[Senate Report 105-123]
[From the U.S. Government Publishing Office]



                                                       Calendar No. 236
105th Congress                                                   Report
                                 SENATE

 1st Session                                                    105-123
_______________________________________________________________________


 
  AMENDING TITLE 38, UNITED STATES CODE, TO MAKE PERMANENT THE NATIVE 
   AMERICAN VETERAN HOUSING LOAN PILOT PROGRAM OF THE DEPARTMENT OF 
                            VETERANS AFFAIRS

                                _______
                                

                October 30, 1997.--Ordered to be printed

_______________________________________________________________________


  Mr. Specter, from the Committee on Veterans' Affairs, submitted the 
                               following

                              R E P O R T

                         [To accompany S. 714]

    The Committee on Veterans' Affairs, to which was referred 
the bill (S. 714) to make permanent the Native American Veteran 
Housing Loan Pilot Program of the Department of Veterans 
Affairs, having considered the same, reports favorably thereon 
and recommends that the bill, as amended, do pass.

                             Committee Bill

    The amendments are as follows:
    Strike out all after the enacting clause as follows:

[SECTION 1. PERMANENT AUTHORITY FOR NATIVE AMERICAN VETERAN HOUSING 
                    LOAN PROGRAM.

    [(a) Permanent Authority.--Section 3761 of title 38, United States 
Code, is amended by striking out subsection (c).
    [(b) Conforming Amendments.--(1) Section 3761(a) of such title is 
amended--
          [(A) by striking out ``shall establish and implement a pilot 
        program'' and inserting in lieu thereof ``shall carry out a 
        pilot program''; and
          [(B) by striking out ``shall establish and implement the 
        pilot program'' and inserting in lieu thereof ``shall carry out 
        the pilot program''.
    [(2) Sections 3761(b) and 3762(i) of such title are each amended by 
striking out ``pilot program'' and inserting in lieu thereof 
``program''.
    [(3) Section 3762 of such title is amended--
          [(A) in subsection (b)(1)(E), by striking out ``pilot program 
        established under this subchapter is implemented'' and 
        inserting in lieu thereof ``program under thissubchapter is 
carried out''; and
          [(B) in subsection (c)(1)(B), by striking out the second 
        sentence.
    [(4)(A) The subchapter heading for subchapter V of chapter 37 of 
such title is amended by striking out ``PILOT''.
    [(B) The section heading for section 3761 of such title is amended 
to read as follows:

[``Sec. 3761. Native American Veteran Housing Loan Program''.

    [(C) The table of sections at the beginning of chapter 37 of such 
title is amended--
          [(i) in the item relating to subchapter V, by striking out 
        ``PILOT''; and
          [(ii) by striking out the item relating to section 3761 and 
        inserting in lieu thereof the following new item:

[``3761. Native American Veteran Housing Loan Program.''.]

    Insert in lieu thereof the following:

SECTION 1. EXTENSION AND IMPROVEMENT OF NATIVE AMERICAN VETERAN HOUSING 
                    LOAN PROGRAM.

    (a) Extension.--Section 3761(c) of title 38, United States Code, is 
amended by striking out ``September 30, 1997'' and inserting in lieu 
thereof ``December 31, 2003''.
    (b) Outreach.--Section 3762(i) of such title is amended--
          (1) by inserting ``(1)'' after ``(i)'';
          (2) in paragraph (1), as so designated--
                  (A) by inserting ``, in consultation with tribal 
                organizations (including the National Congress of 
                American Indians and the National American Indian 
                Housing Council),'' after ``The Secretary shall''; and
                  (B) by striking out ``tribal organizations and''; and
          (3) by adding at the end the following:
    ``(2) Activities under the outreach program shall include the 
following:
          ``(A) Attending conferences and conventions conducted by the 
        National Congress of American Indians in order to work with the 
        National Congress in providing information and training to 
        tribal organizations and Native American veterans regarding the 
        availability of housing benefits under the pilot program and in 
        assisting such organizations and veterans in participating in 
        the pilot program.
          ``(B) Attending conferences and conventions conducted by the 
        National American Indian Housing Council in order to work with 
        the Housing Council in providing information and training to 
        tribal organizations and tribal housing entities regarding the 
        availability of such benefits.
          ``(C) Attending conferences and conventions conducted by the 
        Department of Hawaiian Homelands in order to work with the 
        Department of Hawaiian Homelands in providing information and 
        training to tribal housing entities in Hawaii regarding the 
        availability of such benefits.
          ``(D) Producing and disseminating information to tribal 
        governments, tribal veterans service organizations, and tribal 
        organizations regarding the availability of such benefits.
          ``(E) Assisting tribal organizations and Native American 
        veterans in participating in the pilot program.''.
    (c) Annual Reports.--Section 3762 of such title is further amended 
by adding at the end the following:
    ``(j) Not later than February 1 of each of 1998 through 2003, the 
Secretary shall transmit to the Committees on Veterans' Affairs of the 
Senate and House of Representatives a report relating to--
          ``(1) the implementation of the pilot program under this 
        subchapter during the fiscal year preceding the date of the 
        report;
          ``(2) the Secretary's exercise during such fiscal year of the 
        authority provided under subsection (c)(1)(B) of this title to 
        make loans exceeding the maximum loan amount;
          ``(3) the appraisals performed for the Secretary during such 
        fiscal year under the authority of subsection (d)(2) of this 
        title, including a description of--
                  ``(A) the manner in which such appraisals were 
                performed;
                  ``(B) the qualifications of the appraisers who 
                performed such appraisals; and
                  ``(C) the actions taken by the Secretary with respect 
                to such appraisals to protect the interests of veterans 
                and the United States;
          ``(4) the outreach activities undertaken under subsection (i) 
        of this title during such fiscal year, including--
                  ``(A) a description of such activities on a region-
                by-region basis; and
                  ``(B) an assessment of the effectiveness of such 
                activities in encouraging the participation of Native 
                American veterans in the pilot program;
          ``(5) the pool of Native American veterans who are eligible 
        for participation in the pilot program, including--
                  ``(A) a description and analysis of the pool; and
                  ``(B) a description and assessment of the 
                impediments, if any, to full participation in the pilot 
                program of the Native American veterans in the pool; 
                and
          ``(6) the Secretary's recommendations, if any, for additional 
        legislation regarding the pilot program.'.

SEC. 2. EXTENSION OF AUTHORITIES RELATING TO HOMELESS VETERANS.

    (a) Drug and Alcohol Abuse and Dependence.--Section 1720A(e) of 
title 38, United States Code, is amended by striking out ``December 31, 
1997'' and inserting in lieu thereof ``December 31, 1999''.
    (b) Agreements for Housing Assistance for Homeless Veterans.--
Section 3735(c) of such title is amended by striking out ``December 31, 
1997'' and inserting in lieu thereof ``December 31, 1999''.
    (c) Authority for Community-Based Residential Care for Homeless 
Chronically Mentally Ill Veterans and Other Veterans.--Section 115(d) 
of the Veterans' Benefits and Services Act of 1988 (38 U.S.C. 1712 
note) is amended by striking out ``December 31, 1998'' and inserting in 
lieu thereof ``December 31, 1999''.
    (d) Demonstration Program of Compensated Work Therapy.--Section 
7(a) of Public Law 102-54 (38 U.S.C. 1718 note) is amended by striking 
out ``December 31, 1997'' and inserting in lieu thereof ``December 31, 
1999''.
    (e) Services and Assistance to Homeless Veterans.--The Homeless 
Veterans Comprehensive Service Programs Act of 1992 (38 U.S.C. 7721 
note) is amended--
          (1) in section 2(a), by striking out ``September 30, 1997'' 
        and inserting in lieu thereof ``September 30, 1999'';
          (2) in section 3(a)(2), by striking out ``September 30, 
        1997'' and inserting in lieu thereof ``September 30, 1999''; 
        and
          (3) in section 12, by striking out ``through 1997'' and 
        inserting in lieu thereof ``through 1999''.
    (f) Homeless Veterans' Reintegration Projects.--(1) Section 
738(e)(1) of the Stewart B. McKinney Homeless Assistance Act (42 U.S.C. 
11448(e)(1)) is amended by adding at the end the following:
                  ``(G) $10,000,000 for fiscal year 1999.''.
    (2) Section 741 of such Act (42 U.S.C. 11450) is amended by 
striking out ``December 31, 1997'' and inserting in lieu thereof 
``December 31, 1999''.

SEC. 3. EXTENSION AND EXPANSION OF ENHANCED-USE LEASE AUTHORITY.

    (a) Expansion.--Section 8168(a) of title 38, United States Code, is 
amended by striking out ``20'' and inserting in lieu thereof ``40''.
    (b) Extension.--Section 8169 of such title is amended by striking 
out ``December 31, 1997'' and inserting in lieu thereof ``December 31, 
1999''.

SEC. 4. EXTENSION OF CERTAIN OTHER AUTHORITIES OF THE SECRETARY OF 
                    VETERANS AFFAIRS.

    (a) Pilot Program for Noninstitutional Alternatives to Nursing Home 
Care.--Section 1720C(a) of title 38, United States Code, is amended by 
striking out ``December 31, 1997'' and inserting in lieu thereof 
``December 31, 1999''.
    (b) Health Professional Scholarship Program.--Section 7618 of such 
title is amended by striking out ``December 31, 1997'' and inserting in 
lieu thereof ``December 31, 1999''.

    Amend the title so as to read:

    A bill to extend and improve the Native American Veteran Housing 
Loan Pilot Program of the Department of Veterans Affairs, to extend 
certain authorities of the Secretary of Veterans Affairs relating to 
services for homeless veterans, to extend certain other authorities of 
the Secretary, and for other purposes.

                              Introduction

    On May 7, 1997, Committee Member Daniel K. Akaka introduced 
S. 714, a bill to make permanent the Native American Veteran 
Housing Loan Pilot Program of the Department of Veterans 
Affairs.
    On July 7, 1997, Committee Chairman Arlen Specter 
introduced S. 986 at the request of the Administration. S. 986 
would have, among other things, extended for a 2-year period 
the Native American Veteran Housing Loan Pilot Program.
    On July 17, 1997, Committee Member Ben Nighthorse Campbell 
introduced S. 1027, a bill to extend the Native American 
veteran direct housing loan pilot program, and for other 
purposes. S. 1027 would have extended the program for a 3-year 
period, and would have imposed on VA certain outreach, 
consultation, and reporting obligations.
    On July 25, 1997, the Committee held a hearing to receive 
testimony on S. 714, on S. 986, on other bills pending before 
the Committee, and on Committee Prints before the Committee 
including a Committee Print which would have: extended certain 
authorities relating to the provision of services to homeless 
veterans; extended VA authority to conduct a pilot program for 
the provision of noninstitutional alternatives to nursing home 
care; extended authority to operate a Health Professional 
Scholarship Program; and extended VA authority to enter into 
enhanced use leases. The Committee received testimony from 
Senator Daniel K. Inouye, Senator Barbara Boxer, Representative 
Bob Filner, and Representative Benjamin A. Gilman, and received 
testimony for the record from Representative Sue W. Kelly. The 
Committee also received testimony from Stephen L. Lemons, 
Ed.D., VA's Acting Under Secretary for Benefits, Thomas L. 
Garthwaite, M.D., VA's Deputy Under Secretary for Health, and 
from representatives of The American Legion, Veterans of 
Foreign Wars, Disabled American Veterans, and Vietnam Veterans 
of America. Testimony was also submitted for the record of the 
hearing by the Office of Veterans Affairs, Philippine Embassy; 
Paralyzed Veterans of America; AMVETS; the American Coalition 
for Filipino Veterans; the Coordinating Council of Leaders of 
Veterans Organizations in Southern California; Filipino War 
Veterans, Incorporated; the National Coalition for Homeless 
Veterans; and LA Vets.
    Some of the witnesses expressed views on bills which would 
have extended the Native American Veteran Housing Loan Pilot 
Program; some did not. Of those who expressed views on that 
program, there was an absence of consensus on the bill. The 
American Legion, Veterans of Foreign Wars, Disabled American 
Veterans, Paralyzed Veterans of America, and Vietnam Veterans 
of America expressed support for S. 714. AMVETS opposed the 
permanent extension of the program in S. 714, expressing 
support instead for the VA proposal, as set out in S. 986, to 
extend the program for two years. VA opposed the permanent 
extension of the program as set forth in S. 714.
    With respect to the Committee Print to extend homeless 
veteran services, and other, authorities, some witnesses 
expressed views on its provisions; others did not. Of those who 
commented on the Committee Print, all, including VA, The 
American Legion, Veterans of Foreign Wars, Disabled American 
Veterans, AMVETS, Paralyzed Veterans of America, and Vietnam 
Veterans of America, expressed support for enactment of the 
Committee Print's provisions.

                           Committee Meeting

    After carefully reviewing the testimony from the July 25, 
1997, hearing, the Committee met in open session on October 7, 
1997, and voted by unanimous voice vote to report S. 714, as 
amended, favorably to the Senate.

                     Summary of S. 714 as Reported

    S. 714, as reported (hereinafter referred to as the 
``Committee bill''), contains provisions that would (a) extend 
and improve the VA's Native American Veteran Housing Loan 
Program; (b) extend five authorities under which the VA and the 
Department of Labor's Veterans' Employment and Training Service 
(VETS) either provide services to homeless veterans or assist 
those who provide such services to homeless veterans; and (c) 
extend authorities under which VA (1) conducts a pilot program 
for the provision of noninstitutional alternatives to nursing 
home care; (2) operates a Health Professional Scholarship 
Program; and (3) enters into enhanced use leases.

                               Discussion

Section 1. Extension and improvement of Native American Veteran Housing 
        Loan Program

    Section 1 of the Committee bill, which is derived from S. 
714 and S. 1027, would extend and improve VA's Native American 
Veteran Housing Loan Program.
            Background
    VA conducts a pilot program under which housing loans are 
made directly to eligible Native American veterans. These loans 
are designed to allow such veterans to purchase, build, or 
improve dwellings on Native American trust land. Direct loans 
to such veterans are necessary since, even with VA guarantees, 
commercial lenders will not make mortgage loans to finance the 
purchasing or construction of housing on Native American lands. 
They decline to do so because Federal law would prohibit a 
lender, in the event of default, from taking possession of 
native trust lands.
    Since the inception of the Native American Veteran Housing 
Loan Pilot Program in 1993, there have been fewer loans made 
than anticipated; $3.5 million of the original $5.0 million 
appropriated for the program remains unspent. It would also 
appear that, while Pacific Islanders have made considerable use 
of the benefits which the Committee intended the program to 
provide, the program has been underutilized by North American 
Indians, and other Native American populations.
            Committee bill
    Section 1 of the Committee bill would amend 38 U.S.C. 
Sec. 3761(c) by extending VA authority to operate the Native 
American Home Loan Program for 6 years. As introduced, S. 714 
would have permanently authorized the program. As is noted, 
however, the program appears to be underutilized, particularly 
among American Indian populations, a factor which makes program 
assessment difficult. Further, since the program's inception in 
1993, there have been no extreme fluctuations in interest 
rates, general economic downturns, or other events which might 
demonstrate how the program works under economic conditions 
different from those which have existed in the broader economy 
since 1993. In light of these considerations, the Committee 
bill does not make the program permanent. Rather, it extends 
the program for the finite, but relatively lengthy, period of 6 
years.
    In addition to extending the program, section 1 would also 
amend 38 U.S.C. Sec. 3762(i) to require that VA conduct more 
intensive outreach efforts than it has to date. In the past, VA 
outreach to American Indian populations has been limited to the 
distribution of a single pamphlet of information. Section 1 
would mandate, first, consultations with major tribal 
organizations (including, but not limited to, the National 
Congress of American Indians and the National Indian Housing 
Council) for the purpose of gaining guidance on improved 
outreach methods. Second, it would mandate VA attendance at 
conferences and conventions conducted by the National Congress 
of American Indians, National Indian Housing Council, and the 
Department of Hawaiian Homelands. It is the Committee's 
intention that VA use these, and similar, events to provide 
information, training, and assistance to tribal organizations 
and Native American veterans regarding the availability of 
housing benefits. Finally, section 1 would amend 38 U.S.C. 
Sec. 3762 by adding paragraph (j) to require the Secretary to 
transmit annual reports to the Committees on Veterans' Affairs 
of the Senate and the House of Representatives regarding (1) 
the implementation of the Native American Home Loan Program 
during the preceding fiscal year; (2) VA's exercise, during 
such fiscal year, of the authority to make loans in excess of 
the maximum allowable amount under 38 U.S.C. Sec. 3762 
(c)(1)(B); (3) appraisals performed for the Secretary during 
such fiscal year under 38 U.S.C. Sec. 3732(d)(2); (4) VA 
outreach activities, including (A) a region-by-region 
description and (B) an assessment of the effectiveness of such 
activities on participation in the program by Native American 
veterans; (5) the pool of eligible Native American veterans and 
an assessment of impediments, if any, to participation in the 
program; and (6) the Secretary's recommendations, if any, for 
additional legislation.

Section 2. Extension of authorities relating to homeless veterans

    Section 2 of the Committee bill, which is derived from a 
Committee Print which would have, among other things, extended 
certain authorities relating to the provision of services to 
homeless veterans, would extend each and all of the authorities 
specified in the Committee Print for a 2-year period.
            Background
    The following legal authorities currently exist for the 
provision of services to, among others, homeless veterans: (1) 
VA authority under 38 U.S.C. Sec. 1720A to contract for 
treatment services from community-based facilities; (2) VA 
authority under 38 U.S.C. Sec. 3735(c) to convey acquired 
property to nonprofit organizations for use as shelters; (3) VA 
authority under section 115 of Public Law 100-322 (38 U.S.C. 
Sec. 1712 note) to provide community-based care for homeless 
chronically mentally ill veterans; (4) VA authority under 
Sec. Sec. 7-8, Public Law 102-54 (38 U.S.C. Sec. 1718 note), to 
operate a demonstration project providing compensated work 
therapy and therapeutic transitional housing services; (5) VA 
authority under Sec. Sec. 2-4 and 12, Public Law 102-590 (38 
U.S.C. Sec. 7721 note), to make grants to nonprofit entities 
for the provision of homeless veteran services; and (6) 
Department of Labor authority under 42 U.S.C. Sec. 11450 to 
conduct homeless veterans reintegration projects.
    Community-based treatment services--Prior to the enactment 
of any law specifically directed to needs of homeless veterans 
as a discrete group, VA was authorized by Public Law 96-22 (38 
U.S.C. Sec. 1720A) to contract for services to provide care of 
veterans--homeless or not--suffering from alcohol or drug 
dependence or abuse disorders. This authority, which has 
enabled VA to contract for care, treatment, and rehabilitative 
services in halfway houses, therapeutic communities, 
psychiatric residential treatment centers, and other community-
based treatment centers for eligible veterans suffering such 
disorders, has been, and remains, a primary authority under 
which VA secures care services directed to homeless veterans.
    Authority to convey acquired real property--VA operates 
housing loan programs to assist eligible veterans in purchasing 
or building a home. If a veteran defaults on a mortgage loan 
which was either made, insured, or guaranteed by VA, VA may 
come into possession of the real property which had secured the 
loan in default. VA normally sells such ``acquired properties'' 
to the public.
    In 1991, Congress enacted Public Law 102-54 (38 U.S.C. 
Sec. 3735) which authorized VA to make an alternative use of 
acquired properties: VA may sell, lease, or donate such 
properties to nonprofit organizationsor State or local public 
agencies for their use primarily as shelters for homeless veterans and 
their families.
    Community-based care for homeless chronically mentally ill 
veterans--As noted above, Public Law 96-22 (38 U.S.C. 
Sec. 1720A) authorized VA to contract for community-based 
services for the care of veterans--homeless or not--suffering 
from alcohol or drug dependence or abuse disorders. In Public 
Laws 100-6 and 100-322, Congress first addressed the issue of 
community-based services for homeless veterans specifically. In 
those statutes, VA was granted authority similar to that 
enacted in Public Law 96-22.
    The Homeless Chronically Mentally Ill veterans program, 
established by Public Laws 100-6 and 100-322, authorizes VA to 
provide outreach, medical, psychiatric, and case management 
services. It also authorizes VA to use non-VA, community-based 
residential treatment facilities to provide services and care 
needed by homeless veterans. VA currently has contracts with 
more than 150 community-based entities at 61 VA sites which 
provide residential care at an average cost of $38 per day.
    Compensated work therapy and therapeutic transitional 
housing--With the enactment of Public Law 102-54 in 1991, 
Congress provided a foundation for the expansion of services to 
homeless veterans by authorizing VA to conduct a demonstration 
program linking the provision of compensated work therapy with 
therapeutic transitional housing. The program was designed to 
assist veterans suffering from substance abuse problems or 
severe mental illness to make a successful reentry into 
independent community living. To achieve this end, VA was 
authorized to purchase up to 50 residences where it would 
provide housing in exchange for the payment of rent from funds 
earned through compensated work therapy. The payment of such 
rents was intended to foster self-esteem and independence-
building skills, while minimizing program operating expenses at 
an average cost of $19.25 per day. VA 1996 outcome data 
indicated program success, showing after 3 months that 64 
percent of program participants were alcohol and drug free, 73 
percent were independently housed, and 61 percent were 
employed.
    Grants and per diem payment support--In addition to 
providing medical and social services directly, VA is 
authorized by Public Law 102-590 to make grants to nonprofit 
entities to assist them in providing such services. To date, VA 
has expended approximately $17 million in grants to assist 
public and nonprofit agencies in constructing, acquiring and/or 
renovating facilities to create supportive housing or service 
centers for homeless veterans. Examples of projects that have 
been, or are currently being, developed include: a 100-bed 
transitional housing program focusing on residents'' vocational 
development; a supportive housing facility for 12 terminally 
ill homeless veterans; a community-based residential program 
for elderly homeless veterans; an urban-based multiservice 
drop-in center for veterans; a 30-bed supportive housing 
domiciliary located on the grounds of a VA medical center; and 
several mobile services health and outreach units. Over 1,700 
new community-based beds have been made available through this 
grant program.
    In addition to providing grant funding to assist in startup 
costs, VA is also authorized to make per diem payments to 
provide up to half the operating costs of the facilities opened 
with VA grant assistance. At present, there are 24 programs in 
11 States receiving per diem payments.
    Homeless veterans reintegration projects--The Department of 
Labor's Veterans'' Employment and Training Service is 
authorized, under sections 738-741 of the Stewart B. McKinney 
Homeless Assistance Act (Public Law 100-77, 42 U.S.C. 
Sec. Sec. 11448-11450) to conduct, directly or by grant or 
contract, homeless veterans' reintegration projects. 
Authorizations for appropriations have been provided for fiscal 
years 1993-1998. Funding, however, has not been forthcoming.
            Committee bill
    Section 2 of the Committee bill would extend each of the 
above- outlined authorities for a period of 2 years.

Section 3. Extension and expansion of enhanced-use lease authority

    Section 3 of the Committee bill is derived from a Committee 
Print which would have, among other things, extended VA 
authority to enter into enhanced-use leases. The Committee bill 
would extend that authority for a 2-year period.
            Background
    The enhanced-use leasing program facilitates VA leasing 
arrangements with private sector entities which result in VA 
obtaining needed resources. The concept underlying the program 
is a recognition that VA controls certain properties which, 
from the perspective of a private sector user/developer, might 
be underutilized and which, therefore, might be desirable to 
such users. Such users might be willing to pay for the use of 
VA lands for purposes which are compatible with VA operations 
by providing VA with facilities, services and/or funds in 
exchange for such access. The enhanced-use leasing program 
authorizes such arrangements, on a limited basis. Under current 
authority, no more than 20 such arrangements may be 
consummated. The Committee is informed that, as of the end of 
fiscal year 1997, VA either had entered into, or would soon 
finalize, 19 enhanced-use leases.
            Committee bill
    Section 3 of the Committee bill would extend VA's enhanced-
use leasing authority through December 31, 1999, a 2-year term. 
It would also amend 38 U.S.C. Sec. 8168 to authorize VA to 
enter into no more than 40 enhanced-use leases.

Section 4. Extension of certain other authorities of the Secretary of 
        Veterans Affairs

    Section 4 of the Committee bill is derived from a Committee 
Print which would have, among other things, extended VA 
authority to provide noninstitutional alternatives to nursing 
home care and VA authority to operate a Health Professional 
Scholarship Program. The Committee bill would extend these 
authorities for a 2-year period.
            Background
    Noninstitutional alternatives to nursing home care--VA is 
authorized under 38 U.S.C. Sec. 1720C to conduct a pilot 
project to furnish medical and rehabilitative services in 
noninstitutional settings--e.g., hospital-based home care, 
adult day health care, homemaker/home health aide services, and 
community residential care--to veterans eligible for, and in 
need of, VA nursing home care. Such care has been used 
effectively by many providers to provide cost-effective care to 
patients needing assistance in coping with chronic conditions. 
Noninstitutional programs are designed to manage chronic 
conditions with maximum patient independence and functionality.
    As part of its case management services for veterans who 
would otherwise require nursing home care, VA has coordinated 
homemaker/home health aide services since 1993. In 1996, VA 
made 316,091 home visits to discharged veterans, and, at 116 VA 
medical centers, other providers were reimbursed by VA for home 
health aide services. In addition, VA operates 14 adult day 
health care programs and contracts for such services at 88 
medical centers.
    Health Professional Scholarship Program--VA is authorized 
to provide scholarship assistance to persons studying to be 
registered nurses and other health-related professionals (e.g., 
occupational, physical, or respiratory therapists, nurse 
anesthetists, physician assistants, etc.) in exchange for the 
student's commitment to work for VA for 2 years. This authority 
has served as a means to recruit and retain persons having 
difficult-to-replace health care expertise. Since 1982, over 
4,000 scholarships have been awarded, and over 3,000 recipients 
have completed their education and service obligation to the 
VA.
    VA is not currently awarding new scholarships. Nonetheless, 
recruiting or retention exigencies might arise which would make 
it advantageous for VA to reactivate this authority.
            Committee bill
    Section 4(a) of the Committee bill would extend VA 
authority to furnish medical and rehabilitative services in 
noninstitutional settings as an alternative to nursing home 
care until December 31, 1999. Section 4(b) of the Committee 
bill would extend until December 31, 1999, VA authority to 
conduct a Health Professional Scholarship Program, but it is 
the Committee's expectation that VA will award no new 
scholarships during this term unless it has first notified the 
Committees on Veterans' Affairs of the Senate and the House of 
Representatives of its intention to do so.

                             Cost Estimate

    In compliance with paragraph 11(a) of rule XXVI of the 
Standing Rules of the Senate, the Committee, based on 
information supplied by CBO, estimates that, compared to the 
CBO baseline, there would be no costs or savings resulting from 
enactment of the Committee bill.
    The cost estimate provided by CBO follows:

                                     U.S. Congress,
                               Congressional Budget Office,
                                  Washington, DC, October 22, 1997.
Hon. Arlen Specter,
Chairman, Committee on Veterans' Affairs,
U.S. Senate, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 714, a bill to 
extend and improve the Native American Veteran Housing Loan 
Pilot Program of the Department of Veterans Affairs, to extend 
certain authorities of the Secretary of Veterans Affairs 
relating to services for homeless veterans, to extend certain 
other authorities of the Secretary, and for other purposes.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Mary Helen 
Petrus.
            Sincerely,
                                         June E. O'Neill, Director.
    Enclosure.

S. 714--A bill to make permanent the Native American Veteran Housing 
        Loan Pilot Program of the Department of Veterans Affairs

    Summary: The bill would extend programs pertaining to 
veterans' medical care, housing and job training for homeless 
veterans, and home loans for Native American veterans. S. 714 
would raise direct spending by about $1 million a year over the 
1998-2000 period, and thus pay-as-you-go procedures would 
apply. Assuming appropriation of the necessary amounts, CBO 
estimates that enacting the bill would raise spending subject 
to appropriations by $89 million in 1998 and $280 million over 
the 1998-2002 period. S. 714 contains an intergovernmental 
mandate, as defined in the Unfunded Mandates Reform Act (UMRA), 
but CBO estimates that the mandate threshold ($50 million in 
1996, adjusted annually for inflation) in that act would not be 
exceeded. The bill would impose no new private-sector mandates 
as defined in UMRA.

Estimated cost to the Federal Government

    The estimated budgetary impact of S. 714 is shown in the 
following table.

                                      TABLE 1.--BUDGETARY IMPACT OF S. 714                                      
                                    [By fiscal year, in millions of dollars]                                    
----------------------------------------------------------------------------------------------------------------
                                                                       1998     1999     2000     2001     2002 
----------------------------------------------------------------------------------------------------------------
                                                 DIRECT SPENDING                                                
                                                                                                                
Estimated budget authority.........................................        3    (\1\)    (\1\)        0        0
Estimated outlays..................................................        1        1        1        0        0
                                                                                                                
                                       SPENDING SUBJECT TO APPROPRIATIONS                                       
                                                                                                                
Native American home loans:                                                                                     
    Estimated authorization level..................................        1        1        1        2        2
    Estimated outlays..............................................        1        1        1        2        2
VA medical programs:                                                                                            
    Estimated authorization level..................................       98      131       34        0        0
    Estimated outlays..............................................       88      128       48        0        0
DOL program for homeless veterans:                                                                              
    Estimated authorization level..................................        0       10        0        0        0
    Estimated outlays..............................................        0        1        6        3        0
Total change in spending subject to appropriation under S. 714:                                                 
    Estimated authorization level..................................       99      142       35        2        2
    Estimated outlays..............................................       89      130       55        5       2 
----------------------------------------------------------------------------------------------------------------
\1\ Less than $500,000                                                                                          
 Note. The costs of this bill fall under budget functions 700 (veterans' affairs) and 500 (education,           
  employment, training and social services).                                                                    

            Direct Spending
    The bill would extend two provisions of law that would 
raise direct spending
    Native American Home Loan Pilot Program--The bill would 
extend through December 31, 2003, the Native American Home Loan 
Program, which provides direct home loans to veterans living on 
trust lands. The program was established in 1993 and expired on 
September 30, 1997. Since the program's inception, the 
Department of Veterans Affairs (VA) has made about 165 loans 
and used $1.3 million of the $4.5 million in subsidy 
appropriations. S. 714 would extend the availabilityof the 
remaining $3.2 million, which would constitute a reappropriation. CBO 
estimates that VA would subsidize about 100 loans a year at an annual 
cost of about $1 million a year. Those costs would be direct spending 
through 2000, but they would be subject to appropriations thereafter. 
In addition, CBO estimates that VA's administrative expenses, a 
discretionary cost, would be roughly $500,000 each year over the 1998-
2002 period.
    Enhanced-use leases--The bill would extend through December 
31, 1999, the authority of VA to enter into a limited number of 
enhanced-use leases. Under this authority, VA leases portions 
of its real property in return for cash or in-kind services. 
Cash receipts would be spent for nursing home and medical care 
expenses. CBO estimates that this provision would have little 
or no net budgetary effect because the additional income to the 
government and the spending of that income would offset each 
other.
            Spending subject to appropriations
    For the purpose of this estimate, CBO assumes appropriation 
of the amounts authorized or estimated to be necessary. Outlay 
estimates are based on historical spending patterns.
    Homeless veterans--The bill would extend through fiscal 
year 1999 VA's authority to provide services in community-based 
residential treatment facilities and half-way houses to 
veterans suffering from chronic mental conditions or 
homelessness. Current authority to provide long-term housing in 
community-based half-way houses will expire on December 31, 
1998, and authority for the other activities, primarily the 
Homeless Chronically Mentally Ill Veterans (HCMI) program 
expired on September 30, 1997. Based on 1997 spending for these 
programs, CBO estimates the extension would cost about $37 
million in 1998 and $111 million over the 1998-2000 period.
    The bill would also extend through December 31, 1999, VA's 
Compensated Work Therapy/Transitional Residence (CWT/TR) 
program. This program, which allows veterans with drug and 
alcohol problems or mental illness to live in VA-owned and 
managed housing, will expire on December 31, 1997. According to 
data from VA, it obligated $4 million in 1996 from 
appropriations for medical care for activities and personnel 
related to the CWT/TR program. Thus, CBO estimates that VA 
would obligate a comparable amount from its medical care 
appropriations in 1998 and 1999, resulting in outlays of $3 
million in 1998 and $8 million over the 1998-2000 period.
    In addition, this section would extend through December 31, 
1999, VA's authority under the Homeless Veterans Comprehensive 
Services Program Act of 1992. That act allows VA to award 
grants to organizations that establish homeless shelters and 
supervised, therapeutic housing and to refer homeless veterans 
to these facilities at per them rates. S. 714 would authorize 
the appropriation of $48 million a year to carry out these 
activities. Assuming appropriation of the authorized amounts, 
CBO estimates that VA would spend $32 million during the three-
quarters of fiscal year 1998 and $96 million over the 1998-2000 
period.
    Finally, this bill would authorize appropriations of $10 
million in 1999 for homeless veterans' reintegration projects 
that are carried out through the Department of Labor (DOL). CBO 
estimates that DOL would spend $1 million beginning in 1999 and 
$10 million over the 1998-2002 period.

    TABLE 2.--SPENDING FOR VETERANS' MEDICAL CARE UNDER S. 714 AS ORDERED REPORTED BY THE SENATE COMMITTEE ON   
                                      VETERANS' AFFAIRS ON OCTOBER 7, 1997                                      
                                    [By fiscal year, in millions of dollars]                                    
----------------------------------------------------------------------------------------------------------------
                                                                       1998     1999     2000     2001     2002 
----------------------------------------------------------------------------------------------------------------
Spending under current law:                                                                                     
    Estimated budget authority.....................................   16,313   16,313   16,313   16,313   16,313
    Estimated outlays..............................................   16,150   16,150   16,150   16,150   16,150
Proposed changes:                                                                                               
    Homeless veterans programs:                                                                                 
    Estimated authorization level..................................       80      106       28        0        0
    Estimated outlays..............................................       72      104       39        0        0
    Homemaker/home health aide programs                                                                         
        Estimated authorization level..............................       18       25        6        0        0
        Estimated outlays..........................................       16       24        9        0        0
    Total changes:                                                                                              
    Estimated authorization level..................................       98      131       34        0        0
    Estimated outlays..............................................       88      128       48        0        0
Spending under S. 714 for veterans medical care:                                                                
    Estimated authorization level \1\..............................   16,411   16,444   16,347   16,313   16,313
    Estimated outlays..............................................   16,239   16,278   16,197   16,150  16,150 
----------------------------------------------------------------------------------------------------------------
\1\ Funding for fiscal year 1998 through 2002 is subject to future appropriations actions. The amounts shown hem
  assume that appropriations under current law remain at the 1997 level. If they arc adjusted for inflation, the
  base amounts would grow at a rate of about $500 million a year, but the estimated changes would remain as     
  shown.                                                                                                        

    Other medical care provisions.--The bill would extend 
through December 31, 1999, two programs affecting medical care 
for veterans that will expire on December 31, 1997. One program 
allows VA to furnish homemaker and home-health aide services to 
veterans on a discretionary basis. In 1996, VA spent about $22 
million on these services. Assuming that VA provides the same 
volume of care, CBO estimates that it would spend about $16 
million over three-quarters of fiscal year 1998 and $49 million 
over the 1998-2000 period.
    The second program, Health Professionals Scholarship 
Awards,allows VA to pay tuition and stipends to students 
enrolled in certain health professional schools in return for two years 
of service at the VA. In recent years, VA has not offered these awards 
to recruit health professionals, and information from VA suggests that 
it would not be likely to use them through calendar year 1999. Thus, 
CBO estimates that no additional spending would result from this 
provision in 1998 and 1999.
    Pay-as-you-go-considerations: The Balanced Budget and 
Emergency Deficit Control Act of 1985 sets up pay-as-you-go 
procedures for legislation affecting direct spending or 
receipts. Because the bill would affect direct spending, pay-
as-you-go procedures would apply. The projected changes in 
direct spending are summarized in the following table for 
fiscal years 1998-2007. For purposes of enforcing pay-as-you-go 
procedures, only the effects in the budget year and the 
succeeding four years are counted.

                                        SUMMARY OF PAY-AS-YOU-GO EFFECTS                                        
                                    [By fiscal year, in millions of dollars]                                    
----------------------------------------------------------------------------------------------------------------
                                             1998   1999   2000   2001   2002   2003   2004   2005   2006   2007
----------------------------------------------------------------------------------------------------------------
Change in outlays.........................      1      1      1      0      0      0      0      0      0      0
Changes in receipts.......................                                                                      
(9)Not applicable                                                                                               
----------------------------------------------------------------------------------------------------------------

    Estimated impact on State, local, and tribal governments: 
S. 714 contains an intergovernmental mandate as defined in 
UMRA. The bill would extend and expand, through calendar year 
1999, an existing mandate that preempts state and local 
governments from imposing taxes, fees, and permit requirements 
on VA properties leased to private concerns. This provision 
would make it more attractive for private concerns to build and 
operate facilities on VA property, rather than on private 
property. To the extent that such concerns would otherwise pay 
taxes or fees for affected facilities, either on private 
property or on VA property, the loss of revenue to state and 
local governments would be considered a mandate cost. However, 
based on information from the Department of Veterans Affairs, 
and because the affected projects are generally small, CBO 
estimates that any losses would be minimal and that the mandate 
threshold established in ($50 million in 1996, adjusted 
annually for inflation) would not be exceeded.
    The bill would also reauthorize funding for programs for 
homeless veterans. Some of the services under these programs 
could be provided by state and local governments.
    Estimated impact on the private-sector: The bill would 
impose no new private-sector mandates as defined in UMRA.
    Estimate prepared by: Federal cost: Shawn Bishop (medical 
care) and Sunita D'Monte (housing), Christi Hawley Sadoti 
(veterans reintegration projects); impact on State, local, and 
tribal governments: Marc Nicole; impact on the private sector: 
Rachel Schmidt.
    Estimate approved by: Robert A. Sunshine, Deputy Assistant 
Director for Budget Analysis.

                      Regulatory Impact Statement

    In compliance with paragraph 11(b) of rule XXVI of the 
Standing Rules of the Senate, the Committee on Veterans' 
Affairs has made an evaluation of the regulatory impact that 
would be incurred in carrying out the Committee bill. The 
Committee finds that the Committee bill would not entail any 
regulation of individuals or businesses or result in any impact 
on the personal privacy of any individuals, and that the 
paperwork resulting from enactment would be minimal.

                 Tabulation of Votes Cast in Committee

    In compliance with paragraph 7 of rule XXVI of the Standing 
Rules of the Senate, the following is a tabulation of votes 
cast in person or by proxy by members of the Committee on 
Veterans' Affairs at its October 7, 1997, meeting. On that 
date, the Committee, by unanimous voice vote, ordered S. 714, 
as amended, reported favorably to the Senate.

                             Agency Report

    On July 25, 1997, Stephen L. Lemons, Ed.D., Acting Under 
Secretary for Benefits, and Thomas L. Garthwaite, M.D., Deputy 
Under Secretary for Health, Department of Veterans Affairs, 
submitted testimony on, among other things, S. 714, S. 986, and 
a Committee Print which would have extended authorities 
relating to the provision of services to homeless veterans, VA 
authority to conduct a pilot program for the provision of 
noninstitutional alternatives to nursing home care, VA 
authority to operate a Health Professional Scholarship Program, 
and VA authority to enter into enhanced use leases. An excerpt 
from that testimony is reprinted below:

 Statement of Honorable Stephen L. Lemons, Acting Under Secretary for 
                Benefits, Department of Veterans Affairs

    Mr. Chairman and Members of the Committee, I am pleased to 
be here this morning to discuss those items on your agenda that 
would impact the Veterans Benefits Administration, the National 
Cemetery System, and the Board of Veterans' Appeals. Your 
letter of invitation asked that we address each of the 
following bills and draft proposals: S. 987 (VA requested draft 
legislation proposing a compensation cost-of-living-adjustment 
and other program improvements); S. 464; S. 623; S. 714; S. 
730; Committee Print (to increase the Medal of Honor pension); 
S. 813; S. 986 (VA requested draft legislation proposing home 
loan program improvements); Committee Print (to make technical 
amendments to Public Law 104-275); and Committee Print 
(codification of FY 1997 cost-of-living adjustment legislation, 
Pub. L. No. 104-263).
          * * * * * * *
S. 714--Permanently authorize the Native American Housing Loan Program
    S. 714 would make permanent VA's pilot program for making 
direct housing loans to Native American veterans living on 
trust land. These are loans which VA makes directly to the 
veteran.
    Pub. L. No. 102-547 requires that a Memorandum of 
Understanding be entered into between VA and a Tribal entity 
before VA may make loans to Native Americans who are subject to 
the jurisdiction of that Tribe. These loans may not exceed 
$80,000 each unless the Secretary determines a higher limit is 
necessary due to the significantly higher housing costs. Higher 
loan limits have been approved in Hawaii and the Pacific 
Islands. Under an amendment made last year by Pub. L. No. 104-
275, a veteran may refinance a loan made under this Act if the 
new loan bears an interest rate at least one percentage point 
less than the interest rate on the loan being refinanced.
    Due to the time-consuming groundwork necessary to start 
making loans under this program, the first loans were not made 
until February, 1994. Currently, VA has entered into a total of 
50 MOUs--46 with Indian Tribes, and 4 with Pacific Islanders. 
When the Native American Veteran Direct Loan Program was 
established, we received appropriations of $5 million. Budget 
forecasts estimated that this would support direct loans 
totaling $58.4 million. A total of 164 loans totaling 
approximately $16 million have been made to native Americans 
for the purchase, construction or improvement of dwellings on 
trust land. Further, seven Native Americans, representing 100 
percent of those eligible, have been able to refinance existing 
loans made under this program.
    Clearly, this pilot program has been underutilized to date 
and, although we support its continuation, we believe that 
making the program permanent now would be premature. Although 
we have not formally estimated the costs of a permanent 
extension, those costs would be subject to the pay-as-you-go 
provisions of OBRA 1990. Rather, as reflected in S. 986, which 
you introduced at our request, VA would support a 2-year 
extension of the Native American Veteran Direct Loan Pilot 
Program. This extension would allow us additional time to 
observe the performance of the loans already made as they 
mature, as well as to make more loans for Native American 
veterans whose personal situations may not have permitted a 
home buying decision earlier. Further, it would give us more 
time to maximize the use of the valuable experience we have 
gained to this point, as well as demonstrate to private lenders 
that there is a market for private mortgages on trust lands. 
Finally, based on the activity to date, a 2-year extension 
would not require any additional appropriations. For all these 
reasons, we believe it is more appropriate to extend the pilot 
program and observe its progress rather than to make it 
permanent at this time.
          * * * * * * *
S. 986 (VA draft legislation proposing improvements in the home loan 
        programs)
    Mr. Chairman, you also requested that we comment on S. 986, 
a bill that you introduced at VA's request, which would make 
certain improvements in VA's housing loan programs to save 
costs, provide management efficiencies, and extend the sunset 
on certain expiring authorities.
          * * * * * * *
    Section 7 of S. 986 would extend for 2 years the Native 
American Housing Loan Guarantee program. As previously 
mentioned in our comments on S. 714, we fully support this 
pilot program but believe it appropriate at this time to extend 
it for 2 years to enable VA to further evaluate its 
effectiveness. Based on current loan activity, there is no 
additional appropriation required for extending this program 
for 2 years.
          * * * * * * *

  Statement of Thomas L. Garthwaite, M.D., Deputy Under Secretary for 
                 Health, Department of Veterans Affairs

    Mr. Chairman and Members, I am pleased to be here to 
discuss the array of bills being considered by the Committee. 
Included is S. 801, a bill that would make changes in 
procedures for resolving complaints of employment 
discrimination and sexual harassment, S. 999, a bill pertaining 
to setting standards for how frequently we should offer 
mammograms to women veterans, and a draft bill that would 
change our health care resource allocation system. You also 
asked that we comment on a bill making technical amendments to 
the eligibility legislation enacted last year, a bill extending 
a number of expiring authorities, a draft bill containing 
authorizations for construction projects, and finally, S. 309, 
a bill pertaining to parking fees at a VA facility in Hawaii.
          * * * * * * *

                  Draft Bill--Extensions of Authority

    Another draft bill being considered today would extend the 
authority for several successful VA programs, including VA's 
homeless programs. Authority for all the affected programs will 
otherwise expire at the end of this calendar year.

Homeless programs

    The draft would extend authority for five VA programs for 
homeless veterans. First, it would extend for three years, VA's 
authority to contract for care, treatment, and rehabilitative 
services for alcohol and drug abuse and disabilities in halfway 
houses, therapeutic communicates, psychiatric residential 
treatment centers, and other community-based treatment 
facilities. Second, it would extend for three years our 
demonstration program to provide compensated work therapy and 
therapeutic transitional housing to eligible veterans, and our 
authority to convey real property acquired under the 
Department's home loan guaranty program to nonprofit 
organizations, states, and local governments which agree to use 
the property solely as a shelter primarily for homeless 
veterans and their families.
    The bill would provide a two-year extension of our 
authority to operate demonstration programs for the provision 
of comprehensive services to homeless veterans, and make grants 
and per diem payments to homeless providers who provide housing 
and services to homeless veterans. It also would extend for two 
years the Homeless Veterans Reintegration Projects Program, a 
Labor Department administered program authorized in the Stewart 
B. McKinney Homeless Assistance Act.
    We strongly support extending these programs. As we have 
stated in past reports to Congress and in previous hearings, 
these programs have proven very successful in helping VA meet 
the medical needs of this very vulnerable population of 
veterans. However, as an alternative to simply extending some 
of these programs, we urge the Committee to consider a bill 
currently pending in the House which would consolidate, 
clarify, and codify in a new subchapter of chapter 17 of title 
38, United States Code, authority for several of these VA 
homeless activities. The House Bill would, to some extent, 
replace the patchwork of currently existing programs, several 
of which are authorized in Public Laws, not in title 38, United 
States Code.
    Specifically, the House bill would provide new authority to 
replace existing law authorizing VA's contract program for 
treating veterans with drug and alcohol abuse disabilities in 
halfway houses and community-based facilities, but leave the 
program entirely unchanged. It would also continue and improve 
VA's Compensated Work Therapy/Transitional Residence Program 
(CWT/TR). It wouldconsolidate existing reporting requirements 
into one annual report addressing all of the homeless programs. 
Finally, it would codify authority for VA's program for Homeless 
Chronically Mentally Ill Veterans (HCMI), a program that we note you 
did not extend in your bill, but which we believe should be extended 
unless you act favorably on the House bill.

Noninstitutional alternatives to nursing home care

    Another provision in the draft bill would extend VA's Pilot 
Program for Noninstitutional Alternatives to Nursing Home Care. 
VA currently uses this authority to furnish many veterans with 
health related services through contracts with appropriate 
public and private agencies. This enables many veterans to 
continue living in their homes when they would otherwise have 
to receive care in much costlier nursing homes. We support 
continuation of this authority which provides an alternative 
means for providing veterans with a full continuum of care.

Scholarship program

    Another provision in the draft bill would extend through 
December 31, 2000, VA's authority to award scholarships under 
VA's Health Professional Scholarship Program. This program has 
assisted VA in recruiting and retaining various health 
professionals, most notably nurses, physical therapists, 
occupational therapists, nurse anesthetists, and respiratory 
therapists. Under the program, VA furnished students in the 
above professions with scholarships during the final year or 
two of their education program. In return the student agreed to 
work for VA for a specified period of obligated service.
    Although we do not oppose extending this authority, it is 
unnecessary as VA no longer uses the authority. VA made its 
last award under this program at the end of 1995. Since then, 
we have not funded this program and we do not expect to fund it 
in the future. We are now placing the last scholarship 
recipients in jobs.
    We view this centralized program as unable to meet the 
Department's needs at a time when more and more program 
responsibilities are being de-centralized to the field. 
Moreover, the costs of the program increased significantly over 
time, mirroring the rising costs of tuition and training, and 
the program yielded fewer and fewer benefits to VA.

Enhanced-use leasing

    Another provision in the draft bill would extend for three 
years, VA's authority to enter into enhanced-use leases of VA 
real property. Under the highly successful enhanced-use leasing 
program, the Department enters into leasing arrangements with 
private sector entities to obtain resources beneficial to both 
parties. In return for long-term leases, the Department is able 
to obtain goods, cash, or services, such as space in a building 
built by the lessee.
    We strongly support continuation of this valuable program, 
but we want to point out that current workload indicates that 
the existing cap on the number of enhanced-use leases could be 
reached in the next fiscal year. The Administration is working 
on a proposal to improve the current authority.

          Changes in Existing Law Made by S. 714, as Reported

    In compliance with paragraph 12 of Rule XXVI of the 
Standing Rules of the Senate, changes in existing law made by 
the Committee bill, as reported, are shown as follows (existing 
law proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

                      TITLE 38--VETERANS' BENEFITS

          * * * * * * *

                       PART II--GENERAL BENEFITS

          * * * * * * *

   CHAPTER 17--HOSPITALS, NURSING HOME, DOMICILIARY, AND MEDICAL CARE

          * * * * * * *

 Subchapter II--Hospital, Nursing Home or Domiciliary Care and Medical 
                               Treatment

          * * * * * * *

Sec. 1720A. Treatment and rehabilitation for alcohol or drug dependence 
                    or abuse disabilities

    (a)(1) * * *
          * * * * * * *
    (e) The Secretary may not furnish care and treatment and 
rehabilitative services under subsection (a) of this section 
after [December 31, 1997] December 31, 1999.
          * * * * * * *

Sec. 1720C. Noninstitutional alternatives to nursing home care: pilot 
                    program

    (a) During the period through [December 31, 1997] December 
31, 1999, the Secretary may conduct a pilot program for the 
furnishing of medical, rehabilitative, and health-related 
services in noninstitutional settings for veterans who are 
eligible under this chapter for, and are in need of, nursing 
home care. The Secretary shall give priority for participation 
in such program to veterans who--
          * * * * * * *

              PART III--READJUSTMENT AND RELATED BENEFITS

          * * * * * * *

              CHAPTER 37--HOUSING AND SMALL BUSINESS LOANS

          * * * * * * *

               Subchapter III--Administrative Provisions

          * * * * * * *

Sec. 3735. Housing assistance for homeless veterans

    (a) * * *
          * * * * * * *
    (c) The Secretary may not enter into agreements under 
subsection (a) after [December 31, 1997] December 31, 1999.
          * * * * * * *

   Subchapter V--Native American Veterans Housing Loan Pilot Program

Sec. 3761. Pilot program

    (a) * * *
          * * * * * * *
    (c) No loans may be made under this subchapter after 
[September 30, 1997] December 31, 2003.

Sec. 3762. Direct housing loans to Native American veterans

    (a) * * *
          * * * * * * *
    (i)(1) The Secretary shall, in consultation with tribal 
organizations (including the National Congress of American 
Indians and the National American Indian Housing Council), 
carry out an outreach program to inform and educate [tribal 
organizations and] Native American veterans of the pilot 
program provided for under this subchapter and the availability 
of direct housing loans for Native American veterans who live 
on trust lands.
    (2) Activities under the outreach program shall include the 
following:
          (A) Attending conferences and conventions conducted 
        by the National Congress of American Indians in order 
        to work with the National Congress in providing 
        information and training to tribal organizations and 
        Native American veterans regarding the availability of 
        housing benefits under the pilot program and in 
        assisting such organizations and veterans in 
        participating in the pilot program.
          (B) Attending conferences and conventions conducted 
        by the National American Indian Housing Council in 
        order to work with the Housing Council in providing 
        information and training to tribal organizations and 
        tribal housing entities regarding the availability of 
        such benefits.
          (C) Attending conferences and conventions conducted 
        by the Department of Hawaiian Homelands in order to 
        work with the Department of Hawaiian Homelands in 
        providing information and training to tribal housing 
        entities in Hawaii regarding the availability of such 
        benefits.
          (D) Producing and disseminating information to tribal 
        governments, tribal veterans service organizations, and 
        tribal organizations regarding the availability of such 
        benefits.
          (E) Assisting tribal organizations and Native 
        American veterans in participating in the pilot 
        program.
    (j) Not later than February 1 of each of 1998 through 2003, 
the Secretary shall transmit to the Committees on Veterans' 
Affairs of the Senate and House of Representatives a report 
relating to
          (1) the implementation of the pilot program under 
        this subchapter during the fiscal year preceding the 
        date of the report;
          (2) the Secretary's exercise during such fiscal year 
        of the authority provided under subsection (c)(1)(B) of 
        this title to make loans exceeding the maximum loan 
        amount;
          (3) the appraisals performed for the Secretary during 
        such fiscal year under the authority of subsection 
        (d)(2) of this title, including a description of--
                  (A) the manner in which such appraisals were 
                performed;
                  (B) the qualifications of the appraisers who 
                performed such appraisals; and
                  (C) the actions taken by the Secretary with 
                respect to such appraisals to protect the 
                interests of veterans and the United States;
          (4) the outreach activities undertaken under 
        subsection (i) of this title during such fiscal year, 
        including--
                  (A) a description of such activities on a 
                region-by-region basis; and
                  (B) an assessment of the effectiveness of 
                such activities in encouraging the 
                participation of Native American veterans in 
                the pilot program;
          (5) the pool of Native American veterans who are 
        eligible for participation in the pilot program, 
        including--
                  (A) a description and analysis of the pool; 
                and
                  (B) a description and assessment of the 
                impediments, if any, to full participation in 
                the pilot program of the Native American 
                veterans in the pool; and
          (6) the Secretary's recommendations, if any, for 
        additional legislation regarding the pilot program.
            * * * * * * *

             PART V--BOARDS, ADMINISTRATIONS, AND SERVICES

          * * * * * * *

    CHAPTER 76--HEALTH PROFESSIONALS EDUCATIONAL ASSISTANCE PROGRAM

          * * * * * * *

                   Subchapter II--Scholarship Program

          * * * * * * *

Sec. 7618. Expiration of program

    The Secretary may not furnish scholarships to new 
participants in the Scholarship Program after [December 31, 
1997] December 31, 1999.
          * * * * * * *

            PART VI--ACQUISITION AND DISPOSITION OF PROPERTY

   CHAPTER 81--ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY 
    FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL 
                                PROPERTY

          * * * * * * *

          Subchapter V--Enhanced-used Leases of Real Property

          * * * * * * *

Sec. 8168. Limitation on number of agreements

    (a) Not more than [20] 40 enhanced-use leases may be 
entered into under this subchapter, and not more than 10 such 
leases may be entered into during any fiscal year.
          * * * * * * *

Sec. 8169. Expiration

    The authority of the Secretary to enter into enhanced-use 
leases under this subchapter expires on [December 31, 1997] 
December 31, 1999.
          * * * * * * *

              VETERANS' BENEFITS AND SERVICES ACT OF 1988

                   (Public Law 100-322--May 20, 1988)

          * * * * * * *

SEC. 115. PILOT PROGRAM OF COMMUNITY-BASED RESIDENTIAL CARE FOR 
                    HOMELESS CHRONICALLY MENTALLY ILL AND OTHER 
                    VETERANS

    (a) * * *
          * * * * * * *
    (d) Duration of Program.--The authority for the pilot 
program authorized by this section expires on [December 31, 
1998] December 31, 1999.
          * * * * * * *

                    PUBLIC LAW 102-54--JUNE 13, 1991

          * * * * * * *

SEC. 7. DEMONSTRATION PROGRAM OF COMPENSATED WORK THERAPY AND 
                    THERAPEUTIC TRANSITIONAL HOUSING

    (a) Demonstration Program.--During the period beginning on 
October 1, 1991, and ending on [December 31, 1997] December 31, 
1999, the Secretary of Veterans Affairs may carry out a 
compensated work therapy and therapeutic transitional housing 
demonstration program. The demonstration program shall have two 
components, as follows:
    (1) * * *
          * * * * * * *

      HOMELESS VETERANS COMPREHENSIVE SERVICE PROGRAMS ACT OF 1992

                (Public Law 102-590, November 10, 1992)

          * * * * * * *

SEC. 2. PILOT PROGRAM

    (a) In General.--Subject to the availability of 
appropriations provided for under section 12, the Secretary of 
Veterans Affairs shall establish and operate, through 
[September 30, 1997] September 30, 1999, a pilot program under 
this Act to expand and improve theprovision of benefits and 
services by the Department of Veterans Affairs to homeless veterans.
          * * * * * * *

SEC. 3. GRANTS.

    (a)(1) * * *
    (2) The authority of the Secretary to make grants under 
this section expires on [September 30, 1997] September 30, 
1999.
          * * * * * * *

SEC. 12. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated to carry out this 
Act (other than section 8) $48,000,000 for each of fiscal years 
1993 [through 1997] through 1999. No funds may be used to carry 
out the provisions of sections 2, 3, and 4 of this Act unless 
expressly provided for in an appropriation law. Nothing in this 
Act shall be construed to diminish funds for, continuation of, 
or expansion of existing programs administered by the Secretary 
of Veterans Affairs to serve veterans.
          * * * * * * *

                  TITLE 42--PUBLIC HEALTH AND WELFARE

          * * * * * * *

                    CHAPTER 119--HOMELESS ASSISTANCE

          * * * * * * *

  Subchapter VI--Education, Training, and Community Services Programs

          * * * * * * *

                   Part C--Job Training for Homeless

          * * * * * * *

Sec. 11448. Homeless veterans' reintegration projects

    (a) * * *
          * * * * * * *
    (e) Authorization of Appropriations.--
          (1) There are authorized to be appropriated to carry 
        out this section the following amounts:
                  (A) * * *
          * * * * * * *
                  (G) $10,000,000 for fiscal year 1999.

Sec. 11450. Termination

    The provisions of this part other than section 738 and 740 
shall terminate on [December 31, 1997] December 31, 1999.
          * * * * * * *