or reimbursement for that care. 
     Such care would be defined to include care or treatment for 
     an acute medical condition of such severity that a prudent 
     layperson could reasonably expect the absence of immediate 
     care to result in seriously jeopardizing health, seriously 
     impairing bodily functions, or serious dysfunction of any 
     bodily organ or part. In the case of a veteran with Medicare 
     or insurance coverage, VA would be a secondary payor.
     Conference agreement
       The Senate recedes with a modification that would authorize 
     VA to make reasonable payments for emergency care provided to 
     enrolled veterans subject to the limitation that the veteran 
     must have received VA care within a two-year period prior to 
     such emergency. It would also revise the definition of 
     ``emergency treatment'' to incorporate a ``prudent 
     layperson'' test.


       ELIGIBILITY FOR CARE OF COMBAT-INJURED VETERANS (sec. 112)

     Current law
       Under current law, VA provides hospital care and medical 
     services to veterans who have enrolled for VA care pursuant 
     to section 1705 of title 38, United States Code. Section 1705 
     establishes a priority system for purposes of enrollment. A 
     veteran who has no specific eligibility for care under 
     section 1710(a)(1) and (2) of title 38, United States Code, 
     is eligible for VA care if that veteran agrees to pay 
     applicable copayments. Such veteran is afforded a lower 
     priority for enrollment than veterans eligible under the 
     above-cited provisions.
     House bill
       The House bill (H.R. 2116, section 103) would establish 
     specific eligibility (and a priority for enrollment) for VA 
     health care for a veteran who was injured in combat, but has 
     no other special eligibility for care.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes with a modification that identifies the 
     beneficiaries of this provision as veterans who are Purple 
     Heart recipients.


          ELIGIBILITY FOR CARE OF MILITARY RETIREES (sec. 113)

     Current law
       Military retirees as veterans are eligible for VA care but 
     have no specific eligibility for care based on their 
     retirement status.
     House bill
       The House bill (H.R. 2116, section 104) would establish a 
     specific eligibility (and an enrollment priority within so-
     called ``category A'') for a veteran who has retired from 
     military service, who is eligible for care under the TRICARE 
     program, and who is not otherwise eligible for priority 
     access to VA care. Phased implementation would be based on an 
     interagency agreement, the provisions of which would include 
     reimbursement rates. The agreement would not cover particular 
     geographic areas unless the Secretary could document that VA 
     has capacity in such area to provide timely care to current 
     enrollees and had determined that VA would recover its cost 
     of providing such care.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes with a modification. As revised, the 
     conference agreement waives the otherwise-applicable 
     copayment obligation for an individual receiving VA care 
     under the provisions of this section. Unlike the House Bill, 
     the provision would not establish a new priority 
     classification, for purposes of enrollment, for military 
     retirees.


            TREATMENT FOR SUBSTANCE USE DISORDERS (sec. 114)

     Current law
       VA is authorized to provide medical services, including 
     needed treatment for substance abuse or dependence, to 
     enrolled veterans. Section 1720A of title 38, United States 
     Code, proscribes transferring military members to VA for 
     treatment of such problems other than during the last 30 days 
     of a tour of duty.
     Senate bill
       The Senate bill (S. 1076, section 133) would lift the 
     restriction preventing VA from treating military members for 
     substance abuse or dependency except during the last 30 days 
     of the member's period of service.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes.


                  SEXUAL TRAUMA COUNSELING (sec. 115)

     Current law
       Section 1720D of title 38, United States Code, authorizes 
     VA to provide sexual trauma counseling and other appropriate 
     care and services to veterans who require such services as a 
     result of sexual assault, sexual battery, or sexual 
     harassment experienced while on active duty. This authority 
     expires on December 31, 2001.
     House bill
       The House bill (H.R. 2116, section 108) would require VA to 
     operate a sexual trauma program through December 31, 2002. It 
     would expand the scope of required outreach and require VA to 
     report to Congress on the implementation of that outreach. VA 
     and DOD would also be required to report on joint efforts to 
     inform separating servicemembers about eligibility for, and 
     availability of, VA sexual trauma services. The provision 
     would also require VA, in consultation with DOD, to conduct a 
     study to determine: (1) the extent to which former reservists 
     experienced physical assault or battery of a sexual nature 
     while serving on active duty for training; (2) the extent to 
     which such reservists have sought VA counseling related to 
     such incidents; and (3) the additional resources required to 
     meet the projected needs for such counseling. Finally, the 
     measure would require VA to report on the number of veterans 
     who have received counseling services and the number referred 
     to community sources in connection with such counseling and 
     services.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes with a modification that would extend 
     the program through December 31, 2004.


             specialized mental health services (sec. 116)

     Current law
       Under section 1706(b) of title 38, United States Code, VA 
     is required to maintain its capacity to provide for the 
     specialized treatment and rehabilitative needs of disabled 
     veterans (including, among other specified groups, veterans 
     with mental illness) within distinct programs or facilities 
     dedicated to those specialized needs.
     Senate bill
       The Senate bill (S. 1076, section 132) would require VA to 
     establish a mechanism to augment specialized mental health 
     services to include establishing new programs, expanding 
     provision of services, and increasing staffing. Funding for 
     such program augmentations would be provided through a 
     centralized fund, with an emphasis on initiatives to treat 
     post-traumatic stress disorder and substance use disorders.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes with a modification which would require 
     VA to allocate no less than $15 million to enhance 
     specialized mental health programs, with particular emphasis 
     on programs for the treatment of post-traumatic stress 
     disorder and substance use disorders.

[[Page H11994]]

                   Legislative Provisions Not Adopted


             BENEFITS FOR PERSONS DISABLED IN WORK-THERAPY

     Current law
       Under current law, a veteran who is injured while working 
     in a VA-sponsored vocational rehabilitation program under 
     circumstances which are not the result of negligence or 
     willful misconduct is entitled to compensation under section 
     1151(a)(2) of title 38, United States Code. A veteran who 
     incurs a work-related injury while participating in a VA-
     sponsored compensated work therapy program (authorized under 
     section 1718 of title 38, United States Code), however, is 
     not entitled to VA compensation benefits or to benefits under 
     applicable workers' compensation laws because the veteran is 
     not an ``employee'' of either VA or the private entity at 
     which such individual may work under that program.
     House bill
       The House bill (H.R. 2116, section 105) would establish 
     entitlement to VA compensation and health care coverage in 
     cases in which a veteran becomes disabled or dies as a result 
     of participating in a VA compensated work therapy program.
     Senate bill
       The Senate bill contained no similar provision.

                TITLE II--MEDICAL PROGRAM ADMINISTRATION


                         COPAYMENTS (sec. 201)

     Current law
       Current law sets limited copayment requirements applicable 
     to ambulatory care services. VA is required to charge 
     veterans under treatment for a nonservice-connected condition 
     (other than veterans who are 50 percent or more service-
     connected disabled and veterans whose income is below the 
     pension level) $2 for each 30-day supply of medication. Those 
     whose only basis for eligibility for medical care is veteran 
     status and who have income above the applicable ``means 
     test'' level are also required to pay copayments for each 
     outpatient visit; the copayment rate is at 20 percent of the 
     estimated average cost of an outpatient visit to a VA 
     facility.
     House bill
       The House bill (H.R. 2116, section 201(a)) would (1) 
     authorize the Secretary of Veterans Affairs to increase the 
     $2 drug copayment amount; (2) establish a maximum annual 
     payment applicable to veterans with multiple outpatient 
     prescriptions; and (3) establish copayment requirements on 
     sensory-neural aids (such as hearing aids and eyeglasses), 
     electronic equipment, and other costly items (other than a 
     wheelchair or artificial limbs) furnished veterans for a 
     nonservice-connected condition. Section 201(b) would require 
     the Secretary to revise the copayment amount or amounts 
     charged ``category C'' veterans.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes with a modification. As revised, the 
     measure would authorize the Secretary to set a maximum 
     payment amount for drugs for any veteran, both by year and by 
     month. The measure would not provide authority to establish a 
     new category of copayments for prosthetics.


              health services improvement fund (sec. 202)

     Current law
       Amounts which VA receives through collections and 
     copayments are to be deposited in the Department of Veterans 
     Affairs Medical Care Collections Fund.
     House bill
       The House bill (H.R. 2116, section 202) would establish a 
     new fund in the Treasury in which VA is to deposit amounts 
     received or collected under the following new authorities 
     under the bill: the pilot program for dependents; new 
     copayments and the amount of the increase in copayments 
     provided for under new section 1722A(b) of title 38, United 
     States Code; funds received under enhanced-use leases under 
     new section 8165(a); and payments from the Department of 
     Defense under section 104(c) of the bill. Amounts in the new 
     Health Services Improvement Fund, which is intended to be 
     used to improve services to veterans (such as by improving 
     timeliness of care), are available without fiscal year 
     limitation and without any requirement (such as is applicable 
     to the medical care collections fund) that such funds be 
     specifically appropriated. It is intended that such funds be 
     credited to the extent feasible to the pertinent Department 
     facility to which such collection or payment is attributable.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes with a modification to provide that 
     amounts in the fund are to be allocated to facilities in the 
     same manner as under the Medical Care Collections Fund.


allocations to facilities from medical care collections fund (sec. 203)

     Current law
       Monies collected and recovered by each network and 
     deposited in the Medical Care Collections Fund are to be 
     allocated to such network.
     Senate bill
       The Senate bill (S. 1076, section 134) would provide that, 
     of the monies collected and recovered by VA and deposited in 
     the Medical Care Collections Fund, each facility is to 
     receive the amount collected or recovered on behalf of that 
     facility.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes.


            non-profit corporations for education (sec. 204)

     Current law
       Section 7361 of title 38, United States Code, authorizes VA 
     (through December 31, 2000) to establish a non-profit 
     corporation at any VA medical center to receive and 
     administer funds for the conduct of research.
     House bill
       The House bill (H.R. 2116, section 204) would authorize 
     (through December 31, 2000) the establishment of non-profit 
     corporations at any VA medical center to facilitate research 
     and education, or both, or the expansion of any VA research 
     corporations to facilitate education as well. The provision 
     would specifically identify (by reference to provisions of 
     law) the types of training and education activities such 
     corporations may foster. Such corporations would be subject 
     to the same oversight and accountability measures as the 
     existing research corporations. The provision would make any 
     expenditures related to education activities subject to 
     policies, procedures, and approval processes prescribed by 
     the Under Secretary for Health.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes with a modification that would define 
     the term ``education and training'' and would revise 
     reporting requirements for the corporations.


              extension of certain authorities (sec. 205)

     Current law
       In addition to providing ongoing authority to furnish 
     readjustment counseling to Vietnam-theater veterans and other 
     veterans who served in a theater of combat operations or in 
     certain areas of armed conflict after the Vietnam War, VA is 
     authorized to provide readjustment counseling to veterans of 
     the Vietnam era who seek such counseling before January 1, 
     2000. VA is required, through December 31, 1999, to evaluate 
     the health status of dependents of Persian Gulf War veterans, 
     and to distribute a newsletter to veterans listed in VA's 
     Gulf War registry.
     House bill
       The House bill (H.R. 2116, section 205) would extend 
     through January 1, 2003, the date by which Vietnam era 
     veterans must apply to be eligible for readjustment 
     counseling services.
     Senate bill
       The Senate bill (S. 1076, section 135) would extend the 
     requirements relating to Gulf War veterans for three years.
     Conference agreement
       The Senate recedes to the House with a modification that 
     would extend until December 31, 2003, the period within which 
     Vietnam era veterans may apply for and receive counseling. 
     The House recedes with a modification that would extend the 
     expiring provisions relating to Persian Gulf veterans for 
     four years.


 REESTABLISHMENT OF COMMITTEE ON POST-TRAUMATIC STRESS DISORDER (sec. 
                                  206)

     Current law
       Section 7321 of title 38, United States Code, directs VA to 
     establish and support a Committee on Care of Severely 
     Chronically Mentally Ill Veterans to carry out a continuing 
     assessment of VA's capacity to meet effectively the treatment 
     needs of severely mentally ill veterans and to advise on 
     specific program matters. The Under Secretary of Health is 
     required to report to Congress annually through February 1, 
     2001 on the committee's findings and recommendations and on 
     the steps taken to improve VA treatment of such veterans.
       Section 110 of Public Law 98-528 directed VA to establish a 
     Committee on Post-Traumatic Stress Disorder which is to serve 
     as an advisory committee, to carry out a continuing 
     assessment of VA's capacity to treat PTSD, and to make 
     recommendations on specific program matters. The requirement 
     that VA report to Congress annually regarding the committee's 
     findings and recommendations and steps taken thereon lapsed 
     with the requirement of a report by October 1, 1993.
     House bill
       The House bill (H.R. 2116, section 205) would extend the 
     requirement that VA submit reports (through 2003) to Congress 
     related to the work of the Committee on Care of Severely 
     Chronically Mentally Ill Veterans, and renew the requirement 
     that VA submit reports (through 2004) related to the work of 
     the Committee on Post-Traumatic Stress Disorder.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes to the House regarding the 
     reestablishment of the Committee on Post-Traumatic Stress 
     Disorder. The provision does not extend the reporting 
     requirements for the Committee on Care of Severely

[[Page H11995]]

     Chronically Mentally Ill Veterans; that reporting requirement 
     does not lapse until next year. The Committees on Veterans' 
     Affairs defer action on this provision with no prejudice to 
     the important work done by this body.


                  STATE HOME GRANT PROGRAM (sec. 207)

     Current law
       Current law provides a framework for VA to award grants to 
     States for construction or renovation of nursing homes and 
     domiciliaries for veterans. The law calls for VA regulations 
     which are to include direction as to the number of beds for 
     which grant support is available. The law also sets 
     requirements States must meet in filing applications for such 
     funds. That law also specifies the relative priority to be 
     assigned applications. An application from a State that has 
     made its funding available in advance is to be accorded the 
     highest priority for funding. In assigning priority among 
     such pre-funded State projects, current law provides that 
     priority is to be given to construction or acquisition of 
     nursing home or domiciliary buildings.
     House bill
       The House bill (H.R. 2116, section 206) would provide 
     greater specificity in directing VA to prescribe regulations 
     for the number of beds for which grant assistance may be 
     furnished (providing that such regulations are to be based on 
     projected demand (ten years after the bill's enactment) by 
     veterans who would be 65 or older and who reside in the 
     state). Under such regulations, VA is to establish criteria 
     for determining the relative need for additional beds on the 
     part of a State which already has such State home beds. 
     Section 206(b) would strengthen the requirements governing 
     award of a grant. It would also revise provisions governing 
     the relative priority of each application (among those 
     projects for which States have made their funding available 
     in advance). It would differentiate among applications for 
     new bed construction by reference to the relative need for 
     such beds; by assigning a higher priority to renovation 
     projects (with a total cost exceeding $400,000) than under 
     current law (with highest priority to renovations involving 
     patient life or safety); and by assigning second highest 
     priority to an application from a State that has not 
     previously applied for award of a VA construction grant or a 
     grant for a State nursing home. Section 206(c) would 
     establish a ``transition'' rule providing that current law 
     regulations and provisions governing applications for State 
     home grants would continue in effect with respect to 
     applications for a limited number of projects. Those 
     ``grandfathered'' projects are limited to those projects on 
     the list of approved projects (described in title 38, United 
     States Code, section 8135(b)(4)), established by the 
     Secretary of Veterans Affairs on October 29, 1998 for which 
     States had made sufficient funds available so that the 
     project could proceed upon approval of the grant without 
     further action required by the State to make the funds 
     available for that purpose.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes to the House with a modification to the 
     transition provision, which takes into account the 
     publication by the Secretary of Veterans Affairs on November 
     3, 1999, of a new list of approved projects. The revised 
     transition measure retains the ``grandfathering'' provided 
     for under the House bill while adding a second tier of 
     grandfathered projects. The second tier consists of those 
     ``priority one'' projects on the VA's FY 2000 list (projects 
     for which States have made their funding available in advance 
     and are identified as ``priority group one'' on that list) 
     submitted by States which have not received FY 1999 grant 
     monies and are not included in the first-tier of 
     grandfathered projects.


          EXPANSION OF ENHANCED-USE LEASE AUTHORITY (sec. 208)

     Current law
       VA is authorized to enter into long-term agreements under 
     which VA real property may be leased and improved for uses 
     that are not inconsistent with VA's mission and at least part 
     of the use of the property under the lease is to provide 
     space for an activity contributing to a VA mission. A lease 
     involving construction or substantial renovation may be for 
     up to 35 years (or otherwise for up to 20). VA must receive 
     fair consideration, whether monetary, or in services or 
     facilities. Seventy-five percent of funds received, after 
     deduction of expenses of leasing, are to be deposited in the 
     Nursing Home Revolving Fund; the remainder are to be credited 
     to the medical care account for use of the facility at which 
     the property is located. VA's authority to enter into 
     enhanced-use leases expires on December 31, 2001.
     House bill
       The House bill (H.R. 2116, section 207) would establish an 
     additional, independent basis for entering into a long-term 
     agreement under which VA real property may be leased and 
     improved--namely on a determination that applying the 
     consideration under such a lease to provide medical care 
     (pursuant to a business plan) would demonstrably improve 
     services to eligible veterans in the network where the leased 
     property is located. The provision would extend the maximum 
     lease term to 75 years, and authorize VA to provide in the 
     terms of the lease for it to use minor construction funds for 
     capital contribution payments. The section would also provide 
     that funds received under such arrangements (after required 
     deductions) would be deposited in the new fund under section 
     202 of the bill; VA would be required to make no less than 75 
     percent of the amount attributable to that lease available to 
     the network in which the property is located. The section 
     would also repeal the termination provision.
     Senate bill
       The Senate bill (S. 1076, section 111) would extend until 
     December 31, 2011, VA's authority to enter into ``enhanced-
     use'' leases; extend the maximum authorized term for such 
     leases to 55 years; and authorize the expenditure of minor 
     project construction account funds for capital activities on 
     property leased under that authority. It would require VA to 
     provide training to VA medical center staff on approaching 
     potential lessees in the medical or commercial sectors 
     regarding the possibility of such leasing. The measure would 
     also require VA to secure an independent analysis of 
     opportunities for enhanced-use leasing. The analysis, to be 
     based on a survey and assessment of VA facilities, is to 
     include an integrated business plan for each facility with 
     leasing potential. VA would be authorized to lease property 
     identified as having development potential if the proposed 
     lease is consistent with such a business plan.
     Conference agreement
       The Senate recedes to the House with modifications that 
     address the duration of leasing authority and the policy 
     regarding training of medical center personnel. The 
     conference agreement also includes a provision derived from 
     the Senate bill which would require VA to contract with an 
     appropriate entity or entities to obtain needed expertise in 
     identifying opportunities for leasing. The conferees do not 
     intend, however, that the conduct or planned conduct of any 
     such analyses should impede or delay the VA from developing 
     enhanced-use leasing opportunities which it may identify 
     independent of this provision. The House recedes to the 
     Senate in eliminating provisions of the bill that would have 
     repealed provisions of section 8162 of title 38, United 
     States Code, that prohibit enhanced use agreements unless 
     specifically authorized by law at the West Los Angeles VA 
     Medical Center.


      LICENSURE REQUIREMENT FOR VA HEALTH PROFESSIONALS (sec. 209)

     Current law
       As reflected in section 7402 of title 38, United States 
     Code, a health care professional must be licensed (or, in 
     some instances, registered or certified) in a State to be 
     eligible for appointment to a position in such profession in 
     the VA. Current law does not specifically address the 
     situation of a professional having lost his or her license to 
     practice in one jurisdiction while still being licensed in 
     another.
     House bill
       The House bill (H.R. 2116, section 208) would provide that 
     an individual may not be employed as a title 38, United 
     States Code, health care professional if a State has 
     terminated for cause that individual's license, registration, 
     or certification or such an individual has relinquished such 
     license, registration, or certification after being notified 
     in writing by the State of a potential termination for cause.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes.


               va/dod procurement coordination (sec. 210)

     Current law
       VA and DoD both operate programs to procure pharmaceuticals 
     and medical supplies to support the health care systems of 
     the respective departments.
     Senate bill
       The Senate bill (S. 1076, section 136) would require the 
     Secretaries of the Departments of Veterans Affairs and 
     Defense to submit to Congress, no later than March 31, 2000, 
     a report on cooperation between the departments on 
     procurement of pharmaceuticals and medical supplies.
     House bill
       The House bill contained no provision relating to this 
     matter.
     Conference agreement
       The House recedes.


          reimbursement for medical care in alaska (sec. 211)

     Current law
       VA has authority to set payment rates for treatment 
     furnished by community providers.
     Senate bill
       The Senate bill (S. 1076, section 137) would require that 
     for one year VA, in making payments under section 1728 of 
     title 38, United States Code, use the payment schedule in 
     effect for such purposes as of July 31, 1999 rather than the 
     Participating Physician Fee Schedule under the Medicare 
     program.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes with the understanding that the intent of 
     this section is to provide a transition to a modified payment 
     schedule.

[[Page H11996]]

              TITLE III--MISCELLANEOUS MEDICAL PROVISIONS

             changes in operations and programs (sec. 301)

     Current law
       VA is under no obligation to provide Congress advance 
     notice of proposed changes to the operation of individual 
     facilities unless such changes would in any fiscal year 
     reduce staffing at a facility by a specified percentage. In 
     the event of such a ``reorganization'', as defined in section 
     510 of title 38, United States Code, VA would be required to 
     defer implementation for a specified period to permit 
     congressional review. Under section 1706(b) of title 38, 
     United States Code, VA is to maintain its capacity to provide 
     for the specialized treatment and rehabilitative needs of 
     disabled veterans (including among other specified groups, 
     veterans with mental illness) within distinct programs or 
     facilities dedicated to those specialized needs.
     House bill
       The House bill (H.R. 2116, section 301) would establish new 
     reporting requirements. It would require VA to report and 
     provide justification to Congress on, and defer for a period, 
     plans to ``close'' within any fiscal year more than half the 
     beds within a ``bed section'' of a VA medical center (as 
     those quoted terms are defined). This provision is intended 
     to provide assurance that proposals which would further 
     shrink programs serving veterans with severe mental illness 
     or who require intensive rehabilitation, for example, are 
     making adequate provision for otherwise meeting the special 
     needs of such patients.
       Section 301 would also require VA to notify Congress 
     annually as to the number of (and circumstances regarding) 
     medical and surgical service beds closed during the fiscal 
     year, and as to the number of nursing home beds that were the 
     subject of a mission change during that period.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes.


                     va canteen service (sec. 302)

     Current law
       Current law limits the scope of service which VA's canteens 
     may offer visitors and employees to the sale of merchandise 
     or services for consumption or use on the premises.
     House bill
       The House bill (H.R. 2116, section 302) would lift the 
     restrictions on VA's canteen service relating to off-premises 
     consumption and use, and would make technical changes to 
     revise references in law from ``hospitals and homes'' to 
     ``medical facilities.''
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes with a modification limiting the 
     provision to removing the sales restrictions on off-premises 
     consumption.


                   chiropractic treatment (sec. 303)

     Current law
       VA has specific authority to provide eligible veterans (in 
     addition to hospital care and nursing home care) with needed 
     ``medical services'', a term defined to include 
     ``rehabilitative services'' and other unspecified services 
     that ``the Secretary determines to be reasonable and 
     necessary.'' VA has determined that it has authority (and in 
     some instances has exercised that authority) to provide 
     certain veterans chiropractic treatments under ``fee-basis'' 
     arrangements. Current law does not require (or specifically 
     authorize) VA to furnish veterans with chiropractic treatment 
     nor to have a policy on such treatment.
     House bill
       The House bill (H.R. 2116, section 304) would require the 
     VA Under Secretary for Health, in consultation with 
     chiropractors, to establish a policy regarding chiropractic 
     treatment.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes.


                       hospital naming (sec. 304)

     Current law
       Under section 531 of title 38, United States Code, VA 
     facilities (or any major portion of a facility) shall be 
     named only for its geographic location except as expressly 
     provided by law.
     House bill
       The House bill (H.R. 2116, section 305) would designate the 
     hospital replacement building under construction at the 
     Ioannis A. Lougaris Veterans Affairs Medical Center in Reno, 
     Nevada, as the ``Jack Streeter Building.''
     Senate bill
       The Senate bill (S. 1076, section 112) contains a 
     substantively identical provision.
     Conference agreement
       The conference agreement includes the provision.

             TITLE IV--CONSTRUCTION AND FACILITIES MATTERS


                authorization of construction (sec. 401)

     Current law
       Section 8104 of title 38, United States Code, provides that 
     no funds may be appropriated for any fiscal year, and VA may 
     not obligate or expend funds (other than for planning and 
     design) for any medical construction project involving a 
     total expenditure of more than $4 million unless funds for 
     that project have been specifically authorized by law.
     House bill
       The House bill (H.R. 2116, section 401) would authorize 
     renovations to provide a domiciliary in Orlando, Florida, 
     using previously appropriated funds and construction of a 
     surgical addition at the Kansas City, Missouri, VA Medical 
     Center.
     Senate bill
       The Senate bill (S. 1076, section 141) would authorize 
     construction of a long-term care facility at the Lebanon, 
     Pennsylvania, VA Medical Center, construction of a surgical 
     addition at the Kansas City, Missouri, VA Medical Center, and 
     renovations at VA medical centers in both Fargo, North 
     Dakota, and Atlanta, Georgia.
     Conference agreement
       The conference agreement incorporates all the projects 
     authorized by either bodies and also includes authorization 
     for demolition of buildings at the Leavenworth, Kansas, VA 
     Medical Center.


                  authorization of leasing (sec. 402)

     Current law
       Section 8104 of title 38, United States Code, provides that 
     no funds may be appropriated for any fiscal year, and VA may 
     not obligate or expend funds for any medical facility lease 
     involving an average annual rental of more than $600 
     thousand unless funds for that lease have been 
     specifically authorized by law.
     House bill
       The House bill (H.R. 2116, section 402) would authorize 
     leases of an outpatient clinic in Lubbock, Texas, and of a 
     research building in San Diego, California.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes.


               AUTHORIZATION OF APPROPRIATIONS (sec. 403)

     House bill
       The House bill (H.R. 2116, section 403) would authorize 
     appropriations for fiscal years 2000 and 2001 of $13 million 
     for construction, and $2,178,500 for the leases.
     Senate bill
       The Senate bill (S. 1076, section 141) would authorize 
     appropriations for fiscal years 2000 of $225.5 million for 
     construction.
     Conference agreement
       The conference agreement would authorize appropriations for 
     fiscal years 2000 and 2001 of $57.5 million for construction, 
     and $2,178,500 for the leases.

                   Legislative Provisions Not Adopted


                    MEDICAL SERVICES FOR DEPENDENTS

     Current law
       The VA has authority to treat non-veterans under ``sharing 
     agreements'' authorized under section 8153 of title 38, 
     United States Code. VA lacks authority, however, to recover 
     from insurance companies and other third parties for the cost 
     of care provided to nonveterans.
     House bill
       The House bill (H.R. 2116, section 106) would authorize VA 
     to establish a three-year pilot program in which VA may 
     provide primary health care services to dependents of 
     veterans in up to four networks, provided that such care 
     would not deny or delay access to care for veterans. 
     Participants must have the ability to pay for such care 
     directly or through reimbursement or indemnification by a 
     third party. This section would also require that GAO monitor 
     the pilot program, report its findings to VA and for VA to 
     act on these recommendations as appropriate.
     Senate bill
       The Senate bill contained no similar provision.


   ENHANCED SERVICES PROGRAM AT FACILITIES UNDERGOING MISSION CHANGES

     Current law
       Section 510 of title 38, United States Code, authorizes the 
     Secretary of Veterans Affairs to eliminate or redistribute 
     the functions of VA facilities. Section 510 requires, with 
     respect to an administrative reorganization (a term defined 
     as a reduction in the number of full-time equivalent 
     employees of a specified percentage), that such a 
     reorganization not be implemented for at least 45 days after 
     the Secretary has provided the Committees a detailed report 
     on such proposed reorganization.
     House bill
       The House bill (H.R. 2116, section 107) would establish a 
     process under which VA would (1) conduct studies to identify 
     medical centers which should undergo mission changes, and (2) 
     develop plans for such mission changes and for reallocating 
     savings resulting from such change to improve veterans' 
     access to care and quality of services provided. Section 107 
     would set limits on VA's authority to change medical center 
     missions or close medical centers. It would require: (1) VA 
     to determine (based on market and data analysis) both that 
     the facility

[[Page H11997]]

     (in whole or in part) can no longer be operated efficiently 
     and at optimal quality (because of such factors as the 
     projected need for care-capacity, functional obsolescence, 
     and cost of operating and maintaining physical plant) and 
     that the patients who use the facility can receive care of 
     appropriate quality under contract arrangements or at another 
     VA medical center; (2) that VA consult with and provide for 
     veterans organizations, unions, and other interested parties 
     to participate in the development of a facility realignment 
     plan; (3) VA to provide specified protections for employees 
     who would be displaced under any such plan; (4) VA to 
     maintain ongoing oversight of any hospital care provided 
     under contract under a realignment plan; (5) that 90 percent 
     of operational savings under a realignment be retained by the 
     pertinent VA network and be used to establish new clinics or 
     other means of improving patient access and service; and (6) 
     VA to defer implementing a realignment plan pending the 
     passage of at least 45 days following submission of a report 
     to Congress on the plan.
     Senate bill
       The Senate bill contained no similar provision.


                      VETERANS TOBACCO TRUST FUND

     Current law
       Any monies which the United States might recover (other 
     than under existing recovery provisions of title 38, United 
     States Code) attributable to VA's cost of providing care to 
     veterans for tobacco-related illnesses would be for deposit 
     as miscellaneous receipts in the Treasury.
     House bill
       The House bill (H.R. 2116, section 203) would require that 
     if the United States pursues recovery (other than a recovery 
     currently authorized under title 38, United States Code, for 
     health care costs incurred by the United States that are 
     attributable to tobacco-related illnesses) VA is to: (1) 
     retain the proportional amount of the recovery which is 
     attributable to VA's cost of providing care to veterans for 
     tobacco-related illnesses; and (2) deposit such funds in a 
     trust fund (the ``Veterans Tobacco Trust Fund'') in the 
     Treasury to be available after fiscal year 2004 for medical 
     care and research.
     Senate bill
       The Senate bill contained no similar provision.


                TERMS OF OFFICE FOR VA UNDER SECRETARIES

     Current law
       Appointments to the positions of Under Secretary for 
     Benefits and Under Secretary for Health in the Department of 
     Veterans Affairs shall be for a four-year period, with 
     reappointment permissible for successive like periods; if the 
     President removes such official before the completion of the 
     term, the President is to communicate the reasons for the 
     removal to Congress.
     Senate bill
       The Senate bill (S. 1076, section 138) would strike the 
     provision which sets the term of appointment for the Under 
     Secretary of Benefits and of Health and which requires the 
     President to communicate to Congress the reasons for a 
     removal from office.
     House bill
       The House bill contained no similar provision.

                TITLE V--BENEFITS AND EMPLOYMENT MATTERS

                    Subtitle A--Compensation and DIC


 DEPENDENCY AND INDEMNITY COMPENSATION FOR SURVIVING SPOUSES OF FORMER 
                      PRISONERS OF WAR (sec. 501)

     Current law
       Dependency and indemnity compensation (DIC) is paid to the 
     surviving spouse or children of a veteran when the veteran's 
     death is a result of a service-connected disability. In 
     addition, DIC payments may be authorized for the survivors of 
     veterans who die as a result of their service-connected 
     disabilities if the veteran was rated totally disabled due to 
     a service connected cause for a period of ten or more years 
     immediately preceding death. The survivors of former 
     prisoners of war are eligible for DIC benefits under the same 
     rules as other veterans. However, many former POWs will not 
     meet the ``10-year rule,'' and their surviving spouses would 
     therefore not be eligible for DIC.
     House bill
       The House bill (H.R. 2280, section 102) contained a 
     provision that would authorize dependency and indemnity 
     compensation to the surviving spouses of former prisoners of 
     war who were rated totally and permanently disabled and who 
     had one of the conditions which the law presumes a prisoner 
     of war incurred while in service. Under the House bill, DIC 
     would be payable even though the veteran died of a 
     nonservice-connected disability and irrespective of the ten-
     year rule.
     Senate bill
       The Senate bill (S. 1076, section 204) authorizes DIC to 
     those surviving spouses of certain former prisoners of war 
     who have died from nonservice-connected causes if the former 
     POW was rated totally disabled due to any service-connected 
     cause for a period of one or more years (rather than 10 or 
     more years) immediately prior to death.
     Conference agreement
       The House recedes.


 REINSTATEMENT OF CERTAIN BENEFITS FOR REMARRIED SURVIVING SPOUSES OF 
        VETERANS UPON TERMINATION OF THEIR REMARRIAGE (sec. 502)

     Current law
       Surviving spouses of veterans entitled to veterans benefits 
     lose their eligibility for those benefits if they remarry. 
     Section 8207 of Public Law 105-178 reinstated eligibility for 
     dependency and indemnity compensation to former DIC 
     recipients whose remarriages are terminated. However, 
     ancillary survivor benefits for CHAMPVA medical care, 
     education, and home loan benefits were not reinstated upon 
     termination subsequent marriages.
     House bill
       The House bill (H.R. 2280, section 104) restores CHAMPVA 
     medical coverage, educational assistance, and housing loan 
     benefits to those surviving spouses whose eligibility had 
     been severed as the result of remarriage. This provision 
     extends legislation passed in the 105th Congress (Public 
     Law 105-178) allowing the reinstatement of dependency and 
     indemnity compensation benefits to this group of surviving 
     spouses.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes.


  PRESUMPTION THAT BRONCHIOLO-ALVEOLAR CARCINOMA IS SERVICE-CONNECTED 
                               (sec. 503)

     Current law
       Section 1112(c)(2) of title 38, United States Code, 
     provides veterans who participated in a ``radiation-risk 
     activity'' with eligibility for service-connected 
     compensation benefits based upon a presumption that certain 
     cancers and other diseases were incurred or aggravated during 
     active military service. The presumption applies if the 
     veteran develops one of the specific diseases within 40 years 
     after the last date of exposure to radiation.
     House bill
       The House bill (H.R. 2280, section 102) contained a 
     provision that would add bronchiolo-alveolar carcinoma to the 
     list of presumed service-connected illnesses in veterans 
     exposed to radiation. Scientific research has found that this 
     is not a smoking- related lung cancer.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes.

                         Subtitle B--Employment


     CLARIFICATION OF VETERANS' EMPLOYMENT OPPORTUNITIES (sec. 511)

     Current law
       Section 3304(f) of title 5, United States Code, accords 
     preference-eligible veterans and veterans with three or more 
     years of active duty service the opportunity to compete for 
     vacancies in a Federal agency when the agency opens 
     competition to outside applicants. The Office of Personnel 
     Management (OPM) has interpreted this provision to allow 
     veterans covered by the Act to compete and fill job vacancies 
     only under an ``excepted'' hiring authority. That 
     interpretation has the effect of prohibiting such veteran's 
     job advancement on a competitive basis within an agency since 
     ``excepted'' employees do not acquire ``competitive status.''
     Senate bill
       The Senate bill (S. 1076, section 206) would clarify 
     certain changes in law made under the Veterans Employment 
     Opportunities Act of 1998 (Public Law 105-339). Section 206 
     of S. 1076 would confer competitive status on veterans hired 
     under the Act, thereby allowing them to compete for internal 
     vacancies.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes to the Senate provision in modified form. 
     Language has been stricken from the Senate provision which, 
     according to OPM, could be construed to mean that persons 
     hired under the Act would be exempt from serving a 
     probationary period as civilian employees. Further, 
     additional language has been added to permit OPM to 
     promulgate regulations ensuring that those honorably 
     discharged from active duty military service shortly before 
     completing three years of service are not excluded from 
     coverage under the Act.

                   Legislative Provisions Not Adopted


     PAYMENT RATE OF BURIAL BENEFITS FOR CERTAIN FILIPINO VETERANS

     Current law
       Former members of the Philippine Commonwealth Army may 
     qualify for VA disability compensation, burial benefits, and 
     National Service Life Insurance benefits, and their survivors 
     may qualify for dependency and indemnity compensation. These 
     benefits are paid at half the rate they are provided to U.S. 
     veterans.
     Senate bill
       The Senate bill (S. 1076, section 201) would provide, in 
     cases of death after enactment of section 201, a full-rate 
     funeral expense and plot allowance to Philippine Commonwealth

[[Page H11998]]

     Army veterans who, at the time of death: (a) are naturalized 
     citizens of the United States residing in the U.S. and (b) 
     are receiving compensation for a service-connected disability 
     or would have been eligible for VA pension benefits had their 
     service been deemed to have been active military, naval, or 
     air service.
     House bill
       The House bill contained no similar provision.


      REPEAL OF LIMITATION ON PAYMENTS OF BENEFITS TO INCOMPETENT 
                       INSTITUTIONALIZED VETERANS

     Current law
       Under section 5503 of title 38, United States Code, VA is 
     prohibited from paying compensation and pension benefits to 
     an incompetent veteran who has assets of $1,500 or more if 
     the veteran is being provided institutional care by VA (or 
     another governmental provider) and he or she has no 
     dependents. Such payments are restored if the veteran's 
     assets drop to $500 in value.
     Senate bill
       The Senate bill (S. 1706, section 205) would repeal the 
     limitation on benefit payments imposed by section 5503, title 
     38, United States Code.
     House bill
       The House bill contained no similar provision.

                       TITLE VI--MEMORIAL AFFAIRS

            Subtitle A--American Battle Monuments Commission


 CODIFICATION AND EXPANSION AUTHORITY FOR WORLD WAR II MEMORIAL (sec. 
  601); GENERAL AUTHORITY TO SOLICIT AND RECEIVE CONTRIBUTIONS (sec. 
        602); INTELLECTUAL PROPERTY AND RELATED ITEMS (sec. 603)

     Current law
       Public Law 103-32 authorizes the American Battle Monuments 
     Commission (ABMC) to establish a World War II Memorial in 
     Washington, DC. It will be the first national memorial 
     dedicated to all who served during World War II and 
     acknowledging the commitment and achievement of the entire 
     nation. The memorial is to be funded entirely by private 
     contributions, with donations from individuals, corporations 
     and foundations. Construction of the memorial will begin when 
     all necessary funds have been secured.
     House bill
       The House bill (H.R. 2280, sections 201, 202, 203) would 
     make various revisions to chapter 21 of title 36, United 
     States Code. The House bill would (a) continue the 
     authorization of the ABMC to solicit and accept contributions 
     for a World War II Memorial in the District of Columbia; (b) 
     codify the existing World War II Memorial fund and modify it 
     to reflect changes made in this legislation; (c) modify the 
     purpose for which funds deposited in the Treasury may be 
     used; (d) provide the Commission the authority to borrow up 
     to $65 million from the Treasury for groundbreaking, 
     construction, and dedication of the Memorial on a timely 
     basis; (e) require that in determining whether ABMC has 
     sufficient funds to complete construction of the World War II 
     memorial, the Secretary of the Interior will consider the $65 
     million in funds that the ABMC may borrow from the Treasury 
     as funds available to complete the construction of the 
     memorial, whether or not the ABMC has actually exercised the 
     authority to borrow the funds; (f) authorize the ABMC to 
     accept voluntary services in furtherance of the fundraising 
     activities relative to the memorial; and to (1) establish 
     that a person providing voluntary services will be considered 
     to be a federal employee for purposes of chapter 81 of title 
     5, United States Code, relating to compensation for work-
     related injuries, and chapter 171 of title 28, United States 
     Code, relating to tort claims, in addition; (2) authorize the 
     ABMC to provide for reimbursement of incidental expenses that 
     are incurred by a person providing voluntary services; and 
     (3) disallow the use of volunteer services to displace or 
     replace any Federal employee; (g) require that a contract 
     entered into by the ABMC for the design or construction of 
     the World War II Memorial not be considered a funding 
     agreement as that term is defined in section 201 of title 35, 
     United States Code; and (h) extend the authority to establish 
     the Memorial to December 31, 2005.
       Section 202 would amend section 2103(e) of title 36, United 
     States Code, to specify the conditions by which the ABMC may 
     solicit and receive funds and in-kind donations. It expands 
     the sources from which the ABMC may solicit and receive such 
     funds and requires the ABMC to prescribe guidelines to avoid 
     conflicts of interest.
       Section 203 would amend chapter 21 of title 36, United 
     States Code, by adding a new section 2114 entitled 
     ``Intellectual Property and related items'' to (a) authorize 
     the Commission to use and register intellectual property and 
     grant licenses, and enforce such authority; and (b) require 
     that the Secretary of Defense provide the ABMC with a legal 
     representative in administrative proceedings before the 
     Patent and Trademark Office and Copyright Office.
     Senate bill
       The Senate bill (S. 1706, sections 312, 313, 314) contained 
     substantively identical language.
     Conference agreement
       The conference agreement contains this provision.

                    Subtitle B--National Cemeteries


       ESTABLISHMENT OF ADDITIONAL NATIONAL CEMETERIES (sec. 611)

     Current law
       Congress does not direct the Secretary of Veterans Affairs 
     to establish cemeteries in specific areas. The National 
     Cemetery Administration establishes cemeteries based on areas 
     of greatest need, largely as determined by their 1987 and 
     1994 reports to Congress, both entitled, ``Report on the 
     National Cemetery System.''
     House bill
       The House bill (H.R. 2280, section 211) would direct the 
     Secretary of Veterans Affairs to: (1) establish a national 
     cemetery in each of the four areas in the United States 
     deemed to be most in need of such a cemetery; (2) obligate 
     fiscal year 2000 advance planning funds (APF) for this 
     purpose; (3) submit a report to Congress within 120 days of 
     enactment setting forth the four areas, a schedule for 
     establishment, the estimated cost associated with 
     establishment, and the amount obligated under the APF for 
     this purpose; and (4) until the four cemeteries are 
     completed, submit to Congress an annual report that updates 
     the information included in the initial report.
     Senate bill
       The Senate bill (S. 695, section 1) would direct the 
     Secretary of Veterans Affairs to establish a National 
     Cemetery in the following five areas: Atlanta, Georgia, 
     metropolitan area; Southwestern Pennsylvania; Miami, Florida, 
     metropolitan area; Detroit, Michigan, metropolitan area; and 
     Sacramento, California, metropolitan area. Senate Report 106-
     113 identifies the six areas from both the 1987 and 1994 
     reports to Congress titled ``Report on the National Cemetery 
     System'' that remain unserved. These areas are: (1) Detroit, 
     Michigan; (2) Sacramento, California; (3) Atlanta, Georgia; 
     (4) Miami, Florida; (5) Pittsburgh, Pennsylvania; and (6) 
     Oklahoma City, Oklahoma. In addition, the Senate bill would 
     require that, before selecting the site for the national 
     cemetery to be established, the Secretary consult with the 
     appropriate state and local government officials of each of 
     the five states and appropriate officials of the United 
     States, including the Administrator of General Services, with 
     respect to land belonging to the United States that would be 
     suitable as a location for the establishment of each national 
     cemetery. Further, the Secretary would submit a report to 
     Congress as soon as practicable after the date of enactment 
     on the establishment of national cemeteries, setting forth a 
     schedule for the establishment of each cemetery and an 
     estimate of the costs associated with the establishment of 
     each cemetery.
     Conference agreement
       The Senate recedes to the House provision with a 
     modification to require the Secretary to establish a national 
     cemetery in each of the six areas of the United States deemed 
     to be most in need. It is the Committees' expectation that 
     the Secretary shall act on the six areas identified in Senate 
     Report 106-113 as those areas most in need.


  USE OF FLAT GRAVE MARKERS AT SANTA FE NATIONAL CEMETERY, NEW MEXICO 
                               (sec. 612)

     Current law
       Section 2404(c)(2) of title 38, United States Code, 
     requires grave markers to be upright for interments that 
     occur on or after January 1, 1987, except for certain 
     exceptions.
     Senate bill
       The Senate bill (S. 695, section 2) would authorize the 
     Secretary of Veterans Affairs to provide for flat grave 
     markers at the Santa Fe, New Mexico, National Cemetery. It 
     would also require the Secretary to submit a report to 
     Congress within 90 days assessing the advantages and 
     disadvantages of the National Cemetery Administration using 
     flat grave markers and upright grave markers. The report 
     would have to include upright grave markers and include 
     criteria to be utilized in determining whether to prefer the 
     use of one type of grave marker over the other.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes to the Senate provision but deletes the 
     requirement for a report with respect to upright and flat 
     markers and deletes inclusion of criteria in determining 
     whether to prefer the use of one type of grave marker over 
     the other. The Committees further direct the Secretary to 
     assure Congress within 90 days that the new flat markers at 
     Santa Fe will be implemented and maintained in a way that is 
     befitting of the honor that national cemeteries are intended 
     to bestow upon our Nation's veterans.


  INDEPENDENT STUDY ON IMPROVEMENTS TO VETERANS' CEMETERIES (sec. 613)

     Current law
       There is no provision in title 38, United States Code, 
     requiring the Secretary of Veterans Affairs to conduct an 
     independent study on potential improvements to veterans' 
     cemeteries.
     House bill
       The House bill (H.R. 2280, section 212) would require 
     within 180 days the Secretary of Veterans Affairs to enter 
     into a contract with one or more qualified organizations to 
     conduct a study of national cemeteries. The study would 
     include an assessment of: (a) the one-time repairs required 
     at each national

[[Page H11999]]

     cemetery under the jurisdiction of the National Cemetery 
     Administration to ensure a dignified and respectful setting 
     appropriate to such cemetery; (b) the feasibility of making 
     standards of appearance commensurate with the finest 
     cemeteries in the world; and (c) the number of additional 
     national cemeteries required for burials after 2005. The 
     report would identify, by five-year periods beginning with 
     2005 and ending with 2020, the number of additional  national 
     cemeteries required during each five-year period and the 
     areas in the United States with the greatest concentration 
     of veterans whose needs are not served by national or 
     State veterans' cemeteries. Not later than one year after 
     the date on which the contract is entered into, the 
     contractor would be required to submit a report to the 
     Secretary setting forth the results and conclusions of the 
     study. Not later than 120 days after the report is 
     submitted, the Secretary would transmit to the Congress a 
     copy of the report with any comments.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes to the House provision with an 
     additional requirement that the Secretary submit a report to 
     Congress assessing the advantages and disadvantages of the 
     National Cemetery Administration using flat grave markers and 
     upright grave markers. Additionally, the Secretary is 
     required to report on the current conditions of flat marker 
     sections at all national cemeteries. Finally, the study of 
     the feasibility of making standards of appearance at national 
     cemeteries commensurate with standards of appearance of the 
     finest cemeteries in the world is modified to differentiate 
     between active and closed cemeteries.
       In conducting the study of national cemeteries, the report 
     shall identify as a base but not necessarily be limited to: 
     (1) The number of national cemeteries necessary to ensure 90 
     percent of America's veterans reside within 75 miles of a 
     national or State cemetery; (2) the number and percentage of 
     veterans in each State who would reside within 75 miles of an 
     open national or State cemetery; (3) an estimate of the 
     expected construction costs and the future costs of staffing, 
     equipping and operating the projected national cemeteries in 
     (1) and (2) above; and (4) in addition to projecting cemetery 
     needs at five-year intervals beginning in 2005 and ending in 
     2020, the report should take into account cemeteries which 
     will close to new burials and the age distribution of local 
     veterans' populations during the reporting periods.

                      Subtitle C--Burial Benefits


 INDEPENDENT STUDY ON IMPROVEMENTS TO VETERANS' BURIAL BENEFITS (sec. 
                                  621)

     Current law
       There is no provision in title 38, United States Code, 
     requiring the Secretary of Veterans Affairs to conduct one-
     time or periodic independent assessments of the adequacy and 
     effectiveness of the current burial benefits administered by 
     VA.
     House bill
       The House bill (H.R. 2280, section 212) would require that 
     within 180 days, the Secretary of Veterans Affairs enter into 
     a contract with one or more qualified organizations to 
     conduct a study of national cemeteries, including potential 
     enhancements to burial benefits such as an increase in the 
     plot allowance.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes to the House provision with 
     modifications. Not later than 60 days after the date of 
     enactment, the Secretary shall enter into a contract to 
     independently examine (a) the adequacy and effectiveness of 
     the current burial benefits administered by the Department 
     under chapter 23 of title 38, United States Code, in serving 
     the burial needs of veterans and their families; (b) options 
     to better serve the burial needs of veterans and their 
     families, including modifications of burial benefit amounts 
     and eligibility, together with estimated costs for each such 
     modification; and (c) expansion of authority of the 
     Department to provide burial benefits for burials in private 
     sector cemeteries and to make grants to private sector 
     cemeteries.
       The contractor shall submit a report to the Secretary 
     within 120 days of entering into a contract making 
     appropriate recommendations pursuant to the study findings. 
     Within 60 days after receipt of the report, the Secretary 
     shall transmit to the Committees on Veterans' Affairs of the 
     House of Representatives and the Senate a copy of the report, 
     together with any comments the Secretary considers 
     appropriate.

                TITLE VII--EDUCATION AND HOUSING MATTERS

                     Subtitle A--Education Matters


AVAILABILITY OF MONTGOMERY GI BILL BENEFITS FOR PREPARATORY COURSES FOR 
         COLLEGE AND GRADUATE SCHOOL ENTRANCE EXAMS (sec. 701)

     Current law
       Veterans may not use Montgomery GI Bill education benefits 
     to take preparatory courses for college and graduate school 
     entrance examinations. However, VA does have the authority to 
     pay for preparatory post-educational professional 
     examinations, such as CPA or Bar exams.
     Senate bill
       The Senate bill (S. 1402, section 3) would amend section 
     3452(b) of title 38, United States Code, to include as a 
     ``program of education'' for which the Montgomery GI Bill 
     (MGIB) may be used (a) preparatory courses for a test that is 
     required or utilized for admission to an institution of 
     higher education and (b) a preparatory course for a test 
     that is required or utilized for admission to a graduate 
     school.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes.


  determination of eligibility period for members of the armed forces 
commissioned following completion of officer training school (sec. 702)

     Current law
       Section 3011(a) of title 38, United States Code, requires 
     that MGIB participants complete their initial obligated 
     period of service to receive MGIB benefits. Exceptions to 
     this requirement are limited to individuals whose service is 
     cut short due to disability or hardship, the convenience of 
     the government (if the individual has completed 30 months of 
     a three-year enlistment or 20 months of a two-year 
     enlistment), or due to reduction in force by the service 
     branch. A servicemember who, after a period of continuous 
     active duty and following successful completion of officer 
     training school, is discharged to accept a commission as an 
     officer in the Armed Forces. Under current law, if the 
     discharge occurs before completion of the minimum period of 
     active duty needed to establish MGIB eligibility, the 
     servicemember is ineligible for education benefits.
     Senate bill
       The Senate bill (S. 1402, section 7) would create an 
     additional exception to the requirement that enlistees 
     complete their initial obligated period of service in order 
     to be eligible for MGIB benefits. Individuals who are 
     discharged from service so that they may accept a commission 
     would remain eligible for MGIB benefits if they complete the 
     service obligation incurred in accepting the commission.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes to the Senate provision in modified form 
     to address the following: The conference agreement would 
     allow the two periods of active duty (pre-commissioned and 
     commissioned) to be considered as one, thus allowing these 
     individuals to remain eligible for the MGIB program. Also, 
     under the conference agreement, the eligibility period for 
     using entitlement to educational assistance allowances under 
     the MGIB expires on the later of (1) the end of the 10-year 
     period beginning on the date of enactment, or (2) the end of 
     the 10-year period beginning on the date of the individual's 
     last discharge or release from active duty.


report on veterans' education and vocational training benefits provided 
                        by the states (sec. 703)

     Current law
       Title 38, United States Code, contains no requirement that 
     VA report annually to the Congress on veterans' education and 
     vocational training benefits provided by the States.
     Senate bill
       The Senate bill (S. 1402, section 10) would require that 
     VA, in consultation with the Departments of Defense, 
     Education, and Labor, report annually to the Congress on 
     veterans' education and vocational training benefits provided 
     by the States. The first such report would be due not later 
     than six months after enactment. In addition, section 10 
     expresses the sense of the Senate that the States should 
     admit qualified veterans to State-supported educational 
     institutions without payment of tuition.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes to the Senate provision in modified form. 
     Not later than six months after the date of enactment, the 
     Secretary shall submit to the Committees on Veterans' Affairs 
     of the Senate and the House of Representatives a report on 
     veterans' education and vocational training benefits provided 
     by the States. Benefits to be considered as veterans' 
     education and vocational training benefits include any such 
     benefits provided by a State for which persons are eligible 
     by reason of service in the Armed Forces, including, in the 
     case of persons who died in the Armed Forces or as a result 
     of a disease or disability incurred in the Armed Forces, 
     benefits provided to their survivors or dependents.
       The term ``veteran'' includes a person serving on active 
     duty or in one of the reserve components and a person who 
     died while in the active military, naval, or air service.
       The Committees note that the conference agreement also 
     lists and defines matters specifically to be included in the 
     Secretary's report.

[[Page H12000]]

                      Subtitle B--Housing Matters


 extension of authority for housing loans for members of the selected 
                           reserve (sec. 711)

     Current law
       The Department of Veterans Affairs' authority to guarantee 
     home loans for members of National Guard and Reserve 
     (Selected Reserve) components expires on September 30, 2003.
     House bill
       The House bill (H.R. 2280, section 301) would provide 
     permanent eligibility for former members of the Selected 
     Reserve for veterans housing loan guaranties. Individuals 
     would continue to be required to serve at least six years in 
     the Reserve or National Guard to be eligible.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes in modified form. Eligibility for 
     members of the Selected Reserve for veterans housing loan 
     guarantees is extended to 2007.

                   Legislative Provisions Not Adopted


                    montgomery gi bill enhancements

     Current law
       Except for certain exceptions, chapter 30 of title 38, 
     United States Code, generally provides active duty 
     servicemembers a one-time opportunity to disenroll from the 
     basic educational assistance program under the Montgomery GI 
     Bill, which establishes eligibility for a monthly educational 
     assistance allowance of $536 per month (as of October 1, 
     1999) for 36 months and requires a $100 monthly pay reduction 
     over 12 months and the fulfillment of minimum service 
     requirements. Chapter 35 of title 38, United States Code, 
     provides a monthly survivors' and dependents' educational 
     assistance allowance of $485 per month for full-time 
     enrollment.
     Senate bill
       The Senate bill (S. 1402) would make the following changes 
     to the educational assistance programs under chapter 30 of 
     the Montgomery GI Bill: (a) increase the basic monthly 
     educational assistance allowance to $600 (section 4); (b) 
     allow servicemembers who have not opted out of Montgomery GI 
     Bill participation to increase the monthly rate of 
     educational benefits they receive after service by making 
     contributions, during service, over and above the $1,200 
     basic pay reduction (section 6); (c) authorize servicemembers 
     who had opted out of Montgomery GI Bill (MGIB) participation 
     to reverse their decision to waive their participation by 
     accepting a $100 per month pay reduction for 15 months, or by 
     ``buying into'' participation by making a lump sum $1,500 
     payment (section 8); and (d) authorize VA to make accelerated 
     payments under the terms of regulations that VA would 
     promulgate to allow MGIB participants to receive benefits for 
     a semester, a quarter, or a term at the beginning of the 
     semester, quarter or term (section 9).
       S. 1402 would increase the rates of survivors' and 
     dependents' educational assistance to $550 per month.
     House bill
       The House bill contained no similar provisions.

   TITLE VIII--DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATIVE MATTERS


    enhanced quality assurance program within the veterans benefits 
                       administration (sec. 801)

     Current law
       There is no provision in title 38, United States Code, 
     requiring the Veterans Benefits Administration (VBA) to 
     maintain a quality assurance program that meets governmental 
     standards for internal control, separation of duties, and 
     organizational independence.
     House bill
       The House bill (H.R. 2280, section 502) would require the 
     Secretary of Veterans Affairs to develop and implement a 
     program to review and evaluate initial decisions made by the 
     Veterans Benefits Administration on claims for compensation, 
     pension, education, vocational rehabilitation and counseling, 
     home loans, and insurance benefits.
       The legislation gives discretion to the Department in the 
     organization, number of full-time employees (FTE) and 
     structure of the quality review program. This provision 
     addresses problems identified by the General Accounting 
     Office and the VA Inspector General in their reviews of VBA 
     quality assurance matters. The Secretary is directed to 
     design the program so that it complies with the governmental 
     standards for independence and internal control recommended 
     by the General Accounting Office in its March 1, 1999 report, 
     ``Veterans'' Benefits Claims: Further Improvements Needed in 
     Claims-Processing Accuracy.''
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes.


extension of authority to maintain a regional office in the republic of 
                       the philippines (sec. 802)

     Current law
       Section 315(b) of title 38, United States Code, provides 
     the authority for the Secretary of Veterans Affairs to 
     operate a regional office in the Republic of the Philippines 
     through December 31, 1999. Congress has periodically extended 
     this authority at VA's request in recognition that a regional 
     office in the Philippines is the most cost-effective means of 
     administering VA programs for beneficiaries residing there, 
     in addition to providing an on-site presence to prevent 
     potential fraud.
     Senate bill
       The Senate bill (S. 1076, section 202) would extend to 
     December 31, 2004, VA's authority to operate a Veterans 
     Benefits Administration regional office in the Philippines.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes in modified form. VA's authority to 
     operate a regional office in the Philippines is extended to 
     December 31, 2003.


    EXTENSION OF ADVISORY COMMITTEE ON MINORITY VETERANS (sec. 803)

     Current law
       Public Law 103-466 established the VA's Advisory Committee 
     on Minority Veterans. The Advisory Committee provides advice 
     and consultation on the needs, problems, and concerns of the 
     minority veterans community. The Advisory Committee's 
     statutory authority expires on December 31, 1999.
     House bill
       The House bill (H.R. 2280, section 503) would extend the 
     Advisory Committee on Minority Veterans from December 31, 
     1999 to December 31, 2004.
     Senate bill
       The Senate bill (S. 1076, section 203) contained 
     substantively identical language.
     Conference agreement
       The Senate recedes in modified form. The Advisory Committee 
     on Minority Veterans is extended to December 31, 2003.

                      TITLE IX--HOMELESS VETERANS


      HOMELESS VETERANS' REINTEGRATION PROGRAMS (HVRP) (sec. 901)

     Current law
       Section 738(e)(1) of the Stewart B. McKinney Act, section 
     11448(e)(1) of title 42, United States Code, authorizes $10 
     million for fiscal year 1998 and $10 million for fiscal year 
     1999 for the Secretary of Labor to carry out Homeless 
     Veterans' Reintegration Projects (HVRP). The HVRP 
     appropriations authority expired on September 30, 1999.
     House bill
       The House bill (H.R. 2280, section 302) would create a new 
     section 4111 of chapter 41, title 38, United States Code, to 
     authorize appropriations to the Department of Labor of $10 
     million in fiscal year 2000, $15 million in fiscal year 2001, 
     $20 million in fiscal year 2002, $25 million in fiscal year 
     2003, and $30 million in fiscal year 2004 for the Homeless 
     Veterans' Reintegration Projects.
     Senate bill
       The Senate bill (S. 1076, section 123) would amend section 
     738(e)(1) of the Stewart B. McKinney Homeless Assistance Act 
     to authorize appropriations to the Department of Labor of $10 
     million in fiscal year 2000 and $10 million in fiscal year 
     2001 for the HVRP.
     Conference agreement
       The Senate recedes in modified form. Appropriations are 
     authorized for the HVRP at $10 million in fiscal year 2000, 
     $15 million in fiscal year 2001, $20 million in fiscal year 
     2002, and $20 million in fiscal year 2003.


EXTENSION OF PROGRAM OF HOUSING ASSISTANCE FOR HOMELESS VETERANS (sec. 
                                  902)

     Current law
       VA furnishes assistance to homeless veterans through 
     various mechanisms, both directly and by assisting community-
     based not-for-profit entities that furnish assistance to 
     homeless veterans. VA assistance to community-based 
     organizations takes two primary forms: VA transfers VA-
     acquired residential properties to such entities for their 
     use to house homeless veterans and their families, and VA 
     makes grants to such entities to assist them in establishing 
     new programs to furnish outreach, rehabilitative services, 
     vocational counseling and training, and transitional housing 
     services. Congress extended these two authorities for a two-
     year period in the Veterans' Benefits Act of 1997, Public Law 
     105-114. Such authority expires on December 31, 1999.
     Senate bill
       The Senate bill (S. 1076, section 121) would extend VA's 
     authority to furnish assistance to homeless veterans through 
     various mechanisms, both directly and by assisting community-
     based not-for-profit entities that furnish assistance to 
     homeless veterans, for two years, to December 31, 2001.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes to the Senate in modified form. VA's 
     authority to furnish housing assistance to homeless veterans 
     is extended until December 31, 2003.


                 HOMELESS VETERANS PROGRAMS (sec. 903)

     Current law
       Section 3 of the Homeless Veterans Comprehensive Service 
     Program Act of 1992, authorizes VA (through September 30, 
     1999) to make grants to public or non-profit entities to 
     establish new programs to provide outreach, rehabilitative 
     services, vocational assistance, and transitional housing to 
     homeless veterans. In requiring VA to set criteria

[[Page H12001]]

     for the award of such grants, the law limits to 20 the number 
     of programs incorporating the procurement of vans for which 
     grant support may be provided. To carry out the Act, Public 
     Law 102-590 authorized annual appropriations of $48 million 
     through Fiscal Year 1997, and provided further that nothing 
     in the public law should be construed to diminish funds for 
     continuation or expansion of existing programs.
     House bill
       The House bill (H.R. 2116, section 205) would extend 
     through September 30, 2002, VA's authority to make grants 
     (under the Homeless Veterans Comprehensive Service Program 
     Act of 1992, as amended) for new programs to combat veteran 
     homelessness, and would eliminate the limitation on grant 
     support for programs involving van procurement.
     Senate bill
       The Senate bill (S. 1076, section 122) would extend through 
     September 30, 2001, VA's authority to make grants under the 
     1992 Act and would permit grants to assist in expanding 
     existing programs as well as grants to establish new 
     programs. It would also authorize annual appropriations of 
     $50 million to carry out the Act.
     Conference agreement
       The conference agreement incorporates the provisions of 
     both the House and Senate bills, with a modification to 
     extend the authority under the grant program through 
     September 30, 2003.


   PLAN FOR EVALUATION OF PERFORMANCE OF PROGRAMS TO ASSIST HOMELESS 
                          VETERANS (sec. 904)

     Current law
       The Government Performance and Results Act requires federal 
     departments and agencies to assess and evaluate the 
     effectiveness and outcomes of the programs they administer. 
     The Committees note that the General Accounting Office has 
     determined that the effectiveness of VA programs is unclear. 
     [``Homeless Veterans: VA Expands Partnerships, but Homeless 
     Program Effectiveness is Unclear'' (HEHS-99-53, April 1, 
     1999)]
     Senate bill
       The Senate bill (S. 1076, section 124) would require the 
     Secretary of Veterans Affairs to submit a report, not later 
     than three months after enactment, containing a detailed plan 
     for the evaluation of VA programs to assist homeless 
     veterans. Such plan would be required to contain an 
     identification of outcome measures adopted by VA to determine 
     whether veterans who are provided housing and employment-
     related services are housed and employed six months after 
     securing services under such programs.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes to the Senate provision in modified form. 
     The Secretary of Veterans Affairs is required to submit a 
     plan, in consultation with the Secretaries of Labor and 
     Housing and Urban Development, for evaluating the 
     effectiveness of programs to assist homeless veterans.

      TITLE X--UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

     Subtitle A--Transitional Provisions to Stagger Terms of Judges


       EARLY RETIREMENT AUTHORITY FOR CURRENT JUDGES (sec. 1011)

     Current law
       Under section 7296(b)(2) of title 38, United States Code, a 
     judge of the Court is eligible to retire at the completion of 
     the term for which the judge was appointed if the judge is 
     not re-appointed for another term. There is no provision for 
     the retirement of judges before the completion of their term 
     except for judges who meet age and service (``Rule of 80'') 
     requirements of section 7296(b)(1), title 38, United States 
     Code.
     House bill
       The House bill (H.R. 2280, section 407) would provide for 
     the early retirement of up to five judges.
     Senate Bill
       The Senate bill (S. 1076, section 403) would provide a one-
     time buy-out for judges who meet the Rule of 80 retirement 
     criteria. The Senate bill would also provide for temporary 
     service of judges who retire or complete their terms.
     Conference agreement
       The Senate recedes with modifications to restrict to two 
     the number of judges who may retire early. In addition, the 
     compromise includes provisions which require that a judge who 
     retires early must continue to serve until the judge's 
     successor is appointed or the date on which the judge's 
     original appointment would have expired. During this 
     transitional service, the judge could continue to accrue 
     credit toward a full retirement benefit and would receive a 
     combination of salary and retirement benefits equal to the 
     salaries of other judges. Judges who retire early may elect 
     to be placed in recall status and thereby qualify for post-
     retirement increases in retirement pay.


 MODIFIED TERMS FOR NEXT TWO JUDGES APPOINTED TO THE COURT (sec. 1012)

     Current law
       Under section 7253(c) of title 38, United States Code, all 
     judges are appointed for a term of 15 years.
     Senate bill
       The Senate bill (S. 1076, section 402) would provide for 
     13-year terms for judges appointed to a position on the Court 
     that becomes vacant in the year 2004.
     House bill
       The House bill contained no similar provision.
     Conference agreement
       The House recedes with a modification to change to 13 years 
     the term of office of the first two judges who are appointed 
     after the date of enactment.

          Subtitle B--Other Matters Relating to Retired Judges


                  RECALL OF RETIRED JUDGES (sec. 1021)

     Current law
       There is no provision in current law for the recall of 
     retired judges.
     House bill
       The House bill (H.R. 2280, section 402) would provide for a 
     recall of judges who elect at the time of retirement to be 
     eligible for recall. Judges who elect to be eligible for 
     recall would receive increases in the amount of their retired 
     pay.
     Senate bill
       The Senate bill (S. 1076, section 401) contains a provision 
     that permits judges who have retired or whose terms have 
     expired to continue serving on the court on a temporary 
     basis.
     Conference agreement
       The Senate recedes.


                   JUDGES' RETIREMENT PAY (sec. 1022)

     Current law
       There is no specific provision authorizing judges to 
     receive an increase in the amount of pay received after 
     retirement.
     House bill
       The House bill (H.R. 2280, section 404) would authorize 
     increases in the amount of retired pay for judges who elect 
     to be recalled for service. Judges who do not elect to be 
     eligible for recall would have the amount of their retired 
     pay frozen at the amount for which they are eligible upon 
     leaving office. The House bill also would authorize a cost of 
     living increase for disability retirement benefits paid to 
     judges who retire due to disability.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes with a modification to delete provisions 
     concerning coordination with military retired pay.


                    SURVIVIOR ANNUITIES (sec. 1023)

     Current law
       In order to qualify for a survivor annuity under section 
     7297 (the program available to judges of the Court), title 
     38, United States Code, a surviving spouse must have been 
     married to the judge for at least two years immediately 
     preceding the judge's death, unless there are children born 
     of the marriage. There is no provision for payment of a 
     survivor annuity if a retired judge marries after leaving the 
     bench. Judges are required to contribute 3.5 percent of their 
     pay if they wish to participate in the survivor annuity plan.
     House bill
       The House bill (H.R. 2280, section 405) would reduce the 
     period of marriage needed to qualify for a survivor annuity 
     to one year immediately preceding the judge's death. 
     Provision would be made for a judge to participate in the 
     survivor's benefit plan if the judge marries after leaving 
     the bench. The financial contribution of judges would be 
     changed to reflect the same contribution made by judges who 
     participate in the United States Court of Federal Claims 
     survivor annuity program.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes.


         LIMITATION ON ACTIVITIES OF RETIRED JUDGES (sec. 1024)

     Current law
       There is no provision in title 38, United States Code, 
     limiting the activities of retired judges.
     House bill
       The House bill (H.R. 2280, section 406) would provide for 
     limitation of the activities of retired judges who are recall 
     eligible.
     Senate bill
       The Senate bill contained no similar provision.
     Conference agreement
       The Senate recedes.

 Subtitle C--Rotation of Service of Judges as Chief Judge of the Court

     Current law
       The Chief Judge is appointed for a term of 15 years. 
     Section 7254(d) of title 38, United States Code, provides 
     that in the event of a vacancy, the associate judge senior in 
     service shall serve as ``acting'' Chief Judge unless the 
     President designates another judge to so serve.
     House bill
       The House bill contained no similar provision.
     Senate bill
       The Senate bill contained no similar provision.

[[Page H12002]]

     Conference agreement
       The bill would implement a policy that eliminates the 
     requirement of a separate appointment to the Chief Judge 
     position. Instead, the Chief Judge would be the most senior 
     judge in regular active service on the Court. In the event 
     that two eligible judges had the same seniority in 
     commission, the judge senior in age would be selected.
       This person would serve as Chief Judge for five years and 
     then the next most senior judge would rotate into the 
     position. This provision is modeled on the provision for the 
     Chief Judge for the United States Court of Appeals for the 
     Armed Forces. The conference agreement also eliminates the 
     salary distinction between the Chief Judge and the other 
     judges.

                   Legislative Provisions Not Adopted


              AUTHORITY TO PRESCRIBE RULES AND REGULATIONS

     Current law
       There is no general authority for the Court to prescribe 
     rules and regulations to carry out the provisions of chapter 
     72 of title 38, United States Code. The Court has specific 
     authority to promulgate rules concerning the filing of 
     complaints with respect to judicial conduct and rules of 
     practice and procedures governing proceedings before the 
     Court.
     House bill
       The House bill (H.R. 2280, section 401) would provide for 
     the Court to promulgate rules and regulations to carry out 
     chapter 72 of title 38, United States Code.
     Senate bill
       The Senate bill contained no provision.


                    CALCULATION OF YEARS OF SERVICE

     Current law
       Title 38, United States Code, is silent as to the 
     calculation of years of service for purposes of retirement.
     House bill
       The House bill (H.R. 2280, section 403) would treat 183 
     days or more of service on the Court as a full year for 
     purposes of retirement.
     Senate bill
       The Senate bill contained no similar provision.

           TITLE XI--VOLUNTARY SEPARATION INCENTIVE PROGRAMS

     Current law
       VA does not currently have the authority to offer voluntary 
     separation incentives.
     House bill
       The House bill contained no provision.
     Senate bill
       The Senate bill contained no provision.
     Conference agreement
       The conference agreement provides authority to VA for one 
     year to offer voluntary separation incentives to a limited 
     number of FTEE.

     Bob Stump,
     Chris Smith,
     Jack Quinn,
     Cliff Stearns,
     Lane Evans,
     Corrine Brown,
     Mike Doyle,
                                Managers on the Part of the House.

     Arlen Specter,
     Strom Thurmond,
     Jay Rockefeller,
     Managers on the Part of the Senate.

                          ____________________