Congressional Record, Volume 149 Issue 154 (Wednesday, October 29, 2003)

[Congressional Record Volume 149, Number 154 (Wednesday, October 29, 2003)]
[House]
[Pages H9996-H10008]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

VETERANS HEALTH CARE FACILITIES CAPITAL IMPROVEMENT ACT

Mr. SMITH of New Jersey. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 1720) to authorize the Secretary of Veterans
Affairs to carry out construction projects for the purpose of
improving, renovating, establishing, and updating patient care
facilities at the Department of Veterans Affairs medical centers, as
amended.
The Clerk read as follows:

H.R. 1720

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

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

Sec. 1. Short title.
Sec. 2. Authorization of major medical facility projects for patient
care improvements.
Sec. 3. Authorization of major medical facility projects and leases.
Sec. 4. Authorization of major medical facility projects, former
Fitzsimons Army Medical Center, Aurora, Colorado.
Sec. 5. Limitation on disposal of Lakeside Division, Department of
Veterans Affairs medical facilities, Chicago, Illinois.
Sec. 6. Plans for facilities in southern New Jersey and far South
Texas.
Sec. 7. Increase in major medical facility construction cost threshold.
Sec. 8. Study and report on feasibility of coordination of veterans
health care services in South Carolina with new
university medical center.

[[Page H9997]]

Sec. 9. Name of Department of Veterans Affairs health care facility,
Chicago, Illinois.
Sec. 10. Name of Department of Veterans Affairs outpatient clinic, New
London, Connecticut.
Sec. 11. Office of Research Oversight in Veterans Health
Administration.

SEC. 2. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS FOR
PATIENT CARE IMPROVEMENTS.

(a) In General.--(1) Subject to paragraph (3), the
Secretary of Veterans Affairs is authorized to carry out
major medical facility projects in accordance with this
section, using funds appropriated for fiscal year 2004 or
2005 pursuant to subsection (e). The cost of any such project
may not exceed--
(A) $100,000,000 in fiscal year 2004; and
(B) $125,000,000 in fiscal year 2005.
(2) Projects carried out under this section are not subject
to section 8104(a)(2) of title 38, United States Code.
(3) The Secretary may not award a contract by reason of the
authorization provided by paragraph (1) until after the
Secretary has awarded a contract for each construction
project authorized by section 3(a) and a contract for each
lease authorized by section 3(d).
(b) Type of Projects.--A project carried out under
subsection (a) may be carried out only at a Department of
Veterans Affairs medical center and only for the purpose of
one or more of the following:
(1) Improving a patient care facility.
(2) Replacing a patient care facility.
(3) Renovating a patient care facility.
(4) Updating a patient care facility to contemporary
standards.
(5) Establishing a new patient care facility at a location
where no Department patient care facility exists.
(6) Improving, replacing, or renovating a research facility
or updating such a facility to contemporary standards.
(c) Purpose of Projects.--In selecting medical centers for
projects under subsection (a), the Secretary shall select
projects to improve, replace, renovate, update, or establish
facilities to achieve one or more of the following:
(1) Seismic protection improvements related to patient
safety (or, in the case of a research facility, patient or
employee safety).
(2) Fire safety improvements.
(3) Improvements to utility systems and ancillary patient
care facilities (including such systems and facilities that
may be exclusively associated with research facilities).
(4) Improved accommodation for persons with disabilities,
including barrier-free access.
(5) Improvements at patient care facilities to specialized
programs of the Department, including the following:
(A) Blind rehabilitation centers.
(B) Inpatient and residential programs for seriously
mentally ill veterans, including mental illness research,
education, and clinical centers.
(C) Residential and rehabilitation programs for veterans
with substance-use disorders.
(D) Physical medicine and rehabilitation activities.
(E) Long-term care, including geriatric research,
education, and clinical centers, adult day care centers, and
nursing home care facilities.
(F) Amputation care, including facilities for prosthetics,
orthotics programs, and sensory aids.
(G) Spinal cord injury centers.
(H) Traumatic brain injury programs.
(I) Women veterans' health programs (including particularly
programs involving privacy and accommodation for female
patients).
(J) Facilities for hospice and palliative care programs.
(d) Review Process.--(1) The Secretary shall provide that,
before a project is submitted to the Secretary with a
recommendation that it be approved as a project to be carried
out under the authority of this section, the project shall be
reviewed by a board within the Department of Veterans Affairs
that is independent of the Veterans Health Administration and
that is constituted by the Secretary to evaluate capital
investment projects. The board shall review such project to
determine the project's relevance to the medical care mission
of the Department and whether the project improves,
renovates, repairs, establishes, or updates facilities of the
Department in accordance with this section.
(2) In selecting projects to be carried out under the
authority provided by this section, the Secretary shall
consider the recommendations of the board under paragraph
(1). In any case in which the Secretary approves a project to
be carried out under this section that was not recommended
for such approval by the board under paragraph (1), the
Secretary shall include in the report of the Secretary under
subsection (g)(2) notice of such approval and the Secretary's
reasons for not following the recommendation of the board
with respect to that project.
(e) Authorization of Appropriations.--There are authorized
to be appropriated to the Secretary of Veterans Affairs for
the Construction, Major Projects, account for projects under
this section--
(1) $167,900,000 for fiscal year 2004; and
(2) $600,000,000 for fiscal year 2005.
(f) Limitation.--Projects may be carried out under this
section only using funds appropriated pursuant to the
authorization of appropriations in subsection (e), except
that funds appropriated for advance planning may be used for
the purposes for which appropriated in connection with such
projects.
(g) Reports.--(1) Not later than April 1, 2005, the
Comptroller General shall submit to the Committees on
Veterans' Affairs and on Appropriations of the Senate and
House of Representatives a report evaluating the advantages
and disadvantages of congressional authorization for projects
of the type described in subsection (b) through general
authorization as provided by subsection (a), rather than
through specific authorization as would otherwise be
applicable under section 8104(a)(2) of title 38, United
States Code. Such report shall include a description of the
actions of the Secretary of Veterans Affairs during fiscal
year 2004 to select and carry out projects under this
section.
(2) Not later than 120 days after the date on which the
site for the final project under this section for each such
fiscal year is selected, the Secretary shall submit to the
committees referred to in paragraph (1) a report on the
authorization process under this section. The Secretary shall
include in each such report the following:
(A) A listing by project of each such project selected by
the Secretary under that section, together with a prospectus
description of the purposes of the project, the estimated
cost of the project, and a statement attesting to the review
of the project under subsection (c), and, if that project was
not recommended by the board, the Secretary's justification
under subsection (d) for not following the recommendation of
the board.
(B) An assessment of the utility to the Department of
Veterans Affairs of that authorization process.
(C) Such recommendations as the Secretary considers
appropriate for future congressional policy for
authorizations of major and minor medical facility
construction projects for the Department of Veterans Affairs.
(D) Any other matter that the Secretary considers to be
appropriate with respect to oversight by Congress of capital
facilities projects of the Department of Veterans Affairs.

SEC. 3. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS AND
LEASES.

(a) Project Authorizations.--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 new bed tower to consolidate two
inpatient sites of care in inner city Chicago at the West
Side Division of the Department of Veterans Affairs health
care system in Chicago, Illinois, in an amount not to exceed
$98,500,000.
(2) Seismic corrections to strengthen Medical Center
Building 1 of the Department of Veterans Affairs health care
system in San Diego, California, in an amount not to exceed
$48,600,000.
(3) A project for (A) renovation of all inpatient care
wards at the West Haven, Connecticut, facility of the
Department of Veterans Affairs health system in Connecticut
to improve the environment of care and enhance safety,
privacy, and accessibility, and (B) establishment of a
consolidated medical research facility at that facility, in
an amount not to exceed $50,000,000.
(4) Construction of a medical facility on available Federal
land at the Defense Supply Center, Columbus, Ohio, in an
amount not to exceed $90,000,000.
(5) Construction of a Department of Veterans Affairs-
Department of Navy joint venture, comprehensive outpatient
medical care facility to be built on the grounds of the
Pensacola Naval Air Station, Pensacola, Florida, in an amount
not to exceed $45,000,000.
(b) Authorization of Appropriations.--There is authorized
to be appropriated to the Secretary of Veterans Affairs for
fiscal year 2004 for the Construction, Major Projects,
account $332,100,000 for the projects authorized in
subsection (a).
(c) Limitation.--The projects authorized in subsection (a)
may only be carried out using--
(1) funds appropriated for fiscal year 2004 pursuant to the
authorization of appropriations in subsection (b);
(2) funds appropriated for Construction, Major Projects,
for a fiscal year before fiscal year 2004 that remain
available for obligation; and
(3) funds appropriated for Construction, Major Projects,
for fiscal year 2004 for a category of activity not specific
to a project.
(d) Authorization of Major Medical Facility Leases.--The
Secretary of Veterans Affairs may enter into leases as
follows:
(1) For an outpatient clinic in Charlotte, North Carolina,
in an amount not to exceed $3,000,000.
(2) For facilities for a multi-specialty outpatient clinic
for the Veterans Health Administration and a satellite office
for the Veterans Benefits Administration in Clark County,
Nevada, at an annual lease amount not to exceed $6,500,000.
(3) For facilities authorized in section 4 at the site of
the former Fitzsimons Army Medical Center, Aurora, Colorado,
in an amount not to exceed $30,000,000.

SEC. 4. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS,
FORMER FITZSIMONS ARMY MEDICAL CENTER, AURORA,
COLORADO.

(a) Authorization.--The Secretary of Veterans Affairs may
carry out major medical facility projects under section 8104
of title 38, United States Code, at the site of the former

[[Page H9998]]

Fitzsimons Army Medical Center, Aurora, Colorado. Projects to
be carried out at such site shall be selected by the
Secretary and may include inpatient and outpatient facilities
providing acute, sub-acute, primary, and long-term care
services. The cost of projects under this section shall be
limited to--
(1) an amount not to exceed a total of $300,000,000 if
either direct construction or a combination of direct
construction and leasing is selected by the Secretary under
subsection (b); and
(2) no more than $30,000,000 per year in leasing costs if a
leasing option is selected by the Secretary as the sole
option under subsection (b).
(b) Selection of Option.--The Secretary of Veterans shall
select the option to carry out the authority provided in
subsection (a) of either--
(1) direct construction by the Department of Veterans
Affairs or a combination of direct construction and leasing;
or
(2) leasing alone.
(c) Consultation With Secretary of Defense.--The Secretary
of Veterans Affairs shall consult with the Secretary of
Defense in carrying out this section. Such consultation shall
include consideration of establishing a Department of
Veterans Affairs-Department of Defense joint health-care
venture at the site of the project or projects under
subsection (a).
(d) Authorization of Appropriations.--There is authorized
to be appropriated to the Secretary of Veterans Affairs for
fiscal years 2004, 2005, and 2006 for ``Construction, Major
Projects'' for the purposes authorized in subsection (a).
(e) Limitation.--The projects authorized in subsection (a)
may only be carried out using--
(1) funds appropriated for fiscal year 2004, 2005, or 2006
pursuant to the authorization of appropriations in subsection
(a);
(2) funds appropriated for Construction, Major Projects,
for a fiscal year before fiscal year 2004 that remain
available for obligation; and
(3) funds appropriated for Construction, Major Projects,
for fiscal year 2004, 2005, or 2006 for a category of
activity not specific to a project.
(f) Report to Congressional Committees.--After complying
with applicable provisions of the National Environmental
Policy Act of 1969, but not later than one year after the
date of the enactment of this Act, the Secretary shall submit
to the Committees on Appropriations and the Committees on
Veterans' Affairs of the Senate and House of Representatives
a report on this section. The report shall include the
following:
(1) Notice of the option selected by the Secretary pursuant
to subsection (b) to carry out the authority provided by
subsection (a).
(2) Information on any further planning required to carry
out the authority provided in subsection (a).
(3) Other information of assistance to the committees with
respect to such authority.

SEC. 5. LIMITATION ON DISPOSAL OF LAKESIDE DIVISION,
DEPARTMENT OF VETERANS AFFAIRS MEDICAL
FACILITIES, CHICAGO, ILLINOIS.

(a) Limitation.--The Secretary of Veterans Affairs may not
make a final disposal under section 8162 of title 38, United
States Code, of the Lakeside Division facility of the
Department of Veterans Affairs medical facilities in Chicago,
Illinois, until the Secretary has entered into a contract for
the construction project authorized by section 3(a)(1).
(b) Definition.--For purposes of this section, the term
``disposal'', with respect to the Lakeside Division facility,
includes entering into a long-term lease or sharing agreement
under which a party other than the Secretary has operational
control of the facility.

SEC. 6. PLANS FOR FACILITIES IN SOUTHERN NEW JERSEY AND FAR
SOUTH TEXAS.

(a) Plan.--(1) The Secretary of Veterans Affairs shall
develop--
(A) a plan to establish an inpatient facility to meet
hospital care needs of veterans who reside in southern New
Jersey; and
(B) a plan for hospital care needs of veterans who reside
in far south Texas.
(2) In developing the plans under paragraph (1), the
Secretary shall, at a minimum, consider options using the
existing authorities of section 8111 and 8153 of title 38,
United States Code--
(A) to establish a hospital staffed and managed by
employees of the Department, either in private or public
facilities, including Federal facilities; or
(B) to enter into contracts with existing private
facilities and private providers for that care.
(b) Reports.--The Secretary shall submit to the Committees
on Veterans' Affairs of the Senate and House of
Representatives a report on each plan under subsection (a)
not later than January 31, 2004.
(c) Definitions.--In this section:
(1) The term ``far south Texas'' means the following
counties of the State of Texas: Bee, Calhoun, Crockett,
DeWitt, Dimmit, Goliad, Jackson, Victoria, Webb, Aransas,
Duval, Jim Wells, Kleberg, Nueces, Refugio, San Patricio,
Brooks, Cameron, Hidalgo, Jim Hogg, Kenedy, Starr, Willacy,
and Zapata.
(2) The term ``southern New Jersey'' means the following
counties of the State of New Jersey: Ocean, Burlington,
Camden, Gloucester, Salem, Cumberland, Atlantic, and Cape
May.

SEC. 7. INCREASE IN MAJOR MEDICAL FACILITY CONSTRUCTION COST
THRESHOLD.

Section 8104(a)(3)(A) of title 38, United States Code, is
amended by striking ``$4,000,000'' and inserting
``$6,000,000''.

SEC. 8. STUDY AND REPORT ON FEASIBILITY OF COORDINATION OF
VETERANS HEALTH CARE SERVICES IN SOUTH CAROLINA
WITH NEW UNIVERSITY MEDICAL CENTER.

(a) Study Required.--The Secretary of Veterans Affairs
shall conduct a study to examine the feasibility of
coordination by the Department of Veterans Affairs of its
needs for inpatient hospital, medical care, and long-term
care services for veterans with the pending construction of a
new university medical center at the Medical University of
South Carolina, Charleston, South Carolina.
(b) Matters To Be Included in Study.--(1) As part of the
study under subsection (a), the Secretary shall consider the
following:
(A) Integration with the Medical University of South
Carolina of some or all of the services referred to in
subsection (a) through contribution to the construction of
that university's new medical facility or by becoming a
tenant provider in that new facility.
(B) Construction by the Department of Veterans Affairs of a
new independent inpatient or outpatient facility alongside or
nearby the university's new facility.
(2) In carrying out paragraph (1), the Secretary shall
consider the degree to which the Department of Veterans
Affairs and the university medical center would be able to
share expensive technologies and scarce specialty services
that would affect any such plans of the Secretary or the
university.
(3) In carrying out the study, the Secretary shall
especially consider the applicability of the authorities
under section 8153 of title 38, United States Code (relating
to sharing of health care resources between the Department
and community provider organizations) to govern future
arrangements and relationship between the Department and the
Medical University of South Carolina.
(c) Consultation With Secretary of Defense.--The Secretary
of Veterans Affairs shall consult with the Secretary of
Defense in carrying out the study under this section. Such
consultation shall include consideration of establishing a
Department of Veterans Affairs-Department of Defense joint
health-care venture at the site referred to in subsection
(a).
(d) Report.--Not later than March 31, 2004, the Secretary
shall submit to the Committees on Veterans' Affairs of the
Senate and House of Representatives a report on the results
of the study. The report shall include the Secretary's
recommendations with respect to coordination described in
subsection (a), including recommendations with respect to
each of the matters referred to in subsection (b).

SEC. 9. NAME OF DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE
FACILITY, CHICAGO, ILLINOIS.

The Department of Veterans Affairs health care facility
located at 820 South Damen Avenue in Chicago, Illinois, shall
after the date of the enactment of this Act be known and
designated as the ``Jesse Brown Department of Veterans
Affairs Medical Center''. Any reference to such facility in
any law, map, regulation, document, paper, or other record of
the United States shall be considered to be a reference to
the Jesse Brown Department of Veterans Affairs Medical
Center.

SEC. 10. NAME OF DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT
CLINIC, NEW LONDON, CONNECTICUT.

The Department of Veterans Affairs outpatient clinic
located in New London, Connecticut, shall after the date of
the enactment of this Act be known and designated as the
``John J. McGuirk Department of Veterans Affairs Outpatient
Clinic''. Any reference to such outpatient clinic in any law,
regulation, map, document, record, or other paper of the
United States shall be considered to be a reference to the
John J. McGuirk Department of Veterans Affairs Outpatient
Clinic.

SEC. 11. OFFICE OF RESEARCH OVERSIGHT IN VETERANS HEALTH
ADMINISTRATION.

(a) Statutory Charter.--(1) Chapter 73 of title 38, United
States Code, is amended by inserting after section 7306 the
following new section:

``Sec. 7307. Office of Research Oversight

``(a) Requirement for Office.--(1) There is in the Veterans
Health Administration an Office of Research Oversight
(hereinafter in this section referred to as the `Office').
The Office shall advise the Under Secretary for Health on
matters of compliance and assurance in human subjects
protections, animal welfare, research safety, and research
impropriety and misconduct. The Office shall function
independently of entities within the Veterans Health
Administration with responsibility for the conduct of medical
research programs.
``(2) The Office shall--
``(A) monitor, review, and investigate matters of medical
research compliance and assurance in the Department with
respect to human subjects protections and animal welfare; and
``(B) monitor, review, and investigate matters relating to
the protection and safety of human subjects, research
animals, and Department employees participating in medical
research in Department programs.
``(b) Director.--(1) The head of the Office shall be a
Director, who shall report directly to the Under Secretary
for Health (without delegation).
``(2) Any person appointed as Director shall be--

[[Page H9999]]

``(A) an established expert in the field of medical
research, administration of medical research programs, or
similar fields; and
``(B) qualified to carry out the duties of the Office based
on demonstrated experience and expertise.
``(c) Functions.--(1) The Director shall report to the
Under Secretary for Health on matters relating to protections
of human subjects and laboratory animals under any applicable
Federal law and regulation, the safety of employees involved
in Department medical research programs, and suspected
misconduct and impropriety in such programs. In carrying out
the preceding sentence, the Director shall consult with
employees of the Veterans Health Administration who are
responsible for management and conduct of Department medical
research programs.
``(2) The matters to be reported by the Director to the
Under Secretary under paragraph (1) include the following:
``(A) Lack of required integrity of content, validity of
approach, and ethical conduct of employees in Department
medical research programs.
``(B) Allegations of research impropriety and misconduct by
employees engaged in medical research programs of the
Department.
``(3)(A) When the Director determines that such a
recommendation is warranted, the Director may recommend to
the Under Secretary that a Department research activity be
terminated, suspended, or restricted, in whole or in part.
``(B) In a case in which the Director reasonably believes
that activities of a medical research project of the
Department place human subjects' lives or health at imminent
risk, the Director shall direct that activities under that
project be immediately suspended or, as appropriate and
specified by the Director, be limited.
``(d) General Functions.--(1) The Director shall conduct
periodic inspections and reviews, as the Director determines
appropriate, of medical research programs of the Department.
Such inspections and reviews shall include review of required
documented assurances.
``(2) The Director shall observe external accreditation
activities conducted for accreditation of medical research
programs conducted in facilities of the Department.
``(3) The Director shall investigate allegations of
research impropriety and misconduct in medical research
projects of the Department.
``(4) The Director shall submit to the Under Secretary for
Health, the Secretary, and the Committees on Veterans'
Affairs of the Senate and House of Representatives a report
on any suspected lapse, from whatever cause or causes, in
protecting safety of human subjects and others, including
employees, in medical research programs.
``(5) The Director shall carry out such other duties as the
Under Secretary for Health may require.
``(e) Source of Funds.--Amounts for the activities of the
Office, including its regional offices, shall be derived from
amounts appropriated for the Veterans Health Administration
for Medical Care.
``(f) Annual Report.--Not later than March 15 each year,
the Director of the Office shall submit to the Committees on
Veterans' Affairs of the Senate and House of Representatives
a report on the activities of the Office during the preceding
calendar year. Each such report shall include, with respect
to that year, the following:
``(1) A summary of reviews of individual medical research
programs of the Department completed by the Office.
``(2) Directives and other communications issued by the
Office to field activities of the Department.
``(3) Results of any investigations undertaken by the
Office during the reporting period consonant with the
purposes of this section.
``(4) Other information that would be of interest to those
committees in oversight of the Department medical research
program.
``(g) Medical Research.--For purposes of this section, the
term `medical research' has the meaning given such term in
section 7303(a)(2) of this title.''.
(2) The table of sections at the beginning of such chapter
is amended by inserting after the item relating to section
7306 the following new item:

``7307. Office of Research Oversight.''.
(b) Conforming Amendment.--Section 7303 of title 38, United
States Code, is amended by striking subsection (e).
(c) Comptroller General Report.--(1) The Comptroller
General shall conduct a study to assess--
(A) the effects of the establishment by law of the Office
of Research Oversight in section 7307 of title 38, United
States Code, as added by subsection (a);
(B) the effects of the specification by law of the
functions of that Office; and
(C) improvements in the conduct of ethical medical research
in the Veterans Health Administration.
(2) Not later than January 1, 2006, the Comptroller General
shall submit to the Committees on Veterans' Affairs of the
House and Senate a report on the study conducted under
paragraph (1). The Comptroller General shall include in the
report such recommendations for legislation and
administrative action as the Comptroller General considers
appropriate.
(d) Report by Secretary of Veterans Affairs.--Not later
than 180 days after the date of the enactment of this Act,
the Secretary of Veterans Affairs shall submit to the
Committees on Veterans Affairs' of the Senate and House of
Representatives a report setting forth the results of the
implementation of section 7307 of title 38, United States
Code, as added by subsection (a).

The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New
Jersey (Mr. Smith) and the gentlewoman from Nevada (Ms. Berkley) each
will control 20 minutes.
The Chair recognizes the gentleman from New Jersey (Mr. Smith).
Mr. SMITH of New Jersey. Mr. Speaker, I yield myself such time as I
may consume.
Mr. Speaker, I am pleased that the House is today considering H.R.
1720, as amended, the Veterans Health Care Facilities Capital
Improvement Act. Enactment of this measure would be a significant step
in addressing the problem of crumbling and substandard health care
facilities for our Nation's veterans.
I want to just say at the outset how very delighted and pleased I am
that the gentleman from Connecticut (Mr. Simmons) is here. As the
chairman of the Subcommittee on Health and the prime sponsor of this
bill, he has worked many, many hours in crafting this legislation. I
want to really pay him the highest compliment for the extraordinarily
good work he did in writing this legislation. I thank the gentleman for
his leadership on this. I would also like to thank my friends on the
other side of the aisle for their good, hard work. This is a bipartisan
bill that we present to the House today, and I hope it will get the
full support and assent of this body.
Mr. Speaker, most VA hospitals, clinics, nursing homes, and research
facilities have ongoing needs for maintenance, repair, and
modernization to promote patient and employee safety and provide a
higher standard of care for our Nation's veterans. For example,
hundreds of millions of dollars are needed to address problems at many
VA facilities that could suffer severe damage in the event of an
earthquake. However, projects to address these and other deficiencies
have been put on the shelf while VA contemplates and completes its
CARES process.
The Department of Veterans Affairs is currently undertaking, as I
think many Members know, a market-based national assessment to
determine whether its present health care facilities meet current and
future veterans' health care needs. The VA's process for achieving this
goal, called the Capital Asset Realignment for Enhanced Services, or
CARES, is intended to produce a national plan which the Secretary will
then approve or disapprove by the end of the year. Members, I am sure,
or at least some Members, are aware that while the VA has an aggressive
schedule for completing the planning process, the implementation of
this plan will take many years to complete. In the meantime, a number
of pressing construction needs have been identified.
The committee has been vigilant to avoid authorizing projects at
facilities that might not be needed to serve the future needs of our
veterans. All of the projects authorized by our committee in recent
authorization measures would serve veterans for many years after they
have been completed. Similarly, the projects authorized in this bill
would improve health care for veterans for 20 years or more and are a
wise and, we believe, worthy investment for this Nation to make on
behalf of our veterans.
Let me just say, Mr. Speaker, there are a number of additions to this
bill that were made precisely because Members came to us and made very
persuasive argument as to why they need to be included. The gentleman
from Colorado (Mr. Hefley) and the gentleman from Colorado (Mr.
Beauprez), a member of the committee, really pushed hard on the
Fitzsimons project. That is included in here. The gentleman from New
Jersey (Mr. LoBiondo) from my own State made a very strong estimate and
gave us documentation for a study. That is included in here. There are
others that came to us, again made their cases, cogent cases that they
were; and those have been included in this authorization measure.
Mr. Speaker, I am pleased the House is considering H.R. 1720, as
amended, the Veterans Health Care Facilities Capital Improvement Act.
Enactment of this measure would be a significant step in addressing the
problem

[[Page H10000]]

of crumbling and substandard health care facilities for our Nation's
veterans.
Mr. Speaker, most VA hospitals, clinics, nursing homes and research
facilities have ongoing needs for maintenance, repair and modernization
to promote patient and employee safety and provide a higher standard of
care for our Nation's veterans. For example, hundreds of millions of
dollars are needed to address problems at many VA facilities that could
suffer severe damage in the event of an earthquake. However projects to
address these and other deficiencies have been ``put on the shelf''
while VA completes its CARES process.
The Department of Veterans Affairs is currently undertaking a market-
based national assessment to determine whether its present health care
facilities meet current and future veterans' health care needs. The
VA's process for achieving this goal, called Capital Asset Realignment
for Enhanced Services, or CARES, is intended to produce a national plan
which the Secretary will then approve or disapprove by the end of this
year. While VA has an aggressive schedule for completing the planning
process, the implementation of this plan will take many years to
complete. In the meantime, a number of pressing construction needs have
been identified.
The VA Committee has been vigilant to avoid authorizing projects at
facilities that might not be needed to serve the future needs of
veterans. All of the projects authorized by our committee in recent
authorization measures would serve veterans for many years after they
have been completed. Similarly, the projects authorized in this bill
would improve health care for veterans for 20 years or more, and are a
wise and worthy investment for this Nation to make on behalf of
veterans.
Mr. Speaker, we are coming to a crossroads in the pattern of funding
for VA health care facilities. A consultant's report in June 1998
concluded that VA should be spending (at a minimum) from 2 percent to 4
percent of its ``plant replacement value'' on upkeep and replacement of
its health care facilities. The value of VA facilities was estimated to
be $35 billion in 1998; thus, VA should be spending from $700 million
to $1.4 billion each year to keep pace with its capital needs. Sadly,
VA only received $213 million in VA construction funding for fiscal
year 2003 and only requested $421 million for fiscal year 2004.
When the Undersecretary for Health submitted his admittedly
incomplete CARES plan to the Secretary's CARES commission earlier this
year, it called for a minimum of $3.5 billion in new construction over
the next 5 years. I say the plan was incomplete because it excluded
funding for projects that would enhance VA's ability to provide
veterans with long-term care. The VA Committee has called on the CARES
Commission to address this serious shortcoming. Nevertheless, a plan to
spend $3.5 to $4 billion over the next 5 years means that Congress will
need to appropriate $700 to $800 million every year during that period.
Mr. Speaker, even though the deficit outlook for the next several years
is not good, this is an obligation that has been put off long enough.
The failure to begin addressing this huge backlog in renovation and
modernization projects can only lead to inefficiency and inferior care
for veterans in the future.
Mr. Speaker, H.R. 1720, as amended, would authorize the Department of
Veterans Affairs to improve, establish, restore or replace VA health
care facilities where necessary. The Committee decided in the last
Congress that there is a demonstrable need to provide a more flexible
and responsive authorization process to address the overwhelming
backlog of construction projects, and this bill continues with that
approach.
Under this bill, the Secretary would be authorized to approve
individual facility projects, based on the decisions of a capital
investments board that must carefully and objectively consider each
proposed construction project. The bill provides criteria to be used by
the board that would place a premium on projects to protect patient
safety and privacy, improve seismic protection, and provide barrier-
free accommodations. It would also emphasize improving VA patient care
facilities areas of particular concern, such as specialized care
programs, in order to meet the contemporary standard of care veterans
deserve and need.
H.R. 1720 would require the Secretary to report his actions on
construction to this Committee and to the Committee on Appropriations,
and would mandate a review of the delegated-project approach by the
General Accounting Office, to ensure this is an effective mechanism to
advance VA medical construction during and after the CARES process.
The bill also would authorize construction of a specific set of
urgent major medical projects as follows: Clark County, NV--the lease
of a multi-specialty outpatient clinic and Veterans Benefits
Administration satellite office at an annual rent not to exceed
$6,500,000; Columbus, OH--$90,000,000 to construct a new VA medical
center; West Haven, CT--$50,000,000 to renovate inpatient wards and
research facilities at the Wet Haven VA medical center; Chicago, IL--
$98,500,000 to consolidate inpatient care in a new bed tower at the
West Side Division; San Diego, CA--$48,600,000 for seismic corrections
to Building 1 at the San Diego VA medical center; and Pensacola, FL--
$45,000,000 to construct a joint-venture outpatient clinic at the
Pensacola Naval Air Station. The bill would require the Secretary to
move forward on these projects first before awarding construction
contracts under the general construction delegation provided by the
bill.
Mr. Speaker, this bill would authorize appropriations of $500 million
in fiscal year 2004 and $600 million in fiscal year 2005 to accommodate
construction projects under the various authorities provided.
Additionally, the bill would authorize the appropriation of $300
million over 3 years for the replacement VA medical center near Denver
CO, at the former Fitzsimons site.
Mr. Speaker, as I mentioned, H.R. 1720, as amended, includes the
provisions of H.R. 116, a bill to authorize a joint VA-Air Force health
care facility to be located on the grounds of the ``New Fitzsimons''
campus of the University of Colorado Health Sciences Center, in Aurora,
CO. The bill would require the Secretary, after consulting with the
Secretary of Defense, to decide how to replace the 57-year-old Denver
medical center with a new Federal Regional Medical Center in Aurora.
There is a unique opportunity at this location to enhance VA-DOD
sharing by jointly constructing or leasing a premier health treatment
facility as a joint venture of the VA, the Department of the Air Force,
and the University. We certainly expect that both the Air Force and the
VA will find a way to execute this plan in a manner that advances the
interests of the American taxpayer and the beneficiaries served by the
two Departments.
I want to commend Chairman Joel Hefley and Representative Bob
Beauprez, a Member of the VA Committee, for spurring this project
forward. We would not be considering this measure on the floor of the
House today without their hard work and individual efforts to help make
this project a reality.
H.R. 1720 would also require VA to conduct a study and report on the
feasibility of constructing a new medical center for veterans in
Charleston, SC, and a study for meeting the inpatient hospitalization
needs of southern New Jersey veterans. The Committee appreciates the
work of Mr. Brown, the chairman of our Subcommittee on Benefits, and
Mr. LoBiondo, the distinguished chairman of the Subcommittee on Coast
Guard and Maritime Transportation, for their insight in crafting these
two provisions.
The final measures in the bill, Mr. Speaker, would designate the
Department of Veterans Affairs Outpatient Clinic in New London, CT, as
the John J. McGuirk Department of Veterans Affairs Outpatient Clinic,
and the VA Medical Center at 820 S. Damon Street in Chicago, IL, the
Jesse Brown Veterans Affairs Medical Center.
Our bipartisan bill would also honor the late Jesse Brown, former
Secretary of Veterans Affairs, for his exemplary service to his country
as a combat-wounded U.S. Marine Corps veteran of the Vietnam war and
dedicated leader of the Department of Veterans. Mr. Brown enlisted in
the Marine Corps in 1963 and was seriously wounded in Vietnam. Mr.
Brown's career in veterans' advocacy spanned his entire remaining life.
He served with distinction in the Clinton administration as the third
Secretary of Veterans Affairs, and is buried at Arlington National
Cemetery.
Naming the West Side VA Medical Center after Jesse Brown would
appropriately memorialize his accomplishments and commitment to
improving the quality of life of all veterans.
The final provision in this bill adds a new degree of accountability
to the VA medical research program. The provision is the result of
efforts by two of the Committee's Subcommittee chairmen, Mr. Buyer and
Mr. Simmons. Their proposal is supported by Ms. Hooley and Mr.
Rodriguez, their respective ranking members.
The language of section 11, which is taken from H.R. 1585 as revised
by our Subcommittee on Health requires VA to maintain a permanent and
independent research compliance and assurance office. While
establishment of this office may not provide a complete shield against
possible future abuses, it does send a clear message that the Congress
expects compliance with rules already in place to assure protection of
human subjects who participate in research sponsored by VA.
Finally, I want to thank the Committee's ranking member, Lane Evans,
for his support of this legislation, and for the work of the chairman
and ranking member of the Health Subcommittee, Rob Simmons and Ciro
Rodriguez, respectively, for considering this bill in a timely fashion.
Mr. Speaker, I urge my colleagues to support H.R. 1720, as amended.
Mr. Speaker, I reserve the balance of my time.

[[Page H10001]]

Ms. BERKLEY. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 1720. I would like to thank VA
Committee Chairman Smith and Health Subcommittee Chairman Simmons for
working closely with all of us on this side of the aisle on this
important issue. I also want to thank our ranking member, the gentleman
from Illinois (Mr. Evans), for his steadfast support and hard work on
this legislation. I also want to thank Chairman Smith and the entire
staff for working with us to bring this measure before the House for
consideration today.
This bill contains authorizations for many worthwhile, major medical
construction projects.

{time} 1245

Congress has put a virtual stop to appropriations for major medical
construction projects over the last 4 years since the General
Accounting Office released a report that suggested the VA was spending
too much money maintaining buildings that were not being used to serve
veterans.
Since fiscal year 2000, Congress has appropriated $121 million for
major medical projects. That is about $6 million less than experts
recommend for maintaining and enhancing capital assets. But while
spending for major medical construction projects has declined, the
number of veterans moving into States like my own, the State of Nevada,
continues to explode, and the need for expanded facilities is not being
met.
Southern Nevada's veterans population is one of the fastest glowing
in the Nation, and is getting larger every day. The VA predicts that
the number of annual visits by veterans in the Las Vegas Valley to
their primary health care clinic will rise from 200,000 to more than
half a million by 2010, that is a mere 7 years from now, and the number
of hospital beds needed to serve the veterans in my community will
increase by over 50 percent.
The VA is already struggling to address and meet the current demands
of the VA health care structure in the Las Vegas Valley. Last year,
1,500 southern Nevada veterans were sent to neighboring States because
they could not provide the needed services locally. This is an unfair
burden on these veterans and their families. They should not have to
travel hundreds much miles away for care.
In addition, due to the decrepit conditions and structural
deficiencies, the VA evacuated the Guy Clinic, only 5 years old,
forcing veterans to rely on a string of temporary clinics scattered
across the Las Vegas Valley. Imagine, if you will, what it is like for
an 80-year-old veteran waiting in the desert heat, sometimes up to 110
degrees, to be shuttled from clinic to clinic to receive the health
care he needs.
For example, a veteran who needs a CT scan may have to shuttle from a
temporary site which houses the CT scan technology to then another site
to obtain a prescription for a controlled narcotic that he needs, and
then to a third site for mental health services.
Female veterans who need mammograms have to shuttle to different
clinics just for that one particular service.
As one 81-year-old World War II veteran described the situation,
``You are going from one place to another and it gets confusing. Don't
our veterans deserve a permanent facility to meet all their health care
needs?''
In short, southern Nevada is facing a veterans health care crisis. At
the time H.R. 1720 was introduced and passed by the Committee on
Veterans' Affairs, the VA recognized Las Vegas was in need of a new,
multispecialty outpatient clinic. H.R. 1720 authorized $6.5 million for
annual leases for that clinic. However, in the time since the
legislation has been acted on by the committee, the Department of
Veterans Affairs released the CARES document which proposed $4.6
billion worth of construction, reflecting only a portion of the growing
backlog and veterans growing demand for services.
The VA's average healthcare facility is about 52 years old, so
updates are essential. The failure to make investments has put the VA
way behind in addressing such urgent needs as seismic corrections,
renovations to address patient safety, and privacy concerns and
problems that threaten VA's accreditation by outside quality assurance
agencies.
To address the concern about underutilized buildings, the VA embarked
upon a process to identify veterans needs for health care for the next
20 years. The CARES plan calls for the construction of a full-scale
medical facility in Las Vegas, including a full-service patient care
hospital, an outpatient clinic and a comprehensive long-term care
nursing facility in Las Vegas.
In light of the VA's new plan for a veterans health care facility, I
ask the committee to continue to work with me to update the
authorization level to reflect the demands in southern Nevada and to
allocate funds for a full-service VA medical complex.
America's veterans served our Nation, and now we must honor our
commitment to those brave men and women. Providing high-quality health
care is part of keeping our promise to these heroes and sends an
important message to our troops now deployed at home and abroad in
defense of our Nation. These future veterans, many of whom will soon
call Nevada home, will also one day be eligible for VA care. Investing
now will ensure that we will be able to serve the health care needs of
our veterans, today and in the future.
Mr. Speaker, I reserve the balance of my time.
Mr. SMITH of New Jersey. Mr. Speaker, I yield for the purpose of
making a unanimous consent request to the gentleman from Indiana (Mr.
BUYER), who wrote section 11 dealing with human research protection.
(Mr. BUYER asked and was given permission to revise and extend his
remarks, and include extraneous material.)
Mr. BUYER. Mr. Speaker, I rise in support of this bill and thank the
chairman for including my bill to ensure human subject protection in
research.
Mr. Speaker, today we are considering H.R. 1720, the Veterans Health
Care Facilities Capital Improvement Act, legislation designed to
authorize the Secretary of Veterans Affairs to carry out major
facilities construction projects to improve, renovate, replace, update,
and establish care facilities across the Department of Veterans
Affairs.
One provision I would like to draw your attention to is section 11 of
the bill. Section 11 guarantees that there is an independent oversight
body within the Veterans Health Administration, Department of Veterans
Affairs to oversee research compliance and assurance.
This provision addresses the important issue of human subjects
protection in VA medical research. Since 1999 several hearings have
been held by the House Veterans' Affairs Subcommittee on Oversight and
Investigations. I compliment the work of then Subcommittee Chairman
Terry Everett of Alabama, who also worked to ensure that necessary
actions are taken to assure that our Nation's most vulnerable veterans
are protected and not subjected to harm.
This provision is the final language that was worked out by my
Subcommittee on Oversight and Investigations and Subcommittee Chairman
Simmons of the Health Subcommittee and it reflects the original intent
of H.R. 1585, a bill I introduced because I wanted to ensure that our
Nation's most vulnerable veterans are protected and not in any way
harmed by the very system whose mission it is to safeguard their safety
and well being.
In particular, this bill does the following:
Establishes an independent office to oversee research compliance and
assurance;
Provides that the new office counsels the Under Secretary for Health
on all matters related to the protection of human research subjects,
research misconduct and impropriety, laboratory animal welfare; ethical
conduct of research; and research safety;
That the office shall investigate allegations of research misconduct
and impropriety; suspend or restrict research to ensure the safety, and
ethical treatment of human subjects; preserve the integrity and
validity of research; prevent mistreatment of laboratory animals used
in research; and assure compliance in the conduct of research;
The director of the office shall conduct periodic inspections at
research facilities; observe external accreditation site visits;
investigate allegations of research misconduct and improprieties;
It requires the immediate notification of the Under Secretary for
Health when endangerment of human research subjects is evident or
suspected and requires that Congress be notified when research
misconduct or impropriety has been discovered;
This bill provides that funding for the new office would be
independent from the Office of Research and Development; and
Finally, this bill mandates that the Comptroller General of the
United States conduct a study of the effectiveness of the new office

[[Page H10002]]

and submit a report to Congress by January 1, 2006.
This legislation has strong bipartisan support. I would like to thank
all the cosponsors of the original bill. In particular, I would like to
thank Chairman Chris Smith and Ranking Member Lane Evans and the
Ranking Member of my Subcommittee, Darlene Hooley for their
cosponsorship and support. I ask my colleagues to support H.R. 1720 and
strengthen VA research programs so our veterans are never placed in a
harmful environment.
Mr. SMITH of New Jersey. Mr. Speaker, I yield 5 minutes to the
distinguished gentleman from Connecticut (Mr. Simmons), the prime
sponsor of this legislation and the chairman of our Subcommittee on
Health.
(Mr. SIMMONS asked and was given permission to revise and extend his
remarks, and include extraneous material.)
Mr. SIMMONS. Mr. Speaker, I thank the chairman and the ranking
members of the Committee on Veterans' Affairs for all of their hard
work on this legislation. I also thank my ranking member on the Health
Subcommittee, the gentleman from Texas (Mr. Rodriguez), for all of his
work. This legislation constitutes a bipartisan effort to fund medical
health care facilities for our Nation's veterans.
When I first assumed the chair of the Committee on Veterans' Affairs
Subcommittee on Health, I was committed to providing the resources
necessary to improve these health care facilities for our veterans, and
this has been a bipartisan enterprise for the past 9 months. This
legislation is the fruit of that work, and I think this legislation
speaks very well for the bipartisan effort that we made on the
subcommittee and the committee.
Among other things, this legislation would authorize specific
construction projects, such as in Clark County, Nevada, where we just
heard about the multispecialty outpatient clinic; in Columbus, Ohio, a
new VA medical center; and in West Haven, Connecticut, renovations of a
facility that was first built in 1917.
Mr. Speaker, I am proud of the fact that the State of Connecticut
built this facility in 1917 as a tuberculosis and a neuropsychiatric
hospital, and I am proud of the fact it is affiliated with Yale
University's School of Medicine, which is one of the premier schools of
medicine in the United States. But the question we have to address to
ourselves, not only with this facility but these other facilities, is
how efficient are they in today's day and age? How is the morale of VA
employees, when they work in facilities that are almost 100 years old?
How can we clean them and maintain the standards of sanitation that we
want as we treat our veterans population? How can old hospital wards
become more user-friendly and accommodate the new technologies for
dealing with our veterans? And is there enough renovated space for
these purposes?
That is why we are moving forward to authorize certain construction
projects, such as in Chicago, Illinois, consolidating inpatient care in
a new bed tower in the West Side Division; or in San Diego, California,
doing almost $50 million worth of seismic corrections to Building I at
the VA medical center; or in Pensacola, Florida, a joint-venture
outpatient clinic at the Pensacola Naval Air Station where the Veterans
Administration and the Department of Defense are sharing resources and
sharing technologies to come up with a joint facility, something that
saves our taxpayers a tremendous amount of money.
In the aggregate, Mr. Speaker, this bill would authorize
appropriations of $500 million in fiscal year 2004 and $600 million in
fiscal year 2005 to accommodate the construction projects under the
various authorities provided.
One of these major construction projects, and you will hear from some
of our other Members shortly, is the ``New Fitzsimons'' Campus of the
University of Colorado Health Sciences Center. What the bill would
require is that the Secretary of Defense and the Veterans
Administration work together to create a new medical center in that
area to serve our veterans population.
We have also authorized a joint project in Charleston, South
Carolina, where we will do a feasibility study for a new medical
center, I commend my colleague, the gentleman from South Carolina (Mr.
Brown) for his work on that project. And also an inpatient
hospitalization needs study for southern New Jersey, something that my
colleague, the gentleman from New Jersey (Mr. LoBiondo), has been
involved with.
So as we work our way through the details of this legislation, Mr.
Speaker, it should become clear that this is a joint effort and a joint
product by all members of the Committee on Veterans' Affairs and the
Subcommittee on Health to come up with a hospital authorization bill
that serves the needs of all of our veterans, north and south, east and
west, nationwide.
Mr. Speaker, this legislation we are voting on today will help us
improve, upgrade and even replace VA facilities in specialized areas of
concern, such as spinal cord injury care, hemodialysis, long term care
and medical research. Our bill also gives the VA Secretary flexibility
to move forward on both high priority projects and the CARES process
together. So this is a compromise bill and one that all Members can
support.
This bill would also improve protection and safety of VA medical
research programs. VA research is internationally recognized and has
made important contributions in virtually every area of medicine and
health. But it still needs watchful oversight. I thank the gentleman
from Indiana, Mr. Buyer, for his leadership in crafting these
provisions as part of this legislation, which I strongly support, and I
thank our Full Committee Chairman for agreeing to move this measure
forward as a part of our construction bill.
Mr. Speaker, this legislation would also designate the Department of
Veterans Affairs Outpatient Clinic in New London, Connecticut, the
``John J. McGuirk Department of Veterans Affairs Outpatient Clinic''.
I am very pleased that our bill would memorialize the life and work
of Mr. John J. McGuirk of Connecticut. John was active in promoting
improved care and more available VA clinics in his beloved State of
Connecticut. He was a role model to many of us in the veterans'
community, and was particularly committed to working on behalf of
disabled and elderly veterans--those with the greatest need for ready
access to VA health care. His death in 1999 was a loss to all the
veterans of my State.
John J. McGuirk, a native of the Constitution State, enlisted in the
United States Navy in World War II. He served as an enlisted man in the
dangerous occupation of salvage diver. Hazarding death and injury every
day of his Navy service, Mr. McGuirk worked across the South Pacific
from Pearl Harbor to Manila, Philippines. He served aboard the salvage
ship, USS Laysan Island, in clearing war devastation in Manila Bay.
John McGuirk was decorated with the Philippines Liberation Medal, the
American Theatre Medal, the Asiatic Pacific Theatre Medal and the World
War II Victory Medal.
When Mr. McGuirk's obligation to the United States Navy was
discharged at the war's end, his personal obligation to his country and
fellow veterans endured and became his lifelong commitment.
Mr. McGuirk's advocacy resulted in VA activating a system of
community-based clinics across the State, providing primary care to
thousands of veterans. John McGuirk played an instrumental role in VA's
opening of the community clinic on the grounds of the U.S. Coast Guard
Academy in New London.
John actively served in Post Number Nine of the American Legion of
Connecticut for the entirety of his adult life, including two stints as
Post Commander, as well as Finance Officer and Service Officer. He was
also a member of the Disabled Veterans of America and of U.S. Submarine
Veterans, Inc.
I am proud to promote this effort to memorialize the name of a good
man, a war veteran and a man of peace, John J. McGuirk of Connecticut.
This gesture is but a token of the esteem and affection we hold for him
and his lasting contribution to our State and his service to our
veterans.
Mr. Speaker, I strongly urge my colleagues to support this bill.
Ms. BERKLEY. Mr. Speaker, I yield 2 minutes to the distinguished
gentleman from Illinois (Mr. Evans), the ranking member of the
Committee on Veterans' Affairs.
Mr. EVANS. Mr. Speaker, I rise in strong support of H.R. 1720, as
amended. I want to thank the gentleman from New Jersey (Chairman
Smith), our Subcommittee on Health chairman, the gentleman from
Connecticut (Mr. Simmons), and the ranking member, the gentleman from
Texas (Mr. Rodriguez), for allowing me the time to speak on this bill.
One provision that I am particularly pleased that the bill includes
language that would rename the West Side division of VA Chicago after
the Honorable Jesse Brown. The late Honorable Jesse

[[Page H10003]]

Brown served as Secretary for Veterans Affairs and was a strong
advocate in our budgetary battles at that time in the Clinton
Administration. As Secretary, Jesse made good on his promise of putting
veterans first. Sadly, he left us much too soon after a struggle with
Lou Gehrig's disease. It is fitting that we rename the West Side
division of VA Chicago in his name.
This bill would also give Congress and the VA an opportunity to
reinvigorate VA's flagging major medical construction programs. VA is
at a critical juncture, where it must make billions of dollars worth of
improvements to ensure its ability to provide modern, high-quality and
efficient health care services.
Mr. Speaker, this is a good bill. I thank the chairman of the full
committee for getting it through, and, again, for the way we work
together.
Mr. SMITH of New Jersey. Mr. Speaker, I yield 1 minute to my good
friend and colleague, the gentleman from Nevada (Mr. Gibbons), and
thank him for his work on behalf of the $6.5 million lease for the
outpatient clinic in his area.
(Mr. GIBBONS asked and was given permission to revise and extend his
remarks.)
Mr. GIBBONS. Mr. Speaker, I want to thank the chairman of the
committee for yielding me time.
No doubt all of us in this Chamber realize and recognize the fact
that our veterans risk their lives for our great Nation, and especially
for the freedoms we all enjoy. We owe them much. Today, we take yet
another step toward providing them with the health care services they
deserve.
For example, H.R. 1720 authorizes funding for a Veterans
Administration medical clinic in Clark County, Nevada, allowing the VA
to lease space and provide desperately needed health care services to
one of the fastest growing veterans populations in the country.
While this authorization best serves the short-term needs of Nevada's
veterans, the long-term needs recognized by myself and Veterans
Administration Secretary, Anthony Principi, call for the construction
of a permanent, full-service veterans hospital in southern Nevada.
Until this long-term goal is realized, the establishment of a medical
clinic in Clark County will provide critical health care services to
those veterans in southern Nevada.
I applaud my colleagues for bringing this bill to the floor, and
remain committed to providing our veterans with the best health care
services we can afford.
Ms. BERKLEY. Mr. Speaker, I yield 3 minutes to the gentleman from
California (Mr. Filner).
Mr. FILNER. Mr. Speaker, I thank the gentlewoman, sometimes not so
gentle, for yielding me time.
In fact, I thank the not-so-gentle woman for fighting for these
facilities in her district. She has fought long and hard, and this is
just one of the fruits. She has done a tremendous job.
I want to thank the chairman of the full committee and chairman of
the Subcommittee on Health, the gentleman from New Jersey (Mr. Smith)
and the gentleman from Connecticut (Mr. Simmons) for creating the
environment on our committee that we could talk about these issues and
work towards solving them without partisan rancor. I sincerely
appreciate the efforts by the majority side on these bills.
I too rise in support of H.R. 1720, the Veterans Health Care
Facilities Capital Improvement Act. I think it goes without saying that
if the VA is to provide excellent health care, it must have excellent
health facilities. We simply cannot allow our veterans and our VA
employees to work and be treated in buildings that are unsafe.
Another such building on the list that you have heard is the Medical
Center Building Number 1 in the VA health care system in San Diego, the
medical facility used by veterans in all of San Diego and in my
congressional district.
This building is in desperate need of seismic corrections, including
new exterior bracing enhancements to the existing seismic structures,
with an estimated cost of almost $50 million. Not an insignificant
sum--but the cost of not doing this project would be much higher in
real human lives. The VA has identified more than 60 projects that
require seismic fortification.

{time} 1300

We cannot continue to turn our heads away while VA patients and
employees are in harm's way.
So I compliment all of those who have worked on this, and I urge my
colleagues to support H.R. 1720.
Mr. SMITH of New Jersey. Mr. Speaker, I yield 2 minutes to my good
friend and colleague, the gentleman from Florida (Mr. Miller), and
thank him because he was very instrumental in helping us work on the
language that provides $45 million for an outpatient clinic in
Pensacola. I want to thank him for that outstanding work he did.
Mr. MILLER of Florida. Mr. Speaker, I thank the chairman for yielding
me this time.
Mr. Speaker, I do rise today in full support of H.R. 1720, as
amended, and thank our full committee chairman, the gentleman from New
Jersey (Mr. Smith) and our Subcommittee on Health chairman, the
gentleman from Connecticut (Mr. Simmons), whom we have already heard
from today, for their leadership and their efforts to bring this bill
to authorize major medical construction to final passage today. This is
a good bill, Mr. Speaker, truly a bipartisan compromise, as we have
already heard, and one that deserves the full support of each and every
Member on the House floor.
Mr. Speaker, I represent the first district of Florida, an area of
record growth and a high concentration of active duty servicemembers,
military retired families, and veterans. This bill, as amended,
provides a critical and important first step to providing veterans and
the military communities that I serve in northwest Florida with state-
of-the-art health care in a new, combined Navy-VA clinic in Pensacola.
In VA's budget submission for the fiscal year 2004, the Pensacola
facility is described as ``obsolete'' and ``less than half the required
space for the current and future workload.'' This description does not
paint the true picture of a crowded and totally inadequate facility.
The time to move forward on a new, combined facility is now. Our bill
sets the stage for that progress on behalf of veterans in my district.
I wish to acknowledge the effort of Julie Catellier, the director of
the VA Biloxi and Pensacola facilities, and Captain Richard Buck of the
Pensacola Naval Hospital for their creative and tenacious work and
cooperation to provide a state-of-the-art VA facility and improve the
quality of care for our veterans and military families.
A year ago, the director of the VA Gulf Coast Health Care System and
the commanding officer of the naval hospital in Pensacola coauthored an
innovative DOD-VA joint business plan. The essential groundwork has
been laid; and H.R. 1720, as amended, would authorize a $45 million
health care facility as a joint venture between DOD and VA.
Mr. Speaker, I urge strongly that my colleagues support this
important legislation for not only the veterans in my district, but for
others across the Nation.
Ms. BERKLEY. Mr. Speaker, I yield 3 minutes to the distinguished
gentleman from Illinois (Mr. Davis).
Mr. DAVIS of Illinois. Mr. Speaker, I want to thank the gentlewoman
from Nevada for yielding me this time.
I rise in support of H.R. 1720, the Veterans Health Care Improvement
Act. Incorporated in this legislation is a bill to rename the health
care facility of the Department of Veterans Affairs located at 820
South Damen Avenue in Chicago, Illinois, as the ``Jesse Brown
Department of Veterans Affairs Medical Center.''
I am pleased to have introduced this legislation with the ranking
member of the Committee on Veterans' Affairs, the gentleman from
Illinois (Mr. Evans.) This legislation is supported by the veterans
community and all of my colleagues in the Illinois delegation.
The late Honorable Jesse Brown was sworn in by President Clinton as
the Secretary of Veterans Affairs on January 22, 1993. Secretary Brown
directed the Federal Government's second largest Department,
responsible for a nationwide system of health care services, benefits,
programs, and national cemeteries for America's more than 26 million
veterans. Under Secretary Brown's leadership, the VA expanded

[[Page H10004]]

benefits for veterans who were prisoners of war or were exposed to
agent orange, radiation, or mustard gas. He successfully worked for the
enactment of laws authorizing the VA to pay compensation for those with
undiagnosed illnesses from the Persian Gulf War. His vision and
commitment led to improved technology and redesigned work processes in
an effort to reduce the backlog of veterans benefit claims. His
leadership led to the first national summit meeting on homeless
veterans. Out of the summit, the VA began to award grants to groups
that aid the homeless and added homeless programs to medical centers.
Secretary Brown understood the plight of veterans as well as anyone
because he was a veteran. He was a Marine who was wounded in combat in
1965 while patrolling in Vietnam. He was a true patriot, giving his
best on behalf of his country. His work as executive director of the
Disabled American Veterans prepared him for the challenges that he
would confront at the VA. And let me add that his education at Chicago
City College, Roosevelt University in Chicago, and Catholic University
in Washington, D.C. helped to prepare him for his later success in
life.
Perhaps Secretary Brown's greatest accomplishments would be that he
was a family man, a man of integrity, and a father. The honor that we
bestow on him by renaming the VA facility after him is symbolic in
nature, but substantive in reality for the lives of the people he
touched. He gave the best of himself in service to others. Now we say
thank you.
Finally, Mr. Speaker, I want to thank the members of the Committee on
Veterans' Affairs for moving this legislation. I personally happen to
know several members of Secretary Brown's family, a professor from
Roosevelt University, his mother, his sister and brother-in-law, the
recently retired superintendent of police in Chicago, Terry Hilliard;
and I know that they are all proud of his accomplishments and
appreciate this recognition and would want to extend their thanks to
the Committee on Veterans' Affairs.
Mr. SMITH of New Jersey. Mr. Speaker, I yield 2 minutes to the
distinguished gentleman from Ohio (Mr. Hobson) and thank him for his
work on the medical center, a $90 million authorization that he worked
so hard to procure.
(Mr. HOBSON asked and was given permission to revise and extend his
remarks.)
Mr. HOBSON. Mr. Speaker, I first want to thank the distinguished
chairman and the distinguished subcommittee chairman and ranking member
for inclusion of this provision in the bill. This was a bill initially
sponsored by me and the gentleman from Texas (Mr. Ortiz), and we have
included his facility. I also should note that it was sponsored by the
other two members of the Ohio delegation from Columbus, Ohio, the
gentleman from Ohio (Mr. Tiberi) and the gentlewoman from Ohio (Ms.
Pryce).
Mr. Speaker, I rise in strong support of H.R. 1720, which authorizes
the Secretary of Veterans Affairs to carry out major medical facility
construction projects. I rise not only as a veteran, but as a member of
the Subcommittee on VA, HUD, and Independent Agencies of the Committee
on Appropriations that helps determine the funding priorities of the
Department of Veterans Affairs.
However, no matter which hat I am wearing, I can see clearly that
something needs to be done for the ever-increasing veteran population
in central Ohio. One provision contained in this very important act
will help central Ohio take a huge step toward alleviating serious
problems by authorizing construction of a new VA medical facility in
Columbus, Ohio. Actually, it is in White Hall, Ohio, which is in my
district.
The current Chalmers P. Wylie VA Outpatient Clinic in White Hall, or
actually it is in Columbus; the new one will be in White Hall, has a
high-quality professional medical staff, but the facility is woefully
inadequate for the needs of the area's veterans. Originally, this
clinic was to handle 135,000 annual visits; but last year, it saw more
than 192,000, fully 42 percent more than intended in the original
design, and we do not own the ground, and the lease is up in 10 years.
Over the years, far too many veterans have had to travel up to 3
hours to receive treatment at larger VA medical centers in either
Cleveland, Cincinnati, or elsewhere because of the limited medical
services offered by the current clinic. The cost to transfer these
veterans has reached several million dollars per year.
This bill includes the authority to build a new 260,000 square foot
facility on the Defense Supply Center on the White Hall, Ohio, campus,
which will house a wide variety of new and expanded services that are
not currently offered at the Chalmers P. Wylie facility.
In conclusion, Mr. Speaker, it is vitally important that we move
forward with this legislation and subsequently on the new facility in
White Hall. I am grateful to the members of the Committee on Veterans'
Affairs and this subcommittee, once again, for their expeditious
movement of this bill. I urge everyone to support this bill.
Ms. BERKLEY. Mr. Speaker, I yield 3 minutes to the gentleman from
Texas (Mr. Ortiz).
(Mr. ORTIZ asked and was given permission to revise and extend his
remarks.)
Mr. ORTIZ. Mr. Speaker, let me begin by thanking members of the
Committee on Veterans' Affairs, the subcommittee, the ranking member
and the chairman, and especially the gentleman from New Jersey (Mr.
Smith), and the ranking member, the gentleman from Illinois (Mr.
Evans), and my colleague, the gentleman from Texas (Mr. Rodriguez). I
also want to thank my good friend, the gentleman from Ohio (Mr.
Hobson), who has been a champion for our veterans and their interests,
both in Ohio and south Texas and the rest of the Nation.
Finding a way to get inpatient health care services for our veterans
in south Texas has been a long journey, and it is a labor of love for
all involved. We first began this journey 21 years ago.
We know the debt we owe our veterans today. The soldiers we send
forth in today's war on terrorism are tomorrow's veterans. As liberty
must be defended, the population of veterans in the United States and
south Texas will continue to grow.
I have worked with the Department of Veterans Affairs for a long time
to bring improved services to the long-ignored population of veterans
living in the tip of Texas. The VA has responded with their approach
through the CARES program. It is long overdue for the VA to look
seriously at the long-term needs and service delivery for the
population they serve. Can my colleagues imagine, those who served the
military from the Second World War, the Korean War, and the Vietnam
War, they have to travel all the way to San Antonio, a journey of about
anywhere from 2\1/2\ to 7 hours. Some of them are bedridden. There is
no ambulance service. We are working on that. But thanks to the support
that the VA has given me and the other Members who have needs in their
districts, we really thank them for all the help that they have given
us.
There are presently no inpatient services in this market, other than
a limited contract in the Lower Rio Grande Valley, and limited access
to specialty care patients. Patients must now travel a long, long
journey. Opportunities exist to reduce this gap by working with DOD in
Corpus Christi, as well as the University of Texas Regional Health Care
Academic Center in Harlingen. Two submarkets were identified: Coastal
Bend, Corpus Christi and surrounding area, and Rio Grande Valley,
including Brownsville, Harlingen and surrounding areas, because
transportation between these areas is difficult, involving secondary
roads which take considerable travel time. It was an area that we had
no interstate highways, no freeways until the last 10, 12 years. So to
travel to get to the facility was long and hard.
So I want to thank again the subcommittee and the full committee for
addressing this need and for working with us. Again, I thank my good
friend, the gentleman from Ohio (Mr. Hobson), so much for the help he
gave me on this bill.
Mr. SMITH of New Jersey. Mr. Speaker, I yield 6 minutes to the
distinguished gentleman from Colorado (Mr. Hefley), who is the author
of H.R. 116, which is included as section 4 of this bill, which
authorizes a $300 million Fitzsimons Hospital System, along

[[Page H10005]]

with the gentleman from Colorado (Mr. Beauprez), who is the chief
cosponsor.
(Mr. HEFLEY asked and was given permission to revise and extend his
remarks.)
Mr. HEFLEY. Mr. Speaker, I appreciate the gentleman yielding me this
time.
I rise today in complete support of H.R. 1720, the Veterans Health
Care Facilities Capital Improvement Act, which is a 2-year
authorization bill that will authorize the Secretary of Veterans
Affairs to carry out major medical facility construction projects to
improve, renovate, replace, and update our established patient care
facilities within the Department of Veterans Affairs.
Certainly it is not before it is needed. If my colleagues have
visited many of these facilities, as our chairman has, they would know
how badly this updating and renovation is needed. I want to thank the
chairman particularly. No one could have been more gracious and helpful
than he has been to me in my particular part of this bill, and I
appreciate that so much. The gentleman is so dedicated to better health
care for veterans. The gentleman is the expert in the House of
Representatives, and I look to him for guidance on these subjects. He
has been just great with this. As a matter of fact, I appreciate the
gentleman's whole committee, both Democrats and Republicans. They are
trying to get a job done for the veterans, and they are doing an
excellent job of it.
Again, I appreciate the gentleman from Colorado (Mr. Beauprez), who
is on the committee and is one of my dear friends and colleagues from
the State of Colorado and who has been absolutely dedicated to this
project as well.
As the gentleman indicated, in addition to authorizing $168 million
for fiscal year 2004 and $600 million for fiscal year 2005 for
construction of undesignated major projects, H.R. 1720 also authorizes
the Secretary of Veterans Affairs to carry out a major medical facility
project at the former Fitzsimons Army Medical Center site in Aurora,
Colorado. H.R. 1720 would authorize this project to be carried out,
using a total of approximately $300 million.
The Veterans Medical Center in Denver and the University of Colorado
hospitals have been in a partnership, a next-door partnership since the
Second World War. They have shared expensive and specialized medical
equipment and facilities, such as surgical suites and imaging equipment
and expensive specialty diagnostics and medical treatments; but due to
the lack of space and the landlockness of the hospitals there, when the
University of Colorado needed to modernize and build on a new site,
they went out to the Fitzsimons Army Medical Center and began building
in 1995.
Mr. SMITH of New Jersey. Mr. Speaker, I yield 6 minutes to the
distinguished gentleman from Colorado (Mr. Hefley), who is the author
of H.R. 116, which is included as section 4 of this bill, which
authorizes a $300 million Fitzsimons Hospital System, along with the
gentleman from Colorado (Mr. Beauprez), who is the chief cosponsor.
(Mr. HEFLEY asked and was given permission to revise and extend his
remarks.)

{time} 1315

And the university's move will create a state-of-the-art medical
campus which, in turn, will develop many of the very best services of
in the United States. The Anschutz Cancer Pavilion, which is already
open, is among the best institutions in the Nation for all types of
cancer treatment and research.
The University of Colorado Health Science Center is well known
throughout the country for its organ transplant programs, for instance.
Unfortunately, the University's move created an 8-mile separation
between the University of Colorado and the old veterans hospital that
had been so close before.
This 8-mile separation creates a very real and significant barrier to
quality care for veterans who have been working in cooperation all
these years, the two hospitals.
A study commissioned by the Veterans Integrated Service Network
indicated that high demand for medical services by veterans at the
Denver Veterans Medical Center will continue unabated for at least the
next 20 years. The cost of maintaining the current Denver Veterans
Medical Center, to satisfy minimal accreditation levels until 2020, has
been estimated to be $233 million, and estimates to rebuild the
facility in 2020 are $377 million in today's dollars.
So if we put this $233 million into it, at the end of this period,
this 20-year period, we still have an old facility, and we have put
almost as much into it as it would take to build a new facility.
Planning studies have shown that a move of the Denver Veterans
Medical Center to the Fitzsimons campus is the most cost-effective of
the reasonably accepted alternatives.
The Denver Veterans Medical Center relocation to the Fitzsimons
campus will solve aging facilities issues, cap new facilities cost,
enhance quality of medical care, increase flexibility and reduce
operational costs. Veterans who have highly specialized medical needs
must have easy access to the best diagnostic and treatment programs
that America provides.
In a medical school environment, doctors tend to be better informed
of the latest treatment procedures and protocols. They are closer to
the cutting edge of modern medicine. Quality of medical care for
veterans is enhanced in a medical school teaching hospital. University
physicians and special residency programs provide a significant amount
of care in the Denver veterans medical center. To date, some 90 percent
of the physicians that work at the VA Medical Center also work at the
University of Colorado Health Science Center. And most VA doctors have
faculty appointments in the medical school.
Colocating the University of Colorado hospital in the Denver Veterans
Medical Center will allow university doctors to continue their close
relationship in treating veterans.
Mr. Speaker, let me just summarize real quickly. This is an
opportunity that you do not get very often, to have a medical campus
which is, in essence, right in the middle of a metropolitan area like
Denver, Colorado. If it was not for the closing of Fitzsimons Hospital,
which we all hated at the time, this would never have come about. But
right here, in the middle of this metropolitan area, you will have the
one of the finest, state-of-the-art, cutting edge health medical
facilities in the whole United States. It is going to mean cutting
edge, quality care for veterans. The gentleman from New Jersey (Mr.
Smith) can take a lot of credit when this comes about.

The new VA Medical Center at Fitzsimons site will be veteran-friendly
and will provide a practicable alternative to the Denver Veterans
Medical Center remaining at its current, out-dated facility.
The new Veterans Medical Center at Fitzsimons will be a free-standing
ambulatory and impatient care federal tower building for veterans,
clearly identified as the Veterans Administration Medical Center.
New veterans research facilities will be constructed and there will
be a new veterans long-term care unit located next to the new 180-bed
State veterans nursing home currently being constructed at the site.
Given the rising demand for veterans health care, and the significant
challenges of an aging and increasingly less-efficient Denver Veterans
Medical Center facility, my interest and my efforts are aimed at
continuing the collaboration between the Denver Veterans Medical
Center, University of Colorado Health Sciences Center and University of
Colorado Hospital.
I believe that the opportunity to co-locate the Denver Veterans
Medical Center with the University of Colorado Health Sciences Center
and the University of Colorado Hospital at the Fitzsimons campus will
meet the demand for veteran care in this area through 2020 and beyond;
provide significant savings in both capital and operational costs for
the Department of Veterans Affairs and the taxpayer; continue to meet
the Denver Veterans Medical Center commitment to education and
research; and potentially create a national model for the future of
veterans' care dealing with both a new concept for facilities and
collaboration with long-established partners. More importantly, this
move will retain veteran ``identity'' while also providing optimum
patient care.
To date, over 45 local, state and national Veterans' Service
Organizations and the American Federation of Government Employees,
Local 2241, have expressed their support for this proposal.
I believe that co-locating the Denver Vetrans' Medical Cebter with
the University of Colorado Hospital will achieve the goals of providing
the up-most modern, comprehensive and cost-efficient medical care that
we as a nation owe our veterans.
Congress has a duty to provide the best medical care it can to our
nation's veterans

[[Page H10006]]

and we must always strive for the very best health care services it can
by utilizing the most cost-effective measures available.
The fact is, aging facilities, lack of funds, and the growing demands
on the veterans health system are proving to be daunting obstacles in
meeting Congress' responsibilities to our nation's veterans.
However, the possibility for the Denver Veterans Medical Center to
move to Fitzsimons and co-locate with University of Colorado Health
Sciences Center and University of Colorado Hospital is a unique
opportunity to provide solid and constructive solutions to these
challenges.
Mr. SMITH of New Jersey. Mr. Speaker, I want to thank the gentleman
from Colorado (Mr. Hefley) again, Mr. Speaker, for the outstanding work
that he has done. He has been indefatigable in promoting this project
along with the gentleman from Colorado (Mr. Beauprez). And we are very,
very grateful on the committee to have that kind of advocacy coming our
way on behalf of the veterans.
Mr. Speaker, I would inquire as to our remaining time and ask if the
gentlewoman from Nevada (Ms. Berkley) might yield some of her time. We
have an additional speaker, the gentleman from Colorado (Mr. Beauprez).
The SPEAKER pro tempore (Mr. Terry). The gentleman from New Jersey
(Mr. Smith) has 30 seconds. The gentlewoman (Ms. Berkley) from Nevada
has 5 minutes.
Ms. BERKLEY. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I would be delighted to yield to the gentleman the
balance of our time so that all of his members can speak on behalf of
this legislation. If I could take 30 seconds to sum up.
Mr. Speaker, the gentleman from California (Mr. Filner) in his
remarks referred to me as the not-so-gentlelady from Nevada. I take
great pride in that characterization. I do not think any of us should
be gentle when it comes to issues that affect the health care of our
veterans.
We owe these veterans, men and women, a tremendous debt of gratitude.
We are going to have far more veterans once our war against terrorism
is over. I applaud my colleagues on both sides of the aisle for being
steadfast on this piece of legislation. We should not rest. And none of
us should be able to go back to our districts and look our veterans in
the face if we do not deliver for them now.
Mr. Speaker, I yield the balance of my time to the gentleman from New
Jersey (Mr. Smith).
Mr. SMITH of New Jersey. Mr. Speaker, I thank the gentlewoman from
Nevada (Ms. Berkley) for her gracious yielding.
Mr. Speaker, I yield 3 minutes to the gentleman from Colorado (Mr.
Beauprez). He has been a very strong supporter of this legislation in
general, but particularly for Fitzsimons.
Mr. BEAUPREZ. Mr. Speaker, I also am proud to speak today in strong
support of H.R. 1720, the Veterans Health Care Facilities Capital
Improvement Act. Many facilities in the VA health care system are run-
down, decrepit buildings that are not conducive to providing quality
health care to our veterans.
The Denver Veterans Medical Center in Colorado was constructed
approximately 50 years ago to provide fairly low-volume inpatient care
to our veteran population. In Colorado today, as my distinguished
colleague, the gentleman from Colorado (Mr. Hefley) just outlined, we
have an opportunity to provide health care in a much more efficient
manner.
The Denver Veterans Medical Center is in decaying state. It is faced
with two main alternatives with regard to this facility. The first
alternative is to invest in renovation of this facility and make it
capable of handling the medical needs of our current veteran population
and the changing needs of that population over the next 20 or so years.
After such a renovation, not only would the VA still be left with a 50-
year-old building, but as the gentleman from Colorado (Mr. Hefley)
pointed out, it would also be an orphaned medical center.
The second alternative is to relocate the building to the new
Fitzsimons campus. Such a relocation would allow for a modern facility
to deliver modern health care on a state-of-the-art medical campus, one
that we think will be a standard for the whole Nation.
The VA would be able to take advantage of the University of Colorado
partnership which will provide numerous operational efficiencies, as
well as access to an extensive staff of doctors, technicians, and
specialists.
This legislation would also authorize this critical relocation. The
cost to restore the Denver facility far outweighs the cost of
constructing a new hospital. It is estimated that the savings in
operational efficiencies at Fitzsimons itself will pay for construction
of the new hospital. Regardless of where our veterans happen to live,
they deserve the best care possible.
Mr. Speaker, I want to compliment the gentleman from New Jersey (Mr.
Smith), the gentleman from Connecticut (Mr. Simmons), the gentleman
from Colorado (Mr. Hefley), my colleague, for bringing this important
legislation to the floor.
Again, Mr. Speaker, we believe that the Fitzsimons Veterans Hospital
will become a standard for delivering better health care to our
veterans for years and years to come.
Mr. Speaker, I am proud to speak today in support of H.R. 1720, the
Veterans Health Care Facilities Capital Improvement Act. During my time
serving on the Veterans Affairs Committee I have learned first hand the
difficulties and challenges the VA faces in order to provide healthcare
to our nations veterans. It is my belief H.R. 1720 is one of many steps
we in Congress can take to address the challenges of the VA by
authorizing major medical construction for certain VA facilities.
Many facilities in the VA healthcare system are run-down, decrepit
buildings that are not conducive to providing quality healthcare to our
veterans. It is inconceivable to think the VA system should be expected
to handle an increased amount of patients without the proper medical
facilities in which to do so. We must remember that before we place
increased demands on the VA we must provide the system with the tools
to succeed in their mission of quality, timely healthcare.
As military operations continue to be carried out by the United
States overseas, we will be creating a new generation of veterans in
need of medical services from the VA. As medical costs continue to rise
in the United States, many people, unable to afford private medical
care will enroll for medical care with the VA. Also, as described by
Deputy Secretary Leo Mackay, ``the VA's record of achievement in
medical care has been so dramatic that we are now confronted with
unprecedented demand for our services.'' The population dynamics that
have been taking place in terms of VA enrollment are staggering. We
have record levels of enrollment for VA Health Care today. In many
parts of the country, those numbers will be leveling off, and slowly
decreasing in the years to come. In my home state of Colorado, the
enrollment numbers will only continue to rise.
The history of the VA is a unique one, especially when it comes to
the medical care of our Nation's veterans. The Denver Veterans Medical
Center in Colorado was constructed primarily to provide low-volume
inpatient care to our veteran population. Over time, the VA has worked
to adapt this center to the ways of modern medicine, and to provide
primarily high-volume outpatient care to our veterans. Unfortunately,
the costs associated with the necessary renovations are extremely high,
and this building is finding little potential for further renovation to
address current medical needs with modern medical equipment.
The issues faced by this center are not unique, and are exactly the
types of issues that prompted the CARES process to be initiated. In
1999, the General Accounting Office reported that the ``VA could
enhance veterans' health care benefits if it reduced the level of
resources spent on underused or inefficient buildings, and used these
resources instead. To provide health care more efficiently.'' In
Colorado today, we have just such an opportunity to provide health care
in a much more efficient manner.
Since the construction of this medical center fifty years ago, the VA
has established a partnership with the University of Colorado-Health
Science Center to enhance the quality of care provided here. I am told
that approximately 90 percent of the doctors providing care here are
University doctors. Most research initiatives carried out in this
hospital are carried out with the help of University researchers.
Cutting edge medical procedures are carried out at this hospital
through collaboration between the VA, and the University of Colorado.
After the University's decision to relocate to Fitzsimons was made a
few years ago, the 50-year partnership between CU and the VA has begun
to erode. The VA is losing access to the fine medical staff from CU
that they have relied upon for such a long time.
The University saw the potential to create numerous operational
efficiencies in their move to Fitzsimons, and they acted on it. Today,
the VA has the potential to benefit from many of these same
efficiencies by moving to Fitzsimons, and create other ones through an
extended collaboration with the University and the Department of
Defense. Congress, through H.R. 1720, should authorize the VA to act on
this opportunity in

[[Page H10007]]

much the same way the University did. This House has already begun the
process of action by approving four million dollars in the DoD
appropriation, and an additional nine million dollars in the VA/HUD
appropriation this year.
The Denver Veterans Medical Center is faced with two main
alternatives with regard to their facility. The first alternative is to
invest in the renovation of this facility to make it capable of
handling the medical needs of our current veteran population, and the
changing needs of that population over the next 20 years. After such a
renovation, not only would the VA still be left with a 50-year old
building, but it would also be an orphaned medical center. The second
alternative is to relocate to the new Fitzsimons campus. Such
relocation would allow for a modern facility to deliver modern health
care in a preferred location. The VA would once again be able to take
advantage of the University partnership, which will provide numerous
operational efficiencies as well as access to an extensive staff of
doctors, technicians, and specialists.
It is my belief that the savings in operational efficiencies of
Fitzsimons in itself will pay for the construction of the new hospital.
Of greater importance, the quality of care that could be provided to
our veterans will be much higher at Fitzsimons.
Construction of a new hospital at Fitzsimons also allows for the
ability to build a much needed Spinal Cord Injury center. Such a center
is highly desired not only by the veterans in our district, but it
would also be well suited for ideal research opportunities with
the university. Currently, the closest Spinal Cord Injury center to our
region is a great distance away in Albuquerque, New Mexico.

One final reason construction of a new VA hospital at Fitzsimons is a
better option, lies in the hospital's potential for cutting-edge
enhancements in veteran health care through collaborative research with
the university.
As you know, the Department of Defense has recently expressed an
interest in joining in the collaborative arrangement already espoused
by the University and the VA. The benefits of this arrangement for our
active duty and their families currently stationed at Buckley Air Force
Base would be profound. Aside from having access to a full spectrum of
medical services not available on base, these soldiers and their family
will not have to worry about the potential loss in medical care caused
by deployments of those who serve in the medical corps. The benefits to
the base doctors will also increase significantly, allowing them to
experience medical situations not typically found in a military
community, while also having quick access to some of the greatest
medical resources, references, and research in the country.
Regardless of where our veterans happen to live, they deserve the
best care possible. As the House votes on this measure today, I ask
that we all keep in mind the long-term planning mission of the VA: ``to
improve access to, and the quality and cost effectiveness of, veterans
health care.'' This message cannot be forgotten when addressing the
needs of our veterans living in rural and outlying network areas.
Mr. SMITH of New Jersey. Mr. Speaker, I yield myself such time as I
may consume.
Mr. Speaker, I thank the gentleman from Colorado (Mr. Beauprez), a
good friend, for his statement and for his fine work.
Mr. Speaker, I remind my colleagues we are at a crossroads. We have
not done our due diligence in ensuring that sufficient funds were
available to renovate, to update, to modernize our aging infrastructure
of VA health care and other facilities within the VA, that is to say,
those dealing with research and development.
There was a consultants' report as far as back as June of 1998 that
suggested we spend 2 to 4 percent on plant replacement value to upkeep
these vital facilities. We have not done that. We need to now do some
hurry-up-and-catch-up baseball here. This legislation is certainly a
step in the right direction. I hope it has the full support of our
colleagues.
Mr. TIBERI. Mr. Speaker, I rise today to express my support
for H.R. 1720, the Veterans Health Care Facilities Capital
Improvement Act. I am pleased that the House of
Representatives acted today to approve this important bill.
H.R. 1720 includes language originally included in
legislation introduced by my colleague, Congressman David
Hobson, that authorizes the construction of an expanded VA
medical facility on the campus of the Defense Supply Center
in Columbus, OH.
I have been deeply and personally committed to improving
health care for veterans for nearly 20 years, going back to
my days as a congressional staffer handling veteran's
casework. I know first hand the difficulties our veterans
have had receiving the level of care they earned through
their service to our country.
Columbus is the 15th largest city in America. Central Ohio,
a metropolitan area of 1.2 million people, has over 135,000
veterans who reside here. Yet we have never had a VA
hospital, and our clinic has always been too small to provide
the services needed for our veterans. As one of the fastest
growing areas in the country, we continue to see the number
of veterans in central Ohio increase each year.
On the day it opened in 1995, our existing clinic was
already too small to meet all the health care needs of our
veterans. It was designed to handle 135,000 annual visits.
Last year there were 192,000 visits, and this year the clinic
is handling 823 visits per day, which will total
approximately 205,000 visits in 2003. Furthermore, the
current veterans population projection data does not account
for veterans of Operation Enduring Freedom, Noble Eagle or
Iraqi Freedom. In Ohio alone we have mobilized over 6,000
National Guard and Reserve Forces who are now eligible for
health care, as well as the hundreds of thousands of Active
Duty soldiers of those operations who will be returning home
in the near future. These new veterans will dramatically
swell the rolls at our local facilities.
While our local VA officials do the best they can with the
resources they have been given, the existing facility is
simply too small to meet our current needs, much less the
growing needs of the future.
A continued piecemeal approach to veterans' needs both
wastes taxpayer dollars, and provides substandard care to the
central Ohio men and women who have given so much to our
country. The VA spends nearly $3 million a year shipping our
veterans around the State, admitting emergency cases to a
local hospital, and paying for outpatient specialty care
because they lack adequate facilities. Additionally, the
current facility is leased, and the lease will expire in just
over 10 years. I believe it is not a good use of taxpayer
money to invest dollars in a facility the VA will not control
over the long term.
I want to tell you about a veteran I know who lives in
Pataskala, OH. Mr. Stanley Folk is 78 years old, and is a 60
percent service connected World War II veteran who is forced
to travel to the Cincinnati VA hospital twice a month. He
gets up at 4:30 a.m. to catch a shuttle down to Cincinnati to
get the treatment he needs. He is forced to stay there all
day until the shuttle returns him to Columbus. He does not
get home until well after 7 p.m. The strain of this trip
makes him so tired and ill that he is in bed for several days
after to recover. This would be a hardship on anyone, but is
doubly so for the elderly and disabled. It is unconscionable
that veterans must go through this to get the care they
deserve. The sad part is Mr. Folk is not alone. I could go on
and on with stories of veterans who have faced similar
hardship.
Furthermore, there are many veterans who will not seek
emergency care at night and on weekends, because the VAOPC is
closed, and they are afraid to go to private hospitals with
no prior guarantee the VA will pay the private hospital
expense. These veterans have no health insurance and they are
afraid they will be stuck with a large bill they cannot pay,
so they delay treatment at risk to their health.
I believe the facts clearly show that these facilities and
services are desperately needed to meet the health care needs
of veterans in central Ohio. I would like to thank Chairman
Smith and Ranking Member Evans, as well as Subcommittee
Chairman Simmons and Ranking Member Rodriguez for their hard
work on this legislation. My colleagues in the central Ohio
delegation, Congressman David Hobson and Congresswoman
Deborah Pryce, as well as Ohio Senators Mike DeWine and
George Voinovich, also deserve a great deal of credit for
their hard work on this issue and steadfast support for the
interests of central Ohio's veterans.
Mr. BROWN of South Carolina. Mr. Speaker, Chairman Simmons has done a
fine job of explaining the bill under consideration. I would like to
thank him, Full Committee Chairman Smith, and my colleagues on the
Veterans Affairs Committee for their excellent bipartisan work on this
legislation.
We all understand the significant needs of our VA medical facilities
across this great Nation. Many Members of this Congress have a VA
building in their district that is old and in need of renovation,
maintenance, and repair. The practice of medicine requires constant
modernization of equipment and facilities, and we need to do our best
to ensure that our veterans continue to receive the quality of care
that they deserve. Although there are never enough resources for our
veterans and their medical centers, this bill will authorize much
needed help for those areas most in need.
In addition to the projects authorized in this bill, I think we can
all agree that more needs to be done to encourage VA to coordinate with
the Defense Department, the academic community, and maybe even the
private sector

[[Page H10008]]

when medical facilities are constructed or renovated. During the
consideration of this bill in full committee, I offered an amendment
that was adopted without objection. It would require the Secretary of
Veterans Affairs to conduct a study to examine the feasibility of
coordination by the Department of Veterans Affairs with the Department
of Defense's Naval Hospital Charleston and the pending construction of
a new university medical center at the Medical University of South
Carolina in Charleston, SC.
Our VA Hospital, located in downtown Charleston, was built in 1966.
It was a good facility for its time, and the staff there does a great
job, but it definitely needs a major facelift. The building is located
right next to the Medical University of South Carolina (MUSC), a modern
and growing facility that is in the process of a large expansion
project. MUSC and the VA work well together in many areas, especially
in providing outstanding patient care.
On the old Naval Base, which was closed as a result of the last BRAC,
the Naval Hospital Charleston remains a few miles away. The Navy has
considerably downsized this facility, which mainly serves military
retirees now. It is my understanding that the building may shut down in
the future and move to a new, consolidated clinic location at the Naval
Weapons Station Charleston. The proposed site would be a single
156,000-square-foot facility valued at greater than $30 million, but
there are no plans that I am aware of to coordinate with the VA. It is
clear that there is a tremendous opportunity for the VA, DOD and MUSC
to work together for the good of our veterans and American taxpayers. I
am certain that there are other similar examples throughout the United
States.
I feel very strongly that this is the right thing to do for our
active military personnel, retirees, and veterans. Earlier this year,
we held a hearing on the Presidential Task Force Report, which focused
heavily on VA-DOD resource sharing efforts. Both Undersecretaries McKay
and Chu acknowledged that more could be done in this area, and
Charleston was cited as one of many examples. The VA cannot afford to
always go it alone in the future when planning and constructing new
medical facilities.
For the sake of our veterans and the men and women who serve them in
VA medical facilities, I urge my colleagues to support this bill.
Mr. KIRK. Mr. Speaker, I rise in strong support of the Veterans
Health Care Facilities Capital Improvement Act of 2003. Every American
knows that the face of health care has changed dramatically over the
past decades. This is no less true for military and veterans' health
care. This legislation is vital because it will improve, renovate, and
update patient care facilities at Department of Veterans Affairs
medical centers. More important, this legislation demonstrates the
continued support of Congress for our nation's veterans by providing
the best health service facilities possible.
My district is home to the North Chicago VA Medical Center. On June
19, 2001, the VA released its Capital Asset Realignment for Enhanced
Services (CARES) study. The CARES study developed four options to
improve veterans' heath care in the Chicago area, each of which
recommended the preservation of services offered at North Chicago. The
CARES study also recommended increasing the level the cooperation
between North Chicago VA and the Navy's Great Lakes Naval Hospital.
H.R. 1720 will assist the VA in cases where the department enters
into resource sharing agreements with the DoD. H.R. 1720 is critical to
this mission because the legislation includes a modest adjustment of
the definition of what constitutes a ``major'' construction project.
This legislation will raise the threshold for ``major'' construction
projects to $6 million, and thus allow cooperative sharing agreements
between the VA and DoD continue moving forward with minor projects
without being subjected to burdensome bureaucratic time tables.
Avoiding delays and moving forward with capital improvements to VA
health care facilities will save valuable resources and time, which
will continue the quality of services offered our Nation's active and
veteran population.
In the case of the North Chicago VA Medical Center and Great Lakes
Naval Hospital, integration of the two medical facilities is practical
and urgent. These facilities both sit underutilized and less than a
mile away from each other. Combining these two facilities, state of the
art, Federal health care center will maximize the use of tax dollars,
enhance the training opportunities for young naval medical corps
personnel, and, most important, bring the health care we promised our
service men and veteran population into the 21st century. Changing the
definition of ``major'' construction may allow the VA to move forward
with plans to redesign and construct operating rooms and the emergency
room at North Chicago.
I would like to thank the chief sponsor of this bill Representative
Rob Simmons, and Chairman Chris Smith of the VA Committee for their
work and dedication to America's veterans.
Mr. Speaker, H.R. 1720 will allow the VA to continue moving forward
by providing our Nation's veterans, and in some cases our active duty
personnel, with new improved health care facilities. I urge my
colleagues to support this legislation.
Mrs. SUSAN DAVIS of California. Mr. Speaker, I rise today in strong
support of H.R. 1720, legislation to provide funding for a project
crucial to the veterans' community in the San Diego region.
The Veterans' Affairs Medical Center in La Jolla, California serves
one of the largest veterans communities in the nation. Nearly 240,000
retired military personnel in the San Diego area receive treatment from
at the La Jolla hospital and nearby VA medical facilities.
I can't stress enough how important it is to ensure these facilities
can provide veterans with the treatment they need even at times of
disaster.
Just this week, the dedicated medical staff at area VA medical
facilities worked hard to care for our veterans--despite the poor air
quality and other dangers caused by the horrible wildfires burning in
Southern California. It is crucial that they have the resources to
continue their important work during such difficult times.
H.R. 1720 will help the VA prepare in case another type of disaster
strikes. This legislation provides 50 million dollars to make necessary
seismic corrections to the La Jolla VA medical center.
Mr. Speaker, this project will help ensure that both our veterans and
the medical staff will be safe if a large earthquake strikes. And it
will ensure that the hospital can continue treating our veterans in the
aftermath.
I encourage my colleagues to join me in supporting this legislation
on behalf of our veterans' community and dedicated VA medical personnel
in San Diego.
Mr. SMITH of New Jersey. Mr. Speaker, I yield back the balance of our
time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from New Jersey (Mr. Smith) that the House suspend the rules
and pass the bill, H.R. 1720, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of
those present have voted in the affirmative.
Mr. SMITH of New Jersey. Mr. Speaker, on that I demand the yeas and
nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this motion will be
postponed.

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