[Congressional Record Volume 150, Number 132 (Wednesday, November 17, 2004)]
[House]
[Pages H9772-H9787]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
VETERANS HEALTH PROGRAMS IMPROVEMENT ACT OF 2004
Mr. SMITH of New Jersey. Mr. Speaker, I move to suspend the rules and
concur in the Senate amendments to the bill (H.R. 3936) to amend title
38, United States Code, to authorize the principal office of the United
States Court of Appeals for Veterans Claims to be at any location in
the Washington, DC, metropolitan area, rather than only in the District
of Columbia, and expressing the sense of Congress that a dedicated
Veterans Courthouse and Justice Center should be provided for that
Court and those it serves and should be located, if feasible, at a site
owned by the United States that is part of or proximate to the Pentagon
Reservation, and for other purposes.
The Clerk read as follows:
Senate amendments:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Veterans
Health Programs Improvement Act of 2004''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Reference to title 38, United States Code.
TITLE I--ASSISTANCE TO HOMELESS VETERANS
Sec. 101. Authorization of appropriations.
TITLE II--VETERANS LONG-TERM CARE PROGRAMS
Sec. 201. Assistance for hiring and retention of nurses at State
veterans' homes.
Sec. 202. Treatment of Department of Veterans Affairs per diem payments
to State homes for veterans.
Sec. 203. Extension of authority to provide care under long-term care
pilot programs.
Sec. 204. Prohibition on collection of copayments for hospice care.
TITLE III--MEDICAL CARE
Sec. 301. Sexual trauma counseling program.
Sec. 302. Centers for research, education, and clinical activities on
complex multi-trauma associated with combat injuries.
Sec. 303. Enhancement of medical preparedness of Department of Veterans
Affairs.
TITLE IV--MEDICAL FACILITIES MANAGEMENT AND ADMINISTRATION
Subtitle A--Major Medical Facility Leases
Sec. 401. Major medical facility leases.
Sec. 402. Authorization of appropriations.
Sec. 403. Authority for long-term lease of certain lands of University
of Colorado.
Subtitle B--Facilities Management
Sec. 411. Department of Veterans Affairs Capital Asset Fund.
Sec. 412. Annual report to Congress on inventory of Department of
Veterans Affairs historic properties.
Sec. 413. Authority to acquire and transfer real property for use for
homeless veterans.
Sec. 414. Limitation on implementation of mission changes for specified
Veterans Health Administration facilities.
Sec. 415. Authority to use project funds to construct or relocate
surface parking incidental to a construction or
nonrecurring maintenance project.
Sec. 416. Inapplicability of limitation on use of advance planning
funds to authorized major medical facility projects.
Sec. 417. Improvements to enhanced-use lease authority.
Sec. 418. First option for Commonwealth of Kentucky on Department of
Veterans Affairs Medical Center, Louisville, Kentucky.
Sec. 419. Transfer of jurisdiction, General Services Administration
property, Boise, Idaho.
Subtitle C--Designation of Facilities
Sec. 421. Thomas E. Creek Department of Veterans Affairs Medical
Center.
Sec. 422. James J. Peters Department of Veterans Affairs Medical
Center.
Sec. 423. Bob Michel Department of Veterans Affairs Outpatient Clinic.
Sec. 424. Charles Wilson Department of Veterans Affairs Outpatient
Clinic.
Sec. 425. Thomas P. Noonan, Jr. Department of Veterans Affairs
Outpatient Clinic.
TITLE V--PERSONNEL ADMINISTRATION
Sec. 501. Pilot program to study innovative recruitment tools to
address nursing shortages at Department of Veterans
Affairs health care facilities.
Sec. 502. Technical correction to listing of certain hybrid positions
in Veterans Health Administration.
Sec. 503. Under Secretary for Health.
TITLE VI--OTHER MATTERS
Sec. 601. Extension and codification of authority for recovery audits.
Sec. 602. Inventory of medical waste management activities at
Department of Veterans Affairs health care facilities.
Sec. 603. Inclusion of all enrolled veterans among persons eligible to
use canteens operated by Veterans' Canteen Service.
Sec. 604. Annual reports on waiting times for appointments for
specialty care.
Sec. 605. Technical clarification.
SEC. 2. REFERENCE TO TITLE 38, UNITED STATES CODE.
Except as otherwise expressly provided, whenever in this
Act an amendment or repeal is expressed in terms of an
amendment to, or repeal of, a section or other provision, the
reference shall be considered to be made to a section or
other provision of title 38, United States Code.
TITLE I--ASSISTANCE TO HOMELESS VETERANS
SEC. 101. AUTHORIZATION OF APPROPRIATIONS.
Section 2013 is amended in paragraph (4) by striking
``$75,000,000'' and inserting ``$99,000,000''.
TITLE II--VETERANS LONG-TERM CARE PROGRAMS
SEC. 201. ASSISTANCE FOR HIRING AND RETENTION OF NURSES AT
STATE VETERANS' HOMES.
(a) In General.--(1) Chapter 17 is amended by inserting
after section 1743 the following new section:
``Sec. 1744. Hiring and retention of nurses: payments to
assist States
``(a) Payment Program.--The Secretary shall make payments
to States under this section for the purpose of assisting
State homes in the hiring and retention of nurses and the
reduction of nursing shortages at State homes.
``(b) Eligible Recipients.--Payments to a State for a
fiscal year under this section shall, subject to submission
of an application, be made to any State that during that
fiscal year--
``(1) receives per diem payments under this subchapter for
that fiscal year; and
``(2) has in effect an employee incentive scholarship
program or other employee incentive program at a State home
designed to promote the hiring and retention of nursing staff
and to reduce nursing shortages at that home.
[[Page H9773]]
``(c) Use of Funds Received.--A State may use an amount
received under this section only to provide funds for a
program described in subsection (b)(2). Any program shall
meet such criteria as the Secretary may prescribe. In
prescribing such criteria, the Secretary shall take into
consideration the need for flexibility and innovation.
``(d) Limitations on Amount of Payment.--(1) A payment
under this section may not be used to provide more than 50
percent of the costs for a fiscal year of the employee
incentive scholarship or other employee incentive program for
which the payment is made.
``(2) The amount of the payment to a State under this
section for any fiscal year is, for each State home in that
State with a program described in subsection (b)(2), the
amount equal to 2 percent of the amount of payments estimated
to be made to that State, for that State home, under section
1741 of this title for that fiscal year.
``(e) Applications.--A payment under this section for any
fiscal year with respect to any State home may only be made
based upon an application submitted by the State seeking the
payment with respect to that State home. Any such application
shall describe the nursing shortage at the State home and the
employee incentive scholarship program or other employee
incentive program described in subsection (c) for which the
payment is sought.
``(f) Source of Funds.--Payments under this section shall
be made from funds available for other payments under this
subchapter.
``(g) Disbursement.--Payments under this section to a State
home shall be made as part of the disbursement of payments
under section 1741 of this title with respect to that State
home.
``(h) Use of Certain Receipts.--The Secretary shall require
as a condition of any payment under this section that, in any
case in which the State home receives a refund payment made
by an employee in breach of the terms of an agreement for
employee assistance that used funds provided under this
section, the payment shall be returned to the State home's
incentive program account and credited as a non-Federal
funding source.
``(i) Annual Report From Payment Recipients.--Any State
home receiving a payment under this section for any fiscal
year, shall, as a condition of the payment, be required to
agree to provide to the Secretary a report setting forth in
detail the use of funds received through the payment,
including a descriptive analysis of how effective the
incentive program has been on nurse staffing in the State
home during that fiscal year. The report for any fiscal year
shall be provided to the Secretary within 60 days of the
close of the fiscal year and shall be subject to audit by the
Secretary. Eligibility for a payment under this section for
any later fiscal year is contingent upon the receipt by the
Secretary of the annual report under this subsection for the
previous fiscal year in accordance with this subsection.
``(j) Regulations.--The Secretary shall prescribe
regulations to carry out this section. The regulations shall
include the establishment of criteria for the award of
payments under this section.''.
(2) The table of sections at the beginning of such chapter
is amended by inserting after section 1743 the following new
item:
``1744. Hiring and retention of nurses: payments to assist States.''.
(b) Implementation.--The Secretary of Veterans Affairs
shall implement section 1744 of title 38, United States Code,
as added by subsection (a), as expeditiously as possible. The
Secretary shall establish such interim procedures as
necessary so as to ensure that payments are made to eligible
States under that section commencing not later than June 1,
2005, notwithstanding that regulations under subsection (j)
of that section may not have become final.
SEC. 202. TREATMENT OF DEPARTMENT OF VETERANS AFFAIRS PER
DIEM PAYMENTS TO STATE HOMES FOR VETERANS.
Section 1741 is amended by adding at the end the following
new subsection:
``(e) Payments to States pursuant to this section shall not
be considered a liability of a third party, or otherwise be
used to offset or reduce any other payment made to assist
veterans.''.
SEC. 203. EXTENSION OF AUTHORITY TO PROVIDE CARE UNDER LONG-
TERM CARE PILOT PROGRAMS.
Subsection (h) of section 102 of the Veterans Millennium
Health Care and Benefits Act (38 U.S.C. 1710B note) is
amended--
(1) by inserting ``(1)'' before ``The authority of''; and
(2) by adding at the end the following new paragraph:
``(2) In the case of a veteran who is participating in a
pilot program under this section as of the end of the three-
year period applicable to that pilot program under paragraph
(1), the Secretary may continue to provide to that veteran
any of the services that could be provided under the pilot
program. The authority to provide services to any veteran
under the preceding sentence applies during the period
beginning on the date specified in paragraph (1) with respect
to that pilot program and ending on December 31, 2005.''.
SEC. 204. PROHIBITION ON COLLECTION OF COPAYMENTS FOR HOSPICE
CARE.
Section 1710B(c)(2) is amended--
(1) by striking ``or'' at the end of subparagraph (A);
(2) by redesignating subparagraph (B) as subparagraph (C);
and
(3) by inserting after subparagraph (A) the following new
subparagraph (B):
``(B) to a veteran being furnished hospice care under this
section; or''.
TITLE III--MEDICAL CARE
SEC. 301. SEXUAL TRAUMA COUNSELING PROGRAM.
(a) Permanent Authority for Program.--Section 1720D(a) is
amended--
(1) in paragraph (1), by striking ``During the period
through December 31, 2004, the'' and inserting ``The''; and
(2) in paragraph (2), by striking ``, during the period
through December 31, 2004,''.
(b) Extension to Cover Active Duty for Training.--Such
section is further amended by inserting ``or active duty for
training'' in paragraph (1) before the period at the end.
SEC. 302. CENTERS FOR RESEARCH, EDUCATION, AND CLINICAL
ACTIVITIES ON COMPLEX MULTI-TRAUMA ASSOCIATED
WITH COMBAT INJURIES.
(a) In General.--(1) Subchapter II of chapter 73 of title
38, United States Code, is amended by adding at the end the
following new section:
``Sec. 7327. Centers for research, education, and clinical
activities on complex multi-trauma associated with combat
injuries
``(a) Purpose.--The purpose of this section is to provide
for the improvement of the provision of health care services
and related rehabilitation and education services to eligible
veterans suffering from complex multi-trauma associated with
combat injuries through--
``(1) the development of improved models and systems for
the furnishing by the Department of health care,
rehabilitation, and education services to veterans;
``(2) the conduct of research to support the provision of
such services in accordance with the most current evidence on
multi-trauma injuries; and
``(3) the education and training of health care personnel
of the Department with respect to the provision of such
services.
``(b) Designation of Centers.--(1) The Secretary shall
designate an appropriate number of cooperative centers for
clinical care, consultation, research, and education
activities on combat injuries.
``(2) Each center designated under paragraph (1) shall
function as a center for--
``(A) research on the long-term effects of injuries
sustained as a result of combat in order to support the
provision of services for such injuries in accordance with
the most current evidence on complex multi-trauma;
``(B) the development of rehabilitation methodologies for
treating individuals with complex multi-trauma; and
``(C) the continuous and consistent coordination of care
from the point of referral throughout the rehabilitation
process and ongoing follow-up after return to home and
community.
``(3) The Secretary shall designate one of the centers
designated under paragraph (1) as the lead center for
activities referred to in that paragraph. As the lead center
for such activities, such center shall--
``(A) develop and provide periodic review of research
priorities, and implement protocols, to ensure that projects
contribute to the activities of the centers designated under
paragraph (1);
``(B) oversee the coordination of the professional and
technical activities of such centers to ensure the quality
and validity of the methodologies and statistical services
for research project leaders;
``(C) develop and ensure the deployment of an efficient and
cost-effective data management system for such centers;
``(D) develop and distribute educational materials and
products to enhance the evaluation and care of individuals
with combat injuries by medical care providers of the
Department who are not specialized in the assessment and care
of complex multi-trauma;
``(E) develop educational materials for individuals
suffering from combat injuries and for their families; and
``(F) serve as a resource for the clinical and research
infrastructure of such centers by disseminating clinical
outcomes and research findings to improve clinical practice.
``(4) The Secretary shall designate centers under paragraph
(1) upon the recommendation of the Under Secretary for
Health.
``(5) The Secretary may designate a center under paragraph
(1) only if the center meets the requirements of subsection
(c).
``(c) Requirements for Centers.--To be designated as a
center under this section, a facility shall--
``(1) be a regional lead center for the care of traumatic
brain injury;
``(2) be located at a tertiary care medical center and have
on-site availability of primary and subspecialty medical
services relating to complex multi-trauma;
``(3) have, or have the capacity to develop, the capability
of managing impairments associated with combat injuries;
``(4) be affiliated with a school of medicine;
``(5) have, or have experience with, participation in
clinical research trials;
``(6) provide amputation care and rehabilitation;
``(7) have pain management programs;
``(8) provide comprehensive brain injury rehabilitation;
and
``(9) provide comprehensive general rehabilitation.
``(d) Additional Resources.--The Secretary shall provide
each center designated under this section such resources as
the Secretary determines to be required by such center to
achieve adequate capability of managing individuals with
complex multi-trauma, including--
``(1) the upgrading of blind rehabilitation services by
employing or securing the services of blind rehabilitation
specialists;
``(2) employing or securing the services of occupational
therapists with blind rehabilitation training;
``(3) employing or securing the services of additional
mental health services providers; and
[[Page H9774]]
``(4) employing or securing additional rehabilitation
nursing staff to meet care needs.
``(e) Cooperation With Department of Defense.--(1) The
Secretary of Veterans Affairs may assist the Secretary of
Defense in the care of members of the Armed Forces with
complex multi-trauma at military treatment facilities by--
``(A) making available, in a manner that the Secretary of
Veterans Affairs considers appropriate, certified
rehabilitation registered nurses of the Department of
Veterans Affairs to such facilities to assess and coordinate
the care of such members; and
``(B) making available, in a manner that the Secretary of
Veterans Affairs considers appropriate, blind rehabilitation
specialists of the Department of Veterans Affairs to such
facilities to consult with the medical staff of such
facilities on the special needs of such members who have
visual impairment as a consequence of combat injury.
``(2) Assistance shall be provided under this subsection
through agreements for the sharing of health-care resources
under section 8111 of this title.
``(f) Award of Funding.--Centers designated under this
section may compete for the award of funding from amounts
appropriated for the Department for medical and prosthetics
research.
``(g) Dissemination of Information.--(1) The Under
Secretary for Health shall ensure that information produced
by the centers designated under this section that may be
useful for other activities of the Veterans Health
Administration is disseminated throughout the Administration.
``(2) Information shall be disseminated under this
subsection through publications, through programs of
continuing medical and related education provided through
regional medical education centers under subchapter VI of
chapter 74 of this title, and through other means.
``(h) National Oversight.--The Under Secretary for Health
shall designate an appropriate officer to oversee the
operation of the centers designated under this section and
provide for periodic evaluation of the centers.
``(i) Authorization of Appropriations.--(1) There are
authorized to be appropriated to the Department of Veterans
Affairs for the centers designated under this section amounts
as follows:
``(A) $7,000,000 for fiscal year 2005.
``(B) $8,000,000 for each of fiscal years 2006 through
2008.
``(2) In addition to amounts authorized to be appropriated
by paragraph (1) for a fiscal year, the Under Secretary for
Health may allocate to each center designated under this
section, from other funds authorized to be appropriated for
such fiscal year for the Department generally for medical and
for medical and prosthetic research, such amounts as the
Under Secretary for Health determines appropriate to carry
out the purposes of this section.''.
(2) The table of sections at the beginning of chapter 73 is
amended by inserting after the item relating to section 7326
the following new item:
``7327. Centers for research, education, and clinical activities on
complex multi-trauma associated with combat injuries.''.
(b) Designation of Centers.--The Secretary of Veterans
Affairs shall designate the centers for research, education,
and clinical activities on complex multi-trauma associated
with combat injuries required by section 7327 of title 38,
United States Code (as added by subsection (a)), not later
than 120 days after the date of the enactment of this Act.
(c) Annual Reports.--(1) Not later than eighteen months
after the date of the designation of centers for research,
education, and clinical activities on complex multi-trauma
associated with combat injuries required by section 7327 of
title 38, United States Code (as so added), and annually
thereafter through 2008, the Secretary shall submit to the
Committees on Veterans' Affairs of the Senate and House of
Representatives a report on the status and activities of such
centers during the one-year period beginning on the date of
such designation, for the first such report, and for
successive one-year periods, for subsequent reports.
(2) Each such report shall include, for the period covered
by such report, the following:
(A) A description of the activities carried out at each
center, and the funding provided for such activities.
(B) A description of any advances made in the participating
programs of each center in research, education, training, and
clinical activities on complex multi-trauma associated with
combat injuries.
(C) A description of the actions taken by the Under
Secretary for Health pursuant to subsection (g) of that
section (as so added) to disseminate throughout the Veterans
Health Administration information derived from such
activities.
SEC. 303. ENHANCEMENT OF MEDICAL PREPAREDNESS OF DEPARTMENT
OF VETERANS AFFAIRS.
(a) Peer Review Panel.--In order to assist the Secretary of
Veterans Affairs in selecting facilities of the Department of
Veterans Affairs to serve as sites for centers under section
7328 of title 38, United States Code, as added by subsection
(c), the Secretary shall establish a peer review panel to
assess the scientific and clinical merit of proposals that
are submitted to the Secretary for the selection of such
facilities. The panel shall be established not later than 90
days after the date of the enactment of this Act and shall
include experts in the fields of toxicological research,
infectious diseases, radiology, clinical care of veterans
exposed to such hazards, and other persons as determined
appropriate by the Secretary. Members of the panel shall
serve as consultants to the Department of Veterans Affairs.
Amounts available to the Secretary for Medical Care may be
used for purposes of carrying out this subsection. The panel
shall not be subject to the Federal Advisory Committee Act (5
U.S.C. App.).
(b) Proposals.--The Secretary shall solicit proposals for
designation of facilities as described in subsection (a). The
announcement of the solicitation of such proposals shall be
issued not later than 60 days after the date of the enactment
of this Act, and the deadline for the submission of proposals
in response to such solicitation shall be not later than 90
days after the date of such announcement. The peer review
panel established under subsection (a) shall complete its
review of the proposals and submit its recommendations to the
Secretary not later than 60 days after the date of the
deadline for the submission of proposals. The Secretary shall
then select the four sites for the location of such centers
not later than 45 days after the date on which the peer
review panel submits its recommendations to the Secretary.
(c) Revised Section.--(1) Subchapter II of chapter 73 is
amended by inserting after section 7327, as added by section
302(a)(1) of this Act, a new section with--
(A) a heading as follows:
``Sec. 7328. Medical preparedness centers''; and
(B) a text consisting of the text of subsections (a)
through (h) of section 7325 of title 38, United States Code,
and a subsection (i) at the end as follows:
``(i) Funding.--(1) There are authorized to be appropriated
for the centers under this section $10,000,000 for each of
fiscal years 2005 through 2007.
``(2) In addition to any amounts appropriated for a fiscal
year specifically for the activities of the centers pursuant
to paragraph (1), the Under Secretary for Health shall
allocate to the centers from other funds appropriated for
that fiscal year generally for the Department medical care
account and the Department medical and prosthetic research
account such amounts as the Under Secretary determines
necessary in order to carry out the purposes of this
section.''.
(2) The table of sections at the beginning of chapter 73 is
amended by inserting after the item relating to section 7327,
as added by section 302(a)(2) of this Act, the following new
item:
``7328. Medical preparedness centers.''.
TITLE IV--MEDICAL FACILITIES MANAGEMENT AND ADMINISTRATION
Subtitle A--Major Medical Facility Leases
SEC. 401. MAJOR MEDICAL FACILITY LEASES.
The Secretary of Veterans Affairs may enter into contracts
for major medical facility leases at the following locations,
in an amount for each facility lease not to exceed the amount
shown for that location:
(1) Wilmington, North Carolina, Outpatient Clinic,
$1,320,000.
(2) Greenville, North Carolina, Outpatient Clinic,
$1,220,000.
(3) Norfolk, Virginia, Outpatient Clinic, $1,250,000.
(4) Summerfield, Florida, Marion County Outpatient Clinic,
$1,230,000.
(5) Knoxville, Tennessee, Outpatient Clinic, $850,000.
(6) Toledo, Ohio, Outpatient Clinic, $1,200,000.
(7) Crown Point, Indiana, Outpatient Clinic, $850,000.
(8) Fort Worth, Texas, Tarrant County Outpatient Clinic,
$3,900,000.
(9) Plano, Texas, Collin County Outpatient Clinic,
$3,300,000.
(10) San Antonio, Texas, Northeast Central Bexar County
Outpatient Clinic, $1,400,000.
(11) Corpus Christi, Texas, Outpatient Clinic, $1,200,000.
(12) Harlingen, Texas, Outpatient Clinic, $650,000.
(13) Denver, Colorado, Health Administration Center,
$1,950,000.
(14) Oakland, California, Outpatient Clinic, $1,700,000.
(15) San Diego, California, North County Outpatient Clinic,
$1,300,000.
(16) San Diego, California, South County Outpatient Clinic,
$1,100,000.
SEC. 402. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to the Secretary of
Veterans Affairs for fiscal year 2005 for the Medical Care
account, $24,420,000 for the leases authorized in section
401.
SEC. 403. AUTHORITY FOR LONG-TERM LEASE OF CERTAIN LANDS OF
UNIVERSITY OF COLORADO.
Notwithstanding section 8103 of title 38, United States
Code, the Secretary of Veterans Affairs may enter into a
lease for real property located at the Fitzsimmons Campus of
the University of Colorado for purposes of a medical facility
(as that term is defined in section 8101 of title 38, United
States Code) for a period of up to 75 years.
Subtitle B--Facilities Management
SEC. 411. DEPARTMENT OF VETERANS AFFAIRS CAPITAL ASSET FUND.
(a) Establishment of Fund.--(1) Subchapter I of chapter 81
is amended by adding at the end the following new section:
``Sec. 8118. Authority for transfer of real property;
Department of Veterans Affairs Capital Asset Fund
``(a)(1) The Secretary may transfer real property under the
jurisdiction or control of the Secretary (including
structures and equipment associated therewith) to another
department or agency of the United States, to a State (or a
political subdivision of a State), or to any public or
private entity, including an Indian tribe. Such a transfer
may be made only if the Secretary receives compensation of
not less than the fair market value of the property, except
that no compensation is required, or compensation at less
than fair market value may be accepted, in the case of a
transfer to a grant and
[[Page H9775]]
per diem provider (as defined in section 2002 of this title).
When a transfer is made to a grant and per diem provider for
less than fair market value, the Secretary shall require in
the terms of the conveyance that if the property transferred
is used for any purpose other than a purpose under chapter 20
of this title, all right, title, and interest to the property
shall revert to the United States.
``(2) The Secretary may exercise the authority provided by
this section notwithstanding sections 521, 522, and 541
through 545 of title 40. Any such transfer shall be in
accordance with this section and section 8122 of this title.
``(3) The authority provided by this section may not be
used in a case to which section 8164 of this title applies.
``(4) The Secretary may enter into partnerships or
agreements with public or private entities dedicated to
historic preservation to facilitate the transfer, leasing, or
adaptive use of structures or properties specified in
subsection (b)(3)(D).
``(5) The authority of the Secretary under paragraph (1)
expires on the date that is seven years after the date of the
enactment of this section.
``(b)(1) There is established in the Treasury of the United
States a revolving fund to be known as the Department of
Veterans Affairs Capital Asset Fund (hereinafter in this
section referred to as the `Fund'). Amounts in the Fund shall
remain available until expended.
``(2) Proceeds from the transfer of real property under
this section shall be deposited into the Fund.
``(3) To the extent provided in advance in appropriations
Acts, amounts in the Fund may be expended for the following
purposes:
``(A) Costs associated with the transfer of real property
under this section, including costs of demolition,
environmental remediation, maintenance and repair,
improvements to facilitate the transfer, and administrative
expenses.
``(B) Costs, including costs specified in subparagraph (A),
associated with future transfers of property under this
section.
``(C) Costs associated with enhancing medical care services
to veterans by improving, renovating, replacing, updating, or
establishing patient care facilities through construction
projects to be carried out for an amount less than the amount
specified in 8104(a)(3)(A) for a major medical facility
project.
``(D) Costs, including costs specified in subparagraph (A),
associated with the transfer, lease, or adaptive use of a
structure or other property under the jurisdiction of the
Secretary that is listed on the National Register of Historic
Places.
``(c) The Secretary shall include in the budget
justification materials submitted to Congress for any fiscal
year in support of the President's budget for that fiscal
year for the Department specification of the following:
``(1) The real property transfers to be undertaken in
accordance with this section during that fiscal year.
``(2) All transfers completed under this section during the
preceding fiscal year and completed and scheduled to be
completed during the fiscal year during which the budget is
submitted.
``(3) The deposits into, and expenditures from, the Fund
that are incurred or projected for each of the preceding
fiscal year, the current fiscal year, and the fiscal year
covered by the budget.''.
(2) The table of sections at the beginning of such chapter
is amended by inserting after the item relating to section
8117 the following new item:
``8118. Authority for transfer of real property; Department of Veterans
Affairs Capital Asset Fund.''.
(b) Initial Authorization of Appropriations.--There is
authorized to be appropriated to the Department of Veterans
Affairs Capital Asset Fund established under section 8118 of
title 38, United States Code (as added by subsection (a)),
the amount of $10,000,000.
(c) Termination of Nursing Home Revolving Fund.--(1)
Section 8116 is repealed.
(2) The table of sections at the beginning of chapter 81 is
amended by striking the item relating to section 8116.
(d) Transfer of Unobligated Balances to Capital Asset
Fund.--Any unobligated balances in the nursing home revolving
fund under section 8116 of title 38, United States Code, as
of the date of the enactment of this Act shall be deposited
in the Department of Veterans Affairs Capital Asset Fund
established under section 8118 of title 38, United States
Code (as added by subsection (a)).
(e) Procedures Applicable to Transfers.--(1) Paragraph (2)
of section 8122(a) is amended to read as follows:
``(2) Except as provided in paragraph (3), the Secretary
may not during any fiscal year transfer to any other
department or agency of the United States or to any other
entity real property that is owned by the United States and
administered by the Secretary unless the proposed transfer is
described in the budget submitted to Congress pursuant to
section 1105 of title 31 for that fiscal year.''.
(2) Section 8122(d) is amended--
(A) by inserting ``(1)'' before ``Real property''; and
(B) by adding at the end the following new paragraph:
``(2) The Secretary may transfer real property under this
section, or under section 8118 of this title, if the
Secretary--
``(A) places a notice in the real estate section of local
newspapers and in the Federal Register of the Secretary's
intent to transfer that real property (including land,
structures, and equipment associated with the property);
``(B) holds a public hearing;
``(C) provides notice to the Administrator of General
Services of the Secretary's intention to transfer that real
property and waits for 30 days to elapse after providing that
notice; and
``(D) after such 30-day period has elapsed, notifies the
congressional veterans' affairs committees of the Secretary's
intention to dispose of the property and waits for 60 days to
elapse from the date of that notice.''.
(3) Section 8164(a) is amended by inserting ``8118 or''
after ``rather than under section''.
(4) Section 8165(a)(2) is amended by striking ``nursing
home revolving fund'' and inserting ``Department of Veterans
Affairs Capital Asset Fund established under section 8118 of
this title''.
(f) Contingent Effectiveness.--Subsection (d) and the
amendments made by subsection (c) shall take effect at the
end of the 30-day period beginning on the date on which the
Secretary of Veterans Affairs certifies to Congress that the
Secretary is in compliance with subsection (b) of section
1710B of title 38, United States Code.
(g) Annual Update.--Following a certification under
subsection (f), the Secretary shall submit to Congress an
annual update on that certification.
SEC. 412. ANNUAL REPORT TO CONGRESS ON INVENTORY OF
DEPARTMENT OF VETERANS AFFAIRS HISTORIC
PROPERTIES.
(a) In General.--Not later than December 15 of 2005, 2006,
and 2007, the Secretary of Veterans Affairs shall submit to
the Committees on Veterans' Affairs of the Senate and House
of Representatives a report on the historic properties
administered or controlled by the Secretary.
(b) Initial Report.--In the initial report under subsection
(a), the Secretary shall set forth a complete inventory of
the historic structures and property under the jurisdiction
of the Secretary. The report shall include a description and
classification of each such property based upon historical
nature, current physical condition, and potential for
transfer, leasing, or adaptive use.
(c) Subsequent Reports.--In reports under subsection (a)
after the initial report, the Secretary shall provide an
update of the status of each property identified in the
initial report, with the proposed and actual disposition, if
any, of each property. Each such report shall include any
recommendation of the Secretary for legislation to enhance
the transfer, leasing, or adaptive use of such properties.
SEC. 413. AUTHORITY TO ACQUIRE AND TRANSFER REAL PROPERTY FOR
USE FOR HOMELESS VETERANS.
(a) Authority.--Upon identification of a parcel of real
property meeting the description in subsection (b), the
Secretary of Veterans Affairs may acquire that property (with
the structures and improvements thereon) or, in the case of
property owned by the United States and administered by
another Federal department or agency, may accept
administrative jurisdiction over that property, with the
expectation of promptly transferring that property to a
homeless assistance provider identified under paragraph (2)
of subsection (b), subject to the condition that the primary
purpose for which the property shall be used is to provide
housing for homeless veterans.
(b) Specified Property.--A parcel of real property referred
to in subsection (a) is a parcel in the District of
Columbia--
(1) that the Secretary determines to be suitable for use
for housing for homeless veterans; and
(2) for which there is an identified homeless assistance
provider that is prepared to acquire the property for such
purpose from the Secretary promptly upon the acquisition of
the property by the Secretary.
(c) Transfer of Property.--Upon acquiring real property
under subsection (a), the Secretary shall immediately
transfer all right, title, and interest of the United States
(other than the reversionary interest retained under
subsection (e)) to the homeless assistance provider
identified under subsection (b)(2). Such transfer shall be
for such consideration as the Secretary determines
appropriate.
(d) Terms and Conditions.--The acquisition and transfer of
real property under this section shall be made upon such
terms and conditions as the Secretary may specify not
inconsistent with other applicable provisions of law.
(e) Reverter.--The terms of the transfer shall provide that
if the property is no longer used for the purpose for which
conveyed by the Secretary, title to the property shall revert
to the United States.
SEC. 414. LIMITATION ON IMPLEMENTATION OF MISSION CHANGES FOR
SPECIFIED VETERANS HEALTH ADMINISTRATION
FACILITIES.
(a) Limitation.--The Secretary of Veterans Affairs may not
implement a mission change for a medical facility of the
Department of Veterans Affairs specified in subsection (c)
until--
(1) the Secretary submits to the Committees on Veterans'
Affairs of the Senate and House of Representatives a written
notice of the mission change; and
(2) the period prescribed by subsection (b) has elapsed.
(b) Congressional Review Period.--(1) The period referred
to in subsection (a)(2) is the period beginning on the date
of the receipt of the notice under subsection (a)(1) by the
committees specified in that subsection and ending on the
later of--
(A) the end of the 60-day period beginning on the date on
which the notice is received by those committees; or
(B) the end of a period of 30 days of continuous session of
Congress beginning on the date on which the notification is
received by those committees or, if either House of Congress
is not in session on such date, the first day after such date
that both Houses of Congress are in session.
(2) For the purposes of paragraph (1)(B)--
[[Page H9776]]
(A) the continuity of a session of Congress is broken only
by an adjournment of Congress sine die; and
(B) any day on which either House is not in session because
of an adjournment of more than three days to a day certain is
excluded in the computation of any period of time in which
Congress is in continuous session.
(c) Specified Facilities.--A facility referred to in
subsection (a) as being specified in this subsection is any
of the following facilities of the Department of Veterans
Affairs:
(1) The Department of Veterans Affairs medical centers in
Boston, Massachusetts.
(2) The Department of Veterans Affairs medical centers in
New York City, New York.
(3) The Department of Veterans Affairs medical center in
Big Spring, Texas.
(4) The Carl Vinson Department of Veterans Affairs Medical
Center, Dublin, Georgia.
(5) The Department of Veterans Affairs medical center in
Montgomery, Alabama.
(6) The Department of Veterans Affairs medical center in
Louisville, Kentucky.
(7) The Department of Veterans Affairs medical center in
Muskogee Oklahoma, and the outpatient clinic in Tulsa,
Oklahoma.
(8) The John J. Pershing Department of Veterans Affairs
Medical Center, Poplar Bluff, Missouri.
(9) The Department of Veterans Affairs medical center in
Ft. Wayne, Indiana.
(10) The Department of Veterans Affairs Medical Center in
Waco, Texas.
(11) The Jonathan M. Wainwright Department of Veterans
Affairs Medical Center, Walla Walla, Washington.
(d) Covered Mission Changes.--For purposes of this section,
a mission change for a medical facility shall consist of any
of the following:
(1) Closure of the facility.
(2) Consolidation of the facility.
(3) An administrative reorganization of the facility
covered by section 510(b) of title 38, United States Code.
(e) Required Content of Notice of Mission Change.--Written
notice of a mission change for a medical facility under
subsection (a) shall include the following:
(1) An assessment of the effect of the mission change on
the population of veterans served by the facility.
(2) A description of the availability and quality of health
care, including long-term care, mental health care, and
substance abuse programs, available in the area served by the
facility.
(3) An assessment of the effect of the mission change on
the economy of the community in which the facility is
located.
(4) An analysis of any alternatives to the mission change
proposed by--
(A) the community in which the facility is located;
(B) organizations recognized by the Secretary under section
5902 of title 38, United States Code;
(C) organizations that represent Department employees in
such community; or
(D) the Department.
(f) Medical Facility Consolidation.--For the purposes of
subsection (d)(2), the term ``consolidation'' means an action
that closes one or more medical facilities within a
geographic service area for the purpose of relocating those
activities to another medical facility or facilities.
(g) Coordination of Provisions.--In the case of a mission
change covered by subsection (a) that is also an
administrative reorganization covered by section 510(b) of
title 38, United States Code, both this section and such
section 510(b) shall apply with respect to the implementation
of that mission change.
SEC. 415. AUTHORITY TO USE PROJECT FUNDS TO CONSTRUCT OR
RELOCATE SURFACE PARKING INCIDENTAL TO A
CONSTRUCTION OR NONRECURRING MAINTENANCE
PROJECT.
Section 8109 is amended by adding at the end the following
new subsection:
``(j) Funds in a construction account or capital account
that are available for a construction project or a
nonrecurring maintenance project may be used for the
construction or relocation of a surface parking lot
incidental to that project.''.
SEC. 416. INAPPLICABILITY OF LIMITATION ON USE OF ADVANCE
PLANNING FUNDS TO AUTHORIZED MAJOR MEDICAL
FACILITY PROJECTS.
Section 8104 is amended by adding at the end the following
new subsection:
``(g) The limitation in subsection (f) does not apply to a
project for which funds have been authorized by law in
accordance with subsection (a)(2).''.
SEC. 417. IMPROVEMENTS TO ENHANCED-USE LEASE AUTHORITY.
Section 8166(a) is amended by inserting ``land use,'' in
the second sentence after ``relating to''.
SEC. 418. FIRST OPTION FOR COMMONWEALTH OF KENTUCKY ON
DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER,
LOUISVILLE, KENTUCKY.
(a) Requirement.--Upon determining to convey, lease, or
otherwise dispose of the Department of Veterans Affairs
Medical Center, Louisville, Kentucky, or any portion thereof,
the Secretary of Veterans Affairs shall engage in
negotiations for the conveyance, lease, or other disposal of
the Medical Center or portion thereof solely with the
Commonwealth of Kentucky.
(b) Duration of Requirement.--The requirement for
negotiations under subsection (a) shall remain in effect for
one year after the date of the determination referred to in
that subsection.
(c) Scope of Negotiations.--The negotiations under
subsection (a) shall address the use of the medical center
referred to in subsection (a), or portion thereof, by the
Commonwealth of Kentucky for the primary purpose of the
provision of services for veterans and related activities,
including use for a State veterans' home.
SEC. 419. TRANSFER OF JURISDICTION, GENERAL SERVICES
ADMINISTRATION PROPERTY, BOISE, IDAHO.
(a) Transfer.--The Administrator of General Services shall
transfer to the Secretary of Veterans Affairs, under such
terms and conditions as the Administrator and the Secretary
agree, jurisdiction, custody, and control over the parcel of
real property, including any improvements thereon, consisting
of approximately 2.3 acres located at the General Services
Administration facility immediately north of the Army Reserve
facility in Boise, Idaho.
(b) Utilization.--The Secretary of Veterans Affairs shall
utilize the property transferred under subsection (a) for
purposes relating to the delivery of benefits to veterans.
Subtitle C--Designation of Facilities
SEC. 421. THOMAS E. CREEK DEPARTMENT OF VETERANS AFFAIRS
MEDICAL CENTER.
(a) In General.--The Department of Veterans Affairs medical
center in Amarillo, Texas, shall after the date of the
enactment of this Act be known and designated as the ``Thomas
E. Creek Department of Veterans Affairs Medical Center''.
(b) References.--Any reference in any law, regulation, map,
document, record, or other paper of the United States to the
medical center referred to in subsection (a) shall be
considered to be a reference to the Thomas E. Creek
Department of Veterans Affairs Medical Center.
SEC. 422. JAMES J. PETERS DEPARTMENT OF VETERANS AFFAIRS
MEDICAL CENTER.
(a) In General.--The Department of Veterans Affairs medical
center in the Bronx, New York, shall after the date of the
enactment of this Act be known and designated as the ``James
J. Peters Department of Veterans Affairs Medical Center''.
(b) References.--Any reference in any law, regulation, map,
document, record, or other paper of the United States to the
medical center referred to in subsection (a) shall be
considered to be a reference to the James J. Peters
Department of Veterans Affairs Medical Center.
SEC. 423. BOB MICHEL DEPARTMENT OF VETERANS AFFAIRS
OUTPATIENT CLINIC.
(a) In General.--The Department of Veterans Affairs
outpatient clinic located in Peoria, Illinois, shall after
the date of the enactment of this Act be known and designated
as the ``Bob Michel Department of Veterans Affairs Outpatient
Clinic''.
(b) References.--Any reference in any law, regulation, map,
document, record, or other paper of the United States to the
outpatient clinic referred to in subsection (a) shall be
considered to be a reference to the Bob Michel Department of
Veterans Affairs Outpatient Clinic.
SEC. 424. CHARLES WILSON DEPARTMENT OF VETERANS AFFAIRS
OUTPATIENT CLINIC.
(a) In General.--The Department of Veterans Affairs
outpatient clinic located in Lufkin, Texas, shall after the
date of the enactment of this Act be known and designated as
the ``Charles Wilson Department of Veterans Affairs
Outpatient Clinic''.
(b) References.--Any reference in any law, regulation, map,
document, record, or other paper of the United States to the
outpatient clinic referred to in subsection (a) shall be
considered to be a reference to the Charles Wilson Department
of Veterans Affairs Outpatient Clinic.
SEC. 425. THOMAS P. NOONAN, JR. DEPARTMENT OF VETERANS
AFFAIRS OUTPATIENT CLINIC.
(a) In General.--The Department of Veterans Affairs
outpatient clinic in Sunnyside, Queens, New York, shall after
the date of the enactment of this Act be known and designated
as the ``Thomas P. Noonan, Jr. Department of Veterans Affairs
Outpatient Clinic''.
(b) References.--Any reference in any law, map, regulation,
document, paper, or other record of the United States to the
outpatient clinic referred to in subsection (a) shall be
considered to be a reference to the Thomas P. Noonan, Jr.
Department of Veterans Affairs Outpatient Clinic.
TITLE V--PERSONNEL ADMINISTRATION
SEC. 501. PILOT PROGRAM TO STUDY INNOVATIVE RECRUITMENT TOOLS
TO ADDRESS NURSING SHORTAGES AT DEPARTMENT OF
VETERANS AFFAIRS HEALTH CARE FACILITIES.
(a) Pilot Program.--(1) Not later than 90 days after the
date of the enactment of this Act, the Secretary of Veterans
Affairs shall designate a health care service region, or a
section within such a region, in which health care facilities
of the Department of Veterans Affairs are adversely affected
by a shortage of qualified nurses.
(2) The Secretary shall conduct a pilot program in the
region or section designated under paragraph (1) to determine
the effectiveness of the use of innovative human capital
tools and techniques in the recruitment of qualified nurses
for positions at Department health care facilities in such
region or section and for the retention of nurses at such
facilities. In carrying out the pilot program, the Secretary
shall enter into a contract with a private sector entity for
services under the pilot program for recruitment of qualified
nurses.
(b) Private Sector Recruitment Practices.--For purposes of
the pilot program under this section, the Secretary shall
identify and use recruitment practices that have proven
effective for placing qualified individuals in positions that
are difficult to fill due to shortages of qualified
individuals or other factors. Recruitment practices to be
reviewed by the Secretary for use in the pilot program shall
include--
(1) employer branding and interactive advertising
strategies;
(2) Internet technologies and automated staffing systems;
and
[[Page H9777]]
(3) the use of recruitment, advertising, and communication
agencies.
(c) Streamlined Hiring Process.--In carrying out the pilot
program under this section, the Secretary shall, at health
care facilities of the Department in the region or section in
which the pilot program is conducted, revise procedures and
systems for selecting and hiring qualified nurses to reduce
the length of the hiring process. If the Secretary identifies
measures to streamline and automate the hiring process that
can only be implemented if authorized by law, the Secretary
shall submit to the Committees on Veterans' Affairs of the
Senate and House of Representatives recommendations for such
changes in law as may be necessary to enable such measures to
be implemented.
(d) Report.--Not later than one year after the date of the
enactment of this Act, the Secretary shall submit to the
Committees on Veterans' Affairs of the Senate and House of
Representatives a report on the extent to which the pilot
program achieved the goal of improving the recruitment and
retention of nurses in Department of Veterans Affairs health
care facilities.
SEC. 502. TECHNICAL CORRECTION TO LISTING OF CERTAIN HYBRID
POSITIONS IN VETERANS HEALTH ADMINISTRATION.
Section 7401(3) is amended--
(1) by striking ``and dental technologists'' and inserting
``technologists, dental hygienists, dental assistants''; and
(2) by striking ``technicians, therapeutic radiologic
technicians, and social workers'' and inserting
``technologists, therapeutic radiologic technologists, social
workers, blind rehabilitation specialists, and blind
rehabilitation outpatient specialists''.
SEC. 503. UNDER SECRETARY FOR HEALTH.
Section 305(a)(2) is amended--
(1) in the matter preceding subparagraph (A), by striking
``shall be a doctor of medicine and''; and
(2) in subparagraph (A), by striking ``and in health-care''
and inserting ``or in health-care''.
TITLE VI--OTHER MATTERS
SEC. 601. EXTENSION AND CODIFICATION OF AUTHORITY FOR
RECOVERY AUDITS.
Section 1703 is amended by adding at the end the following
new subsection:
``(d)(1) The Secretary shall conduct a program of recovery
audits for fee basis contracts and other medical services
contracts for the care of veterans under this section, and
for beneficiaries under sections 1781, 1782, and 1783 of this
title, with respect to overpayments resulting from processing
or billing errors or fraudulent charges in payments for non-
Department care and services. The program shall be conducted
by contract.
``(2) Amounts collected, by setoff or otherwise, as the
result of an audit under the program conducted under this
subsection shall be available for the purposes for which
funds are currently available to the Secretary for medical
care and for payment to a contractor of a percentage of the
amount collected as a result of an audit carried out by the
contractor.
``(3) The Secretary shall allocate all amounts collected
under this subsection with respect to a designated geographic
service area of the Veterans Health Administration, net of
payments to the contractor, to that region.
``(4) The authority of the Secretary under this subsection
terminates on September 30, 2008.''.
SEC. 602. INVENTORY OF MEDICAL WASTE MANAGEMENT ACTIVITIES AT
DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE
FACILITIES.
(a) Inventory.--The Secretary of Veterans Affairs shall
establish and maintain a national inventory of medical waste
management activities in the health care facilities of the
Department of Veterans Affairs. The inventory shall include
the following:
(1) A statement of the current national policy of the
Department on managing and disposing of medical waste,
including regulated medical waste in all its forms.
(2) A description of the program of each geographic service
area of the Department to manage and dispose of medical
waste, including general medical waste and regulated medical
waste, with a description of the primary methods used in
those programs and the associated costs of those programs,
with cost information shown separately for in-house costs
(including full-time equivalent employees) and contract
costs.
(b) Report.--Not later than June 30, 2005, the Secretary of
Veterans Affairs shall submit to the Committees on Veterans'
Affairs of the Senate and House of Representatives a report
on medical waste management activities in the facilities of
the Department of Veterans Affairs. The report shall include
the following:
(1) The inventory established under subsection (a),
including all the matters specified in that subsection.
(2) A listing of each violation of medical waste management
and disposal regulations reported at any health care facility
of the Department over the preceding five years by any
Federal or State agency, along with an explanation of any
remedial or other action taken by the Secretary in response
to each such reported violation.
(3) A description of any plans to modernize, consolidate,
or otherwise improve the management of medical waste and
disposal programs at health care facilities of the
Department, including the projected costs associated with
such plans and any barriers to achieving goals associated
with such plans.
(4) An assessment or evaluation of the available methods of
disposing of medical waste and identification of which of
those methods are more desirable from an environmental
perspective in that they would be least likely to result in
contamination of air or water or otherwise cause future
cleanup problems.
SEC. 603. INCLUSION OF ALL ENROLLED VETERANS AMONG PERSONS
ELIGIBLE TO USE CANTEENS OPERATED BY VETERANS'
CANTEEN SERVICE.
The text of section 7803 is amended to read as follows:
``(a) Primary Beneficiaries.--Canteens operated by the
Service shall be primarily for the use and benefit of--
``(1) veterans hospitalized or domiciled at the facilities
at which canteen services are provided; and
``(2) other veterans who are enrolled under section 1705 of
this title.
``(b) Other Authorized Users.--Service at such canteens may
also be furnished to--
``(1) personnel of the Department and recognized veterans'
organizations who are employed at a facility at which canteen
services are provided and to other persons so employed;
``(2) the families of persons referred to in paragraph (1)
who reside at the facility; and
``(3) relatives and other persons while visiting a person
specified in this section.''.
SEC. 604. ANNUAL REPORTS ON WAITING TIMES FOR APPOINTMENTS
FOR SPECIALTY CARE.
(a) Annual Reports.--Not later than January 31 each year
through 2007, the Secretary of Veterans Affairs shall submit
to the Committees on Veterans' Affairs of the Senate and the
House of Representatives a report on waiting times for
appointments for specialty health care from the Department of
Veterans Affairs under chapter 17 of title 38, United States
Code, during the preceding year.
(b) Report Elements.--Each report under subsection (a)
shall specify, for the year covered by the report, the
following:
(1) A tabulation of the number of veterans whose
appointment for specialty health care furnished by the
Department was more than three months after the date of the
scheduling of such appointment, and the waiting times of such
veterans for such appointments, for each category of
specialty care furnished by the Department, broken out by
Veterans Integrated Service Network.
(2) An identification of the categories of specialty care
furnished by the Department for which there were delays of
more than three months between the scheduling date of
appointments and appointments in each Veterans Integrated
Service Network.
(3) A discussion of the reasons for the delays identified
under paragraph (2) for each category of care for each
Veterans Integrated Service Network so identified, including
lack of personnel, financial resources, or other resources.
(c) Certification on Report Information.--The Comptroller
General of the United States shall certify to the committees
of Congress referred to in subsection (a) whether or not each
report under this section is accurate.
SEC. 605. TECHNICAL CLARIFICATION.
Section 8111(d)(2) is amended by inserting before the
period at the end of the last sentence the following: ``and
shall be available for any purpose authorized by this
section''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New
Jersey (Mr. Smith) and the gentleman from Texas (Mr. Rodriguez) 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 rise in very strong support of H.R. 3936, the Veterans
Health Programs Improvement Act of 2004. The bill, as amended,
represents a compromise agreement between the House Committee on
Veterans' Affairs and the Senate on these matters.
Mr. Speaker, I want to thank the gentleman from Illinois (Mr. Evans),
the committee's ranking member, for his work on this. I especially want
to thank the gentleman from Connecticut (Mr. Simmons) for his admirable
leadership as chairman of the Subcommittee on Health, where most of
these measures originated. He has done a tremendous job as chairman. As
a 37-year Army veteran, he has put veterans first and has done so in a
way that is extraordinary.
Again, I want to thank him for his work and his meticulous attention
to detail. It has made the difference. This bill, regrettably, went
through a lot of difficulties and travail, and yet he persevered. And I
want to thank our chairman of that subcommittee for his leadership. It
has been extraordinary.
I also want to thank the gentleman from Texas (Mr. Rodriguez), the
ranking member of that subcommittee. Again, these bills are bipartisan.
We have worked together very closely, and it is a pleasure to bring
this before the body today.
Mr. Speaker, H.R. 3936 contains more than 33 measures that would
improve the management and the administration of veterans health care
programs. I want to highlight just a few of those provisions that are
contained in the bill.
The VA's homeless grant and per diem program is an economical,
flexible, and innovative approach to housing and supportive services
for thousands of homeless veterans. The compromise agreement would
increase the
[[Page H9778]]
fiscal year 2005 authorization level for VA's grant and per diem
program from $75 million to $99 million. The Department requested this
increase because it has received far more requests for funding from
meritorious potential grantees than it can support under existing
funding limits.
Another important provision compromise would direct the Secretary to
make payments to assist the 128 State-operated nursing homes in hiring
and retaining nursing personnel. These homes provide long-term care to
over 38,000 veterans annually in an excellent partnership with the VA,
and this provision encourages their efforts to keep highly qualified
staff caring for these veterans.
Mr. Speaker, today we are at war overseas. We know war can produce
terrible physical injuries, and we must do everything possible for
wounded servicemembers. This compromise agreement would authorize the
VA to establish, in conjunction with the Department of Defense, a
limited number of new centers for research, education, and clinical
care to improve rehabilitative services for complex traumatic injuries,
such as those being suffered by our brave soldiers and Marines in Iraq.
These centers will be a Godsend for these wounded war veterans and for
their families.
This bill provides VA authority to enter into a 75-year lease to
acquire a medical facility on the new Fitzsimons Campus of the
University of Colorado. It is anticipated this Federal-State health
sciences campus would share many high-cost specialized services and
provide expanded access for Air Force beneficiaries at the nearby
Buckley Air Force Base.
I want to recognize and thank the gentleman from Colorado (Mr.
Beauprez) for his leadership on this important provision and the
chairman of the Committee on Standards of Official Conduct, who has
also done yeoman's work on this as well.
Mr. Speaker, our compromise agreement would improve the process for
disposing of unneeded VA properties and authorize the proceeds from
property transfers to be deposited into a new VA capital asset fund.
{time} 1445
The new fund would facilitate transfers, leases and adaptive uses of
VA properties, including historic properties. This compromise agreement
also includes authorization for naming five VA medical centers,
including one in Illinois to be named for the distinguished House
minority leader, Bob Michel. Having served with Bob and having great
respect for him, I am grateful that this provision is in here, and I
want to thank my colleagues for their support for it. It also names
facilities in Texas and New York for two heroic Marines who gave their
lives for freedom in Vietnam.
Mr. Speaker, the staff of the Committee on Veterans Affairs has
worked hard in this Congress to examine ways to provide the best
possible health care to those who have earned the honored title of
``veteran.'' I would like to recognize the staff of the Subcommittee on
Health: John Bradley, staff director; Dolores Dunn and Kathleen Greve,
professional staff members; Susan Edgerton, Democratic staff director;
and VA detailee Rosalind Howard. I would also like to thank our full
committee staff, Pat Ryan to my left, chief counsel and staff director;
Kingston Smith, deputy chief counsel; Jeannie McNally, legislative
coordinator; and Jim Holley, Democratic staff director.
I also thank the Senate committee staff director, Bill Tuerk, and
Bill Cahill, III, professional staff member. I also thank Kim Lipsky,
Alexandra Sardegna and Amanda Krohn of the Democratic professional
staff for their contributions. This has been a true collaborative
effort.
Again, I thank all who have participated in shaping, crafting and
making this an extremely valuable bill that will soon be on the desk of
President Bush for his signature.
Mr. Speaker, I move that the House suspend the rules and concur in
the Senate amendments to H.R. 3936.
Mr. Speaker, I rise in strong support of H.R. 3936, the Veterans
Health Programs Improvement Act of 2004.
H.R. 3936, as amended, represents a compromise agreement between the
Committees on Veterans' Affairs of the House and Senate.
Mr. Speaker, I want to thank the gentleman from Illinois, Mr. Evans,
Ranking Member of the Veterans' Affairs Committee, who has helped to
shape this particular legislation. Also, I want to thank the gentleman
from Connecticut, Mr. Simmons, for his outstanding leadership as
Chairman of the Subcommittee on Health, where most of these measures
originated. Finally, I thank the gentleman from Texas, Mr. Rodriguez,
the Ranking Member, who has worked in a bipartisan effort to help craft
this and numerous other important veterans' health bills during his
time in Congress.
Chairman Specter and Ranking Member Graham of the Senate Veterans'
Affairs Committee also contributed to the legislation before the House
today.
Mr. Speaker, VA's homeless grant and per diem program provides
competitive grants to community and faith-based organizations that
offer transitional housing or comprehensive service centers for
homeless veterans. This program is an economical, flexible and
innovative approach to housing and supportive services for homeless
veterans in all 50 States and in the District. Over 6,000 beds are now
available nationally to veterans through this vital community network.
In 2003, 66 percent of the veterans discharged from these VA-funded
programs went on to either independent living or residential-program
housing. The compromise agreement will increase the fiscal year 2005
authorization level for this key program from $75 million to $99
million. The department requested this increase because it has received
far more requests for funding from meritorious potential grantees than
it can support under existing funding limits.
Another important provision in this compromise agreement would direct
the Secretary to make payments to assist states in hiring and retaining
nursing personnel at State-operated nursing homes for veterans. The 128
State veterans' homes collectively represent the largest institutional
provider of long-term care to elderly veterans, now caring for over
38,000 veterans annually in 47 States. I am personally aware of
staffing difficulties that the three New Jersey State veterans' homes
in Vineland, Paramus and Menlo Park have faced over the past several
years in their efforts to recruit and retain quality nursing staff to
those homes. We need this new incentives program all across the
country. It would allow State homes currently receiving per diem
payments from VA with established employee-incentive programs to apply
for assistance to retain and recruit their nurses. This provision
encourages their efforts to keep highly-qualified staff caring for
veterans.
Another provision affecting the State home programs would specify
that per diem payments made by VA to States for the care of veterans in
these homes may not be used to offset or reduce third party payments
made to assist veterans, whether from private, State or other Federal
sources.
There is well established history of partnership between the Federal
and State governments providing care for veterans. This originated with
the first Federal law in 1888, providing $100 per year in aid to States
to help alleviate the burden of caring for sick and disabled soldiers.
This partnership and the first annual payments preceded the advent of
the Veterans Administration and the State Home program as we know them
today--but Congressional intent has remained constant and clear. Since
1960, Congress has taken an active role in expanding the State home
programs to include four levels of care, increased per diem payments
and grant funding for construction of facilities. The Congress and its
Veterans' Committees are adamant that this partnership and the mutual
reliance by VA and the States should not be inadvertently affected by
the rules of any other program which is not specifically targeted at
caring for aged and infirmed veterans.
Mr. Speaker, 12 years ago, with Public Law 102-585, it was
acknowledged that women who experienced sexual trauma while on
active military duty may undergo a variety of psychological and
physical health effects requiring special counseling. This law
authorized VA to provide mental health counseling for these women
veterans. Two years later, eligibility for VA sexual trauma counseling
and treatment was broadened in Public Law 103-452 to include veterans
of either gender who experience sexual trauma while serving on active
duty. H.R. 3936 would make permanent VA's authority to provide sexual
trauma counseling to veterans.
Mr. Speaker, the shortage of nurses throughout the United States is
well documented and VA must position itself to take advantage of all
opportunities available to deal with this shortage. H.R. 3936 would
establish a pilot program to evaluate the use of proven private sector
techniques, such as employer branding, interactive advertising,
automated staffing systems and the use of outside recruitment agencies
and online technologies to improve VA's program for recruiting nursing
personnel.
Mr. Speaker, how well we know that we are at war overseas. We know
war can produce
[[Page H9779]]
terrible physical injuries. In previous wars, many soldiers did not
survive the very serious injuries of the kind being seen in Iraq and
Afghanistan today. The means were not available for quick evacuation to
sophisticated medical treatment. Today military medical treatment
capabilities have greatly improved for complex traumatic injuries.
However, Mr. Speaker, this success creates new challenges for the
caregivers who have patients with complex traumatic injuries. The
compromise agreement will authorize VA to establish in cooperation with
the Department of Defense a limited number of new centers for research,
education and clinical activities to improve rehabilitative services
for these veterans. I particularly want to thank Senator Bob Graham,
Ranking Member of the Senate Veterans' Affairs Committee, for his work
in helping us reach agreement on this provision. These centers will be
a godsend for these wounded war veterans and their families.
Mr. Speaker, the delivery of health care in this country and in the
VA system has undergone a profound transformation over the last decade.
Once a hospital based health care system, today's VA has made a
significant shift from inpatient to outpatient services, with
tremendous growth in the number of enrolled veterans. Yet, much of VA
health care bricks-and-mortar infrastructure was designed and built
decades ago--some parts of it over a century ago--in a bygone era of
health care delivery when long stays in the hospital were the norm.
In 1999, a General Accounting Office report not surprisingly found
that VA's cost of operating and maintaining its large inventory of old
buildings was a huge and avoidable drain on resources. In the years
since that GAO report, VA has undergone a major initiative referred to
as the Capital Asset Realignment for Enhanced Services (CARES)
initiative, to assess the best use of VA's capital assets for the
veteran population to be served, and to use resources more effectively
to improve health care delivery to these veterans.
While awaiting the CARES recommendations, little was done by the
Department to upgrade VA's physical plants. This legislation is
consistent with the CARES recommendations and would provide VA the
needed authority to execute leases for 16 community-based outpatient
clinics at a cost of approximately $24.4 million, in fiscal year 2005,
in the States of California, Colorado, Florida, Indiana, North
Carolina, Ohio, Tennessee, Texas and Virginia. Most of these leases
will upgrade existing clinic locations. All of these leases were
requested by the VA.
Mr. Speaker, this bill also provides VA authority to enter into a 75-
year lease to acquire a medical facility on the Fitzsimons Campus of
the University of Colorado in Aurora. It is anticipated that a new
federal-state health sciences campus would share many high cost and
specialized services, and also would provide expanded access to care
for Air Force beneficiaries from nearby Buckley Air Force Base. I want
to recognize and thank the gentleman from Colorado, Mr. Beauprez, for
his leadership in developing this good Federal health policy to serve
the people of Colorado.
Mr. Speaker, our compromise agreement would improve the process for
disposing of unneeded VA properties and authorize the proceeds from
these property transfers to be deposited into a new VA Capital Asset
Fund. The new fund would defray VA's cost of transferring property
including demolition, environmental restoration, historic preservation
and establishment of new health facilities. This bill would authorize
appropriations of $10 million in seed money to launch the fund to
support these initiatives.
Mr. Speaker, the VA has one of the largest federal inventories of
properties with significant historic value. In fact, 24 VA medical
center campuses are already listed on the National Register of Historic
Places, and even more are eligible for this designation. This
compromise agreement would allow the Secretary to enter into new
partnerships or agreements with entities dedicated to historic
preservation, and to use the funds in the Capital Asset Fund to
facilitate transfers, leases or adaptive uses of those historic
properties that are no longer useful for VA health care. Thus, this
compromise agreement would protect history and at the same time the way
to new uses of structures that have served their purposes for veterans.
Mr. Speaker, this compromise agreement includes authorization to name
VA facilities to honor two heroic Marines who gave this country the
greatest measure of their personal devotion, giving their lives in
combat to save others in Vietnam. Lance Corporals Thomas E. Creek of
Texas and Thomas P. Noonan, Jr. of New York were each posthumously
awarded the Nation's highest military decoration, the Congressional
Medal of Honor, for their selfless deeds.
The late James J. Peters of New York, a war hero in Vietnam, and a
leader of paralyzed veterans after his service, would also be honored
by our naming a VA outpatient clinic in the Bronx in his memory.
Further, Mr. Speaker, a VA facility in Illinois will be named in
honor of our distinguished former House Minority Leader, Bob Michel,
and a facility in Texas will be named in honor of the public service of
another former Member of this House, Charles Wilson.
Mr. Speaker, under current law, VA must comply with a variety of
Federal, state and local laws and regulations relating to the
collecting, handling and disposing of medical waste. Failure to adhere
to these laws and regulations could place patients, VA employees and
their communities in hazardous situations, as well as subject VA to
civil or criminal penalties. This bill would provide a means for
Congress to evaluate the effectiveness of VA's medical waste management
policies and determine whether additional procedures are needed to
reduce environmental and heath risks. The costs of waste disposal would
be assessed as well. The bill would require VA to establish and
maintain an inventory of medical waste management activities in VA
facilities and report to Congress on its inventory, regulatory
compliance, and violations of record, along with plans for management
improvements.
Mr. Speaker, the staff of the Veterans' Affairs Committee has worked
hard in this Congress to examine ways of providing the best possible
health care for those who have earned the honored title of ``veteran.''
I would like to recognize the staff of the Subcommittee on Health: John
Bradley, Staff Director, Dolores Dunn and Kathleen Greve, professional
staff members; Susan Edgerton, Democratic Staff Director, and VA
detailee Rosalind Howard. I'd also like to thank our full Committee
staff: Patrick Ryan, Chief Counsel and Staff Director; Kingston Smith,
Deputy Chief Counsel; Jeannie McNally, our Legislative Coordinator; and
Jim Holley, Democratic Staff Director.
Finally, I want to compliment the Senate Veterans' Affairs Committee
staff: Bill Tuerk, Staff Director and Chief Counsel; and Bill Cahill
III, professional staff member. I also want to recognize Kim Lipsky,
Alexandra Sardegna and Amanda Krohn, of the Democratic professional
staff, for their contributions to this bill.
For the benefit of my colleagues, I include at this point in the
record a joint explanatory statement describing the compromise
agreement we have reached with the other body.
Mr. Speaker, I ask unanimous consent to revise and extend my remarks
and that all Members may have 5 legislative days in which to revise and
extend their remarks, and include extraneous material on H.R. 3936, as
amended.
Mr. Speaker, one final word on homeless veterans: these veterans who
need services and a place to lay their heads have difficult problems.
VA's programs and the hundreds of community and faith-based programs
that serve in partnership with VA work miracles with many of them. The
continuation and expansion of these programs with the goal of
eradicating chronic homelessness in the veteran population has been one
of my top goals as Chairman of this Committee. I intend to further
address this program in the next Congress, so that those who once wore
the nation's military uniform and who are now homeless. These veterans
need a hand up to turn their lives around, and we should provide that
hand.
I urge my colleagues to support this measure to enhance health care
for veterans.
Mr. Speaker, I reserve the balance of my time.
Mr. RODRIGUEZ. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise in support of H.R. 3936, the Veterans Health
Programs Improvement Act of 2004. I want to take this opportunity to
thank the gentleman from New Jersey (Mr. Smith) for his efforts, the
ranking member, the gentleman from Illinois (Mr. Evans) also, as well
as the gentleman from Connecticut (Mr. Simmons) of the Subcommittee on
Health, and the House and Senate committee staffs for addressing some
of the concerns raised in earlier pieces of this legislation. We now
have a bill which I am pleased to lend my support to.
The bill includes provisions from a bill I introduced, H.R. 3849, the
Military Sexual Trauma Counseling Act of 2004 to permanently extend
VA's authority to provide counseling and treatment for the women and
men who have experienced sexual trauma during their service in the
military. Current authority for the program expires at the end of this
year. Therefore, it is critical that we pass this legislation today.
Overwhelming demand has been demonstrated for this program. Thousands
of veterans, in addition to Reservists and National Guardsmen, have
taken
[[Page H9780]]
advantage of the resources available to them.
As the number of women serving in the military continue to grow, the
need for the program is sadly more evident. Already we hear media
reports that more than 100 troops returning from both Iraq and
Afghanistan have stated that they were raped during their service.
Although it is unfortunate that we need this particular program, I am
pleased we are now on the road to ensuring that we will have these
services for current and future veterans.
Again, I would like to thank the gentleman from Connecticut (Mr.
Simmons) for his leadership and cooperation in including the Military
Sexual Trauma Program in this bill. I also thank the gentleman from New
Jersey (Mr. Smith) and the gentleman from Illinois (Mr. Evans), the
ranking member, for their support.
I am also supportive of the provisions to increase the funding levels
available for the homeless grant and the per diem programs from $75
million to $99 million for 2005. We still have a very long way to go in
meeting the Congress's goals to eliminating chronic homelessness by
2011, and this bill can help us get there.
This particular legislation also includes a provision that will
require the Secretary of the VA to establish and maintain an inventory
of the medical waste management activities in VA facilities, including
inventory, regulatory violations and plans for management improvements.
We believe the VA should be on the frontline of environmental
protection policies, and these provisions help to make that happen.
There are provisions also from our Senate counterparts in this bill,
including a requirement that the VA report annually through 2007 on
veterans waiting more than 3 months for scheduled appointments in
specialty care and the reasons for these delays.
This measure also requires the Secretary of the VA to establish a
pilot program to study innovative recruitment tools to address the
nursing shortage within the VA. We must be able to recruit and retain
well-qualified nurses to care for our veterans. This pilot will help
the VA Health Administration identify and adopt the best practices of
private industries in hiring of well-qualified nurses.
Now the largest provider of long-term care to our Nation's veterans,
the State veterans' home system plays a vital role in caring for the
growing number of aging veterans.
This bill will authorize VA to make payments to assist State
veterans' homes in hiring and retaining nurses, to help care for our
aging veterans, and adds a clarification that per diem payments made by
the VA to State veterans' homes are not to be used to offset or reduce
third-party payments, such as Medicaid, made to assist veterans.
There are a high number of veterans returning home that have injuries
from the war in both Iraq and Afghanistan. This measure authorizes the
establishment of four cooperative centers for research, education and
clinical activities to improve the rehabilitation services available to
veterans suffering from complex multi-trauma associated with combat
injuries. These centers build on the Veterans Health Administration's
nationally recognized care for special populations such as post-
traumatic stress disorders, spinal cord injuries, traumatic brain
injuries, as well as visual impairment, and will prove to be most
valuable in providing future combat injury rehabilitation.
While the CARES process was under way, the VA health care system has
managed within infrastructure that is in sore need of repair and
upgrade. This bill establishes a VA Capital Asset Fund that will help
strengthen our funding flow to assist the VA in developing and
improving its properties. These funds will allow the VA to improve
properties for disposal as well as future disposal and for minor
construction. These funds also will allow the VA to use funds for
improving properties.
The Secretary of Veterans Affairs will be given the flexibility in
using funds to develop advance planning for major construction projects
previously authorized and additional authority to transfer unneeded
real property and retain the proceeds from the transfer. The bill
authorizes $10 million to be appropriated to the Capital Asset Fund
where it can be used for these purposes.
Mr. Speaker, 16 major new leases are authorized in this bill,
including leases throughout this country. Because many of the VA
important historic buildings are poorly maintained or falling apart, I
am pleased that the Committee on Veterans' Affairs concluded that the
VA should use funds to preserve historic properties. It is the
committee's intent for VA to provide a series of reports to address its
large inventory of these registered assets.
This legislation will extend the VA authority to provide care to the
veterans participating in long-term care pilot programs which were
previously authorized until December, 2005.
This is a bill that we all should be very proud of.
Mr. Speaker, I reserve the balance of my time.
Mr. SMITH of New Jersey. Mr. Speaker, I yield such time as he may
consume to the gentleman from Connecticut (Mr. Simmons).
Mr. SIMMONS. Mr. Speaker, I rise to add my strong support to H.R.
3936, the Veterans Health Programs Improvement Act of 2004.
I want to acknowledge what some of my colleagues have already said. I
want to acknowledge the committee leadership for its commitment to our
veterans under the direction of our very able and very courageous
chairman, the gentleman from New Jersey (Mr. Smith). The gentleman from
New Jersey has been a remarkable leader over the last 2 years. He has
been a courageous leader. He has stood up in this body and leadership
councils for our veterans, and I look forward to his continued
leadership as our chairman in the 109th Congress.
I also recognize the work of the ranking member, the gentleman from
Illinois (Mr. Evans), who also serves with me as co-chairmen of the
U.S. Vietnam Caucus. He has made extraordinary contributions to our
veterans in this legislation and in other bills we have taken up before
this body.
Finally, I want to express very special words of gratitude to my
colleague and ranking member on the Subcommittee on Health, the
gentleman from San Antonio, Texas (Mr. Rodriguez).
Let me just share with the body two anecdotes. One, I traveled to San
Antonio to chair a field hearing with the gentleman from Texas (Mr.
Rodriguez), and we studied how the Department of Defense in that
community and how the Veterans' Administration interact to provide
health services not only for active troops but for our veterans. What
was immediately apparent to me was the warmth with which his local
constituents treated him because of his long interest in veterans, an
interest that extends back at least 8 years as a member of this body.
But then I invited the gentleman from Texas up to the lovely, warm,
pleasant weather of Connecticut, where we spent some time at Newington,
Connecticut, at a VA facility. Not only did we have a hearing at that
facility but then the gentleman from Texas (Mr. Rodriguez) went to the
State Veterans Home at Rocky Hill and spent many hours looking at that
facility to see how the VA and the Connecticut State Department of
Veteran Affairs interacted once again to provide these services. This
shows a very genuine interest on his part in veterans not only in his
own State but in Connecticut and elsewhere throughout the country.
We are going to miss that genuine interest in our veterans. I thank
the gentleman for his service to the subcommittee, to the committee and
to our Nation's veterans.
Our chairman has summarized many of the provisions of this bill. What
I would like to do is just point out a couple of features that I think
are particularly important.
First and foremost, America has a tradition of caring for her
veterans dating back to the Plymouth Colony where the Pilgrims enacted
laws to assist sick and disabled soldiers. In 1811, our young country
established the first domiciliary and medical facility for veterans
that was authorized by the national government and today the Veterans'
Administration has stewardship over the fourth largest real estate
inventory in the Federal Government, over 20,000 buildings and tens of
thousands of acres of land.
One of the provisions of this bill allows the Secretary of the
Veterans' Administration to get his arms around
[[Page H9781]]
this huge inventory through the CARES project, a master plan for
realigning the VA's inventory of capital assets in response to GAO
findings and our committee oversight that some of these facilities were
underutilized and that some dollars could be saved.
In addition, what this legislation does is provide language for the
reuse of historic properties. On the one hand, properties that can be
adopted to new uses but, secondly, properties that are truly historic
and ought to be preserved and protected, for example, the Eisenhower
Recovery Room at the Fitzsimmons Hospital in Colorado. We are engaged
in a major effort to build a state-of-the-art facility at Fitzsimmons.
It will be co-located with the State university hospital system, but
that historic room in Fitzsimmons will be preserved and protected into
the future.
Furthermore, the hiring and retraining of nursing staff in VA and
State veterans homes, this legislation provides provisions that will
address that challenge, the challenge of the almost 100,000 vacant
nursing positions and a growing need for health care workers
nationwide. It allows the VA to look outside for recruiting and
advertising these positions and using interactive and online
technologies to improve their exposure in today's recruiting market.
{time} 1500
It also allows the State veterans homes to apply for a new grant
program to serve as an incentive to attract nurses to State homes for
their employment there with a 50-50 split between the VA and the State
homes.
I have spent a long time at the Connecticut State home at Rocky Hill.
This is a successor to the first State home built in America which was
built just after the Civil War. They provide a wonderful service, but
if they could work interactively with the VA in Connecticut, they could
enhance that service, both in providing more nurses and also in
providing better services for our veterans. That is what this
legislation attempts to do.
Mr. Speaker, H.R. 3936 was carefully crafted to give the VA the
flexibility and authority it needs to manage its capital assets. At the
same time, it holds VA accountable for protecting the public interest
of the United States as stewards of the valuable inventory of
structures and lands held in trust by the VA. Finally, it provides the
VA with the resources needed to enhance nurses and other professionals
within the system so that they can better provide the services that we
need. I urge my colleagues to support this legislation.
Mr. RODRIGUEZ. Mr. Speaker, I yield 2 minutes to the gentleman from
Illinois (Mr. Evans), ranking member of the Committee on Veterans'
Affairs.
Mr. EVANS. Mr. Speaker, I rise in support of H.R. 3936, the Veterans
Health Programs Improvement Act of 2004. I want to thank the gentleman
from New Jersey (Mr. Smith) again for his leadership on these issues.
Every time we try to do something good, his name is always in the
forefront of the action. I want to thank the gentleman from Texas (Mr.
Rodriguez) who came to our committee, has done great work as the
subcommittee ranking member obviously through helping not only the
gentleman from Connecticut (Mr. Simmons) but all veterans across the
board. If we gave Medal of Honor awards to Members, he would certainly
be given one.
I want to thank everybody for developing this legislation. We have
accomplished a lot. Of particular interest to me is the establishment
of the capital asset fund to help renovate some of the VA's most
underutilized facilities. The VA needs to meet construction priorities
in order to maintain a health care system infrastructure that will be
called on increasingly as our service men and women return from Iraq
with physical and psychological disabilities.
I am also pleased that the legislation will permanently allow the VA
to provide sexual trauma counseling to those men and women who have
experienced such trauma. The VA should continue to be available to
veterans who need help picking up the pieces after these tragic events.
This measure also includes a requirement for VA to develop a pilot to
examine the effectiveness of interactive and online recruiting
techniques. This pilot program is just one step to update VA's
recruitment tools to what are now commonplace recruitment practices in
the private sector.
I support this legislation, and I urge my colleagues to do the same.
Mr. SMITH of New Jersey. Mr. Speaker, for the benefit of my
colleagues, I include at this point in the Record a joint explanatory
statement describing the compromise agreement we have reached with the
other body.
EXPLANATORY STATEMENT ON SENATE AMENDMENTS TO H.R. 3936
H.R. 3936, as amended, the Veterans Health Programs
Improvement Act of 2004, (Compromise Agreement) reflects a
negotiated agreement reached by the House and Senate
Committees on Veterans' Affairs (the Committees) concerning
provisions in a number of bills considered by the House and
the Senate during the 2nd Session of the 108th Congress. The
measures considered in this compromise are: H.R. 1318, passed
the House on September 13, 2004; H.R. 2786, as introduced in
the House on July 17, 2003, H.R. 4231, as amended, passed the
House on September 30, 2004; H.R. 4248, as amended, passed
the House on October 7, 2004; H.R. 4317, passed the House on
June 1, 2004; H.R. 4608, passed the House on July 21, 2004;
H.R. 4658, as amended, passed the House on October 7, 2004;
H.R. 4768, as amended, passed the House on September 29,
2004; H.R. 4836, passed the House on September 13, 2004
(House Bills); and S. 2485, as amended, reported by the
Senate Committee on Veterans' Affairs on September 27, 2004;
and S. 2596, as introduced in the Senate on June 24, 2004
(Senate Bills).
The House and Senate Committees on Veterans' Affairs have
prepared the following explanation of the Compromise
Agreement. Differences between the provisions of the
Compromise Agreement and the related provisions of the House
and Senate bills are noted, except for clerical corrections,
conforming changes made necessary by the Compromise
Agreement, and minor drafting, technical, and clarifying
changes.
TITLE I--ASSISTANCE TO HOMELESS VETERANS
sec. 101--authorization of appropriations
Current law
Section 2013 of title 38, United States Code, authorizes
appropriations of $60 million for fiscal year 2002, and $75
million per year for fiscal years 2003 through 2005, for a
program to make grants to providers of comprehensive services
for homeless veterans.
House bill
Section 2 of H.R. 4248 would increase the annual authorized
appropriation for this program to $99 million for fiscal year
2005.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 203 of the Compromise Agreement follows the House
language.
TITLE II--VETERANS LONG-TERM CARE PROGRAMS
sec. 201--assistance for hiring and retention of nurses at state
veterans homes
Current law
Subchapter V, chapter 17 of title 38, United States Code,
authorizes VA to make payments to States for the care of
veterans in a State veterans' home.
House bill
Section 5 of H.R. 4231 would amend subchapter V, chapter 17
of title 38, United States Code, to add a new section 1744 to
authorize the Secretary to make payments to States for the
purpose of assisting State veterans' homes in the hiring and
retention of registered nurses through the use of an approved
incentive program.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 201 of the Compromise Agreement follows the House
language.
sec. 202--treatment of department of veterans affairs per diem payments
to state homes for veterans
Current law
Section 1741 of title 38, United States Code, establishes
criteria for VA payments to States for the care of veterans
in a State veterans' home.
House bill
The House Bills contain no comparable provision.
Senate bill
Section 203 of S. 2485 would amend section 1741 of title
38, United States Code, to add a new subsection (e) to
clarify that per diem payments made by VA to States for the
care of veterans in a State veterans' home would not be used
to offset or reduce other third party payments made to assist
veterans.
Compromise agreement
Section 202 of the Compromise Agreement follows the Senate
language.
sec. 203--extension of authority to provide care under long-term care
pilot programs
Current law
Section 102 of Public Law 106-117, The Veterans Millennium
Health Care and Benefits Act, directed VA to carry out three
pilot programs over a three-year period to determine the
feasibility and practicability of different models for
providing long-term care.
[[Page H9782]]
The authority for the pilot program expires December 31, 204.
House bill
Section 107 of H.R. 4768 would extend VA's authority to
provide health care services under the long-term care pilot
programs authorized in Public Law 106-117 through December
31, 2005.
Senate bill
Section 206 of S. 2485 contains a similar provision.
Compromise agreement
Section 203 of the Compromise Agreement contains this
provision.
sec. 204--prohibition on collection of copayments for hospice care
Current law
Section 1710B(c) of title 38, United States Code, requires
certain veterans to pay a copayment for extended care
services furnished under that section.
House bill
The House Bills contain no comparable provision.
Senate bill
Section 201 of S. 2485 would exempt veterans receiving
hospice care under Section 1710B from copayment obligations.
Compromise agreement
Section 204 of the Compromise Agreement follows the Senate
language.
TITLE III--MEDICAL CARE
sec. 301--sexual trauma counseling program
Current law
Section 1720(D)(a) of title 38, United States Code,
authorizes VA to provide counseling services to veterans who
may have experienced sexual trauma while serving on active
duty through December 31, 2004.
House bill
Section 3 of H.R. 4248 would make this authority permanent.
Senate bill
Section 202 of S. 2485 would make this authority permanent
and broaden the authority to include the treatment of former
Reservists who may have experienced sexual trauma while not
serving on active duty.
Compromise agreement
Section 301 of the Compromise Agreement follows the House
language with a modification. The modification broadens the
authority to provide counseling services to individuals who
may have experienced sexual trauma while on active duty for
training.
SEC. 302--CENTERS FOR RESEARCH, EDUCATION, AND CLINICAL ACTIVITIES ON
COMPLEX MULTI-TRAUMA ASSOCIATED WITH COMBAT INJURIES
Current law
There is no comparable provision in current law.
House bill
The House Bills contain no comparable provision.
Senate bill
Section 205 of S. 2485 would establish, in collaboration
with the Department of Defense, at least one, but not more
than three, VA ``War-Related Blast Injury Centers'', and
establish procedures for the Secretary's designation of such
centers. These centers would provide comprehensive
rehabilitation programs, targeted education and outreach
programs, and research initiatives for veterans injured by
explosive blasts in combat theaters.
Compromise agreement
Section 203 of the Compromise Agreement authorizes, and
authorized the appropriations to support, the Secretary to
establish an appropriate number of centers for research,
education, and clinical activities to improve and coordinate
rehabilitative services for veterans suffering from complex
multi-trauma from combat injuries. The Compromise Agreement
consolidates a number of current VA clinical, research and
other practices for traumatic brain injuries, blind
rehabilitation and VA's concepts for combat-injury
rehabilitation. The Compromise Agreement requires this
authority be coordinated between the Departments of Veterans
Affairs and Defense under section 8111 of title 38, United
States Code.
SEC. 303--ENHANCEMENT OF MEDICAL PREPAREDNESS OF DEPARTMENT OF VETERANS
AFFAIRS
Current law
Section 7325 of title 38, United States Code, requires the
Secretary to establish four Medical Emergency Preparedness
Research Centers.
House bill
Section 202 of H.R. 4768 would amend chapter 73, of title
38, United States Code to add a new section 7327, to direct
the Secretary to take a series of actions by dates certain to
establish four Medical Emergency Preparedness Research
Centers.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 303 of the Compromise Agreement follows section
202(a) through (c) of the House language.
TITLE IV--MEDICAL FACILITIES MANAGEMENT AND ADMINISTRATION SUBTITLE A--
MAJOR MEDICAL FACILITY LEASES
SEC. 401--MAJOR MEDICAL FACILITY LEASES
Current law
Section 8104(a)(2) of title 38, United States Code,
prohibits VA from obligating or expending more than $600,000
per year for a lease unless that lease has been specifically
authorized by law.
House bill
Section 101(a) of H.R. 4768 would authorize major medical
facility leases in the following locations: (1) Wilmington,
North Carolina, Outpatient Clinic, $1,320,000; (2)
Greenville, North Carolina, Outpatient Clinic, $1,220,000;
(3) Norfolk, Virginia, Outpatient Clinic, $1,250,000; (4)
Summerfield, Florida, Marion County Outpatient, Clinic,
$1,230,000; (5) Knoxville, Tennessee, Outpatient Clinic,
$850,000; (6) Toledo, Ohio, Outpatient, Clinic, $1,200,000;
(7) Crown Point, Indiana, Outpatient Clinic, $850,000; (8)
Forth Worth, Texas, Tarrant County Outpatient Clinic,
$3,900,000; (9) Plano, Texas, Collin County Outpatient
Clinic, $3,300,000; (10) San Antonio, Texas, Northeast
Central Bexar County Outpatient Clinic, $1,400,000; (11)
Corpus Christi, Texas, Outpatient Clinic, $1,200,000; (12)
Harlingen, Texas, Outpatient Clinic, $650,000; (13) Denver,
Colorado, Health Administration Center, $1,950,000; (14)
Oakland, California, Outpatient Clinic, $1,700,000; (15) San
Diego, California, North County Outpatient Clinic,
$1,300,000; and (16) San Diego, California, South County
Outpatient Clinic, $1,100,000.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 401 of the Compromise Agreement follows the House
language.
SEC. 402--AUTHORIZATION OF APPROPRIATIONS
Current law
Section 8104(a)(2) of title 38, United States Code,
prohibits funds from being appropriated for a VA major
medical facility lease, unless that appropriation has been
specifically authorized by law.
House bill
Section 101(b) of H.R. 4768 would authorize $24,420,000 to
carry out major medical facility leases specified location in
the bill.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 402 of the Compromise Agreement follows the House
language.
SEC. 403--AUTHORITY FOR LONG-TERM LEASE OF CERTAIN LANDS OF UNIVERSITY
OF COLORADO
Current law
Section 490(h) of title 40, United States Code, limits
lease agreements between the Federal Government and any
person, co-partnership, corporation, or other public or
private entity to periods not exceeding twenty years.
House bill
Section 101(c) of H.R. 4768 would authorize VA to enter
into a long-term lease of up to 75 years for land to
construct a new VA medical facility at the Fitzsimons Campus
of the University of Colorado, Aurora, Colorado.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 403 of the Compromise Agreement follows the House
language. The authority provided in this section is
permissive and intended by the Committees to foster good-
faith negotiations between the partners to this lease
agreement. In the event that the Secretary of Veterans
Affairs determines the terms or conditions of the lease not
to be in the best interest of the United States, the
Secretary should propose an alternative strategy to Congress.
The Committees not that the Administrator of General Services
has delegated to the Secretary of Veterans Affairs the
authority to enter into lease agreements for VA major medical
facility leases.
SUBTITLE B--FACILITIES MANAGEMENT
sec. 411--department of veterans affairs capital asset fund
Current law
Section 8122 of title 38, United States Code, authorizes
the Secretary to dispose of real property administered by VA
and retain the proceeds from such a disposal, but only if the
property is considered excess to any need, there is no use
for the property in providing services to homeless veterans,
and the property is valued at less than $50,000. In cases
where a property carries value in excess of $50,000, any
disposal must be proposed in the President's budget. In the
event such property is so disposed of, proceeds are deposited
into the Nursing Home Revolving Fund for construction,
acquisition, or alteration of VA nursing homes.
House bill
Section 102 of H.R. 4768 would amend chapter 81 of title
38, United States Code, to add a new section 8118 to provide
the Secretary authority to transfer by sale, exchange or
lease unneeded real properties. It would establish a
Department of Veterans Affairs Capital Asset Fund to finance
these transfers, as well as to construct new and improved VA
health care facilities. The Fund could also be used for
demolition, environmental restoration, maintenance, repair,
historic preservation, and administrative expenses. Section
102 would establish fair market value as the basis for
property transfers.
[[Page H9783]]
It would require the Secretary to include in each budget
submission to Congress a report of the uses of the Capital
Asset Fund and descriptive information on each transfer
completed, pending, and planned. The section would also
repeal the Nursing Home Revolving Fund in section 8116 of
title 38, United States Code, and transfer remaining balances
from that fund to the new Fund. The authority of Section 102
would be contingent upon the Secretary's certifying to
Congress that VA facilities maintain long-term care capacity
as required by section 1710B(b) of title 38, United States
Code.
Senate bill
Section 101 of S. 2485 contains a similar proposal.
Compromise agreement
Section 411 of the Compromise Agreement follows the House
language with modification. The Compromise Agreement modified
the contingency authority to pertain to repeal of the Nursing
Home Revolving Fund and its remainder deposits. All other
authority of section 411 is effective on enactment.
Sec. 412--annual report to congress on inventory of department of
veterans affairs historic property
Current law
No similar provision exists under current law.
House bill
Section 103 of H.R. 4768 would require VA to establish a
national inventory of historic VA properties and would
require two subsequent annual reports to Congress on the
status and plans associated with any VA property listed on
the National Register of Historic Places.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 412 of the Compromise Agreement follows the House
language.
sec. 413--authority to acquire and transfer real property for use for
homeless veterans
Current law
Section 8103 of title 38, United States Code, authorizes
the Secretary to acquire such land or interest in land as
necessary for the purpose of providing medical services.
House bill
The House Bills contain no comparable provision.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 413 of the Compromise Agreement authorizes the
Secretary to acquire property in the District of Columbia
that the Secretary determines is suitable for providing
services to homeless veterans, if the Secretary identifies a
provider of homeless services that is prepared to acquire the
property from the Secretary. The Compromise Agreement
requires the Secretary, having so identified a provider, to
promptly transfer the acquired property to that provider of
homeless services. The Compromise Agreement provides a
reverter power to the Secretary if the provider of homeless
services discontinues providing services to homeless
veterans.
sec. 414--limitation on implementation of mission changes for specified
veterans health administration facilities
Current law
Section 401 of Public Law 108-170, the ``Veterans Health
Care, Capital Asset, and Business Improvement Act of 2003'',
requires VA to notify Congress of facility closings proposed
under the Capital Asset Realignment for Enhanced Services
initiative, and prohibits such closings until the lapse of 60
days following the notification or 30 days of continuous
session of Congress, whichever is longer.
House bill
The House Bills contained no comparable provision.
Senate bill
Section 104 of S. 2485 would prohibit the Secretary from
implementing a mission change for a medical facility (other
than a mission change prescribed by the Secretary in the
Capital Asset Realignment for Enhanced Services (CARES)
initiative) until 90 days after the date on which the
Secretary submits to the Committees written notice of the
mission change.
Compromise agreement
Section 414 of the Compromise Agreement prohibits the
Secretary from implementing a mission change until the lapse
of 60 days following the notification or 30 days of
continuous session of Congress, whichever is longer, at VA
Medical Centers in the following locations: Boston,
Massachusetts; New York City, New York; Big Springs, Texas;
Dublin, Georgia; Montgomery, Alabama; Louisville, Kentucky;
Muskogee (and the outpatient clinic in Tulsa), Oklahoma;
Poplar Bluff, Missouri; Ft. Wayne, Indiana; Waco, Texas; and
Walla Walla, Washington.
SEC. 415--AUTHORITY TO USE PROJECT FUNDS TO CONSTRUCT OR RELOCATE
SURFACE PARKING INCIDENTAL TO A CONSTRUCTION OR NONRECURRING
MAINTENANCE PROJECT
Current law
Section 8109 of title 38, United States Code, limits the
funding of construction, alteration or acquisition of VA
parking facilities to the collections made from parking fees
at VA facilities and deposited into the Parking Revolving
Fund.
House bill
Section 104 of H.R. 4768 would authorize the use of funds
in a construction or capital account for the relocation of a
surface parking facility if the relocation is necessitated by
a construction or non-recurring maintenance project.
Senate bill
Section 103 of S. 2485 would authorize the use of funds in
a construction or capital account for the relocation of a
surface parking facility if the relocation is necessitated by
a construction or non-recurring maintenance project.
Compromise agreement
Section 415 of the Compromise Agreement contains this
provision.
SEC. 416--INAPPLICABILITY OF LIMITATION ON USE OF ADVANCE PLANNING
FUNDS TO AUTHORIZED MAJOR MEDICAL FACILITY PROJECTS
Current law
Section 8104 of title 38, United States Code, limits the
amount VA may obligate for the design and development of a
major construction proposal to $500,000, unless VA notifies
Congress and waits for a period of 30 days.
House bill
Section 105 of H.R. 4768 would provide more flexibility to
VA by eliminating the ``notice and wait'' provision if the
project VA is planning has already been authorized by law.
Senate bill
Section 106 of S. 2485 contains a similar provision.
Compromise agreement
Section 416 of the Compromise Agreement contains this
provision.
SEC. 417--IMPROVEMENTS TO ENHANCE-USE LEASE AUTHORITY
Current law
Section 8162 of title 38, United States Code, authorizes VA
to lease real property within its jurisdiction to non-Federal
entities provided the lease contributes to the mission of VA
and enhance the use of the property. The enhanced-use lease
authority in this section restricts the projects the
Secretary may consider to those plans set forth by the Under
Secretary for Health. Section 8166, of title 38, United
States Code, provides the Secretary permissive authority to
disregard State and local laws relating to building codes,
permits or inspections that would regulate or restrict
construction, alteration, repair, remodeling or improvement
of VA property associated with an enhanced-use lease.
House bill
Section 106 of H.R. 4768 would add to existing exemptions
from State and local laws for enhanced-use leases, any land-
use laws and ordinances.
Senate bill
Section 102 of S. 2485 would extend the enhanced-use lease
authority to the Veterans Benefits Administration and the
National Cemetery Administration.
Compromise agreement
Section 417 of the Compromise Agreement follows the House
language.
SEC. 418--FIRST OPTION FOR COMMONWEALTH OF KENTUCKY ON DEPARTMENT OF
VETERANS AFFAIRS MEDICAL CENTER, LOUISVILLE, KENTUCKY
Current law
Section 8122 of title 38, United States Code, requires VA
to transfer real property for fair market value and describe
the transfer in its annual budget to Congress. This section
includes an exception for the transfer of VA property to a
State for use as the site of a State nursing home or
domiciliary.
House bill
The House Bills contain no comparable provision.
Senate bill
Section 131 of S. 2485 would require VA for one year, if it
determines that it will convey, lease, or otherwise dispose
of all or part of the VA Medical Center in Louisville,
Kentucky, to negotiate for the conveyance, lease, or other
disposal of the property to the Commonwealth of Kentucky to
provide services for veterans or for other purposes. The bill
would require the Commonwealth to pay fair market value for
the property if VA transfers such property to the
Commonwealth.
Compromise agreement
Section 418 of the Compromise Agreement follows the Senate
language, with a modification to include use of the property
as a State veterans' home.
SEC. 419--TRANSFER OF JURISDICTION, GENERAL SERVICES ADMINISTRATION
PROPERTY, BOISE, IDAHO
Current law
No similar provision exists under current law.
House bill
The House Bills contain no comparable provision.
Senate bill
Section 111 of S. 2485 would direct the Administrator of
General Services to transfer to the Secretary of Veterans
Affairs certain property in Boise, Idaho, for the purpose of
use in providing veterans benefits services.
Compromise agreement
Section 419 of the Compromise Agreement follows the Senate
language.
[[Page H9784]]
SUBTITLE C--DESIGNATION OF FACILITIES
SEC. 421--THOMAS E. CREEK DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
Current law
Section 531 of title 38, United States Code, prohibits the
naming of VA facilities other than for the geographic area in
which they are located, unless expressly provided by law.
House bill
H.R. 4836 would designate the Department of Veterans
Affairs Medical Center in Amarillo, Texas as the ``Thomas E.
Creek Department of Veterans Affairs Medical Center''.
Senate bill
The Senate Bills contain no comparable provision
Compromise agreement.
Section 421 of the Compromise Agreement follows the House
language.
SEC. 422--JAMES J. PETERS DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
Current law
Section 531 of title 38, United States Code, prohibits the
naming of VA facilities other than for the geographic area in
which they are located, unless expressly provided by law.
House bill
H.R. 2786 would designate the Department of Veterans
Affairs Medical Center in the Bronx, New York as the ``James
J. Peters Department of Veterans Affairs Medical Center''.
Senate bill
Section 121 of S. 2485 contains a similar provision.
Compromise agreement
Section 422 of the Compromise Agreement contains this
provision.
SEC. 423--BOB MICHEL DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC
Current law
Section 531 of title 38, United States Code, prohibits the
naming of VA facilities other than for the geographic area in
which they are located, unless expressly provided by law.
House bill
H.R. 4608 would designate the Department of Veterans
Affairs outpatient clinic in Peoria, Illinois as the ``Bob
Michel Department of Veterans Affairs Outpatient Clinic''.
Senate bill
S. 2596 contains a similar provision.
Compromise agreement
Section 423 of the Compromise Agreement contains this
provision.
SEC. 424--CHARLES WILSON DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT
CLINIC
Current law
Section 531 of title 38, United States Code, prohibits the
naming of VA facilities other than for the geographic area in
which they are located, unless expressly provided by law.
House bill
H.R. 4317 would designate the Department of Veterans
Affairs outpatient clinic in Lufkin, Texas as the ``Charles
Wilson Department of Veterans Affairs Outpatient Clinic''.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 424 of the Compromise Agreement follows the House
language.
SEC. 425--THOMAS P. NOONAN, JR. DEPARTMENT OF VETERANS AFFAIRS
OUTPATIENT CLINIC
Current law
Section 531 of title 38, United States Code, prohibits the
naming of VA facilities other than for the geographic area in
which they are located, unless expressly provided by law.
House bill
H.R. 1318 would designate the Department of Veterans
Affairs outpatient clinic in Sunnyside, Queens, New York as
the ``Thomas P. Noonan, Jr. Department of Veterans Affairs
Outpatient Clinic''.
Senate bill
The Senate Bills contain no comparable provision.
Compromise bill
Section 425 of the Compromise Agreement follows the House
language.
TITLE V--PERSONNEL ADMINISTRATION
SEC. 501--PILOT PROGRAM TO STUDY INNOVATIVE RECRUITMENT TOOLS TO
ADDRESS NURSING SHORTAGES AT DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE
FACILITIES
Current law
No similar provision exists under current law.
House bill
Section 2 of H.R. 4231 would establish a pilot program
within VA to study the use of outside recruitment,
advertising and communications agencies and the use of
interactive and online technologies to improve VA's program
for recruiting nursing personnel.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 501 of the Compromise Agreement follows the House
language.
SEC. 502--TECHNICAL CORRECTION TO LISTING OF CERTAIN HYBRID POSITIONS
IN VETERANS HEALTH ADMINISTRATION
Current law
Section 7401 of title 38, United States Code, authorizes VA
to appoint in a hybrid manner under title 5, United States
Code and title 38, United States Code, certain scientific and
professional medical care personnel.
House bill
Section 4 of H.R. 4231 would make technical corrections to
the description of certain occupations included in section
7401 treatable as hybrid appointments, and add blind
rehabilitation specialists and blind rehabilitation
outpatient specialists to these hybrid appointment
categories.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 502 of the Compromise Agreement follows the House
language.
SEC. 503--UNDER SECRETARY FOR HEALTH
Current law
Section 305(A)(2) of title 38, United States Code, requires
that the Under Secretary for Health be a ``doctor of
medicine.''
House bill
Section 7 of H.R. 4231 would repeal the requirement that
VA's Under Secretary for Health be a medical doctor.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 503 of the Compromise Agreement follows the House
language.
TITLE VI--OTHER MATTERS
SEC. 601--EXTENSION AND CODIFICATION OF AUTHORITY FOR RECOVERY AUDITS
Current law
Section 116 of Public Law 108-199, ``Consolidated
Appropriations Act, 2004'', requires the Secretary to conduct
a program of recovery audits to recoup overpayments for fee
basis and other medical services contracts for the care of
veterans.
House bill
The House Bills contain no comparable provision.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 601 of the Compromise Agreement requires the
Secretary of Veterans Affairs to contract to conduct a
program of recovery audits for fee basis and other contract
care of veterans. The requirement expires on September 30,
2008.
The Committees are encouraged by the Department's increased
third party collection in 2003, as a result of more
aggressive efforts to improve VA business practices. The
Committees expect the Department to assist third party health
insurers to process disputed VA claims by using an automated
system to download information in standardized formats and to
ensure compliance with rules governing dispute resolution
through the appeals process.
SEC. 602--INVENTORY OF MEDICAL WASTE MANAGEMENT ACTIVITIES AT
DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE FACILITIES
Current law
No similar provision exists under current law.
House bill
Section 401 of H.R. 4658 would require the Secretary to
establish and maintain an inventory of medical waste
management activities in VA medical facilities and submit a
report on such activities by April 15, 2005. The VA would be
required to report on plans to modernize or improve the
management of medical waste and evaluate the most desirable
methods of disposal from an environmental perspective.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 602 of the Compromise Agreement follows the House
language with a modification to change the report date to
June 30, 2005.
SEC. 603--INCLUSION OF ALL ENROLLED VETERANS AMONG PERSONS ELIGIBLE TO
USE CANTEENS OPERATED BY VETERANS' CANTEEN SERVICE
Current law
Section 7803 of title 38, United States Code, defines those
persons eligible to use the Veterans' Canteen Service.
House bill
Section 201 of H.R 4768 would expand the definition of
persons eligible to use the Veterans' Canteen Service to
include all individuals enrolled in VA health care under
section 1705 of title 38, United States Code, or employed at
VA facilities, as well as families and relatives of veteran
patients.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 603 of the Compromise Agreement follows the House
language.
[[Page H9785]]
SEC. 604--ANNUAL REPORTS ON WAITING TIMES FOR APPOINTMENTS FOR
SPECIALTY CARE
Current law
No similar provision exists under current law.
House bill
The House Bills contain no comparable provision.
Senate bill
Section 207 of S. 2485 would require VA to report annually
on patient appointment waiting times, including specialty and
primary care services, and separate the data by facility and
network.
Compromise agreement
Section 604 of the Compromise Agreement requires the
Secretary to report, not later than January 31 of each year
through 2007, on veterans waiting more than 3 months for
scheduled appointments in specialty care clinics and on any
reasons for such delays. Further, the Compromise Agreement
requires the Comptroller General to certify the accuracy of
the report submitted under this section.
SEC. 605--TECHNICAL CLARIFICATION
Current law
Section 8111 of title 38, United States Code, requires the
Secretary and the Secretary of Defense to enter into
agreements and contracts for the mutually beneficial sharing
of health care resources and establishes a fund, known as the
``DOD-VA Health Care Sharing Incentive Fund'' to provide
incentives to enter into such sharing initiatives.
House bill
Section 6 of H.R. 4231 would make the established DOD-VA
Health Care Sharing Incentive Fund available for any purpose
authorized by section 8111.
Senate bill
The Senate Bills contain no comparable provision.
Compromise agreement
Section 605 of the Compromise Agreement follows the House
language.
Mr. SMITH of New Jersey. Mr. Speaker, I yield 3 minutes to the
gentleman from Florida (Mr. Stearns), the author of the law, the
Millennium Health Care Act, which has made a tremendous difference on
behalf of our seniors who are veterans who need long-term health care.
(Mr. STEARNS asked and was given permission to revise and extend his
remarks.)
Mr. STEARNS. Mr. Speaker, I thank the distinguished chairman of the
Committee on Veterans' Affairs, and also I want to thank the gentleman
from Connecticut who chairs the Subcommittee on Health for what an
outstanding job he has done, having served as the chairman of that
committee with the very, very good staff that he has. I think it is a
credit to him what we are accomplishing.
I think all of my colleagues know that Florida has one of the largest
growing populations of veterans. So many of us in Florida have to be
particularly sensitive. We need new facilities down there. That is why
I am very supportive of H.R. 3936, the Veterans Health Programs
Improvement Act. I especially appreciate that it incorporates
provisions of H.R. 4768, the Facilities Management Act of 2004, of
which I was an original cosponsor. I thank the chairman for including
that in H.R. 3936. This will authorize projects which the CARES
(Capital Asset Realignment for Enhanced Services) Commission
recommended to the Secretary of Veterans Affairs. He based his
recommendations last May upon that, and that is included in this bill.
Mr. Speaker, under CARES, the VA reviewed all of its facilities
systematically to consider where resources might be reallocated for
optimal service to veterans. I think the veterans should realize that
this was a systematic study. As more veterans have relocated to the
Southeast over the years, it appears the VA has insufficient clinic
room in the Southeast, particularly in my State of Florida.
Accordingly, the majority of the leases which this legislation would
authorize are facilities to be located in the South. The aim has been
to match the assets with the veterans, and this bill does just that.
Florida, as we know, has the second largest veterans population and the
number one oldest.
Obviously, I am pleased to see a lease for a regional health care
facility in South Marion County, my home county, Summerfield, Florida.
The plans are for this clinic to offer comprehensive services to
veterans, including audiology, which is very important; ophthalmology;
dermatology, particularly in Florida; minor surgery; and complete
imaging services. It is going to be housed in a 75,000-square-foot
building and provide more services and greater resources for the
veterans than the existing VA outpatient clinics that we have
throughout my congressional district. Even better, while this clinic is
predicted to be opened in the summer of 2007, appropriations willing,
the generous, resourceful people of north central Florida have indeed
offered the VA the use of free space for an interim clinic, so that
should expedite it. So our ever-increasing veterans population can see
immediate relief for their long health-care waits in the winter when
they come down will be decreased, and this more comprehensive specialty
clinic which the act authorizes will be built and in the long run will
help everybody. I am very enthusiastically supporting this bill.
I want to thank both the Democrats and Republicans on the Committee
on Veterans' Affairs and particularly the gentleman from Connecticut
(Mr. Simmons) and the gentleman from New Jersey (Mr. Smith) for their
support.
Mr. RODRIGUEZ. Mr. Speaker, I yield 4\1/2\ minutes to the gentleman
from California (Mr. Filner), a member of the Committee on Veterans'
Affairs and an activist in pushing forward on issues regarding
veterans.
Mr. FILNER. Mr. Speaker, as a member of the VA Subcommittee on
Health, I also rise in support of H.R. 3936 which includes, as we have
heard, a lot of provisions to enhance services to our Nation's
veterans. We have thanked the gentleman from New Jersey (Mr. Smith),
the gentleman from Illinois (Mr. Evans) and the gentleman from
Connecticut (Mr. Simmons).
I would particularly like to just thank the gentleman from Texas (Mr.
Rodriguez), the ranking member, for his service. I always say, when I
get to the committee meetings, ``Ciro, you're my hero.'' The gentleman
from Texas, for the 8 years he has been here, has fought steadfastly
for his veterans not only in San Antonio but in the United States as a
whole. He has done a tremendous amount for health care for our veterans
in this Nation, and we thank him for his service. We are going to miss
him.
One of the important provisions of this bill is to set up a pilot
program to study new and innovative ways to improve the recruitment and
retention of nurses at the VA. We all know about the shortage of nurses
in our Nation, and we cannot rely on the old methods of recruitment.
The use of online technology, for example, can be a valuable tool in
finding nurses who are interested in serving the country through their
work at a VA medical facility.
Likewise, we have to find ways to keep the nurses that we recruit. A
second bill that is before us after this has a provision in fact for
alternative work schedules for nurses. Allowing nurses to work these
flexible hours to accommodate personal and family needs is a sure way
to improve their lives and to encourage them to continue working at the
VA center. In addition, this bill provides payments to States to assist
State veterans homes in their hiring and retention of nurses.
I think we all know that funding for grants is vital for homeless
veterans. That program will be authorized in this bill at a level of
$99 million, an increase of $24 million. Although we all know that even
more funding is needed to assist the homeless veterans of our Nation,
this authorization is a welcome increase. Homelessness among veterans
is a national disgrace. I know we are all firmly behind the gentleman
from New Jersey's goal of eliminating chronic homelessness within the
veterans population in 10 years. This bill will help us reach that
goal.
The bill also gives permanent authority to the VA Secretary to
continue the military sexual trauma counseling program that was
established in 1992. As we have heard, this program provides counseling
and treatment for the men and women who have experienced sexual trauma
or harassment while in the military service. Again, the gentleman from
Texas was a major supporter of this program, and we thank him for his
leadership once again.
Funding to open several new outpatient clinics is included in this
bill, including two in San Diego County, a portion of which I
represent. The VA's move to open clinics near veterans' homes has been
overwhelmingly successful.
I will also continue work for a full outpatient health clinic in
Imperial
[[Page H9786]]
County, which is also in my congressional district.
I should add that, as we look at the ways we fund outpatient clinics,
the formulas used involve only population. We ought to also, I think,
include ``isolation'' of a county or an area because that is also
important, not just the numbers.
These are a few of the provisions in H.R. 3936. Health care of our
veterans has to be a priority all the time but especially at this time
when we have so many active duty soldiers fighting for this Nation.
Whether they are from World War II or from the present conflicts in
Afghanistan and Iraq, they are looking to us to meet their needs.
Morale in active duty depends on how we are going to treat our soldiers
when they come home, so I hope everyone supports H.R. 3936.
Mr. SMITH of New Jersey. Mr. Speaker, I yield 3\1/2\ minutes to the
gentleman from Indiana (Mr. Souder).
Mr. SOUDER. Mr. Speaker, I first want to thank the gentleman from New
Jersey (Mr. Smith) for his leadership and advocacy on behalf of
veterans. No one has worked harder for veterans than he has. I
appreciate his commitment not only on this bill but across the board in
working to improve veterans health care and the benefits for veterans
in the United States. I also want to specifically thank John Bradley on
the gentleman from New Jersey's committee staff for his willingness to
work with my staff on matters of concern to veterans in my district.
The bill before us contains many important provisions related to
veterans health care and facilities management. Particularly, section
414 is of specific interest to veterans in my district, and I
appreciate the inclusion of this language to force additional reporting
to Congress as far as informing us of changes or closure of veterans
hospitals.
In May of this year, Secretary Principi issued his decision on the
CARES Commission recommendations for veterans health care. Among the
slated changes was a mission change for the Fort Wayne veterans
hospital located in my district. The decision called for closure of the
hospital's inpatient beds and a transfer of those patients to either a
community hospital in the local area or the Indianapolis veterans
hospital. Fort Wayne is the largest veterans hospital and city in the
United States affected by this bill. It is the second largest city in
Indiana. The northern Indiana hospital covers an area larger than 2
million people who live 2 to 4 hours from Indianapolis and have no
desire to go to Indianapolis, especially for continuing outpatient
care; or for some inpatient care; or far away from their doctors where
they have to get motels, where their spouses have to come, far away
from their families, where their children will not visit them. They
have no interest in this process.
Fort Wayne is one of the top military recruiting areas in the United
States. In addition, our Guard and Reserve units are regularly serving
on the front lines. Currently, I have a Reserve unit of over 200 men
and women in Afghanistan for a year. I just had an Air Guard unit
return to Fort Wayne from the Middle East. I have another large Reserve
unit that just returned from a year down in Guantanamo. This spring, I
had an Army Guard unit of 700 return from 14 months in Iraq. None of
this was considered in the CARES Commission report.
In Congress, we are asked to repeatedly support, which I support as
well, actions in Afghanistan, actions in Iraq and other parts of the
world. But we cannot ask men and women in our Guard and Reserve to
repeatedly be called up and then not have health care in the districts
that they live in.
{time} 1515
The CARES Commission assumed retirement communities, and where the
military bases were, were where the future demand was going to be. But
if we are going to use the Guard and Reserve in the way we are using
them, we are going to provide them health care because if they are on
the frontline in combat, they are going to be treated like other
military personnel. And if they get called up a second time and third
time around, the health care system is going to be revolutionized in
the United States, and these people do not retire in Florida. They do
not live there. They do not go where the bases are. They live in the
communities they work in, in the Guard and the Reserve. And we have to
factor this in as we look at the health care system.
Obviously, population shifts have occurred. Obviously, modernization
is needed in our veterans hospitals. Obviously, outpatient services are
the growing category in all kinds of health care, and we do not need
more input. But what I fear when we look at the obvious trends that are
occurring is, this is a back-door way to actually reduce benefits for
many veterans and people in the Guard and Reserve in areas where they
have been loyal patriotic Americans risking and dying, as many have in
my district already in these wars, and they do not deserve to have
their health care diminished dramatically.
Mr. RODRIGUEZ. Mr. Speaker, I yield 2 minutes to the gentlewoman from
California (Ms. Waters).
Ms. WATERS. Mr. Speaker, I would like to thank my colleagues on both
sides of the aisle: The gentleman from New Jersey (Chairman Smith); the
gentleman from Connecticut (Mr. Simmons), subcommittee chairman; the
gentleman from Illinois (Mr. Evans), our ranking member; and the
gentleman from Texas (Mr. Rodriguez), ranking member of the
subcommittee. They have done a fabulous job in putting together this
legislation.
And this is a good day for veterans. It is a good day for veterans
because, again, we are beginning to address some of the issues that we
should have addressed a long time ago. Let me just say the gentleman
from Texas (Mr. Rodriguez) has done a very wonderful job. I am very
proud of the work he has done, and I really do commend him to the care
and attention that he has given.
And to the gentleman from Illinois (Mr. Evans), I served with the
gentleman from Illinois (Mr. Evans) when I first came to the House, and
I had the opportunity even to vote for him to be Chair. Sonny
Montgomery has never forgiven me. But he is the best advocate the
veterans have ever had, and I appreciate him each and every day.
Mr. Speaker, this bill is important for a number of reasons. Someone
mentioned earlier that homelessness among the veterans of this country
is a disgrace, and it really is. I was at the U.S. Vets again on
Veterans Day, and that program fed over 600 or 700 veterans off the
street who were homeless. Some of them were fortunate enough to be in
the program; others just off the street who were fed that day. But any
place that one goes in America and particularly in our cities, when
they go to the areas where the homeless congregate, whether they are in
the downtowns or wherever they are, disproportionately those will be
veterans. So this bill increases the overall authorization for the
Grant and Per Diem Homeless Veterans Assistance Program from $75
million to $99 million in funding year 2005, and I hope that each year
it will continue to go up.
It is a good bill. It has a lot of good things that are covered in
the bill. And so I am pleased that I am here to support it, and I would
ask my colleagues to do so.
Mr. SMITH of New Jersey. Mr. Speaker, I reserve the balance of my
time.
Mr. RODRIGUEZ. Mr. Speaker, I yield 2 minutes to the gentlewoman from
California (Ms. Solis).
Ms. SOLIS. Mr. Speaker, I would also like to rise in support of the
Veterans Health Program Improvement Act and to the gentleman from Texas
(Mr. Rodriguez), the distinguished manager of this particular
legislation, who has been a strong advocate for many years on the
health care of our veterans.
I would also like to recognize the gentleman from Illinois (Mr.
Evans), the ranking Democrat on this committee, also and thank him for
allowing me the opportunity to speak.
As a Member here, this is now going on my third term. But L.A. County
in the area that I represent has one of the largest concentrations of
veterans, a large number of Vietnam veterans, but in particular, many
that are now serving in Iraq and Afghanistan.
And I am very delighted to see that there has been an extension of
the sexual trauma counseling program, and this has been made permanent,
and I would like to commend those that worked on this in particular
because this has been a subject for the Women's
[[Page H9787]]
Caucus. We actually had an informal hearing here and brought forward
individuals to talk to us about how we could remedy this problem. It is
something we have to work on, and sexual assault in the military is
something that we all know is unacceptable. The counseling program is
one step towards helping victims access services that they deserve. And
studies, as we know, have shown that three-fourths of the female
veterans who are raped did not report the incident to a ranking
officer. Many did not know how to, and some even thought that rape was
somehow expected in the military. Since August of 2002 until November 1
of this year, there has been an estimated 261 cases of sexual assault
in Iraq, Kuwait, Afghanistan and Bahrain.
We must enforce a zero-tolerance policy within the Armed Forces and
protect all of our veterans, women and men, from having to cope with
these injustices. And I urge the Congress to support this piece of
vital legislation and also want to thank those who worked on this
legislation to increase the health care services for our veterans.
Mr. RODRIGUEZ. Mr. Speaker, I yield myself such time as I may
consume.
Let me say that this particular piece of legislation is extremely
important. I know, as has been mentioned, the importance of the number
of veterans that are still estimated to be homeless, some 299,000
veterans out there that sleep under the bridges, and I know that our
efforts in this area will help begin to continue to decrease the number
of those homeless veterans that are out there.
According to the VA, 45 percent of the homeless veterans also suffer
from mental health disorders. We know the importance of coming forth on
post-traumatic stress disorder and how critical that is. And I also
want to just emphasize how key and how important it is for the sexual
trauma situations where we have improved in increasing the number of
women in the military, and as we do that, we need to make sure that we
have a good safe place for a work environment where they can feel
comfortable in addition to the services that are needed.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise as a strong supporter
of H.R. 3936 the Veterans Health Programs Improvement Act of 2004 which
would increase the authorization of appropriations for grants to
benefit homeless veterans, would improve programs for management and
administration of veterans' facilities and health care programs. I want
to thank Chairman Smith and Ranking Member Evans for bringing this
necessary piece of legislation before this entire body.
Veterans are some of America's most valued members of society. These
are people who served our Nation in a time of need, people who risked
their lives to protect our own. Yet, it pains me to say that many of
these same veterans who fought so bravely and risked so much in lands
far abroad have come back to their nation and are now homeless. The
problem of homeless veterans is far more prevalent than we would like
to believe. About one-third of the entire adult homeless population has
served their country in the Armed Services. On any given day, as many
as 250,000 veterans, both male and female, are living on the streets or
in shelters, and perhaps twice as many experience hopelessness at some
point during the course of a year. Many other veterans are considered
near homeless or at risk because of their poverty, lack of support from
family and friends, and dismal living conditions in cheap hotels or in
overcrowded or substandard housing.
This legislation is necessary not only because this problem is so
devastating and prevalent, but also because homeless veterans have
special needs that are unique from those faced by the rest of the
homeless population. Almost all homeless veterans are male, with three
percent being female, the vast majority are single, and most come from
poor, disadvantaged backgrounds. Homeless veterans tend to be older and
more educated than homeless non-veterans. But similar to the general
population of homeless adult males, about 45% of homeless veterans
suffer from mental illness and slightly more than 70% suffer from
alcohol or other drug abuse problems. Roughly 56% are African American
or Hispanic.
I believe that the Veterans Health Programs Improvement Act will help
make an impact in helping homeless veterans and ensuring that they have
a viable future. This legislation has a number of important provisions,
but in my mind none is more important than the issue of homeless
veterans. If we cannot even provide our brave veterans with basic
necessities then where are we as a Nation? Our Nation's veterans did
not risk their lives abroad so that they could come home and feel a
cold shoulder. We must all have outrage that so many of our Nation's
veterans live this way; only then can we find a way to correct this
injustice.
Mr. REYES. Mr. Speaker, I rise today in support of H.R. 3936, the
Veterans Health Programs Improvement Act of 2004. I would like to thank
the sponsors of this legislation, Chairman Chris Smith and Ranking
Member Lane Evans for their work to bring it through the House Veterans
Affairs Committee and to the floor expeditiously.
Among other important actions, H.R. 3936 would provide the needed
funding to assist our homeless veterans. As a Vietnam veteran and
Member of Congress, I know the importance of addressing and
appropriately funding programs to end homelessness among our veteran
population. I feel this legislation is a step in the right direction to
meet this need.
Sadly, today's homeless veteran population are men and women who have
resorted to living out in the streets of the very same country they
committed to serve. In addition, nearly half of this population
consists of veterans who served with me in Vietnam.
Mr. Speaker, I can't stress enough the importance of this
legislation, especially at a time of conflict that is increasing the
veteran population. We should not forget the sacrifices made by our
Nation's veterans. Instead, we need to uphold our promise to care for
those who have answered the call to duty.
Mr. Speaker, I strongly urge my colleagues to support the passage of
this important bill.
Mr. BEAUPREZ. Mr. Speaker, I rise today in support of H.R. 3936, the
Veterans Health Programs Improvement Act of 2004. Today, more than
ever, it is imperative that we address the benefits we provide to our
Nation's veterans. Over the past few decades, the needs of veterans
have evolved, and it is incumbent upon us to ensure the benefits they
have so dutifully earned will sufficiently meet those changing needs.
Included in this bill is language to allow the Department of Veterans
Affairs to begin negotiations with the University of Colorado for the
land on which to build a new, state-of-the-art veterans medical
facility on the Fitzsimons Campus in Aurora, CO. This landmark veterans
hospital will be capable of providing services that were previously
unthinkable in many of the unequipped, outdated VA hospitals of the
past.
Through a collaboration between the VA, the DOD, and the University
of Colorado, veterans in the Rocky Mountain region will gain access to
a higher quality of health care made possible thanks to 21st century
innovations and the synergy of this unique partnership.
Mr. Speaker, I applaud the efforts of everyone involved in bringing
this bill to the floor for a vote today. It is a paramount piece of
legislation not only for the veterans in my district, but for all of
our Nation's veterans, and I strongly support its intent.
Mr. RODRIGUEZ. Mr. Speaker, I yield back the balance of my time.
Mr. SMITH of New Jersey. Mr. Speaker, I yield back the balance of my
time.
The SPEAKER pro tempore (Mr. Terry). The question is on the motion
offered by the gentleman from New Jersey (Mr. Smith) that the House
suspend the rules and concur in the Senate amendments to the bill, H.R.
3936.
The question was taken; and (two-thirds having voted in favor
thereof) the rules were suspended and the Senate amendments were
concurred in.
A motion to reconsider was laid on the table.
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