[Congressional Record (Bound Edition), Volume 150 (2004), Part 17]
[Senate]
[Pages 23753-23769]
[From the U.S. Government Publishing Office, www.gpo.gov]




            VETERANS HEALTH PROGRAMS IMPROVEMENT ACT OF 2004

  Mr. SMITH of New Jersey. Mr. Speaker, I move to suspend the rules and 
concur in the Senate amendments to the bill (H.R. 3936) to amend title 
38, United States Code, to authorize the principal office of the United 
States Court of Appeals for Veterans Claims to be at any location in 
the Washington, DC, metropolitan area, rather than only in the District 
of Columbia, and expressing the sense of Congress that a dedicated 
Veterans Courthouse and Justice Center should be provided for that 
Court and those it serves and should be located, if feasible, at a site 
owned by the United States that is part of or proximate to the Pentagon 
Reservation, and for other purposes.
  The Clerk read as follows:

       Senate amendments:
       Strike out all after the enacting clause and insert:

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Veterans 
     Health Programs Improvement Act of 2004''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

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

                TITLE I--ASSISTANCE TO HOMELESS VETERANS

Sec. 101. Authorization of appropriations.

               TITLE II--VETERANS LONG-TERM CARE PROGRAMS

Sec. 201. Assistance for hiring and retention of nurses at State 
              veterans' homes.
Sec. 202. Treatment of Department of Veterans Affairs per diem payments 
              to State homes for veterans.
Sec. 203. Extension of authority to provide care under long-term care 
              pilot programs.
Sec. 204. Prohibition on collection of copayments for hospice care.

                        TITLE III--MEDICAL CARE

Sec. 301. Sexual trauma counseling program.
Sec. 302. Centers for research, education, and clinical activities on 
              complex multi-trauma associated with combat injuries.
Sec. 303. Enhancement of medical preparedness of Department of Veterans 
              Affairs.

       TITLE IV--MEDICAL FACILITIES MANAGEMENT AND ADMINISTRATION

               Subtitle A--Major Medical Facility Leases

Sec. 401. Major medical facility leases.
Sec. 402. Authorization of appropriations.
Sec. 403. Authority for long-term lease of certain lands of University 
              of Colorado.

                   Subtitle B--Facilities Management

Sec. 411. Department of Veterans Affairs Capital Asset Fund.
Sec. 412. Annual report to Congress on inventory of Department of 
              Veterans Affairs historic properties.
Sec. 413. Authority to acquire and transfer real property for use for 
              homeless veterans.
Sec. 414. Limitation on implementation of mission changes for specified 
              Veterans Health Administration facilities.

[[Page 23754]]

Sec. 415. Authority to use project funds to construct or relocate 
              surface parking incidental to a construction or 
              nonrecurring maintenance project.
Sec. 416. Inapplicability of limitation on use of advance planning 
              funds to authorized major medical facility projects.
Sec. 417. Improvements to enhanced-use lease authority.
Sec. 418. First option for Commonwealth of Kentucky on Department of 
              Veterans Affairs Medical Center, Louisville, Kentucky.
Sec. 419. Transfer of jurisdiction, General Services Administration 
              property, Boise, Idaho.

                 Subtitle C--Designation of Facilities

Sec. 421. Thomas E. Creek Department of Veterans Affairs Medical 
              Center.
Sec. 422. James J. Peters Department of Veterans Affairs Medical 
              Center.
Sec. 423. Bob Michel Department of Veterans Affairs Outpatient Clinic.
Sec. 424. Charles Wilson Department of Veterans Affairs Outpatient 
              Clinic.
Sec. 425. Thomas P. Noonan, Jr. Department of Veterans Affairs 
              Outpatient Clinic.

                   TITLE V--PERSONNEL ADMINISTRATION

Sec. 501. Pilot program to study innovative recruitment tools to 
              address nursing shortages at Department of Veterans 
              Affairs health care facilities.
Sec. 502. Technical correction to listing of certain hybrid positions 
              in Veterans Health Administration.
Sec. 503. Under Secretary for Health.

                        TITLE VI--OTHER MATTERS

Sec. 601. Extension and codification of authority for recovery audits.
Sec. 602. Inventory of medical waste management activities at 
              Department of Veterans Affairs health care facilities.
Sec. 603. Inclusion of all enrolled veterans among persons eligible to 
              use canteens operated by Veterans' Canteen Service.
Sec. 604. Annual reports on waiting times for appointments for 
              specialty care.
Sec. 605. Technical clarification.

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

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

                TITLE I--ASSISTANCE TO HOMELESS VETERANS

     SEC. 101. AUTHORIZATION OF APPROPRIATIONS.

       Section 2013 is amended in paragraph (4) by striking 
     ``$75,000,000'' and inserting ``$99,000,000''.

               TITLE II--VETERANS LONG-TERM CARE PROGRAMS

     SEC. 201. ASSISTANCE FOR HIRING AND RETENTION OF NURSES AT 
                   STATE VETERANS' HOMES.

       (a) In General.--(1) Chapter 17 is amended by inserting 
     after section 1743 the following new section:

     ``Sec. 1744. Hiring and retention of nurses: payments to 
       assist States

       ``(a) Payment Program.--The Secretary shall make payments 
     to States under this section for the purpose of assisting 
     State homes in the hiring and retention of nurses and the 
     reduction of nursing shortages at State homes.
       ``(b) Eligible Recipients.--Payments to a State for a 
     fiscal year under this section shall, subject to submission 
     of an application, be made to any State that during that 
     fiscal year--
       ``(1) receives per diem payments under this subchapter for 
     that fiscal year; and
       ``(2) has in effect an employee incentive scholarship 
     program or other employee incentive program at a State home 
     designed to promote the hiring and retention of nursing staff 
     and to reduce nursing shortages at that home.
       ``(c) Use of Funds Received.--A State may use an amount 
     received under this section only to provide funds for a 
     program described in subsection (b)(2). Any program shall 
     meet such criteria as the Secretary may prescribe. In 
     prescribing such criteria, the Secretary shall take into 
     consideration the need for flexibility and innovation.
       ``(d) Limitations on Amount of Payment.--(1) A payment 
     under this section may not be used to provide more than 50 
     percent of the costs for a fiscal year of the employee 
     incentive scholarship or other employee incentive program for 
     which the payment is made.
       ``(2) The amount of the payment to a State under this 
     section for any fiscal year is, for each State home in that 
     State with a program described in subsection (b)(2), the 
     amount equal to 2 percent of the amount of payments estimated 
     to be made to that State, for that State home, under section 
     1741 of this title for that fiscal year.
       ``(e) Applications.--A payment under this section for any 
     fiscal year with respect to any State home may only be made 
     based upon an application submitted by the State seeking the 
     payment with respect to that State home. Any such application 
     shall describe the nursing shortage at the State home and the 
     employee incentive scholarship program or other employee 
     incentive program described in subsection (c) for which the 
     payment is sought.
       ``(f) Source of Funds.--Payments under this section shall 
     be made from funds available for other payments under this 
     subchapter.
       ``(g) Disbursement.--Payments under this section to a State 
     home shall be made as part of the disbursement of payments 
     under section 1741 of this title with respect to that State 
     home.
       ``(h) Use of Certain Receipts.--The Secretary shall require 
     as a condition of any payment under this section that, in any 
     case in which the State home receives a refund payment made 
     by an employee in breach of the terms of an agreement for 
     employee assistance that used funds provided under this 
     section, the payment shall be returned to the State home's 
     incentive program account and credited as a non-Federal 
     funding source.
       ``(i) Annual Report From Payment Recipients.--Any State 
     home receiving a payment under this section for any fiscal 
     year, shall, as a condition of the payment, be required to 
     agree to provide to the Secretary a report setting forth in 
     detail the use of funds received through the payment, 
     including a descriptive analysis of how effective the 
     incentive program has been on nurse staffing in the State 
     home during that fiscal year. The report for any fiscal year 
     shall be provided to the Secretary within 60 days of the 
     close of the fiscal year and shall be subject to audit by the 
     Secretary. Eligibility for a payment under this section for 
     any later fiscal year is contingent upon the receipt by the 
     Secretary of the annual report under this subsection for the 
     previous fiscal year in accordance with this subsection.
       ``(j) Regulations.--The Secretary shall prescribe 
     regulations to carry out this section. The regulations shall 
     include the establishment of criteria for the award of 
     payments under this section.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after section 1743 the following new 
     item:

``1744. Hiring and retention of nurses: payments to assist States.''.

       (b) Implementation.--The Secretary of Veterans Affairs 
     shall implement section 1744 of title 38, United States Code, 
     as added by subsection (a), as expeditiously as possible. The 
     Secretary shall establish such interim procedures as 
     necessary so as to ensure that payments are made to eligible 
     States under that section commencing not later than June 1, 
     2005, notwithstanding that regulations under subsection (j) 
     of that section may not have become final.

     SEC. 202. TREATMENT OF DEPARTMENT OF VETERANS AFFAIRS PER 
                   DIEM PAYMENTS TO STATE HOMES FOR VETERANS.

       Section 1741 is amended by adding at the end the following 
     new subsection:
       ``(e) Payments to States pursuant to this section shall not 
     be considered a liability of a third party, or otherwise be 
     used to offset or reduce any other payment made to assist 
     veterans.''.

     SEC. 203. EXTENSION OF AUTHORITY TO PROVIDE CARE UNDER LONG-
                   TERM CARE PILOT PROGRAMS.

       Subsection (h) of section 102 of the Veterans Millennium 
     Health Care and Benefits Act (38 U.S.C. 1710B note) is 
     amended--
       (1) by inserting ``(1)'' before ``The authority of''; and
       (2) by adding at the end the following new paragraph:
       ``(2) In the case of a veteran who is participating in a 
     pilot program under this section as of the end of the three-
     year period applicable to that pilot program under paragraph 
     (1), the Secretary may continue to provide to that veteran 
     any of the services that could be provided under the pilot 
     program. The authority to provide services to any veteran 
     under the preceding sentence applies during the period 
     beginning on the date specified in paragraph (1) with respect 
     to that pilot program and ending on December 31, 2005.''.

     SEC. 204. PROHIBITION ON COLLECTION OF COPAYMENTS FOR HOSPICE 
                   CARE.

       Section 1710B(c)(2) is amended--
       (1) by striking ``or'' at the end of subparagraph (A);
       (2) by redesignating subparagraph (B) as subparagraph (C); 
     and
       (3) by inserting after subparagraph (A) the following new 
     subparagraph (B):
       ``(B) to a veteran being furnished hospice care under this 
     section; or''.

                        TITLE III--MEDICAL CARE

     SEC. 301. SEXUAL TRAUMA COUNSELING PROGRAM.

       (a) Permanent Authority for Program.--Section 1720D(a) is 
     amended--
       (1) in paragraph (1), by striking ``During the period 
     through December 31, 2004, the'' and inserting ``The''; and
       (2) in paragraph (2), by striking ``, during the period 
     through December 31, 2004,''.
       (b) Extension to Cover Active Duty for Training.--Such 
     section is further amended by inserting ``or active duty for 
     training'' in paragraph (1) before the period at the end.

     SEC. 302. CENTERS FOR RESEARCH, EDUCATION, AND CLINICAL 
                   ACTIVITIES ON COMPLEX MULTI-TRAUMA ASSOCIATED 
                   WITH COMBAT INJURIES.

       (a) In General.--(1) Subchapter II of chapter 73 of title 
     38, United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 7327. Centers for research, education, and clinical 
       activities on complex multi-trauma associated with combat 
       injuries

       ``(a) Purpose.--The purpose of this section is to provide 
     for the improvement of the provision

[[Page 23755]]

     of health care services and related rehabilitation and 
     education services to eligible veterans suffering from 
     complex multi-trauma associated with combat injuries 
     through--
       ``(1) the development of improved models and systems for 
     the furnishing by the Department of health care, 
     rehabilitation, and education services to veterans;
       ``(2) the conduct of research to support the provision of 
     such services in accordance with the most current evidence on 
     multi-trauma injuries; and
       ``(3) the education and training of health care personnel 
     of the Department with respect to the provision of such 
     services.
       ``(b) Designation of Centers.--(1) The Secretary shall 
     designate an appropriate number of cooperative centers for 
     clinical care, consultation, research, and education 
     activities on combat injuries.
       ``(2) Each center designated under paragraph (1) shall 
     function as a center for--
       ``(A) research on the long-term effects of injuries 
     sustained as a result of combat in order to support the 
     provision of services for such injuries in accordance with 
     the most current evidence on complex multi-trauma;
       ``(B) the development of rehabilitation methodologies for 
     treating individuals with complex multi-trauma; and
       ``(C) the continuous and consistent coordination of care 
     from the point of referral throughout the rehabilitation 
     process and ongoing follow-up after return to home and 
     community.
       ``(3) The Secretary shall designate one of the centers 
     designated under paragraph (1) as the lead center for 
     activities referred to in that paragraph. As the lead center 
     for such activities, such center shall--
       ``(A) develop and provide periodic review of research 
     priorities, and implement protocols, to ensure that projects 
     contribute to the activities of the centers designated under 
     paragraph (1);
       ``(B) oversee the coordination of the professional and 
     technical activities of such centers to ensure the quality 
     and validity of the methodologies and statistical services 
     for research project leaders;
       ``(C) develop and ensure the deployment of an efficient and 
     cost-effective data management system for such centers;
       ``(D) develop and distribute educational materials and 
     products to enhance the evaluation and care of individuals 
     with combat injuries by medical care providers of the 
     Department who are not specialized in the assessment and care 
     of complex multi-trauma;
       ``(E) develop educational materials for individuals 
     suffering from combat injuries and for their families; and
       ``(F) serve as a resource for the clinical and research 
     infrastructure of such centers by disseminating clinical 
     outcomes and research findings to improve clinical practice.
       ``(4) The Secretary shall designate centers under paragraph 
     (1) upon the recommendation of the Under Secretary for 
     Health.
       ``(5) The Secretary may designate a center under paragraph 
     (1) only if the center meets the requirements of subsection 
     (c).
       ``(c) Requirements for Centers.--To be designated as a 
     center under this section, a facility shall--
       ``(1) be a regional lead center for the care of traumatic 
     brain injury;
       ``(2) be located at a tertiary care medical center and have 
     on-site availability of primary and subspecialty medical 
     services relating to complex multi-trauma;
       ``(3) have, or have the capacity to develop, the capability 
     of managing impairments associated with combat injuries;
       ``(4) be affiliated with a school of medicine;
       ``(5) have, or have experience with, participation in 
     clinical research trials;
       ``(6) provide amputation care and rehabilitation;
       ``(7) have pain management programs;
       ``(8) provide comprehensive brain injury rehabilitation; 
     and
       ``(9) provide comprehensive general rehabilitation.
       ``(d) Additional Resources.--The Secretary shall provide 
     each center designated under this section such resources as 
     the Secretary determines to be required by such center to 
     achieve adequate capability of managing individuals with 
     complex multi-trauma, including--
       ``(1) the upgrading of blind rehabilitation services by 
     employing or securing the services of blind rehabilitation 
     specialists;
       ``(2) employing or securing the services of occupational 
     therapists with blind rehabilitation training;
       ``(3) employing or securing the services of additional 
     mental health services providers; and
       ``(4) employing or securing additional rehabilitation 
     nursing staff to meet care needs.
       ``(e) Cooperation With Department of Defense.--(1) The 
     Secretary of Veterans Affairs may assist the Secretary of 
     Defense in the care of members of the Armed Forces with 
     complex multi-trauma at military treatment facilities by--
       ``(A) making available, in a manner that the Secretary of 
     Veterans Affairs considers appropriate, certified 
     rehabilitation registered nurses of the Department of 
     Veterans Affairs to such facilities to assess and coordinate 
     the care of such members; and
       ``(B) making available, in a manner that the Secretary of 
     Veterans Affairs considers appropriate, blind rehabilitation 
     specialists of the Department of Veterans Affairs to such 
     facilities to consult with the medical staff of such 
     facilities on the special needs of such members who have 
     visual impairment as a consequence of combat injury.
       ``(2) Assistance shall be provided under this subsection 
     through agreements for the sharing of health-care resources 
     under section 8111 of this title.
       ``(f) Award of Funding.--Centers designated under this 
     section may compete for the award of funding from amounts 
     appropriated for the Department for medical and prosthetics 
     research.
       ``(g) Dissemination of Information.--(1) The Under 
     Secretary for Health shall ensure that information produced 
     by the centers designated under this section that may be 
     useful for other activities of the Veterans Health 
     Administration is disseminated throughout the Administration.
       ``(2) Information shall be disseminated under this 
     subsection through publications, through programs of 
     continuing medical and related education provided through 
     regional medical education centers under subchapter VI of 
     chapter 74 of this title, and through other means.
       ``(h) National Oversight.--The Under Secretary for Health 
     shall designate an appropriate officer to oversee the 
     operation of the centers designated under this section and 
     provide for periodic evaluation of the centers.
       ``(i) Authorization of Appropriations.--(1) There are 
     authorized to be appropriated to the Department of Veterans 
     Affairs for the centers designated under this section amounts 
     as follows:
       ``(A) $7,000,000 for fiscal year 2005.
       ``(B) $8,000,000 for each of fiscal years 2006 through 
     2008.
       ``(2) In addition to amounts authorized to be appropriated 
     by paragraph (1) for a fiscal year, the Under Secretary for 
     Health may allocate to each center designated under this 
     section, from other funds authorized to be appropriated for 
     such fiscal year for the Department generally for medical and 
     for medical and prosthetic research, such amounts as the 
     Under Secretary for Health determines appropriate to carry 
     out the purposes of this section.''.
       (2) The table of sections at the beginning of chapter 73 is 
     amended by inserting after the item relating to section 7326 
     the following new item:

``7327. Centers for research, education, and clinical activities on 
              complex multi-trauma associated with combat injuries.''.

       (b) Designation of Centers.--The Secretary of Veterans 
     Affairs shall designate the centers for research, education, 
     and clinical activities on complex multi-trauma associated 
     with combat injuries required by section 7327 of title 38, 
     United States Code (as added by subsection (a)), not later 
     than 120 days after the date of the enactment of this Act.
       (c) Annual Reports.--(1) Not later than eighteen months 
     after the date of the designation of centers for research, 
     education, and clinical activities on complex multi-trauma 
     associated with combat injuries required by section 7327 of 
     title 38, United States Code (as so added), and annually 
     thereafter through 2008, the Secretary shall submit to the 
     Committees on Veterans' Affairs of the Senate and House of 
     Representatives a report on the status and activities of such 
     centers during the one-year period beginning on the date of 
     such designation, for the first such report, and for 
     successive one-year periods, for subsequent reports.
       (2) Each such report shall include, for the period covered 
     by such report, the following:
       (A) A description of the activities carried out at each 
     center, and the funding provided for such activities.
       (B) A description of any advances made in the participating 
     programs of each center in research, education, training, and 
     clinical activities on complex multi-trauma associated with 
     combat injuries.
       (C) A description of the actions taken by the Under 
     Secretary for Health pursuant to subsection (g) of that 
     section (as so added) to disseminate throughout the Veterans 
     Health Administration information derived from such 
     activities.

     SEC. 303. ENHANCEMENT OF MEDICAL PREPAREDNESS OF DEPARTMENT 
                   OF VETERANS AFFAIRS.

       (a) Peer Review Panel.--In order to assist the Secretary of 
     Veterans Affairs in selecting facilities of the Department of 
     Veterans Affairs to serve as sites for centers under section 
     7328 of title 38, United States Code, as added by subsection 
     (c), the Secretary shall establish a peer review panel to 
     assess the scientific and clinical merit of proposals that 
     are submitted to the Secretary for the selection of such 
     facilities. The panel shall be established not later than 90 
     days after the date of the enactment of this Act and shall 
     include experts in the fields of toxicological research, 
     infectious diseases, radiology, clinical care of veterans 
     exposed to such hazards, and other persons as determined 
     appropriate by the Secretary. Members of the panel shall 
     serve as consultants to the Department of Veterans Affairs. 
     Amounts available to the Secretary for Medical Care may be 
     used for purposes of carrying out this subsection. The panel 
     shall not be subject to the Federal Advisory Committee Act (5 
     U.S.C. App.).
       (b) Proposals.--The Secretary shall solicit proposals for 
     designation of facilities as described in subsection (a). The 
     announcement of the solicitation of such proposals shall be 
     issued not later than 60 days after the date of the enactment 
     of this Act, and the deadline for the submission of proposals 
     in response to such solicitation shall be not later than 90 
     days after the date of such announcement. The peer review 
     panel established under subsection (a) shall complete its 
     review of the proposals and submit

[[Page 23756]]

     its recommendations to the Secretary not later than 60 days 
     after the date of the deadline for the submission of 
     proposals. The Secretary shall then select the four sites for 
     the location of such centers not later than 45 days after the 
     date on which the peer review panel submits its 
     recommendations to the Secretary.
       (c) Revised Section.--(1) Subchapter II of chapter 73 is 
     amended by inserting after section 7327, as added by section 
     302(a)(1) of this Act, a new section with--
       (A) a heading as follows:

     ``Sec. 7328. Medical preparedness centers''; and

       (B) a text consisting of the text of subsections (a) 
     through (h) of section 7325 of title 38, United States Code, 
     and a subsection (i) at the end as follows:
       ``(i) Funding.--(1) There are authorized to be appropriated 
     for the centers under this section $10,000,000 for each of 
     fiscal years 2005 through 2007.
       ``(2) In addition to any amounts appropriated for a fiscal 
     year specifically for the activities of the centers pursuant 
     to paragraph (1), the Under Secretary for Health shall 
     allocate to the centers from other funds appropriated for 
     that fiscal year generally for the Department medical care 
     account and the Department medical and prosthetic research 
     account such amounts as the Under Secretary determines 
     necessary in order to carry out the purposes of this 
     section.''.
       (2) The table of sections at the beginning of chapter 73 is 
     amended by inserting after the item relating to section 7327, 
     as added by section 302(a)(2) of this Act, the following new 
     item:

``7328. Medical preparedness centers.''.

       TITLE IV--MEDICAL FACILITIES MANAGEMENT AND ADMINISTRATION

               Subtitle A--Major Medical Facility Leases

     SEC. 401. MAJOR MEDICAL FACILITY LEASES.

       The Secretary of Veterans Affairs may enter into contracts 
     for major medical facility leases at the following locations, 
     in an amount for each facility lease not to exceed the amount 
     shown for that location:
       (1) Wilmington, North Carolina, Outpatient Clinic, 
     $1,320,000.
       (2) Greenville, North Carolina, Outpatient Clinic, 
     $1,220,000.
       (3) Norfolk, Virginia, Outpatient Clinic, $1,250,000.
       (4) Summerfield, Florida, Marion County Outpatient Clinic, 
     $1,230,000.
       (5) Knoxville, Tennessee, Outpatient Clinic, $850,000.
       (6) Toledo, Ohio, Outpatient Clinic, $1,200,000.
       (7) Crown Point, Indiana, Outpatient Clinic, $850,000.
       (8) Fort Worth, Texas, Tarrant County Outpatient Clinic, 
     $3,900,000.
       (9) Plano, Texas, Collin County Outpatient Clinic, 
     $3,300,000.
       (10) San Antonio, Texas, Northeast Central Bexar County 
     Outpatient Clinic, $1,400,000.
       (11) Corpus Christi, Texas, Outpatient Clinic, $1,200,000.
       (12) Harlingen, Texas, Outpatient Clinic, $650,000.
       (13) Denver, Colorado, Health Administration Center, 
     $1,950,000.
       (14) Oakland, California, Outpatient Clinic, $1,700,000.
       (15) San Diego, California, North County Outpatient Clinic, 
     $1,300,000.
       (16) San Diego, California, South County Outpatient Clinic, 
     $1,100,000.

     SEC. 402. AUTHORIZATION OF APPROPRIATIONS.

       There is authorized to be appropriated to the Secretary of 
     Veterans Affairs for fiscal year 2005 for the Medical Care 
     account, $24,420,000 for the leases authorized in section 
     401.

     SEC. 403. AUTHORITY FOR LONG-TERM LEASE OF CERTAIN LANDS OF 
                   UNIVERSITY OF COLORADO.

       Notwithstanding section 8103 of title 38, United States 
     Code, the Secretary of Veterans Affairs may enter into a 
     lease for real property located at the Fitzsimmons Campus of 
     the University of Colorado for purposes of a medical facility 
     (as that term is defined in section 8101 of title 38, United 
     States Code) for a period of up to 75 years.

                   Subtitle B--Facilities Management

     SEC. 411. DEPARTMENT OF VETERANS AFFAIRS CAPITAL ASSET FUND.

       (a) Establishment of Fund.--(1) Subchapter I of chapter 81 
     is amended by adding at the end the following new section:

     ``Sec. 8118. Authority for transfer of real property; 
       Department of Veterans Affairs Capital Asset Fund

       ``(a)(1) The Secretary may transfer real property under the 
     jurisdiction or control of the Secretary (including 
     structures and equipment associated therewith) to another 
     department or agency of the United States, to a State (or a 
     political subdivision of a State), or to any public or 
     private entity, including an Indian tribe. Such a transfer 
     may be made only if the Secretary receives compensation of 
     not less than the fair market value of the property, except 
     that no compensation is required, or compensation at less 
     than fair market value may be accepted, in the case of a 
     transfer to a grant and per diem provider (as defined in 
     section 2002 of this title). When a transfer is made to a 
     grant and per diem provider for less than fair market value, 
     the Secretary shall require in the terms of the conveyance 
     that if the property transferred is used for any purpose 
     other than a purpose under chapter 20 of this title, all 
     right, title, and interest to the property shall revert to 
     the United States.
       ``(2) The Secretary may exercise the authority provided by 
     this section notwithstanding sections 521, 522, and 541 
     through 545 of title 40. Any such transfer shall be in 
     accordance with this section and section 8122 of this title.
       ``(3) The authority provided by this section may not be 
     used in a case to which section 8164 of this title applies.
       ``(4) The Secretary may enter into partnerships or 
     agreements with public or private entities dedicated to 
     historic preservation to facilitate the transfer, leasing, or 
     adaptive use of structures or properties specified in 
     subsection (b)(3)(D).
       ``(5) The authority of the Secretary under paragraph (1) 
     expires on the date that is seven years after the date of the 
     enactment of this section.
       ``(b)(1) There is established in the Treasury of the United 
     States a revolving fund to be known as the Department of 
     Veterans Affairs Capital Asset Fund (hereinafter in this 
     section referred to as the `Fund'). Amounts in the Fund shall 
     remain available until expended.
       ``(2) Proceeds from the transfer of real property under 
     this section shall be deposited into the Fund.
       ``(3) To the extent provided in advance in appropriations 
     Acts, amounts in the Fund may be expended for the following 
     purposes:
       ``(A) Costs associated with the transfer of real property 
     under this section, including costs of demolition, 
     environmental remediation, maintenance and repair, 
     improvements to facilitate the transfer, and administrative 
     expenses.
       ``(B) Costs, including costs specified in subparagraph (A), 
     associated with future transfers of property under this 
     section.
       ``(C) Costs associated with enhancing medical care services 
     to veterans by improving, renovating, replacing, updating, or 
     establishing patient care facilities through construction 
     projects to be carried out for an amount less than the amount 
     specified in 8104(a)(3)(A) for a major medical facility 
     project.
       ``(D) Costs, including costs specified in subparagraph (A), 
     associated with the transfer, lease, or adaptive use of a 
     structure or other property under the jurisdiction of the 
     Secretary that is listed on the National Register of Historic 
     Places.
       ``(c) The Secretary shall include in the budget 
     justification materials submitted to Congress for any fiscal 
     year in support of the President's budget for that fiscal 
     year for the Department specification of the following:
       ``(1) The real property transfers to be undertaken in 
     accordance with this section during that fiscal year.
       ``(2) All transfers completed under this section during the 
     preceding fiscal year and completed and scheduled to be 
     completed during the fiscal year during which the budget is 
     submitted.
       ``(3) The deposits into, and expenditures from, the Fund 
     that are incurred or projected for each of the preceding 
     fiscal year, the current fiscal year, and the fiscal year 
     covered by the budget.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     8117 the following new item:

``8118. Authority for transfer of real property; Department of Veterans 
              Affairs Capital Asset Fund.''.

       (b) Initial Authorization of Appropriations.--There is 
     authorized to be appropriated to the Department of Veterans 
     Affairs Capital Asset Fund established under section 8118 of 
     title 38, United States Code (as added by subsection (a)), 
     the amount of $10,000,000.
       (c) Termination of Nursing Home Revolving Fund.--(1) 
     Section 8116 is repealed.
       (2) The table of sections at the beginning of chapter 81 is 
     amended by striking the item relating to section 8116.
       (d) Transfer of Unobligated Balances to Capital Asset 
     Fund.--Any unobligated balances in the nursing home revolving 
     fund under section 8116 of title 38, United States Code, as 
     of the date of the enactment of this Act shall be deposited 
     in the Department of Veterans Affairs Capital Asset Fund 
     established under section 8118 of title 38, United States 
     Code (as added by subsection (a)).
       (e) Procedures Applicable to Transfers.--(1) Paragraph (2) 
     of section 8122(a) is amended to read as follows:
       ``(2) Except as provided in paragraph (3), the Secretary 
     may not during any fiscal year transfer to any other 
     department or agency of the United States or to any other 
     entity real property that is owned by the United States and 
     administered by the Secretary unless the proposed transfer is 
     described in the budget submitted to Congress pursuant to 
     section 1105 of title 31 for that fiscal year.''.
       (2) Section 8122(d) is amended--
       (A) by inserting ``(1)'' before ``Real property''; and
       (B) by adding at the end the following new paragraph:
       ``(2) The Secretary may transfer real property under this 
     section, or under section 8118 of this title, if the 
     Secretary--
       ``(A) places a notice in the real estate section of local 
     newspapers and in the Federal Register of the Secretary's 
     intent to transfer that real property (including land, 
     structures, and equipment associated with the property);
       ``(B) holds a public hearing;
       ``(C) provides notice to the Administrator of General 
     Services of the Secretary's intention to transfer that real 
     property and waits for 30 days to elapse after providing that 
     notice; and
       ``(D) after such 30-day period has elapsed, notifies the 
     congressional veterans' affairs committees of the Secretary's 
     intention to dispose of the

[[Page 23757]]

     property and waits for 60 days to elapse from the date of 
     that notice.''.
       (3) Section 8164(a) is amended by inserting ``8118 or'' 
     after ``rather than under section''.
       (4) Section 8165(a)(2) is amended by striking ``nursing 
     home revolving fund'' and inserting ``Department of Veterans 
     Affairs Capital Asset Fund established under section 8118 of 
     this title''.
       (f) Contingent Effectiveness.--Subsection (d) and the 
     amendments made by subsection (c) shall take effect at the 
     end of the 30-day period beginning on the date on which the 
     Secretary of Veterans Affairs certifies to Congress that the 
     Secretary is in compliance with subsection (b) of section 
     1710B of title 38, United States Code.
       (g) Annual Update.--Following a certification under 
     subsection (f), the Secretary shall submit to Congress an 
     annual update on that certification.

     SEC. 412. ANNUAL REPORT TO CONGRESS ON INVENTORY OF 
                   DEPARTMENT OF VETERANS AFFAIRS HISTORIC 
                   PROPERTIES.

       (a) In General.--Not later than December 15 of 2005, 2006, 
     and 2007, the Secretary of Veterans Affairs shall submit to 
     the Committees on Veterans' Affairs of the Senate and House 
     of Representatives a report on the historic properties 
     administered or controlled by the Secretary.
       (b) Initial Report.--In the initial report under subsection 
     (a), the Secretary shall set forth a complete inventory of 
     the historic structures and property under the jurisdiction 
     of the Secretary. The report shall include a description and 
     classification of each such property based upon historical 
     nature, current physical condition, and potential for 
     transfer, leasing, or adaptive use.
       (c) Subsequent Reports.--In reports under subsection (a) 
     after the initial report, the Secretary shall provide an 
     update of the status of each property identified in the 
     initial report, with the proposed and actual disposition, if 
     any, of each property. Each such report shall include any 
     recommendation of the Secretary for legislation to enhance 
     the transfer, leasing, or adaptive use of such properties.

     SEC. 413. AUTHORITY TO ACQUIRE AND TRANSFER REAL PROPERTY FOR 
                   USE FOR HOMELESS VETERANS.

       (a) Authority.--Upon identification of a parcel of real 
     property meeting the description in subsection (b), the 
     Secretary of Veterans Affairs may acquire that property (with 
     the structures and improvements thereon) or, in the case of 
     property owned by the United States and administered by 
     another Federal department or agency, may accept 
     administrative jurisdiction over that property, with the 
     expectation of promptly transferring that property to a 
     homeless assistance provider identified under paragraph (2) 
     of subsection (b), subject to the condition that the primary 
     purpose for which the property shall be used is to provide 
     housing for homeless veterans.
       (b) Specified Property.--A parcel of real property referred 
     to in subsection (a) is a parcel in the District of 
     Columbia--
       (1) that the Secretary determines to be suitable for use 
     for housing for homeless veterans; and
       (2) for which there is an identified homeless assistance 
     provider that is prepared to acquire the property for such 
     purpose from the Secretary promptly upon the acquisition of 
     the property by the Secretary.
       (c) Transfer of Property.--Upon acquiring real property 
     under subsection (a), the Secretary shall immediately 
     transfer all right, title, and interest of the United States 
     (other than the reversionary interest retained under 
     subsection (e)) to the homeless assistance provider 
     identified under subsection (b)(2). Such transfer shall be 
     for such consideration as the Secretary determines 
     appropriate.
       (d) Terms and Conditions.--The acquisition and transfer of 
     real property under this section shall be made upon such 
     terms and conditions as the Secretary may specify not 
     inconsistent with other applicable provisions of law.
       (e) Reverter.--The terms of the transfer shall provide that 
     if the property is no longer used for the purpose for which 
     conveyed by the Secretary, title to the property shall revert 
     to the United States.

     SEC. 414. LIMITATION ON IMPLEMENTATION OF MISSION CHANGES FOR 
                   SPECIFIED VETERANS HEALTH ADMINISTRATION 
                   FACILITIES.

       (a) Limitation.--The Secretary of Veterans Affairs may not 
     implement a mission change for a medical facility of the 
     Department of Veterans Affairs specified in subsection (c) 
     until--
       (1) the Secretary submits to the Committees on Veterans' 
     Affairs of the Senate and House of Representatives a written 
     notice of the mission change; and
       (2) the period prescribed by subsection (b) has elapsed.
       (b) Congressional Review Period.--(1) The period referred 
     to in subsection (a)(2) is the period beginning on the date 
     of the receipt of the notice under subsection (a)(1) by the 
     committees specified in that subsection and ending on the 
     later of--
       (A) the end of the 60-day period beginning on the date on 
     which the notice is received by those committees; or
       (B) the end of a period of 30 days of continuous session of 
     Congress beginning on the date on which the notification is 
     received by those committees or, if either House of Congress 
     is not in session on such date, the first day after such date 
     that both Houses of Congress are in session.
       (2) For the purposes of paragraph (1)(B)--
       (A) the continuity of a session of Congress is broken only 
     by an adjournment of Congress sine die; and
       (B) any day on which either House is not in session because 
     of an adjournment of more than three days to a day certain is 
     excluded in the computation of any period of time in which 
     Congress is in continuous session.
       (c) Specified Facilities.--A facility referred to in 
     subsection (a) as being specified in this subsection is any 
     of the following facilities of the Department of Veterans 
     Affairs:
       (1) The Department of Veterans Affairs medical centers in 
     Boston, Massachusetts.
       (2) The Department of Veterans Affairs medical centers in 
     New York City, New York.
       (3) The Department of Veterans Affairs medical center in 
     Big Spring, Texas.
       (4) The Carl Vinson Department of Veterans Affairs Medical 
     Center, Dublin, Georgia.
       (5) The Department of Veterans Affairs medical center in 
     Montgomery, Alabama.
       (6) The Department of Veterans Affairs medical center in 
     Louisville, Kentucky.
       (7) The Department of Veterans Affairs medical center in 
     Muskogee Oklahoma, and the outpatient clinic in Tulsa, 
     Oklahoma.
       (8) The John J. Pershing Department of Veterans Affairs 
     Medical Center, Poplar Bluff, Missouri.
       (9) The Department of Veterans Affairs medical center in 
     Ft. Wayne, Indiana.
       (10) The Department of Veterans Affairs Medical Center in 
     Waco, Texas.
       (11) The Jonathan M. Wainwright Department of Veterans 
     Affairs Medical Center, Walla Walla, Washington.
       (d) Covered Mission Changes.--For purposes of this section, 
     a mission change for a medical facility shall consist of any 
     of the following:
       (1) Closure of the facility.
       (2) Consolidation of the facility.
       (3) An administrative reorganization of the facility 
     covered by section 510(b) of title 38, United States Code.
       (e) Required Content of Notice of Mission Change.--Written 
     notice of a mission change for a medical facility under 
     subsection (a) shall include the following:
       (1) An assessment of the effect of the mission change on 
     the population of veterans served by the facility.
       (2) A description of the availability and quality of health 
     care, including long-term care, mental health care, and 
     substance abuse programs, available in the area served by the 
     facility.
       (3) An assessment of the effect of the mission change on 
     the economy of the community in which the facility is 
     located.
       (4) An analysis of any alternatives to the mission change 
     proposed by--
       (A) the community in which the facility is located;
       (B) organizations recognized by the Secretary under section 
     5902 of title 38, United States Code;
       (C) organizations that represent Department employees in 
     such community; or
       (D) the Department.
       (f) Medical Facility Consolidation.--For the purposes of 
     subsection (d)(2), the term ``consolidation'' means an action 
     that closes one or more medical facilities within a 
     geographic service area for the purpose of relocating those 
     activities to another medical facility or facilities.
       (g) Coordination of Provisions.--In the case of a mission 
     change covered by subsection (a) that is also an 
     administrative reorganization covered by section 510(b) of 
     title 38, United States Code, both this section and such 
     section 510(b) shall apply with respect to the implementation 
     of that mission change.

     SEC. 415. AUTHORITY TO USE PROJECT FUNDS TO CONSTRUCT OR 
                   RELOCATE SURFACE PARKING INCIDENTAL TO A 
                   CONSTRUCTION OR NONRECURRING MAINTENANCE 
                   PROJECT.

       Section 8109 is amended by adding at the end the following 
     new subsection:
       ``(j) Funds in a construction account or capital account 
     that are available for a construction project or a 
     nonrecurring maintenance project may be used for the 
     construction or relocation of a surface parking lot 
     incidental to that project.''.

     SEC. 416. INAPPLICABILITY OF LIMITATION ON USE OF ADVANCE 
                   PLANNING FUNDS TO AUTHORIZED MAJOR MEDICAL 
                   FACILITY PROJECTS.

       Section 8104 is amended by adding at the end the following 
     new subsection:
       ``(g) The limitation in subsection (f) does not apply to a 
     project for which funds have been authorized by law in 
     accordance with subsection (a)(2).''.

     SEC. 417. IMPROVEMENTS TO ENHANCED-USE LEASE AUTHORITY.

       Section 8166(a) is amended by inserting ``land use,'' in 
     the second sentence after ``relating to''.

     SEC. 418. FIRST OPTION FOR COMMONWEALTH OF KENTUCKY ON 
                   DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, 
                   LOUISVILLE, KENTUCKY.

       (a) Requirement.--Upon determining to convey, lease, or 
     otherwise dispose of the Department of Veterans Affairs 
     Medical Center, Louisville, Kentucky, or any portion thereof, 
     the Secretary of Veterans Affairs shall engage in 
     negotiations for the conveyance, lease, or other disposal of 
     the Medical Center or portion thereof solely with the 
     Commonwealth of Kentucky.
       (b) Duration of Requirement.--The requirement for 
     negotiations under subsection (a) shall remain in effect for 
     one year after the date of the determination referred to in 
     that subsection.
       (c) Scope of Negotiations.--The negotiations under 
     subsection (a) shall address the use of the medical center 
     referred to in subsection (a), or portion thereof, by the 
     Commonwealth of

[[Page 23758]]

     Kentucky for the primary purpose of the provision of services 
     for veterans and related activities, including use for a 
     State veterans' home.

     SEC. 419. TRANSFER OF JURISDICTION, GENERAL SERVICES 
                   ADMINISTRATION PROPERTY, BOISE, IDAHO.

       (a) Transfer.--The Administrator of General Services shall 
     transfer to the Secretary of Veterans Affairs, under such 
     terms and conditions as the Administrator and the Secretary 
     agree, jurisdiction, custody, and control over the parcel of 
     real property, including any improvements thereon, consisting 
     of approximately 2.3 acres located at the General Services 
     Administration facility immediately north of the Army Reserve 
     facility in Boise, Idaho.
       (b) Utilization.--The Secretary of Veterans Affairs shall 
     utilize the property transferred under subsection (a) for 
     purposes relating to the delivery of benefits to veterans.

                 Subtitle C--Designation of Facilities

     SEC. 421. THOMAS E. CREEK DEPARTMENT OF VETERANS AFFAIRS 
                   MEDICAL CENTER.

       (a) In General.--The Department of Veterans Affairs medical 
     center in Amarillo, Texas, shall after the date of the 
     enactment of this Act be known and designated as the ``Thomas 
     E. Creek Department of Veterans Affairs Medical Center''.
       (b) References.--Any reference in any law, regulation, map, 
     document, record, or other paper of the United States to the 
     medical center referred to in subsection (a) shall be 
     considered to be a reference to the Thomas E. Creek 
     Department of Veterans Affairs Medical Center.

     SEC. 422. JAMES J. PETERS DEPARTMENT OF VETERANS AFFAIRS 
                   MEDICAL CENTER.

       (a) In General.--The Department of Veterans Affairs medical 
     center in the Bronx, New York, shall after the date of the 
     enactment of this Act be known and designated as the ``James 
     J. Peters Department of Veterans Affairs Medical Center''.
       (b) References.--Any reference in any law, regulation, map, 
     document, record, or other paper of the United States to the 
     medical center referred to in subsection (a) shall be 
     considered to be a reference to the James J. Peters 
     Department of Veterans Affairs Medical Center.

     SEC. 423. BOB MICHEL DEPARTMENT OF VETERANS AFFAIRS 
                   OUTPATIENT CLINIC.

       (a) In General.--The Department of Veterans Affairs 
     outpatient clinic located in Peoria, Illinois, shall after 
     the date of the enactment of this Act be known and designated 
     as the ``Bob Michel Department of Veterans Affairs Outpatient 
     Clinic''.
       (b) References.--Any reference in any law, regulation, map, 
     document, record, or other paper of the United States to the 
     outpatient clinic referred to in subsection (a) shall be 
     considered to be a reference to the Bob Michel Department of 
     Veterans Affairs Outpatient Clinic.

     SEC. 424. CHARLES WILSON DEPARTMENT OF VETERANS AFFAIRS 
                   OUTPATIENT CLINIC.

       (a) In General.--The Department of Veterans Affairs 
     outpatient clinic located in Lufkin, Texas, shall after the 
     date of the enactment of this Act be known and designated as 
     the ``Charles Wilson Department of Veterans Affairs 
     Outpatient Clinic''.
       (b) References.--Any reference in any law, regulation, map, 
     document, record, or other paper of the United States to the 
     outpatient clinic referred to in subsection (a) shall be 
     considered to be a reference to the Charles Wilson Department 
     of Veterans Affairs Outpatient Clinic.

     SEC. 425. THOMAS P. NOONAN, JR. DEPARTMENT OF VETERANS 
                   AFFAIRS OUTPATIENT CLINIC.

       (a) In General.--The Department of Veterans Affairs 
     outpatient clinic in Sunnyside, Queens, New York, shall after 
     the date of the enactment of this Act be known and designated 
     as the ``Thomas P. Noonan, Jr. Department of Veterans Affairs 
     Outpatient Clinic''.
       (b) References.--Any reference in any law, map, regulation, 
     document, paper, or other record of the United States to the 
     outpatient clinic referred to in subsection (a) shall be 
     considered to be a reference to the Thomas P. Noonan, Jr. 
     Department of Veterans Affairs Outpatient Clinic.

                   TITLE V--PERSONNEL ADMINISTRATION

     SEC. 501. PILOT PROGRAM TO STUDY INNOVATIVE RECRUITMENT TOOLS 
                   TO ADDRESS NURSING SHORTAGES AT DEPARTMENT OF 
                   VETERANS AFFAIRS HEALTH CARE FACILITIES.

       (a) Pilot Program.--(1) Not later than 90 days after the 
     date of the enactment of this Act, the Secretary of Veterans 
     Affairs shall designate a health care service region, or a 
     section within such a region, in which health care facilities 
     of the Department of Veterans Affairs are adversely affected 
     by a shortage of qualified nurses.
       (2) The Secretary shall conduct a pilot program in the 
     region or section designated under paragraph (1) to determine 
     the effectiveness of the use of innovative human capital 
     tools and techniques in the recruitment of qualified nurses 
     for positions at Department health care facilities in such 
     region or section and for the retention of nurses at such 
     facilities. In carrying out the pilot program, the Secretary 
     shall enter into a contract with a private sector entity for 
     services under the pilot program for recruitment of qualified 
     nurses.
       (b) Private Sector Recruitment Practices.--For purposes of 
     the pilot program under this section, the Secretary shall 
     identify and use recruitment practices that have proven 
     effective for placing qualified individuals in positions that 
     are difficult to fill due to shortages of qualified 
     individuals or other factors. Recruitment practices to be 
     reviewed by the Secretary for use in the pilot program shall 
     include--
       (1) employer branding and interactive advertising 
     strategies;
       (2) Internet technologies and automated staffing systems; 
     and
       (3) the use of recruitment, advertising, and communication 
     agencies.
       (c) Streamlined Hiring Process.--In carrying out the pilot 
     program under this section, the Secretary shall, at health 
     care facilities of the Department in the region or section in 
     which the pilot program is conducted, revise procedures and 
     systems for selecting and hiring qualified nurses to reduce 
     the length of the hiring process. If the Secretary identifies 
     measures to streamline and automate the hiring process that 
     can only be implemented if authorized by law, the Secretary 
     shall submit to the Committees on Veterans' Affairs of the 
     Senate and House of Representatives recommendations for such 
     changes in law as may be necessary to enable such measures to 
     be implemented.
       (d) Report.--Not later than one year after the date of the 
     enactment of this Act, the Secretary shall submit to the 
     Committees on Veterans' Affairs of the Senate and House of 
     Representatives a report on the extent to which the pilot 
     program achieved the goal of improving the recruitment and 
     retention of nurses in Department of Veterans Affairs health 
     care facilities.

     SEC. 502. TECHNICAL CORRECTION TO LISTING OF CERTAIN HYBRID 
                   POSITIONS IN VETERANS HEALTH ADMINISTRATION.

       Section 7401(3) is amended--
       (1) by striking ``and dental technologists'' and inserting 
     ``technologists, dental hygienists, dental assistants''; and
       (2) by striking ``technicians, therapeutic radiologic 
     technicians, and social workers'' and inserting 
     ``technologists, therapeutic radiologic technologists, social 
     workers, blind rehabilitation specialists, and blind 
     rehabilitation outpatient specialists''.

     SEC. 503. UNDER SECRETARY FOR HEALTH.

       Section 305(a)(2) is amended--
       (1) in the matter preceding subparagraph (A), by striking 
     ``shall be a doctor of medicine and''; and
       (2) in subparagraph (A), by striking ``and in health-care'' 
     and inserting ``or in health-care''.

                        TITLE VI--OTHER MATTERS

     SEC. 601. EXTENSION AND CODIFICATION OF AUTHORITY FOR 
                   RECOVERY AUDITS.

       Section 1703 is amended by adding at the end the following 
     new subsection:
       ``(d)(1) The Secretary shall conduct a program of recovery 
     audits for fee basis contracts and other medical services 
     contracts for the care of veterans under this section, and 
     for beneficiaries under sections 1781, 1782, and 1783 of this 
     title, with respect to overpayments resulting from processing 
     or billing errors or fraudulent charges in payments for non-
     Department care and services. The program shall be conducted 
     by contract.
       ``(2) Amounts collected, by setoff or otherwise, as the 
     result of an audit under the program conducted under this 
     subsection shall be available for the purposes for which 
     funds are currently available to the Secretary for medical 
     care and for payment to a contractor of a percentage of the 
     amount collected as a result of an audit carried out by the 
     contractor.
       ``(3) The Secretary shall allocate all amounts collected 
     under this subsection with respect to a designated geographic 
     service area of the Veterans Health Administration, net of 
     payments to the contractor, to that region.
       ``(4) The authority of the Secretary under this subsection 
     terminates on September 30, 2008.''.

     SEC. 602. INVENTORY OF MEDICAL WASTE MANAGEMENT ACTIVITIES AT 
                   DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE 
                   FACILITIES.

       (a) Inventory.--The Secretary of Veterans Affairs shall 
     establish and maintain a national inventory of medical waste 
     management activities in the health care facilities of the 
     Department of Veterans Affairs. The inventory shall include 
     the following:
       (1) A statement of the current national policy of the 
     Department on managing and disposing of medical waste, 
     including regulated medical waste in all its forms.
       (2) A description of the program of each geographic service 
     area of the Department to manage and dispose of medical 
     waste, including general medical waste and regulated medical 
     waste, with a description of the primary methods used in 
     those programs and the associated costs of those programs, 
     with cost information shown separately for in-house costs 
     (including full-time equivalent employees) and contract 
     costs.
       (b) Report.--Not later than June 30, 2005, the Secretary of 
     Veterans Affairs shall submit to the Committees on Veterans' 
     Affairs of the Senate and House of Representatives a report 
     on medical waste management activities in the facilities of 
     the Department of Veterans Affairs. The report shall include 
     the following:
       (1) The inventory established under subsection (a), 
     including all the matters specified in that subsection.
       (2) A listing of each violation of medical waste management 
     and disposal regulations reported at any health care facility 
     of the Department over the preceding five years by any 
     Federal or State agency, along with an explanation of any 
     remedial or other action taken by the Secretary in response 
     to each such reported violation.
       (3) A description of any plans to modernize, consolidate, 
     or otherwise improve the management of medical waste and 
     disposal programs at

[[Page 23759]]

     health care facilities of the Department, including the 
     projected costs associated with such plans and any barriers 
     to achieving goals associated with such plans.
       (4) An assessment or evaluation of the available methods of 
     disposing of medical waste and identification of which of 
     those methods are more desirable from an environmental 
     perspective in that they would be least likely to result in 
     contamination of air or water or otherwise cause future 
     cleanup problems.

     SEC. 603. INCLUSION OF ALL ENROLLED VETERANS AMONG PERSONS 
                   ELIGIBLE TO USE CANTEENS OPERATED BY VETERANS' 
                   CANTEEN SERVICE.

       The text of section 7803 is amended to read as follows:
       ``(a) Primary Beneficiaries.--Canteens operated by the 
     Service shall be primarily for the use and benefit of--
       ``(1) veterans hospitalized or domiciled at the facilities 
     at which canteen services are provided; and
       ``(2) other veterans who are enrolled under section 1705 of 
     this title.
       ``(b) Other Authorized Users.--Service at such canteens may 
     also be furnished to--
       ``(1) personnel of the Department and recognized veterans' 
     organizations who are employed at a facility at which canteen 
     services are provided and to other persons so employed;
       ``(2) the families of persons referred to in paragraph (1) 
     who reside at the facility; and
       ``(3) relatives and other persons while visiting a person 
     specified in this section.''.

     SEC. 604. ANNUAL REPORTS ON WAITING TIMES FOR APPOINTMENTS 
                   FOR SPECIALTY CARE.

       (a) Annual Reports.--Not later than January 31 each year 
     through 2007, the Secretary of Veterans Affairs shall submit 
     to the Committees on Veterans' Affairs of the Senate and the 
     House of Representatives a report on waiting times for 
     appointments for specialty health care from the Department of 
     Veterans Affairs under chapter 17 of title 38, United States 
     Code, during the preceding year.
       (b) Report Elements.--Each report under subsection (a) 
     shall specify, for the year covered by the report, the 
     following:
       (1) A tabulation of the number of veterans whose 
     appointment for specialty health care furnished by the 
     Department was more than three months after the date of the 
     scheduling of such appointment, and the waiting times of such 
     veterans for such appointments, for each category of 
     specialty care furnished by the Department, broken out by 
     Veterans Integrated Service Network.
       (2) An identification of the categories of specialty care 
     furnished by the Department for which there were delays of 
     more than three months between the scheduling date of 
     appointments and appointments in each Veterans Integrated 
     Service Network.
       (3) A discussion of the reasons for the delays identified 
     under paragraph (2) for each category of care for each 
     Veterans Integrated Service Network so identified, including 
     lack of personnel, financial resources, or other resources.
       (c) Certification on Report Information.--The Comptroller 
     General of the United States shall certify to the committees 
     of Congress referred to in subsection (a) whether or not each 
     report under this section is accurate.

     SEC. 605. TECHNICAL CLARIFICATION.

       Section 8111(d)(2) is amended by inserting before the 
     period at the end of the last sentence the following: ``and 
     shall be available for any purpose authorized by this 
     section''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Smith) and the gentleman from Texas (Mr. Rodriguez) each 
will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey (Mr. Smith).
  Mr. SMITH of New Jersey. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise in very strong support of H.R. 3936, the Veterans 
Health Programs Improvement Act of 2004. The bill, as amended, 
represents a compromise agreement between the House Committee on 
Veterans' Affairs and the Senate on these matters.
  Mr. Speaker, I want to thank the gentleman from Illinois (Mr. Evans), 
the committee's ranking member, for his work on this. I especially want 
to thank the gentleman from Connecticut (Mr. Simmons) for his admirable 
leadership as chairman of the Subcommittee on Health, where most of 
these measures originated. He has done a tremendous job as chairman. As 
a 37-year Army veteran, he has put veterans first and has done so in a 
way that is extraordinary.
  Again, I want to thank him for his work and his meticulous attention 
to detail. It has made the difference. This bill, regrettably, went 
through a lot of difficulties and travail, and yet he persevered. And I 
want to thank our chairman of that subcommittee for his leadership. It 
has been extraordinary.
  I also want to thank the gentleman from Texas (Mr. Rodriguez), the 
ranking member of that subcommittee. Again, these bills are bipartisan. 
We have worked together very closely, and it is a pleasure to bring 
this before the body today.
  Mr. Speaker, H.R. 3936 contains more than 33 measures that would 
improve the management and the administration of veterans health care 
programs. I want to highlight just a few of those provisions that are 
contained in the bill.
  The VA's homeless grant and per diem program is an economical, 
flexible, and innovative approach to housing and supportive services 
for thousands of homeless veterans. The compromise agreement would 
increase the fiscal year 2005 authorization level for VA's grant and 
per diem program from $75 million to $99 million. The Department 
requested this increase because it has received far more requests for 
funding from meritorious potential grantees than it can support under 
existing funding limits.
  Another important provision compromise would direct the Secretary to 
make payments to assist the 128 State-operated nursing homes in hiring 
and retaining nursing personnel. These homes provide long-term care to 
over 38,000 veterans annually in an excellent partnership with the VA, 
and this provision encourages their efforts to keep highly qualified 
staff caring for these veterans.
  Mr. Speaker, today we are at war overseas. We know war can produce 
terrible physical injuries, and we must do everything possible for 
wounded servicemembers. This compromise agreement would authorize the 
VA to establish, in conjunction with the Department of Defense, a 
limited number of new centers for research, education, and clinical 
care to improve rehabilitative services for complex traumatic injuries, 
such as those being suffered by our brave soldiers and Marines in Iraq. 
These centers will be a Godsend for these wounded war veterans and for 
their families.
  This bill provides VA authority to enter into a 75-year lease to 
acquire a medical facility on the new Fitzsimons Campus of the 
University of Colorado. It is anticipated this Federal-State health 
sciences campus would share many high-cost specialized services and 
provide expanded access for Air Force beneficiaries at the nearby 
Buckley Air Force Base.
  I want to recognize and thank the gentleman from Colorado (Mr. 
Beauprez) for his leadership on this important provision and the 
chairman of the Committee on Standards of Official Conduct, who has 
also done yeoman's work on this as well.
  Mr. Speaker, our compromise agreement would improve the process for 
disposing of unneeded VA properties and authorize the proceeds from 
property transfers to be deposited into a new VA capital asset fund.

                              {time}  1445

  The new fund would facilitate transfers, leases and adaptive uses of 
VA properties, including historic properties. This compromise agreement 
also includes authorization for naming five VA medical centers, 
including one in Illinois to be named for the distinguished House 
minority leader, Bob Michel. Having served with Bob and having great 
respect for him, I am grateful that this provision is in here, and I 
want to thank my colleagues for their support for it. It also names 
facilities in Texas and New York for two heroic Marines who gave their 
lives for freedom in Vietnam.
  Mr. Speaker, the staff of the Committee on Veterans Affairs has 
worked hard in this Congress to examine ways to provide the best 
possible health care to those who have earned the honored title of 
``veteran.'' I would like to recognize the staff of the Subcommittee on 
Health: John Bradley, staff director; Dolores Dunn and Kathleen Greve, 
professional staff members; Susan Edgerton, Democratic staff director; 
and VA detailee Rosalind Howard. I would also like to thank our full 
committee staff, Pat Ryan to my left, chief counsel and staff director; 
Kingston Smith, deputy chief counsel; Jeannie McNally, legislative 
coordinator; and Jim Holley, Democratic staff director.
  I also thank the Senate committee staff director, Bill Tuerk, and 
Bill Cahill, III, professional staff member. I

[[Page 23760]]

also thank Kim Lipsky, Alexandra Sardegna and Amanda Krohn of the 
Democratic professional staff for their contributions. This has been a 
true collaborative effort.
  Again, I thank all who have participated in shaping, crafting and 
making this an extremely valuable bill that will soon be on the desk of 
President Bush for his signature.
  Mr. Speaker, I move that the House suspend the rules and concur in 
the Senate amendments to H.R. 3936.
  Mr. Speaker, I rise in strong support of H.R. 3936, the Veterans 
Health Programs Improvement Act of 2004.
  H.R. 3936, as amended, represents a compromise agreement between the 
Committees on Veterans' Affairs of the House and Senate.
  Mr. Speaker, I want to thank the gentleman from Illinois, Mr. Evans, 
Ranking Member of the Veterans' Affairs Committee, who has helped to 
shape this particular legislation. Also, I want to thank the gentleman 
from Connecticut, Mr. Simmons, for his outstanding leadership as 
Chairman of the Subcommittee on Health, where most of these measures 
originated. Finally, I thank the gentleman from Texas, Mr. Rodriguez, 
the Ranking Member, who has worked in a bipartisan effort to help craft 
this and numerous other important veterans' health bills during his 
time in Congress.
  Chairman Specter and Ranking Member Graham of the Senate Veterans' 
Affairs Committee also contributed to the legislation before the House 
today.
  Mr. Speaker, VA's homeless grant and per diem program provides 
competitive grants to community and faith-based organizations that 
offer transitional housing or comprehensive service centers for 
homeless veterans. This program is an economical, flexible and 
innovative approach to housing and supportive services for homeless 
veterans in all 50 States and in the District. Over 6,000 beds are now 
available nationally to veterans through this vital community network. 
In 2003, 66 percent of the veterans discharged from these VA-funded 
programs went on to either independent living or residential-program 
housing. The compromise agreement will increase the fiscal year 2005 
authorization level for this key program from $75 million to $99 
million. The department requested this increase because it has received 
far more requests for funding from meritorious potential grantees than 
it can support under existing funding limits.
  Another important provision in this compromise agreement would direct 
the Secretary to make payments to assist states in hiring and retaining 
nursing personnel at State-operated nursing homes for veterans. The 128 
State veterans' homes collectively represent the largest institutional 
provider of long-term care to elderly veterans, now caring for over 
38,000 veterans annually in 47 States. I am personally aware of 
staffing difficulties that the three New Jersey State veterans' homes 
in Vineland, Paramus and Menlo Park have faced over the past several 
years in their efforts to recruit and retain quality nursing staff to 
those homes. We need this new incentives program all across the 
country. It would allow State homes currently receiving per diem 
payments from VA with established employee-incentive programs to apply 
for assistance to retain and recruit their nurses. This provision 
encourages their efforts to keep highly-qualified staff caring for 
veterans.
  Another provision affecting the State home programs would specify 
that per diem payments made by VA to States for the care of veterans in 
these homes may not be used to offset or reduce third party payments 
made to assist veterans, whether from private, State or other Federal 
sources.
  There is well established history of partnership between the Federal 
and State governments providing care for veterans. This originated with 
the first Federal law in 1888, providing $100 per year in aid to States 
to help alleviate the burden of caring for sick and disabled soldiers. 
This partnership and the first annual payments preceded the advent of 
the Veterans Administration and the State Home program as we know them 
today--but Congressional intent has remained constant and clear. Since 
1960, Congress has taken an active role in expanding the State home 
programs to include four levels of care, increased per diem payments 
and grant funding for construction of facilities. The Congress and its 
Veterans' Committees are adamant that this partnership and the mutual 
reliance by VA and the States should not be inadvertently affected by 
the rules of any other program which is not specifically targeted at 
caring for aged and infirmed veterans.
  Mr. Speaker, 12 years ago, with Public Law 102-585, it was 
acknowledged that women who experienced sexual trauma while on active 
military duty may undergo a variety of psychological and physical 
health effects requiring special counseling. This law authorized VA to 
provide mental health counseling for these women veterans. Two years 
later, eligibility for VA sexual trauma counseling and treatment was 
broadened in Public Law 103-452 to include veterans of either gender 
who experience sexual trauma while serving on active duty. H.R. 3936 
would make permanent VA's authority to provide sexual trauma counseling 
to veterans.
  Mr. Speaker, the shortage of nurses throughout the United States is 
well documented and VA must position itself to take advantage of all 
opportunities available to deal with this shortage. H.R. 3936 would 
establish a pilot program to evaluate the use of proven private sector 
techniques, such as employer branding, interactive advertising, 
automated staffing systems and the use of outside recruitment agencies 
and online technologies to improve VA's program for recruiting nursing 
personnel.
  Mr. Speaker, how well we know that we are at war overseas. We know 
war can produce terrible physical injuries. In previous wars, many 
soldiers did not survive the very serious injuries of the kind being 
seen in Iraq and Afghanistan today. The means were not available for 
quick evacuation to sophisticated medical treatment. Today military 
medical treatment capabilities have greatly improved for complex 
traumatic injuries.
  However, Mr. Speaker, this success creates new challenges for the 
caregivers who have patients with complex traumatic injuries. The 
compromise agreement will authorize VA to establish in cooperation with 
the Department of Defense a limited number of new centers for research, 
education and clinical activities to improve rehabilitative services 
for these veterans. I particularly want to thank Senator Bob Graham, 
Ranking Member of the Senate Veterans' Affairs Committee, for his work 
in helping us reach agreement on this provision. These centers will be 
a godsend for these wounded war veterans and their families.
  Mr. Speaker, the delivery of health care in this country and in the 
VA system has undergone a profound transformation over the last decade. 
Once a hospital based health care system, today's VA has made a 
significant shift from inpatient to outpatient services, with 
tremendous growth in the number of enrolled veterans. Yet, much of VA 
health care bricks-and-mortar infrastructure was designed and built 
decades ago--some parts of it over a century ago--in a bygone era of 
health care delivery when long stays in the hospital were the norm.
  In 1999, a General Accounting Office report not surprisingly found 
that VA's cost of operating and maintaining its large inventory of old 
buildings was a huge and avoidable drain on resources. In the years 
since that GAO report, VA has undergone a major initiative referred to 
as the Capital Asset Realignment for Enhanced Services (CARES) 
initiative, to assess the best use of VA's capital assets for the 
veteran population to be served, and to use resources more effectively 
to improve health care delivery to these veterans.
  While awaiting the CARES recommendations, little was done by the 
Department to upgrade VA's physical plants. This legislation is 
consistent with the CARES recommendations and would provide VA the 
needed authority to execute leases for 16 community-based outpatient 
clinics at a cost of approximately $24.4 million, in fiscal year 2005, 
in the States of California, Colorado, Florida, Indiana, North 
Carolina, Ohio, Tennessee, Texas and Virginia. Most of these leases 
will upgrade existing clinic locations. All of these leases were 
requested by the VA.
  Mr. Speaker, this bill also provides VA authority to enter into a 75-
year lease to acquire a medical facility on the Fitzsimons Campus of 
the University of Colorado in Aurora. It is anticipated that a new 
federal-state health sciences campus would share many high cost and 
specialized services, and also would provide expanded access to care 
for Air Force beneficiaries from nearby Buckley Air Force Base. I want 
to recognize and thank the gentleman from Colorado, Mr. Beauprez, for 
his leadership in developing this good Federal health policy to serve 
the people of Colorado.
  Mr. Speaker, our compromise agreement would improve the process for 
disposing of unneeded VA properties and authorize the proceeds from 
these property transfers to be deposited into a new VA Capital Asset 
Fund. The new fund would defray VA's cost of transferring property 
including demolition, environmental restoration, historic preservation 
and establishment of new health facilities. This bill would authorize 
appropriations of $10 million in seed money to launch the fund to 
support these initiatives.

[[Page 23761]]

  Mr. Speaker, the VA has one of the largest federal inventories of 
properties with significant historic value. In fact, 24 VA medical 
center campuses are already listed on the National Register of Historic 
Places, and even more are eligible for this designation. This 
compromise agreement would allow the Secretary to enter into new 
partnerships or agreements with entities dedicated to historic 
preservation, and to use the funds in the Capital Asset Fund to 
facilitate transfers, leases or adaptive uses of those historic 
properties that are no longer useful for VA health care. Thus, this 
compromise agreement would protect history and at the same time the way 
to new uses of structures that have served their purposes for veterans.
  Mr. Speaker, this compromise agreement includes authorization to name 
VA facilities to honor two heroic Marines who gave this country the 
greatest measure of their personal devotion, giving their lives in 
combat to save others in Vietnam. Lance Corporals Thomas E. Creek of 
Texas and Thomas P. Noonan, Jr. of New York were each posthumously 
awarded the Nation's highest military decoration, the Congressional 
Medal of Honor, for their selfless deeds.
  The late James J. Peters of New York, a war hero in Vietnam, and a 
leader of paralyzed veterans after his service, would also be honored 
by our naming a VA outpatient clinic in the Bronx in his memory.
  Further, Mr. Speaker, a VA facility in Illinois will be named in 
honor of our distinguished former House Minority Leader, Bob Michel, 
and a facility in Texas will be named in honor of the public service of 
another former Member of this House, Charles Wilson.
  Mr. Speaker, under current law, VA must comply with a variety of 
Federal, state and local laws and regulations relating to the 
collecting, handling and disposing of medical waste. Failure to adhere 
to these laws and regulations could place patients, VA employees and 
their communities in hazardous situations, as well as subject VA to 
civil or criminal penalties. This bill would provide a means for 
Congress to evaluate the effectiveness of VA's medical waste management 
policies and determine whether additional procedures are needed to 
reduce environmental and heath risks. The costs of waste disposal would 
be assessed as well. The bill would require VA to establish and 
maintain an inventory of medical waste management activities in VA 
facilities and report to Congress on its inventory, regulatory 
compliance, and violations of record, along with plans for management 
improvements.
  Mr. Speaker, the staff of the Veterans' Affairs Committee has worked 
hard in this Congress to examine ways of providing the best possible 
health care for those who have earned the honored title of ``veteran.'' 
I would like to recognize the staff of the Subcommittee on Health: John 
Bradley, Staff Director, Dolores Dunn and Kathleen Greve, professional 
staff members; Susan Edgerton, Democratic Staff Director, and VA 
detailee Rosalind Howard. I'd also like to thank our full Committee 
staff: Patrick Ryan, Chief Counsel and Staff Director; Kingston Smith, 
Deputy Chief Counsel; Jeannie McNally, our Legislative Coordinator; and 
Jim Holley, Democratic Staff Director.
  Finally, I want to compliment the Senate Veterans' Affairs Committee 
staff: Bill Tuerk, Staff Director and Chief Counsel; and Bill Cahill 
III, professional staff member. I also want to recognize Kim Lipsky, 
Alexandra Sardegna and Amanda Krohn, of the Democratic professional 
staff, for their contributions to this bill.
  For the benefit of my colleagues, I include at this point in the 
record a joint explanatory statement describing the compromise 
agreement we have reached with the other body.
  Mr. Speaker, one final word on homeless veterans: these veterans who 
need services and a place to lay their heads have difficult problems. 
VA's programs and the hundreds of community and faith-based programs 
that serve in partnership with VA work miracles with many of them. The 
continuation and expansion of these programs with the goal of 
eradicating chronic homelessness in the veteran population has been one 
of my top goals as Chairman of this Committee. I intend to further 
address this program in the next Congress, so that those who once wore 
the nation's military uniform and who are now homeless. These veterans 
need a hand up to turn their lives around, and we should provide that 
hand.
  I urge my colleagues to support this measure to enhance health care 
for veterans.
  Mr. Speaker, I reserve the balance of my time.
  Mr. RODRIGUEZ. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise in support of H.R. 3936, the Veterans Health 
Programs Improvement Act of 2004. I want to take this opportunity to 
thank the gentleman from New Jersey (Mr. Smith) for his efforts, the 
ranking member, the gentleman from Illinois (Mr. Evans) also, as well 
as the gentleman from Connecticut (Mr. Simmons) of the Subcommittee on 
Health, and the House and Senate committee staffs for addressing some 
of the concerns raised in earlier pieces of this legislation. We now 
have a bill which I am pleased to lend my support to.
  The bill includes provisions from a bill I introduced, H.R. 3849, the 
Military Sexual Trauma Counseling Act of 2004 to permanently extend 
VA's authority to provide counseling and treatment for the women and 
men who have experienced sexual trauma during their service in the 
military. Current authority for the program expires at the end of this 
year. Therefore, it is critical that we pass this legislation today.
  Overwhelming demand has been demonstrated for this program. Thousands 
of veterans, in addition to Reservists and National Guardsmen, have 
taken advantage of the resources available to them.
  As the number of women serving in the military continue to grow, the 
need for the program is sadly more evident. Already we hear media 
reports that more than 100 troops returning from both Iraq and 
Afghanistan have stated that they were raped during their service.
  Although it is unfortunate that we need this particular program, I am 
pleased we are now on the road to ensuring that we will have these 
services for current and future veterans.
  Again, I would like to thank the gentleman from Connecticut (Mr. 
Simmons) for his leadership and cooperation in including the Military 
Sexual Trauma Program in this bill. I also thank the gentleman from New 
Jersey (Mr. Smith) and the gentleman from Illinois (Mr. Evans), the 
ranking member, for their support.
  I am also supportive of the provisions to increase the funding levels 
available for the homeless grant and the per diem programs from $75 
million to $99 million for 2005. We still have a very long way to go in 
meeting the Congress's goals to eliminating chronic homelessness by 
2011, and this bill can help us get there.
  This particular legislation also includes a provision that will 
require the Secretary of the VA to establish and maintain an inventory 
of the medical waste management activities in VA facilities, including 
inventory, regulatory violations and plans for management improvements. 
We believe the VA should be on the frontline of environmental 
protection policies, and these provisions help to make that happen.
  There are provisions also from our Senate counterparts in this bill, 
including a requirement that the VA report annually through 2007 on 
veterans waiting more than 3 months for scheduled appointments in 
specialty care and the reasons for these delays.
  This measure also requires the Secretary of the VA to establish a 
pilot program to study innovative recruitment tools to address the 
nursing shortage within the VA. We must be able to recruit and retain 
well-qualified nurses to care for our veterans. This pilot will help 
the VA Health Administration identify and adopt the best practices of 
private industries in hiring of well-qualified nurses.
  Now the largest provider of long-term care to our Nation's veterans, 
the State veterans' home system plays a vital role in caring for the 
growing number of aging veterans.
  This bill will authorize VA to make payments to assist State 
veterans' homes in hiring and retaining nurses, to help care for our 
aging veterans, and adds a clarification that per diem payments made by 
the VA to State veterans' homes are not to be used to offset or reduce 
third-party payments, such as Medicaid, made to assist veterans.
  There are a high number of veterans returning home that have injuries 
from the war in both Iraq and Afghanistan.

[[Page 23762]]

This measure authorizes the establishment of four cooperative centers 
for research, education and clinical activities to improve the 
rehabilitation services available to veterans suffering from complex 
multi-trauma associated with combat injuries. These centers build on 
the Veterans Health Administration's nationally recognized care for 
special populations such as post-traumatic stress disorders, spinal 
cord injuries, traumatic brain injuries, as well as visual impairment, 
and will prove to be most valuable in providing future combat injury 
rehabilitation.
  While the CARES process was under way, the VA health care system has 
managed within infrastructure that is in sore need of repair and 
upgrade. This bill establishes a VA Capital Asset Fund that will help 
strengthen our funding flow to assist the VA in developing and 
improving its properties. These funds will allow the VA to improve 
properties for disposal as well as future disposal and for minor 
construction. These funds also will allow the VA to use funds for 
improving properties.
  The Secretary of Veterans Affairs will be given the flexibility in 
using funds to develop advance planning for major construction projects 
previously authorized and additional authority to transfer unneeded 
real property and retain the proceeds from the transfer. The bill 
authorizes $10 million to be appropriated to the Capital Asset Fund 
where it can be used for these purposes.
  Mr. Speaker, 16 major new leases are authorized in this bill, 
including leases throughout this country. Because many of the VA 
important historic buildings are poorly maintained or falling apart, I 
am pleased that the Committee on Veterans' Affairs concluded that the 
VA should use funds to preserve historic properties. It is the 
committee's intent for VA to provide a series of reports to address its 
large inventory of these registered assets.
  This legislation will extend the VA authority to provide care to the 
veterans participating in long-term care pilot programs which were 
previously authorized until December, 2005.
  This is a bill that we all should be very proud of.
  Mr. Speaker, I reserve the balance of my time.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield such time as he may 
consume to the gentleman from Connecticut (Mr. Simmons).
  Mr. SIMMONS. Mr. Speaker, I rise to add my strong support to H.R. 
3936, the Veterans Health Programs Improvement Act of 2004.
  I want to acknowledge what some of my colleagues have already said. I 
want to acknowledge the committee leadership for its commitment to our 
veterans under the direction of our very able and very courageous 
chairman, the gentleman from New Jersey (Mr. Smith). The gentleman from 
New Jersey has been a remarkable leader over the last 2 years. He has 
been a courageous leader. He has stood up in this body and leadership 
councils for our veterans, and I look forward to his continued 
leadership as our chairman in the 109th Congress.
  I also recognize the work of the ranking member, the gentleman from 
Illinois (Mr. Evans), who also serves with me as co-chairmen of the 
U.S. Vietnam Caucus. He has made extraordinary contributions to our 
veterans in this legislation and in other bills we have taken up before 
this body.
  Finally, I want to express very special words of gratitude to my 
colleague and ranking member on the Subcommittee on Health, the 
gentleman from San Antonio, Texas (Mr. Rodriguez).
  Let me just share with the body two anecdotes. One, I traveled to San 
Antonio to chair a field hearing with the gentleman from Texas (Mr. 
Rodriguez), and we studied how the Department of Defense in that 
community and how the Veterans' Administration interact to provide 
health services not only for active troops but for our veterans. What 
was immediately apparent to me was the warmth with which his local 
constituents treated him because of his long interest in veterans, an 
interest that extends back at least 8 years as a member of this body.
  But then I invited the gentleman from Texas up to the lovely, warm, 
pleasant weather of Connecticut, where we spent some time at Newington, 
Connecticut, at a VA facility. Not only did we have a hearing at that 
facility but then the gentleman from Texas (Mr. Rodriguez) went to the 
State Veterans Home at Rocky Hill and spent many hours looking at that 
facility to see how the VA and the Connecticut State Department of 
Veteran Affairs interacted once again to provide these services. This 
shows a very genuine interest on his part in veterans not only in his 
own State but in Connecticut and elsewhere throughout the country.
  We are going to miss that genuine interest in our veterans. I thank 
the gentleman for his service to the subcommittee, to the committee and 
to our Nation's veterans.
  Our chairman has summarized many of the provisions of this bill. What 
I would like to do is just point out a couple of features that I think 
are particularly important.
  First and foremost, America has a tradition of caring for her 
veterans dating back to the Plymouth Colony where the Pilgrims enacted 
laws to assist sick and disabled soldiers. In 1811, our young country 
established the first domiciliary and medical facility for veterans 
that was authorized by the national government and today the Veterans' 
Administration has stewardship over the fourth largest real estate 
inventory in the Federal Government, over 20,000 buildings and tens of 
thousands of acres of land.
  One of the provisions of this bill allows the Secretary of the 
Veterans' Administration to get his arms around this huge inventory 
through the CARES project, a master plan for realigning the VA's 
inventory of capital assets in response to GAO findings and our 
committee oversight that some of these facilities were underutilized 
and that some dollars could be saved.
  In addition, what this legislation does is provide language for the 
reuse of historic properties. On the one hand, properties that can be 
adopted to new uses but, secondly, properties that are truly historic 
and ought to be preserved and protected, for example, the Eisenhower 
Recovery Room at the Fitzsimmons Hospital in Colorado. We are engaged 
in a major effort to build a state-of-the-art facility at Fitzsimmons. 
It will be co-located with the State university hospital system, but 
that historic room in Fitzsimmons will be preserved and protected into 
the future.
  Furthermore, the hiring and retraining of nursing staff in VA and 
State veterans homes, this legislation provides provisions that will 
address that challenge, the challenge of the almost 100,000 vacant 
nursing positions and a growing need for health care workers 
nationwide. It allows the VA to look outside for recruiting and 
advertising these positions and using interactive and online 
technologies to improve their exposure in today's recruiting market.

                              {time}  1500

  It also allows the State veterans homes to apply for a new grant 
program to serve as an incentive to attract nurses to State homes for 
their employment there with a 50-50 split between the VA and the State 
homes.
  I have spent a long time at the Connecticut State home at Rocky Hill. 
This is a successor to the first State home built in America which was 
built just after the Civil War. They provide a wonderful service, but 
if they could work interactively with the VA in Connecticut, they could 
enhance that service, both in providing more nurses and also in 
providing better services for our veterans. That is what this 
legislation attempts to do.
  Mr. Speaker, H.R. 3936 was carefully crafted to give the VA the 
flexibility and authority it needs to manage its capital assets. At the 
same time, it holds VA accountable for protecting the public interest 
of the United States as stewards of the valuable inventory of 
structures and lands held in trust by the VA. Finally, it provides the 
VA with the resources needed to enhance nurses and other professionals 
within the system so that they can better provide the services that we 
need. I urge

[[Page 23763]]

my colleagues to support this legislation.
  Mr. RODRIGUEZ. Mr. Speaker, I yield 2 minutes to the gentleman from 
Illinois (Mr. Evans), ranking member of the Committee on Veterans' 
Affairs.
  Mr. EVANS. Mr. Speaker, I rise in support of H.R. 3936, the Veterans 
Health Programs Improvement Act of 2004. I want to thank the gentleman 
from New Jersey (Mr. Smith) again for his leadership on these issues. 
Every time we try to do something good, his name is always in the 
forefront of the action. I want to thank the gentleman from Texas (Mr. 
Rodriguez) who came to our committee, has done great work as the 
subcommittee ranking member obviously through helping not only the 
gentleman from Connecticut (Mr. Simmons) but all veterans across the 
board. If we gave Medal of Honor awards to Members, he would certainly 
be given one.
  I want to thank everybody for developing this legislation. We have 
accomplished a lot. Of particular interest to me is the establishment 
of the capital asset fund to help renovate some of the VA's most 
underutilized facilities. The VA needs to meet construction priorities 
in order to maintain a health care system infrastructure that will be 
called on increasingly as our service men and women return from Iraq 
with physical and psychological disabilities.
  I am also pleased that the legislation will permanently allow the VA 
to provide sexual trauma counseling to those men and women who have 
experienced such trauma. The VA should continue to be available to 
veterans who need help picking up the pieces after these tragic events.
  This measure also includes a requirement for VA to develop a pilot to 
examine the effectiveness of interactive and online recruiting 
techniques. This pilot program is just one step to update VA's 
recruitment tools to what are now commonplace recruitment practices in 
the private sector.
  I support this legislation, and I urge my colleagues to do the same.
  Mr. SMITH of New Jersey. Mr. Speaker, for the benefit of my 
colleagues, I include at this point in the Record a joint explanatory 
statement describing the compromise agreement we have reached with the 
other body.

        EXPLANATORY STATEMENT ON SENATE AMENDMENTS TO H.R. 3936

       H.R. 3936, as amended, the Veterans Health Programs 
     Improvement Act of 2004, (Compromise Agreement) reflects a 
     negotiated agreement reached by the House and Senate 
     Committees on Veterans' Affairs (the Committees) concerning 
     provisions in a number of bills considered by the House and 
     the Senate during the 2nd Session of the 108th Congress. The 
     measures considered in this compromise are: H.R. 1318, passed 
     the House on September 13, 2004; H.R. 2786, as introduced in 
     the House on July 17, 2003, H.R. 4231, as amended, passed the 
     House on September 30, 2004; H.R. 4248, as amended, passed 
     the House on October 7, 2004; H.R. 4317, passed the House on 
     June 1, 2004; H.R. 4608, passed the House on July 21, 2004; 
     H.R. 4658, as amended, passed the House on October 7, 2004; 
     H.R. 4768, as amended, passed the House on September 29, 
     2004; H.R. 4836, passed the House on September 13, 2004 
     (House Bills); and S. 2485, as amended, reported by the 
     Senate Committee on Veterans' Affairs on September 27, 2004; 
     and S. 2596, as introduced in the Senate on June 24, 2004 
     (Senate Bills).
       The House and Senate Committees on Veterans' Affairs have 
     prepared the following explanation of the Compromise 
     Agreement. Differences between the provisions of the 
     Compromise Agreement and the related provisions of the House 
     and Senate bills are noted, except for clerical corrections, 
     conforming changes made necessary by the Compromise 
     Agreement, and minor drafting, technical, and clarifying 
     changes.

                TITLE I--ASSISTANCE TO HOMELESS VETERANS


               sec. 101--authorization of appropriations

     Current law
       Section 2013 of title 38, United States Code, authorizes 
     appropriations of $60 million for fiscal year 2002, and $75 
     million per year for fiscal years 2003 through 2005, for a 
     program to make grants to providers of comprehensive services 
     for homeless veterans.
     House bill
       Section 2 of H.R. 4248 would increase the annual authorized 
     appropriation for this program to $99 million for fiscal year 
     2005.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 203 of the Compromise Agreement follows the House 
     language.

               TITLE II--VETERANS LONG-TERM CARE PROGRAMS


   sec. 201--assistance for hiring and retention of nurses at state 
                             veterans homes

     Current law
       Subchapter V, chapter 17 of title 38, United States Code, 
     authorizes VA to make payments to States for the care of 
     veterans in a State veterans' home.
     House bill
       Section 5 of H.R. 4231 would amend subchapter V, chapter 17 
     of title 38, United States Code, to add a new section 1744 to 
     authorize the Secretary to make payments to States for the 
     purpose of assisting State veterans' homes in the hiring and 
     retention of registered nurses through the use of an approved 
     incentive program.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 201 of the Compromise Agreement follows the House 
     language.


sec. 202--treatment of department of veterans affairs per diem payments 
                      to state homes for veterans

     Current law
       Section 1741 of title 38, United States Code, establishes 
     criteria for VA payments to States for the care of veterans 
     in a State veterans' home.
     House bill
       The House Bills contain no comparable provision.
     Senate bill
       Section 203 of S. 2485 would amend section 1741 of title 
     38, United States Code, to add a new subsection (e) to 
     clarify that per diem payments made by VA to States for the 
     care of veterans in a State veterans' home would not be used 
     to offset or reduce other third party payments made to assist 
     veterans.
     Compromise agreement
       Section 202 of the Compromise Agreement follows the Senate 
     language.


 sec. 203--extension of authority to provide care under long-term care 
                             pilot programs

     Current law
       Section 102 of Public Law 106-117, The Veterans Millennium 
     Health Care and Benefits Act, directed VA to carry out three 
     pilot programs over a three-year period to determine the 
     feasibility and practicability of different models for 
     providing long-term care. The authority for the pilot program 
     expires December 31, 204.
     House bill
       Section 107 of H.R. 4768 would extend VA's authority to 
     provide health care services under the long-term care pilot 
     programs authorized in Public Law 106-117 through December 
     31, 2005.
     Senate bill
       Section 206 of S. 2485 contains a similar provision.
     Compromise agreement
       Section 203 of the Compromise Agreement contains this 
     provision.


   sec. 204--prohibition on collection of copayments for hospice care

     Current law
       Section 1710B(c) of title 38, United States Code, requires 
     certain veterans to pay a copayment for extended care 
     services furnished under that section.
     House bill
       The House Bills contain no comparable provision.
     Senate bill
       Section 201 of S. 2485 would exempt veterans receiving 
     hospice care under Section 1710B from copayment obligations.
     Compromise agreement
       Section 204 of the Compromise Agreement follows the Senate 
     language.

                        TITLE III--MEDICAL CARE


               sec. 301--sexual trauma counseling program

     Current law
       Section 1720(D)(a) of title 38, United States Code, 
     authorizes VA to provide counseling services to veterans who 
     may have experienced sexual trauma while serving on active 
     duty through December 31, 2004.
     House bill
       Section 3 of H.R. 4248 would make this authority permanent.
     Senate bill
       Section 202 of S. 2485 would make this authority permanent 
     and broaden the authority to include the treatment of former 
     Reservists who may have experienced sexual trauma while not 
     serving on active duty.
     Compromise agreement
       Section 301 of the Compromise Agreement follows the House 
     language with a modification. The modification broadens the 
     authority to provide counseling services to individuals who 
     may have experienced sexual trauma while on active duty for 
     training.


 SEC. 302--CENTERS FOR RESEARCH, EDUCATION, AND CLINICAL ACTIVITIES ON 
          COMPLEX MULTI-TRAUMA ASSOCIATED WITH COMBAT INJURIES

     Current law
       There is no comparable provision in current law.

[[Page 23764]]


     House bill
       The House Bills contain no comparable provision.
     Senate bill
       Section 205 of S. 2485 would establish, in collaboration 
     with the Department of Defense, at least one, but not more 
     than three, VA ``War-Related Blast Injury Centers'', and 
     establish procedures for the Secretary's designation of such 
     centers. These centers would provide comprehensive 
     rehabilitation programs, targeted education and outreach 
     programs, and research initiatives for veterans injured by 
     explosive blasts in combat theaters.
     Compromise agreement
       Section 203 of the Compromise Agreement authorizes, and 
     authorized the appropriations to support, the Secretary to 
     establish an appropriate number of centers for research, 
     education, and clinical activities to improve and coordinate 
     rehabilitative services for veterans suffering from complex 
     multi-trauma from combat injuries. The Compromise Agreement 
     consolidates a number of current VA clinical, research and 
     other practices for traumatic brain injuries, blind 
     rehabilitation and VA's concepts for combat-injury 
     rehabilitation. The Compromise Agreement requires this 
     authority be coordinated between the Departments of Veterans 
     Affairs and Defense under section 8111 of title 38, United 
     States Code.


SEC. 303--ENHANCEMENT OF MEDICAL PREPAREDNESS OF DEPARTMENT OF VETERANS 
                                AFFAIRS

     Current law
       Section 7325 of title 38, United States Code, requires the 
     Secretary to establish four Medical Emergency Preparedness 
     Research Centers.
     House bill
       Section 202 of H.R. 4768 would amend chapter 73, of title 
     38, United States Code to add a new section 7327, to direct 
     the Secretary to take a series of actions by dates certain to 
     establish four Medical Emergency Preparedness Research 
     Centers.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 303 of the Compromise Agreement follows section 
     202(a) through (c) of the House language.

TITLE IV--MEDICAL FACILITIES MANAGEMENT AND ADMINISTRATION SUBTITLE A--
                     MAJOR MEDICAL FACILITY LEASES


                SEC. 401--MAJOR MEDICAL FACILITY LEASES

     Current law
       Section 8104(a)(2) of title 38, United States Code, 
     prohibits VA from obligating or expending more than $600,000 
     per year for a lease unless that lease has been specifically 
     authorized by law.
     House bill
       Section 101(a) of H.R. 4768 would authorize major medical 
     facility leases in the following locations: (1) Wilmington, 
     North Carolina, Outpatient Clinic, $1,320,000; (2) 
     Greenville, North Carolina, Outpatient Clinic, $1,220,000; 
     (3) Norfolk, Virginia, Outpatient Clinic, $1,250,000; (4) 
     Summerfield, Florida, Marion County Outpatient, Clinic, 
     $1,230,000; (5) Knoxville, Tennessee, Outpatient Clinic, 
     $850,000; (6) Toledo, Ohio, Outpatient, Clinic, $1,200,000; 
     (7) Crown Point, Indiana, Outpatient Clinic, $850,000; (8) 
     Forth Worth, Texas, Tarrant County Outpatient Clinic, 
     $3,900,000; (9) Plano, Texas, Collin County Outpatient 
     Clinic, $3,300,000; (10) San Antonio, Texas, Northeast 
     Central Bexar County Outpatient Clinic, $1,400,000; (11) 
     Corpus Christi, Texas, Outpatient Clinic, $1,200,000; (12) 
     Harlingen, Texas, Outpatient Clinic, $650,000; (13) Denver, 
     Colorado, Health Administration Center, $1,950,000; (14) 
     Oakland, California, Outpatient Clinic, $1,700,000; (15) San 
     Diego, California, North County Outpatient Clinic, 
     $1,300,000; and (16) San Diego, California, South County 
     Outpatient Clinic, $1,100,000.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 401 of the Compromise Agreement follows the House 
     language.


               SEC. 402--AUTHORIZATION OF APPROPRIATIONS

     Current law
       Section 8104(a)(2) of title 38, United States Code, 
     prohibits funds from being appropriated for a VA major 
     medical facility lease, unless that appropriation has been 
     specifically authorized by law.
     House bill
       Section 101(b) of H.R. 4768 would authorize $24,420,000 to 
     carry out major medical facility leases specified location in 
     the bill.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 402 of the Compromise Agreement follows the House 
     language.


SEC. 403--AUTHORITY FOR LONG-TERM LEASE OF CERTAIN LANDS OF UNIVERSITY 
                              OF COLORADO

     Current law
       Section 490(h) of title 40, United States Code, limits 
     lease agreements between the Federal Government and any 
     person, co-partnership, corporation, or other public or 
     private entity to periods not exceeding twenty years.
     House bill
       Section 101(c) of H.R. 4768 would authorize VA to enter 
     into a long-term lease of up to 75 years for land to 
     construct a new VA medical facility at the Fitzsimons Campus 
     of the University of Colorado, Aurora, Colorado.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 403 of the Compromise Agreement follows the House 
     language. The authority provided in this section is 
     permissive and intended by the Committees to foster good-
     faith negotiations between the partners to this lease 
     agreement. In the event that the Secretary of Veterans 
     Affairs determines the terms or conditions of the lease not 
     to be in the best interest of the United States, the 
     Secretary should propose an alternative strategy to Congress. 
     The Committees not that the Administrator of General Services 
     has delegated to the Secretary of Veterans Affairs the 
     authority to enter into lease agreements for VA major medical 
     facility leases.

                   SUBTITLE B--FACILITIES MANAGEMENT


      sec. 411--department of veterans affairs capital asset fund

     Current law
       Section 8122 of title 38, United States Code, authorizes 
     the Secretary to dispose of real property administered by VA 
     and retain the proceeds from such a disposal, but only if the 
     property is considered excess to any need, there is no use 
     for the property in providing services to homeless veterans, 
     and the property is valued at less than $50,000. In cases 
     where a property carries value in excess of $50,000, any 
     disposal must be proposed in the President's budget. In the 
     event such property is so disposed of, proceeds are deposited 
     into the Nursing Home Revolving Fund for construction, 
     acquisition, or alteration of VA nursing homes.
     House bill
       Section 102 of H.R. 4768 would amend chapter 81 of title 
     38, United States Code, to add a new section 8118 to provide 
     the Secretary authority to transfer by sale, exchange or 
     lease unneeded real properties. It would establish a 
     Department of Veterans Affairs Capital Asset Fund to finance 
     these transfers, as well as to construct new and improved VA 
     health care facilities. The Fund could also be used for 
     demolition, environmental restoration, maintenance, repair, 
     historic preservation, and administrative expenses. Section 
     102 would establish fair market value as the basis for 
     property transfers. It would require the Secretary to include 
     in each budget submission to Congress a report of the uses of 
     the Capital Asset Fund and descriptive information on each 
     transfer completed, pending, and planned. The section would 
     also repeal the Nursing Home Revolving Fund in section 8116 
     of title 38, United States Code, and transfer remaining 
     balances from that fund to the new Fund. The authority of 
     Section 102 would be contingent upon the Secretary's 
     certifying to Congress that VA facilities maintain long-term 
     care capacity as required by section 1710B(b) of title 38, 
     United States Code.
     Senate bill
       Section 101 of S. 2485 contains a similar proposal.
     Compromise agreement
       Section 411 of the Compromise Agreement follows the House 
     language with modification. The Compromise Agreement modified 
     the contingency authority to pertain to repeal of the Nursing 
     Home Revolving Fund and its remainder deposits. All other 
     authority of section 411 is effective on enactment.


   Sec. 412--annual report to congress on inventory of department of 
                   veterans affairs historic property

     Current law
       No similar provision exists under current law.
     House bill
       Section 103 of H.R. 4768 would require VA to establish a 
     national inventory of historic VA properties and would 
     require two subsequent annual reports to Congress on the 
     status and plans associated with any VA property listed on 
     the National Register of Historic Places.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 412 of the Compromise Agreement follows the House 
     language.


 sec. 413--authority to acquire and transfer real property for use for 
                           homeless veterans

     Current law
       Section 8103 of title 38, United States Code, authorizes 
     the Secretary to acquire such land or interest in land as 
     necessary for the purpose of providing medical services.

[[Page 23765]]


     House bill
       The House Bills contain no comparable provision.
       Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 413 of the Compromise Agreement authorizes the 
     Secretary to acquire property in the District of Columbia 
     that the Secretary determines is suitable for providing 
     services to homeless veterans, if the Secretary identifies a 
     provider of homeless services that is prepared to acquire the 
     property from the Secretary. The Compromise Agreement 
     requires the Secretary, having so identified a provider, to 
     promptly transfer the acquired property to that provider of 
     homeless services. The Compromise Agreement provides a 
     reverter power to the Secretary if the provider of homeless 
     services discontinues providing services to homeless 
     veterans.


sec. 414--limitation on implementation of mission changes for specified 
               veterans health administration facilities

     Current law
       Section 401 of Public Law 108-170, the ``Veterans Health 
     Care, Capital Asset, and Business Improvement Act of 2003'', 
     requires VA to notify Congress of facility closings proposed 
     under the Capital Asset Realignment for Enhanced Services 
     initiative, and prohibits such closings until the lapse of 60 
     days following the notification or 30 days of continuous 
     session of Congress, whichever is longer.
     House bill
       The House Bills contained no comparable provision.
     Senate bill
       Section 104 of S. 2485 would prohibit the Secretary from 
     implementing a mission change for a medical facility (other 
     than a mission change prescribed by the Secretary in the 
     Capital Asset Realignment for Enhanced Services (CARES) 
     initiative) until 90 days after the date on which the 
     Secretary submits to the Committees written notice of the 
     mission change.
     Compromise agreement
       Section 414 of the Compromise Agreement prohibits the 
     Secretary from implementing a mission change until the lapse 
     of 60 days following the notification or 30 days of 
     continuous session of Congress, whichever is longer, at VA 
     Medical Centers in the following locations: Boston, 
     Massachusetts; New York City, New York; Big Springs, Texas; 
     Dublin, Georgia; Montgomery, Alabama; Louisville, Kentucky; 
     Muskogee (and the outpatient clinic in Tulsa), Oklahoma; 
     Poplar Bluff, Missouri; Ft. Wayne, Indiana; Waco, Texas; and 
     Walla Walla, Washington.


   SEC. 415--AUTHORITY TO USE PROJECT FUNDS TO CONSTRUCT OR RELOCATE 
     SURFACE PARKING INCIDENTAL TO A CONSTRUCTION OR NONRECURRING 
                          MAINTENANCE PROJECT

     Current law
       Section 8109 of title 38, United States Code, limits the 
     funding of construction, alteration or acquisition of VA 
     parking facilities to the collections made from parking fees 
     at VA facilities and deposited into the Parking Revolving 
     Fund.
     House bill
       Section 104 of H.R. 4768 would authorize the use of funds 
     in a construction or capital account for the relocation of a 
     surface parking facility if the relocation is necessitated by 
     a construction or non-recurring maintenance project.
     Senate bill
       Section 103 of S. 2485 would authorize the use of funds in 
     a construction or capital account for the relocation of a 
     surface parking facility if the relocation is necessitated by 
     a construction or non-recurring maintenance project.
     Compromise agreement
       Section 415 of the Compromise Agreement contains this 
     provision.


  SEC. 416--INAPPLICABILITY OF LIMITATION ON USE OF ADVANCE PLANNING 
          FUNDS TO AUTHORIZED MAJOR MEDICAL FACILITY PROJECTS

     Current law
       Section 8104 of title 38, United States Code, limits the 
     amount VA may obligate for the design and development of a 
     major construction proposal to $500,000, unless VA notifies 
     Congress and waits for a period of 30 days.
     House bill
       Section 105 of H.R. 4768 would provide more flexibility to 
     VA by eliminating the ``notice and wait'' provision if the 
     project VA is planning has already been authorized by law.
     Senate bill
       Section 106 of S. 2485 contains a similar provision.
     Compromise agreement
       Section 416 of the Compromise Agreement contains this 
     provision.


         SEC. 417--IMPROVEMENTS TO ENHANCE-USE LEASE AUTHORITY

     Current law
       Section 8162 of title 38, United States Code, authorizes VA 
     to lease real property within its jurisdiction to non-Federal 
     entities provided the lease contributes to the mission of VA 
     and enhance the use of the property. The enhanced-use lease 
     authority in this section restricts the projects the 
     Secretary may consider to those plans set forth by the Under 
     Secretary for Health. Section 8166, of title 38, United 
     States Code, provides the Secretary permissive authority to 
     disregard State and local laws relating to building codes, 
     permits or inspections that would regulate or restrict 
     construction, alteration, repair, remodeling or improvement 
     of VA property associated with an enhanced-use lease.
     House bill
       Section 106 of H.R. 4768 would add to existing exemptions 
     from State and local laws for enhanced-use leases, any land-
     use laws and ordinances.
     Senate bill
       Section 102 of S. 2485 would extend the enhanced-use lease 
     authority to the Veterans Benefits Administration and the 
     National Cemetery Administration.
     Compromise agreement
       Section 417 of the Compromise Agreement follows the House 
     language.


 SEC. 418--FIRST OPTION FOR COMMONWEALTH OF KENTUCKY ON DEPARTMENT OF 
         VETERANS AFFAIRS MEDICAL CENTER, LOUISVILLE, KENTUCKY

     Current law
       Section 8122 of title 38, United States Code, requires VA 
     to transfer real property for fair market value and describe 
     the transfer in its annual budget to Congress. This section 
     includes an exception for the transfer of VA property to a 
     State for use as the site of a State nursing home or 
     domiciliary.
     House bill
       The House Bills contain no comparable provision.
     Senate bill
       Section 131 of S. 2485 would require VA for one year, if it 
     determines that it will convey, lease, or otherwise dispose 
     of all or part of the VA Medical Center in Louisville, 
     Kentucky, to negotiate for the conveyance, lease, or other 
     disposal of the property to the Commonwealth of Kentucky to 
     provide services for veterans or for other purposes. The bill 
     would require the Commonwealth to pay fair market value for 
     the property if VA transfers such property to the 
     Commonwealth.
     Compromise agreement
       Section 418 of the Compromise Agreement follows the Senate 
     language, with a modification to include use of the property 
     as a State veterans' home.


  SEC. 419--TRANSFER OF JURISDICTION, GENERAL SERVICES ADMINISTRATION 
                         PROPERTY, BOISE, IDAHO

     Current law
       No similar provision exists under current law.
     House bill
       The House Bills contain no comparable provision.
     Senate bill
       Section 111 of S. 2485 would direct the Administrator of 
     General Services to transfer to the Secretary of Veterans 
     Affairs certain property in Boise, Idaho, for the purpose of 
     use in providing veterans benefits services.
     Compromise agreement
       Section 419 of the Compromise Agreement follows the Senate 
     language.

                 SUBTITLE C--DESIGNATION OF FACILITIES


SEC. 421--THOMAS E. CREEK DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER

     Current law
       Section 531 of title 38, United States Code, prohibits the 
     naming of VA facilities other than for the geographic area in 
     which they are located, unless expressly provided by law.
     House bill
       H.R. 4836 would designate the Department of Veterans 
     Affairs Medical Center in Amarillo, Texas as the ``Thomas E. 
     Creek Department of Veterans Affairs Medical Center''.
     Senate bill
       The Senate Bills contain no comparable provision
     Compromise agreement.
       Section 421 of the Compromise Agreement follows the House 
     language.


SEC. 422--JAMES J. PETERS DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER

     Current law
       Section 531 of title 38, United States Code, prohibits the 
     naming of VA facilities other than for the geographic area in 
     which they are located, unless expressly provided by law.
     House bill
       H.R. 2786 would designate the Department of Veterans 
     Affairs Medical Center in the Bronx, New York as the ``James 
     J. Peters Department of Veterans Affairs Medical Center''.
     Senate bill
       Section 121 of S. 2485 contains a similar provision.
     Compromise agreement
       Section 422 of the Compromise Agreement contains this 
     provision.

[[Page 23766]]




 SEC. 423--BOB MICHEL DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC

     Current law
       Section 531 of title 38, United States Code, prohibits the 
     naming of VA facilities other than for the geographic area in 
     which they are located, unless expressly provided by law.
     House bill
       H.R. 4608 would designate the Department of Veterans 
     Affairs outpatient clinic in Peoria, Illinois as the ``Bob 
     Michel Department of Veterans Affairs Outpatient Clinic''.
     Senate bill
       S. 2596 contains a similar provision.
     Compromise agreement
       Section 423 of the Compromise Agreement contains this 
     provision.


  SEC. 424--CHARLES WILSON DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT 
                                 CLINIC

     Current law
       Section 531 of title 38, United States Code, prohibits the 
     naming of VA facilities other than for the geographic area in 
     which they are located, unless expressly provided by law.
     House bill
       H.R. 4317 would designate the Department of Veterans 
     Affairs outpatient clinic in Lufkin, Texas as the ``Charles 
     Wilson Department of Veterans Affairs Outpatient Clinic''.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 424 of the Compromise Agreement follows the House 
     language.


    SEC. 425--THOMAS P. NOONAN, JR. DEPARTMENT OF VETERANS AFFAIRS 
                           OUTPATIENT CLINIC

     Current law
       Section 531 of title 38, United States Code, prohibits the 
     naming of VA facilities other than for the geographic area in 
     which they are located, unless expressly provided by law.
     House bill
       H.R. 1318 would designate the Department of Veterans 
     Affairs outpatient clinic in Sunnyside, Queens, New York as 
     the ``Thomas P. Noonan, Jr. Department of Veterans Affairs 
     Outpatient Clinic''.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise bill
       Section 425 of the Compromise Agreement follows the House 
     language.

                   TITLE V--PERSONNEL ADMINISTRATION


   SEC. 501--PILOT PROGRAM TO STUDY INNOVATIVE RECRUITMENT TOOLS TO 
ADDRESS NURSING SHORTAGES AT DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE 
                               FACILITIES

     Current law
       No similar provision exists under current law.
     House bill
       Section 2 of H.R. 4231 would establish a pilot program 
     within VA to study the use of outside recruitment, 
     advertising and communications agencies and the use of 
     interactive and online technologies to improve VA's program 
     for recruiting nursing personnel.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 501 of the Compromise Agreement follows the House 
     language.


 SEC. 502--TECHNICAL CORRECTION TO LISTING OF CERTAIN HYBRID POSITIONS 
                   IN VETERANS HEALTH ADMINISTRATION

     Current law
       Section 7401 of title 38, United States Code, authorizes VA 
     to appoint in a hybrid manner under title 5, United States 
     Code and title 38, United States Code, certain scientific and 
     professional medical care personnel.
     House bill
       Section 4 of H.R. 4231 would make technical corrections to 
     the description of certain occupations included in section 
     7401 treatable as hybrid appointments, and add blind 
     rehabilitation specialists and blind rehabilitation 
     outpatient specialists to these hybrid appointment 
     categories.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 502 of the Compromise Agreement follows the House 
     language.


                  SEC. 503--UNDER SECRETARY FOR HEALTH

     Current law
       Section 305(A)(2) of title 38, United States Code, requires 
     that the Under Secretary for Health be a ``doctor of 
     medicine.''
     House bill
       Section 7 of H.R. 4231 would repeal the requirement that 
     VA's Under Secretary for Health be a medical doctor.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 503 of the Compromise Agreement follows the House 
     language.

                        TITLE VI--OTHER MATTERS


 SEC. 601--EXTENSION AND CODIFICATION OF AUTHORITY FOR RECOVERY AUDITS

     Current law
       Section 116 of Public Law 108-199, ``Consolidated 
     Appropriations Act, 2004'', requires the Secretary to conduct 
     a program of recovery audits to recoup overpayments for fee 
     basis and other medical services contracts for the care of 
     veterans.
     House bill
       The House Bills contain no comparable provision.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 601 of the Compromise Agreement requires the 
     Secretary of Veterans Affairs to contract to conduct a 
     program of recovery audits for fee basis and other contract 
     care of veterans. The requirement expires on September 30, 
     2008.
       The Committees are encouraged by the Department's increased 
     third party collection in 2003, as a result of more 
     aggressive efforts to improve VA business practices. The 
     Committees expect the Department to assist third party health 
     insurers to process disputed VA claims by using an automated 
     system to download information in standardized formats and to 
     ensure compliance with rules governing dispute resolution 
     through the appeals process.


     SEC. 602--INVENTORY OF MEDICAL WASTE MANAGEMENT ACTIVITIES AT 
         DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE FACILITIES

     Current law
       No similar provision exists under current law.
     House bill
       Section 401 of H.R. 4658 would require the Secretary to 
     establish and maintain an inventory of medical waste 
     management activities in VA medical facilities and submit a 
     report on such activities by April 15, 2005. The VA would be 
     required to report on plans to modernize or improve the 
     management of medical waste and evaluate the most desirable 
     methods of disposal from an environmental perspective.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 602 of the Compromise Agreement follows the House 
     language with a modification to change the report date to 
     June 30, 2005.


SEC. 603--INCLUSION OF ALL ENROLLED VETERANS AMONG PERSONS ELIGIBLE TO 
           USE CANTEENS OPERATED BY VETERANS' CANTEEN SERVICE

     Current law
       Section 7803 of title 38, United States Code, defines those 
     persons eligible to use the Veterans' Canteen Service.
     House bill
       Section 201 of H.R 4768 would expand the definition of 
     persons eligible to use the Veterans' Canteen Service to 
     include all individuals enrolled in VA health care under 
     section 1705 of title 38, United States Code, or employed at 
     VA facilities, as well as families and relatives of veteran 
     patients.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 603 of the Compromise Agreement follows the House 
     language.


    SEC. 604--ANNUAL REPORTS ON WAITING TIMES FOR APPOINTMENTS FOR 
                             SPECIALTY CARE

     Current law
       No similar provision exists under current law.
     House bill
       The House Bills contain no comparable provision.
     Senate bill
       Section 207 of S. 2485 would require VA to report annually 
     on patient appointment waiting times, including specialty and 
     primary care services, and separate the data by facility and 
     network.
     Compromise agreement
       Section 604 of the Compromise Agreement requires the 
     Secretary to report, not later than January 31 of each year 
     through 2007, on veterans waiting more than 3 months for 
     scheduled appointments in specialty care clinics and on any 
     reasons for such delays. Further, the Compromise Agreement 
     requires the Comptroller General to certify the accuracy of 
     the report submitted under this section.


                   SEC. 605--TECHNICAL CLARIFICATION

     Current law
       Section 8111 of title 38, United States Code, requires the 
     Secretary and the Secretary of Defense to enter into 
     agreements and contracts for the mutually beneficial sharing 
     of

[[Page 23767]]

     health care resources and establishes a fund, known as the 
     ``DOD-VA Health Care Sharing Incentive Fund'' to provide 
     incentives to enter into such sharing initiatives.
     House bill
       Section 6 of H.R. 4231 would make the established DOD-VA 
     Health Care Sharing Incentive Fund available for any purpose 
     authorized by section 8111.
     Senate bill
       The Senate Bills contain no comparable provision.
     Compromise agreement
       Section 605 of the Compromise Agreement follows the House 
     language.

  Mr. SMITH of New Jersey. Mr. Speaker, I yield 3 minutes to the 
gentleman from Florida (Mr. Stearns), the author of the law, the 
Millennium Health Care Act, which has made a tremendous difference on 
behalf of our seniors who are veterans who need long-term health care.
  Mr. STEARNS. Mr. Speaker, I thank the distinguished chairman of the 
Committee on Veterans' Affairs, and also I want to thank the gentleman 
from Connecticut who chairs the Subcommittee on Health for what an 
outstanding job he has done, having served as the chairman of that 
committee with the very, very good staff that he has. I think it is a 
credit to him what we are accomplishing.
  I think all of my colleagues know that Florida has one of the largest 
growing populations of veterans. So many of us in Florida have to be 
particularly sensitive. We need new facilities down there. That is why 
I am very supportive of H.R. 3936, the Veterans Health Programs 
Improvement Act. I especially appreciate that it incorporates 
provisions of H.R. 4768, the Facilities Management Act of 2004, of 
which I was an original cosponsor. I thank the chairman for including 
that in H.R. 3936. This will authorize projects which the CARES 
(Capital Asset Realignment for Enhanced Services) Commission 
recommended to the Secretary of Veterans Affairs. He based his 
recommendations last May upon that, and that is included in this bill.
  Mr. Speaker, under CARES, the VA reviewed all of its facilities 
systematically to consider where resources might be reallocated for 
optimal service to veterans. I think the veterans should realize that 
this was a systematic study. As more veterans have relocated to the 
Southeast over the years, it appears the VA has insufficient clinic 
room in the Southeast, particularly in my State of Florida. 
Accordingly, the majority of the leases which this legislation would 
authorize are facilities to be located in the South. The aim has been 
to match the assets with the veterans, and this bill does just that. 
Florida, as we know, has the second largest veterans population and the 
number one oldest.
  Obviously, I am pleased to see a lease for a regional health care 
facility in South Marion County, my home county, Summerfield, Florida. 
The plans are for this clinic to offer comprehensive services to 
veterans, including audiology, which is very important; ophthalmology; 
dermatology, particularly in Florida; minor surgery; and complete 
imaging services. It is going to be housed in a 75,000-square-foot 
building and provide more services and greater resources for the 
veterans than the existing VA outpatient clinics that we have 
throughout my congressional district. Even better, while this clinic is 
predicted to be opened in the summer of 2007, appropriations willing, 
the generous, resourceful people of north central Florida have indeed 
offered the VA the use of free space for an interim clinic, so that 
should expedite it. So our ever-increasing veterans population can see 
immediate relief for their long health-care waits in the winter when 
they come down will be decreased, and this more comprehensive specialty 
clinic which the act authorizes will be built and in the long run will 
help everybody. I am very enthusiastically supporting this bill.
  I want to thank both the Democrats and Republicans on the Committee 
on Veterans' Affairs and particularly the gentleman from Connecticut 
(Mr. Simmons) and the gentleman from New Jersey (Mr. Smith) for their 
support.
  Mr. RODRIGUEZ. Mr. Speaker, I yield 4\1/2\ minutes to the gentleman 
from California (Mr. Filner), a member of the Committee on Veterans' 
Affairs and an activist in pushing forward on issues regarding 
veterans.
  Mr. FILNER. Mr. Speaker, as a member of the VA Subcommittee on 
Health, I also rise in support of H.R. 3936 which includes, as we have 
heard, a lot of provisions to enhance services to our Nation's 
veterans. We have thanked the gentleman from New Jersey (Mr. Smith), 
the gentleman from Illinois (Mr. Evans) and the gentleman from 
Connecticut (Mr. Simmons).
  I would particularly like to just thank the gentleman from Texas (Mr. 
Rodriguez), the ranking member, for his service. I always say, when I 
get to the committee meetings, ``Ciro, you're my hero.'' The gentleman 
from Texas, for the 8 years he has been here, has fought steadfastly 
for his veterans not only in San Antonio but in the United States as a 
whole. He has done a tremendous amount for health care for our veterans 
in this Nation, and we thank him for his service. We are going to miss 
him.
  One of the important provisions of this bill is to set up a pilot 
program to study new and innovative ways to improve the recruitment and 
retention of nurses at the VA. We all know about the shortage of nurses 
in our Nation, and we cannot rely on the old methods of recruitment. 
The use of online technology, for example, can be a valuable tool in 
finding nurses who are interested in serving the country through their 
work at a VA medical facility.
  Likewise, we have to find ways to keep the nurses that we recruit. A 
second bill that is before us after this has a provision in fact for 
alternative work schedules for nurses. Allowing nurses to work these 
flexible hours to accommodate personal and family needs is a sure way 
to improve their lives and to encourage them to continue working at the 
VA center. In addition, this bill provides payments to States to assist 
State veterans homes in their hiring and retention of nurses.
  I think we all know that funding for grants is vital for homeless 
veterans. That program will be authorized in this bill at a level of 
$99 million, an increase of $24 million. Although we all know that even 
more funding is needed to assist the homeless veterans of our Nation, 
this authorization is a welcome increase. Homelessness among veterans 
is a national disgrace. I know we are all firmly behind the gentleman 
from New Jersey's goal of eliminating chronic homelessness within the 
veterans population in 10 years. This bill will help us reach that 
goal.
  The bill also gives permanent authority to the VA Secretary to 
continue the military sexual trauma counseling program that was 
established in 1992. As we have heard, this program provides counseling 
and treatment for the men and women who have experienced sexual trauma 
or harassment while in the military service. Again, the gentleman from 
Texas was a major supporter of this program, and we thank him for his 
leadership once again.
  Funding to open several new outpatient clinics is included in this 
bill, including two in San Diego County, a portion of which I 
represent. The VA's move to open clinics near veterans' homes has been 
overwhelmingly successful.
  I will also continue work for a full outpatient health clinic in 
Imperial County, which is also in my congressional district.
  I should add that, as we look at the ways we fund outpatient clinics, 
the formulas used involve only population. We ought to also, I think, 
include ``isolation'' of a county or an area because that is also 
important, not just the numbers.
  These are a few of the provisions in H.R. 3936. Health care of our 
veterans has to be a priority all the time but especially at this time 
when we have so many active duty soldiers fighting for this Nation. 
Whether they are from World War II or from the present conflicts in 
Afghanistan and Iraq, they are looking to us to meet their needs. 
Morale in active duty depends on how we are going to treat our soldiers 
when they come home, so I hope everyone supports H.R. 3936.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield 3\1/2\ minutes to the 
gentleman from Indiana (Mr. Souder).

[[Page 23768]]


  Mr. SOUDER. Mr. Speaker, I first want to thank the gentleman from New 
Jersey (Mr. Smith) for his leadership and advocacy on behalf of 
veterans. No one has worked harder for veterans than he has. I 
appreciate his commitment not only on this bill but across the board in 
working to improve veterans health care and the benefits for veterans 
in the United States. I also want to specifically thank John Bradley on 
the gentleman from New Jersey's committee staff for his willingness to 
work with my staff on matters of concern to veterans in my district.
  The bill before us contains many important provisions related to 
veterans health care and facilities management. Particularly, section 
414 is of specific interest to veterans in my district, and I 
appreciate the inclusion of this language to force additional reporting 
to Congress as far as informing us of changes or closure of veterans 
hospitals.
  In May of this year, Secretary Principi issued his decision on the 
CARES Commission recommendations for veterans health care. Among the 
slated changes was a mission change for the Fort Wayne veterans 
hospital located in my district. The decision called for closure of the 
hospital's inpatient beds and a transfer of those patients to either a 
community hospital in the local area or the Indianapolis veterans 
hospital. Fort Wayne is the largest veterans hospital and city in the 
United States affected by this bill. It is the second largest city in 
Indiana. The northern Indiana hospital covers an area larger than 2 
million people who live 2 to 4 hours from Indianapolis and have no 
desire to go to Indianapolis, especially for continuing outpatient 
care; or for some inpatient care; or far away from their doctors where 
they have to get motels, where their spouses have to come, far away 
from their families, where their children will not visit them. They 
have no interest in this process.
  Fort Wayne is one of the top military recruiting areas in the United 
States. In addition, our Guard and Reserve units are regularly serving 
on the front lines. Currently, I have a Reserve unit of over 200 men 
and women in Afghanistan for a year. I just had an Air Guard unit 
return to Fort Wayne from the Middle East. I have another large Reserve 
unit that just returned from a year down in Guantanamo. This spring, I 
had an Army Guard unit of 700 return from 14 months in Iraq. None of 
this was considered in the CARES Commission report.
  In Congress, we are asked to repeatedly support, which I support as 
well, actions in Afghanistan, actions in Iraq and other parts of the 
world. But we cannot ask men and women in our Guard and Reserve to 
repeatedly be called up and then not have health care in the districts 
that they live in.

                              {time}  1515

  The CARES Commission assumed retirement communities, and where the 
military bases were, were where the future demand was going to be. But 
if we are going to use the Guard and Reserve in the way we are using 
them, we are going to provide them health care because if they are on 
the frontline in combat, they are going to be treated like other 
military personnel. And if they get called up a second time and third 
time around, the health care system is going to be revolutionized in 
the United States, and these people do not retire in Florida. They do 
not live there. They do not go where the bases are. They live in the 
communities they work in, in the Guard and the Reserve. And we have to 
factor this in as we look at the health care system.
  Obviously, population shifts have occurred. Obviously, modernization 
is needed in our veterans hospitals. Obviously, outpatient services are 
the growing category in all kinds of health care, and we do not need 
more input. But what I fear when we look at the obvious trends that are 
occurring is, this is a back-door way to actually reduce benefits for 
many veterans and people in the Guard and Reserve in areas where they 
have been loyal patriotic Americans risking and dying, as many have in 
my district already in these wars, and they do not deserve to have 
their health care diminished dramatically.
  Mr. RODRIGUEZ. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
California (Ms. Waters).
  Ms. WATERS. Mr. Speaker, I would like to thank my colleagues on both 
sides of the aisle: The gentleman from New Jersey (Chairman Smith); the 
gentleman from Connecticut (Mr. Simmons), subcommittee chairman; the 
gentleman from Illinois (Mr. Evans), our ranking member; and the 
gentleman from Texas (Mr. Rodriguez), ranking member of the 
subcommittee. They have done a fabulous job in putting together this 
legislation.
  And this is a good day for veterans. It is a good day for veterans 
because, again, we are beginning to address some of the issues that we 
should have addressed a long time ago. Let me just say the gentleman 
from Texas (Mr. Rodriguez) has done a very wonderful job. I am very 
proud of the work he has done, and I really do commend him to the care 
and attention that he has given.
  And to the gentleman from Illinois (Mr. Evans), I served with the 
gentleman from Illinois (Mr. Evans) when I first came to the House, and 
I had the opportunity even to vote for him to be Chair. Sonny 
Montgomery has never forgiven me. But he is the best advocate the 
veterans have ever had, and I appreciate him each and every day.
  Mr. Speaker, this bill is important for a number of reasons. Someone 
mentioned earlier that homelessness among the veterans of this country 
is a disgrace, and it really is. I was at the U.S. Vets again on 
Veterans Day, and that program fed over 600 or 700 veterans off the 
street who were homeless. Some of them were fortunate enough to be in 
the program; others just off the street who were fed that day. But any 
place that one goes in America and particularly in our cities, when 
they go to the areas where the homeless congregate, whether they are in 
the downtowns or wherever they are, disproportionately those will be 
veterans. So this bill increases the overall authorization for the 
Grant and Per Diem Homeless Veterans Assistance Program from $75 
million to $99 million in funding year 2005, and I hope that each year 
it will continue to go up.
  It is a good bill. It has a lot of good things that are covered in 
the bill. And so I am pleased that I am here to support it, and I would 
ask my colleagues to do so.
  Mr. SMITH of New Jersey. Mr. Speaker, I reserve the balance of my 
time.
  Mr. RODRIGUEZ. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
California (Ms. Solis).
  Ms. SOLIS. Mr. Speaker, I would also like to rise in support of the 
Veterans Health Program Improvement Act and to the gentleman from Texas 
(Mr. Rodriguez), the distinguished manager of this particular 
legislation, who has been a strong advocate for many years on the 
health care of our veterans.
  I would also like to recognize the gentleman from Illinois (Mr. 
Evans), the ranking Democrat on this committee, also and thank him for 
allowing me the opportunity to speak.
  As a Member here, this is now going on my third term. But L.A. County 
in the area that I represent has one of the largest concentrations of 
veterans, a large number of Vietnam veterans, but in particular, many 
that are now serving in Iraq and Afghanistan.
  And I am very delighted to see that there has been an extension of 
the sexual trauma counseling program, and this has been made permanent, 
and I would like to commend those that worked on this in particular 
because this has been a subject for the Women's Caucus. We actually had 
an informal hearing here and brought forward individuals to talk to us 
about how we could remedy this problem. It is something we have to work 
on, and sexual assault in the military is something that we all know is 
unacceptable. The counseling program is one step towards helping 
victims access services that they deserve. And studies, as we know, 
have shown that three-fourths of the female veterans who are raped did 
not report the incident to a ranking officer. Many did not know how to, 
and some even thought that rape was somehow expected in the military. 
Since

[[Page 23769]]

August of 2002 until November 1 of this year, there has been an 
estimated 261 cases of sexual assault in Iraq, Kuwait, Afghanistan and 
Bahrain.
  We must enforce a zero-tolerance policy within the Armed Forces and 
protect all of our veterans, women and men, from having to cope with 
these injustices. And I urge the Congress to support this piece of 
vital legislation and also want to thank those who worked on this 
legislation to increase the health care services for our veterans.
  Mr. RODRIGUEZ. Mr. Speaker, I yield myself such time as I may 
consume.
  Let me say that this particular piece of legislation is extremely 
important. I know, as has been mentioned, the importance of the number 
of veterans that are still estimated to be homeless, some 299,000 
veterans out there that sleep under the bridges, and I know that our 
efforts in this area will help begin to continue to decrease the number 
of those homeless veterans that are out there.
  According to the VA, 45 percent of the homeless veterans also suffer 
from mental health disorders. We know the importance of coming forth on 
post-traumatic stress disorder and how critical that is. And I also 
want to just emphasize how key and how important it is for the sexual 
trauma situations where we have improved in increasing the number of 
women in the military, and as we do that, we need to make sure that we 
have a good safe place for a work environment where they can feel 
comfortable in addition to the services that are needed.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise as a strong supporter 
of H.R. 3936 the Veterans Health Programs Improvement Act of 2004 which 
would increase the authorization of appropriations for grants to 
benefit homeless veterans, would improve programs for management and 
administration of veterans' facilities and health care programs. I want 
to thank Chairman Smith and Ranking Member Evans for bringing this 
necessary piece of legislation before this entire body.
  Veterans are some of America's most valued members of society. These 
are people who served our Nation in a time of need, people who risked 
their lives to protect our own. Yet, it pains me to say that many of 
these same veterans who fought so bravely and risked so much in lands 
far abroad have come back to their nation and are now homeless. The 
problem of homeless veterans is far more prevalent than we would like 
to believe. About one-third of the entire adult homeless population has 
served their country in the Armed Services. On any given day, as many 
as 250,000 veterans, both male and female, are living on the streets or 
in shelters, and perhaps twice as many experience hopelessness at some 
point during the course of a year. Many other veterans are considered 
near homeless or at risk because of their poverty, lack of support from 
family and friends, and dismal living conditions in cheap hotels or in 
overcrowded or substandard housing.
  This legislation is necessary not only because this problem is so 
devastating and prevalent, but also because homeless veterans have 
special needs that are unique from those faced by the rest of the 
homeless population. Almost all homeless veterans are male, with three 
percent being female, the vast majority are single, and most come from 
poor, disadvantaged backgrounds. Homeless veterans tend to be older and 
more educated than homeless non-veterans. But similar to the general 
population of homeless adult males, about 45% of homeless veterans 
suffer from mental illness and slightly more than 70% suffer from 
alcohol or other drug abuse problems. Roughly 56% are African American 
or Hispanic.
  I believe that the Veterans Health Programs Improvement Act will help 
make an impact in helping homeless veterans and ensuring that they have 
a viable future. This legislation has a number of important provisions, 
but in my mind none is more important than the issue of homeless 
veterans. If we cannot even provide our brave veterans with basic 
necessities then where are we as a Nation? Our Nation's veterans did 
not risk their lives abroad so that they could come home and feel a 
cold shoulder. We must all have outrage that so many of our Nation's 
veterans live this way; only then can we find a way to correct this 
injustice.
  Mr. REYES. Mr. Speaker, I rise today in support of H.R. 3936, the 
Veterans Health Programs Improvement Act of 2004. I would like to thank 
the sponsors of this legislation, Chairman Chris Smith and Ranking 
Member Lane Evans for their work to bring it through the House Veterans 
Affairs Committee and to the floor expeditiously.
  Among other important actions, H.R. 3936 would provide the needed 
funding to assist our homeless veterans. As a Vietnam veteran and 
Member of Congress, I know the importance of addressing and 
appropriately funding programs to end homelessness among our veteran 
population. I feel this legislation is a step in the right direction to 
meet this need.
  Sadly, today's homeless veteran population are men and women who have 
resorted to living out in the streets of the very same country they 
committed to serve. In addition, nearly half of this population 
consists of veterans who served with me in Vietnam.
  Mr. Speaker, I can't stress enough the importance of this 
legislation, especially at a time of conflict that is increasing the 
veteran population. We should not forget the sacrifices made by our 
Nation's veterans. Instead, we need to uphold our promise to care for 
those who have answered the call to duty.
  Mr. Speaker, I strongly urge my colleagues to support the passage of 
this important bill.
  Mr. BEAUPREZ. Mr. Speaker, I rise today in support of H.R. 3936, the 
Veterans Health Programs Improvement Act of 2004. Today, more than 
ever, it is imperative that we address the benefits we provide to our 
Nation's veterans. Over the past few decades, the needs of veterans 
have evolved, and it is incumbent upon us to ensure the benefits they 
have so dutifully earned will sufficiently meet those changing needs.
  Included in this bill is language to allow the Department of Veterans 
Affairs to begin negotiations with the University of Colorado for the 
land on which to build a new, state-of-the-art veterans medical 
facility on the Fitzsimons Campus in Aurora, CO. This landmark veterans 
hospital will be capable of providing services that were previously 
unthinkable in many of the unequipped, outdated VA hospitals of the 
past.
  Through a collaboration between the VA, the DOD, and the University 
of Colorado, veterans in the Rocky Mountain region will gain access to 
a higher quality of health care made possible thanks to 21st century 
innovations and the synergy of this unique partnership.
  Mr. Speaker, I applaud the efforts of everyone involved in bringing 
this bill to the floor for a vote today. It is a paramount piece of 
legislation not only for the veterans in my district, but for all of 
our Nation's veterans, and I strongly support its intent.
  Mr. RODRIGUEZ. Mr. Speaker, I yield back the balance of my time.
  Mr. SMITH of New Jersey. Mr. Speaker, I yield back the balance of my 
time.
  The SPEAKER pro tempore (Mr. Terry). The question is on the motion 
offered by the gentleman from New Jersey (Mr. Smith) that the House 
suspend the rules and concur in the Senate amendments to the bill, H.R. 
3936.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the Senate amendments were 
concurred in.
  A motion to reconsider was laid on the table.

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