[Congressional Record (Bound Edition), Volume 149 (2003), Part 21]
[Senate]
[Pages 29602-29612]
[From the U.S. Government Publishing Office, www.gpo.gov]




 VETERANS HEALTH CARE AUTHORITIES EXTENSION AND IMPROVEMENT ACT OF 2003

  Mr. THOMAS. Madam President, I ask unanimous consent that the Senate 
now proceed to the immediate consideration of Calendar No. 383, S. 
1156.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The assistant legislative clerk read as follows:

       A bill (S. 1156) to amend title 38, United States Code, to 
     improve and enhance the provision of long-term health care 
     for veterans by the Department of Veterans Affairs, to 
     enhance and improve authorities relating to the 
     administration of personnel of the Department of Veterans 
     Affairs, and for other purposes.

  There being no objection, the Senate proceeded to consider the bill, 
which had been reported from the Committee on Veterans' Affairs, with 
an amendment to the title and an amendment to strike all after the 
enacting clause and inserting in lieu thereof the following:
  [Strike the part shown in black brackets and insert the part shown in 
italic.]

                                S. 1156

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

     [SECTION 1. SHORT TITLE.

       [This Act may be cited as the ``Department of Veterans 
     Affairs Long-Term Care and Personnel Authorities Enhancement 
     Act of 2003''.

           [TITLE I--EXTENSION AND ENHANCEMENT OF AUTHORITIES

     [SEC. 101. EXTENSION AND MODIFICATION OF CERTAIN HEALTH CARE 
                   AUTHORITIES.

       [(a) Treatment of Noninstitutional Extended Care Services 
     as Medical Services.--Section 1701(a)(10)(A) of title 38, 
     United States Code, is amended by striking ``December 31, 
     2003'' and inserting ``December 31, 2008''.
       [(b) Required Nursing Home Care.--(1) Subsection (a) of 
     section 1710A of such title is amended by striking ``70 
     percent'' and inserting ``50 percent''.
       [(2) Subsection (c) of such section is amended by striking 
     ``December 31, 2003'' and inserting ``December 31, 2008''.

     [SEC. 102. ENHANCED AGREEMENT AUTHORITY FOR PROVISION OF 
                   NURSING HOME CARE AND ADULT DAY HEALTH CARE IN 
                   NON-DEPARTMENT OF VETERANS AFFAIRS FACILITIES.

       [Section 1720 of title 38, United States Code, is amended--
       [(1) in subsection (c)--
       [(A) by designating the existing text as paragraph (2); and
       [(B) by inserting before paragraph (2), as so designated, 
     the following new paragraph (1):
       [``(1) In furnishing nursing home care or adult day health 
     care under this section, the Secretary may enter into 
     agreements for furnishing such care utilizing such 
     authorities relating to agreements for the provision of 
     services under section 1866 of the Social Security Act (42 
     U.S.C. 1395cc) that the Secretary considers appropriate.''; 
     and
       [(2) in subsection (f)(1)(B), by inserting ``or agreement'' 
     after ``contract'' each place it appears.

                 [TITLE II--CONSTRUCTION AUTHORIZATION

     [SEC. 201. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS.

       [The Secretary of Veterans Affairs may carry out the 
     following major medical facility projects, with each project 
     to be carried out in an amount not to exceed the amount 
     specified for that project:
       [(1) Construction of a long-term care facility in Lebanon, 
     Pennsylvania, $14,500,000.
       [(2) Construction of a long-term care facility in Beckley, 
     West Virginia, $20,000,000.

     [SEC. 202. AUTHORIZATION OF APPROPRIATIONS.

       [(a) In General.--There are authorized to be appropriated 
     for the Secretary of Veterans Affairs for fiscal year 2004 
     for the Construction, Major Projects, account, a total of 
     $34,500,000 for the projects authorized in paragraphs (1) and 
     (2) of section 201.
       [(b) Limitation.--The projects authorized in section 201 
     may only be carried out using--
       [(1) funds appropriated for fiscal year 2004 pursuant to 
     the authorization of appropriations in subsection (a);
       [(2) funds appropriated for Construction, Major Projects, 
     for a fiscal year before fiscal year 2004 that remain 
     available for obligation; and
       [(3) funds appropriated for Construction, Major Projects, 
     for fiscal year 2004 for a category of activity not specific 
     to a project.

                         [TITLE III--PERSONNEL

     [SEC. 301. MODIFICATION OF AUTHORITIES ON APPOINTMENTS OF 
                   PERSONNEL IN THE VETERANS HEALTH 
                   ADMINISTRATION.

       [(a) Positions Treatable as Hybrid Status Positions.--
     Section 7401 of title 38, United States Code, is amended--
       [(1) in paragraph (2), by striking ``Psychologists'' and 
     all that follows through ``other scientific'' and inserting 
     ``Other scientific''; and
       [(2) by striking paragraph (3) and inserting the following 
     new paragraph (3):
       [``(3) Audiologists, speech pathologists, and audiologist-
     speech pathologists, biomedical engineers, certified or 
     registered respiratory therapists, dietitians, licensed 
     physical therapists, licensed practical or vocational nurses, 
     medical instrument technicians, medical records 
     administrators or specialists, medical records technicians, 
     medical technologists, nuclear medicine technologists, 
     occupational therapists, occupational therapy assistants, 
     orthotist-prosthetists, pharmacists, pharmacy technicians, 
     physical therapy assistants, prosthetic representatives, 
     psychologists, diagnostic radiologic technicians, therapeutic 
     radiologic technicians, social workers, and personnel in such 
     other positions as the Secretary designates (subject to 
     section 7403(f)(4) of this title) for purposes of this 
     paragraph as necessary for the medical care of veterans.''.
       [(b) Report on Proposal To Designate Additional Positions 
     as Hybrid Status Positions.--Section 7403(f) of such title is 
     amended by adding at the end the following new paragraph:
       [``(4) Not later than 45 days before the date on which the 
     Secretary proposes to designate a position as a position 
     necessary for the medical care of veterans for which 
     appointment may be made under section 7401(3) of this title, 
     the Secretary shall submit to the Committees on Veterans' 
     Affairs of the Senate and the House of Representatives a 
     report on the proposed designation.''.
       [(c) Temporary, Part-Time, and Without Compensation 
     Appointments.--Section 7405 of such title is amended--
       [(1) in subsection (a)--
       [(A) in paragraph (1), by striking subparagraphs (B) and 
     (C) and inserting the following new subparagraphs:
       [``(B) Positions listed in section 7401(3) of this title.
       [``(C) Librarians.''; and
       [(B) in paragraph (2), by striking subparagraph (B) and 
     inserting the following new subparagraph (B):
       [``(B) Positions listed in section 7401(3) of this 
     title.''; and
       [(2) in subsection (c)(1), by striking ``section 7401(1)'' 
     and inserting ``paragraphs (1) and (3) of section 7401''.
       [(d) Authority for Additional Pay for Certain Health Care 
     Professionals.--Section 7454(b)(1) of such title is amended 
     by striking ``certified or registered'' and all

[[Page 29603]]

     that follows through ``occupational therapists,'' and 
     inserting ``individuals in positions listed in section 
     7401(3) of this title,''.

     [SEC. 302. COVERAGE OF EMPLOYEES OF VETERANS' CANTEEN SERVICE 
                   UNDER ADDITIONAL EMPLOYMENT LAWS.

       [Section 7802(5) is amended by inserting before the 
     semicolon the following: ``. Employees and personnel under 
     this clause may be considered for appointment in Department 
     positions in the competitive service in the same manner that 
     Department employees in the competitive service are 
     considered for transfer to such positions. An employee or 
     individual appointed as personnel under this clause who is 
     appointed to a Department position under the authority of the 
     preceding sentence shall be treated as having a career 
     appointment in such position once such employee or individual 
     meets the three-year requirement for career tenure (with any 
     previous period of employment or appoint- ment in the Service 
     being counted toward satisfaction of such requirement)''.

     [SEC. 303. EFFECTIVE DATE OF MODIFICATION OF TREATMENT FOR 
                   RETIREMENT ANNUITY PURPOSES OF CERTAIN PART-
                   TIME SERVICE OF CERTAIN DEPARTMENT OF VETERANS 
                   AFFAIRS HEALTH-CARE PROFESSIONALS.

       [(a) Effective Date.--The effective date of the amendment 
     made by section 132 of the Department of Veterans Affairs 
     Health Care Programs Enhancement Act of 2001 (Public Law 107-
     135; 115 Stat. 2454) shall be as follows:
       [(1) January 23, 2002, in the case of health care 
     professionals referred to in subsection (c) of section 7426 
     of title 38, United States Code (as so amended), who retire 
     on or after that date.
       [(2) The date of the enactment of this Act, in the case of 
     health care professionals referred to in such subsection (c) 
     who retired before January 23, 2002, but after April 7, 1986.
       [(b) Recomputation of Annuity.--The Office of Personnel 
     Management shall recompute the annuity of each health-care 
     professional described in the first sentence of subsection 
     (c) of section 7426 of title 38, United States Code (as so 
     amended), who retired before January 23, 2002, but after 
     April 7, 1986, in order to take into account the amendment 
     made by section 132 of the Department of Veterans Affairs 
     Health Care Programs Enhancement Act of 2001. Such 
     recomputation shall be effective only with respect to 
     annuities paid after the date of the enactment of this Act, 
     and shall apply beginning the first day of the first month 
     beginning after the date of the enactment of this Act.

     [SEC. 304. PERMANENT AUTHORITY FOR USE OF CONTRACT PHYSICIANS 
                   FOR DISABILITY EXAMINATIONS.

       [(a) Permanent Authority.--Section 504 of the Veterans' 
     Benefits Improvements Act of 1996 (Public Law 104-275; 110 
     Stat. 3341; 38 U.S.C. 5101 note) is amended--
       [(1) in subsection (a), by striking ``may conduct a pilot 
     program'' and all that follows through ``may be made by'' and 
     inserting ``may carry out examinations with respect to the 
     medical disability of applicants for benefits under the laws 
     administered by the Secretary through''; and
       [(2) in subsection (c), by striking ``the pilot program 
     under''.
       [(b) Repeal of Limitation and Obsolete Authority.--That 
     section is further amended--
       [(1) by striking subsections (b) and (d); and
       [(2) by redesignating subsection (c), as amended by 
     subsection (a) of this section, as subsection (b).
       [(c) Conforming Amendment.--The heading for that section is 
     amended to read as follows:

     [``SEC. 504. AUTHORITY FOR USE OF CONTRACT PHYSICIANS FOR 
                   DISABILITY EXAMINATIONS.''.]

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Veterans 
     Health Care Authorities Extension and Improvement Act of 
     2003''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

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

 TITLE I--EXTENSION AND MODIFICATION OF CERTAIN HEALTH CARE AUTHORITIES

Sec. 101. Extension and modification of certain health care 
              authorities.
Sec. 102. Enhanced agreement authority for provision of nursing home 
              care and adult day health care in non-Department of 
              Veterans Affairs facilities.
Sec. 103. Expansion of pilot program of Department of Veterans Affairs 
              on assisted living for veterans.
Sec. 104. Improvement of program for provision of specialized mental 
              health services to veterans.

             TITLE II--CONSTRUCTION AND FACILITIES MATTERS

                  Subtitle A--Construction Authorities

Sec. 201. Increase in threshold for major medical facility construction 
              projects.
Sec. 202. Demolition of obsolete, dilapidated, and hazardous structures 
              on Department of Veterans Affairs property.

                Subtitle B--Construction Authorizations

Sec. 211. Authorization of major medical facility projects.
Sec. 212. Authorization of major medical facility leases.
Sec. 213. Authorization of appropriations.

                 Subtitle C--Designation of Facilities

Sec. 221. Designation of Department of Veterans Affairs outpatient 
              clinic, Horsham, Pennsylvania.
Sec. 222. Designation of Department of Veterans Affairs health care 
              facility, Chicago, Illinois.
Sec. 223. Designation of Department of Veterans Affairs Medical Center, 
              Houston, Texas.
Sec. 224. Designation of Department of Veterans Affairs Medical Center, 
              Minneapolis, Minnesota.

                      TITLE III--PERSONNEL MATTERS

Sec. 301. Modification of authority on appointments of personnel in the 
              Veterans Health Administration.
Sec. 302. Coverage of employees of Veterans' Canteen Service under 
              additional employment laws.
Sec. 303. Effective date of modification of treatment for retirement 
              annuity purposes of certain part-time service of certain 
              Department of Veterans Affairs health-care professionals.

                        TITLE IV--OTHER MATTERS

 Subtitle A--Capital Asset Realignment for Enhanced Services Initiative

Sec. 401. Advance notification of capital asset realignment initiative.
Sec. 402. Authorization of major construction projects in connection 
              with capital asset realignment initiative.

               Subtitle B--Extension of Other Authorities

Sec. 411. Three-year extension of housing assistance for homeless 
              veterans.
Sec. 412. Four-year extension of evaluation of health status of spouses 
              and children of Persian Gulf War veterans.

                       Subtitle C--Other Matters

Sec. 421. Modification of eligibility of Filipino veterans for health 
              care in the United States.
Sec. 422. Repeal of limits on terms of certain officials in Office of 
              Under Secretary for Health.

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

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

 TITLE I--EXTENSION AND MODIFICATION OF CERTAIN HEALTH CARE AUTHORITIES

     SEC. 101. EXTENSION AND MODIFICATION OF CERTAIN HEALTH CARE 
                   AUTHORITIES.

       (a) Treatment of Noninstitutional Extended Care Services as 
     Medical Services.--Section 1701(10)(A) is amended by striking 
     ``December 31, 2003'' and inserting ``December 31, 2008''.
       (b) Required Nursing Home Care.--Section 1710A(c) is 
     amended by striking ``December 31, 2003'' and inserting 
     ``December 31, 2008''.

     SEC. 102. ENHANCED AGREEMENT AUTHORITY FOR PROVISION OF 
                   NURSING HOME CARE AND ADULT DAY HEALTH CARE IN 
                   NON-DEPARTMENT OF VETERANS AFFAIRS FACILITIES.

       Section 1720 is amended--
       (1) in subsection (c)--
       (A) by designating the existing text as paragraph (2); and
       (B) by inserting before paragraph (2), as so designated, 
     the following new paragraph (1):
       ``(1) In furnishing nursing home care, adult day health 
     care, or other extended care services under this section, the 
     Secretary may enter into agreements for furnishing such care 
     or services utilizing such authorities relating to agreements 
     for the provision of services under section 1866 of the 
     Social Security Act (42 U.S.C. 1395cc) as the Secretary 
     considers appropriate.''; and
       (2) in subsection (f)(1)(B), by inserting ``or agreement'' 
     after ``contract'' each place it appears.

     SEC. 103. EXPANSION OF PILOT PROGRAM OF DEPARTMENT OF 
                   VETERANS AFFAIRS ON ASSISTED LIVING FOR 
                   VETERANS.

       Section 103(b) of the Veterans Millennium Health Care and 
     Benefits Act (Public Law 106-117; 113 Stat. 1552; 38 U.S.C. 
     1710B note) is amended--
       (1) by striking ``Location of Pilot Program.--'' and 
     inserting ``Locations of Pilot Program.--(1)''; and
       (2) by adding at the end the following new paragraph:
       ``(2)(A) In the addition to the health care region of the 
     Department selected for the pilot program under paragraph 
     (1), the Secretary may also carry out the pilot program in 
     not more than one additional designated health care region of 
     the Department selected by the Secretary for purposes of this 
     section.
       ``(B) Notwithstanding subsection (f), the authority of the 
     Secretary to provide services under the pilot program in a 
     health care region of the Department selected under 
     subparagraph (A) shall cease on the date that is three years 
     after the commencement of the provision of services under the 
     pilot program in the health care region.''.

[[Page 29604]]



     SEC. 104. IMPROVEMENT OF PROGRAM FOR PROVISION OF SPECIALIZED 
                   MENTAL HEALTH SERVICES TO VETERANS.

       (a) Increase in Funding.--Subsection (c) of section 116 of 
     the Veterans Millennium Health Care and Benefits Act (Public 
     Law 106-117; 113 Stat. 1559; 38 U.S.C. 1712A note) is 
     amended--
       (1) in paragraph (1), by striking ``$15,000,000'' and 
     inserting ``$25,000,000 in each of fiscal years 2004, 2005, 
     and 2006'';
       (2) in paragraph (2), by striking ``$15,000,000'' and 
     inserting ``$25,000,000''; and
       (3) in paragraph (3)--
       (A) by inserting ``(A)'' after ``(3)''; and
       (B) by adding at the end the following new subparagraph:
       ``(B) For purposes of this paragraph, in fiscal years 2004, 
     2005, and 2006, the fiscal year utilized to determine the 
     baseline amount shall be fiscal year 2003.''.
       (b) Allocation of Funds.--Subsection (d) of that section is 
     amended--
       (1) by striking ``The Secretary'' and inserting ``(1) In 
     each of fiscal years 2004, 2005, and 2006, the Secretary''; 
     and
       (2) by adding at the end the following new paragraphs:
       ``(2) In allocating funds to facilities in a fiscal year 
     under paragraph (1), the Secretary shall ensure that--
       ``(A) not less than $10,000,000 is allocated by direct 
     grants to programs that are identified by the Mental Health 
     Strategic Health Care Group and the Committee on Care of 
     Severely Chronically Mentally Ill Veterans;
       ``(B) not less than $5,000,000 is allocated for programs on 
     post-traumatic stress disorder; and
       ``(C) not less than $5,000,000 is allocated for programs on 
     substance abuse disorder.
       ``(3) The Secretary shall provide that the funds to be 
     allocated under this section during each of fiscal years 
     2004, 2005, and 2006 are funds for a special purpose program 
     for which funds are not allocated through the Veterans 
     Equitable Resource Allocation system.''.

             TITLE II--CONSTRUCTION AND FACILITIES MATTERS

                  Subtitle A--Construction Authorities

     SEC. 201. INCREASE IN THRESHOLD FOR MAJOR MEDICAL FACILITY 
                   CONSTRUCTION PROJECTS.

       Section 8104(a)(3)(A) is amended by striking ``$4,000,000'' 
     and inserting ``$9,000,000''.

     SEC. 202. DEMOLITION OF OBSOLETE, DILAPIDATED, AND HAZARDOUS 
                   STRUCTURES ON DEPARTMENT OF VETERANS AFFAIRS 
                   PROPERTY.

       (a) In General.--Chapter 81 is amended by adding at the end 
     the following new subchapter:

                     ``SUBCHAPTER VI--OTHER MATTERS

     ``Sec. 8171. Demolition of obsolete, dilapidated, and 
       hazardous structures

       ``(a) Establishment of Fund.--There is established in the 
     Treasury a fund to be known as the Department of Veterans 
     Affairs Facilities Demolition Fund.
       ``(b) Elements of Fund.--The fund shall consist of the 
     following:
       ``(1) Amounts authorized to be appropriated to the fund.
       ``(2) Any other amounts deposited or transferred to the 
     fund by law.
       ``(c) Availability of Amounts in Fund.--Subject to the 
     provisions of appropriations Acts, amounts in the fund shall 
     be available to the Secretary for the purpose of the 
     demolition and removal, whether in whole or in part, of 
     obsolete, dilapidated, or hazardous structures on Department 
     property.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 81 is amended by adding at the end the 
     following:

                     ``SUBCHAPTER VI--OTHER MATTERS

``8171. Demolition of obsolete, dilapidated, and hazardous 
              structures.''.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated for the Department of Veterans Affairs for 
     fiscal year 2004, $25,000,000 for deposit in the Department 
     of Veterans Affairs Facilities Demolition Fund established by 
     section 8171 of title 38, United States Code, as added by 
     this section.

                Subtitle B--Construction Authorizations

     SEC. 211. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS.

       The Secretary of Veterans Affairs may carry out the 
     following major medical facility projects, with each project 
     to be carried out in an amount not to exceed the amount 
     specified for that project:
       (1) Construction of a long-term care facility in Lebanon, 
     Pennsylvania, $14,500,000.
       (2) Construction of a long-term care facility in Beckley, 
     West Virginia, $20,000,000.

     SEC. 212. AUTHORIZATION OF MAJOR MEDICAL FACILITY LEASES.

       The Secretary of Veterans Affairs may enter into leases for 
     medical facilities as follows:
       (1) Lease for the relocation and expansion of a health 
     administration center, Denver, Colorado, in an amount not to 
     exceed $4,080,000.
       (2) Lease for an outpatient clinic extension or for sharing 
     of Department of Veterans Affairs and Department of Defense 
     resources, Pensacola, Florida, in an amount not to exceed 
     $3,800,000.
       (3) Lease of an outpatient clinic extension, Boston, 
     Massachusetts, in an amount not to exceed $2,879,000.
       (4) Lease of a satellite outpatient clinic, Charlotte, 
     North Carolina, in an amount not to exceed $2,626,000.

     SEC. 213. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There are authorized to be appropriated 
     for the Secretary of Veterans Affairs for fiscal year 2004--
       (1) for the Construction, Major Projects, account, a total 
     of $34,500,000 for the projects authorized in section 211; 
     and
       (2) for the Medical Care account, a total of $13,385,000 
     for the leases authorized in section 212.
       (b) Limitation.--The projects authorized in section 211 may 
     only be carried out using--
       (1) funds appropriated for fiscal year 2004 pursuant to the 
     authorization of appropriations in subsection (a);
       (2) funds appropriated for Construction, Major Projects, 
     for a fiscal year before fiscal year 2004 that remain 
     available for obligation; and
       (3) funds appropriated for Construction, Major Projects, 
     for fiscal year 2004 for a category of activity not specific 
     to a project.

                 Subtitle C--Designation of Facilities

     SEC. 221. DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS 
                   OUTPATIENT CLINIC, HORSHAM, PENNSYLVANIA.

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

     SEC. 222. DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS 
                   HEALTH CARE FACILITY, CHICAGO, ILLINOIS.

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

     SEC. 223. DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS 
                   MEDICAL CENTER, HOUSTON, TEXAS.

       The Department of Veterans Affairs Medical Center in 
     Houston, Texas, shall after the date of the enactment of this 
     Act be known and designated as the ``Michael E. DeBakey 
     Department of Veterans Affairs Medical Center''. Any 
     reference to such facility in any law, regulation, map, 
     document, record, or other paper of the United States shall 
     be considered to be a reference to the Michael E. DeBakey 
     Department of Veterans Affairs Medical Center.

     SEC. 224. DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS 
                   MEDICAL CENTER, MINNEAPOLIS, MINNESOTA.

       The Department of Veterans Affairs Medical Center in 
     Minneapolis, Minnesota, shall after the date of the enactment 
     of this Act be known and designated as the ``Paul Wellstone 
     Department of Veterans Affairs Medical Center''. Any 
     reference to such medical center in any law, regulation, map, 
     document, record, or other paper of the United States shall 
     be considered to be a reference to the Paul Wellstone 
     Department of Veterans Affairs Medical Center.

                      TITLE III--PERSONNEL MATTERS

     SEC. 301. MODIFICATION OF AUTHORITY ON APPOINTMENTS OF 
                   PERSONNEL IN THE VETERANS HEALTH 
                   ADMINISTRATION.

       Section 7401 is amended--
       (1) in paragraph (2), by striking ``Psychologists'' and all 
     that follows through ``dietitians,'' and inserting 
     ``Dietitians,''; and
       (2) in paragraph (3)--
       (A) by inserting ``other psychologists,'' after ``approved 
     by the Secretary,''; and
       (B) by striking ``and occupational therapists'' and 
     inserting ``occupational therapists, kinesiologists, and 
     social workers''.

     SEC. 302. COVERAGE OF EMPLOYEES OF VETERANS' CANTEEN SERVICE 
                   UNDER ADDITIONAL EMPLOYMENT LAWS.

       Section 7802(5) is amended by inserting before the 
     semicolon the following: ``. Employees and personnel under 
     this clause may be considered for appointment in Department 
     positions in the competitive service in the same manner that 
     Department employees in the competitive service are 
     considered for transfer to such positions. An employee or 
     individual appointed as personnel under this clause who is 
     appointed to a Department position under the authority of the 
     preceding sentence shall be treated as having a career 
     appointment in such position once such employee or individual 
     meets the three-year requirement for career tenure (with any 
     previous period of employment or appointment in the Service 
     being counted toward satisfaction of such requirement)''.

     SEC. 303. EFFECTIVE DATE OF MODIFICATION OF TREATMENT FOR 
                   RETIREMENT ANNUITY PURPOSES OF CERTAIN PART-
                   TIME SERVICE OF CERTAIN DEPARTMENT OF VETERANS 
                   AFFAIRS HEALTH-CARE PROFESSIONALS.

       (a) Effective Date.--The effective date of the amendment 
     made by section 132 of the Department of Veterans Affairs 
     Health Care Programs Enhancement Act of 2001 (Public Law 107-
     135; 115 Stat. 2454) shall be as follows:
       (1) January 23, 2002, in the case of health care 
     professionals referred to in subsection (c) of section 7426 
     of title 38, United States Code (as so amended), who retire 
     on or after that date.
       (2) The date of the enactment of this Act, in the case of 
     health care professionals referred to in such subsection (c) 
     who retired before January 23, 2002, but after April 7, 1986.

[[Page 29605]]

       (b) Recomputation of Annuity.--The Office of Personnel 
     Management shall recompute the annuity of each health-care 
     professional described in the first sentence of subsection 
     (c) of section 7426 of title 38, United States Code (as so 
     amended), who retired before January 23, 2002, but after 
     April 7, 1986, in order to take into account the amendment 
     made by section 132 of the Department of Veterans Affairs 
     Health Care Programs Enhancement Act of 2001. Such 
     recomputation shall be effective only with respect to 
     annuities paid after the date of the enactment of this Act, 
     and shall apply beginning the first day of the first month 
     beginning after the date of the enactment of this Act.

                        TITLE IV--OTHER MATTERS

 Subtitle A--Capital Asset Realignment for Enhanced Services Initiative

     SEC. 401. ADVANCE NOTIFICATION OF CAPITAL ASSET REALIGNMENT 
                   INITIATIVE.

       (a) Requirement for Advance Notification.--Before taking 
     any action proposed under the Capital Asset Realignment for 
     Enhanced Services initiative of the Department of Veterans 
     Affairs, the Secretary of Veterans Affairs shall submit to 
     Congress a written notification of the intent to take such 
     action.
       (b) Limitation.--The Secretary may not take any proposed 
     action described in subsection (a) until the later of--
       (1) the expiration of the 60-day period beginning on the 
     date on which the Secretary submits to Congress the 
     notification of the proposed action required under subsection 
     (a); or
       (2) the expiration of a period of 30 days of continuous 
     session of Congress beginning on such date of notification 
     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.
       (c) Continuous Session of Congress.--For the purposes of 
     subsection (b)--
       (1) the continuity of session of Congress is broken only by 
     an adjournment of Congress sine die; and
       (2) the days on which either House is not in session 
     because of an adjournment of more than three days to a day 
     certain are excluded in the computation of any period of time 
     in which Congress is in continuous session.

     SEC. 402. AUTHORIZATION OF MAJOR CONSTRUCTION PROJECTS IN 
                   CONNECTION WITH CAPITAL ASSET REALIGNMENT 
                   INITIATIVE.

       (a) Authority To Carry Out Major Construction Projects.--
     Subject to subsection (b), the Secretary of Veterans Affairs 
     may carry out major construction projects, and plan for such 
     projects, as outlined in the final report of the Capital 
     Asset Realignment for Enhanced Services Commission and 
     approved by the Secretary.
       (b) Limitation.--The Secretary may not exercise the 
     authority in subsection (a) until 60 days after the date of 
     the submittal of the report required by subsection (c).
       (c) Report on Proposed Major Construction Projects.--(1) 
     The Secretary shall submit to the Committees on Veterans' 
     Affairs of the Senate and House of Representatives a report 
     describing the major construction projects the Secretary 
     proposes to carry out in connection with the Capital Asset 
     Realignment for Enhanced Services initiative.
       (2) The report shall list each proposed major construction 
     project in order of priority, with such priority determined 
     in the order as follows:
       (A) The use of the facility to be constructed or altered as 
     a replacement or enhancement facility necessitated by the 
     loss, closure, or other divestment of major infrastructure or 
     clinical space at a Department of Veterans Affairs medical 
     facility currently in operation, as determined by the 
     Secretary.
       (B) The use of such facility to provide tertiary and acute 
     care services to a population that is determined under the 
     Capital Asset Realignment for Enhanced Services initiative to 
     be in need of such facility and not currently served by such 
     facility.
       (C) The use of such facility as an outpatient clinic to 
     provide basic care services to a population of veterans in 
     need of such services, as determined by the Secretary.
       (D) The need for such facility to further an enhanced-use 
     lease or sharing agreement.
       (E) Any other factors that the Secretary considers to be of 
     importance in providing care to eligible veterans.
       (3) In developing the list of projects and according a 
     priority to each project, the Secretary should consider the 
     importance of allocating available resources equitably among 
     the regional health care networks of the Department and take 
     into account recent shifts in populations of veterans among 
     such regional health care networks.
       (d) Multiyear Contract Authority.--To the extent that funds 
     are otherwise available for obligation, the Secretary may 
     enter into a multiyear contract for a major construction 
     project under this section. The period of such a multiyear 
     contract may not exceed five program years. If a multiyear 
     contract under this subsection is not fully funded when 
     entered into, the contract shall provide that performance 
     under the contract during the second and subsequent years of 
     the contract is contingent upon the appropriation of funds 
     and may provide for a cancellation payment to be made to the 
     contractor if such appropriations are not made.
       (e) Funding.--To carry out major construction projects 
     under the Capital Asset Realignment for Enhanced Services 
     initiative, the Secretary may use any combination of funds 
     appropriated for such initiative and funds available to the 
     Secretary for major construction.
       (f) Major Construction Project Defined.--In this section, 
     the term ``major construction project'' means a major medical 
     facility project, as that term is defined in section 
     8104(a)(3)(A) of title 38, United States Code, as amended by 
     section 201 of this Act.

               Subtitle B--Extension of Other Authorities

     SEC. 411. THREE-YEAR EXTENSION OF HOUSING ASSISTANCE FOR 
                   HOMELESS VETERANS.

       Section 2041(c) is amended by striking ``December 31, 
     2003'' and inserting ``December 31, 2006''.

     SEC. 412. FOUR-YEAR EXTENSION OF EVALUATION OF HEALTH STATUS 
                   OF SPOUSES AND CHILDREN OF PERSIAN GULF WAR 
                   VETERANS.

       Section 107(b) of the Persian Gulf War Veterans' Benefits 
     Act (title I of Public Law 103-446; 38 U.S.C. 1117 note) is 
     amended by striking ``December 31, 2003'' and inserting 
     ``December 31, 2007''.

                       Subtitle C--Other Matters

     SEC. 421. MODIFICATION OF ELIGIBILITY OF FILIPINO VETERANS 
                   FOR HEALTH CARE IN THE UNITED STATES.

       The text of section 1734 is amended to read as follows:
       ``(a) The Secretary shall, within the limits of Department 
     facilities, furnish hospital and nursing home care and 
     medical services to an individual described in subsection (b) 
     in the same manner as provided for under section 1710 of this 
     title.
       ``(b) An individual described in this subsection is any 
     individual who is residing in the United States and is a 
     citizen of, or an alien lawfully admitted for permanent 
     residence in, the United States as follows:
       ``(1) A Commonwealth Army veteran.
       ``(2) A new Philippine Scout.''.

     SEC. 422. REPEAL OF LIMITS ON TERMS OF CERTAIN OFFICIALS IN 
                   OFFICE OF UNDER SECRETARY FOR HEALTH.

       Section 7306 is amended--
       (1) by striking subsection (d); and
       (2) by redesignating subsections (e) and (f) as subsections 
     (d) and (e), respectively.
       Amend the title to read as follows: ``A bill to amend title 
     38, United States Code, to improve and enhance the provision 
     of long-term health care for veterans by the Department of 
     Veterans Affairs, to enhance and improve authorities relating 
     to the administration of personnel of the Department of 
     Veterans Affairs, to authorize major construction projects 
     for the Department of Veterans Affairs, and for other 
     purposes.''.

  Mr. SPECTER. Madam President, I have sought recognition today to 
explain briefly the provisions of S. 1156, the proposed Veterans Health 
Care, Capital Asset, and Business Improvement Act of 2003, as the 
ranking member of the Committee on Veterans Affairs, Senator Graham of 
Florida, and I propose be amended to incorporate provisions contained 
in S. 1156 as reported by the Committee on Veterans Affairs on November 
10, 2003, and also to contain provisions derived from H.R. 1720, passed 
by the House on October 29, 2003, H.R. 2357, passed by the House on 
July 21, 2003, H.R. 2433, passed by the House on September 10, 2003, 
H.R. 3260, passed by the House on October 8, 2003, and H.R. 3387, 
passed by the House October 29, 2003.
  This bill, as so amended, incorporates agreements reached between the 
Senate Committee on Veterans' Affairs, which I am privileged to chair, 
and our counterpart committee in the House of Representatives, on 
legislation relating to the provision of health care services by the 
Department of Veterans Affairs. I thank the Ranking Member, Senator 
Graham of Florida, and the Chairman and Ranking Member of the House 
Committee on Veterans Affairs, Representative Chris Smith of New Jersey 
and Representative Lane Evans of Illinois, for their advocacy for 
veterans and for their cooperation in resolving issues raised by the 
bills considered in our respective bodies. Inasmuch as S. 1156, as 
reported by the Committee on Veterans' Affairs, itself incorporated 
provisions drawn from nine separate Senate bills, S. 1156 as presented 
to the Senate today is properly viewed as a bill that incorporates 
provisions from 14 separate pieces of legislation. A bill containing 
such a range of material would not have been knitted together, as this 
one has been, without a spirit of cooperation and bipartisanship from 
the other body. The Ranking Member, Senator Graham of Florida, and I 
appreciate the leadership of the House Committee on Veterans Affairs.
  Since this is a lengthy bill--over 50 pages--I will not endeavor in 
this statement to explain in detail each and every provision. Rather, I 
will discuss the highlights briefly in this statement, and refer my 
colleagues to a Joint Explanatory Statement, which I ask be 
incorporated into the Record as if read, for a detailed explanation of 
the bill as amended.

[[Page 29606]]

  The starting point for S. 1156, as presented to the Senate today, was 
S. 1156, the proposed Veterans' Health Care Authorities Extension and 
Improvement Act of 2003. That bill was marked up by the Senate 
Committee on Veterans' Affairs on September 30, 2003, and reported on 
November 10, 2003. S. 1156, as reported, contained a number of 
elements; its key provisions would have extended mandates that VA 
provide nursing home care and outpatient-based long term care services 
to our senior veterans; improved VA assisted living and mental health 
programs; modified VA personnel provisions relating to non-physician 
providers of healthcare services and employees of VA's Veterans Canteen 
Service; and authorized major medical facility projects and projects 
related to VA's Capital Assets Realignment for Enhanced Services, 
CARES, initiative. Each and all of these provisions, with some 
modifications as appropriate, are contained in S. 1156 as presented to 
the Senate today.
  The major change between the bill, as reported, and the current bill 
is the addition of provisions contained in House-passed legislation. 
House-approved provisions incorporated into the bill would allow 
radiation-exposed veterans higher priority access to VA health care; 
exempt former prisoners-of-war from pharmaceutical copayments; create 
in VA an Office of Research Oversight; authorize VA to allow ``Saturday 
premium pay'' to licensed practical nurses and nursing assistants; and 
authorize additional needed VA construction projects. All of these 
added provisions are constructive and useful.
  I ask that my colleagues in the Senate approve this legislation. It 
is good bipartisan legislation that is supported by VA's extraordinary 
Secretary, the Honorable Anthony J. Principi, and by the major veterans 
service organizations.
  I ask unanimous consent that the Joint Explanatory Statement that 
accompanies my statement today be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

  Explanatory Statement on S. 1156, as Amended--Veterans Health Care, 
          Capital Asset, and Business Improvement Act of 2003

       S. 1156, as amended, the Veterans Health Care, Capital 
     Asset, and Business Improvement Act of 2003, (hereinafter, 
     ``Compromise Agreement'') reflects a negotiated agreement 
     reached by the Senate and House of Representatives Committees 
     on Veterans' Affairs concerning provisions in a number of 
     bills considered by the House and Senate during the 1st 
     session of the 108th Congress. The measures considered in 
     this compromise are: S. 1156, as amended, as reported by the 
     Senate Committee on Veterans' Affairs on November 10, 2003 
     (hereinafter, ``Senate bill''); S. 1815 introduced on 
     November 4, 2003; H.R. 2357, as amended, passed the House on 
     July 21, 2003; H.R. 2433, as amended, passed the House on 
     September 10, 2003; H.R. 1720, as amended, passed the House 
     on October 29, 2003; H.R. 3260, as introduced in the House on 
     October 8, 2003; and H.R. 3387, as introduced in the House on 
     October 29, 2003 (hereinafter, ``House bills'').
       The House and Senate Committees on Veterans' Affairs have 
     prepared the following explanation of the Compromise 
     Agreement. Differences between the provisions contained in 
     the Compromise Agreement and the related provisions of the 
     Senate bill and the House bills are noted, except for 
     clerical corrections, conforming changes made necessary by 
     the Compromise Agreement, and minor drafting, technical, and 
     clarifying changes.

          TITLE I--HEALTH CARE AUTHORITIES AND RELATED MATTERS


             improved benefits for former prisoners of war

     Current Law
       Section 1712 of title 38, United States Code, authorizes 
     outpatient dental services and related dental appliances to 
     veterans who are former prisoners of war (POWs) if they were 
     detained or interned for a period of at least 90 days.
       Section 1722A of title 38, United States Code, requires 
     veterans who are not service-connected with a disability 
     rated at more than 50 percent or eligible for pensions under 
     section 1521 of title 38, United States Code, to make 
     copayments for medications.
     Senate Bill
       The Senate bill contains no comparable provisions.
     House Bill
       Section 3 of H.R. 3260 would authorize veterans who are 
     former POWs to receive outpatient dental care, irrespective 
     of the number of days held captive, and would exempt former 
     POWs from the requirement to make copayments on outpatient 
     prescription medications.
     Compromise Agreement
       Section 101 of the Compromise Agreement follows the House 
     language.


   provision of health care to veterans who participated in certain 
     department of defense chemical and biological warfare testing

     Current Law
       There is no comparable provision in current law.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 2 of H.R. 2433, as amended, would authorize the 
     Department of Veterans Affairs (hereinafter ``VA'' or 
     ``Department'') to provide higher priority health care to 
     veterans who participated in Project Shipboard Hazard and 
     Defense (SHAD), Project 112 or related land-based tests 
     conducted by the Department of Defense Desert Test Center, 
     from 1962 through 1973, without those veterans needing an 
     adjudicated service-connected disability to establish their 
     priority for care.
     Compromise Agreement
       Section 102 of the Compromise Agreement follows the House 
     language.


eligibility for department of veterans affairs health care for certain 
      Filipino world war ii veterans residing in the united states

     Current Law
       Section 1734 of title 38, United States Code, establishes 
     that veterans of the Commonwealth Army and New Philippine 
     Scouts residing legally in the United States are eligible for 
     VA health care services for the treatment of service-
     connected disabilities and, in the case of Commonwealth Army 
     veterans, for non service-connected conditions if they are in 
     receipt of disability compensation.
     Senate Bill
       Section 421 of the Senate bill contains a similar 
     provision.
     House Bill
       Section 3 of H.R. 2357, as amended, would authorize VA 
     health care for additional World War II Filipino veterans who 
     reside legally in the United States. These veterans of the 
     Commonwealth Army and New Philippine Scouts, would be subject 
     to the same eligibility and means test requirements as U.S. 
     veterans. The House bill would require the Secretary of 
     Veterans Affairs (hereinafter, ``Secretary'') to certify each 
     fiscal year that sufficient resources are available at the VA 
     health care facilities where the majority of these veterans 
     would seek care.
     Compromise Agreement
       Section 103 of the Compromise Agreement follows the House 
     language, except the Compromise Agreement does not include 
     the resource availability certification requirement.


                 enhancement of rehabilitative services

     Current Law
       Chapter 31 of title 38 authorizes VA to provide vocational 
     rehabilitation services. VA is authorized under chapter 17 of 
     title 38 to offer medical care and compensated work therapy 
     to certain veterans.
     Senate Bill
       The Senate bill contains no comparable provisions.
     House Bill
       Section 3 of H.R. 3387 would authorize the Secretary to 
     provide therapeutic employment support services (i.e., skills 
     training and development services, employment support 
     services, and job development and placement services) to 
     patients in need of rehabilitation for mental health 
     disorders, including serious mental illness and substance use 
     disorders.
       Section 3 of H.R. 3387 would also authorize VA to use funds 
     in the Special Therapeutic and Rehabilitation Activities Fund 
     (STRAF) authorized under section 1718(c) of title 38, United 
     States Code, to furnish such therapeutic employment support 
     services.
     Compromise Agreement
       Section 104 of the Compromise Agreement follows the House 
     language.


  enhanced agreement authority for provision of nursing home care and 
              adult day health care in contract facilities

     Current Law
       Section 1720 of title 38, United States Code, authorizes VA 
     to contract for the provision of nursing home care and adult 
     day health care for certain veterans and members of the Armed 
     Forces.
     Senate Bill
       Section 102 of the Senate bill would expand VA's authority 
     to enter into relationships based upon ``provider 
     agreements'' with Centers for Medicare and Medicaid Services 
     (CMS)-certified, small, community-based nursing homes and 
     non-institutional extended care providers, by permitting VA 
     to use provider agreements similar to those used by CMS.
     House Bill
       The House bills contain no comparable provision.

[[Page 29607]]


     Compromise Agreement
       Section 105 of the Compromise Agreement generally follows 
     the Senate language.


    five-year extension of period for provision of noninstitutional 
         extended-care services and required nursing home care

     Current Law
       Section 1701(10)(A) of title 38, United States Code, 
     requires VA to provide noninstitutional extended care 
     services to enrolled veterans. In addition, section 1710A(c) 
     of title 38, United States Code, requires VA to provide 
     nursing home care to high-priority veterans in need of care.
     Senate Bill
       Section 101 of the Senate bill would extend the authorities 
     for noninstitutional extended care and required nursing home 
     care through December 31, 2008.
     House Bill
       Section 2 of H.R. 3260 would extend the authorities for the 
     noninstitutional extended care services and required nursing 
     home care to December 31, 2008. The report required under 
     section 101 of Public Law 106-117 would be extended until 
     January 1, 2008.
     Compromise Agreement
       Section 106 of the Compromise Agreement follows the House 
     language from subsection 2(a) and (b) of H.R. 3260.


 expansion of department of veterans affairs pilot program on assisted 
                          living for veterans

     Current Law
       Section 103(b) of Public Law 106-117 authorizes the 
     establishment of a pilot program in one VA geographic health 
     care region to provide assisted living services to veterans.
     Senate Bill
       Section 103 of the Senate bill would authorize the 
     establishment of one additional assisted living pilot program 
     for three years from the commencement of the provision of 
     assisted living services under the program.
     House Bill
       The House bills contain no comparable provision.
     Compromise Agreement
       Section 107 of the Compromise Agreement follows the Senate 
     language.


   improvement of program for provision of specialized mental health 
                          services to veterans

     Current Law
       Section 116(c) of Public Law 106-117 provides funding in 
     the amount of $15,000,000 for specialized mental health 
     services in fiscal years 2004, 2005 and 2006.
     Senate Bill
       Section 104 of the Senate bill would increase the funding 
     authorization for these specialized mental health services 
     from $15,000,000 to $25,000,000, and would specify allocation 
     of these funds outside the Veterans Equitable Resource 
     Allocation system.
     House Bill
       The House bills contain no comparable provisions.
     Compromise Agreement
       Section 108 of the Compromise Agreement follows the Senate 
     language.

             TITLE II--CONSTRUCTION AND FACILITIES MATTERS

                    Subtitle A--Program Authorities


 increase in threshold for major medical facility construction projects

     Current Law
       Section 8104(a)(3) of title 38, United States Code, defines 
     a major medical facility project as a project for 
     construction, alteration, or acquisition of a medical 
     facility involving a total expenditure of more than 
     $4,000,000.
     Senate Bill
       Section 201 of the Senate bill would raise the threshold 
     for major medical facility projects from $4,000,000 to 
     $9,000,000.
     House Bill
       Section 7 of H.R. 1720, as amended, would raise the 
     threshold for major medical facility projects from $4,000,000 
     to $6,000,000.
     Compromise Agreement
       Section 201 of the Compromise Agreement would raise the 
     threshold for major medical facility projects from $4,000,000 
     to $7,000,000.


              enhancements to enhanced-use lease authority

     Current Law
       Section 8162 of title 38, United States Code, authorizes 
     the Secretary to enter into enhanced-use leases of Veterans 
     Health Administration (VHA) real property under the 
     jurisdiction of the Secretary.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 4 of H.R. 3260 would extend the jurisdiction of 
     this authority to the Veterans Benefits Administration (VBA) 
     and National Cemetery Administration (NCA), for properties of 
     these Administrations under the control of the Secretary. 
     Further, the bill would streamline the process and 
     notification requirements and allow proceeds from an 
     enhanced-use lease to be credited to accounts for use by VHA, 
     VBA or NCA as appropriate. The bill would allow individual VA 
     facilities to be reimbursed for the expenses incurred by the 
     development and execution of enhanced-use leases.
     Compromise Agreement
       Section 202 of the Compromise Agreement adopts the 
     provisions of the House bill which streamline the approval 
     process for enhanced use leases in VHA. The provisions 
     concerning the expansion of this authority to properties of 
     NCA and VBA have been omitted due to mandatory spending 
     concerns.


     simplification of annual report on long-range health planning

     Current Law
       Section 8107 of title 38, United States Code, requires VA 
     to submit annually a report regarding the long-range health 
     planning of the Department. Included in that report is a 
     five-year strategic plan for the provision of health care 
     services to veterans, a plan for the coordination of care 
     among the geographic health care regions of the Department, a 
     profile of each such region, any planned changes to the 
     mission of any medical facility of the Department, and a 
     listing of the 20 VA major medical facility projects with the 
     highest priority.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 7(d) of H.R. 3260 would change the report date on 
     the Annual Report on Long-Range Health Planning to June 1 of 
     each year.
     Compromise Agreement
       Section 203 of the Compromise Agreement rescinds section 
     8107(b)(3) and (4) of title 38, United States Code, to 
     simplify the required report by removing the detailed 
     prescription of its content.

                   Subtitle B--Project Authorizations


            authorization of major medical facility projects

     Current Law
       Section 8104(2) of title 38, United States Code, requires 
     Congressional authorization of any VA major medical facility 
     construction project.
     Senate Bill
       Section 211 of the Senate bill, as reported, would 
     authorize the following major construction projects:

------------------------------------------------------------------------
              Location                      Purpose             Cost
------------------------------------------------------------------------
Lebanon, PA........................  New Long-Term Care      $14,500,000
                                      Facility.
Beckley, WV........................  New Long-Term Care       20,000,000
                                      Facility.
------------------------------------------------------------------------

     House Bill
       Section 3 of H.R. 1720, as amended, would authorize the 
     following major construction projects:

------------------------------------------------------------------------
              Location                      Purpose             Cost
------------------------------------------------------------------------
Chicago, IL........................  New Inpatient Bed       $98,500,000
                                      Tower.
San Diego, CA......................  Seismic Corrections,     48,600,000
                                      Building 1.
West Haven, CT.....................  Renovate Inpatient       50,000,000
                                      Wards & Consolidate
                                      Medical Research
                                      Facilities.
Columbus, OH.......................  New Medical Facility.    90,000,000
Pensacola, FL......................  New VA-Navy Joint        45,000,000
                                      Venture Outpatient
                                      Clinic.
------------------------------------------------------------------------

     Compromise Agreement
       Section 211 of the Compromise Agreement authorizes the 
     major construction projects for Lebanon, Pennsylvania; 
     Beckley, West Virginia; Chicago, Illinois; San Diego, 
     California; West Haven, Connecticut; and Pensacola, Florida.


             authorization of major medical facility leases

     Current Law
       Section 8104 of title 38, United States Code, requires 
     Congressional authorization of any VA medical facility lease 
     with an annual lease payment of more than $600,000.
     Senate Bill
       Section 212 of the Senate bill, as reported, would 
     authorize the following leases:

------------------------------------------------------------------------
              Location                      Purpose             Cost
------------------------------------------------------------------------
Denver, CO.........................  Relocate Health          $4,080,000
                                      Administration
                                      Center.
Pensacola, FL......................  Relocate Outpatient       3,800,000
                                      Clinic.
Boston, MA.........................  Extend Outpatient         2,879,000
                                      Clinic.
Charlotte, NC......................  Relocate Outpatient       2,626,000
                                      Clinic.
------------------------------------------------------------------------

     House Bill
       Section 3 of H.R. 1720, as amended, would authorize the 
     following leases:

------------------------------------------------------------------------
              Location                      Purpose             Cost
------------------------------------------------------------------------
Charlotte, NC......................  Outpatient Clinic....    $3,000,000
Clark County, NV...................  Multi-specialty           6,500,000
                                      Outpatient Clinic.
Aurora, CO.........................  Regional Federal         30,000,000
                                      Medical Center.
------------------------------------------------------------------------

     Compromise Agreement
       Section 212 of the Compromise Agreement authorizes the 
     leases for Charlotte, North Carolina, and Boston, 
     Massachusetts.
       The Compromise Agreement contains the provision of Section 
     211 of H.R. 1720, as amended, to authorize a major 
     construction project for Pensacola, Florida. It was 
     determined that no lease authority for the Pensacola site was 
     necessary. Further, the Compromise Agreement would not 
     authorize a lease supporting relocation and expansion of the 
     Health Administration Center (HAC) in

[[Page 29608]]

     Denver, Colorado. The Committees believe the Department has 
     not justified the continuing expansion of activities at the 
     HAC. The Committees are concerned that this administrative 
     function, originally authorized to process reimbursement 
     claims for the Civilian Health and Medical Program for the VA 
     (CHAMPVA), has inflated its activities well beyond its 
     original responsibilities. The Committees urge VA to 
     reconsider whether the long-term obligation of leased space 
     and the significant growth of staff at the HAC, as opposed to 
     other methods of accomplishing these various tasks, are 
     warranted.
       The Compromise Agreement generally follows the Senate 
     language on the Regional Federal Medical Center lease at the 
     former Fitzsimons Army Medical Center in Aurora, Colorado, 
     pending a decision by the Secretaries of Veterans Affairs and 
     Defense on the nature of any joint venture undertaking at the 
     site. However, advance planning is authorized for this 
     project under section 213 of the Compromise Agreement.


                    advance planning authorizations

     Current Law
       Section 8104(2) of title 38, United States Code, requires 
     Congressional authorization of all VA major medical facility 
     construction project.
     Senate Bill
       The Senate bill contains no similar provisions.
     House Bill
       Section 3 of H.R. 1720, as amended, would authorize major 
     construction projects in Columbus, Ohio; Denver (Aurora), 
     Colorado; and the lease of a Multi-specialty Outpatient 
     Clinic in Clark County (Las Vegas), Nevada.
     Compromise Agreement
       Section 213 of the Compromise Agreement authorizes advance 
     planning funds for fiscal year 2004 for purposes of 
     developing new medical facilities at the following locations:

------------------------------------------------------------------------
              Location                      Purpose             Cost
------------------------------------------------------------------------
Columbus, OH.......................  Advance Planning.....    $9,000,000
Las Vegas, NV......................  Advance Planning.....    25,000,000
Pittsburgh, PA.....................  Advance Planning.....     9,000,000
Denver (Aurora), CO................  Advance Planning.....    26,000,000
East Central Florida...............  Advance Planning.....    17,500,000
------------------------------------------------------------------------

       The Committees concluded these projects, while warranted, 
     require further development. The Committees believe these 
     projects should be considered high priorities from VA's 
     ongoing review of future health care infrastructure needs, 
     the Capital Asset Realignment for Enhanced Services (CARES) 
     initiative.
       Given VA's documented plan to pursue significant capital 
     investments and improvements in health care infrastructure 
     and the Committees' understanding that the Appropriations 
     Committees of the House and Senate are hesitant to provide 
     funds for new VA medical facility construction prior to the 
     completion of the CARES process, the Compromise agreement 
     authorizes $86,500,000 to allow for planning of projects at 
     these sites.


                    authorization of appropriations

     Current Law
       Section 8104(2) of title 38, United States Code, requires 
     Congressional authorization of appropriations for VA major 
     medical facility projects.
     Senate Bill
       Section 213 of the Senate bill would authorize $34,500,000 
     for fiscal year 2004 for projects authorized and $4,984,000 
     for the leases authorized by this bill.
     House Bill
       Section 3 of H.R. 1720, as amended, would authorize 
     $332,100,000 to be appropriated in fiscal year 2004 for the 
     projects authorized by this bill.
     Compromise Agreement
       Section 214 of the Compromise Agreement authorizes 
     $276,600,000 for fiscal year 2004 for the major construction 
     projects authorized in section 211 of the Compromise 
     Agreement. In addition, section 214 of the Compromise 
     Agreement authorizes the appropriation of $86,500,000 for 
     advanced planning projects identified in section 213 of the 
     Compromise Agreement.

 Subtitle C--Capital Asset Realignment for Enhanced Services Initiative


authorization of major construction projects in connection with capital 
                      asset realignment initiative

     Current Law
       Section 8104(2) of title 38, United States Code, requires 
     Congressional authorization of all VA major medical facility 
     projects.
     Senate Bill
       Section 402 of the Senate bill would authorize the 
     Secretary to carry out major construction projects outlined 
     in the final report on the CARES initiative. This authority 
     would be subject to a 60-day advance notification to 
     Congress. The Secretary would be required to submit a list 
     containing each major project in order of priority, based on 
     the criteria specified in the bill. The bill also would add a 
     provision authorizing multi-year contract authority for major 
     construction projects.
     House Bill
       The House bills contain no comparable provisions.
     Compromise Agreement
       Section 221 of the Compromise Agreement follows the Senate 
     language with modifications. The Compromise Agreement would 
     require a 45-day advance notification to Congress prior to 
     carrying out major medical facility construction projects 
     selected by the Secretary. The Secretary would be required to 
     submit a one-time report to Congress by February 1, 2004, 
     that lists each proposed major construction project in order 
     of priority. The Compromise Agreement establishes these 
     priorities as follows: (a) to replace or enhance a facility 
     necessitated by the loss, closure or other divestment of a VA 
     medical facility currently in operation; (b) to remedy life-
     safety deficiencies, including seismic, egress, and fire 
     deficiencies; (c) to provide health care services to an 
     underserved population; (d) to renovate or modernize 
     facilities, including providing barrier free design, 
     improving building systems and utilities, or enhancing 
     clinical support services; (e) to further an enhanced-use 
     lease or sharing agreement; and (f) to give the Secretary 
     discretion to select other projects of importance in 
     providing care to veterans.
       The authority to enter into any major medical facility 
     construction contracts for projects selected under the 
     authority of section 221 of the Compromise Agreement would 
     expire on September 30, 2006.


       advance notification of capital asset realignment actions

     Current Law
       There is no comparable provision in current law.
     Senate Bill
       Section 401 of the Senate bill would require the Secretary 
     to provide Congress a 60-day advance notification of any 
     actions proposed by the Department under the CARES 
     initiative.
     House Bill
       The House bills contain no comparable provisions.
     Compromise Agreement
       Section 222 of the Compromise Agreement follows the Senate 
     language with modifications. VA would be required to notify 
     Congress in writing of actions under the CARES initiative 
     that would result in medical facility closures, significant 
     staff realignments or medical facility consolidations. The 
     Compromise Agreement would prohibit such actions for 60 days 
     (or 30 days of continuous session of Congress) after such 
     notifications are made.


 sense of congress and report on access to health care for veterans in 
                              rural areas.

     Current Law
       There is no comparable provision in current law.
     Compromise Agreement
       Section 223 of the Compromise Agreement would express the 
     sense of Congress recognizing the difficulties in access to 
     VA health care faced by veterans residing in rural areas and 
     require VA to report to the Committees on Veterans' Affairs 
     with a plan of action to improve access to health care for 
     veterans residing in rural areas. A report of VA's plan to 
     improve access to health care for these veterans would be due 
     not later than 120 days after the date of enactment of this 
     Act.

                  Subtitle D--Plans for New Facilities


         plans for hospital care facilities in specified areas

     Current Law
       There is no comparable provision in current law.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 6 of H.R. 1720, as amended, would require the 
     Secretary to develop plans for meeting the future hospital 
     care needs of veterans who reside in a number of counties of 
     southern New Jersey and far southern counties of Texas, with 
     a report to the Committees by January 31, 2004.
     Compromise Agreement
       Section 231 of the Compromise Agreement follows the House 
     language and would add a requirement for plans for the 
     Florida Panhandle and North Central Washington. The due date 
     of the report required would be adjusted in section 231 of 
     the Compromise Agreement to April 15, 2004.


study and report on feasibility of coordination of veterans health care 
     services in south carolina with new university medical center

     Current Law
       There is no comparable provision in current law.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 8 of H.R. 1720, as amended, would require the 
     Secretary to conduct a feasibility study in coordination with 
     the Medical University of South Carolina and in consultation 
     with the Secretary of Defense, to consider establishing a 
     joint health-care venture to deliver inpatient, outpatient 
     and/or long-term care to veterans, military personnel, and 
     other beneficiaries who reside in Charleston, South Carolina, 
     with a report to the Committees by March 31, 2004.

[[Page 29609]]


     Compromise Agreement
       Section 232 of the Compromise Agreement follows the House 
     language and adjusts the due date of the report to April 15, 
     2004.

                 Subtitle E--Designation of Facilities


designation of department of veterans affairs medical center, prescott, 
arizona, as the bob stump department of veterans affairs medical center

     Current Law
       Section 531 of title 38, United States Code, requires a 
     Department facility, structure or real property to be named 
     after the geographic area in which the facility, structure or 
     real property is located, except as expressly provided by 
     law.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 8 of H.R. 3260 would name the VA Medical Center in 
     Prescott, Arizona, the ``Bob Stump Department of Veterans 
     Affairs Medical Center.''
     Compromise Agreement
       Section 241 of the Compromise Agreement follows the House 
     language.


  designation of department of veterans affairs health care facility, 
 chicago, illinois, as the jesse brown department of veterans affairs 
                             medical center

     Current Law
       Section 531 of title 38, United States Code, requires a 
     Department facility, structure or real property to be named 
     after the geographic area in which the facility, structure or 
     real property is located, except as expressly provided by 
     law.
     Senate Bill
       Section 222 of the Senate bill contains a similar 
     provision.
     House Bill
       Section 9 of H.R. 1720, as amended, would name the VA 
     Chicago Health Care System, West Side Division, the ``Jesse 
     Brown Department of Veterans Affairs Medical Center.''
     Compromise Agreement
       Section 242 of the Compromise Agreement contains this 
     provision.


DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, HOUSTON, 
TEXAS, AS THE MICHAEL E. DEBAKEY DEPARTMENT OF VETERANS AFFAIRS MEDICAL 
                                 CENTER

     Current Law
       Section 531 of title 38, United States Code, requires a 
     Department facility, structure or real property to be named 
     after the geographic area in which the facility, structure or 
     real property is located, except as expressly provided by 
     law.
     Senate Bill
       Section 223 of the Senate bill would name the VA Medical 
     Center located in Houston, Texas, the ``Michael E. DeBakey 
     Department of Veterans Affairs Medical Center.''
     House Bill
       The House bills contain no comparable provision.
     Compromise Agreement
       Section 243 of the Compromise Agreement follows the Senate 
     language.


DESIGNATION OF THE DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, SALT 
LAKE CITY, UTAH, AS THE GEORGE E. WAHLEN DEPARTMENT OF VETERANS AFFAIRS 
                             MEDICAL CENTER

     Current Law
       Section 531 of title 38, United States Code, requires a 
     Department facility, structure or real property to be named 
     after the geographic area in which the facility, structure or 
     real property is located, except as expressly provided by 
     law.
     Senate Bill
       S. 1815 would name the VA Medical Center located in Salt 
     Lake City, Utah, the ``George E. Wahlen Department of 
     Veterans Affairs Medical Center.''
     House Bill
       The House bills contain no comparable provision.
     Compromise Agreement
       Section 244 of the Compromise Agreement follows the Senate 
     language.


 DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC, NEW 
                          LONDON, CONNECTICUT

     Current Law
       Section 531 of title 38, United States Code, requires a 
     Department facility, structure or real property to be named 
     after the geographic area in which the facility, structure or 
     real property is located, except as expressly provided by 
     law.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 10 of H.R. 1720, as amended, would name the 
     outpatient clinic located in New London, Connecticut, the 
     ``John J. McGuirk Department of Veterans Affairs Outpatient 
     Clinic.''
     Compromise Agreement
       Section 245 of the Compromise Agreement follows the House 
     language.


   DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC, 
                         HORSHAM, PENNSYLVANIA

     Current Law
       Section 531 of title 38, United States Code, requires a 
     Department facility, structure or real property to be named 
     after the geographic area in which the facility, structure or 
     real property is located, except as expressly provided by 
     law.
     Senate Bill
       Section 221 of the Senate bill, as reported, would name the 
     VA Outpatient Clinic located in Horsham, Pennsylvania, the 
     ``Victor J. Saracini Department of Veterans Affairs 
     Outpatient Clinic.''
     House Bill
       The House bills contain no comparable provision.
     Compromise Agreement
       Section 246 of the Compromise Agreement follows the Senate 
     language.

                      TITLE III--PERSONNEL MATTERS


  MODIFICATION OF CERTAIN AUTHORITIES ON APPOINTMENT AND PROMOTION OF 
            PERSONNEL IN THE VETERANS HEALTH ADMINISTRATION

     Current Law
       Section 7401 of title 38, United States Code, authorizes VA 
     to appoint medical care personnel, under title 5, United 
     States Code, or title 38, United States Code, depending on 
     the duties of such personnel.
     Senate Bill
       Section 301 of the Senate bill would modify title 38 to 
     authorize the appointment of psychologists, kinesiologists 
     and social workers, under title 38 provisions as opposed to 
     title 5 provisions.
     House Bill
       The House bills contain no comparable provisions.
     Compromise Agreement
       Section 301 of the Compromise Agreement follows the Senate 
     language with modifications.
       The Compromise agreement reflects two important policy 
     goals. First, VA will be permitted to hire clinical staff in 
     a timely fashion through use of the direct appointment 
     authority provided in title 38, United States Code. Second, 
     employee representatives will be afforded an opportunity to 
     participate in a dialogue and process with VA management to 
     determine the best system under which to promote the 
     clinicians appointed under this section.
       The Committees believe that VA management and the promotion 
     policy for clinical staff can benefit from interactions with 
     employee representatives. The Committees would allow the 
     Secretary the discretion to develop a system for judging the 
     merits of an individual's advancement in VA, provided that 
     the Secretary reports to the Committees the actions taken 
     under this authority.


   APPOINTMENT OF CHIROPRACTORS IN THE VETERANS HEALTH ADMINISTRATION

     Current Law
       Public Law 107-135 requires VA to establish a Veterans 
     Health Administration-wide program for chiropractic care.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 2 of H.R. 2357, as amended, would authorize VA 
     appointment of chiropractors under title 38, United States 
     Code. The House bill would establish the qualifications of 
     appointees, the period of appointments and promotions, set 
     grades and pay scales, provide temporary and part-time 
     appointments, authorize residencies and internships, extend 
     malpractice and negligence protection coverage, define 
     chiropractors as scarce medical specialists for contracting 
     purposes, authorize reimbursement of continuing professional 
     education expenses, and exempt chiropractors from collective 
     bargaining, consistent with the provisions in chapter 74 of 
     title 38, the United States Code. The bill would provide for 
     an effective date of 180 days from enactment.
     Compromise Agreement
       Section 302 of the Compromise Agreement follows the House 
     language with modifications that would redefine ``medical 
     care'' occupations as ``health care'' occupations and 
     eliminate provisions that would provide for residencies and 
     internships and reimbursement of continuing professional 
     education expenses.


 ADDITIONAL PAY FOR SATURDAY TOURS OF DUTY FOR ADDITIONAL HEALTH CARE 
             WORKERS IN THE VETERANS HEALTH ADMINISTRATION

     Current Law
       Title 38, United States Code, specifies in sections 7453 
     and 7454 that nurses, physician assistants, and expanded-
     function dental auxiliaries are entitled to additional pay 
     for working regular tours of duty of Saturdays. Under this 
     authority, respiratory therapists, physical therapists, 
     practical or vocational nurses, pharmacists and occupational 
     therapists are also entitled to additional pay for Saturday 
     tours, if the Secretary determines it is necessary in order 
     to hire and retain these health care professionals.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 4 of H.R. 2433, as amended, would amend section 
     7454 (b) of title 38, United

[[Page 29610]]

     States Code, to authorize premium pay for Saturday tours of 
     duty for additional VHA health care workers.
     Compromise Agreement
       Section 303 of the Compromise Agreement follows the House 
     language.


  COVERAGE OF EMPLOYEES OF VETERANS' CANTEEN SERVICE UNDER ADDITIONAL 
                            EMPLOYMENT LAWS

     Current Law
       Section 7802 of title 38, United States Code, authorizes 
     appointment of Veterans' Canteen Service (VCS) employees.
     Senate Bill
       Section 302 of the Senate bill contains a similar 
     provision.
     House Bill
       Section 5 of H.R. 2433, as amended, would authorize hourly 
     workers of VCS to be qualified for competitive title 5, 
     United States Code, appointments in VA in recognition of 
     time-in service obtained in the VCS.
     Compromise Agreement
       Section 304 of the Compromise Agreement contains this 
     provision.

                        TITLE IV--OTHER MATTERS


     office of research oversight in veterans health administration

     Current Law
       There is no similar provision in current law.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 11 of H.R. 1720, as amended, would add a new 
     section 7307 to title 38, United States Code, to establish an 
     Office of Research Oversight within the Veterans Health 
     Administration to monitor, review and investigate matters of 
     medical research compliance and assurance in VA, including 
     matters relating to the protection and safety of human 
     subjects, research animals and VA employees participating in 
     VA medical research programs. The bill would require an 
     annual report to the Committees on Veterans' Affairs of the 
     Senate and House of Representatives on the activities of the 
     Office of Research Oversight during the preceding calendar 
     year and require that the activities of the Office of 
     Research Oversight be funded from amounts appropriated for VA 
     medical care.
       Further, under the bill, the General Accounting Office 
     (GAO) would be required to submit a report to Congress not 
     later than January 1, 2006, on the results of the 
     establishment of the Office of Research Oversight and any 
     recommendations for other legislative and administrative 
     actions. Finally, the Secretary would be required to submit a 
     report to Congress setting forth the Department's 
     implementation of the requirement to establish an Office of 
     Research Oversight, and related provisions, not later than 
     180 days after the date of enactment.
     Compromise Agreement
       Section 401 of the Compromise Agreement follows the House 
     language with modifications that would not include references 
     to animal welfare, research animals and laboratory animals. 
     Section 7307(c)(2)(A) of title 38, United States Code, 
     referencing peer review responsibilities would also not be 
     included in the Compromise Agreement, along with the required 
     reports from GAO and the Secretary.


 enhancement of authorities relating to nonprofit research corporations

     Current Law
       Sections 7361 through 7366 of title 38, United States Code, 
     establish the authority for VA's Nonprofit Research 
     Corporations. Section 7368 of title 38, United States Code, 
     provides that no such corporations may be established after 
     December 31, 2003.
     Senate Bill
       The Senate bill contains no comparable provisions.
     House Bill
       Section 6 of H.R. 3260 would cover employees of Nonprofit 
     Research Corporations under the Federal Tort Claims Act and 
     would extend the authority to create new Nonprofit Research 
     Corporations through December 31, 2008.
     Compromise Agreement
       Section 402 of the Compromise Agreement follows the House 
     language.


 department of defense participation in revolving supply fund purchases

     Current Law
       Section 8121 of title 38, United States Code, establishes 
     authority for VA to use a revolving supply fund to operate 
     and maintain its supply system.
     Senate Bill
       The Senate bill contains no comparable provision.
     House Bill
       Section 5 of H.R. 3260 would extend authority to the 
     Secretary of Defense to purchase medical equipment, services 
     and supplies through VA's revolving supply fund beginning in 
     fiscal year 2004. The Department of Defense (DoD) would be 
     required to reimburse VA's revolving supply fund using DoD 
     appropriations.
     Compromise Agreement
       Section 403 of the Compromise Agreement follows the House 
     language.


    five-year extension of housing assistance for homeless veterans

     Current Law
       Section 2041(c) of title 38, United States Code, authorizes 
     the Secretary to enter into housing assistance agreements for 
     homeless veterans until December 31, 2003.
     Senate Bill
       Section 411 of the Senate bill would extend the authority 
     of the Secretary to enter into housing assistance agreements 
     through December 31, 2006.
     House Bill
       Section 6 of H.R. 3387 would extend the authority of the 
     Secretary to enter into housing assistance agreements until 
     December 31, 2008.
     Compromise Agreement
       Section 404 of the Compromise Agreement follows the House 
     language.


                          report date changes

     Current Law
       Title 38, United States Code, requires:
       (a) in section 516(e)(1)(A), a quarterly report summarizing 
     the employment discrimination complaints filed against senior 
     managers; the report is due no later than 30 days after the 
     end of each quarter;
       (b) in section 2065(a), an annual report on assistance to 
     homeless veterans; the report is due no later than April 15 
     each year;
       (c) in section 7321(d)(2), an annual report of the 
     Committee on Care of Severely Chronically Mentally Ill 
     Veterans; the report is due no later than February 1 each 
     year through 2004;
       (d) in section 8107, an annual report on long-range health 
     planning; due June 1 of each year;
       (e) in section 8153(g), an annual report on sharing of 
     health care resources; the report is due no later than 60 
     days after the end of each fiscal year; and
       (f) in section 1712A note and enacted in section 110(e)(2) 
     of Public Law 106-117, an annual report of the Special 
     Committee on PTSD; the report is due February 1 of each of 
     the three following years.
     Senate Bill
       The Senate bill contains no comparable provisions.
     House Bill
       Section 7 of H.R. 3260, subsection (a) would extend the 
     Senior Managers Quarterly Report from 30 days to 45 days 
     following each quarter; subsection (b) would change the 
     report due date from April 15 to June 15 of each year for the 
     annual report on Assistance to Homeless Veterans; subsection 
     (c) would change the report due date from February 1 to June 
     1 of each year for the annual report of the Committee on Care 
     of Severely Chronically Mentally Ill Veterans through 2004; 
     subsection (d) would change the report date on the Annual 
     Reports on Long-Range Health Planning to June 1 of each year; 
     subsection (e) would change the report due dates on the 
     Annual Report on Sharing of Health Care Resources to February 
     1 of each year; and subsection (f) would change the report 
     due date on the Annual Report of the Special Committee on 
     PTSD to May 1 of each year through 2004.
       Section 7(a) of H.R. 3387 would extend the annual reporting 
     requirement for the Committee on Care of Severely Chronically 
     Mentally Ill Veterans in Section 7321(d)(2) to February 1, 
     2009. Section 7(b) of H.R. 3387 would extend the annual 
     report of the Special Committee on PTSD to February 1, 2009.
     Compromise Agreement
       Section 405 of the Compromise Agreement follows the House 
     language on the provisions in subsections (a), (b), and (e) 
     of the House bill and would extend the reports in subsections 
     (c) and (f) of the House bill through 2008. Section 405 of 
     the Compromise Agreement would simplify the reporting 
     requirements in subsection (d) of the House bill without 
     altering the report due date.

     LEGISLATIVE PROVISIONS NOT ADOPTED


    demolition of obsolete, dilapated, and hazardous structures on 
                department of veterans affairs property

     Current Law
       There is no similar provision in current law.
     Senate Bill
       Section 202 of the Senate bill would add section 8171 to 
     title 38, United States Code, to authorize the demolition of 
     obsolete, dilapidated, and hazardous structures; would 
     establish a specific fund in the Treasury designated as the 
     Department of Veterans Affairs Facilities Demolition Fund; 
     and would authorize an appropriation of $25,000,000 for 
     fiscal year 2004 for this Demolition Fund.
     House Bill
       The House bills contain no comparable provision.
     Compromise Agreement
       The Compromise Agreement does not contain this provision.

[[Page 29611]]



                         SUPPLEMENTARY MATTERS


                san juan, puerto rico va medical center

       In 1999, Congress provided $50,000,000 to the VA Medical 
     Center in San Juan, Puerto Rico, to assist that facility in 
     correcting numerous structural safety issues. Since then, VA 
     has spent $4,000,000 of those funds on the design and 
     planning of a bed tower that will alleviate the strain on the 
     older bed tower currently in use. The remaining $46,000,000 
     will be used for the tower's construction, with a projected 
     Spring 2004 groundbreaking. The Committees understand that 
     the Secretary has pledged at least an additional $25,000,000 
     to enhance this project and minimize any reduction of total 
     beds at this facility. Even with the completion of this 
     construction, the Committees are advised that additional 
     seismic and utility upgrades are needed at the San Juan VA. 
     The Committees encourage the Secretary to honor this pledge 
     and continue the practice of providing high quality services 
     to the veterans of Puerto Rico.
  Mr. GRAHAM of Florida. Madam President, I rise today to urge swift 
passage of S. 1156, which is essentially a conference report on various 
veterans' health care measures. This bill will dramatically assist the 
Department of Veterans Affairs in providing quality health care to our 
Nation's veterans. I would like to highlight some of the key 
provisions.
  The compromise agreement would authorize $17.5 million in advanced 
planning funds for a new medical facility in East-Central Florida. 
While this is only an authorization, I note that the VA-HUD 
appropriations bill will likely contain an unspecified pot of 
construction funding--up to $600 million total. These funds will likely 
be used for East-Central Florida and other worthy projects stemming 
from VA's realignment effort.
  Veterans living in East-Central Florida are in dire need of a full-
fledged VA hospital. One VA report found that since 1996, ``the Central 
Florida market sustained the greatest workload expansion of the entire 
VA system--105 percent.'' Other VA studies have deemed the region as 
``the logical choice for infrastructure investment for all major 
Inpatient and Outpatient categories.'' The decision about where to 
place a new VA hospital in this region falls to VA, but I encourage 
Secretary Principi to carefully study all the options to ensure that 
the most appropriate location is chosen.
  The demand for care in East-Central Florida heretofore has also been 
validated by the Capital Asset Realignment for Enhanced Services 
(CARES) process. CARES is a multi-stage analysis that VA has undertaken 
of its assets and infrastructure nationwide, for the purposes of making 
according adjustments to meet the projected health care needs of 
veterans over the next 20 years. The process has reached its final 
stages, with the release of a Draft National Plan currently under 
review by a commission.
  The CARES initiative will have profound ramifications for hospitals 
all across the country. As such, the compromise agreement includes a 
provision that I fought for, granting Congress a 60-day notice and wait 
period before commencing any closures or consolidations that result 
from CARES recommendations. It is imperative that Congress have a role 
in this process, as the delivery of health care to our nation's 
veterans will be greatly affected by its outcome. This became 
particularly apparent when the Draft National Plan was unveiled, 
revealing the targeting for closure of up to 6,000 beds nationwide--
including some 1,500 long-term care and 800 psychiatry beds. As long-
term care and mental health were not factored into the original CARES 
model, many questions were raised about the validity of the process.
  The Veterans Health Care, Capital Asset, and Business Improvement Act 
of 2003 would also authorize the construction of a comprehensive 
outpatient medical care facility at the Pensacola Naval Air Station, in 
Pensacola, FL. The clinic, as envisioned, would be a joint venture 
between VA and the Department of the Navy. This area of my home state 
is greatly underserved in terms of medical facilities for 
servicemembers and veterans, and I am pleased to be a part of bringing 
vital health care services to the region.
  Because of the need for quality, accessible hospital services for 
veterans in the Pensacola area and surrounding counties, this bill 
would require VA to develop a plan to meet their inpatient needs. While 
there is no doubt that the VA-Navy clinic would provide vital 
outpatient services, inpatient care will still be lacking. This 
provision seeks to address that facet of the health care continuum for 
veterans in the Panhandle.
  Another important provision of the compromise agreement would expand 
VA's assisted living pilot program to one additional site. The assisted 
living pilot program is designed to help the large numbers of men and 
women in the VA system over the age of 65, who either need long-term 
care now or potentially will need it in the future. The pilot program 
was first established through The Veterans Millennium Health Care and 
Benefits Act, which gave VA clear authority to furnish an assisted 
living service, including to the spouses of veterans.
  The CARES Draft National Plan also puts emphasis on assisted living 
programs. No fewer than 19 sites are proposed to be converted into 
assisted living facilities. The assisted living pilot program seeks to 
help VA address inequities in availability of noninstitutional services 
by developing models for proliferating the program nationwide. I am 
hopeful that Network 8 will apply to be the next pilot program. There 
is a great need for long-term care services in my home state of 
Florida.
  I am proud to have worked on this valuable piece of legislation for 
our Nation's veterans, and I urge my colleagues to support it.
  Mr. INOUYE. Madam President, I commend Senator Arlen Specter and the 
Committee on Veterans Affairs for their efforts in support of S. 1156, 
the Veterans Health Care Authorities Extension and Improvement Act of 
2003, which would improve the provision of long-term health care for 
veterans by the Department of Veterans Affairs.
  I would like to take this opportunity to comment on the section of S. 
1156 that authorizes the VA to provide Filipino veterans residing in 
the United States the same medical benefits that are currently provided 
to veterans of the Armed Forces of the United States. Approximately 
9,500 Filipino veterans residing in the United States would be eligible 
for these benefits.
  Many of you are aware of my continued support and advocacy on behalf 
of the Filipino World War II veterans, and the importance of addressing 
their plight. As an American, I believe the treatment of Filipino World 
War II veterans is bleak and shameful. Throughout the years, I have 
sponsored several measures to rectify the wrongs committed against 
these World War II veterans, and I am grateful to the committee for the 
assistance and consideration given to my past initiatives. While some 
strides have been made, I believe more needs to be done to assist these 
veterans who are in their twilight years. Of the 120,000 who originally 
served in the Commonwealth Army during World War II, approximately 
59,899 Filipino veterans currently reside in the United States and the 
Philippines. According to the Department of Veterans Affairs, the 
Filipino veteran population is expected to decrease to approximately 
20,000, or roughly one-third of the current population, by 2010.
  I support the provision in S. 1156 that authorizes the VA to provide 
Filipino veterans residing in the United States the same medical 
benefits that are currently provided to veterans of the Armed Forces of 
the United States. However, I remain concerned that these benefits are 
restricted to only those veterans residing in the United States. In my 
view, a distinction should not be made between veterans residing in the 
United States and those residing in the Philippines.
  As a result of a citizenship statute enacted by the Congress in 1990, 
some Filipino veterans who were able to travel came to the United 
States to become United States citizens. At the same time, many other 
Filipino World War II veterans were unable to travel to the United 
States and take advantage of the naturalization benefit because of 
their advanced age. The law was subsequently amended in the Fiscal Year 
1993 Departments of State,

[[Page 29612]]

Justice, Commerce and the Judiciary Appropriations Act, Public Law 102-
395, to allow the naturalization process for these veterans to occur in 
the Philippines. Since then, a distinction has been made, and benefits 
have been provided to only those Filipino veterans residing in the 
United States.
  I believe it is unfair to make this distinction. The Commonwealth 
Army of the Philippines was called to serve with the United States 
Armed Forces in the Far East during World War II under President 
Roosevelt's July 26, 1941, military order. Together, these gallant men 
and women stood in harm's way with our American soldiers to fight our 
common enemies during World War II. Because all Filipino veterans stood 
in equal jeopardy during World War II, I do not believe we should draw 
a distinction based on their current residency in the U.S. or in the 
Philippines. All of them were at equal risk, and so all should receive 
equal benefits.
  Accordingly, I introduced S. 68, the Filipino Veterans' Benefits 
Improvements Act of 2003, which provides health and disability 
compensation benefits that are similar to the provision included in S. 
1156, but without limitations based on the residency of the veterans. I 
strongly urge Chairman Specter and members of the Committee to give 
consideration to S. 68, and to work with me in the coming year to 
provide health benefits to veterans residing in the Philippines.
  Heroes should never be forgotten or ignored, so let us not turn our 
backs on those who sacrificed so much. Many of the Filipinos who fought 
so hard for our nation have been honored with American citizenship. Let 
us now work to repay all of these brave men and women for their 
sacrifices by providing them the veterans' benefits they deserve.
  Mr. THOMAS. Madam President, I ask unanimous consent that the 
substitute amendment which is at the desk be agreed to, the committee 
substitute, as amended, be agreed to, the bill, as amended, be read a 
third time and passed, the amendment to the title as reported be 
amended with the amendment at the desk, the title amendment, as 
amended, be agreed to, the motions to reconsider be laid upon the table 
en bloc, and that any statements relating to the bill be printed in the 
Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 2203) in the nature of a substitute was agreed to.
  (The amendment is printed in today's Record under ``Text of 
Amendments.'')
  The committee amendment in the nature of a substitute, as amended, 
was agreed to.
  The amendment (No. 2204) was agreed to, as follows:


                           amendment no. 2204

       Amend the title to read as follows: ``A bill to amend title 
     38, United States Code, to improve and enhance provision of 
     health care for veterans, to authorize major construction 
     projects and other facilities matters for the Department of 
     Veterans Affairs, to enhance and improve authorities relating 
     to the administration of personnel of the Department of 
     Veterans Affairs, and for other purposes.''.
  The bill (S. 1156), as amended, was read the third time and passed.
  The title amendment, as amended, was agreed to.

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