[Congressional Record (Bound Edition), Volume 149 (2003), Part 22]
[House]
[Pages 30691-30711]
[From the U.S. Government Publishing Office, www.gpo.gov]




 VETERANS HEALTH CARE, CAPITAL ASSET, AND BUSINESS IMPROVEMENT ACT OF 
                                  2003

  Mr. SMITH of New Jersey. Madam Speaker, I move to suspend the rules 
and pass the Senate bill (S. 1156) 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 Clerk read as follows:

                                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; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Veterans 
     Health Care, Capital Asset, and Business 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--HEALTH CARE AUTHORITIES AND RELATED MATTERS

Sec. 101. Improved benefits for former prisoners of war.
Sec. 102. Provision of health care to veterans who participated in 
              certain Department of Defense chemical and biological 
              warfare testing.
Sec. 103. Eligibility for Department of Veterans Affairs health care 
              for certain Filipino World War II veterans residing in 
              the United States.
Sec. 104. Enhancement of rehabilitative services.
Sec. 105. Enhanced agreement authority for provision of nursing home 
              care and adult day health care in contract facilities.
Sec. 106. Five-year extension of period for provision of 
              noninstitutional extended-care services and required 
              nursing home care.
Sec. 107. Expansion of Department of Veterans Affairs pilot program on 
              assisted living for veterans.
Sec. 108. Improvement of program for provision of specialized mental 
              health services to veterans.

             TITLE II--CONSTRUCTION AND FACILITIES MATTERS

                    Subtitle A--Program Authorities

Sec. 201. Increase in threshold for major medical facility construction 
              projects.
Sec. 202. Enhancements to enhanced-use lease authority.
Sec. 203. Simplification of annual report on long-range health 
              planning.

                   Subtitle B--Project Authorizations

Sec. 211. Authorization of major medical facility projects.
Sec. 212. Authorization of major medical facility leases.
Sec. 213. Advance planning authorizations.
Sec. 214. Authorization of appropriations.

 Subtitle C--Capital Asset Realignment for Enhanced Services Initiative

Sec. 221. Authorization of major construction projects in connection 
              with Capital Asset Realignment Initiative.
Sec. 222. Advance notification of capital asset realignment actions.
Sec. 223. Sense of Congress and report on access to health care for 
              veterans in rural areas.

                  Subtitle D--Plans for New Facilities

Sec. 231. Plans for facilities in specified areas.
Sec. 232. Study and report on feasibility of coordination of veterans 
              health care services in South Carolina with new 
              university medical center.

                 Subtitle E--Designation of Facilities

Sec. 241. Designation of Department of Veterans Affairs medical center, 
              Prescott, Arizona, as the Bob Stump Department of 
              Veterans Affairs Medical Center.
Sec. 242. Designation of Department of Veterans Affairs health care 
              facility, Chicago, Illinois, as the Jesse Brown 
              Department of Veterans Affairs Medical Center.
Sec. 243. Designation of Department of Veterans Affairs medical center, 
              Houston, Texas, as the Michael E. DeBakey Department of 
              Veterans Affairs Medical Center.
Sec. 244. Designation of Department of Veterans Affairs medical center, 
              Salt Lake City, Utah, as the George E. Wahlen Department 
              of Veterans Affairs Medical Center.
Sec. 245. Designation of Department of Veterans Affairs outpatient 
              clinic, New London, Connecticut.
Sec. 246. Designation of Department of Veterans Affairs outpatient 
              clinic, Horsham, Pennsylvania.

                      TITLE III--PERSONNEL MATTERS

Sec. 301. Modification of certain authorities on appointment and 
              promotion of personnel in the Veterans Health 
              Administration.
Sec. 302. Appointment of chiropractors in the Veterans Health 
              Administration.
Sec. 303. Additional pay for Saturday tours of duty for additional 
              health care workers in the Veterans Health 
              Administration.
Sec. 304. Coverage of employees of Veterans' Canteen Service under 
              additional employment laws.

                        TITLE IV--OTHER MATTERS

Sec. 401. Office of Research Oversight in Veterans Health 
              Administration.
Sec. 402. Enhancement of authorities relating to nonprofit research 
              corporations.
Sec. 403. Department of Defense participation in Revolving Supply Fund 
              purchases.
Sec. 404. Five-year extension of housing assistance for homeless 
              veterans.
Sec. 405. Report date changes.

     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--HEALTH CARE AUTHORITIES AND RELATED MATTERS

     SEC. 101. IMPROVED BENEFITS FOR FORMER PRISONERS OF WAR.

       (a) Outpatient Dental Care for All Former Prisoners of 
     War.--Section 1712(a)(1)(F) is amended by striking ``and who 
     was detained or interned for a period of not less than 90 
     days''.
       (b) Exemption From Pharmacy Copayment Requirement.--Section 
     1722A(a)(3) is amended--
       (1) by striking ``or'' at the end of subparagraph (A);
       (2) by redesignating subparagraph (B) as subparagraph (C); 
     and
       (3) by inserting after subparagraph (A) the following new 
     subparagraph (B):
       ``(B) to a veteran who is a former prisoner of war; or''.

     SEC. 102. PROVISION OF HEALTH CARE TO VETERANS WHO 
                   PARTICIPATED IN CERTAIN DEPARTMENT OF DEFENSE 
                   CHEMICAL AND BIOLOGICAL WARFARE TESTING.

       Section 1710(e) is amended--
       (1) in paragraph (1), by adding at the end the following 
     new subparagraph:
       ``(E) Subject to paragraphs (2) and (3), a veteran who 
     participated in a test conducted by the Department of Defense 
     Deseret Test Center as part of a program for chemical and 
     biological warfare testing from 1962 through 1973 (including 
     the program designated as

[[Page 30692]]

     `Project Shipboard Hazard and Defense (SHAD)' and related 
     land-based tests) is eligible for hospital care, medical 
     services, and nursing home care under subsection (a)(2)(F) 
     for any illness, notwithstanding that there is insufficient 
     medical evidence to conclude that such illness is 
     attributable to such testing.'';
       (2) in paragraph (2)(B)--
       (i) by striking out ``paragraph (1)(C) or (1)(D)'' and 
     inserting ``subparagraph (C), (D), or (E) of paragraph (1)''; 
     and
       (ii) by striking ``service described in that paragraph'' 
     and inserting ``service or testing described in such 
     subparagraph''; and
       (3) in paragraph (3)--
       (A) by striking ``and'' at the end of subparagraph (B);
       (B) by striking the period at the end of subparagraph (C) 
     and inserting ``; and''; and
       (C) by adding at the end the following new subparagraph:
       ``(D) in the case of care for a veteran described in 
     paragraph (1)(E), after December 31, 2005.''.

     SEC. 103. ELIGIBILITY FOR DEPARTMENT OF VETERANS AFFAIRS 
                   HEALTH CARE FOR CERTAIN FILIPINO WORLD WAR II 
                   VETERANS RESIDING IN THE UNITED STATES.

       The text of section 1734 is amended to read as follows:
       ``(a) The Secretary shall furnish hospital and nursing home 
     care and medical services to any individual described in 
     subsection (b) in the same manner, and subject to the same 
     terms and conditions, as apply to the furnishing of such care 
     and services to individuals who are veterans as defined in 
     section 101(2) of this title. Any disability of an individual 
     described in subsection (b) that is a service-connected 
     disability for purposes of this subchapter (as provided for 
     under section 1735(2) of this title) shall be considered to 
     be a service-connected disability for purposes of furnishing 
     care and services under the preceding sentence.
       ``(b) Subsection (a) applies to any individual who is a 
     Commonwealth Army veteran or new Philippine Scout and who--
       ``(1) is residing in the United States; and
       ``(2) is a citizen of the United States or an alien 
     lawfully admitted to the United States for permanent 
     residence.''.

     SEC. 104. ENHANCEMENT OF REHABILITATIVE SERVICES.

       (a) Rehabilitative Services Through Medical Care 
     Authority.--Section 1701(8) is amended by striking ``(other 
     than those types of vocational rehabilitation services 
     provided under chapter 31 of this title)''.
       (b) Expansion of Authorized Rehabilitative Services.--(1) 
     Section 1718 is amended--
       (A) by redesignating subsections (d), (e), and (f) as 
     subsections (e), (f), and (g), respectively; and
       (B) by inserting after subsection (c) the following new 
     subsection (d):
       ``(d) In providing to a veteran rehabilitative services 
     under this chapter, the Secretary may furnish the veteran 
     with the following:
       ``(1) Work skills training and development services.
       ``(2) Employment support services.
       ``(3) Job development and placement services.''.
       (2) Subsection (c) of such section is amended--
       (A) in paragraph (1), by striking ``subsection (b) of this 
     section'' and inserting ``subsection (b) or (d)''; and
       (B) in paragraph (2)--
       (i) by striking ``subsection (b) of this section'' and 
     inserting ``subsection (b) or (d)''; and
       (ii) by striking ``paragraph (2) of such subsection'' and 
     inserting ``subsection (b)(2)''.

     SEC. 105. ENHANCED AGREEMENT AUTHORITY FOR PROVISION OF 
                   NURSING HOME CARE AND ADULT DAY HEALTH CARE IN 
                   CONTRACT FACILITIES.

       (a) Enhanced Authority.--Subsection (c) of section 1720 is 
     amended--
       (1) by designating the existing text as paragraph (2); and
       (2) by inserting before paragraph (2), as so designated, 
     the following new paragraph (1):
       ``(1)(A) 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 with--
       ``(i) in the case of the medicare program, a provider of 
     services that has entered into a provider agreement under 
     section 1866(a) of the Social Security Act (42 U.S.C. 
     1395cc(a)); and
       ``(ii) in the case of the medicaid program, a provider 
     participating under a State plan under title XIX of such Act 
     (42 U.S.C. 1396 et seq.).
       ``(B) In entering into an agreement under subparagraph (A) 
     with a provider of services described in clause (i) of that 
     subparagraph or a provider described in clause (ii) of that 
     subparagraph, the Secretary may use the procedures available 
     for entering into provider agreements under section 1866(a) 
     of the Social Security Act.''.
       (b) Conforming Amendment.--Subsection (f)(1)(B) of such 
     section is amended by inserting ``or agreement'' after 
     ``contract'' each place it appears.

     SEC. 106. FIVE-YEAR EXTENSION OF PERIOD FOR PROVISION OF 
                   NONINSTITUTIONAL EXTENDED-CARE SERVICES AND 
                   REQUIRED NURSING HOME CARE.

       (a) Noninstitutional Extended Care Services.--Section 
     1701(10)(A) is amended by striking ``the date of the 
     enactment of the Veterans Millennium Health Care and Benefits 
     Act and ending on December 31, 2003,'' and inserting 
     ``November 30, 1999, and ending on December 31, 2008,''.
       (b) Required Nursing Home Care.--Section 1710A(c) is 
     amended by striking ``December 31, 2003'' and inserting 
     ``December 31, 2008''.

     SEC. 107. EXPANSION OF DEPARTMENT OF VETERANS AFFAIRS PILOT 
                   PROGRAM 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 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.''.

     SEC. 108. 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 used 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 use 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--Program 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 ``$7,000,000''.

     SEC. 202. ENHANCEMENTS TO ENHANCED-USE LEASE AUTHORITY.

       (a) Notification of Property To Be Leased.--Section 8163 is 
     amended--
       (1) in the first sentence of subsection (a)--
       (A) by striking ``designate a property to be leased under 
     an enhanced-use lease'' and inserting ``enter into an 
     enhanced-use lease with respect to certain property''; and
       (B) by striking ``before making the designation'' and 
     inserting ``before entering into the lease'';
       (2) in subsection (b), by striking ``of the proposed 
     designation'' and inserting ``to the congressional veterans' 
     affairs committees and to the public of the proposed lease''; 
     and
       (3) in subsection (c)--
       (A) in paragraph (1)--
       (i) by striking ``designate the property involved'' and 
     inserting ``enter into an enhanced-use lease of the property 
     involved''; and
       (ii) by striking ``to so designate the property'' and 
     inserting ``to enter into such lease'';
       (B) in paragraph (2), by striking ``90-day period'' and 
     inserting ``45-day period'';
       (C) in paragraph (3)--
       (i) by striking ``general description'' in subparagraph (D) 
     and inserting ``description of the provisions''; and
       (ii) by adding at the end the following new subparagraph:

[[Page 30693]]

       ``(G) A summary of a cost-benefit analysis of the proposed 
     lease.''; and
       (D) by striking paragraph (4).
       (b) Disposition of Leased Property.--Section 8164 is 
     amended--
       (1) in subsection (a)--
       (A) by striking ``by requesting the Administrator of 
     General Services to dispose of the property pursuant to 
     subsection (b)'' in the first sentence; and
       (B) by striking the third sentence;
       (2) in subsection (b)--
       (A) by striking ``Secretary and the Administrator of 
     General Services jointly determine'' and inserting 
     ``Secretary determines''; and
       (B) by striking ``Secretary and the Administrator 
     consider'' and inserting ``Secretary considers''; and
       (3) in subsection (c), by striking ``90 days'' and 
     inserting ``45 days''.
       (c) Use of Proceeds.--Section 8165 is amended--
       (1) in subsection (a)(2), by striking ``and remaining after 
     any deduction from such funds under the laws referred to in 
     subsection (c)'';
       (2) in subsection (b), by adding at the end the following 
     new sentence: ``The Secretary may use the proceeds from any 
     enhanced-use lease to reimburse applicable appropriations of 
     the Department for any expenses incurred in the development 
     of additional enhanced-use leases.''; and
       (3) by striking subsection (c).
       (d) Clerical Amendments.--(1) The heading of section 8163 
     is amended to read as follows:

     ``Sec. 8163. Hearing and notice requirements regarding 
       proposed leases''.

       (2) The item relating to section 8163 in the table of 
     sections at the beginning of chapter 81 is amended to read as 
     follows:

``8163. Hearing and notice requirements regarding proposed leases.''.

     SEC. 203. SIMPLIFICATION OF ANNUAL REPORT ON LONG-RANGE 
                   HEALTH PLANNING.

       Section 8107(b) is amended by striking paragraphs (3) and 
     (4).

                   Subtitle B--Project 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.
       (3) Construction of a new bed tower to consolidate two 
     inpatient sites of care in the city of Chicago at the West 
     Side Division of the Department of Veterans Affairs health 
     care system in Chicago, Illinois, in an amount not to exceed 
     $98,500,000.
       (4) Seismic corrections to strengthen Medical Center 
     Building 1 of the Department of Veterans Affairs health care 
     system in San Diego, California, in an amount not to exceed 
     $48,600,000.
       (5) A project for (A) renovation of all inpatient care 
     wards at the West Haven, Connecticut, facility of the 
     Department of Veterans Affairs health system in Connecticut 
     to improve the environment of care and enhance safety, 
     privacy, and accessibility, and (B) establishment of a 
     consolidated medical research facility at that facility, in 
     an amount not to exceed $50,000,000.
       (6) Construction of a Department of Veterans Affairs-
     Department of the Navy joint venture comprehensive outpatient 
     medical care facility to be built on the grounds of the 
     Pensacola Naval Air Station, Pensacola, Florida, in an amount 
     not to exceed $45,000,000.

     SEC. 212. AUTHORIZATION OF MAJOR MEDICAL FACILITY LEASES.

       The Secretary of Veterans Affairs may enter into leases for 
     medical facilities as follows:
       (1) For an outpatient clinic in Charlotte, North Carolina, 
     in an amount not to exceed $3,000,000.
       (2) For an outpatient clinic extension, Boston, 
     Massachusetts, in an amount not to exceed $2,879,000.

     SEC. 213. ADVANCE PLANNING AUTHORIZATIONS.

       The Secretary of Veterans Affairs may carry out advance 
     planning for a major medical facility project at each of the 
     following locations, with such planning to be carried out in 
     an amount not to exceed the amount specified for that 
     location:
       (1) Denver, Colorado, in an amount not to exceed 
     $30,000,000, of which $26,000,000 shall be provided by the 
     Secretary of Veterans Affairs and $4,000,000 shall be 
     provided by the Secretary of Defense.
       (2) Pittsburgh, Pennsylvania, in an amount not to exceed 
     $9,000,000.
       (3) Las Vegas, Nevada, in an amount not to exceed 
     $25,000,000.
       (4) Columbus, Ohio, in an amount not to exceed $9,000,000.
       (5) East Central, Florida, in an amount not to exceed 
     $17,500,000.

     SEC. 214. 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 $363,100,000, of which--
       (A) $276,600,000 is for the projects authorized in section 
     211; and
       (B) $86,500,000 is for the advance planning authorized in 
     section 213; and
       (2) for the Medical Care account, $5,879,000 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--Capital Asset Realignment for Enhanced Services Initiative

     SEC. 221. 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 as specified 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 45 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 and the Committees on Appropriations of the Senate 
     and House of Representatives not later than February 1, 2004, 
     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 remedy of life and safety code deficiencies, 
     including seismic, egress, and fire deficiencies at such 
     facility.
       (C) The use of such facility to provide health care 
     services to a population that is determined under the Capital 
     Asset Realignment for Enhanced Services initiative to be 
     underserved or not currently served by such facility.
       (D) The renovation or modernization of such facility, 
     including the provision of barrier-free design, improvement 
     of building systems and utilities, or enhancement of clinical 
     support services.
       (E) The need for such facility to further an enhanced-use 
     lease or sharing agreement.
       (F) Any other factor 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 geographic service areas of the Department and take into 
     account recent shifts in populations of veterans among those 
     geographic service areas.
       (d) Sunset.--The Secretary may not enter into a contract to 
     carry out major construction projects under the authority in 
     subsection (a) after September 30, 2006.

     SEC. 222. ADVANCE NOTIFICATION OF CAPITAL ASSET REALIGNMENT 
                   ACTIONS.

       (a) Requirement for Advance Notification.--If the Secretary 
     of Veterans Affairs approves a recommendation resulting from 
     the Capital Asset Realignment for Enhanced Services 
     initiative, then before taking any action resulting from that 
     recommendation that would result in--
       (1) a medical facility closure;
       (2) an administrative reorganization described in 
     subsection (c) of section 510 of title 38, United States 
     Code; or
       (3) a medical facility consolidation,
     the Secretary shall submit to Congress a written notification 
     of the intent to take such action.
       (b) Limitation.--Upon submitting a notification under 
     subsection (a), the Secretary may not take any action 
     described in the notification until the later of--
       (1) the end of the 60-day period beginning on the date on 
     which the notification is received by Congress; or
       (2) the end of a period of 30 days of continuous session of 
     Congress beginning on the date on which the notification is 
     received by Congress or, if either House of Congress is not 
     in session on such date, the first day after such date on 
     which both Houses of Congress are in session.
       (c) Continuous Session of Congress.--For the purposes of 
     subsection (b)--
       (1) the continuity of a session of Congress is broken only 
     by an adjournment of Congress sine die; and
       (2) any day on which either House is not in session because 
     of an adjournment of more

[[Page 30694]]

     than three days to a day certain is excluded in the 
     computation of any period of time in which Congress is in 
     continuous session.
       (d) Medical Facility Consolidation.--For the purposes of 
     subsection (a), the term ``medical facility consolidation'' 
     means an action that closes one or more medical facilities 
     for the purpose of relocating those activities to another 
     medical facility or facilities within the same geographic 
     service area.

     SEC. 223. SENSE OF CONGRESS AND REPORT ON ACCESS TO HEALTH 
                   CARE FOR VETERANS IN RURAL AREAS.

       (a) Sense of Congress.--Recognizing the difficulties that 
     veterans residing in rural areas encounter in gaining access 
     to health care in facilities of the Department of Veterans 
     Affairs, it is the sense of Congress that the Secretary of 
     Veterans Affairs should take steps to ensure that an 
     appropriate mix of facilities and clinical staff is available 
     for health care for veterans residing in rural areas.
       (b) Report.--Not later than 120 days after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to the Committees on Veterans' Affairs of the 
     Senate and House of Representatives a report describing the 
     steps the Secretary is taking, and intends to take, to 
     improve access to health care for veterans residing in rural 
     areas.

                  Subtitle D--Plans for New Facilities

     SEC. 231. PLANS FOR FACILITIES IN SPECIFIED AREAS.

       (a) Southern New Jersey.--(1) The Secretary of Veterans 
     Affairs shall develop a plan for meeting the future hospital 
     care needs of veterans who reside in southern New Jersey.
       (2) For purposes of paragraph (1), the term ``southern New 
     Jersey'' means the following counties of the State of New 
     Jersey: Ocean, Burlington, Camden, Gloucester, Salem, 
     Cumberland, Atlantic, and Cape May.
       (b) Far South Texas.--(1) The Secretary shall develop a 
     plan for meeting the future hospital care needs of veterans 
     who reside in far south Texas.
       (2) For purposes of paragraph (1), the term ``far south 
     Texas'' means the following counties of the State of Texas: 
     Bee, Calhoun, Crockett, DeWitt, Dimmit, Goliad, Jackson, 
     Victoria, Webb, Aransas, Duval, Jim Wells, Kleberg, Nueces, 
     Refugio, San Patricio, Brooks, Cameron, Hidalgo, Jim Hogg, 
     Kenedy, Starr, Willacy, and Zapata.
       (c) North Central Washington.--(1) The Secretary shall 
     develop a plan for meeting the future hospital care needs of 
     veterans who reside in north central Washington.
       (2) For purposes of paragraph (1), the term ``north central 
     Washington'' means the following counties of the State of 
     Washington: Chelan, Douglas, Ferry, Grant, Kittitas, and 
     Okanogan.
       (d) Pensacola Area.--(1) The Secretary shall develop a plan 
     for meeting the future hospital care needs of veterans who 
     reside in the Pensacola area.
       (2) For purposes of paragraph (1), the term ``Pensacola 
     area'' means--
       (A) the counties of Escambia, Santa Rosa, Okaloosa, Walton, 
     Holmes, Washington, Bay, Jackson, Calhoun, Liberty, Gulf, and 
     Franklin of the State of Florida; and
       (B) the counties of Covington, Geneva, Houston, and 
     Escambia of the State of Alabama.
       (e) Consideration of Use of Certain Existing Authorities.--
     In developing the plans under this section, the Secretary 
     shall, at a minimum, consider options using the existing 
     authorities of sections 8111 and 8153 of title 38, United 
     States Code, to--
       (1) establish a hospital staffed and managed by employees 
     of the Department, either in private or public facilities, 
     including Federal facilities; or
       (2) enter into contracts with existing Federal facilities, 
     private facilities, and private providers for that care.
       (f) Report.--The Secretary shall submit to the Committees 
     on Veterans' Affairs of the Senate and House of 
     Representatives a report on each plan under this section not 
     later than April 15, 2004.

     SEC. 232. STUDY AND REPORT ON FEASIBILITY OF COORDINATION OF 
                   VETERANS HEALTH CARE SERVICES IN SOUTH CAROLINA 
                   WITH NEW UNIVERSITY MEDICAL CENTER.

       (a) Study Required.--The Secretary of Veterans Affairs 
     shall conduct a study to examine the feasibility of 
     coordination by the Department of Veterans Affairs of its 
     needs for inpatient hospital, medical care, and long-term 
     care services for veterans with the pending construction of a 
     new university medical center at the Medical University of 
     South Carolina, Charleston, South Carolina.
       (b) Matters To Be Included in Study.--(1) As part of the 
     study under subsection (a), the Secretary shall consider the 
     following:
       (A) Integration with the Medical University of South 
     Carolina of some or all of the services referred to in 
     subsection (a) through contribution to the construction of 
     that university's new medical facility or by becoming a 
     tenant provider in that new facility.
       (B) Construction by the Department of Veterans Affairs of a 
     new independent inpatient or outpatient facility alongside or 
     nearby the university's new facility.
       (2) In carrying out paragraph (1), the Secretary shall 
     consider the degree to which the Department and the 
     university medical center would be able to share expensive 
     technologies and scarce specialty services that would affect 
     any such plans of the Secretary or the university.
       (3) In carrying out the study, the Secretary shall 
     especially consider the applicability of the authorities 
     under section 8153 of title 38, United States Code (relating 
     to sharing of health care resources between the Department 
     and community provider organizations), to govern future 
     arrangements and relationships between the Department and the 
     Medical University of South Carolina.
       (c) Consultation With Secretary of Defense.--The Secretary 
     of Veterans Affairs shall consult with the Secretary of 
     Defense in carrying out the study under this section. Such 
     consultation shall include consideration of establishing a 
     Department of Veterans Affairs-Department of Defense joint 
     health-care venture at the site referred to in subsection 
     (a).
       (d) Report.--Not later than April 15, 2004, the Secretary 
     shall submit to the Committees on Veterans' Affairs of the 
     Senate and House of Representatives a report on the results 
     of the study. The report shall include the Secretary's 
     recommendations with respect to coordination described in 
     subsection (a), including recommendations with respect to 
     each of the matters referred to in subsection (b).

                 Subtitle E--Designation of Facilities

     SEC. 241. DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS 
                   MEDICAL CENTER, PRESCOTT, ARIZONA, AS THE BOB 
                   STUMP DEPARTMENT OF VETERANS AFFAIRS MEDICAL 
                   CENTER.

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

     SEC. 242. DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS 
                   HEALTH CARE FACILITY, CHICAGO, ILLINOIS, AS THE 
                   JESSE BROWN DEPARTMENT OF VETERANS AFFAIRS 
                   MEDICAL CENTER.

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

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

       The Department of Veterans Affairs Medical Center in Salt 
     Lake City, Utah, shall after the date of the enactment of 
     this Act be known and designated as the ``George E. Wahlen 
     Department of Veterans Affairs Medical Center''. Any 
     references 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 George E. Wahlen 
     Department of Veterans Affairs Medical Center.

     SEC. 245. DESIGNATION OF DEPARTMENT OF VETERANS AFFAIRS 
                   OUTPATIENT CLINIC, NEW LONDON, CONNECTICUT.

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

     SEC. 246. 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

[[Page 30695]]

     of the United States shall be considered to be a reference to 
     the Victor J. Saracini Department of Veterans Affairs 
     Outpatient Clinic.

                      TITLE III--PERSONNEL MATTERS

     SEC. 301. MODIFICATION OF AUTHORITIES ON APPOINTMENT AND 
                   PROMOTION OF PERSONNEL IN THE VETERANS HEALTH 
                   ADMINISTRATION.

       (a) Positions Treatable as Hybrid Status Positions.--(1) 
     Section 7401 is amended--
       (A) by striking paragraph (2) and inserting the following 
     new paragraph (2):
       ``(2) Scientific and professional personnel, such as 
     microbiologists, chemists, and biostatisticians.''; and
       (B) 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 and dental technologists, nuclear medicine 
     technologists, occupational therapists, occupational therapy 
     assistants, kinesiotherapists, orthotist-prosthetists, 
     pharmacists, pharmacy technicians, physical therapy 
     assistants, prosthetic representatives, psychologists, 
     diagnostic radiologic technicians, therapeutic radiologic 
     technicians, and social workers.''.
       (2) Personnel appointed to the Veterans Health 
     Administration before the date of the enactment of this Act 
     who are in an occupational category of employees specified in 
     paragraph (3) of section 7401 of title 38, United States 
     Code, by reason of the amendment made by paragraph (1)(B) of 
     this subsection shall, as of such date, be deemed to have 
     been appointed to the Administration under such paragraph 
     (3).
       (b) Appointments and Promotions.--Section 7403 of such 
     title is amended--
       (1) in subsection (f)(3)--
       (A) by inserting ``reductions-in-force, the applicability 
     of the principles of preference referred to in paragraph (2), 
     rights of part-time employees,'' after ``adverse actions,'';
       (B) by inserting ``, whether appointed under this section 
     or section 7405(a)(1)(B) of this title'' after ``such 
     positions''; and
       (C) by inserting a comma after ``status)''; and
       (2) by adding at the end the following new subsection:
       ``(h)(1) If the Secretary uses the authority provided in 
     subsection (c) for the promotion and advancement of an 
     occupational category of employees described in section 
     7401(3) of this title, as authorized by subsection (f)(1)(B), 
     the Secretary shall do so through one or more systems 
     prescribed by the Secretary. Each such system shall be 
     planned, developed, and implemented in collaboration with, 
     and with the participation of, exclusive employee 
     representatives of such occupational category of employees.
       ``(2)(A) Before prescribing a system of promotion and 
     advancement of an occupational category of employees under 
     paragraph (1), the Secretary shall provide to exclusive 
     employee representatives of such occupational category of 
     employees a written description of the proposed system.
       ``(B) Not later than 30 days after receipt of the 
     description of a proposed system under subparagraph (A), 
     exclusive employee representatives may submit to the 
     Secretary the recommendations, if any, of such exclusive 
     employee representatives with respect to the proposed system.
       ``(C) The Secretary shall give full and fair consideration 
     to any recommendations received under subparagraph (B) in 
     deciding whether and how to proceed with a proposed system.
       ``(3) The Secretary shall implement immediately any part of 
     a system of promotion and advancement under paragraph (1) 
     that is proposed under paragraph (2) for which the Secretary 
     receives no recommendations from exclusive employee 
     representatives under paragraph (2).
       ``(4) If the Secretary receives recommendations under 
     paragraph (2) from exclusive employee representatives on any 
     part of a proposed system of promotion and advancement under 
     that paragraph, the Secretary shall determine whether or not 
     to accept the recommendations, either in whole or in part. If 
     the Secretary determines not to accept all or part of the 
     recommendations, the Secretary shall--
       ``(A) notify the congressional veterans' affairs committees 
     of the recommendations and of the portion of the 
     recommendations that the Secretary has determined not to 
     accept;
       ``(B) meet and confer with such exclusive employee 
     representatives, for a period not less than 30 days, for 
     purposes of attempting to reach an agreement on whether and 
     how to proceed with the portion of the recommendations that 
     the Secretary has determined not to accept;
       ``(C) at the election of the Secretary, or of a majority of 
     such exclusive employee representatives who are participating 
     in negotiations on such matter, employ the services of the 
     Federal Mediation and Conciliation Service during the period 
     referred to in subparagraph (B) for purposes of reaching such 
     agreement; and
       ``(D) if the Secretary determines that activities under 
     subparagraph (B), (C), or both are unsuccessful at reaching 
     such agreement and determines (in the sole and unreviewable 
     discretion of the Secretary) that further meeting and 
     conferral under subparagraph (B), mediation under 
     subparagraph (C), or both are unlikely to reach such 
     agreement--
       ``(i) notify the congressional veterans' affairs committees 
     of such determinations, identify for such committees the 
     portions of the recommendations that the Secretary has 
     determined not to accept, and provide such committees an 
     explanation and justification for determining to implement 
     the part of the system subject to such portions of the 
     recommendations without regard to such portions of the 
     recommendations; and
       ``(ii) commencing not earlier than 30 days after notice 
     under clause (i), implement the part of the system subject to 
     the recommendations that the Secretary has determined not to 
     accept without regard to those recommendations.
       ``(5) If the Secretary and exclusive employee 
     representatives reach an agreement under paragraph (4) 
     providing for the resolution of a disagreement on one or more 
     portions of the recommendations that the Secretary had 
     determined not to accept under that paragraph, the Secretary 
     shall immediately implement such resolution.
       ``(6) In implementing a system of promotion and advancement 
     under this subsection, the Secretary shall--
       ``(A) develop and implement mechanisms to permit exclusive 
     employee representatives to participate in the periodic 
     review and evaluation of the system, including peer review, 
     and in any further planning or development required with 
     respect to the system as a result of such review and 
     evaluation; and
       ``(B) provide exclusive employee representatives 
     appropriate access to information to ensure that the 
     participation of such exclusive employee representative in 
     activities under subparagraph (A) is productive.
       ``(7)(A) The Secretary may from time to time modify a 
     system of promotion and advancement under this subsection.
       ``(B) In modifying a system, the Secretary shall take into 
     account any recommendations made by the exclusive employee 
     representatives concerned.
       ``(C) In modifying a system, the Secretary shall comply 
     with paragraphs (2) through (5) and shall treat any proposal 
     for the modification of a system as a proposal for a system 
     for purposes of such paragraphs.
       ``(D) The Secretary shall promptly submit to the 
     congressional veterans' affairs committees a report on any 
     modification of a system. Each report shall include--
       ``(i) an explanation and justification of the modification; 
     and
       ``(ii) a description of any recommendations of exclusive 
     employee representatives with respect to the modification and 
     a statement whether or not the modification was revised in 
     light of such recommendations.
       ``(8) In the case of employees who are not within a unit 
     with respect to which a labor organization is accorded 
     exclusive recognition, the Secretary may develop procedures 
     for input from representatives under this subsection from any 
     appropriate organization that represents a substantial 
     percentage of such employees or, if none, in such other 
     manner as the Secretary considers appropriate, consistent 
     with the purposes of this subsection.
       ``(9) In this subsection, the term `congressional veterans' 
     affairs committees' means the Committees on Veterans' Affairs 
     of the Senate and the House of Representatives.''.
       (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 that follows 
     through ``occupational therapists,'' and inserting 
     ``individuals in positions listed in section 7401(3) of this 
     title,''.

     SEC. 302. APPOINTMENT OF CHIROPRACTORS IN THE VETERANS HEALTH 
                   ADMINISTRATION.

       (a) Appointments.--Section 7401 is amended--
       (1) in the matter preceding paragraph (1), by striking 
     ``medical'' and inserting ``health''; and
       (2) in paragraph (1), by inserting ``chiropractors,'' after 
     ``podiatrists,''.
       (b) Qualifications of Appointees.--Section 7402(b) is 
     amended--
       (1) by redesignating paragraph (10) as paragraph (11); and
       (2) by inserting after paragraph (9) the following new 
     paragraph (10):

[[Page 30696]]

       ``(10) Chiropractor.--To be eligible to be appointed to a 
     chiropractor position, a person must--
       ``(A) hold the degree of doctor of chiropractic, or its 
     equivalent, from a college of chiropractic approved by the 
     Secretary; and
       ``(B) be licensed to practice chiropractic in a State.''.
       (c) Period of Appointments and Promotions.--Section 
     7403(a)(2) is amended by adding at the end the following new 
     subparagraph:
       ``(H) Chiropractors.''.
       (d) Grades and Pay Scales.--Section 7404(b)(1) is amended 
     by striking the third center heading in the table and 
     inserting the following:

    ``CLINICAL PODIATRIST, CHIROPRACTOR, AND OPTOMETRIST SCHEDULE''.

       (e) Malpractice and Negligence Protection.--Section 7316(a) 
     is amended--
       (1) in paragraph (1), by striking ``medical'' each place it 
     appears and inserting ``health''; and
       (2) in paragraph (2)--
       (A) by striking ``medical'' the first place it appears and 
     inserting ``health''; and
       (B) by inserting ``chiropractor,'' after ``podiatrist,''.
       (f) Treatment as Scarce Medical Specialists for Contracting 
     Purposes.--Section 7409(a) is amended by inserting 
     ``chiropractors,'' in the second sentence after 
     ``optometrists,''.
       (g) Collective Bargaining Exemption.--Section 7421(b) is 
     amended by adding at the end the following new paragraph:
       ``(8) Chiropractors.''.
       (h) Effective Date.--The amendments made by this section 
     shall take effect at the end of the 180-day period beginning 
     on the date of the enactment of this Act.

     SEC. 303. ADDITIONAL PAY FOR SATURDAY TOURS OF DUTY FOR 
                   ADDITIONAL HEALTH CARE WORKERS IN THE VETERANS 
                   HEALTH ADMINISTRATION.

       (a) In General.--Section 7454(b) is amended by adding at 
     the end the following new paragraph:
       ``(3) Employees appointed under section 7408 of this title 
     shall be entitled to additional pay on the same basis as 
     provided for nurses in section 7453(c) of this title.''.
       (b) Applicability.--The amendment made by subsection (a) 
     shall take effect with respect to the first pay period 
     beginning on or after January 1, 2004.

     SEC. 304. COVERAGE OF EMPLOYEES OF VETERANS' CANTEEN SERVICE 
                   UNDER ADDITIONAL EMPLOYMENT LAWS.

       (a) Coverage.--Paragraph (5) of section 7802 is amended by 
     inserting before the semicolon a period and the following: 
     ``An employee appointed under this section may be considered 
     for appointment to a Department position in the competitive 
     service in the same manner that a Department employee in the 
     competitive service is considered for transfer to such 
     position. An employee of the Service who is appointed to a 
     Department position in the competitive service under the 
     authority of the preceding sentence may count toward the 
     time-in-service requirement for a career appointment in such 
     position any previous period of employment in the Service''.
       (b) Technical Amendments.--Such section is further 
     amended--
       (1) by striking the semicolon at the end of each of 
     paragraphs (1) through (10) and inserting a period;
       (2) by striking ``The Secretary '' and all that follows 
     through ``(1) establish,'' and inserting ``(a) Locations for 
     Canteens.--The Secretary shall establish,'';
       (3) by redesignating paragraphs (2) through (11) as 
     subsections (b) through (k), respectively, and by realigning 
     those subsections (as so redesignated) so as to be flush to 
     the left margin;
       (4) in subsection (b) (as so redesignated), by inserting 
     ``Warehouses and Storage Depots.--The Secretary shall'' 
     before ``establish'';
       (5) in subsection (c) (as so redesignated), by inserting 
     ``Space, Buildings, and Structures.--The Secretary shall'' 
     before ``furnish'';
       (6) in subsection (d) (as so redesignated), by inserting 
     ``Equipment, Services, and Utilities.--The Secretary shall'' 
     before ``transfer'';
       (7) in subsection (e) (as so redesignated and as amended by 
     subsection (a)), by inserting ``Personnel.--The Secretary 
     shall'' before ``employ'';
       (8) in subsection (f) (as so redesignated), by inserting 
     ``Contracts and Agreements.--The Secretary shall'' before 
     ``make all'';
       (9) in subsection (g) (as so redesignated), by inserting 
     ``Prices.--The Secretary shall'' before ``fix the'';
       (10) in subsection (h) (as so redesignated), by inserting 
     ``Gifts and Donations.--The Secretary may'' before 
     ``accept'';
       (11) in subsection (i) (as so redesignated), by inserting 
     ``Rules and Regulations.--The Secretary shall'' before ``make 
     such'';
       (12) in subsection (j) (as so redesignated), by inserting 
     ``Delegation.--The Secretary may'' before ``delegate such''; 
     and
       (13) in subsection (k) (as so redesignated), by inserting 
     ``Authority To Cash Checks, Etc.--The Secretary may'' before 
     ``authorize''.

                        TITLE IV--OTHER MATTERS

     SEC. 401. OFFICE OF RESEARCH OVERSIGHT IN VETERANS HEALTH 
                   ADMINISTRATION.

       (a) Statutory Charter.--(1) Chapter 73 is amended by 
     inserting after section 7306 the following new section:

     ``Sec. 7307. Office of Research Oversight

       ``(a) Requirement for Office.--(1) There is in the Veterans 
     Health Administration an Office of Research Oversight 
     (hereinafter in this section referred to as the `Office'). 
     The Office shall advise the Under Secretary for Health on 
     matters of compliance and assurance in human subjects 
     protections, research safety, and research impropriety and 
     misconduct. The Office shall function independently of 
     entities within the Veterans Health Administration with 
     responsibility for the conduct of medical research programs.
       ``(2) The Office shall--
       ``(A) monitor, review, and investigate matters of medical 
     research compliance and assurance in the Department with 
     respect to human subjects protections; and
       ``(B) monitor, review, and investigate matters relating to 
     the protection and safety of human subjects and Department 
     employees participating in medical research in Department 
     programs.
       ``(b) Director.--(1) The head of the Office shall be a 
     Director, who shall report directly to the Under Secretary 
     for Health (without delegation).
       ``(2) Any person appointed as Director shall be--
       ``(A) an established expert in the field of medical 
     research, administration of medical research programs, or 
     similar fields; and
       ``(B) qualified to carry out the duties of the Office based 
     on demonstrated experience and expertise.
       ``(c) Functions.--(1) The Director shall report to the 
     Under Secretary for Health on matters relating to protections 
     of human subjects in medical research projects of the 
     Department under any applicable Federal law and regulation, 
     the safety of employees involved in Department medical 
     research programs, and suspected misconduct and impropriety 
     in such programs. In carrying out the preceding sentence, the 
     Director shall consult with employees of the Veterans Health 
     Administration who are responsible for the management and 
     conduct of Department medical research programs.
       ``(2) The matters to be reported by the Director to the 
     Under Secretary under paragraph (1) shall include allegations 
     of research impropriety and misconduct by employees engaged 
     in medical research programs of the Department.
       ``(3)(A) When the Director determines that such a 
     recommendation is warranted, the Director may recommend to 
     the Under Secretary that a Department research activity be 
     terminated, suspended, or restricted, in whole or in part.
       ``(B) In a case in which the Director reasonably believes 
     that activities of a medical research project of the 
     Department place human subjects' lives or health at imminent 
     risk, the Director shall direct that activities under that 
     project be immediately suspended or, as appropriate and 
     specified by the Director, be limited.
       ``(d) General Functions.--(1) The Director shall conduct 
     periodic inspections and reviews, as the Director determines 
     appropriate, of medical research programs of the Department. 
     Such inspections and reviews shall include review of required 
     documented assurances.
       ``(2) The Director shall observe external accreditation 
     activities conducted for accreditation of medical research 
     programs conducted in facilities of the Department.
       ``(3) The Director shall investigate allegations of 
     research impropriety and misconduct in medical research 
     projects of the Department.
       ``(4) The Director shall submit to the Under Secretary for 
     Health, the Secretary, and the Committees on Veterans' 
     Affairs of the Senate and House of Representatives a report 
     on any suspected lapse, from whatever cause or causes, in 
     protecting safety of human subjects and others, including 
     employees, in medical research programs of the Department.
       ``(5) The Director shall carry out such other duties as the 
     Under Secretary for Health may require.
       ``(e) Source of Funds.--Amounts for the activities of the 
     Office, including its regional offices, shall be derived from 
     amounts appropriated for the Veterans Health Administration 
     for Medical Care.
       ``(f) Annual Report.--Not later than March 15 each year, 
     the Director shall submit to the Committees on Veterans' 
     Affairs of the Senate and House of Representatives a report 
     on the activities of the Office during the preceding calendar 
     year. Each such report shall include, with respect to that 
     year, the following:
       ``(1) A summary of reviews of individual medical research 
     programs of the Department completed by the Office.
       ``(2) Directives and other communications issued by the 
     Office to field activities of the Department.
       ``(3) Results of any investigations undertaken by the 
     Office during the reporting period consonant with the 
     purposes of this section.

[[Page 30697]]

       ``(4) Other information that would be of interest to those 
     committees in oversight of the Department medical research 
     program.
       ``(g) Medical Research.--For purposes of this section, the 
     term `medical research' means medical research described in 
     section 7303(a)(2) of this title.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     7306 the following new item:

``7307. Office of Research Oversight.''.

     /  (b) Conforming Amendment.--Section 7303 is amended by 
     striking subsection (e).

     SEC. 402. ENHANCEMENT OF AUTHORITIES RELATING TO NONPROFIT 
                   RESEARCH CORPORATIONS.

       (a) Coverage of Personnel Under Tort Claims Laws.--(1) 
     Subchapter IV of chapter 73 is amended by inserting after 
     section 7364 the following new section:

     ``Sec. 7364A. Coverage of employees under certain Federal 
       tort claims laws

       ``(a) An employee of a corporation established under this 
     subchapter who is described by subsection (b) shall be 
     considered an employee of the Government, or a medical care 
     employee of the Veterans Health Administration, for purposes 
     of the following provisions of law:
       ``(1) Section 1346(b) of title 28.
       ``(2) Chapter 171 of title 28.
       ``(3) Section 7316 of this title
       ``(b) An employee described in this subsection is an 
     employee who--
       ``(1) has an appointment with the Department, whether with 
     or without compensation;
       ``(2) is directly or indirectly involved or engaged in 
     research or education and training that is approved in 
     accordance with procedures established by the Under Secretary 
     for Health for research or education and training; and
       ``(3) performs such duties under the supervision of 
     Department personnel.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     7364 the following new item:

``7364A. Coverage of employees under certain Federal tort claims 
              laws.''.
       (b) Clarification of Executive Director's Ethics 
     Certification Duties.--Section 7366(c) is amended--
       (1) by inserting ``(1)'' after ``(c)'';
       (2) by striking ``any year--'' and all that follows through 
     ``shall be subject'' and inserting ``any year shall be 
     subject'';
       (3) by striking ``functions; and'' and inserting 
     ``functions.''; and
       (4) by striking paragraph (2) and inserting the following:
       ``(2) Each corporation established under this subchapter 
     shall each year submit to the Secretary a statement signed by 
     the executive director of the corporation verifying that each 
     director and employee has certified awareness of the laws and 
     regulations referred to in paragraph (1) and of the 
     consequences of violations of those laws and regulations in 
     the same manner as Federal employees are required to so 
     certify.''.
       (c) Five-Year Extension of Authority to Establish Research 
     Corporations.--Section 7368 is amended by striking ``December 
     31, 2003'' and inserting ``December 31, 2008''.

     SEC. 403. DEPARTMENT OF DEFENSE PARTICIPATION IN REVOLVING 
                   SUPPLY FUND PURCHASES.

       (a) Enhancement of Department of Defense Participation.--
     Section 8121 is amended--
       (1) by redesignating subsections (b) and (c) as subsections 
     (d) and (e), respectively;
       (2) by designating the last sentence of subsection (a) as 
     subsection (c); and
       (3) by inserting after paragraph (3) of subsection (a) the 
     following new subsection (b):
       ``(b) The Secretary may authorize the Secretary of Defense 
     to make purchases through the fund in the same manner as 
     activities of the Department. When services, equipment, or 
     supplies are furnished to the Secretary of Defense through 
     the fund, the reimbursement required by paragraph (2) of 
     subsection (a) shall be made from appropriations made to the 
     Department of Defense, and when services or supplies are to 
     be furnished to the Department of Defense, the fund may be 
     credited, as provided in paragraph (3) of subsection (a), 
     with advances from appropriations available to the Department 
     of Defense.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall apply only with respect to funds appropriated for a 
     fiscal year after fiscal year 2003.

     SEC. 404. FIVE-YEAR EXTENSION OF HOUSING ASSISTANCE FOR 
                   HOMELESS VETERANS.

       Section 2041(c) is amended by striking ``December 31, 
     2003'' and inserting ``December 31, 2008''.

     SEC. 405. REPORT DATE CHANGES.

       (a) Senior Managers Quarterly Report.--Section 516(e)(1)(A) 
     is amended by striking ``30 days'' and inserting ``45 days''.
       (b) Annual Report on Assistance to Homeless Veterans.--
     Section 2065(a) is amended by striking ``April 15 of each 
     year'' and inserting ``June 15 of each year''.
       (c) Annual Report of Committee on Care of Severely 
     Chronically Mentally Ill Veterans.--Section 7321(d)(2) is 
     amended by striking ``February 1, 1998, and February 1 of 
     each of the six following years'' and inserting ``June 1 of 
     each year through 2008''.
       (d) Annual Report on Sharing of Health Care Resources.--
     Section 8153(g) is amended--
       (1) by striking ``not more than 60 days after the end of 
     each fiscal year'' and inserting ``not later than February 1 
     of each year''; and
       (2) by inserting ``during the preceding fiscal year'' after 
     ``under this section''.
       (e) Annual Report of Special Committee on PTSD.--Section 
     110(e)(2) of the Veterans' Health Care Act of 1984 (38 U.S.C. 
     1712A note) is amended by striking ``February 1 of each of 
     the three following years'' and inserting ``May 1 of each 
     year through 2008''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Smith) and the gentleman from Texas (Mr. Rodriguez) each 
will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey (Mr. Smith).
  Mr. SMITH of New Jersey. Madam Speaker, I yield such time as he may 
consume to the gentleman from Connecticut (Mr. Simmons), the chairman 
of our Subcommittee on Health, who is the prime author of this 
legislation.
  Mr. SIMMONS. Madam Speaker, I thank the gentleman from New Jersey 
(Mr. Smith) the distinguished chairman of the Committee on Veterans' 
Affairs, for all the hard work that he has done over the course of this 
year, and in previous years, in an effort to bring this legislation to 
final passage today. He is truly a friend of America's veterans.
  Madam Speaker, the bill before us combines substantial portions of 
seven House and Senate bills dealing with veterans health care matters. 
As the Subcommittee on Health chairman, I am pleased that we are 
proposing to rebuild substantial portions of the Department of Veterans 
Affairs aging capital infrastructure, which is a fancy way of saying 
their hospital and health care facilities.
  Most Members know that America cares for her veterans more than any 
other country in the world and has provided health care facilities for 
her veterans for over 100 years. That is the good news. Regrettably, 
the bad news is that many of these facilities, which provide excellent 
health care services to our veterans, show signs of aging. They need 
upgrading or replacement, and that is one of the purposes of the bill 
before us today.
  This legislation is the result of compromise between the House and 
the Senate. It is the product of many minds. And I am grateful to my 
ranking member, the gentleman from Texas (Mr. Rodriguez) for all of his 
help in bringing us to this point here today.
  In summary, the bill would authorize six new medical building 
probables at a total cost of $276.6 million in Chicago, San Diego, West 
Haven, Lebanon, Beckley, and Pensacola. It also authorizes advance 
planning of $86.5 million for the Veterans Administration to design 
five new projects in Denver, Colorado, Columbus, Ohio, Pittsburgh, 
Pennsylvania, Las Vegas, Nevada, and East Central, Florida. I am 
confident these projects will be funded once they are fully designed 
with the authorization provided in this bill.
  The Denver project, for example, is a joint venture involving the 
Veterans Administration and the Air Force to establish a new 
Fitzsimmons Hospital Center. We believe this project will move forward 
with $26 million from the VA added to $4 million from the Air Force. 
And I thank my colleagues, the gentleman from Colorado (Mr. Beauprez) 
and the gentleman from Colorado (Mr. Hefley) for all of their hard work 
on this project.
  Another very important planning project in our bill is for Columbus, 
Ohio. It would relocate and expand an existing VA clinic to available 
Federal property. And while this committee wanted to provide the full 
authorization this year, and, in fact, this body did so, that was 
opposed by the other body. In the spirit of compromise the committees 
agreed to provide $9 million for advance planning for the new clinic in 
Columbus. I thank the gentleman from Ohio (Mr. Hobson) for his 
leadership and help with this matter. I personally look forward to 
going out to Ohio, hopefully, in the company of Secretary Principi, to 
review the project.
  In Pittsburgh, Pennsylvania, the VA needs a new health facility to 
replace

[[Page 30698]]

two aging hospitals, both of which are over 50 years old. The committee 
has agreed to provide planning funds of $9 million for this project as 
well.
  In addition to these projects, the bill with also delegate to 
Secretary Principi the ability to prioritize construction projects 
coming out of VA's so-called ``CARES'' process, provided appropriations 
to support these projects would be available. And we are confident this 
approach is a responsible way to proceed. With this delegation of 
authority to the Secretary, however, we also impose some limits on the 
VA in this bill. If, for example, as a result of CARES, the Secretary 
is closing VA medical facilities, or significantly reducing health care 
staff or consolidating two or more hospitals, we request that VA report 
these plans to Congress and wait 60 days before proceeding.
  In closing, Madam Speaker, I would like to mention two hospital or 
facility naming pieces of this legislation. First of all, I had the 
honor as a member of the Committee on Armed Services to serve under 
Chairman Bob Stump, who also was a distinguished chairman of the 
Committee on Veterans' Affairs. There is no truer friend to America's 
veterans than Bob Stump. And we lost him earlier this year, 
unfortunately, to a long illness. But we wanted to memorialize his 
service to American veterans in an appropriate and respectful way, 
which is why our bill names the Prescott, Arizona, VA Medical Center 
the Bob Stump Department of Veterans Affairs Medical Center.
  As well, I want to honor a very distinguished veteran from my own 
district, John McGuirk, a native of Connecticut, who enlisted in the 
United States Navy during World War II, serving as a salvage diver. He 
hazarded death and injury every day of his service, serving in the 
South Pacific from Pearl Harbor to Manila in the Philippines, including 
service aboard the salvage ship U.S.S. Laysan Island.
  John McGuirk was instrumental in establishing a community-based 
outreach clinic in New London, Connecticut, on the grounds of the U.S. 
Coast Guard Academy. And this legislation will memorialize him by 
naming this clinic after him.
  Madam Speaker, I urge all Members to vote in support of final passage 
of this legislation, the Veterans Health Care Capital Asset and 
Business Improvement Act of 2003.

                              {time}  1230

  Mr. RODRIGUEZ. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise in support of S. 1156, as amended, the Veterans 
Health Care, Capital Assets and Business Improvement Act of 2003.
  This legislation draws the best from provisions offered in this body 
and the Senate. I have worked closely on the bill with the chairman of 
the Subcommittee on Health, the gentleman from Connecticut (Mr. 
Simmons). I want to thank him for his graciousness and the hard work. I 
would also like to thank the gentleman from New Jersey (Mr. Smith) and 
also the ranking member, the gentleman from Illinois (Mr. Evans), for 
their assistance in finalizing this bill.
  I am very pleased that the bill includes important provisions from 
H.R. 2433, as amended, a bill I introduced with the support of the 
gentleman from Connecticut (Mr. Simmons). I also appreciate the 
persistence of the gentleman from California (Mr. Thompson), who will 
be speaking, in ensuring that these tests were brought to light in the 
items that we would be bringing before in this piece of legislation.
  This bill will take important steps to remedy the serious wrong done 
to some of our veterans during the Cold War era. The military conducted 
a series of about 50 tests over almost a decade to determine the 
effects of the number of biological and chemical exposures to military 
operations and whether such exposures could be adequately protected. 
Many of these veterans participated without their knowledge, and too 
often veterans who participated in these tests were not properly 
protected from exposure to the number of stimulants as well as, 
occasionally, live agents. These agents included sarin and VX nerve 
gas, as well as biological war agents including Q fever and rabbit 
fever.
  The military has now completed a number of investigations into the 
operations of the Deseret Test Center and concluded that as many as 
6,000 veterans may have been involved. Veteran participation is 
unacceptable, and we recognize this, and we are concerned; and we want 
to assure them that if they are suffering lasting health consequence 
that we will do something about this.
  I am very pleased that this legislation does something about that. 
This bill provides high-priority eligibility for the next 2 years to 
allow them to seek and receive VA treatment for the health problems 
including those that may be related to the problems, especially to the 
exposure of these hazardous agents.
  This authority will allow them, and it will not adequately compensate 
them for what they have gone through, but we are at least beginning to 
try to correct the situation that we find ourselves in. Allowing them 
to have their health care concerns addressed may begin to give them the 
peace of mind this Nation owes them.
  I am also pleased the final bill includes many provisions on the bill 
H.R. 1720, as amended. Madam Speaker, this bill authorizes many worthy 
construction projects to which the VA has given high priority. 
Unfortunately, the VA major medical construction has suffered for years 
as Congress has waited for the results of the CARES program, which is 
Capital Assets Realignment for Enhanced Services. I hope now that VA is 
about to approve a final plan, Congress will see fit to provide the 
appropriations VA requires to invest in its outdated infrastructure 
that we know is lacking. So we are hoping that we can do more as the 
report comes out.
  A provision in our bill is designed to assure Congress that we are 
also adequately informed of some less positive developments that may 
result from this process, facility closures, staff realignments, as 
well as consolidations that may affect many veterans.
  I am also pleased that this bill would give us both the assurance of 
this notification and the time to respond to these developments. 
Regardless of its outcome, CARES gave us at least one thing of value 
and that is the information that it has provided us. Last fall, the VA 
came forward with data that confirmed the ongoing concerns. I, along 
with my good friend, the gentleman from Texas (Mr. Ortiz), have talked 
about the veterans of south Texas. I know the gentleman from Texas (Mr. 
Ortiz) will be speaking today. They suffered long, miserable journeys, 
up to 6 hours one way, to receive hospital care and some specialized 
services. And I do not think that anyone knew many of our veterans had 
the worst access to acute hospital care in the Nation like in south 
Texas.
  I am pleased this bill will require the VA to report to us on the 
steps it intends to take to resolve this long-lasting problem in south 
Texas.
  This bill will also provide new benefits to former prisoners of war. 
Under the current law, neither Jessica Lynch nor her comrades who 
suffered internment in Iraq would be eligible to receive outpatient 
dental care from the VA. Why? Because they were in captivity for fewer 
than 90 days. Veterans who have experienced the trauma associated with 
being prisoners of war deserve dental care regardless of the time of 
the captivity.
  This bill will also do away with these veterans medication co-
payments. Surely we can all agree that these veterans have paid enough. 
This bill will extend and enhance long-term care and mental health 
programs. The VA continues to study how it will provide care in the 
future. Congress must remain vigilant about the programs that are 
needed by some of the most vulnerable veterans in the system.
  I am pleased we have continued to support two internal watchdogs to 
monitor and report to Congress on the methods of improving mental 
health programs within the VA for the seriously mentally ill and for 
victims of post-traumatic stress disorder.

[[Page 30699]]

  With troops who have seen the consequences of combat still in the 
field, we need the VA permanent programs to be available to both men 
and women who have trouble readjusting to civilian life.
  Madam Speaker, there are numerous additional provisions in the bill 
that will allow the VA to provide better care to our veterans. I would 
like to thank the committee leadership and the staff for their hard 
work on this bill.
  Madam Speaker, I rise in support of S. 1156, as amended, the Veterans 
Health Care, Capital Asset And Business Improvement Act of 2003. The 
bill draws the best from provisions offered in this body and in the 
Senate. I have worked closely on this bill with the Chairman of the 
Health Subcommittee, Mr. Simmons. I would also like to thank Chairman 
Smith and Ranking Member Evans for their assistance in finalizing this 
bill.
  I am most pleased that the bill includes important provisions from 
H.R. 2433, as amended, a bill I introduced with the support of my 
Chairman, Mr. Simmons. I also appreciate the persistence of the 
gentleman from California, Mike Thompson in ensuring that these tests 
were brought to light. This bill will take important steps to remedy a 
serious wrong done to some veterans during the Cold War era. The 
military conducted a series of about 50 tests over almost a decade to 
determine the effect of a number of biological and chemical exposures 
on military operations and whether such exposures could be adequately 
detected. Too often veterans who participated, sometimes unwittingly, 
in these tests were not properly protected from exposures to a number 
of stimulants and, occasionally, live agents. These agents included 
Sarin and VX nerve gas as well as biological war agents including Q 
fever and rabbit fever.
  The military has now completed a number of investigations into the 
operations of the Deseret Test Center and concluded that as many as 
6000 veterans may have been involved. Veteran participants are 
understandably concerned and want assurances that they are not 
suffering lasting health consequences related to these tests. This bill 
provides high-priority health care eligibility to these veterans for 
the next two years to allow them to seek and receive VA treatment for 
any health problems, including those they believe may be related to 
exposures to these hazardous agents. This authority will never 
adequately compensate veterans for their participation in dangerous 
tests, but allowing them to have their health care concerns addressed 
may begin to give them the peace-of-mind the nation owes them.
  I am also pleased that the final bill includes many of the provisions 
from H.R. 1720, as amended. Madam Speaker, this bill authorizes many 
worthy construction projects to which VA has given high priority. 
Unfortunately, VA's major medical construction has languished for years 
as Congress has waited for the results of the Capital Assets 
Realignment for Enhanced Services (CARES) study. I hope now that VA is 
about to approve a final plan, Congress will see fit to provide the 
appropriations VA requires to invest in its outdated infrastructure. If 
so, this will be a positive outcome of CARES. A provision of our bill 
is designed to ensure Congress that we are also adequately informed of 
some less positive developments that may result from this process--
facility closures, staff reassignments and consolidations that may 
affect many veterans. I am pleased that this bill will give us both the 
assurance of this notification and the time to respond to these 
developments.
  Regardless of its outcomes, CARES gave us at least one thing of 
value--information. Last fall, VA came forward with data that confirm 
ongoing concerns I, along with my good friend Solomon Ortiz, have had 
about the veterans of South Texas. We knew they often suffered long, 
miserable journeys--up to 6 hours one way--to receive hospital care and 
some specialized services, but I don't think anyone knew many of our 
veterans had the worst access to acute hospital care in the nation! I 
am pleased this bill will require VA to report to us on steps it 
intends to take to resolve this longstanding problem.
  This bill will provide new benefits to former prisoners-of-war. Under 
current law, neither Jessica Lynch nor her comrades who suffered 
internment in Iraq would be eligible to receive outpatient dental care 
from the VA. Why? Because they were in captivity for fewer than 90 
days. While this limitation on eligibility was based on a rationale, it 
now seems capricious. Veterans who have experienced the trauma 
associated with being a prisoner of war deserve dental care regardless 
of their time in captivity. This bill will also do away with these 
veterans' medication copayments. Surely we can all agree that these 
veterans have paid enough.
  This bill will extend and enhance long-term care and mental health 
problems. As VA continues to study how it will provide health care in 
the future Congress must remain vigilant about these programs that 
consume many resources but are needed by some of the most vulnerable 
veterans in the system. I am pleased we will also require two internal 
watchdogs that have made solid recommendations for improving mental 
health programs to continue to report to Congress on the VA's services 
for the seriously mentally ill and for veterans with Post-Traumatic 
Stress Disorder. With troops who have seen the consequences of combat 
still in the field we will need VA's pre-eminent programs to be 
available to the men and women who have trouble readjusting to civilian 
life.
  Madam Speaker, there are a number of additional provisions in this 
bill that will allow VA to provide better care to our veterans. I thank 
the Committee leadership and the staff for their hard work on the bill 
and want to commend it to all of my colleagues.
  Madam Speaker, I reserve the balance of my time.
  Mr. SMITH of New Jersey. Madam Speaker, I yield 3 minutes to the 
gentleman from Indiana (Mr. Buyer), the distinguished chairman of our 
Subcommittee on Oversight and Investigations.
  Mr. BUYER. Madam Speaker, this is excellent bipartisan legislation, 
not only between the Members of this body but also between the House 
and the Senate. This is a good compromise, not only with regard to 
major facility construction, whether it is to improve, renovate, 
replace, update and establish new health care facilities around the 
country. That is an excellent portion of this bill.
  I would like to bring to my colleagues' attention that included in 
this compromise package is some legislation I authored to ensure the 
ethical treatment and safety of veterans who participate in VA medical 
research. We spend a lot of money on VA medical research, and there 
have been some incidents over the years whereby veterans have been 
harmed. And just the title of what it is called, Human Subject 
Protection, by calling humans subjects, it even sort of desensitizes 
the issue that there is a human being here at stake.
  The VA medical research human subject protections section of this 
bill does the following:
  We will establish an independent office to oversee research and 
compliance and assurance.
  This bill will also provide that the new office counsels the Under 
Secretary for Health on all matters related to the protection of human 
research subjects, research misconduct and impropriety, and also the 
ethical conduct of research, and research safety.
  That office shall investigate allegations of research, misconduct and 
impropriety; suspend or restrict research to ensure the safety and 
ethical treatment of human subjects; and assure compliance in the 
conduct of research.
  The director of the office shall conduct periodic inspections at 
research facilities, observe external accreditation site visits, 
investigate allegations of research misconduct and improprieties.
  This bill also requires the immediate notification of the Under 
Secretary for Health when endangerment of human research subjects is 
evident or suspected and requires that Congress be notified when 
research misconduct or impropriety has been discovered.
  This bill provides that funding for the new office would be 
independent from the Office of Research and Development.
  Finally, the bill mandates that the Comptroller General of the United 
States conduct a study of the effectiveness of this new office and 
submit a report to Congress by January 1, 2006.
  I want to thank all Members of the House Committee on Veterans' 
Affairs and the Senate for including this language in section IV of the 
bill. In particular, I want to thank the gentleman from New Jersey (Mr. 
Smith) and the ranking member, the gentleman from Illinois (Mr. Evans), 
and the ranking member of the Subcommittee on Oversight and 
Investigations, the gentlewoman from Oregon (Ms. Hooley), for co-
sponsoring the legislation. Also, in

[[Page 30700]]

particular, the gentleman from Connecticut (Mr. Simmons) and the 
ranking member, the gentleman from Texas (Mr. Rodriguez), for this bill 
at the subcommittee level, for bringing this to the attention of all of 
our colleagues. This is good legislation and good work, and I thank 
everyone for their efforts.
  Mr. RODRIGUEZ. Madam Speaker, I yield 2 minutes to the gentleman from 
Illinois (Mr. Evans), the ranking Democrat.
  Mr. EVANS. Madam Speaker, I rise to support the Veterans Health Care, 
Capital Asset and Business Improvement Act of 2003. I want to start out 
by thanking the gentleman from New Jersey (Mr. Smith) again for his 
willingness to work closely with me and the Democratic members of the 
committee to develop this as a final package. Credit goes to the 
gentleman from Connecticut (Mr. Simmons) and the ranking member, the 
gentleman from Texas (Mr. Rodriguez), for moving these measures to the 
floor today.
  The bill anticipates the final approval of the CARES plan, 
identifying Congress's priorities requiring notification of major 
initiatives that come before the plan. I will continue to work behind 
the curtain and in front of the public to get this legislation passed.
  The bill memorializes two great friends of mine: Bob Stump, who was 
an advocate for veterans throughout his career. We truly miss him not 
being on the committee anymore. He was a great American, and we salute 
his courage in standing up for what he believed in. Also, Jesse Brown, 
a veterans advocate as well, the former Secretary of Veterans Affairs 
for veterans. And we recognize these contributions of these two 
veterans with the passage of this bill.
  This is a laudable effort for improving services for elderly and 
mentally-ill veterans. It strives to make VA the first choice. I am 
proud of the committee's work.
  Madam Speaker, I rise to support the Veterans Health Care, Capital 
Asset and Business Improvement Act of 2003. I want to thank Chairman 
Smith for his ongoing commitment to veterans and his willingness to 
work closely with us on the development of this final package.
  There are many important provisions in this bill. I appreciate the 
good bipartisan work of Chairman Simmons and Ranking Member Rodriguez 
in shepherding these measures from the Health Subcommittee to our 
consideration of a final conference package on the floor today.
  This bill anticipates the final approval of the National Capital 
Asset Realignment for Enhanced Services (CARES) Plan. This Plan may set 
the framework for the first significant investment in the VA medical 
care system's infrastructure in several years. We are now way behind in 
making the needed investments--some estimate that the deficit is as 
high as $6 billion in delayed VA projects. VA's Phase I Study in VISN 
12 has offered interested parties a view to the future under a CARES-
like process. I had to look no further than upstate Illinois to see how 
the administration might handle the hundreds of new proposals it has on 
tap if most of the recommendations in the Draft CARES Plan are adopted.
  The answers I received about the plan for VISN 12 were unsettling. 
This is particularly true since this Phase I study is the prototype for 
the larger National plan. VA planned to close one of the divisions of 
VA Chicago without sure funding for a modern new bed tower at the other 
division. This replacement facility was, in my view and many others, 
the linchpin to a successful integration. There are still no plans to 
develop the on-site multispecialty outpatient clinic veterans were 
promised.
  This spring I introduced H.R. 2349 which authorized funds to 
construct the new bed tower at the West Side division of VA in Chicago. 
It also attempted to hold VA's feet to the fire to fund and build the 
new bed tower by prohibiting VA from disposing of the closed facility 
until it began construction on its replacement. Instead of the 
restrictions I put on VA in my bill, I have agreed to establish 
priorities for spending appropriations designated for CARES projects. 
This conference package gives the highest priority to facilities, such 
as West Side, that are needed to replace capacity at facilities that 
CARES will recommend closing, consolidating or converting in some 
fashion. It also gives high priorities to projects that remedy life 
safety and seismic deficiencies.
  My bill contained additional projects that are worthy of our 
appropriators' consideration. It authorizes $48,600,000 for the 
correction of seismic deficiencies in San Diego, California, and 
$50,000,000 for medical care and research renovations in West Haven, 
Connecticut. My bill included lease authority for Las Vegas. We have 
since learned that VA's needs there may be evolving and settled on 
appropriating advance planning funds in the amount of $25,000,000 for a 
major medical facility project there.
  The bill also adopts language inspired by a provision introduced by 
my friend from Kansas, Dennis Moore. His bill has tremendous and broad-
based support in this body. The provision requires VA to notify 
Congress in writing of actions proposed under the CARES initiative that 
would result in medical facility closures, significant staff 
realignments or medical facility consolidations and prohibits VA from 
taking these actions before 45 days following the notification or 30 
days of continuous session of Congress.
  I plan to continue to look behind the CARES process to ensure that VA 
is making its decisions in the best interest of veterans--not the 
bottom line.
  In addition to honoring my friend, the late Jesse Brown, the former 
Secretary ``for'' Veterans Affairs by naming the VA Medical Center 
(West Side Division) in Chicago for him, this final package will name 
the Prescott VA Medical Center for our Committee's former Chairman, and 
my personal friend, the late Bob Stump. We honor two true veterans' 
advocates with the passage of this bill, and I am pleased to be 
associated with it.
  Madam Speaker, I am pleased that we are finally able to authorize VA 
to provide health care to certain Filipino World War II veterans of the 
Philippines Commonwealth Army and former Philippines ``New Scouts'' who 
permanently reside in the United States, in the same manner as provided 
to U.S. veterans. I commend my colleague, Mr. Filner, for his 
persistence in seeing this to fruition.
  Several years ago, my friend from California, Mike Thompson, 
discovered that many veterans had participated in a series of dangerous 
tests to identify the military's ability to detect and protect itself 
from biological and chemical attacks. His doggedness led the military 
to admit responsibility for conducting these tests which involved 
spraying American troops with agents that were, in some cases, 
extremely potent. The ranking member of the Health Subcommittee, Ciro 
Rodriguez, saw an opportunity to do some justice for these veterans by 
giving them access to VA health care for any condition for two years. 
This will allow these veterans to seek care for conditions they believe 
may be related to their exposures. I am pleased to support this 
provision.
  This bill is laudable for improving services for elderly and mentally 
ill veterans. One provision allows VA authority to provide work skills 
training and development services, employment support services and job 
development and placement services as part of a more comprehensive 
rehabilitation package. This is likely to improve the therapeutic 
outcomes for seriously mentally ill veterans, homeless veterans and 
veterans with substance use disorders--those who can truly benefit from 
hands-on job coaching services. It extends authority for VA to provide 
properties foreclosed under its home loan program to nonprofit homeless 
service providers. VA has made extensive use of this authority and 
nonprofits have provided many nights of care to homeless veterans as a 
result.
  The bill extend VA's authority to provide a range of non-
institutional extended care services and a mandate to provide medically 
necessary, institutional nursing care services to severely service-
connected disabled veterans through December 31, 2008. It allows VA to 
extend and add a site to its important pilot program on assisted living 
for veterans. It provides earmarked funding for specialized mental 
health services for veterans in each of the next three fiscal years. It 
also continues the reports of two important VA advisory groups who have 
made a series of solid recommendations to the Under Secretary for 
Health and the Congress about programs for seriously mentally ill 
veterans and veterans with post-traumatic stress disorder.
  Finally, this bill strives to make VA an employer of choice. We have 
reached one of those rare compromises that seem to offer something to 
everyone by creating a new appointment and promotion authority for 
certain clinical personnel, such as clinical psychologists, social 
workers, audiologists, kinesiologists, and others in the Veterans 
Health Administration (VHA). This authority will allow these employees 
to enjoy some of the same protections other Federal workers have, but 
will also provide VA with greater hiring and

[[Page 30701]]

promotion flexibility. Some health care workers, mostly nursing 
assistants, will enjoy Saturday premium pay under this bill. It will 
allow VA to appoint employees of the Veterans' Canteen Service taking 
into consideration their time in service in that capacity. We have 
offered VHA the authority to hire chiropractors to enhance the types of 
health care services it routinely offers veterans.
  Madam Speaker, I am proud of the Committee's work on this bill and 
encourage all of my colleagues to approve it.
  Mr. SMITH of New Jersey. Madam Speaker, I yield 2 minutes to the 
distinguished gentleman from Arizona (Mr. Renzi), a member of the 
committee, and a very active one at that.
  Mr. RENZI. Madam Speaker, I want to begin by commending the chairman, 
the gentleman from New Jersey (Mr. Smith), and the gentleman from 
Illinois (Mr. Evans), the gentleman from Connecticut (Mr. Simmons), and 
the gentleman from Texas (Mr. Rodriguez) for their hard work in 
crafting a comprehensive bill that gives great improvements to veterans 
health care programs.
  It is imperative at this time especially that we honor the service of 
veterans and provide for the quality of life they have helped foster 
for their years of service to us and this Nation.
  This bill ensures the VA health care system will continue to provide 
the highest quality health care services to our Nation's patriots.
  I would like to take a minute to highlight a provision in this bill 
that honors the memory of a veteran that served in this body. 
Congressman Bob Stump dedicated his life to the service of this 
country, first in World War II as a Navy medic, then as an elected 
official in the State of Arizona, and also in the House of 
Representatives here in Washington.
  Throughout his career, he devoted his efforts to taking care of men 
and women in uniform on and off the battlefield who committed 
themselves to defend this Nation and our Constitution. As the previous 
chairman of the House Committee on Veterans' Affairs, he worked for 
over 20 years in support of increased health care benefits for veterans 
and in strengthening the Montgomery GI Bill to allow veterans to have 
greater access to education and training.
  This bill honors the legacy of Bob Stump and his steadfast commitment 
to veterans by renaming the Prescott Veterans Affairs Medical Center in 
Prescott, Arizona, the Bob Stump Veterans Affairs Medical Center.
  I would like to thank members of his staff, Delores Dunn, Joanne 
Keeane, and Susan Hosinpellar, who continue to carry on the tradition 
of his service. It is they who brought forward this idea, along with 
the Arizona delegation who helped make it happen. It is a fitting 
tribute to one of our Nation's greatest heroes.
  Mr. RODRIGUEZ. Madam Speaker, I yield 3 minutes to the gentleman from 
California (Mr. Filner).
  Mr. FILNER. Madam Speaker, I also rise in support of S. 1156 as it 
comes to the House.
  As I said yesterday on the floor of the House and I will say again to 
the chairman of the Committee on Veterans' Affairs and the ranking 
member, the gentleman from New Jersey (Mr. Smith) and the gentleman 
from Illinois (Mr. Evans), if we take the benefits package that we 
passed yesterday and the health package that we will pass today, the 
sum together of these make this year one of the most productive years 
ever for benefits and health care for our Nation's veterans.

                              {time}  1245

  I want to congratulate our leadership on that.
  Let me just speak quickly to two of the provisions in this bill. One 
of them provides access to the veterans medical facilities to all 
Filipino World War II veterans who legally reside in the United States. 
This is a benefit that comes from my bill, H.R. 664, and for which I 
have been fighting for many years, and I thank all the folks involved, 
the gentleman from Connecticut (Chairman Simmons), the gentleman from 
Texas (Ranking Member Rodriguez), as well as Veterans' Affairs 
Secretary Principi for bringing this to the floor today.
  The Filipino soldiers during World War II helped us win the war in 
the Pacific, and their brave, courageous stands in the epic battles of 
Bataan and Corregidor, their critical participation in guerrilla 
warfare that slowed up the Japanese advance, caused them to suffer 
greatly after the war when the Congress of 1946 deprived them of the 
very benefits in both health and benefits that they had been promised.
  These veterans are now in their seventies and eighties. Their most 
urgent need is health care. So it is with great joy that I urge my 
colleagues to vote for this bill. It will restore dignity and honor to 
these brave veterans where over 50 years of injustice burns in their 
hearts. Their sons and daughters and they themselves, I know, are 
watching this floor today and are going to have great celebration when 
we pass this bill later on.
  What we are saying here today is that these veterans are indeed 
United States veterans, and we are going to begin remedying the 
historical injustice that we inflicted upon them. We will make good on 
the promise of America for these brave veterans.
  In addition, as has been mentioned, this bill contains major medical 
investments in many areas of this country, including San Diego, 
California. The average health care facility in the VA is more than 50 
years old. So we have to update these buildings. The building in San 
Diego is in dire need of seismic correction, and it is one of 60 
projects that the VA has identified that need these seismic 
corrections. So we cannot turn our heads away without acting any 
longer. We cannot continue to leave VA patients and employees in harm's 
way.
  For all these reasons and more, I urge passage of Senate bill 1156.
  Mr. SMITH of New Jersey. Mr. Speaker, because there have been so many 
requests for time on our side, as well as on the Democratic side, I ask 
unanimous consent that we extend this debate by 10 minutes equally 
divided between the minority and majority.
  The SPEAKER pro tempore (Mr. Burgess). Is there objection to the 
request of the gentleman from New Jersey?
  There was no objection.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield 2 minutes to the 
gentleman from Colorado (Mr. Hefley), the distinguished chairman of the 
Committee on Standards of Official Conduct.
  Mr. HEFLEY. Mr. Speaker, let me tell my colleagues this is a good 
bill. This recognizes needs that have gone unmet for in some cases 
seems like generations, and I am not going to go through and describe 
the bill in its totality because other speakers have done it better 
than I can, but let me just say an area that I am particularly 
interested in is the authorization for the Secretary of Veterans' 
Affairs to enter into a contract in the amount of $26 million for the 
advance planning and engineering for the VA medical facility project at 
the former Fitzsimons Army Medical Center site in Aurora, Colorado.
  As the gentleman from Connecticut (Mr. Simmons) said, the University 
of Colorado Hospital is moving to this new medical campus, which is 
really going to be something to see when it is completed, and they have 
cooperated with the veterans hospital over the years, and now to bring 
the veterans hospital out there with the savings that goes with that, 
it is going to be a magnificent medical facility.
  The VA Medical Center at Fitzsimons, with this co-location with the 
Colorado Health Sciences Center and University of Colorado Hospital 
will be a veteran-friendly, state-of-the-art medical campus providing 
veterans with highly specialized medical needs with easy access to the 
best diagnostic and treatment programs that America can provide for 
veterans anywhere in America.
  The Denver Veterans Medical Center's relocation is a unique 
opportunity to provide solid and constructive solutions to the 
challenges of aging facilities issues and new facilities costs while 
providing enhanced quality of medical care for veterans.
  I believe that co-locating the Denver Veterans Medical Center with 
the University of Colorado Hospital will

[[Page 30702]]

achieve the goals of providing the most modern, comprehensive and cost-
effective medical care that our Nation can provide our veterans.
  Congress has a duty to provide the best medical care it can to our 
Nation's veterans, and we must always strive for the very best health 
care services it can by utilizing the most cost-effective measures 
available, and for this reason, I am very much in support of Senate 
bill 1156 and encourage my colleagues to vote for it.
  I have said it before, and so I am being redundant, but I will say it 
again, no one cares more about the veterans of this Nation than the 
gentleman from New Jersey (Mr. Smith) and the gentleman from 
Connecticut (Mr. Simmons), and they have just done a magnificent job of 
putting this bill together with the limitations we have. It is a 
wonderful bill.
  Mr. RODRIGUEZ. Mr. Speaker, I yield 3\1/2\ minutes to the gentlewoman 
from Nevada (Ms. Berkley), a member of the committee.
  Ms. BERKLEY. Mr. Speaker, I thank the gentleman from Texas for his 
leadership in this issue.
  Mr. Speaker, I rise today in support of this legislation which 
contains so many worthwhile VA medical construction projects across the 
country, including a medical complex in southern Nevada. I would like 
to thank the gentleman from New Jersey (Mr. Smith), the Committee on 
Veterans' Affairs chairman, and the gentleman from Illinois (Mr. 
Evans), the ranking member, for working closely with me and other 
members on this important measure.
  Southern Nevada's veterans population is one of the fastest growing 
in the United States. The VA predicts that the number of annual visits 
by veterans in the Las Vegas Valley to their primary health care clinic 
will rise from 200,000 to more than a half a million by 2010. That is a 
mere 7 years from now, and the number of hospital beds needed to serve 
the veterans in my community will increase by 50 percent.
  The VA is already struggling to address and meet the current demands 
on the VA health care structure in the Las Vegas valley. Last year, 
1,500 southern Nevada veterans were sent to neighboring States because 
we could not provide the needed services locally. This is a terrible 
burden on those veterans and their families. They should not have to 
travel hundreds of miles across the country for needed care.
  In addition, due to the decrepit conditions and structural 
deficiencies, the VA evacuated the Addelier D. Guy VA Clinic in Las 
Vegas after only 5 years in operation, forcing veterans to rely on a 
string of temporary clinics scattered across the Las Vegas Valley. I 
cannot tell my colleagues what a travesty it is when I see 80-year-old 
veterans waiting for a shuttle in 110 degree temperature in the middle 
of Las Vegas summers, waiting for a shuttle to pick them up to take 
them from one location to another for their health care needs. It is a 
horrible sight to see and must be corrected as quickly as possible.
  In short, southern Nevada is facing a veterans health care crisis. 
Recently, the Department of Veterans' Affairs released the CARES 
document which proposes $4.6 billion worth of VA construction projects 
across the country. The CARES initiative directs funding to construct 
new facilities in areas where veterans populations are growing such as 
the Las Vegas Valley. Because of the explosive growth in the number of 
veterans living in and around Las Vegas, the CARES initiative calls for 
the construction of a full-scale medical facility, including a full-
service patient care hospital and outpatient clinic and a comprehensive 
long-term care nursing facility of which we have none of those.
  To fully understand the current health and medical care needs of the 
5 million veterans and veteran services that will be needed in the next 
20 years, the CARES Commission evaluated the plan and heard testimony 
in 38 public hearings across the country, including Las Vegas, from 
veterans, Members of Congress, VA employees, local government officials 
and veteran service groups. I commend the work of the CARES Commission. 
This process was done with our veterans squarely in mind, focused not 
only on those areas that have multiple facilities but also on the 
fastest growing regions, like southern Nevada, which lack the 
facilities needed to keep pace with the sudden influx of veterans from 
other areas of the country. Any plan to address shortcomings in 
veterans' care must reflect the need to expand services in areas where 
our veterans live.
  This bill that I speak of, and that we are here today to discuss, 
authorizes the Secretary of the VA to provide $25 million to carry out 
the advance planning of a full-scale VA medical complex in Las Vegas, 
Nevada, as outlined through the draft of the CARES plan. This 
authorization is the first step in addressing the health care crisis of 
the veterans in southern Nevada.
  I urge my colleagues to support this legislation. I cannot tell my 
colleagues how important it is to the veterans across the country.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield 2 minutes to the 
distinguished gentleman from Colorado (Mr. Beauprez), who along with 
the gentleman from Colorado (Mr. Hefley) worked very, very hard for the 
Fitzsimons Hospital, and I am very grateful for their help.
  Mr. BEAUPREZ. Mr. Speaker, I thank the gentleman for yielding me the 
time.
  Mr. Speaker, I am proud to speak today in support of the Veterans 
Health Care Capital Asset and Business Improvement Act of 2003.
  Like many systems in the VA, the Denver Medical Veterans Center in 
Colorado was constructed about 50 years ago primarily to provide low-
volume inpatient care to our veteran population in Colorado. Today, we 
have an opportunity to provide health care in a much more efficient 
manner.
  This legislation, as has already been mentioned, will allow for the 
relocation of the VA hospital to the new Fitzsimons campus. Such 
relocation would allow for a modern facility to deliver modern health 
care on a state-of-the-art medical campus. The VA would be able to 
continue the synergistic University of Colorado partnership which will 
provide numerous operational efficiencies, as well as access to an 
extensive staff of doctors, technicians and specialists. S. 1156 would 
authorize this critical relocation.
  It is my belief that the savings in operational efficiencies at 
Fitzsimons in itself will pay for the construction of the new hospital. 
Construction of a new hospital at Fitzsimons also allows for the 
ability to build a much-needed spinal cord injury center.
  This new hospital and the strengthened partnership holds potential 
for cutting edge enhancements in veteran health care through 
collaborative research with the university. The unparalleled quality of 
health care that will be afforded to our veterans with this unique 
partnership is not something that we should deny our veterans. In 
addition to the university and the VA, this legislation authorizes the 
DOD to join the Fitzsimons VA partnership to provide health care to the 
nearby Buckley Air Force Base. Many of us believe that the new 
Fitzsimons VA Hospital may become a new model for delivery of health 
care for our veteran population.
  Regardless of where our veterans happen to live, they deserve the 
best care possible, and as the House votes today on this measure, I ask 
that we all keep in mind the long-term planning mission of the VA, 
which is to improve access to and the quality and cost-effectiveness of 
veteran health care.
  I want to particularly thank and commend my colleagues, the gentleman 
from Colorado (Mr. Hefley), especially the gentleman from New Jersey 
(Mr. Smith), the chairman; and the gentleman from Connecticut (Mr. 
Simmons), subcommittee chairman; the gentleman from Texas (Mr. 
Rodriguez), the subcommittee ranking member, and the gentleman from 
Illinois (Mr. Evans), the ranking member, for their passionate, 
unrelenting service on behalf of our veterans and for bringing this 
legislation to the floor. I commend them, and I also thank my

[[Page 30703]]

colleagues in the other body for looking favorably on this critical 
project. I strongly support the passage of S. 1156.
  Mr. Speaker, I am proud to speak today in support of S. 1156, the 
Veterans Health Care Capital Asset and Business Improvement Act of 
2003. Many facilities in the VA healthcare system are run-down, 
decrepit buildings that are not conducive to providing quality 
healthcare to our veterans.
  The Denver Veterans Medical Center in Colorado was constructed about 
50 years ago primarily to provide low-volume inpatient care to our 
veteran population. In Colorado today, we have an opportunity to 
provide health care in a much more efficient manner.
  The Denver Veterans Medical Center in its decaying state is faced 
with two main alternatives with regard to their facility. The first 
alternative is to invest in the renovation of this facility to make it 
capable of handling the medical needs of our current veteran 
population, and the changing needs of that population over the next 20 
years. After such a renovation, not only would the VA still be left 
with a 50-year old buildings, but it would also be an orphaned medical 
center, as the University of Colorado Health Science Center--the VA 
partner for 50 years--is relocating to the redeveloping Fitzsimons Army 
Base.
  The second alternative is to relocate the VA Hospital to the new 
Fitzsimons campus, as well. Such relocation would allow for a modern 
facility to deliver modern health care on a state of the art medical 
campus. The VA would be able to continue the synergistic University of 
Colorado partnership, which will provide numerous operational 
efficiencies as well as access to an extensive staff of doctors, 
technicians, and specialists. S. 1156 would authorize this critical 
relocation.
  It is my belief that the savings in operational efficiencies at 
Fitzsimons in itself will pay for the construction of the new hospital. 
Construction of a new hospital at Fitzsimons also allows for the 
ability to build a much-needed Spinal Cord Injury center.
  One final reason construction of a new VA hospital at Fitzsimons is a 
better option, lies in the hospital's potential for cutting-edge 
enhancements in veteran health care through collaborative research with 
the university. The unparallel quality of healthcare that will be 
afforded to veterans with this unique partnership is not something we 
can deny to our veterans. Additionally, this legislation authorizes the 
DOD to join in the Fitzsimons VA partnership to provide healthcare to 
the nearby Buckley Air Force Base. Many of us believe that the new 
Fitzsimons VA Hospital may become a new model for delivery of 
healthcare for our military veterans.
  Regardless of where our veterans happen to live, they deserve the 
best care possible. As the House votes on this measure today, I ask 
that we all keep in mind the long-term planning mission of the VA: ``to 
improve access to, and the quality and cost effectiveness of, veterans 
health care.'' I would like to thank my colleagues Mr. Hefley, Chairman 
Smith and Chairman Simmons for their leadership on their efforts to 
bring this measure to the floor. I also thank my colleagues in the 
other body for looking favorably on this critical project. I strongly 
support S. 1156 and hope my colleagues will join me in passing this 
important legislation.
  Mr. RODRIGUEZ. Mr. Speaker, I yield 3 minutes to the gentlewoman from 
California (Ms. Millender-McDonald).
  Ms. MILLENDER-McDONALD. Mr. Speaker, I rise in strong support of the 
Department of Veterans Affairs Long-Term Care and Personnel Authorities 
Enhancement Act of 2003. I would like to thank the gentleman from New 
Jersey (Chairman Smith) and the gentleman from Illinois (Ranking Member 
Evans) for their commitment to veterans issues and their steadfast 
leadership and dedication to those men and women who have served us 
admirably in this country and throughout the world.
  I want to also thank the gentleman from Connecticut (Mr. Simmons), 
subcommittee chair, and the gentleman from Texas (Mr. Rodriguez), the 
ranking member, for their dedication and leadership. They are all 
steadfast in ensuring that veterans have their proper stay in terms of 
care.
  Another person who has worked tirelessly for the committee and for 
Filipino veterans is my colleague and friend from California (Mr. 
Filner). His commitment and resolve has been stellar on behalf of these 
veterans whom we both serve.

                              {time}  1300

  This bill, Mr. Speaker, is a long time coming. There are many, many 
good measures in this bill. I applaud the committee for doing good and 
timely work.
  Mr. Speaker, addressing the current and future needs of our veterans 
must continue to be a national top priority. There is one important 
measure in this bill, though, that has been particularly close to me 
for the past several years. I want to applaud and thank members of the 
Committee on Veterans' Affairs for including the authorization to 
provide hospital and nursing home care and medical services to Filipino 
World War II veterans of the Philippines Commonwealth Army and former 
Philippines New Scouts in the same manner that is provided for other 
U.S. veterans and who reside permanently in the United States.
  Currently, there are 11,000 World War II Filipino veterans who are 
citizens or legal residents of the United States. Many of these brave 
veterans are in their seventies and eighties and in desperate need of 
health benefits, and I am proud to represent many of them in my 
district. Passage of this language provides health benefits to these 
brave men, as well as benefiting our communities across the country.
  I represent a district with approximately 35,000 Filipinos, the 
largest population of Filipino veterans in America. And for several 
years now, I have put my heart and soul into the welfare of many 
Filipino veterans who have asked me to help them in their struggle for 
recognition and equity in acquiring benefits.
  I have witnessed firsthand how providing these long overdue health 
benefits will affect our families, our neighborhoods, our friends and, 
ultimately, our communities. I urge my colleagues to support this very 
important legislation on behalf of all of our veterans, and especially 
these Filipino veterans who have waited long enough.
  Finally, I want to commend the committee on H.R. 2297, the Veterans 
Benefit Act of 2003, which passed the floor last night. This 
legislation addressed many issues that are also very important to the 
Filipino community. H.R. 2297 included language that extended 
eligibility for burial in the National Cemeteries to new Filipino 
scouts.
  For this, Mr. Speaker, and for all other reasons and the great 
provisions of this bill, I want to thank the committee, and especially 
thank the Secretary of Veterans Affairs, Secretary Principi, for his 
leadership and guidance.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield 1 minute to my good 
friend, the gentleman from Nevada (Mr. Gibbons).
  Mr. GIBBONS. Mr. Speaker, in honor of our former friend and 
colleague, a World War II veteran, the veterans' great friend across 
this country, the late Bob Stump, I rise in strong support of this 
legislation, S. 1156, the Department of Veterans Affairs Long-Term Care 
and Personnel Authorities Enhancement Act of 2003. I want to add my 
voice in support of those who have already spoken in support of this 
legislation.
  This bill goes a long way in providing our Nation's veterans with the 
medical care that they have earned and deserve. The long-term health 
care that this bill provides communities across the country, including 
southern Nevada, is desperately needed. Southern Nevada, as you have 
already heard, has one of the highest, fastest-growing veterans 
populations in the country; and their needs have far outstrip the 
current care capacity of the current VA facilities in the area.
  Fulfilling the current and future health care needs of our veterans 
must remain a high priority. I applaud the commitment of our colleagues 
in the House, especially the Nevada delegation, in meeting the needs of 
Nevada's veterans. I also applaud the work of my colleagues in the 
other Chamber on this bill.
  I urge my colleagues in the House to support S. 1156. The assistance 
it provides to Nevada's veterans and veterans across this country is 
long overdue.
  Mr. RODRIGUEZ. Mr. Speaker, I yield 3 minutes to the gentleman from 
California (Mr. Thompson), who has

[[Page 30704]]

been in the forefront of the issue of Project SHAD and Project 112.
  Mr. THOMPSON of California. Mr. Speaker, I thank the ranking member 
for yielding me time.
  Mr. Speaker, I rise today in support of this bill. It includes a 
number of provisions that are of critical importance to our veterans 
community. One such inclusion is based on the bill authored by the 
gentleman from Texas (Mr. Rodriguez) that would provide health care 
free of charge to veterans who participated in what are known as 
Project 112 and Project SHAD. These projects were a series of over 100 
tests that subjected our servicemen and our servicewomen to harmful 
chemical and biological agents and possibly to decontaminates now 
believed to be harmful. While we still have a long way to go in getting 
to the bottom of this issue, this bill provides important care to our 
veterans who, in many cases, unknowingly participated in these trials. 
I commend the gentleman from Texas (Mr. Rodriguez) and the other 
members of the committee for working to provide for this critical 
health care provision.
  My own experience with this came when a constituent of mine called 
and said that he had participated in Project SHAD. He and a number of 
his shipmates now have cancer, and he wanted help.
  After 3 years of investigation, the Department of Defense revealed 
last year that these tests involved live agents, in some cases, VX 
nerve gas, sarin nerve gas, and E. coli. The Department of Defense 
describes VX as one of the most lethal substances ever synthesized, and 
sarin, as we all know, was used in that tragic terrorist attack, not 
only tragic, but deadly terrorist attack, on the Tokyo subway a few 
years ago. We put at least 5,000 of our servicemembers at risk by 
exposing them to these hazardous agents.
  We have a duty to rectify this disgraceful conduct on the part of the 
Department of Defense. Project 112 and Project SHAD and similar cases 
of chemical and biological testing involving servicemembers are issues 
of trust and integrity. Our military personnel put their trust in our 
government to protect them, and our integrity has been compromised 
because, nearly 40 years later, we are still not protecting them.
  I urge all Members of this House to vote for this bill and take one 
step towards renewing this trust in our veterans, whom we so respect 
and so depend upon.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield 2 minutes to the 
distinguished gentleman from Nebraska (Mr. Osborne).
  Mr. OSBORNE. Mr. Speaker, I would like to especially thank the 
gentleman from New Jersey (Chairman Smith), the gentleman from 
Connecticut (Chairman Simmons), and the gentleman from Texas (Mr. 
Rodriguez) for their work on this bill. It is an excellent piece of 
legislation.
  Mr. Speaker, the biggest veterans health care issue in my district, 
which is largely rural, is access. We have a great many veterans who 
are driving hundreds of miles and sometimes many hours to a clinic; and 
as a result, many of them, particularly the oldest and the sickest, 
simply cannot get there. They do not have access. Also, of course, they 
are facing waiting lists sometimes of several months.
  Mr. Speaker, what I did was I submitted legislation to provide 
vouchers for health care to local hospitals. That legislation is not in 
this particular bill. However, this legislation expresses the sense of 
Congress that the Secretary of Veterans Affairs should take steps to 
ensure that an appropriate mix of facilities and clinical staff is 
available for health care for veterans residing in rural areas. I 
really applaud members for getting that in there, because I think that 
is badly needed.
  In addition, the legislation also contains a requirement that 120 
days after the date of enactment of this legislation, the Secretary of 
Veterans Affairs shall submit to the Committee on Veterans' Affairs of 
the Senate and the House a report describing the steps the Secretary is 
taking to improve access to health care for veterans residing in rural 
areas.
  So I applaud Members for getting that in there and also requiring at 
least a 120-day report. We appreciate this. I would like to thank my 
colleagues for including these important provisions, and thank them for 
this bill. I urge support.
  Mr. RODRIGUEZ. Mr. Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Ortiz), whom we consider our dean, who is also responsible 
for some of this legislation.
  Mr. ORTIZ. Mr. Speaker, I thank the gentleman for yielding me time.
  Mr. Speaker, this bill requires a plan for in-patient services for 
veterans in south Texas by January 31, 2004, either through VA or 
through contracts with private hospitals.
  Of course, I would like to thank my good friend, the gentleman from 
Ohio (Mr. Hobson), for his help in finding more health services for our 
veterans; and also my good friend, the gentleman from New Jersey 
(Chairman Smith); the gentleman from Illinois (Chairman Simmons), my 
good friend; the gentleman from Illinois (Mr. Evans); and, of course, 
the gentleman from Texas (Mr. Rodriguez), who intervened at a critical 
point to ensure south Texas was kept in this bill.
  In my district I have four military installations. Through the years, 
we know what happens when a veteran gets ready to retire. What he does 
is he moves close to a military installation. Well, in this case the 
hospital that we had was shut down several years ago. But now under 
this bill and with this contract that they are talking about, opening 
up for in-patient care, it gives hope to the veterans who live in the 
area.
  Mr. Speaker, we have veterans from the Second World War and the 
Korean War. Some of them are bed-ridden, and it takes 6 to 7 hours for 
them to go to the nearest VA hospital, which happens to be in San 
Antonio. I think that part of the healing process is the idea of being 
close to your family. But when you are removed from your family and 
have to travel and take that patient away from his family to a point 
that is 200 to 300 miles away, it does not work.
  They deserve no less than this. The Lord knows that these VA patients 
and veterans have waited for a long, long time.
  I am glad that this bill is also honoring my good friend that I got 
to know for a long time, Bob Stump from Arizona. I am glad that we are 
honoring his memory.
  Please, I ask my friends to vote for this bill.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield 2 minutes to the 
distinguished gentleman from Florida (Mr. Miller), and thank him for 
the great work he did on the Pensacola Outpatient Clinic, the $45 
million that he was instrumental in putting in there.
  Mr. MILLER of Florida. Mr. Speaker, I will not say many of the things 
that a lot of my colleagues have already said on the floor today, but I 
do want to say thank you to our chairman, the gentleman from New Jersey 
(Mr. Smith), our subcommittee chairman, the gentleman from Illinois 
(Mr. Simmons), and certainly the ranking member. In fact, I thank all 
the members of the Committee on Veterans' Affairs on both sides of the 
aisle.
  I want to say that the first district of Florida probably includes 
some of the most striking examples of access to care challenges that 
this country ever had. I have almost 100,000 veterans that live in the 
Panhandle. All of them are eligible to receive health care through the 
VA. Pensacola ranks in the top 10 in veteran populations in the Nation, 
and Fort Walton Beach tops that list.
  Despite these numbers, our community-based outpatient clinic in 
Pensacola treats twice the number of Panhandle veterans than it was 
designed to do. Veterans in Fort Walton and farther east must travel to 
the other side of Eglin Air Force Base, which spans over 700 square 
miles in the middle of my district, in order to even reach the 
Pensacola clinic. For VA in-patient care, all of my patients must go to 
Biloxi, Mississippi, a trip upwards of 200 miles for some of my 
residents.
  I would say in VA's budget submission for this fiscal year, the 
Pensacola facility was described as ``obsolete.''

[[Page 30705]]

This description does not even come close to painting an accurate 
picture of the crowded and totally inadequate facility. The time to 
move forward on providing a new facility is now, and this bill sets the 
pace.
  I am proud that the Naval Hospital Pensacola has been ahead of the 
bell curve on the implementation of co-sharing agreements, as has the 
96th Medical Group at Eglin Air Force Base. Whereas both facilities 
have the potential to set the pace for the rest of the Nation in 
regards to issues of VA and DOD resource-sharing, the CARES Commission 
report acknowledges this in its ``highest priority project request'' 
for land to build a replacement Pensacola clinic at the Naval Hospital 
Pensacola, with the Navy to provide contract hospitalization for 
medicine and surgical care.
  This bill, Mr. Speaker, underscores the solidarity amongst all 
stakeholders in this endeavor. I would say that nothing makes me 
prouder than to represent the veterans of northwest Florida, and I urge 
my colleagues to support S. 1156.
  Mr. RODRIGUEZ. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, let me take this opportunity, first of all, to thank the 
gentleman from New Jersey (Chairman Smith) and the gentleman from 
Illinois (Chairman Simmons) for their hard work on this particular 
bill.
  I also want to take time to also recognize our leading Democrat, the 
gentleman from Illinois (Mr. Evans), for his hard work on this specific 
bill. I also want to take this opportunity to thank all the Members who 
participated to make this happen, such as the gentleman from Texas (Mr. 
Ortiz) and the gentleman from California (Mr. Thompson), as well as 
those on the Republican side.
  Mr. Speaker, I have no further requests for time, and I yield back 
the balance of my time.

                              {time}  1315

  Mr. SMITH of New Jersey. Mr. Speaker, I yield 1 minute to the 
gentleman from Ohio (Mr. Tiberi), and thank the gentleman for his work 
on the Columbus, Ohio project which has advance planning funds to the 
tune of $9 million in this bill.
  Mr. TIBERI. Mr. Speaker, I am very disappointed that this final bill 
does not fully authorize a new veterans health care facility in central 
Ohio, as was done in the House bill we approved earlier this year, 
thanks to the hard work by the gentleman from Ohio (Chairman Hobson), 
my central Ohio colleague; but as importantly, the gentleman from New 
Jersey (Chairman Smith) and the subcommittee chairman, the gentleman 
from Connecticut (Mr. Simmons), who worked extremely hard to get that 
commitment in the bill that we passed here, a facility badly in need of 
expansion. That $90 million represented a beginning-to-end commitment 
that this House made. This bill before us includes only $9 million for 
planning purposes. That cut was made by the other body, and is 
something that we in the House knew nothing about, were not consulted 
with, and we are stuck with the version before us today.
  The money included in this bill for the new central Ohio veterans' 
facility is a start for an area long underserved by the veterans 
administration, but it is only a start. I want to assure the veterans 
community in central Ohio that I am committed to finishing the job and 
making a new expanded health care facility a reality in the years to 
come.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield 1 minute to the 
gentleman from Connecticut (Mr. Simmons).
  Mr. SIMMONS. Mr. Speaker, I would like to briefly respond to the 
gentleman from Ohio (Mr. Tiberi) to say that it is a start, it is a 
good start, and we are going to be with the gentleman all the way. I 
look forward to coming to Ohio with Secretary Principi to visit the 
facility.
  I would also like to thank the subcommittee staff director, John 
Bradley, and the minority staff director, Susan Edgerton for their hard 
work, and I would like to make a comment. Over 100 years ago, the U.S. 
Marine Corps was dispatched to China to relieve the diplomatic 
legations in that country that were under great pressure from the Boxer 
Rebellion, and when they came back, they adopted the term ``gung-ho.'' 
To be gung-ho, to be enthusiastic, to be filled with vigor for 
something. But the term ``gung-ho'' comes from the Chinese. I see the 
gentleman from Illinois (Mr. Evans) is smiling, he probably knows, 
which means work together.
  Under the leadership of the chairman and the ranking member, we have 
worked together on this legislation, and we have accomplished something 
that we have not accomplished for 5 years, which is an authorization 
bill, hopefully, heading to the White House for the President's 
signature.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield myself the balance of 
my time.
  Mr. Speaker, first of all, I thank the gentleman from Illinois (Mr. 
Evans). Again, we have collaborated on a bill working with the 
subcommittee chairman, the gentleman from Connecticut (Mr. Simmons), 
and the ranking member, the gentleman from Texas (Mr. Rodriguez), and 
we have produced an extraordinarily good piece of legislation.
  We worked with the other body, and I want to thank Senator Arlen 
Specter, the chairman, and the ranking member, Senator Graham. There 
was give and take, obviously. We began working on this very 
comprehensive product last spring. Again, this is a combination of a 
number of bills rolled and packaged into one bill. Project Shad was 
mentioned earlier by my colleague from California, and the gentleman 
from Texas (Mr. Rodriguez) mentioned it as well. This bill is not 
everything we would like. The next time I find a bill on this floor 
that is will be the first time.
  We did pass over to the other body the full money for the Columbus 
project, and we got back advance planning funding from the other body. 
While it is not everything we wanted, it certainly will ensure that 
that project goes forward. The $9 million is not chump change and will 
be sufficient to get the job done. I want to assure my colleagues we 
have done our due diligence. This is a very good piece of veterans 
legislation.
  I want to thank our staff, Pat Ryan; John Bradley, who is the staff 
director for the subcommittee; Kingston Smith, our deputy chief 
counsel; Jeannie McNally; Mary McDermott; Peter Dickinson; Steve 
Kirkland; Bernie Dotson; Summer Larson; Kathleen Greve; Delores Dunn; 
Paige McManus; Devon Seibert; and Veronica Crowe. As my colleague 
mentioned, we have had great cooperation with our friends on the other 
side of the aisle.
  Again, this is a quintessential bipartisan piece of legislation, 
something that this entire body can be proud of, and it will advance 
the ball significantly when it comes to veterans health care as well as 
the construction project.
  Let me also remind my colleagues that we have passed over to the 
other body H.R. 11 and another bill that I sponsored and a bill that 
the gentleman from Kansas (Mr. Moran) sponsored in the last Congress, 
and they never came back. They listed a number of projects that should 
have but did not get funded and were not authorized. Now, finally in 
this Congress, under the great leadership of the gentleman from 
Connecticut (Mr. Simmons), we have gotten that product back from the 
Senate, and it will go to President Bush for his signature. This is a 
great day for veterans. Again, I thank all of my colleagues for their 
cooperation and leadership.
  Mr. Speaker, I include for the Record a joint explanatory statement.

  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 (``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

[[Page 30706]]

     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; 
     S. 1815 introduced on November 4, 2003 (``Senate Bill''); 
     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 (``House Bill'').
       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 provision.
     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 (``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 Deseret 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 S. 1156 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 (``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, United States Code, 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 provision.
     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 S. 1156 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 Bill contains no comparable provision.
     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 S. 1156 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 S. 1156 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 Bill contains 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 S. 1156 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 Bill contains no comparable provision.

[[Page 30707]]


     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 S. 1156 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 S. 1156 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
                                      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 S. 1156 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 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 comparable provision.
     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

[[Page 30708]]

     of appropriations for VA major medical facility projects.
     Senate Bill
       Section 213 of S. 1156 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 would authorize 
     $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 S. 1156 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 Bill contains no comparable provision.
     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 S. 1156 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 Bill contains no comparable provision.
     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.
     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 S. 1156 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 S. 1156 would name the VA Medical Center 
     located in Houston, Texas, the ``Michael E. DeBakey 
     Department of Veterans Affairs Medical Center.''

[[Page 30709]]


     House Bill
       The House Bill contains 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 Bill contains 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 S. 1156 would name the VA Outpatient Clinic 
     located in Horsham, Pennsylvania, the ``Victor J. Saracini 
     Department of Veterans Affairs Outpatient Clinic.''
     House Bill
       The House Bill contains 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 S. 1156 would modify title 38, United States 
     Code, to authorize the appointment of psychologists, 
     kinesiologists and social workers, under title 38 provisions 
     as opposed to title 5, United States Code, provisions.
     House Bill
       The House Bill contains no comparable provision.
     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 State 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 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 S. 1156 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 comparable 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

[[Page 30710]]

     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 provision.
     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 S. 1156 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;
       (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 provision.
     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 S. 1156 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 Bill contains no comparable provision.

                         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. ACEVEDO-VILA. Mr. Speaker, I rise today to urge my colleagues to 
vote in favor of S. 1156--Department of Veterans Affairs Long-Term 
Personnel Authorities Act of 2003. This bill represents a step in the 
right direction for many of our veteran communities.
  In the interest of my constituents, this bill and the language 
contained within brings to the forefront the problems at the San Juan 
VA Medical Center and opens opportunities to provide immediate relief 
for the Veterans in Puerto Rico to receive the care they need and 
deserve.
  Through the actions of these two committees, the Democrats and 
Republicans alike, they have sent a clear message of appreciation to 
the over 140,000 Puerto Rican veterans for their service in defense of 
our shared values. Puerto Ricans have served proudly in every armed 
conflict since the First World War. The language in this bill 
acknowledges the value of their service.
  Currently, there are over 5,000 Puerto Rican men and women who are 
serving in the armed forces in Iraq, Afghanistan, Guantanamo and many 
other regions throughout the world. The language in this bill sends the 
right message to these young men and women that when they serve their 
Nation well, the United States Congress will serve them well.
  I congratulate my colleagues on a job well done. Through long hours 
of deliberation and patient listening and understanding, both chambers 
of this Congress have come to what I believe is an impressive piece of 
bipartisan work. Now, it is my hope that the Secretary will move 
swiftly to reprogram the necessary funds to build a new bed tower at 
the San Juan VA Medical Center. Without the additional dollars 
mentioned in this bill, the San Juan VA Medical Center would have been 
forced to provide services with a bed loss of 120. This would have put 
additional burdens on a facility, which the C.A.R.E.S. Committee

[[Page 30711]]

has deemed to be spatially deficient. The Committees understood this 
and worked to include language to encourage the Secretary to move 
forward.
  The construction of the new bed tower will allow the San Juan VA 
Medical Center to provide safer and more modern services for the 
immediate future to the veterans and the service people returning from 
Iraq and Afghanistan.
  I would like to personally thank Chairman Smith, the Ranking Member, 
Mr. Filner, Ms. Corrine Brown and the other members of the committee 
for working with me on these vital projects. The report language is 
more than a listing of projects--it is sending the right message to the 
140,000 veterans in Puerto Rico; it sends the right message to the 
5,000 Puerto Ricans who have been called to active service in Iraq, and 
it certainly sends the right message to the families of the 13 Puerto 
Ricans who have sacrificed their lives this year in service of the 
United States against the war on terror.
  I look forward to continually working with my colleagues in both 
chambers to provide for the veterans in Puerto Rico. Again, I thank my 
colleagues for working so diligently on these first steps to improve 
healthcare for our veterans and urge my colleagues to vote ``yes'' to 
approve this bill.
  Mr. MATHESON. Mr. Speaker, as a strong supporter of the military, I 
am pleased to support this legislation, which enhances veterans health 
care.
  I am especially pleased that this bill also honors George E. Wahlen, 
Utah's only living Medal of Honor winner. George Wahlen is a dedicated 
American and Utah is proud to pay tribute to his service by renaming 
the Salt Lake Veterans Affairs Medical Center in his honor.
  George Wahlen's twenty-year service to this nation as a soldier was 
not his only contribution. Even now, he continues to serve as an 
advocate for both active troops and veterans. I am proud to honor this 
patriot, just as I am proud of all Americans who serve their country.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield back the balance of my 
time.
  The SPEAKER pro tempore (Mr. Burgess). The question is on the motion 
offered by the gentleman from New Jersey (Mr. Smith) that the House 
suspend the rules and pass the Senate bill, S. 1156.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of 
those present have voted in the affirmative.
  Mr. SMITH of New Jersey. Mr. Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

                          ____________________