[Senate Report 106-397]
[From the U.S. Government Publishing Office]



                                                       Calendar No. 787
106th Congress                                                   Report
                                 SENATE
 2d Session                                                     106-397

======================================================================



 
               VETERANS PROGRAMS ENHANCEMENT ACT OF 2000

                                _______
                                

               September 6, 2000.--Ordered to be printed

                                _______
                                

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

                              R E P O R T

                         [To accompany S. 1810]

    The Committee on Veterans' Affairs, to which was referred a 
bill (S. 1810) to clarify and improve veterans' claims and 
appellate procedures, 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 and insert in lieu 
thereof the following:

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans Programs 
Enhancement Act of 2000''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

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

                       TITLE I--BENEFITS MATTERS

              Subtitle A--Compensation and Pension Matters

Sec. 101. Clarification and enhancement of authorities relating to the 
processing of claims for veterans benefits.
Sec. 102. Expansion of list of diseases presumed to be service-
connected for radiation-exposed veterans.
Sec. 103. Special monthly compensation for female veterans who lose a 
breast as a result of a service-connected disability.

                     Subtitle B--Education Matters

Sec. 111. Making uniform the requirement for high school diploma or 
equivalency before application for Montgomery GI Bill benefits.
Sec. 112. Repeal of requirement for initial obligated period of active 
duty as condition of eligibility for Montgomery GI Bill benefits.
Sec. 113. Availability under survivors' and dependents' educational 
assistance of preparatory courses for college and graduate school 
entrance exams.
Sec. 114. Election of certain recipients of commencement of period of 
eligibility for survivors' and dependents' educational assistance.
Sec. 115. Adjusted effective date for award of survivors' and 
dependents' educational assistance.

                      Subtitle C--Housing Matters

Sec. 121. Elimination of reduction in assistance for specially adapted 
housing for disabled veterans for veterans having joint ownership of 
housing units.
Sec. 122. Increase in maximum amount of housing loan guarantee.
Sec. 123. Termination of collection of loan fees from veterans rated 
eligible for compensation at pre-discharge rating examinations.

                     Subtitle D--Insurance Matters

Sec. 131. Premiums for term service disabled veterans' insurance for 
veterans older than age 70.
Sec. 132. Increase in automatic maximum coverage under Servicemembers' 
Group Life Insurance and Veterans' Group Life Insurance.
Sec. 133. Family coverage under Servicemembers' Group Life Insurance.

                       Subtitle E--Burial Matters

Sec. 141. Eligibility for interment in the national cemeteries of 
certain Filipino veterans of World War II.

                     Subtitle F--Employment Matters

Sec. 151. Veterans employment emphasis under Federal contracts for 
recently separated veterans.
Sec. 152. Comptroller General audit of veterans employment and training 
service of the Department of Labor.

      Subtitle G--Benefits for Children of Female Vietnam Veterans

Sec. 161. Short title.
Sec. 162. Benefits for the children of female Vietnam veterans who 
suffer from certain birth defects.

                   Subtitle H--Other Benefits Matters

Sec. 171. Review of dose reconstruction program of the Defense Threat 
Reduction Agency.

                     TITLE II--HEALTH CARE MATTERS

Sec. 201. Veterans not subject to copayments for medications.
Sec. 202. Establishment of position of Advisor on Physician Assistants 
within Office of Undersecretary for Health.
Sec. 203. Temporary full-time appointments of certain medical 
personnel.

             TITLE III--CONSTRUCTION AND FACILITIES MATTERS

                    Subtitle A--Construction Matters

Sec. 301. Authorization of major medical facility projects for fiscal 
year 2001.
Sec. 302. Authorization of additional major medical facility project 
for fiscal year 2000.
Sec. 303. Authorization of appropriations.

                       Subtitle B--Other Matters

Sec. 311. Maximum term of lease of Department of Veterans Affairs 
property for homeless purposes.
Sec. 312. Land conveyance, Miles City Veterans Administration Medical 
Complex, Miles City, Montana.
Sec. 313. Conveyance of Ft. Lyon Department of Veterans Affairs Medical 
Center, Colorado, to the State of Colorado.
Sec. 314. Effect of closure of Ft. Lyon Department of Veterans Affairs 
Medical Center on administration of health care for veterans.

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

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

                       TITLE I--BENEFITS MATTERS

              Subtitle A--Compensation and Pension Matters

SEC. 101. CLARIFICATION AND ENHANCEMENT OF AUTHORITIES RELATING TO THE 
                    PROCESSING OF CLAIMS FOR VETERANS BENEFITS.

    (a) Definition of Claimant.--Chapter 51 is amended--
          (1) by redesignating section 5101 as section 5101A; and
          (2) by inserting before section 5101A, as so redesignated, 
        the following new section:

``Sec. 5101. Definition of `claimant'

    ``For purposes of this chapter, the term `claimant' means any 
individual who submits a claim for benefits under the laws administered 
by the Secretary.''.
    (b) Incomplete Applications.--Section 5103(a) is amended by 
striking ``evidence'' both places it appears and inserting 
``information''.
    (c) Reaffirmation and Clarification of Duty to Assist.--Chapter 51 
is further amended by inserting after section 5103 the following new 
section:

``Sec. 5103A. Assistance to claimants

    ``(a) Except as provided in subsection (b), the Secretary shall 
make reasonable efforts to assist in the development of information and 
medical or lay evidence necessary to establish the eligibility of a 
claimant for benefits under the laws administered by the Secretary.
    ``(b) The Secretary is not required to provide assistance to a 
claimant under subsection (a) if no reasonable possibility exists, as 
determined in accordance with regulations prescribed under subsection 
(f), that such assistance would aid in the establishment of the 
eligibility of the claimant for benefits under the laws administered by 
the Secretary.
    ``(c) In any claim for benefits under the laws administered by the 
Secretary, the assistance provided by the Secretary under subsection 
(a) shall include the following:
          ``(1) Informing the claimant and the claimant's 
        representative, if any, of the information and medical or lay 
        evidence needed in order to aid in the establishment of the 
        eligibility of the claimant for benefits under the laws 
        administered by the Secretary.
          ``(2) Informing the claimant and the claimant's 
        representative, if any, if the Secretary is unable to obtain 
        any information or medical or lay evidence described in 
        paragraph (1).
    ``(d)(1) In any claim for disability compensation under chapter 11 
of this title, the assistance provided by the Secretary under 
subsection (a) shall include, in addition to the assistance provided 
under subsection (c), the following:
          ``(A) Obtaining the relevant service and medical records 
        maintained by applicable governmental entities that pertain to 
        the veteran for the period or periods of the veteran's service 
        in the active military, naval, or air service.
          ``(B) Obtaining existing records of relevant medical 
        treatment or examination provided at Department health-care 
        facilities or at the expense of the Department, but only if the 
        claimant has furnished information sufficient to locate such 
        records.
          ``(C) Obtaining from governmental entities any other relevant 
        records the claimant adequately identifies and authorizes the 
        Secretary to obtain.
          ``(D) Making reasonable efforts to obtain from private 
        persons and entities any other relevant records the claimant 
        adequately identifies and authorizes the Secretary to obtain.
          ``(E) Providing a medical examination needed for the purpose 
        of determining the existence of a current disability if the 
        claimant submits verifiable evidence, as determined in 
        accordance with the regulations prescribed under subsection 
        (f), establishing that the claimant is unable to afford medical 
        treatment.
          ``(F) Providing such other assistance as the Secretary 
        considers appropriate.
    ``(2) The efforts made to obtain records under subparagraphs (A), 
(B), and (C) of paragraph (1) shall continue until it is reasonably 
certain, as determined in accordance with the regulations prescribed 
under subsection (f), that such records do not exist.
    ``(e) If while obtaining or after obtaining information or lay or 
medical evidence under subsection (d) the Secretary determines that a 
medical examination or a medical opinion is necessary to substantiate 
entitlement to a benefit, the Secretary shall provide such medical 
examination or obtain such medical opinion.
    ``(f) The Secretary shall prescribe regulations for purposes of the 
administration of this section.''.
    (d) Cost of Other Agencies in Furnishing Information.--Section 5106 
is amended by adding at the end the following new sentence: ``The cost 
of providing such information shall be borne by the department or 
agency providing such information.''.
    (e) Repeal of ``Well-Grounded Claim'' Rule.--Section 5107 is 
amended to read as follows:

``Sec. 5107. Burden of proof; benefit of the doubt

    ``(a) Except when otherwise provided by this title or by the 
Secretary in accordance with the provisions of this title, a claimant 
shall have the burden of proof in establishing entitlement to benefits 
under the laws administered by the Secretary.
    ``(b) The Secretary shall consider all information and lay and 
medical evidence of record in a case before the Department with respect 
to benefits under laws administered by the Secretary, and shall give 
the claimant the benefit of the doubt when there is an approximate 
balance of positive and negative evidence regarding an issue material 
to the determination of the matter.''.
    (f) Applicability of Enhanced Authorities.--(1) Except as 
specifically provided otherwise, section 5103A of title 38, United 
States Code (as added by subsection (c)), and section 5107 of title 38, 
United States Code (as amended by subsection (e)), shall apply to any 
claim pending on or filed on or after the date of the enactment of this 
Act.
    (2)(A) In the case of a claim for benefits described in 
subparagraph (B), the Secretary of Veterans Affairs shall, upon the 
request of the claimant, or upon the Secretary's motion, order such 
claim readjudicated in accordance with section 5103A of title 38, 
United States Code (as so added), and section 5107 of title 38, United 
States Code (as so amended), as if the denial or dismissal of such 
claim as described in that subparagraph had not been made.
    (B) A claim for benefits described in this subparagraph is any 
claim for benefits--
          (i) the denial of which became final during the period 
        beginning on July 14, 1999, and ending on the date of the 
        enactment of this Act; and
          (ii) which was denied or dismissed because the claim was not 
        well grounded (as that term was used in section 5107(a) of 
        title 38, United States Code, during the period referred to in 
        clause (i)).
    (3) No claim shall be readjudicated under paragraph (2) unless the 
request for readjudication is filed, or the motion made, not later than 
two years after the date of the enactment of this Act.
    (4) In the absence of a timely request of a claimant under 
paragraph (3), nothing in this subsection shall be construed as 
establishing a duty on the part of the Secretary to locate and 
readjudicate a claim described in paragraph (2)(B).
    (g) Clerical Amendments.--The table of sections at the beginning of 
chapter 51 is amended--
          (1) by striking the item relating to section 5101 and 
        inserting the following new items:

``5101. Definition of `claimant'.
``5101A. Claims and forms.''; and

          (2) by inserting after the item relating to section 5103 the 
        following new item:

``5103A. Assistance to claimants.''.

SEC. 102. EXPANSION OF LIST OF DISEASES PRESUMED TO BE SERVICE-
                    CONNECTED FOR RADIATION-EXPOSED VETERANS.

    Section 1112(c)(2) is amended by adding at the end the following:
          ``(P) Lung cancer.
          ``(Q) Colon cancer.
          ``(R) Tumors of the brain and central nervous system.
          ``(S) Ovarian cancer.''.

SEC. 103. SPECIAL MONTHLY COMPENSATION FOR FEMALE VETERANS WHO LOSE A 
                    BREAST AS A RESULT OF A SERVICE-CONNECTED 
                    DISABILITY.

    (a) In General.--Section 1114(k) is amended--
          (1) by striking ``or has suffered'' and inserting ``has 
        suffered''; and
          (2) by inserting after ``air and bone conduction,'' the 
        following: ``or, in the case of a female veteran, has suffered 
        the anatomical loss of one or both breasts (including loss by 
        mastectomy),''.
    (b) Effective Date.--(1) The amendments made by subsection (a) 
shall take effect on the date of the enactment of this Act, and shall 
apply with respect to payment of compensation under section 1114(k) of 
title 38, United States Code (as so amended), for months beginning on 
or after that date.
    (2) No compensation may be paid for any period before the date of 
the enactment of this Act by reason of the amendments made by 
subsection (a).

                     Subtitle B--Education Matters

SEC. 111. MAKING UNIFORM THE REQUIREMENT FOR HIGH SCHOOL DIPLOMA OR 
                    EQUIVALENCY BEFORE APPLICATION FOR MONTGOMERY GI 
                    BILL BENEFITS.

    (a) Active Duty Program.--(1) Section 3011 is amended--
          (A) in subsection (a), by striking paragraph (2) and 
        inserting the following new paragraph (2):
          ``(2) who completes the requirements of a secondary school 
        diploma (or equivalency certificate), or successfully completes 
        (or otherwise receives academic credit for) the equivalent of 
        12 semester hours in a program of education leading to a 
        standard college degree, before applying for benefits under 
        this section; and'';
          (B) by striking subsection (e); and
          (C) by redesignating subsections (f), (g), (h), and (i) as 
        subsections (e), (f), (g), and (h), respectively.
    (2) Section 3017(a)(1)(A)(ii) is amended by striking ``clause 
(2)(A)'' and inserting ``clause (2)''.
    (b) Selected Reserve Program.--Section 3012 is amended--
          (1) in subsection (a), by striking paragraph (2) and 
        inserting the following new paragraph (2):
          ``(2) who completes the requirements of a secondary school 
        diploma (or equivalency certificate), or successfully completes 
        (or otherwise receives academic credit for) the equivalent of 
        12 semester hours in a program of education leading to a 
        standard college degree, before applying for benefits under 
        this section; and'';
          (2) by striking subsection (f); and
          (3) by redesignating subsection (g) as subsection (f).
    (c) Withdrawal of Election Not To Enroll.--Section 3018(b)(4) is 
amended to read as follows:
          ``(4) before applying for benefits under this section--
                  ``(A) completes the requirements of a secondary 
                school diploma (or equivalency certificate); or
                  ``(B) successfully completes (or otherwise receives 
                academic credit for) the equivalent of 12 semester 
                hours in a program of education leading to a standard 
                college degree; and''.
    (d) Educational Assistance Program for Members of the Selected 
Reserve.--Paragraph (2) of section 16132(a) of title 10, United States 
Code, is amended to read as follows:
          ``(2) before applying for benefits under this section, has 
        completed the requirements of a secondary school diploma (or an 
        equivalency certificate);''.

SEC. 112. REPEAL OF REQUIREMENT FOR INITIAL OBLIGATED PERIOD OF ACTIVE 
                    DUTY AS CONDITION OF ELIGIBILITY FOR MONTGOMERY GI 
                    BILL BENEFITS.

    (a) Active Duty Program.--Section 3011, as amended by section 111 
of this Act, is further amended--
          (1) in subsection (a)(1)(A)--
                  (A) by striking clause (i) and inserting the 
                following new clause (i):
                          ``(i) who serves an obligated period of 
                        active duty of at least two years of continuous 
                        active duty in the Armed Forces; or''; and
                  (B) in clause (ii)(II), by striking ``in the case of 
                an individual who completed not less than 20 months'' 
                and all that follows through ``was at least three 
                years'' and inserting ``if, in the case of an 
                individual with an obligated period of service of two 
                years, the individual completes not less than 20 months 
                of continuous active duty under that period of 
                obligated service, or, in the case of an individual 
                with an obligated period of service of three years, the 
                individual completes not less than 30 months of 
                continuous active duty under that period of obligated 
                service'';
          (2) in subsection (d)(1), by striking ``individual's initial 
        obligated period of active duty'' and inserting ``obligated 
        period of active duty on which an individual's entitlement to 
        assistance under this section is based'';
          (3) in subsection (g)(2)(A), as redesignated by section 
        111(a)(1)(C) of this Act, by striking ``during an initial 
        period of active duty,'' and inserting ``during the obligated 
        period of active duty on which entitlement to assistance under 
        this section is based,''; and
          (4) in subsection (h), as so redesignated, by striking 
        ``initial''.
    (b) Selected Reserve Program.--Section 3012 is amended--
          (1) in subsection (a)(1)(A)(i), by striking ``, as the 
        individual's'' and all that follows through ``Armed Forces'' 
        and inserting ``an obligated period of active duty of at least 
        two years of continuous active duty in the Armed Forces''; and
          (2) in subsection (e)(1), by striking ``initial''.
    (c) Duration of Assistance.--Section 3013 is amended--
          (1) in subsection (a)(2), by striking ``individual's initial 
        obligated period of active duty'' and inserting ``obligated 
        period of active duty on which such entitlement is based''; and
          (2) in subsection (b)(1), by striking ``individual's initial 
        obligated period of active duty'' and inserting ``obligated 
        period of active duty on which such entitlement is based''.
    (d) Amount of Assistance.--Section 3015 is amended--
          (1) in the second sentence of subsection (a), by inserting 
        before ``a basic educational assistance allowance'' the 
        following: ``in the case of an individual entitled to an 
        educational assistance allowance under this chapter whose 
        obligated period of active duty on which such entitlement is 
        based is three years,'';
          (2) in subsection (b), by striking ``and whose initial 
        obligated period of active duty is two years,'' and inserting 
        ``whose obligated period of active duty on which such 
        entitlement is based is two years,''; and
          (3) in subsection (c)(2), by striking subparagraphs (A) and 
        (B) and inserting the following new subparagraphs (A) and (B):
                  ``(A) whose obligated period of active duty on which 
                such entitlement is based is less than three years;
                  ``(B) who, beginning on the date of the commencement 
                of such obligated period of active duty, serves a 
                continuous period of active duty of not less than three 
                years; and''.

SEC. 113. AVAILABILITY UNDER SURVIVORS' AND DEPENDENTS' EDUCATIONAL 
                    ASSISTANCE OF PREPARATORY COURSES FOR COLLEGE AND 
                    GRADUATE SCHOOL ENTRANCE EXAMS.

    Paragraph (5) of section 3501(a) is amended by adding at the end 
the following new sentence: ``The term also includes any preparatory 
course described in section 3002(3)(B) of this title.''.

SEC. 114. ELECTION OF CERTAIN RECIPIENTS OF COMMENCEMENT OF PERIOD OF 
                    ELIGIBILITY FOR SURVIVORS' AND DEPENDENTS' 
                    EDUCATIONAL ASSISTANCE.

    Section 3512(a)(3) is amended by striking ``8 years after,'' and 
all that follows through the end and inserting ``8 years after the date 
elected by the person (if such election is approved as the beginning 
date of such period by the Secretary and is made during the period 
between such birthdays) which beginning date--
          ``(A) in the case of a person whose eligibility is based on a 
        parent who has a service-connected total disability permanent 
        in nature, shall be between the dates described in subsection 
        (d) of this section; and
          ``(B) in the case of a person whose eligibility is based on 
        the death of a parent, shall be between--
                  ``(i) the date of the parent's death; and
                  ``(ii) the date of the Secretary's decision that the 
                death was service-connected;''.

SEC. 115. ADJUSTED EFFECTIVE DATE FOR AWARD OF SURVIVORS' AND 
                    DEPENDENTS' EDUCATIONAL ASSISTANCE.

    (a) In General.--Section 5113 is amended--
          (1) in subsection (a), by striking ``subsection (b) of this 
        section,'' and inserting ``subsections (b) and (c),'';
          (2) by redesignating subsection (b) as subsection (c); and
          (3) by inserting after subsection (a) the following new 
        subsection (b):
    ``(b)(1) In determining the effective date of an award of 
educational assistance under chapter 35 of this title for an individual 
described in paragraph (2) based on an original claim, the Secretary 
shall consider the individual's application under section 3513 of this 
title as having been filed on the effective date from which the 
Secretary, by rating decision, determines that the veteran from whom 
eligibility for such educational assistance is derived either died of a 
service-connected disability or established the existence of a total 
service-connected disability evaluated as permanent in nature if that 
effective date is more than one year before the date the rating 
decision is made.
    ``(2) An individual referred to in paragraph (1) is a person 
eligible for educational assistance under chapter 35 of this title by 
reason of subparagraph (A)(i), (A)(ii), (B), or (D) of section 
3501(a)(1) of this title who--
          ``(A) submits to the Secretary an original application under 
        section 3513 of this title for educational assistance under 
        that chapter within one year after the date that the Secretary 
        issues the rating decision on which the individual's 
        eligibility for such educational assistance is based;
          ``(B) claims such educational assistance for pursuit of an 
        approved program of education during a period or periods 
        preceding the one-year period ending on the date on which the 
        individual's application under that section is received by the 
        Secretary; and
          ``(C) would, without regard to this subsection, have been 
        entitled to such educational assistance for pursuit of such 
        approved program of education if the individual had submitted 
        such application on the effective date from which the Secretary 
        determined that the individual was eligible for such 
        educational assistance.''.
    (b) Stylistic Amendment.--Subsection (c) of that section, as 
redesignated by subsection (a)(2) of this section, is amended by 
striking ``of this section''.
    (c) Applicability.--The amendments made by this section shall take 
effect on the date of the enactment of this Act, and shall apply with 
respect to applications first made under section 3513 of title 38, 
United States Code, that--
          (1) are received by the Secretary of Veterans Affairs on or 
        after the date of the enactment of this Act; or
          (2) as of that date are pending with the Secretary or 
        exhaustion of available administrative and judicial remedies.

                      Subtitle C--Housing Matters

SEC. 121. ELIMINATION OF REDUCTION IN ASSISTANCE FOR SPECIALLY ADAPTED 
                    HOUSING FOR DISABLED VETERANS FOR VETERANS HAVING 
                    JOINT OWNERSHIP OF HOUSING UNITS.

    Section 2102 is amended by adding at the end the following new 
subsection:
    ``(c) The amount of assistance afforded under subsection (a) for a 
veteran authorized assistance by section 2101(a) of this title shall 
not be reduced by reason that title to the housing unit, which is 
vested in the veteran, is also vested in any other person, if the 
veteran resides in the housing unit.''.

SEC. 122. INCREASE IN MAXIMUM AMOUNT OF HOUSING LOAN GUARANTEE.

    (a) In General.--Subparagraph (A)(i)(IV) of section 3703(a)(1) is 
amended by striking ``$50,750'' and inserting ``$63,175''.
    (b) Conforming Amendment.--Subparagraph (B) of that section is 
amended by striking ``$50,750'' and inserting ``$63,175''.

SEC. 123. TERMINATION OF COLLECTION OF LOAN FEES FROM VETERANS RATED 
                    ELIGIBLE FOR COMPENSATION AT PRE-DISCHARGE RATING 
                    EXAMINATIONS.

    Section 3729(c) is amended--
          (1) by inserting ``(1)'' before ``A fee''; and
          (2) by adding at the end the following new paragraph:
    ``(2) A veteran who is rated eligible to receive compensation as a 
result of a pre-discharge disability examination and rating shall be 
treated as receiving compensation for purposes of this subsection as of 
the date on which the veteran is rated eligible to receive compensation 
as a result of the pre-discharge disability examination and rating 
without regard to whether an effective date of the award of 
compensation is established as of that date.''.

                     Subtitle D--Insurance Matters

SEC. 131. PREMIUMS FOR TERM SERVICE DISABLED VETERANS' INSURANCE FOR 
                    VETERANS OLDER THAN AGE 70.

    Section 1922 is amended by adding at the end the following new 
subsection:
    ``(c) The premium rate of any term insurance issued under this 
section shall not exceed the renewal age 70 premium rate.''.

SEC. 132. INCREASE IN AUTOMATIC MAXIMUM COVERAGE UNDER SERVICEMEMBERS' 
                    GROUP LIFE INSURANCE AND VETERANS' GROUP LIFE 
                    INSURANCE.

    (a) Maximum Under Servicemembers' Group Life Insurance.--Section 
1967 is amended in subsections (a), (c), and (d) by striking 
``$200,000'' each place it appears and inserting ``$250,000''.
    (b) Maximum Under Veterans' Group Life Insurance.--Section 1977(a) 
is amended by striking ``$200,000'' each place it appears and inserting 
``$250,000''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the first day of the first month that begins more than 120 
days after the date of the enactment of this Act.

SEC. 133. FAMILY COVERAGE UNDER SERVICEMEMBERS' GROUP LIFE INSURANCE.

    (a) Insurable Dependents.--Section 1965 is amended by adding at the 
end the following:
          ``(10) The term `insurable dependent', with respect to a 
        member, means the following:
                  ``(A) The member's spouse.
                  ``(B) A child of the member for so long as the child 
                is unmarried and the member is providing over 50 
                percent of the support of the child.''.
    (b) Insurance Coverage.--(1) Subchapter III of chapter 19 is 
amended by inserting after section 1967 the following new section:

``Sec. 1967A. Insurance of dependents

    ``(a) Subject to the provisions of this section, any policy of 
insurance purchased by the Secretary under section 1966 of this title 
shall also automatically insure against death each insurable dependent 
of a member.
    ``(b)(1) A member insurable under this subchapter may make an 
election not to insure a spouse under this subchapter.
    ``(2) Except as provided in subsection (c)(3), a spouse covered by 
an election under paragraph (1) is not insured under this section.
    ``(3) Except as otherwise provided under this section, no insurable 
dependent of a member is insured under this section unless the member 
is insured under this subchapter.
    ``(c)(1) Subject to an election under paragraph (2), the amount for 
which a person insured under this section is insured under this 
subchapter is as follows:
          ``(A) In the case of a member's spouse, the lesser of--
                  ``(i) the amount for which the member is insured 
                under this subchapter; or
                  ``(ii) $50,000.
          ``(B) In the case of a member's child, $5,000.
    ``(2) A member may elect in writing to insure the member's spouse 
in an amount less than the amount provided for under paragraph (1)(A). 
The amount of insurance so elected shall be evenly divisible by 
$10,000.
    ``(3) If a spouse eligible for insurance under this section is not 
so insured, or is insured for less than the maximum amount provided for 
under subparagraph (A) of paragraph (1) by reason of an election made 
by the member concerned under paragraph (2), the spouse may thereafter 
be insured under this section in the maximum amount or any lesser 
amount elected as provided for in paragraph (2) upon written 
application by the member, proof of good health of the spouse, and 
compliance with such other terms and conditions as may be prescribed by 
the Secretary.
    ``(d)(1) Insurance coverage under this section with respect to an 
insurable dependent of the member shall cease--
          ``(A) upon election made in writing by the member to 
        terminate the coverage; or
          ``(B) the date that is 120 days after the earlier of--
                  ``(i) the date of the member's death;
                  ``(ii) the date of termination of the insurance on 
                the member under this subchapter; or
                  ``(iii) the date on which the insurable dependent of 
                the member no longer meets the criteria applicable to 
                an insurable dependent as specified in section 1965(10) 
                of this title.
    ``(2)(A) At the election of an insured spouse whose insurance under 
this subchapter is terminated under paragraph (1), the insurance shall 
be converted to an individual policy of insurance upon written 
application for conversion made to the participating company selected 
by the insured spouse and the payment of the required premiums.
    ``(B) The individual policy of insurance of an insured spouse 
making an election under subparagraph (A) shall become effective on the 
date of the termination of the spouse's insurance under paragraph (1).
    ``(C) The second, fourth, and fifth sentences of section 1977(e) of 
this title shall apply with respect to the insurance of an insured 
spouse under this paragraph.
    ``(e)(1) During any period in which the spouse of a member is 
insured under this section, there shall be deducted each month from the 
member's basic or other pay, or otherwise collected from the member, 
until the member's separation or release from active duty an amount 
determined by the Secretary (which shall be the same for all such 
members) as the premium allocable to the pay period for providing that 
insurance coverage.
    ``(2)(A) The Secretary shall determine the premium amounts to be 
charged for insurance coverage for spouses of members under this 
section.
    ``(B) The premium amounts shall be determined on the basis of sound 
actuarial principles and shall include an amount necessary to cover the 
administrative costs to the insurer or insurers providing such 
insurance.
    ``(C) Each premium rate for the first policy year shall be 
continued for subsequent policy years, except that the rate may be 
adjusted for any such subsequent policy year on the basis of the 
experience under the policy, as determined by the Secretary in advance 
of that policy year.
    ``(3) Any amounts deducted or collected under paragraph (1), 
together with the income derived from any dividends or premium rate 
adjustments received from insurers with respect to insurance under this 
section, shall be deposited to the credit of the revolving fund 
established by section 1969(d) of this title, and shall be available 
for payment and use in accordance with the provisions of that section.
    ``(f) Any amount of insurance in force on an insurable dependent of 
a member under this section on the date of the dependent's death shall 
be paid, upon the establishment of a valid claim therefor, to the 
member or, in the event of the member's death before payment to the 
member can be made, then to the person or persons entitled to receive 
payment of the proceeds of insurance on the member' life under section 
1970 of this title.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 1967 the 
following new item:

``1967A. Insurance of dependents.''.

    (c) Effective Date and Initial Implementation.--(1) This section 
and the amendments made by this section shall take effect on the first 
day of the first month that begins more than 120 days after the date of 
the enactment of this Act, except that paragraph (2) shall take effect 
on the date of the enactment of this Act.
    (2) The Secretary of Veterans Affairs, in consultation with the 
Secretaries of the military departments, the Secretary of 
Transportation, the Secretary of Commerce, and the Secretary of Health 
and Human Services, shall take such action as is necessary to ensure 
that each member of the uniformed services on active duty (other than 
active duty for training) during the period between the date of the 
enactment of this Act and the effective date under paragraph (1) is 
furnished an explanation of the insurance benefits available for 
dependents under the amendments made by this section and is afforded an 
opportunity before such effective date to make elections that are 
authorized under those amendments to be made with respect to 
dependents.

                       Subtitle E--Burial Matters

SEC. 141. ELIGIBILITY FOR INTERMENT IN THE NATIONAL CEMETERIES OF 
                    CERTAIN FILIPINO VETERANS OF WORLD WAR II.

    (a) Eligibility of Certain Commonwealth Army Veterans.--Section 
2402 is amended by adding at the end the following new paragraph:
          ``(8) Any individual whose service is described in section 
        107(a) of this title if such individual at the time of death--
                  ``(A) was a naturalized citizen of the United States; 
                and
                  ``(B) resided in the United States.''.
    (b) Conforming Amendment.--Section 107(a)(3) is amended by striking 
the period at the end and inserting the following: ``, and chapter 24 
of this title to the extent provided for in section 2402(8) of this 
title.''.
    (c) Applicability.--The amendments made by this section shall take 
effect on the date of the enactment of this Act, and shall apply with 
respect to deaths occurring on or after that date.

                     Subtitle F--Employment Matters

SEC. 151. VETERANS EMPLOYMENT EMPHASIS UNDER FEDERAL CONTRACTS FOR 
                    RECENTLY SEPARATED VETERANS.

    (a) Employment Emphasis.--Subsection (a) of section 4212 is amended 
in the first sentence by inserting ``recently separated veterans,'' 
after ``veterans of the Vietnam era,''.
    (b) Conforming Amendments.--Subsection (d)(1) of that section is 
amended by inserting ``recently separated veterans,'' after ``veterans 
of the Vietnam era,'' each place it appears in subparagraphs (A) and 
(B).
    (c) Recently Separated Veteran Defined.--Section 4211 is amended by 
adding at the end the following new paragraph:
    ``(6) The term `recently separated veteran' means any veteran 
during the one-year period beginning on the date of such veteran's 
discharge or release from active duty.''.

SEC. 152. COMPTROLLER GENERAL AUDIT OF VETERANS EMPLOYMENT AND TRAINING 
                    SERVICE OF THE DEPARTMENT OF LABOR.

    (a) Requirement.--The Comptroller General of the United States 
shall carry out a comprehensive audit of the Veterans Employment and 
Training Service of the Department of Labor. The purpose of the audit 
is to provide a basis for future evaluations of the effectiveness of 
the Service is meeting its mission.
    (b) Commencement Date.--The audit required by subsection (a) shall 
commence not earlier than January 1, 2001.
    (c) Elements.--In carrying out the audit of the Veterans Employment 
and Training Service required by subsection (a), the Comptroller 
General shall--
          (1) review the requirements applicable to the Service under 
        law, including requirements under title 38, United States Code, 
        and the regulations thereunder;
          (2) evaluate the organizational structure of the Service; and
          (3) evaluate or assess any other matter relating to the 
        Service that the Comptroller General considers appropriate for 
        the purpose specified in subsection (a).
    (d) Report.--Not later than one year after the date of the 
enactment of this Act, the Comptroller General shall submit to the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives a report on the audit carried out under subsection (a). 
The report shall include--
          (1) the results of the audit; and
          (2) any recommendations that the Comptroller General 
        considers appropriate regarding the organization or functions 
        of the Veterans Employment and Training Service of the 
        Department of Labor.

      Subtitle G--Benefits for Children of Female Vietnam Veterans

SEC. 161. SHORT TITLE.

    This subtitle may be cited as the ``Children of Women Vietnam 
Veterans' Benefits Act of 2000''.

SEC. 162. BENEFITS FOR THE CHILDREN OF FEMALE VIETNAM VETERANS WHO 
                    SUFFER FROM CERTAIN BIRTH DEFECTS.

    (a) In General.--Chapter 18 is amended by adding at the end the 
following new subchapter:

``SUBCHAPTER II--CHILDREN OF FEMALE VIETNAM VETERANS BORN WITH CERTAIN 
                             BIRTH DEFECTS

``Sec. 1811. Definitions

    ``In this subchapter:
          ``(1) The term `child', with respect to a female Vietnam 
        veteran, means a natural child of the female Vietnam veteran, 
        regardless of age or marital status, who was conceived after 
        the date on which the female Vietnam veteran first entered the 
        Republic of Vietnam during the Vietnam era (as specified in 
        section 101(29)(A) of this title).
          ``(2) The term `covered birth defect' means each birth defect 
        identified by the Secretary under section 1812 of this title.
          ``(3) The term `female Vietnam veteran' means any female 
        individual who performed active military, naval, or air service 
        in the Republic of Vietnam during the Vietnam era (as so 
        specified), without regard to the characterization of the 
        individual's service.

``Sec. 1812. Birth defects covered

    ``(a) Identification.--Subject to subsection (b), the Secretary 
shall identify the birth defects of children of female Vietnam veterans 
that--
          ``(1) are associated with the service of female Vietnam 
        veterans in the Republic of Vietnam during the Vietnam era (as 
        specified in section 101(29)(A) of this title); and
          ``(2) result in the permanent physical or mental disability 
        of such children.
    ``(b) Limitations.--(1) The birth defects identified under 
subsection (a) may not include birth defects resulting from the 
following:
          ``(A) A familial disorder.
          ``(B) A birth-related injury.
          ``(C) A fetal or neonatal infirmity with well-established 
        causes.
    ``(2) The birth defects identified under subsection (a) may not 
include spina bifida.
    ``(c) List.--The Secretary shall prescribe in regulations a list of 
the birth defects identified under subsection (a).

``Sec. 1813. Benefits and assistance

    ``(a) Health Care.--(1) The Secretary shall provide a child of a 
female Vietnam veteran who was born with a covered birth defect such 
health care as the Secretary determines is needed by the child for such 
birth defect or any disability that is associated with such birth 
defect.
    ``(2) The Secretary may provide health care under this subsection 
directly or by contract or other arrangement with a health care 
provider.
    ``(3) For purposes of this subsection, the definitions in section 
1803(c) of this title shall apply with respect to the provision of 
health care under this subsection, except that for such purposes--
          ``(A) the reference to `specialized spina bifida clinic' in 
        paragraph (2) of such section 1803(c) shall be treated as a 
        reference to a specialized clinic treating the birth defect 
        concerned under this subsection; and
          ``(B) the reference to `vocational training under section 
        1804 of this title' in paragraph (8) of such section 1803(c) 
        shall be treated as a reference to vocational training under 
        subsection (b).
    ``(b) Vocational Training.--(1) The Secretary may provide a program 
of vocational training to a child of a female Vietnam veteran who was 
born with a covered birth defect if the Secretary determines that the 
achievement of a vocational goal by the child is reasonably feasible.
    ``(2) Subsections (b) through (e) of section 1804 of this title 
shall apply with respect to any program of vocational training provided 
under paragraph (1).
    ``(c) Monetary Allowance.--(1) The Secretary shall pay a monthly 
allowance to any child of a female Vietnam veteran who was born with a 
covered birth defect for any disability resulting from such birth 
defect.
    ``(2) The amount of the monthly allowance paid under this 
subsection shall be based on the degree of disability suffered by the 
child concerned, as determined in accordance with a schedule for rating 
disabilities resulting from covered birth defects that is prescribed by 
the Secretary.
    ``(3) In prescribing a schedule for rating disabilities under 
paragraph (2), the Secretary shall establish four levels of disability 
upon which the amount of the monthly allowance under this subsection 
shall be based.
    ``(4) The amount of the monthly allowance paid under this 
subsection shall be as follows:
          ``(A) In the case of a child suffering from the lowest level 
        of disability prescribed in the schedule for rating 
        disabilities under this subsection, $100.
          ``(B) In the case of a child suffering from the lower 
        intermediate level of disability prescribed in the schedule for 
        rating disabilities under this subsection, the greater of--
                  ``(i) $214; or
                  ``(ii) the monthly amount payable under section 
                1805(b)(3) of this title for the lowest level of 
                disability prescribed for purposes of that section.
          ``(C) In the case of a child suffering from the higher 
        intermediate level of disability prescribed in the schedule for 
        rating disabilities under this subsection, the greater of--
                  ``(i) $743; or
                  ``(ii) the monthly amount payable under section 
                1805(b)(3) of this title for the intermediate level of 
                disability prescribed for purposes of that section.
          ``(D) In the case of a child suffering from the highest level 
        of disability prescribed in the schedule for rating 
        disabilities under this subsection, the greater of--
                  ``(i) $1,272; or
                  ``(ii) the monthly amount payable under section 
                1805(b)(3) of this title for the highest level of 
                disability prescribed for purposes of that section.
    ``(5) Amounts under subparagraphs (A), (B)(i), (C)(i), and (D)(i) 
of paragraph (4) shall be subject to adjustment from time to time under 
section 5312 of this title.
    ``(6) Subsections (c) and (d) of section 1805 of this title shall 
apply with respect to any monthly allowance paid under this subsection.
    ``(d) General Limitations on Availability of Benefits and 
Assistance.--(1) No individual receiving benefits or assistance under 
this section may receive any benefits or assistance under subchapter I 
of this chapter.
    ``(2) In any case where affirmative evidence establishes that the 
covered birth defect of a child results from a cause other than the 
active military, naval, or air service in the Republic of Vietnam of 
the female Vietnam veteran who is the mother of the child, no benefits 
or assistance may be provided the child under this section.
    ``(e) Regulations.--The Secretary shall prescribe regulations for 
purposes of the administration of the provisions of this section.''.
    (b) Administrative Provisions.--Chapter 18 is further amended by 
inserting after subchapter II, as added by subsection (a) of this 
section, the following new subchapter:

                ``SUBCHAPTER III--ADMINISTRATIVE MATTERS

``Sec. 1821. Applicability of certain administrative provisions

    ``The provisions of sections 5101(c), 5110(a), (b)(2), (g), and 
(i), 5111, and 5112(a), (b)(1), (b)(6), (b)(9), and (b)(10) of this 
title shall apply with respect to benefits and assistance under this 
chapter in the same manner as such provisions apply to veterans' 
disability compensation.

``Sec. 1822. Treatment of receipt of monetary allowance on other 
                    benefits

    ``(a) Notwithstanding any other provision of law, receipt by an 
individual of a monetary allowance under this chapter shall not impair, 
infringe, or otherwise affect the right of the individual to receive 
any other benefit to which the individual is otherwise entitled under 
any law administered by the Secretary.
    ``(b) Notwithstanding any other provision of law, receipt by an 
individual of a monetary allowance under this chapter shall not impair, 
infringe, or otherwise affect the right of any other individual to 
receive any benefit to which such other individual is entitled under 
any law administered by the Secretary based on the relationship of such 
other individual to the individual who receives such monetary 
allowance.
    ``(c) Notwithstanding any other provision of law, a monetary 
allowance paid an individual under this chapter shall not be considered 
as income or resources in determining eligibility for or the amount of 
benefits under any Federal or Federally-assisted program.''.
    (c) Repeal of Superseded Matter.--(1) Subsections (c) and (d) of 
section 1805 are repealed.
    (2) Section 1806 is repealed.
    (d) Redesignation of Existing Matter.--Chapter 18 is further 
amended by inserting before section 1801 the following:

 ``SUBCHAPTER I--CHILDREN OF VIETNAM VETERANS BORN WITH SPINA BIFIDA''.

    (e) Conforming Amendments.--(1) Sections 1801 and 1802 are each 
amended by striking ``this chapter'' and inserting ``this subchapter''.
    (2) Section 1805(a) is amended by striking ``this chapter'' and 
inserting ``this section''.
    (f) Clerical Amendments.--(1)(A) The chapter heading of chapter 18 
is amended to read as follows:

       ``CHAPTER 18--BENEFITS FOR CHILDREN OF VIETNAM VETERANS''.

    (1) The tables of chapters at beginning, and at the beginning of 
part II, are each amended by striking the item relating to chapter 18 
and inserting the following new item:

  ``18. Benefits for Children of Vietnam Veterans...........    1801''.

    (2) The table of sections at the beginning of chapter 18 is 
amended--
          (A) by inserting after the chapter heading the following:

 ``SUBCHAPTER I--CHILDREN OF VIETNAM VETERANS BORN WITH SPINA BIFIDA'';

          (B) by striking the item relating to section 1806; and
          (C) by adding at the end the following:

``SUBCHAPTER II--CHILDREN OF FEMALE VIETNAM VETERANS BORN WITH CERTAIN 
                             BIRTH DEFECTS

``1811. Definitions.
``1812. Birth defects covered.
``1813. Benefits and assistance.

                ``SUBCHAPTER III--ADMINISTRATIVE MATTERS

``1821. Applicability of certain administrative provisions.
``1822. Treatment of receipt of monetary allowance on other 
benefits.''.
    (g) Applicability.--(1) Except as provided in paragraph (2), the 
amendments made by this section shall take effect on the first day of 
the first month beginning more than one year after the date of the 
enactment of this Act.
    (2) The Secretary of Veterans Affairs shall identify birth defects 
under section 1822 of title 38, United States Code (as added by 
subsection (a) of this section), and shall prescribe the regulations 
required by subchapter II of that title (as so added), not later than 
the effective date specified in paragraph (1).
    (3) No benefit or assistance may be provided under subchapter II of 
chapter 18 of title 38, United States Code (as so added), for any 
period before the effective date specified in paragraph (1) by reason 
of the amendments made by this section.

                   Subtitle H--Other Benefits Matters

SEC. 171. REVIEW OF DOSE RECONSTRUCTION PROGRAM OF THE DEFENSE THREAT 
                    REDUCTION AGENCY.

    (a) Review by National Academy of Sciences.--Not later than 30 days 
after the date of the enactment of this Act, the Secretary of Defense 
shall enter into a contract with the National Academy of Sciences to 
carry out periodic reviews of the dose reconstruction program of the 
Defense Threat Reduction Agency.
    (b) Review Activities.--The periodic reviews of the dose 
reconstruction program under the contract under subsection (a) shall 
consist of the periodic selection of random samples of doses 
reconstructed by the Defense Threat Reduction Agency in order to 
determine--
          (1) whether or not the reconstruction of the sampled doses is 
        accurate;
          (2) whether or not the reconstructed dosage number is 
        accurately reported;
          (3) whether or not the assumptions made regarding radiation 
        exposure based upon the sampled doses are credible; and
          (4) whether or not the data from nuclear tests used by the 
        Defense Threat Reduction Agency as part of the reconstruction 
        of the sampled doses is accurate.
    (c) Duration of Review.--The periodic reviews under the contract 
under subsection (a) shall occur over a period of 24 months.
    (d) Report.--(1) Not later than 60 days after the conclusion of the 
period referred to in subsection (c) the National Academy of Sciences 
shall submit to Congress a report on its activities under the contract 
under this section.
    (2) The report shall include the following:
          (A) A detailed description of the activities of the National 
        Academy of Sciences under the contract.
          (B) Any recommendations that the National Academy of Sciences 
        considers appropriate regarding a permanent system of review of 
        the dose reconstruction program of the Defense Threat Reduction 
        Agency.

                     TITLE II--HEALTH CARE MATTERS

SEC. 201. VETERANS NOT SUBJECT TO COPAYMENTS FOR MEDICATIONS.

    Subparagraph (B) of section 1722A(a)(3) is amended to read as 
follows:
          ``(B) to a veteran who is considered by the Secretary to be 
        unable to defray the expenses of necessary care under section 
        1722 of this title.''.

SEC. 202. ESTABLISHMENT OF POSITION OF ADVISOR ON PHYSICIAN ASSISTANTS 
                    WITHIN OFFICE OF UNDERSECRETARY FOR HEALTH.

    (a) Establishment.--Subsection (a) of section 7306 is amended--
          (1) by redesignating paragraph (9) as paragraph (10); and
          (2) by inserting after paragraph (8) the following new 
        paragraph (9):
          ``(9) The Advisor on Physician Assistants, who shall carry 
        out the responsibilities set forth in subsection (f).''.
    (b) Responsibilities.--That section is further amended--
          (1) by redesignating subsection (f) as subsection (g); and
          (2) by inserting after subsection (e) the following new 
        subsection (f):
    ``(f) The Advisor on Physician Assistants under subsection (a)(9) 
shall--
          ``(1) advise the Under Secretary for Health on matters 
        regarding the optimal utilization of physician assistants by 
        the Veterans Health Administration;
          ``(2) advise the Under Secretary for Health on the 
        feasibility and desirability of establishing clinical 
        privileges and practice areas for physician assistants in the 
        Administration;
          ``(3) develop initiatives to facilitate the utilization of 
        the full range of clinical capabilities of the physician 
        assistants employed by the Administration;
          ``(4) provide advice on policies affecting the employment of 
        physician assistants by the Administration, including policies 
        on educational requirements, national certification, 
        recruitment and retention, staff development, and the 
        availability of educational assistance (including scholarship, 
        tuition reimbursement, and loan repayment assistance); and
          ``(5) carry out such other responsibilities as the Under 
        Secretary for Health shall specify.''.

SEC. 203. TEMPORARY FULL-TIME APPOINTMENTS OF CERTAIN MEDICAL 
                    PERSONNEL.

    (a) Physician Assistants Awaiting Certification or Licensure.--
Paragraph (2) of section 7405(c) is amended--
          (1) by striking ``nursing,'' and inserting ``nursing''; and
          (2) by inserting ``who have successfully completed a full 
        course of training as a physician assistant in a recognized 
        school approved by the Secretary,'' before ``or who''.
    (b) Medical Support Personnel.--That section is further amended--
          (1) by redesignating paragraph (3) as paragraph (4); and
          (2) by inserting after paragraph (2) the following new 
        paragraph (3):
    ``(3)(A) Temporary full-time appointments of persons in positions 
referred to in subsection (a)(1)(D) shall not exceed three years.
    ``(B) Temporary full-time appointments under this paragraph may be 
renewed for one or more additional periods not in excess of three years 
each.''.

             TITLE III--CONSTRUCTION AND FACILITIES MATTERS

                    Subtitle A--Construction Matters

SEC. 301. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS FOR FISCAL 
                    YEAR 2001.

    The Secretary of Veterans Affairs may carry out the following major 
medical projects, with each project to be carried out in the amount 
specified for that project:
          (1) Construction of a 120-bed gero-psychiatric facility at 
        the Department of Veterans Affairs Palo Alto Health Care 
        System, Menlo Park Division, California, $26,600,000.
          (2) Construction of a nursing home at the Department of 
        Veterans Affairs Medical Center, Beckley, West Virginia, 
        $9,500,000.

SEC. 302. AUTHORIZATION OF ADDITIONAL MAJOR MEDICAL FACILITY PROJECT 
                    FOR FISCAL YEAR 2000.

    Section 401 of the Veterans Millennium Health Care and Benefits Act 
(Public Law 106-117; 113 Stat. 1572) is amended by adding at the end 
the following:
          ``(7) Renovation of psychiatric nursing units at the 
        Department of Veterans Affairs Medical Center, Murfreesboro, 
        Tennessee, in an amount not to exceed $14,000,000.''.

SEC. 303. AUTHORIZATION OF APPROPRIATIONS.

    (a) Authorization of Appropriations for Fiscal Year 2001 
Projects.--There are authorized to be appropriated to the Secretary of 
Veterans Affairs for fiscal year 2001 and for fiscal year 2002, 
$36,100,000 for the Construction, Major Projects, account for the 
projects authorized in section 301.
    (b) Authorization of Appropriations for Additional Fiscal Year 2000 
Project.--Section 403 of the Veterans Millennium Health Care and 
Benefits Act (Public Law 106-117; 113 Stat. 1573) is amended--
          (1) in subsection (a)(1), by striking ``$57,500,000 for the 
        projects authorized in paragraphs (1) through (5)'' and 
        inserting ``$71,500,000 for the projects authorized in 
        paragraphs (1) through (5) and (7)''; and
          (2) in subsection (b), by inserting ``and (7)'' after 
        ``through (5)'' in the matter preceding paragraph (1).
    (c) Limitation.--The projects authorized in section 301 may only be 
carried out using--
          (1) funds appropriated for fiscal year 2001 or fiscal year 
        2002 pursuant to the authorization of appropriations in 
        subsection (a);
          (2) funds appropriated for Construction, Major Projects for a 
        fiscal year before fiscal year 2001 that remain available for 
        obligation; and
          (3) funds appropriated for Construction, Major Projects for 
        fiscal year 2001 for a category of activity not specific to a 
        project.

                       Subtitle B--Other Matters

SEC. 311. MAXIMUM TERM OF LEASE OF DEPARTMENT OF VETERANS AFFAIRS 
                    PROPERTY FOR HOMELESS PURPOSES.

    Section 3735(a)(4) is amended by striking ``three years'' and 
inserting ``20 years''.

SEC. 312. LAND CONVEYANCE, MILES CITY VETERANS ADMINISTRATION MEDICAL 
                    COMPLEX, MILES CITY, MONTANA.

    (a) Conveyance Required.--The Secretary of Veterans Affairs shall 
convey, without consideration, to Custer County, Montana (in this 
section referred to as the ``County''), all right, title, and interest 
of the United States in and to the parcels of real property consisting 
of the Miles City Veterans Administration Medical Center complex, which 
has served as a medical and support complex for the Department of 
Veterans Affairs in Miles City, Montana.
    (b) Timing of Conveyance.--The conveyance required by subsection 
(a) shall be made as soon as practicable after the date of the 
enactment of this Act.
    (c) Conditions of Conveyance.--The conveyance required by 
subsection (a) shall be subject to the condition that the County--
          (1) use the parcels conveyed, whether directly or through an 
        agreement with a public or private entity, for veterans 
        activities, community and economic development, or such other 
        public purposes as the County considers appropriate; or
          (2) convey the parcels to an appropriate public or private 
        entity for use for the purposes specified in paragraph (1).
    (d) Conveyance of Improvements.--(1) As part of the conveyance 
required by subsection (a), the Secretary may also convey to the County 
any improvements, equipment, fixtures, and other personal property 
located on the parcels conveyed under that subsection that are not 
required by the Secretary.
    (2) Any conveyance under this subsection shall be without 
consideration.
    (e) Use Pending Conveyance.--Until such time as the real property 
to be conveyed under subsection (a) is conveyed by deed under this 
section, the Secretary may continue to lease the real property, 
together with any improvements thereon, under the terms and conditions 
of the current lease of the real property.
    (f) Maintenance Pending Conveyance.--The Secretary shall be 
responsible for maintaining the real property to be conveyed under 
subsection (a), and any improvements, equipment, fixtures, and other 
personal property to be conveyed under subsection (d), in its condition 
as of the date of the enactment of this Act until such time as the real 
property, and such improvements, equipment, fixtures, and other 
personal property are conveyed by deed under this section.
    (g) Legal Description.--The exact acreage and legal description of 
the real property to be conveyed under subsection (a) shall be 
determined by a survey satisfactory to the Secretary.
    (h) Additional Terms and Conditions.--The Secretary may require 
such additional terms and conditions in connection with the conveyance 
under this section as the Secretary determines appropriate to protect 
the interests of the United States.

SEC. 313. CONVEYANCE OF FT. LYON DEPARTMENT OF VETERANS AFFAIRS MEDICAL 
                    CENTER, COLORADO, TO THE STATE OF COLORADO.

    (a) Conveyance Authorized.--Notwithstanding any other provision of 
law and subject to the provisions of this section, the Secretary of 
Veterans Affairs may convey, without consideration, to the State of 
Colorado all right, title, and interest of the United States in and to 
a parcel of real property, including improvements thereon, consisting 
of approximately 512 acres and comprising the location of the Ft. Lyon 
Department of Veterans Affairs Medical Center. The purpose of the 
conveyance is to permit the State of Colorado to utilize the property 
for purposes of a correctional facility.
    (b) Public Access.--(1) The Secretary may not make the conveyance 
of real property authorized by subsection (a) unless the State of 
Colorado agrees to provide appropriate public access to Kit Carson 
Chapel, which is located on the real property, and the cemetery located 
adjacent to the real property.
    (2) The State of Colorado may satisfy the condition specified in 
paragraph (1) with respect to Kit Carson Chapel by relocating the 
chapel to Fort Lyon National Cemetery, Colorado, or another appropriate 
location approved by the Secretary.
    (c) Plan Regarding Conveyance.--(1) The Secretary may not make the 
conveyance authorized by subsection (a) before the date on which the 
Secretary implements a plan providing the following:
          (A) Notwithstanding sections 1720(a)(3) and 1741 of title 38, 
        United States Code, that veterans who are receiving inpatient 
        or institutional long-term care at Ft. Lyon Department of 
        Veterans Affairs Medical Center as of the date of the enactment 
        of this Act are provided appropriate inpatient or institutional 
        long-term care under the same terms and conditions as such 
        veterans are receiving inpatient or institutional long-term 
        care as of that date.
          (B) That the conveyance of the Ft. Lyon Department of 
        Veterans Affairs Medical Center does not result in a reduction 
        of health care services available to veterans in the catchment 
        area of the Medical Center.
          (C) Improvements in veterans' overall access to health care 
        in the catchment area through, for example, the opening of 
        additional outpatient clinics.
    (2) The Secretary shall prepare the plan referred to in paragraph 
(1) in consultation with appropriate representatives of veterans 
service organizations and other appropriate organizations.
    (3) The Secretary shall publish a copy of the plan referred to in 
paragraph (1) before implementation of the plan.
    (d) Environmental Restoration.--The Secretary may not make the 
conveyance authorized by subsection (a) until the Secretary completes 
the evaluation and performance of any environmental restoration 
activities required by the Comprehensive Environmental Response, 
Compensation, and Liability Act of 1980 (42 U.S.C. 9601 et seq.), and 
by any other provision of law.
    (e) Personal Property.--As part of the conveyance authorized by 
subsection (a), the Secretary may convey, without consideration, to the 
State of Colorado any furniture, fixtures, equipment, and other 
personal property associated with the property conveyed under that 
subsection that the Secretary determines is not required for purposes 
of the Department of Veterans Affairs health care facilities to be 
established by the Secretary in southern Colorado or for purposes of 
Fort Lyon National Cemetery.
    (f) Legal Description.--The exact acreage and legal description of 
the real property to be conveyed under subsection (a) shall be 
determined by a survey satisfactory to the Secretary. Any costs 
associated with the survey shall be borne by the State of Colorado.
    (g) Additional Terms and Conditions.--The Secretary may require 
such other terms and conditions in connection with the conveyances 
authorized by subsections (a) and (e) as the Secretary considers 
appropriate to protect the interests of the United States.

SEC. 314. EFFECT OF CLOSURE OF FT. LYON DEPARTMENT OF VETERANS AFFAIRS 
                    MEDICAL CENTER ON ADMINISTRATION OF HEALTH CARE FOR 
                    VETERANS.

    (a) Payment for Nursing Home Care.--Notwithstanding any limitation 
under section 1720 or 1741 of title 38, United States Code, the 
Secretary of Veterans Affairs may pay the State of Colorado, or any 
private nursing home care facility, for costs incurred in providing 
nursing home care to any veteran who is relocated from the Ft. Lyon 
Department of Veterans Affairs Medical Center, Colorado, to the State 
of Colorado or such private facility, as the case may be, as a result 
of the closure of the Ft. Lyon Department of Veterans Affairs Medical 
Center.
    (b) Obligation to Provide Extended Care Services.--Nothing in 
section 313 of this Act or this section may be construed to alter or 
otherwise effect the obligation of the Secretary to meet the 
requirements of section 1710B(b) of title 38, United States Code, 
relating to staffing and levels of extended care services in fiscal 
years after fiscal year 1998.
    (c) Extension of Voluntary Early Retirement Authority.--
Notwithstanding section 1109(a) of the Department of Veterans Affairs 
Employment Reduction Assistance Act of 1999 (title XI of Public Law 
106-117; 113 Stat. 1599; 5 U.S.C. 5597 note), the authority to pay 
voluntary separation incentive payments under that Act to employees of 
the Ft. Lyon Department of Veterans Affairs Medical Center shall apply 
to eligible employees (as defined by section 1110 of that Act) at the 
Ft. Lyon Department of Veterans Affairs Medical Center whose separation 
occurs before June 30, 2001.
    (d) Report on Veterans Health Care in Southern Colorado.--Not later 
than one year after the conveyance, if any, authorized by section 313, 
the Under Secretary for Health of the Department of Veterans Affairs, 
acting through the Director of Veterans Integrated Service Network 
(VISN) 19, shall submit to the Committees on Veterans' Affairs of the 
Senate and the House of Representatives a report on the status of the 
health care system for veterans under the Network in the Southern 
Colorado. The report shall describe any improvements to the system in 
Southern Colorado that have been put into effect in the period 
beginning on the date of the conveyance and ending on the date of the 
report.
    Amend the title to read as follows: ``A Bill to amend title 38, 
United States Code, to expand and improve compensation and pension, 
education, housing loan, insurance, and other benefits for veterans, 
and for other purposes.''.

                              Introduction

    On October 27, 1999, Committee member Senator Patty Murray 
introduced S. 1810, the proposed ``Veterans Claims and Appeals 
Procedures Clarification and Improvement Act of 2000.'' S. 
1810, as introduced, would have clarified the role of the 
Department of Veterans Affairs (hereinafter, ``VA'') in 
assisting veterans and other claimants in developing the 
factual record pertinent to VA's adjudication of the claim. In 
addition, S. 1810, as introduced, would have specified that 
procedures for hearings, investigations and other proceedings 
in connection with the consideration of claims for VA benefits 
shall be exclusive; would have precluded the U.S. Court of 
Appeals for Veterans Claims (hereinafter, ``CAVC''), in the 
exercise of its exclusive jurisdiction to review decisions of 
the VA's Board of Veterans' Appeals (hereinafter, ``BVA''), 
from considering allegations of error raised by VA that were 
not raised by the appellant or the CAVC; and would have amended 
the standard under which CAVC might set aside BVA findings of 
fact, modifying it from a ``clearly erroneous'' standard to a 
``not reasonably supported by a preponderance of the evidence'' 
standard.
    On March 21, 2000, the Committee's ranking minority member, 
Senator John D. Rockefeller IV, introduced S. 2264, the 
proposed ``Recognition of Physician Assistants in the 
Department of Veterans Affairs Act of 2000.'' S. 2264 would 
have established within the VA's Veterans Health Administration 
(hereinafter, ``VHA'') the position of Advisor on Physician 
Assistants.
    On May 11, 2000, Ranking Minority Member Rockefeller 
introduced S. 2544, the proposed ``Children of Women Vietnam 
Veterans' Benefits Act of 2000.'' S. 2544 would have provided 
health care, vocational training, and monetary allowance 
benefits to children with covered birth defects born to women 
Vietnam veterans.
    On May 25, 2000, Senator Max Baucus introduced S. 2637, a 
bill to require VA to convey land in Miles City, MT, to Custer 
County, MT. On June 29, 2000, Senator Wayne Allard introduced 
S. 2827, a bill to authorize VA to convey land in Ft. Lyon, CO, 
to the State of Colorado, subject to, among other things, 
conditions relating to the continued provision of long-term and 
extended care medical services provided by VA at that site, and 
subject to requirements relating to the retirement rights of VA 
personnel employed at that site.

                           Committee Hearing

    On July 20, 2000, the Committee held a hearing on 
legislation pending before the Committee. Among the measures on 
which the Committee received testimony was S. 1810 and 
alternative language, as set forth in a draft bill proposed by 
Committee Chairman Arlen Specter, to clarify VA's duty to 
assist claimants; S. 2264; S. 2544, and alternative language, 
as set forth in a draft bill proposed by Committee Chairman 
Specter, which would have provided health care, vocational 
training, and monetary allowance benefits to children with 
covered birth defects born to women Vietnam veterans; S. 2637; 
S. 2827; modifications to VA education, home loan, life 
insurance, burial benefit, and employment assistance programs, 
as specified in a draft bill proposed by Committee Chairman 
Specter; provisions relating to veteran-patients' copayments 
for prescription medications and the appointment of physician 
assistants as specified in a draft bill proposed by Committee 
Chairman Specter; a proposed modification in the maximum term 
for which VA might lease acquired real property to providers of 
housing assistance services to homeless veterans, and 
authorizations for major medical construction projects at 
Murfreesboro, TN, and Menlo Park, CA, as specified in a draft 
bill proposed by Committee Chairman Specter; provisions 
relating to compensation to women veterans who have suffered 
the anatomical loss of a breast as a result of a service-
connected disability, as specified in a draft bill proposed by 
Committee Chairman Specter; and provisions modifying section 
106 of Public Law 102-585 relating to limitations on medical 
care services which may be provided to women veterans, as 
specified in a draft bill proposed by Committee Chairman 
Specter.
    The Committee received testimony from, among others, 
representatives of VA and representatives of The American 
Legion, the Veterans of Foreign Wars, the Disabled American 
Veterans, AMVETS, and the Paralyzed Veterans of America. The 
Committee also received written statements for the record from 
the Vietnam Veterans of America; the Veterans Affairs Physician 
Assistants Association; and the American Academy of Physician 
Assistants.

                           Committee Meeting

    On July 27, 2000, the Committee met in open session to 
consider legislation pending before the Committee. Among the 
measures so considered was S. 1810, as amended to incorporate a 
substitute which set forth language relating to VA's duty to 
assist claimants which was drawn from draft bill language which 
had been proposed by Committee Chairman Specter and which had 
been on the agenda of the Committee's July 20, 2000, hearing. 
Also incorporated into the substitute were other items that had 
been on the Committee's July 20, 2000, hearing agenda, 
including: S. 2264 (relating to the establishment of the 
position of Advisor on Physician Assistants); S. 2544 (relating 
to benefits to children with covered birth defects born to 
women Vietnam veterans); provisions drawn from S. 2637 
(relating to the conveyance of land in Miles City, MT, to 
Custer County, MT); provisions drawn from S. 2827 (relating to 
the conveyance of land in Ft. Lyon, CO, to the State of 
Colorado); and provisions drawn from draft bills proposed by 
Committee Chairman Specter relating to modifications to VA 
education, home loan, life insurance, burial benefit, and 
employment assistance programs; provisions relating to 
prescription medication copayments, physician assistant 
appointments, VA leases of acquired real property to providers 
of services to homeless veterans, and construction 
authorizations; and provisions relating to compensation for 
women veterans for the service-connected loss of a breast. The 
Committee voted by unanimous voice vote to report S. 1810 
favorably to the Senate, as so amended and as further amended 
to incorporate an amendment offered by Committee member Senator 
Paul Wellstone at the Committee meeting relating to diseases 
deemed to be presumptively service-connected when contracted by 
radiation-exposed veterans.

               Summary of the Committee Bill as Reported

    S. 1810, as reported (hereinafter, the ``Committee bill'') 
contains three titles that would modify current benefits and 
health care programs administered by VA, and which relate to VA 
construction and facilities management issues, as summarized 
below.

                       title i--benefits matters

    Title I contains freestanding provisions and amendments to 
title 38, United States Code, that would:
    1. Codify VA's duty to assist veterans and other claimants 
in developing the factual record pertinent to VA's adjudication 
of the veteran's or other claimant's claim (section 101).
    2. Add lung cancer, colon cancer, tumors of the brain and 
central nervous system, and ovarian cancer to the statutory 
listing of diseases that are presumptively service-connected if 
they are contracted by a veteran exposed to radiation in 
service (section 102).
    3. Provide special monthly compensation to women veterans 
who have sustained the service-connected loss of a breast 
(section 103).
    4. Establish uniform eligibility requirements relating to 
the receipt of a high school diploma or equivalency certificate 
by participants in VA educational assistance programs (section 
111).
    5. Repeal a limitation on eligibility for educational 
assistance which permits participation only after the 
completion of an ``initial'' obligated term of service (section 
112).
    6. Allow survivors and dependents to use eligibility for 
educational assistance benefits to pursue test preparation 
courses (section 113).
    7. Expand the time within which survivors and dependents 
may claim educational benefits (section 114).
    8. Modify the effective date for survivors' and dependents' 
eligibility for educational benefits (section 115).
    9. Specify that specially adapted housing grants will not 
be reduced merely because the home to be adapted is co-owned by 
a person other than the veteran who is entitled to the grant 
(section 121).
    10. Increase the maximum VA home loan guaranty (from 
$50,750 to $63,175) (section 115).
    11. Eliminate home loan fees to veterans rated eligible for 
compensation at pre-discharge medical examinations (section 
122).
    12. Cap term Service-Disabled Veterans Insurance premiums 
at the age 70 renewable level (section 131).
    13. Increase maximum Servicemembers Group Life Insurance 
coverage (from $200,000 to $250,000)(section 132).
    14. Authorize participation of the dependants of 
servicemembers in the Servicemembers Group Life Insurance 
program (section 133).
    15. Make certain Filipino veterans of World War II eligible 
for burial benefits (section 141).
    16. Require that the veterans employment emphasis programs 
of Federal contractors be extended to recently separated 
veterans (section 151).
    17. Require the Comptroller General of the United States to 
conduct an audit of the Veterans' Employment and Training 
Service, U.S. Department of Labor (section 152).
    18. Provide health care benefits, vocational training 
services, and monetary allowances to children with birth 
defects born to women Vietnam veterans (section 162).
    19. Require the National Academy of Sciences to conduct a 
review of the Department of Defense's methodology for 
estimating the doses of radiation to which certain veterans had 
been exposed (section 171).

                     title ii--health care matters

    Title II contains amendments to title 38, United States 
Code, that would:
    1. Waive the requirement that certain veterans who qualify 
for priority access to VA health care services on the basis of 
income make copayments for prescription medications (section 
201).
    2. Establish the position of Advisor on Physician 
Assistants in VHA (section 202).
    3. Authorize temporary appointments of physician assistants 
(section 203).

             title iii--construction and facilities matters

    Title III contains freestanding provisions and amendments 
to title 38, United States Code, that would:
    1. Authorize major medical construction projects (sections 
301-303).
    2. Extend the maximum term of leases (from 3 to 20 years) 
for which VA may lease acquired property to providers of 
services to homeless veterans (section 311).
    3. Convey land in Miles City, MT, to Custer County, MT 
(section 312).
    4. Convey land in Ft. Lyons, CO, to the State of Colorado 
(section 313-314).

                               Discussion


                       title i--benefits matters

              Subtitle A--Compensation and Pension Matters


Duty to assist

            Background
    Chapter 51, Subchapter I, of title 38, United States Code, 
sets out the administrative procedures which must be followed 
by claimants applying for benefits under title 38. Claimants 
are expected to fill out appropriate claim forms and supply 
necessary information to expedite the processing of claims by 
VA. Subchapter I also lists the responsibilities of VA to 
provide certain types of assistance to claimants. VA must 
provide appropriate application forms, notify claimants when 
they have submitted incomplete applications, provide timely 
decisions to claimants, and provide assistance to claimants in 
gathering evidence to substantiate their eligibility for 
benefits. With respect to this latter requirement that VA 
provide assistance to claimants, section 5107(a) of title 38, 
United States Code, states as follows:
    [A] person who submits a claim for benefits under a law 
administered by the Secretary shall have the burden of 
submitting evidence sufficient to justify a belief by a fair 
and impartial individual that the claim is well grounded. The 
Secretary shall assist such a claimant in developing the facts 
pertinent to the claim.
    This provision--the principles of which had been specified 
by VA regulation prior to codification in the Veterans' 
Judicial Review Act of 1988, Public Law 100-687--was enacted to 
reflect the longstanding VA policy of assisting veterans and 
other claimants in gathering evidence in support of their 
claims.
    The ``well groundedness'' and ``duty to assist'' concepts, 
when they were codified, had meaning in prior VA regulations 
and practice. As a consequence of that fact, they were applied 
by VA, after codification, in a manner that was consistent with 
past practice, rather than in a manner which might have better 
conformed to CAVC's later interpretation of the strict terms of 
the statute. As in the past, VA continued to assist veterans 
and claimants by gathering military service records, VA and 
private medical records, other relevant private and 
governmental evidence, and, when appropriate, by providing 
medical examinations. But VA did not, as a threshold matter, 
require that claimants submit evidence necessary to establish 
``well groundedness'' before it would render such assistance.
    A series of CAVC rulings during the 1990's construed the 
``well groundedness'' and ``duty to assist'' concepts, and 
explored two major issues: what evidence would be required for 
a claimant to satisfy the requirement that he or she submit a 
``well-grounded'' claim; and in what sequence would the 
claimant's obligation to submit a well-grounded claim and VA's 
``duty to assist'' the claimant in developing the facts 
pertinent to the claim be discharged. The evolution of CAVC 
case law on both issues is summarized below seriatim:
     In Gilbert v. Derwinski, 1 Vet.App. 49 (1990), the 
Court held that the provisions of section 5107(a) established 
``chronological obligations'' in the VA claims process and 
that, accordingly, the obligation rests with the claimant to 
submit a well-grounded or ``facially valid'' claim before VA 
becomes obligated to assist the claimant.
     In Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990), 
the Court noted that ``[b]ecause a well grounded claim is 
neither defined by the statute nor the legislative history, it 
must be given a common sense construction. A well grounded 
claim is a plausible claim, one which is meritorious on its own 
or capable of substantiation. Such a claim need not be 
conclusive but only possible . . . . '' See also White v. 
Derwinski, 1 Vet.App. 519, 521 (1991) (the well-grounded 
threshold is ``rather low,'' and is ``the only requirement 
needed to obtain the Secretary's assistance''); Tirpak v. 
Derwinski, 2 Vet.App. 609, 610 (1992) (the evidence required to 
make a claim well grounded need not be conclusive; however, the 
law ``requires more than just an allegation; a claimant must 
submit supporting evidence'' that a claim is plausible); King 
v. Brown, 5 Vet.App. 19 (1993) (a well-grounded claim is one 
that would meet the ``well-pleaded'' requirement applicable to 
civil actions under Rule 8(a)(2) of the Federal Rules of Civil 
Procedure); and Grottveit v. Brown, 5 Vet.App. 91, 93 (1993) 
(in cases where a claimant seeks benefits rooted in a medical 
condition claimed to be service related, a well- grounded claim 
is one that is supported by medical evidence submitted by the 
claimant).
     In Grivois v. Brown, 6 Vet.App. 136 (1994), the 
Court admonished VA for developing claims that had not 
initially met a ``well groundedness'' threshold. The Court 
stated that, under Gilbert, supra, it is VA's ``duty to avoid 
adjudicating implausible claims at the expense of delaying 
well-grounded ones.'' (Despite Grivois, VA issued policy 
directives ordering VA regional offices to develop all evidence 
pertinent to a claim before making a determination of ``well 
groundedness.'')
     In Caluza v. Brown, 7 Vet.App. 498, 506 (1995), 
the Court identified the following requirements which would, in 
the Court's view, be necessary to establish a well-grounded 
claim: (1) a medical diagnosis of a current disability; (2) 
medical or lay evidence of the inservice occurrence or 
aggravation of a disease or injury; and (3) medical evidence of 
a nexus or link between an inservice injury or disease and the 
current disability. The U.S. Court of Appeals for the Federal 
Circuit affirmed Caluza in Epps v. Gober, 126 F.3d 1464 (Fed. 
Cir. 1997).
     Finally, in Morton v. West, 12 Vet.App. 477 
(1999), CAVC held that VA does not have discretion to adopt 
policies to assist claimants prior to the submission of a well-
grounded claim under the test set forth in Caluza, and 
invalidated the policies adopted by VA after Grivois.
    As a consequence of Morton, VA now has directed regional 
offices to subject all claims to an initial review to determine 
whether they are well grounded before proceeding (if the claim 
is well grounded) to assist the claimant in fully developing 
the claim. If the claim is not ``well grounded'' and the 
claimant fails to make it ``well grounded'' after notice to 
that effect, VA will deny the claim.
            Committee Bill
    Morton and its predecessors have significantly altered the 
type--and the timing--of assistance which VA had traditionally 
provided to veterans and other claimants seeking VA benefits. 
Irrespective of--and prior to--the Court's interpretation of 
the language of section 5107, VA had traditionally assisted 
claimants ``up front.'' In Morton, the Court ruled that VA is 
not free to do so--although the Court did note in Morton that 
Congress could specify a different rule by statute. The 
Committee here chooses to do so. The Committee bill, in 
summary, modifies the pertinent statutes to reinstate VA's 
traditional practice of assisting veterans at the beginning of 
the claims process. In doing so, the Committee concludes that 
the concept of ``well groundedness'' has no further practical 
utility, and so it has eliminated the term from pertinent 
statutes. The Committee also takes this opportunity to clarify 
other legal issues related to the concept of VA's ``duty to 
assist'' claimants.
    Section 101(a) of the Committee bill would add a new 
section 5101 to title 38, United States Code, to define the 
term ``claimant.'' The purpose of this provision is to ensure 
that VA assists all persons--including nonveterans, e.g., 
survivors, who might be eligible for VA benefits, and persons 
claiming to be veterans but who may have not yet proven that 
they are, in fact, veterans--at the beginning of the claims 
process.
    Section 101(b) of the Committee bill would substitute the 
term ``information'' in place of the term ``evidence'' in 
section 5103(a) of title 38. The purpose of this provision is 
to clarify that claimants will not be obligated to present any 
evidence per se upon initial application for benefits. What 
will be required is for them to completely and accurately 
provide the data requested in VA's application for benefits, 
omitting none of the pertinent ``information'' requested in 
that form. It is the Committee's understanding that such 
``information'' consists of items readily in the possession of 
most claimants, e.g., residence address, income information, 
marital status, etc. Claimants would be under no obligation to 
submit medical or lay evidence upon initial application for 
benefits, although it would always be to a claimant's advantage 
to do so if such information is in his or her possession.
    Section 101(c) of the Committee bill would create a new 
section 5103A of title 38 to clarify (1) the assistance and 
notifications that VA must provide to claimants who apply for 
all VA benefits; and (2) the assistance and notifications that 
VA will provide, more specifically, to claimants who apply for 
disability compensation.
    Subsection (a) of the proposed section 5103A would require 
VA to make reasonable efforts to assist a claimant in the 
development of information and medical or lay evidence 
necessary to establish eligibility for benefits sought by the 
claimant. The purpose of this subsection is to reaffirm VA's 
``duty to assist'' claimants in the development of evidence; 
claimants would be entitled to such assistance as a matter of 
right. And such assistance would no longer be contingent upon 
the claimant first submitting a ``well-grounded'' claim.
    The Committee recognizes that VA administers a wide variety 
of benefits and that, in many cases, there may be no need for 
VA to gather ``medical or lay evidence.'' The Committee 
believes that its use of the term ``necessary'' in subsection 
(a) gives to VA the necessary latitude to determine the 
appropriate evidence to develop. On the other hand, VA 
discretion is not unlimited; the Committee expects that 
``reasonable efforts'' will be made by VA to assist claimants 
and that those efforts will not be perfunctory. At the same 
time, the Committee understands that a point may be reached 
where the search for evidence becomes futile. In such cases, VA 
assistance in the further pursuit of information or evidence 
would no longer be ``reasonable.''
    Subsection (b) of the proposed 5103A would permit VA to 
withhold assistance to claimants if VA determines that no 
reasonable possibility exists that such assistance would aid in 
the establishing eligibility for the benefit sought. The 
Committee understands that there will be some claims that 
clearly lack merit due to statutory bars precluding entitlement 
or other reasons, e.g., in a case where a veteran served in 
peacetime, he or she would lack statutory eligibility for 
pension benefits.
    Subsection (c) of the proposed 5103A would require the VA 
to notify claimants and their representatives, if any, of the 
information and medical or lay evidence needed to aid in 
establishing eligibility for benefits. It would also require VA 
to notify claimants when it is unable to obtain any such 
information or medical or lay evidence. While it is the VA's 
duty to obtain information and evidence, the Committee expects 
that claimants who are made aware of what is needed--or what 
cannot be found--will cooperate with VA to locate and obtain 
the required evidence if they are able to do so.
    Subsection (d) of the proposed 5103A would specify the 
assistance that VA will render when a claimant seeks disability 
compensation. Paragraph (A) of subsection (d)(1) would direct 
VA to obtain relevant service and medical records from 
applicable governmental entities, e.g., the Department of the 
Army. Paragraph (B) would direct VA to obtain records of 
relevant medical treatment provided by VA (or at VA's expense) 
if the claimant has submitted to VA sufficient information to 
assist VA in locating such records. Paragraph (C) would direct 
VA to obtain all other relevant records from other governmental 
entities, provided that the claimant adequately identifies such 
records. Paragraph (D) would direct VA to obtain private 
records that the claimant has adequately identified. Paragraph 
(E) would direct VA to provide a medical examination for the 
purposes of determining the existence of a current disability 
if the claimant submits evidence that he or she is unable to 
afford medical treatment. Finally, paragraph (F) would permit 
the VA to provide such other assistance as it deems 
appropriate. Subsection (d)(2) would require VA to continue its 
efforts to obtain records, as required under this subsection, 
until it is reasonably certain that such records do not exist.
    The above delineation of VA--and claimant--obligations 
captures the Committee's understanding of the assistance VA 
had, prior to Morton, historically provided to claimants 
seeking disability compensation. On the subject of record 
retrieval, the Committee notes that a different level of effort 
will be expected when VA is obtaining records in the 
government's, as opposed to a private entity's, possession. 
While efforts to obtain evidence may never be minimal or 
perfunctory, a special obligation is imposed on VA when a 
governmental entity is the possessor of evidence.
    Subsection (e) of the proposed 5103A would require VA to 
provide a medical examination when VA determines that a medical 
examination is necessary to substantiate entitlement to a 
benefit. A determination as to the necessity of an examination 
would be made by VA after review of all or, if sufficient, some 
of the evidence obtained as a consequence of VA's execution of 
subsection (d). It is the Committee's intention that if VA were 
about to deny a claim because of the lack of evidence that 
would be generated by a medical examination, VA would in such 
circumstances provide the veteran with such an examination.
    Subsection (f) of the proposed 5103A would authorize the 
Secretary to prescribe regulations to administer the provisions 
of proposed 5103A.
    Section 101(d) of the Committee bill would amend section 
5106 of title 38, United States Code, by specifying that costs 
associated with providing VA-requested information from other 
governmental entities will be borne by the governmental entity 
providing such information.
    Section 101(e) of the Committee bill would amend section 
5107 of title 38, United States Code, to eliminate the 
requirement that claimants submit evidence sufficient to 
justify the belief that his or her claim is ``well grounded'' 
before VA will execute its duty to assist. Since the assistance 
to be provided by VA would be delineated in the proposed 
section 5103A, reference to VA's ``duty to assist'' claimants 
would also be eliminated from section 5107. Section 5107(a), as 
amended, would specify that the burden of proof to establish 
entitlement to VA benefits remains with the claimant; the 
Committee notes that while VA will be obligated to provide 
assistance to claimants, the responsibility for proving a claim 
ultimately will rest with the claimant. That said, the amended 
section 5107(b) retains the language in current section 5107(b) 
requiring that claimants be given the ``benefit of the doubt'' 
when there exists an ``approximate balance of positive and 
negative evidence regarding an issue material to the 
determination of the matter.''
    Section 101(f) of the Committee bill would specify that the 
assistance required by proposed section 5103A would apply to 
any claim filed or pending before VA or the applicable 
appellate court on or after the date of enactment. In addition, 
section 101(f) would require that claims denied or dismissed by 
VA for failure to meet the ``well groundedness'' test since 
July 14, 1999--the date of the Morton decision--be 
readjudicated at the request of the claimant or upon motion of 
the Secretary.
    Section 101(g) of the Committee bill would make clerical 
amendments to chapter 51 in light of changes contained in 
Section 101.

Diseases presumed to be service-connected for radiation-exposed 
        veterans

            Background
    As a general rule, diseases which are incurred or 
aggravated during active military, naval, or air service are 
``service connected'' and, thus, give rise to eligibility for 
VA compensation and other benefits. Diseases which become 
manifest only after service may give rise to such eligibility 
under rules which specify legal presumptions with respect to 
such diseases. With respect to veterans who were exposed to 
radiation in service, such rules are set forth in section 1112 
of title 38, United States Code.
    Section 1112(c)(2) of title 38 lists 16 diseases which, if 
they become manifest in a radiation-exposed veteran at any time 
in his or her lifetime, will be considered to have been 
incurred in or aggravated during active service. Thus, veterans 
who contract such diseases will generally be eligible for 
benefits as ``service-connected'' veterans even though there is 
no direct evidence that they contracted such diseases during 
service.
            Committee Bill
    Section 102 of the Committee bill would amend section 
1112(c)(2) of title 38 by adding four additional diseases-lung 
cancer, colon cancer, tumors of the brain and central nervous 
system, and ovarian cancer--to the statutory listing of 
diseases which will be presumed to be ``service-connected'' if 
they are contracted by radiation-exposed veterans.

Special monthly compensation for breast loss

            Background
    Addition to ``ordinary'' disability compensation, VA pays 
additional compensation to veterans who, as a result of a 
service-connected disability, have suffered the anatomical 
loss, or the loss of use of, organs specified by statute. 
Currently, additional compensation of $76 per month per loss is 
paid to veterans who have suffered the loss of a foot, a hand, 
a creative organ, or both buttocks. Additional compensation is 
also paid to veterans who have lost vision, speech or hearing 
capabilities. See 38 U.S.C. Sec. 1114(k). More serious 
anatomical losses, e.g., the loss of both feet, both legs, or 
total blindness, give rise to additional compensation at 
different, and higher, rates.
            Committee Bill
    The Committee bill would add the following additional 
anatomical loss to the ``special monthly compensation'' 
statutory listing in cases where such loss is sustained by a 
woman veteran due to service-connected disability: ``one or 
both breasts (including loss by mastectomy)''. In the 
Committee's view, the loss of a breast by a woman is consistent 
with the types of anatomical losses now listed in subsection 
(k).

                     Subtitle B--Education Matters

            Background
    Under chapter 30 of title 38, United States Code, 
educational assistance benefits (commonly referred to as the 
Montgomery GI Bill or ``MGIB'' benefits) are provided to 
otherwise eligible members of the armed services who first 
entered active duty after June 30, 1985, and who did not 
decline to participate in the program. The rate of basic pay of 
servicemembers who are MGIB participants is reduced by $100 for 
each of the first 12 months of active duty service. Those who 
serve at least 3 years in active service, or who serve at least 
2 years in active service and, thereafter, serve 4 years of 
continuous duty in the Selected Reserve, and who participate in 
full-time study after service, receive $536 per month; for 
full-time-study, veteran students/trainees whose enlistment 
terms were 2 years receive a monthly benefit $436.
    The spouses and children of servicemembers who died in 
service, or were permanently and totally disabled in service, 
are eligible for Dependents Educational Assistance benefits, 
under Chapter 35 of title 38, so long as they meet eligibility 
criteria set forth in chapter 35. Surviving spouses, for 
example, remain eligible so long as they are not remarried. 
Surviving children generally remain eligible for such benefits 
until they reach the age of 26, although extensions may be 
granted. Full-time students participating in the Dependents 
Educational Assistance program receive $485 per month.
            Committee Bill
    In order to be eligible for MGIB participation, veterans 
and members of the Selected Reserves must have secured a high 
school diploma or a diploma equivalency certificate, or must 
have completed the equivalent of 12 semester hours in a program 
of education leading to a standard college degree. Generally, 
this prerequisite must be satisfied before completion of an 
initial period of obligated service or, in the case of the 
Selected Reserve benefit, before completion of initial active 
duty for training. Exceptions to this general rule have been 
enacted to allow, in certain cases, larger timeframes to 
satisfy its terms; such exceptions, however, have led to 
confusion and, perhaps, inequity. More fundamentally, such 
timeframes, tied as they are to the applicant's time in 
service, have led to the denial of benefits to individuals who 
served their country honorably but have only later--after such 
statutory deadlines have passed--earned a high school diploma 
or equivalency certificate or completed 12 semester hours of 
college. Section 111 of the Committee bill would simplify this 
situation by creating a single, uniform secondary school 
diploma requirement as a prerequisite for eligibility for 
education benefits--a requirement that, prior to applying for 
benefits, the applicant will have received a high school 
diploma or equivalency certificate, or will have completed the 
equivalent of 12 semester hours in a program of education 
leading to a standard college degree.
    Another prerequisite to MGIB eligibility is completion of 
an ``initial obligated period of active duty.'' See 38 U.S.C. 
Sec. Sec. 3011(a)(1)(A)(i), 3012(a)(1)(A)(i)(emphasis added). 
The Committee has learned of cases involving individuals who 
failed to complete an initial period of service and who later 
enlisted again and then served honorably for an entire 
obligated period of service. Such individuals are not now 
eligible for MGIB participation even though they completed an 
entire enlistment because the enlistment they did complete was 
not their initial enlistment. Section 112 of the Committee bill 
would strike the requirement that MGIB benefit entitlement be 
predicated on serving an ``initial'' period of obligated 
service and substitute in its place a requirement that an 
obligated period of active duty be served.
    Sections 3002(3) and 3501(a)(5) of title 38 define the 
``programs of education'' for which veterans, and surviving 
spouses and children, will receive education assistance 
benefits. Section 701 of Public Law 106-118 modified section 
3002(3) to permit such assistance while a veteran--but not a 
surviving spouse or child--takes preparatory courses for 
standardized tests used for admission to college or graduate 
school. Section 113 of the Committee bill rectifies that 
oversight by allowing survivors' and dependents' educational 
assistance benefits to be provided to this group while such 
preparatory courses are being taken.
    As noted above, children who are eligible for Dependents 
Educational Assistance benefits generally remain eligible until 
they reach the age of 26. In cases, however, where a child only 
becomes eligible for those benefits after he or she has reached 
18 years of age (due, e.g., to the death or service-connected 
permanent and total disability of a servicemember-parent when 
the child is 20), such benefits remain available to the child 
for a period of 8 years after the service-connected death or 
disability. As these rules are now drafted, they can operate, 
in practice, to shorten the timeframe of eligibility in cases 
where, for example, the child only becomes aware of his or her 
eligibility when it is later determined that the death or 
disability was, in fact, service connected. Section 114 of the 
Committee bill would rectify the loss of benefits otherwise 
permitted in such situations by allowing the Dependents 
Educational Assistance-eligible child to choose the starting 
date of his or her eligibility. Such children could choose any 
date as a starting date between the time when they first become 
eligible for benefits (the date of the parent's actual death or 
disability) and the date on which VA has made a determination 
that the death or disability in question was, in fact, service 
connected. A similar rule now applies to Dependents Educational 
Assistance-eligible spouses. See 38 U.S.C. Sec. 3512(b)(3).
    As noted in the preceding paragraph, cases arise where 
eligibility for Dependents Educational Assistance is not 
determined until VA adjudicates a claim. Cases can arise where 
a particular death or disability is not determined to be 
service connected until a considerable period of time--even 
years--after death or the onset of disability. In many such 
cases, the spouse or child might have already started (or even 
completed) his or her higher education prior to the 
adjudication of the underlying claim, but had not requested 
that his or her eligibility for Chapter 35 Dependents 
Educational Assistance benefits be adjudicated in advance of a 
decision on the underlying claim. Under current law, such 
persons may be deemed eligible for Chapter 35 benefits 
retroactively, but only for a 1-year period. Section 114 of the 
Committee bill would rectify this situation by allowing VA to 
retroactively award Chapter 35 benefits for a period exceeding 
1 year to a spouse or child who would otherwise be eligible for 
Chapter 35 benefits so long as the claiming person files an 
application for such benefits within 1 year after VA makes a 
determination on the death or disability claim from which 
eligibility for the requested benefits arises.

                      Subtitle C--Housing Matters


Specially adapted housing grants

            Background
    Veterans with severe disabilities that limit ambulatory 
powers, e.g., the loss of use of both legs, are eligible under 
chapter 21 of title 38 for specially adapted housing grants of 
up to $43,000 to finance the purchase or remodeling of housing 
units with special adaptions necessary to accommodate their 
disabilities. Co-ownership of the property by the veteran and 
another person is not relevant to the amount of the grant if 
the co-owner is the veteran's spouse. If, however, the co-owner 
is person other than the veteran's spouse, the maximum grant 
amount is reduced by regulation to reflect the veteran's 
partial ownership of the property interest, e.g., if the 
veteran jointly owns the property with one other person, the 
maximum grant is $21,500. 38 C.F.R. Sec. 36.4403. In 1999, VA 
made 770 specially adapted housing grants; VA estimates that it 
makes 5-10 grants per year to persons who owned a home with a 
person other than a spouse.
            Committee Bill
    Section 121 of the Committee Bill would amend section 2102 
of chapter 21 to allow VA to make non-reduced grants for 
specially adapted housing in cases where title to the housing 
unit is not vested solely in the veteran, if the veteran 
resides in the housing unit.

Home loan guaranty ceiling and fees

            Background
    The VA Home Loan Guaranty Program facilitates the extension 
of favorable credit terms by private lenders to veterans, to 
active duty servicemembers, to certain members of the Selected 
Reserves, and to certain surviving spouses, see 38 U.S.C. 
Sec. 3701, for the purchase, construction, or improvement of 
homes. The program operates by substituting the Federal 
Government's guaranty of a portion of the loan amount, thereby 
enabling creditworthy borrowers to secure favorable credit 
terms even if they lack funds for a significant downpayment. 
For loans of up to $45,000, VA guarantees up to 50 percent of 
the loan amount; for loans between $45,000 and $144,000, VA 
guarantees up to 40 percent, with a maximum guaranty of 
$36,000; and for loans of more than $144,000, VA guarantees 25 
percent of the loan amount, with a maximum guaranty of $50,750. 
Under current mortgage loan industry practices, a loan guaranty 
of $50,750 is sufficient to allow a veteran home purchaser to 
borrow up to $203,000 toward the purchase of a home with no 
downpayment.
    Home purchasers participating in the VA home loan guaranty 
program generally must pay a fee for participation. The amount 
of the fee depends upon the percentage of downpayment made by 
the veteran. Veterans who make a downpayment of less than 5% 
pay a fee of 3% of the loan amount. Those who make a 
downpayment of between 5% and 10% pay a 1.5% fee. Veterans who 
make a downpayment of 10% or more pay a fee of 1.25% of the 
loan amount. Fees are waived with respect to veterans receiving 
compensation for a service-connected disability. See 38 U.S.C. 
Sec. 3729(c).
            Committee Bill
    Section 122 of the Committee Bill would amend section 3703 
(a)(1) of title 38 to increase the maximum amount of the VA 
guaranty from $50,750 to $63,175. In many markets, housing 
prices have risen to the point that a guaranty of $50,750 is 
not sufficient to allow a veteran-purchaser who would otherwise 
qualify to finance the purchase of a significant segment of the 
housing stock in his or her home area. An increase of the 
guaranty amount to $63,175 would make no downpayment financing 
of up to $252,700 available to qualified home loan guaranty 
program participants.
    As noted above, fees are waived with respect to veterans 
receiving compensation for a service-connected disability. 
Section 123 of the Committee Bill would amend section 3729 of 
title 38 to add an additional category of fee-exempt borrower: 
persons who have been evaluated by VA as having compensable 
service-connected disabilities but who are not yet receiving 
disability compensation because they are still on active duty. 
In order to streamline its processes for adjudicating 
eligibility for compensation, VA increasingly offers medical 
examinations to, and rates the disabilities of, active duty 
servicemembers as part of the separation or retirement process. 
Under current law, VA cannot now waive collection of loan fees 
from such persons because they are not actually receiving--and 
they cannot actually receive--compensation while they remain on 
active duty. Active duty servicemembers can, however, 
participate in the VA home loan guaranty program. The Committee 
Bill would allow VA to waive fees for such persons even though 
they are not receiving VA compensation at the time they seek 
home loan financing.

                     Subtitle D--Insurance Matters

            Background
    Under Chapter 19 of title 38, VA administers programs 
providing life insurance coverage for certain veterans. These 
programs include the Service-Disabled Veterans Insurance (SDVI) 
program, which was created in 1951. This program provides up to 
$10,000 in life insurance coverage to veterans with service-
connected disabilities, and up to $30,000 for veterans who are 
totally disabled. (Premiums are waived with respect to this 
latter group.) There are currently 147,870 SDVI policies in 
force.
    Disabled veterans insured through the SDVI program pay 
premiums at the same rate as comparable non-disabled 
individuals. Veterans may elect coverage under either term or 
``permanent'' policies. Premiums for ``permanent'' plans are 
substantially higher initially, but they do not increase as the 
insured ages. Term insurance premiums are substantially lower 
than ``permanent'' plan premiums when the insured is relatively 
young but, as is the case with all term life insurance 
policies, these premiums increase over time. In the case of 
SDVI term policies, premiums increase every 5 years to reflect 
the increased risk of death as individuals age.
    The Servicemembers Group Life Insurance Program (SGLI) 
provides up to $200,000 in coverage to individuals on active 
duty in the Armed Forces; to members of the Ready Reserves, the 
Commissioned Corps of the National Oceanic and Atmospheric 
Administration, and the Public Health Service; to cadets and 
midshipmen of the four service academies; and to members of the 
Reserve Officer Training Corps. The SGLI program is entirely 
self supporting except for costs attributable to excess 
mortality resulting from military hazards; those ``excess'' 
costs, if any, are borne by the uniformed services, a 
contingency last experienced during the Vietnam War. Coverage 
is available in $10,000 increments up to a maximum of $200,000 
unless the servicemember declines coverage or elects coverage 
at a reduced amount. The current SGLI premium is $.08 per month 
per $1,000 of coverage. There are 2,307,000 SGLI policies in 
force.
            Committee Bill
    Section 131 of the Committee bill would cap premiums for 
SDVI term policies at the age 70 renewal rate, currently, $5.87 
per month per thousand dollars coverage. Term insurance 
policies become almost unaffordable for veterans over the age 
of 70. In recognition of that fact, premiums for other VA life 
insurance programs, e.g., the National Service Life Insurance 
program available to World War II veterans, have been capped at 
the rate established for renewal at age 70. The Committee Bill 
would provide the same benefit to the service-connected 
veterans insured through the SDVI program.
    Section 132 of the Committee bill would increase the 
maximum amount of coverage available through the SGLI program 
from $200,000 to $250,000. The maximum amount of SGLI coverage 
has not been increased since 1992; the Consumer Price Index has 
increased 18% since that time.
    Section 133 of the Committee bill would create a new 
section 1967A within chapter 19 of title 38. This new section 
would provide to SGLI-insured servicemembers an opportunity to 
provide for coverage of their spouses and children. Just as is 
the case for coverage of servicemembers, dependents' coverage 
would be ``automatic'' unless it is declined. The amount of 
coverage for a spouse would be equal to the coverage of the 
insured servicemember, up to a maximum of $50,000. The lives of 
an insured servicemembers' dependent children would be insured 
for $5,000.

                       Subtitle E--Burial Matters

            Background
    The Philippine Islands became a U.S. possession at the 
conclusion of the Spanish-American War in 1898, and remained a 
U.S. possession until 1946. Public Law 73-127, enacted in 1934, 
established the Philippine Islands as a Commonwealth which had 
certain powers relating to its internal affairs and the power 
to organize and maintain a Commonwealth Army. The United States 
reserved the right to place all Commonwealth forces under U.S. 
command between 1934 and the date of Philippine independence 
(July 4, 1946); President Franklin D. Roosevelt exercised this 
authority on July 26, 1941, and brought the Philippine 
Commonwealth Army under the command of the U.S. Army Forces of 
the Far East (USAFFE). During World War II, certain organized 
guerrilla resistance units were recognized by the U.S. Army as 
having fought under U.S. command; these units are now 
recognized to have been part of the Philippine Commonwealth 
Army. Members of the Philippine Commonwealth Army remained 
under command of the USAFFE until June 29, 1946.
    After World War II, Congress limited the size and scope of 
U.S. veterans' benefits available to Commonwealth Army 
veterans, taking into consideration differences in the costs-
of-living in the United States and the Philippines, and also 
taking into account the newly independent Nation's 
responsibility to care for its own veterans. Congress did not, 
however, make Commonwealth Army veterans ineligible for U.S. 
benefits. Then-and now-former members of the Commonwealth Army 
may qualify for disability compensation, burial benefits, and 
National Service Life Insurance benefits, and their survivors 
may qualify for Dependency and Indemnity Compensation. Such 
benefits, however, are provided at half the rate they are 
provided to U.S. veterans due to the difference in the cost of 
living in the Phillippines relative to the United States. 
Commonwealth Army veterans are not eligible for other VA 
benefits, including pension payments, health care benefits 
(except on a space-available basis, in the United States, for 
service-connected disabilities), burial in the national 
cemeteries, or readjustment benefits.
            Committee Bill
    Section 141 of the Committee bill would amend 38 U.S.C. 
Sec. 2402(4) to provide, in cases where a Commonwealth Army 
veteran dies after enactment of section 141, for the 
eligibility of a Commonwealth Army veteran for burial in a 
national cemetery if, at the time of death, he is a naturalized 
citizen of the United States, and he is resident in the United 
States.

                     Subtitle F--Employment Matters

            Background
    The Department of Labor, Veterans' Employment and Training 
Service (VETS), has primary responsibility for the 
implementation of laws relating to veterans' employment. 
Section 4102 of title 38 states Congressional intent with 
respect to veterans' employment programs as follows: ``The 
Congress declares as its intent that there shall be an 
effective (1) job and job training counseling program, (2) 
employment placement service program, and (3) job training 
placement service program for eligible veterans and eligible 
persons. . . .''
    Chapter 42 of title 38 specifies employment and training 
programs for certain veterans. Among these programs is one, set 
forth in section 4212, which requires that certain Federal 
contractors and subcontractors take affirmative action to 
employ and advance ``special disabled veterans'' (generally, 
veterans with serious employment handicaps or disability 
ratings of 30% or higher), Vietnam-era veterans, and other 
veterans who are ``preference eligible'' (generally, veterans 
who have served during wartime or in a campaign or expedition 
for which a campaign badge has been authorized).
    Public Law 104-275, the ``Veterans' Benefits Improvements 
Act of 1996,'' established the Commission on Servicemembers and 
Veterans Transition Assistance, a bipartisan commission which 
was charged with reviewing all programs designed to assist 
servicemembers and veterans in making the transition from 
service to civilian life, and with recommending improvements in 
those programs. In its report to the Congress, the Commission 
concluded, among other things, that the employment service 
priorities of VETS do not focus on the veterans most in need of 
assistance; that VETS is not sufficiently accountable for 
results; and that services that are provided would be improved 
if they were privatized or transferred from the Department of 
Labor to VA.
            Committee Bill
    Section 151 of the Committee bill would add ``recently 
separated veterans'' (veterans who have been discharged or 
released from active duty within a 1-year period) to the 
universe of veterans to whom Federal contractors and 
subcontractors must extend affirmative action to employ and 
advance. It is the Committee's finding that such veterans are 
among those who most urgently need to be reintegrated into the 
civilian economy.
    The Committee is concerned that programs administered by 
VETS are not as effective as they might be. Particularly 
troublesome to the Committee is the fact that, according to 
VETS data, only 26% of veterans who sought assistance from 
State employment offices secured jobs in a recent program year 
as a result of that assistance, and only 12% of veterans 
secured permanent employment. In addition, the Committee 
remains mindful of the findings of the Commission on 
Servicemembers and Veterans Transition Assistance summarized 
above. Thus, Section 152 of the Committee bill directs that the 
General Accounting Office conduct a comprehensive audit of VETS 
to evaluate the organizational structure of VETS and applicable 
legislation and regulations governing it.

      Subtitle G--Benefits for Children of Female Vietnam Veterans

            Background
    In October 1998, the VA's Environmental Epidemiology 
Service released a study titled ``Women Vietnam Veterans 
Reproductive Outcomes Health Study.'' This study, which was 
based on a review of the actual health histories of over 80% of 
the 4,140 women Vietnam veterans known to be alive as of 
January 1, 1992, found that the offspring of these women have 
suffered a statistically significant increase in the prevalence 
of birth defects (10.5% vs. 7.0%), and severe birth defects 
(7.7% vs. 5.8%) in comparison to the children of other women 
Vietnam-era veterans. The study came to these conclusions after 
having accounted for variations in age, race and other 
demographic factors, rank and characteristics of service 
variables, and variations in smoking, alcohol and drug use, and 
other potentially confounding factors, of cohort and control 
group members. This VA analysis has been subjected to peer 
review for verification, which review has resulted in, 
according to VA, acceptance for publication of the VA study in 
September 2000.
    VA currently has authority to compensate veterans (and 
dependents) for a veteran's service-connected diseases or 
injuries. In addition, VA may, pursuant to Public Law 104-204, 
provide benefits to children of Vietnam veterans--but only to 
those children who were born with spina bifida.
            Committee Bill
    Subtitle G of Title I of the Committee bill would, in 
summary, extend (with a single variation) to the children born 
with birth defects to women Vietnam veterans the same benefits 
as those now afforded to Vietnam veterans' children with spina 
bifida under chapter 18 of title 38, United States Code. Under 
chapter 18 of title 38, children with spina bifida of Vietnam 
veterans currently receive:
    1. A monthly monetary allowance, varying by degree of 
disability of the person with spina bifida;
    2. Health care for any disability associated with that 
person's spina bifida; and
    3. Vocational training, job placement, and post-job-
placement services.
    The Committee concludes that the ``Women Vietnam Veterans 
Reproductive Outcomes Health Study'' sufficiently makes the 
case that women Vietnam veterans have sustained a 
disproportionate risk of bearing children with birth defects 
and that, accordingly, benefits like those extended to the 
spina bifida children of Vietnam veterans should be afforded to 
all children with birth defects who were born to Vietnam 
veteran women.
    Section 162 of the Committee bill puts into place the basic 
entitlement to benefits and creates a new subchapter to chapter 
18 of title 38. Section 1811 of that new subchapter would 
define key terms, and section 1812 would specify the health 
care, vocational training, and monetary allowance benefits to 
which covered persons would be entitled. Benefits would be 
provided to women Vietnam veterans' children born with birth 
defects which have resulted in permanent physical or mental 
disability, except for birth defects which VA may determine 
were caused by familial disorders, birth-related injuries, or 
fetal or neonatal infirmities. As noted above, the benefits 
provided would be, with one exception, the same as those 
provided to spina bifida children of Vietnam veterans. The 
variation is this: Public Law 104-204 provides for a three-
tiered monetary allowance scheme under which the spina bifida 
children of Vietnam veterans with varying degrees of disability 
receive compensation. The Committee bill adds a fourth, and 
lower, tier benefit for persons covered by the Committee bill 
in recognition of the fact that the Committee bill covers a 
broad spectrum of birth defects and some of those birth defects 
are less disabling than spina bifida is.

                   Subtitle H--Other Benefits Matters

            Background
    Pursuant to Public Law 100-321, VA provides compensation to 
veterans who were exposed to ionizing radiation in service (due 
to participation in the occupation forces of Hiroshima or 
Nagasaki immediately after WWII, or in nuclear testing 
activities during the Cold War era) and who, subsequently, are 
diagnosed with the ``presumptive diseases'' listed in 38 U.S.C. 
Sec. 1112(c)(2). VA may also compensate radiation-exposed 
veterans with diseases not presumed to be service connected if 
it determines that it is at least as likely as not that the 
disease is the result of exposure taking into account the 
amount of exposure and the radiogenic properties of the 
disease, but VA requires that such exposures be verified 
through dose reconstruction analysis provided by the Department 
of Defense (hereinafter, ``DOD''). See 38 C.F.R. Sec. 3.311.
    On April 21, 1998, the Committee held a hearing regarding 
compensation for illnesses associated with exposure to ionizing 
radiation while in service. At that hearing, the Committee 
learned that very few veterans have been granted service 
connection for diseases potentially resulting from radiation 
exposures in cases where the veterans have had to rely on DOD 
dose reconstruction. In most cases, DOD dose reconstructions 
have led VA to conclude that if the veteran was exposed to 
radiation, the exposure was not at a sufficient level of 
radiation to cause illness. Some members of a panel of 
scientists at that hearing, however, were skeptical of DOD's 
dose reconstruction methodology.
    In light of the absence of consensus on the validity of 
DOD's dose reconstruction methodology, Chairman Specter and 
Ranking Minority Member Rockefeller requested that GAO review 
DOD's dose reconstruction process. The results of that inquiry 
are set forth in GAO's report, ``Independent Review Could 
Improve Credibility of Radiation Exposure Estimates'' (GAO/
HEHS-00-32), January 28, 2000. While GAO found that dose 
reconstruction tends to overstate rather than understate actual 
exposure, GAO also found that, among other things, the National 
Academy of Sciences' Institute of Medicine, and the National 
Research Council, are critical of DOD's quality controls and 
its lack of a peer review process. GAO recommended that DOD 
establish a process for independent review of its dose 
reconstruction process.
            Committee Bill
    Section 171 of the Committee bill specifies that, 
consistent with GAO's recommendation, DOD shall contract with 
the National Academy of Sciences (hereinafter, ``NAS'') to 
carry out periodic reviews of the dose reconstruction program. 
NAS would review whether DOD's reconstruction of sampled doses 
is accurate; whether DOD assumptions regarding exposure based 
upon sampled doses are credible; and whether data from nuclear 
testing used by DOD in its reconstructions are accurate. The 
review would last 24 months and culminate in a report detailing 
NAS' findings and recommendations, if any, for a permanent 
review program.

                     title ii--health care matters

Medication copayments

            Background
    Under current law, VA provides medical care, without 
imposing an obligation to make copayments for such care, to 
veterans who are ``unable to defray the expenses of necessary 
care . . . .'' 38 U.S.C. Sec. 1710(a)(2)(G). Whether a given 
veteran is, or is not, ``unable to defray'' is determined by 
comparing his or her annual income against a sliding scale of 
income thresholds (currently calculated at $22,888 for veterans 
with no dependents, $27,469 for veterans with one dependent, 
plus additional allowances for additional dependents).
    A separate provision of law, 38 U.S.C. Sec. 1722A, mandates 
that VA charge a copayment for each 30-day supply of 
prescription medications provided to a veteran on an outpatient 
basis if that medication is for the treatment of a non-service-
connected condition. Two categories of veterans are exempted 
from the copayment obligation: veterans who have service-
connected disability ratings of 50% or higher; and veterans 
whose annual income does not exceed the maximum amount of 
``means-tested'' VA pension that would be payable if such 
veteran were to qualify for pension. Eligibility for pension--
like priority eligibility for health care on the basis of one's 
means--is determined by measuring the veteran's annual income 
and comparing it to a sliding scale of income thresholds. The 
eligibility thresholds, however, differ from one another; the 
pension threshold is $8,989 for a veteran with no dependents 
and $11,773 for a veteran with one dependent, and, as noted 
above, the ``unable to defray'' thresholds are higher. As a 
consequence, veterans who are given priority access to VA 
health care and are exempted from making copayments for that 
health care under one measurement of their means, are required 
to make copayments for medications under a different 
measurement of their means.
            Committee Bill
    Section 201 of the Committee bill would unify the copayment 
exemption thresholds at the pension rate. It is the Committee's 
view that if a veteran is deemed to be eligible for priority 
access to health care without copayments because he or she 
meets an ``unable to defray'' test, the veteran similarly lacks 
the means to defray a medication copayment obligation.

Physician assistants

            Background
    Physician assistants have become an increasingly important 
component of VA treatment teams, particularly as VA, like the 
Nation's health care system generally, makes a transition to 
primary-based care. VA's current medical management structure 
does not fully reflect this reality; it remains, in part, as it 
was when VA was a hospital-based provider of care. For example, 
the Office of the Under Secretary for Health is staffed by 
various officials, drawn from the professions of medicine, 
nursing, pharmacy, dietetics, podiatry, and optometry. See 38 
U.S.C. Sec. 7306. That office, however, is not staffed by a 
service director or other official trained as a physician 
assistant.
    Similarly, VA has statutory authority to employ, on a 
temporary full-time basis, yet-to-be licensed professionals who 
have successfully completed a full course of training in 
nursing, or in other statutorily recognized disciplines, but 
not physician assistants. See 38 U.S.C. Sec. 7405(c)(2). This 
statute was enacted to facilitate VA hiring of such 
professionals, on a temporary basis, after they have completed 
training but not to exceed 2 years, while they await the 
receipt of licenses, registrations, or certifications which are 
prerequisites to meeting professional quality standards and to 
securing non-temporary employment at VA.
    At the time section 7405 was enacted, physician assistants 
were not required by the Commission on Accreditation of Allied 
Health Education Programs to obtain licenses or other 
certifications before meeting professional quality standards--
but now they are. VA, however, only offers them 1-year, non-
renewable appointments rather than 2-year appointments while 
they await licensing. See 38 U.S.C. Sec. 7405(3). This 
limitation has harmed VA physician assistant recruiting efforts 
since it can take more than 1 year for these professionals to 
complete their licensing requirements, a situation that causes 
recently trained physician assistants to decline VA 
appointments which must be terminated if licensing is not 
completed within 1 year.
            Committee Bill
    Section 202 of the Committee bill adds to the list of 
professions which, by statute, form the Office of the Under 
Secretary for Health. It would direct that that office employ 
an Advisor to the Under Secretary on Physician Assistants. This 
person would be responsible for advising the Under Secretary on 
matters relating to the optimal utilization of physician 
assistants, the appropriate clinical privileges and practice 
areas for physician assistants, initiatives to utilize 
physician assistants more optimally, and policies affecting the 
employment of physician assistants.
    Section 203 of the Committee bill would authorize VA to 
appoint persons who have completed a full course of physician 
assistant training to temporary full-time positions on the same 
2-year basis under which nurses, and other professionals, are 
now hired.

             title iii--construction and facilities matters

                    Subtitle A--Construction Matters

            Background
    VA may not obligate or expend funds on any ``major medical 
facility project'' unless that project has been specifically 
authorized by law. See 38 U.S.C. Sec. 8104. A ``major medical 
facility project'' is one that will involve the construction, 
alteration, or acquisition of a medical facility involving the 
total expenditure of more than $4 million.
    In 1999, funds were appropriated for VA to proceed on a 
major construction project in Murfreesboro, TN, which has not 
been authorized. VA, therefore, has been precluded from 
expending funds on that project. VA has requested authorization 
to proceed on that project and on a second project in Menlo 
Park, CA. The Committee's staff has considered both proposals 
and has visited the sites of both proposed projects.
            Committee Bill
    Subtitle A of title III of the Committee bill would 
authorize the two major medical facility projects requested by 
VA: a renovation of a psychiatric nursing care unit at 
Murfreesboro, TN ($14 million); and the construction of a gero-
psychiatric facility at Palo Alto/Menlo Park, CA ($26.6 
million). In addition, the Committee bill would authorize the 
construction of a nursing home at Beckley, WV, at a cost of 
$9.5 million.
    The Murfreesboro, TN, project would provide renovations to 
the medical center's long-term psychiatric care unit by 
rebuilding four units of 30 beds each. The current facility, 
constructed in the 1940's, lacks proper privacy facilities in 
sleeping and shower areas, and is equipped to treat only two 
female patients at a given time. In addition, the long-term 
psychiatric care unit's nursing station is ill-equipped to 
monitor and care for severely mentally ill patients. As a 
consequence, the Joint Commission on Accreditation of 
Healthcare Organizations has been critical of the facility.
    The Menlo Park, CA, project would replace the current 109-
bed gero-psychiatric care nursing home on the grounds of the 
Palo Alto Health Care System's Menlo Park Division. In addition 
to replacing existing beds, the project would add an additional 
11 beds, for a total of 120 gero-psychiatric beds, that are 
needed to meet increasing demand for nursing home care in 
northern California. The current facility, built in 1967, meets 
neither VA nor State of California earthquake safety standards, 
and this project is necessary to ensure structural integrity 
and, thus, the safety of the elder veterans this facility 
treats.
    The West Virginia project would provide for a new 120-bed 
nursing home care unit on the grounds of the Beckley VA Medical 
Center to replace the medical center's current 50-bed unit, 
which is fully occupied 95% of the time. The demand for skilled 
and palliative care in the medical center's catchment area far 
exceeds VA's current capacity, and with only two community 
facilities offering even limited access to veterans for 
Alzheimer's/dementia care, the community is unable to meet the 
needs of local veterans. Of the 120 beds in the new facility, 
20 would be devoted to skilled nursing care, 20 to a dementia 
special care unit, and 80 for long-term nursing beds, with 10 
of those specifically designated for palliative care use.

                       Subtitle B--Other Matters


Leases to providers of services to homeless veterans

            Background
    As noted above, VA's Home Loan Guaranty Program assists 
veterans in readjusting to civilian life by facilitating their 
purchase, construction, or improvement of homes. VA does so by 
encouraging private lenders to extend favorable credit terms to 
veterans by guaranteeing repayment of a portion of the lender-
provided home loan.
    Unfortunately, it is the case that, in unusual 
circumstances, veterans default on mortgage loans guaranteed by 
VA. In such cases, the lender will foreclose and VA, as 
guarantor, may come into possession of the property. Such 
properties, typically, are sold to the public by VA. VA, 
however, has the option of leasing such properties to public 
and nonprofit private providers of services to homeless 
veterans so that such service-providers may offer shelter and 
other services to homeless veterans and their families. See 38 
U.S.C. Sec. 3735. Such leases to the providers of services to 
homeless veterans, however, may not exceed 3 years in term.
            Committee Bill
    Providers of services to homeless veterans have shown a 
willingness to invest funds in the renovation of VA-leased 
properties to make them more suitable for providing services to 
homeless veterans and their families. VA encourages such 
investments by service-providers by offering grants and per 
diem subsidies to assist them in establishing assistance 
programs. Even so, providers typically require financing to 
cover their share of costs, but lenders often require assurance 
that the borrower's program will operate for a period exceeding 
3 years before they will provide renovation financing. Section 
311 of the Committee bill would extend the maximum term of VA 
leases to providers of services to homeless veterans from 3 to 
20 years.

Property transfers

            Background
    Generally, when a Federal agency such as VA finds that it 
no longer needs real property that it occupies, it reports the 
``excess'' to the General Services Administration (hereinafter, 
``GSA''). GSA then ``shops'' the property to other Federal 
entities and, simultaneously, requests that the Department of 
Housing and Urban Development (hereinafter, ``HUD'') determine 
whether the property is suitable for use in providing services 
to homeless persons. See 42 U.S.C. Sec. 11411. In cases where 
another Federal agency can use the property, it is transferred 
to that agency. If there is no such Federal need, it is made 
available to HUD for use for providing shelter or other 
services to homeless persons--if it is suitable for that 
purpose. If it is not suitable for that purpose, it is declared 
``surplus'' and then may be transferred to State or local 
government entities, but only for specific statutory purposes, 
see 40 U.S.C. Sec. 484(j). Otherwise, it can only be sold for 
other governmental use for a fair market value price, or it can 
be sold to the public by sealed bid or auction.
            Committee Bill
    Sections 312-314 would, for these two cases, streamline the 
above-outlined property disposal procedures by authorizing VA 
to convey two properties to other governmental users (in one 
case, a county government and in the other case, a State 
government). In one case, VA would transfer medical center 
facilities in Miles City, MT, to Custer County, MT, while 
leasing back space in which it would operate an outpatient 
clinic. Custer County would devote the transferred land to 
assisted living apartments for the elderly and to a number of 
other economic enhancement and community activity uses, 
including education and training courses at Miles Community 
College, a Technology Center, local fire department training, 
and use by the Montana Area Food Bank. VA, in turn, would be 
relieved of the requirement to spend over $500,000 per year 
maintaining a facility that is poorly suited to provide health 
care to the veterans of eastern Montana. VA could devote the 
funds so saved to opening and operating outpatient clinics 
throughout rural Montana.
    The other property conveyance would take place at Ft. Lyon, 
CO. In this case, excess VA property used as medical center and 
nursing home care facilities would be conveyed to the State of 
Colorado for use by the State as a corrections facility. Under 
the terms of the Committee bill, the conveyance would not take 
place unless and until arrangements had been made to protect 
the interests of affected patients and employees of the Ft. 
Lyon VA Medical Center (VAMC). With respect to patients, VA 
would be directed to make alternate arrangements to ensure that 
appropriate medical care and nursing home care services would 
continue to be provided, on the same basis that care had been 
provided at the Ft. Lyon VAMC, to all veterans who had been 
receiving such services at the medical center. Such services 
would be provided, if necessary, by community facilities at VA 
expense notwithstanding any legal limitations--e.g., those set 
forth in 38 U.S.C. Sec. 1720 limiting the time for which such 
care might be provided to veterans for non-service-connected 
disabilities--that might otherwise apply. Further, VA would be 
authorized to offer voluntary separation incentive payments to 
eligible employees of the Ft. Lyon VAMC. In addition, the State 
would be required to allow public access to the Kit Carson 
Chapel located on the grounds of the VAMC. And, finally, the 
Committee bill would require that VA file a report, not later 
than 1 year after the conveyance, concerning the status of the 
VA health care system in Southern Colorado.

                             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 the Congressional Budget Office 
(hereinafter, ``CBO''), estimates that enactment of the 
Committee bill would result in an increase in direct spending, 
as compared to costs under current law and as scored against 
the current CBO baseline, of $44 million in fiscal year 2001, 
$651 million in fiscal years 2001 through 2005, and $1.7 
billion in fiscal years 2001 through 2010. In addition, 
enactment of the Committee bill would, according to CBO, result 
in additional outlays of $64 million in fiscal year 2001, and 
$369 million in fiscal years 2001 through 2005, assuming 
appropriations of the necessary amounts. The Committee bill 
would not affect the budgets of State, local, or tribal 
governments, and would impose no intergovernmental or private 
sector mandates as defined in the Unfunded Mandates Reform Act.
    The cost estimate provided by CBO, setting forth a detailed 
breakdown of costs, follows:

                                     U.S. Congress,
                               Congressional Budget Office,
                                   Washington, DC, August 22, 2000.
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. 1810, the Veterans 
Programs Enhancement Act of 2000.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Sunita 
D'Monte.
            Sincerely,
                                          Dan L. Crippen, Director.
    Enclosure.

               congressional budget office cost estimate

S. 1810--Veterans Programs Enhancement Act of 2000

    Summary: S. 1810 contains provisions that would affect a 
wide range of veterans' programs, including readjustment 
benefits, disability compensation, dependency and indemnity 
compensation (DIC), and veterans' medical care. CBO estimates 
that enacting the bill would increase direct spending by $44 
million in 2001, $651 million over the 2001-2005 period, and 
$1.7 billion over the 2001-2010 period. Because the bill would 
affect direct spending, pay-as-you-go procedures would apply. 
In addition, the bill would authorize funding or modify 
provisions governing a number of discretionary veterans' 
programs, which would result in additional outlays of $64 
million in 2001 and $369 million over the 2001-2005 period, 
assuming appropriation of the necessary amounts.
    S. 1810 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would impose no costs on state, local, or tribal 
governments. Any costs to state, local, or tribal governments 
as a result of enactment of this bill would be incurred 
voluntarily.
    Estimated cost to the Federal Government: The estimated 
budgetary impact of the bill is shown in Table 1. The costs of 
this legislation fall within budget function 700 (veterans 
benefits and services).

    TABLE 1.--ESTIMATED BUDGETARY IMPACT OF S. 1810, AS ORDERED REPORTED BY THE SENATE COMMITTEE ON VETERANS'
                                                     AFFAIRS
----------------------------------------------------------------------------------------------------------------
                                                                     By fiscal year, in millions of dollars
                                                               -------------------------------------------------
                                                                  2001      2002      2003      2004      2005
----------------------------------------------------------------------------------------------------------------
                                           CHANGES IN DIRECT SPENDING

Estimated budget authority....................................        32        76       154       177       197
Estimated outlays.............................................        44        81       152       176       198

                                  CHANGES IN SPENDING SUBJECT TO APPROIPRIATION

Estimated authorization level.................................       126        93        61        61        61
Estimated outlays.............................................        64        98        72        71        64
----------------------------------------------------------------------------------------------------------------

                           basis of estimate

Direct spending

    The bill would affect direct spending in several programs, 
including disability compensation, veterans' home loans, and 
readjustment benefits (see Table 2).
    Disability Compensation.--Enacting the bill would increase 
direct spending for compensation for veterans exposed to 
radiation, veterans who suffer a service-connected loss of one 
or both breasts, and certain veterans' children with birth 
defects.
    Veterans exposed to radiation.--Section 102 would add four 
conditions to the list of diseases presumed to be connected to 
participation in atmospheric testing or occupation of Hiroshima 
and Nagasaki. By requiring a presumption that, for certain 
veterans, these illnesses are service-connected, the bill would 
increase the number of radiation-exposed veterans who are 
eligible for disability compensation or whose spouses are 
eligible for dependency and indemnity compensation. CBO 
estimates that enacting section 102 would increase direct 
spending by $19 million in 2001 and by about $513 million over 
the 2001-2005 period.
    Data from the Defense Special Weapons Agency (formerly the 
Defense Nuclear Agency) indicate that approximately 210,000 
military personnel participated in atmospheric nuclear tests. 
In addition, approximately 200,000 military personnel 
participated in the post-war occupation of Hiroshima and 
Nagasaki, Japan. Assuming that the average age of participants 
was 24 years at the time for participation, CBO estimates that 
about 200,000 of those veterans are alive today.

                          TABLE 2.--ESTIMATED CHANGES IN DIRECT SPENDING UNDER S. 1810
----------------------------------------------------------------------------------------------------------------
                                                            By fiscal year, outlays in millions of dollars
                                                     -----------------------------------------------------------
                                                        2000      2001      2002      2003      2004      2005
----------------------------------------------------------------------------------------------------------------
                                             DISABILITY COMPENSATION

Spending under current law..........................    18,816    19,719    20,505    21,215    21,898    24,377
Proposed changes....................................         0        20        63       121       146       169
                                                     -----------------------------------------------------------
      Spending under S. 1810........................    18,816    19,739    20,568    21,336    22,044    24,546
                                                     ===========================================================
                                              VETERANS' HOME LOANS

Spending under current law..........................       506       187       154       395       393       390
Proposed changes....................................         0         9         8        25        25        24
                                                     -----------------------------------------------------------
      Spending under S. 1810........................       506       196       162       420       418       414
                                                     ===========================================================
                                              READJUSTMENT BENEFITS
Spending under current law..........................     1,459     1,473     1,489     1,512     1,545     1,587
Proposed changes....................................         0         1         2         2         2         2
                                                     -----------------------------------------------------------
      Spending under S. 1810........................     1,459     1,474     1,491     1,514     1,547     1,589
                                                     ===========================================================
                                      SERVICE-DISABLED VETERANS' INSURANCE
Spending under current law..........................        13        18         5         5         5         5
Proposed changes....................................         0     (\1\)     (\1\)         1         1         1
                                                     -----------------------------------------------------------
      Spending Under S. 1810........................        13        18         5         6         6         6
                                                     ===========================================================
                                             PRESCRIPTION COPAYMENTS

Spending under current law..........................         0       -68       -41       -41       -39       -36
Proposed changes....................................         0        14         8         3         2         2
                                                     -----------------------------------------------------------
      Spending under S. 1810........................         0       -54       -33       -38       -37       -34
----------------------------------------------------------------------------------------------------------------
\1\ Less than $500,000.

    To estimate the caseload of veterans having each disease, 
CBO used disease and age-specific incidence and mortality rates 
from the National Cancer Institute. (CBO has no basis for 
estimating different incidence and mortality rates for this 
particular population.) Based on this analysis, CBO estimates 
that about 8,000 of these veterans and nearly 11,000 spouses of 
deceased veterans would be eligible for benefits in 2001. The 
estimate assumes that roughly 25,000 veterans died from these 
diseases during the 1945-2000 period, that two-thirds of the 
deceased veterans had spouses, that 20 percent of those spouses 
remarried, making them ineligible for DIC, and that some 
spouses died during the same period.
    For the 2001-2005 period, CBO estimates benefit payments 
based on the incidence of the qualifying diseases, expected 
mortality rates among veterans and survivors, the number of 
potential beneficiaries at the start of 2001, and assumptions 
about annual participation. CBO projects that of the 19,000 
veterans and survivors who would be eligible for benefits in 
2001 about 2,000 would receive benefits in that year. 
Recognizing that a small number of affected veterans and 
survivors may draw benefits under current law and that not all 
potential new beneficiaries would participate, CBO assumes that 
50 percent of all eligible survivors at the end of 2000 would 
apply for benefits and 75 percent of all veterans and post-1998 
survivors would participate in the program. We also assume that 
it would take about three years to reach the full estimated 
participation rate. CBO anticipates that by 2005 approximately 
13,000 veterans and survivors would receive benefits as a 
result of enacting this section.
    CBO used data from the Department of Veterans Affairs (VA) 
that was specific to the four diseases to calculate the average 
compensation payments to veterans. Average annual benefits for 
veterans with the diseases vary from about $16,000 for brain 
cancer to about $5,000 for ovarian cancer, reflecting the 
differing disability ratings of veterans currently receiving 
benefits for these illnesses. However, those benefit levels 
also include payments to veterans for additional disabilities, 
and thus incremental benefits under section 102 would be less 
than those averages. CBO has no information as to what portions 
of those averages stem from disabilities other than those 
covered by the bill. We assume that incremental compensation 
benefits would fall below those averages by $2,000. For DIC 
recipients, the estimated benefit is approximately $11,000 
annually for all survivors. This estimate also assumes that 
beneficiaries would receive annual cost-of-living adjustments.
    Section 102 also would lead VA to provide additional 
medical care services, assuming appropriation of necessary 
amounts. Information about those estimated costs are provided 
below with other spending subject to appropriation.
    Compensation for mastectomies.--Section 103 would provide 
additional disability compensation to veterans who suffer a 
service-connected loss of one or both breasts by mastectomy. 
Under current law, veterans who lose certain body parts or 
sensory or vocal capabilities because of a service-connected 
condition are entitled to special monthly compensation of $76 a 
month in 2000 for each eligible impairment. Section 103 would 
authorize these special payments for veterans who have lost one 
or both breasts from a radical or modified mastectomy that is 
related to a service-connected condition.
    CBO estimates that about 350 veterans are currently 
receiving disability payments for these type of mastectomies, 
and based on data from VA, about 35 new beneficiaries are added 
every year. Over the 2001-2004 period, the new payments would 
cost less than $500,000 annually. From 2005 through 2010, 
annual spending would be over $500,000 but less than $1 
million.
    Children with birth defects.--Under current law, certain 
children with spina bifida are eligible for benefits from VA. 
Section 162 would extend those benefits to certain children 
with other birth defects. Children with birth defects that are 
genetic in nature and that arise from well-known and recognized 
causes would not be eligible.
    This section provides for a monthly allowance to be paid to 
each individual based on the severity of the disability. The 
bill would establish four levels of disability and associated 
payments that would range from $100 a month to $1,272 a month. 
For this estimate, CBO assumes that potential beneficiaries 
would be distributed uniformly across the four categories and 
that 75 percent of them would apply for and receive payments. 
CBO estimates that the allowance would cost about $1 million a 
year.
    Section 162 also would extend health care benefits to these 
children, assuming appropriation of the necessary amounts. 
Information about the estimated costs are provided below with 
other spending subject to appropriation.
    Veterans' Home Loans.--The bill also would increase direct 
spending for certain veterans' housing benefits.
    Increase in loan guaranty.--Section 122 would increase the 
maximum loan guaranty amount from $50,750 to $63,175, thereby 
raising the maximum loan amount from $203,000 to $252,700 (for 
large loan amounts, VA can only guaranty 25 percent of the loan 
amount). CBO estimates that enacting this section would 
increase direct spending by $9 million in 2001 and by $90 
million over the 2001-2005 period. The cost over 10 years would 
be approximately $220 million. Based on information from VA, 
CBO estimates that the provision would result in 8,000 new 
loans a year over the 2001-2010 period. In addition, roughly 
3,000 loans each year would now be made with higher loan 
amounts--these would not be new borrowers, but veterans who 
would no longer need a downpayment to qualify for the VA loan 
guaranty benefit.
    Other housing provisions.--Section 121 would prohibit VA 
from reducing a grant for specially adapted housing if the 
title to the property is held jointly by the veteran and 
another person. Section 123 would waive the loan fee for any 
veteran who has been rated eligible for compensation benefits 
even if an effective date for receiving compensation has not 
yet been established; under current law, a veteran must be 
receiving compensation payments before the loan fee is waived. 
Both sections would affect few borrowers and would have 
insignificant effects on direct spending.
    Readjustment Benefits.--Subtitle B contains several 
provisions that would affect veterans readjustment benefits.
    Diploma requirement.--To be eligible for the Montgomery GI 
Bill (MGIB) under current law, an individual must meet certain 
educational prerequisites before the end of his or her initial 
period of obligated service. Section 111 would remove the time 
constraint by allowing a secondary school diploma or its 
equivalent to be obtained at any time before applying for MGIB 
benefits. Based on information from the Department of Defense 
(DoD), CBO estimates that this section would make an additional 
300 individuals eligible for the program each year. Based on 
current usage rates for MGIB benefits, CBO estimates an 
additional 20 trainees would use MGIB benefits in 2001, 
increasing to almost 300 additional trainees in 2010. CBO 
estimates that the provision would cost $100,000 in 2001, $2 
million over the 2001-2005 period, and $7 million over the 
2001-2010 period.
    Obligation for duty.--MGIB eligibility also requires an 
individual to complete his initial service obligation. Section 
112 would relax that requirement, allowing eligibility to be 
based on any completed period of obligated service. This would 
allow an individual who separated from the service during one 
period of duty to qualify for MGIB benefits by completing a 
subsequent obligated period of service. Based on information 
from DoD, CBO estimates that, of those individuals separating 
from the service each year, an additional 65 would be eligible 
for MGIB benefits. Assuming that about half of these 
individuals use their benefits and that they train according to 
current usage rates, the cost would be about $60,000 in 2001, 
about $1 million over the 2001-2005 period, and about $3 
million over the 2001-2010 period.
    Preparatory courses.--Section 113 would extend MGIB 
benefits to cover preparatory courses for college or graduate 
school entrance exams. Veterans who would otherwise consume 
their entire entitlement would forgo a payment at the end of 
their training if they use the benefit under this section, but 
for all other veterans, this section would add to spending. CBO 
estimates that this provision would increase direct spending by 
about $3 million over the 2001-2005 period. The estimate 
assumes that each year about 1,700 participants would receive 
an average benefit of about $365 for preparatory courses.
    Period of eligibility.--Section 114 would offer certain 
children, who are eligible for education benefits because of 
the service-connected death or total disability of a parent, a 
greater choice as to the beginning date of their eligibility 
period. Current law allows a child who becomes eligible for 
such benefits between the ages of 18 and 26 to choose a 
starting date that is either the date of the parent's death or 
the date the Secretary of Veterans Affairs finds the death to 
be service-connected. Section 114 would allow those adult 
children to begin the period of eligibility at any time between 
those two dates. Similarly, adult children whose eligibility is 
based on a parent's disability could choose to begin their 
eligibility periods at any time between the effective date of 
the parent's disability and the date the Secretary first finds 
the disability to be permanent, total, and service-connected.
    The bill would extend the eligibility period for about 
1,700 adult children whose benefits expire each year according 
to data from VA. About 7 percent of them are training when they 
reach the end of the eligibility period. CBO assumes that half 
of those adult children whose eligibility period expires could 
gain extra time by changing their start dates as the bill would 
allow. CBO estimates this provision would result in an 
additional 60 trainees a year at a total annual cost of about 
$200,000.
    Effective date of entitlement.--Section 115 would allow 
retroactive payments to otherwise eligible dependents of 
veterans for education undertaken during the period after the 
veteran died or became totally disabled but before the 
disability was found to be total or the death or disability was 
found to be service-connected. Currently, most dependents file 
an application for benefits after the Secretary's finding of 
service-connected death or disability. While this finding may 
be made several years after the date of death or what is found 
to be the effective date of the disability, benefits may not be 
granted for more than one year before the date of receipt of 
the dependent's application. This section would direct the 
Secretary to consider any application received within a year of 
the finding to have been filed on the effective date of death 
or disability.
    Based on information from the VA, CBO estimates section 115 
would initially result in about 125 additional requests for 
retroactive benefits in 2001 and 2002, and about 50 additional 
requests in succeeding years. Thus, the cost would be higher in 
the first few years because of a backlog of newly qualified 
applicants. The estimated cost over the 2001-2005 period would 
be about $2.5 million.
    Service-Disabled Veterans' Insurance.--The Service-Disabled 
Veterans' Insurance (SDVI) program insures veterans with 
service-connected disabilities. Participants receive a subsidy 
equal to the difference between the premiums they pay, which 
account for age but not disabilities, and the actual cost of 
the program. The term policies are renewable for life, but the 
premiums at the older ages can be costly. Section 131 would 
eliminate increases in premiums when beneficiaries over age 70 
renew their policies; that is, premiums on renewals would be 
capped at the rate for 70-year-olds.
    For this estimate, CBO used data from VA on premiums for 
policyholders 70 or more years of age and the premiums under 
the proposed cap. The difference represents an additional 
subsidy that VA would provide. For 2001 and 2002, the cost 
would be less than $500,000 annually. From 2003 through 2005, 
the annual cost would be more than $500,000 but less than $1 
million.
    Prescription Copayments.--The bill contains a provision 
that would lower the amounts that VA receives from copayments 
for medical care. Under current law, VA may spend some of those 
receipts; thus, the impact on direct spending is limited to the 
effects of timing and the likelihood that VA does not spend as 
much as it collects. Because receipts would be forgone before 
spending would be lowered, the effect of timing is to raise 
costs in the near term. Eventually, the lowered spending would 
offset the loss of receipts except, however, to the extent that 
VA does not spend all that it could from those collections. CBO 
estimates that this provision would cost $14 million in 2001, 
but the annual cost would decline to about $2 million a year by 
2004. At some point after then reduced spending might offset 
the forgone receipts. Other assumptions and impacts of this 
provision are discussed below with other parts of the bill that 
would affect spending subject to appropriation.
    Burial Benefits for Certain Filipino Veterans.--Section 141 
would expand the eligibility for interment in national 
cemeteries to certain Filipino veterans of World War II (WWII). 
Current law allows for certain members of Philippine military 
forces that were in service to the Armed Forces of the United 
States during World War II to receive some veterans' benefits. 
This provision would allow for the burial of these veterans in 
national cemeteries. Using the number of living WWII Filipino 
veterans, expected mortality rates, assumptions about veterans' 
burial rates in national cemeteries, and the costs for such 
interment, CBO estimates that it would cost less than $500,000 
annually to provide this benefit.

Spending subject to appropriation

    Table 3 shows the estimated effects of S. 1810 on 
discretionary programs, assuming that appropriations are 
provided in the amount of the estimated authorizations.
    Medical Care.--Implementing the bill would increase 
discretionary spending for veterans' medical care by $58 
million in 2001 and $287 million over the 2001-2005 period.

                   TABLE 3. ESTIMATED CHANGES IN SPENDING SUBJECT TO APPROPRIATION FOR S. 1810
----------------------------------------------------------------------------------------------------------------
                                                                By fiscal year, in millions of dollars
                                                     -----------------------------------------------------------
                                                        2000      2001      2002      2003      2004      2005
----------------------------------------------------------------------------------------------------------------
                                             VETERANS' MEDICAL CARE

Spending under current law:
    Estimated authorization level 1,2...............    19,493    19,493    19,493    19,493    19,493    19,493
    Estimated outlays:..............................    18,791    19,312    19,441    19,415    19,396    19,377
Proposed changes:
    Estimated authorization level...................         0        72        86        53        53        53
    Estimated outlays...............................         0        58        78        49        51        51
Spending under S. 1810:
    Estimated authorization level...................    19,493    19,565    19,579    19,546    19,546    19,546
    Estimated outlays...............................    18,791    19,370    19,518    19,464    19,447    19,428

                                           GENERAL OPERATING EXPENSES

Spending under current law:
    Estimated authorization Level 1,2...............       941       941       941       941       941       941
    Estimated outlays...............................       925       941       941       941       941       941
Proposed changes:
    Estimated authorization level...................         0         4         7         8         8         8
    Estimated outlays...............................         0         4         7         7         8         8
Spending under S. 1810:
    Estimated authorization level...................       941       945       948       949       949       949
    Estimated outlays...............................       925       945       948       948       949       949

                                       CONSTRUCTION OF MEDICAL FACILITIES

Spending under current law:
    Budget authority 1..............................        65         0         0         0         0         0
    Estimated outlays...............................       253       217       171       116        56        27
Proposed changes:
    Estimated authorization level...................         0        50         0         0         0         0
    Estimated outlays...............................         0         2        13        16        12         5
Spending under S. 1810:
    Estimated authorization level...................        65        50         0         0         0         0
    Estimated outlays...............................       253       219       184       132        68        32

                             SUMMARY OF CHANGES IN SPENDING SUBJECT TO APPROPRIATION

    Estimated authorization level...................         0       126        93        61        61        61
    Estimated outlays...............................         0        64        98        72        71        64
----------------------------------------------------------------------------------------------------------------
\1\ The figure shown for 2000 is the amount appropriated for that year.
\2\ The estimate assumes that funding under current law will remain at the level appropriated for 2000 without
  adjustment for inflation. If funding over the 2001-2005 period is adjusted for inflation, the base amounts for
  medical care and general operating expenses would increase by about $600 million a year and $30 million a
  year, respectively. In both cases the estimated changes would remain as shown under ``Proposed Changes.''

    Prescription copayments. Under current law, VA provides 
prescription drugs to beneficiaries when VA both writes and 
fills a prescription. The current copayment for these 
prescriptions is $2, although VA may increase the copayment to 
$5 in early 2001. Many veterans are exempted from the copayment 
because they have service-connected disabilities or a low 
enough income. Section 201 would raise the income threshold 
thereby increasing the number of veterans who would not pay for 
prescriptions.
    For income-based exemptions the current threshold is about 
$9,000 for a single individual, although the amount varies 
based on the number of dependents. The new threshold would be 
roughly $22,000 for a single individual. According to VA, the 
individuals in the affected category purchase about 40 percent 
of the prescriptions for which VA charges a copayment. In 2001, 
CBO expects pharmaceutical copayments to reach about $80 
million from the $2 copayment amount and an additional $120 
million from the increase in pharmaceutical copayments from $2 
to $5. Thus, the cost of the proposal would be 40 percent of 
those amounts.
    Differentiating the copayment into two streams is important 
because the relevant amounts are treated differently in federal 
budgeting. Money from the first $2 in copayments can be spent 
by VA only if it receives a subsequent appropriation. (The 
authority to collect the first $2 of the copayment expires at 
the end of fiscal year 2002.) Additional copayment receipts 
over $2 can be spent automatically, that is, without further 
appropriation. Although the forgone receipts are nearly offset 
by a reduction in spending, the provision would result in a 
greater demand for appropriations to offset the reduced 
spending. CBO estimates that VA's need for discretionary 
funding would increase by $297 million over the 2001-2005 
period.
    Veterans exposed to radiation.--VA provides medical care to 
veterans based on priorities established in law. The highest 
priorities are given to veterans with service-connected 
disabilities, but VA also has a program to provide health care 
to veterans with potentially radiogenic diseases, but only for 
treatment of those diseases. Under section 102, certain 
veterans with lung, ovarian, colon, and tumors of the brain and 
central nervous system would receive the highest priorities 
because their diseases would be presumed to be service-
connected. By requiring this presumption of service connection, 
the bill would probably draw a greater number of veterans to VA 
for care. It might also lead some veterans who currently 
receive care from VA to have a greater share of their needs 
taken care of by VA.
    CBO estimates that implementing the bill would raise 
spending on veterans' medical care for radiation-related 
treatment by $1 million in 2001 and by $14 million over the 
2001-2005 period, assuming appropriation of the necessary 
amounts. This estimate depends primarily on assumptions about 
how many of the affected veterans already receive the highest 
priorities, how many veterans the bill would attract to the VA 
health system, and how many current patients would receive a 
greater range of care. The key assumptions are as follows:
     Roughly one-third of these veterans would already 
have high-priority access based on other compensable service-
connected disabilities or income, as allowed under current law. 
(This figure is based on CBO's estimate of the proportion of 
WWII veterans with such status in 1996.)
     About one-tenth of the veterans who gain a higher 
priority would use VA medical services. CBO estimates that VA's 
per capita spending would be about $13,000 annually for most 
new cancer patients. This cost factor, which is roughly three 
times VA's average annual cost per user, is based on a recent 
study showing a comparable difference between Medicare's 
average annual cost per beneficiary with certain types of 
cancer, including lung cancer, and all beneficiaries who 
receive medical care. CBO estimates that care for the remaining 
new patients would cost VA the same per capita amount that it 
spends for current patients.
     About one-fourth of the veterans who would use 
priority care under this bill would already be receiving cancer 
treatment from VA, based on data from the 1992 Survey of 
Veterans. CBO estimates that VA would spend an additional 
$1,300 annually for these veterans.
    Section 102 also would provide for additional payments of 
disability compensation and DIC that would constitute direct 
spending. The estimates of those costs are discussed above 
under the heading ``Direct Spending.''
    Children with birth defects.--Under current law, certain 
children with spina bifida are eligible for benefits from VA. 
Section 162 would extend those benefits to certain children 
with other birth defects. CBO estimates that fewer than 200 
people would be eligible for benefits under the bill, based on 
information from VA and adjustments for mortality and the 
severity of the birth defect. Given the potential for severe 
birth defects, we estimate that the cost of providing health 
care to those individuals could total up to $12,000 per person. 
As with spina bifida patients, new beneficiaries would not need 
to receive their health care at VA facilities, but could 
instead be reimbursed by VA for care received outside of the VA 
system. Because the health care need not be received at VA 
facilities, CBO expects that roughly 50 percent of those 
eligible would use this benefit. (If the care had to be 
received at VA facilities, we expect that this percentage would 
be significantly lower.) CBO estimates that providing health 
care to these people would cost $1 million a year, assuming 
appropriation of the necessary amounts.
    This section also provides for a monthly allowance that 
would constitute direct spending. The estimates of those costs 
are discussed above under the heading ``Direct Spending.''
    General Operating Expenses.--CBO estimates that 
implementing S. 1810 would increase VA operating expenses by $4 
million in 2001 and $34 million over the 2001-2005 period. 
Section 101 would require VA to provide more assistance than it 
does under current law to veterans who file claims for 
benefits. The bill would require VA to pursue certain records 
that are necessary to establish a claim, to inform veterans of 
any information the VA needs to adjudicate an incomplete claim, 
pursue information the veteran authorizes or requests the VA to 
obtain, and inform the veteran when the department cannot 
locate information pertinent to a claim.
    If relevant for claims to disability compensation, VA would 
be required to obtain pertinent records, including a veterans' 
medical record from military service, his or her service 
record, any records of treatment provided by the VA, and any 
other relevant materials available from other federal agencies. 
The bill would also require VA to provide medical exams to 
veterans who need them to substantiate their claims. Also, the 
bill would allow any claimant who had a claim denied since July 
14, 1999, to resubmit it if the claim was denied because of 
insufficient evidence.
    CBO expects that, in order to carry out its 
responsibilities under section 101, VA would have to hire 
additional claims adjudicators. Based on information from the 
VA, CBO assumes that 110 additional claims adjudicators would 
be hired at an estimated cost of $3 million in salary and 
benefits in 2001 and about $7 million annually thereafter. CBO 
estimates that training would cost about $1 million a year and 
that one-time costs associated with expanding the claims 
processing staff would be about $700,000 in 2001. The cost of 
providing medical exams is covered under current law. CBO does 
not expect a significant increase in benefit payments as a 
result of this bill.
    Construction of Medical Facilities.--Section 303 would 
authorize appropriations of $50.1 million to complete three 
projects that are specified in the bill and to continue certain 
projects authorized under current law. CBO estimates that those 
funds would be spent over the next five years, with most of the 
outlays occurring from 2002 through 2004.
    Dose Reconstruction Review.--Section 171 would require DoD 
to enter into a contract with the National Academy of Sciences 
(NAS) to carry out periodic reviews of the dose reconstruction 
program, which is used to estimate the amount of radiation to 
which certain veterans may have been exposed. Between 1945 and 
1962 about 200,000 active military personnel participated in 
atmospheric nuclear tests, and some were exposed to potentially 
harmful doses of radiation. For certain types of cancers not 
automatically presumed linked to radiation exposure, dose 
reconstruction is used to adjudicate compensation benefits. 
This section would require NAS to review the current dose 
reconstruction program, over a period of not more than 24 
months, to determine its accuracy. Based on information 
provided by NAS, CBO estimates that the two-year study would 
cost less than $1 million.
    Pay-as-you-go Considerations: The Balanced Budget and 
Emergency Deficit Control Act sets up pay-as-you-go procedures 
for legislation affecting direct spending or receipts. The net 
changes in direct spending are shown in the following table. 
For the purposes of enforcing pay-as-you-go procedures, only 
the effects in the current year, the budget year, and the 
succeeding four years are counted.

                                          TABLE 4. ESTIMATED IMPACT OF S. 1810 ON DIRECT SPENDING AND RECEIPTS
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          By fiscal year, in millions of dollars
                                                                 ---------------------------------------------------------------------------------------
                                                                   2000    2001    2002    2003    2004    2005    2006    2007    2008    2009    2010
--------------------------------------------------------------------------------------------------------------------------------------------------------
Changes in outlays..............................................       0      44      81     152     176     198     193     186     208     214     217
Changes in receipts.............................................                                      Not applicable
--------------------------------------------------------------------------------------------------------------------------------------------------------

    Intergovernmental and private-sector impact: S. 1810 
contains no intergovernmental or private-sector mandates as 
defined in UMRA. A provision of the bill that would authorize 
the conveyance of the Fort Lyon medical facility would place 
certain conditions on the state of Colorado. Any costs to the 
state as a result of those conditions would be incurred 
voluntarily. The remaining provisions of the bill would impose 
no costs on state, local, or tribal governments.
    Estimate prepared by: Federal Costs: Veterans Home Loans: 
Sunita D'Monte; Readjustment Benefits: Sarah T. Jennings; 
Disability Compensation: Michelle Patterson; and Veterans 
Medical Programs: Sam Papenfuss.
    Impact on State, Local, and Tribal Governments: Susan Sieg 
Tompkins.
    Impact on the Private Sector: Rachel Schmidt.
    Estimate approved by: Peter H. Fontaine, 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 July 27, 2000, meeting. On that date, 
the Committee, by unanimous voice vote, ordered S. 1810, as 
amended, reported favorably to the Senate.

                             Agency Report

    On July 20, 2000, the Honorable Joseph Thompson, Under 
Secretary for Benefits, Department of Veterans Affairs, 
appeared before the Committee and submitted testimony on, among 
other things, a draft bill to increase, effective as of 
December 1, 2000, the rates of compensation for veterans with 
service-connected disabilities and the rates of dependency and 
indemnity compensation for the survivors of certain disabled 
veterans. Excerpts from this statement are reprinted below:

Statement of Joseph Thompson, Under Secretary for Benefits, Department 
of Veterans Affairs, before the Committee on Veterans' Affairs, United 
                      States Senate, July 20, 2000


                              introduction


    Mr. Chairman and Members of the Committee, thank you for 
the opportunity to testify today on the Department of Veterans 
Affairs (sic) disability claims processing. I am pleased to be 
here with you to provide a status report on the adjudication of 
these claims and to discuss the efforts the Department has made 
to improve claims processing.

           *       *       *       *       *       *       *



                              legislation


    Mr. Chairman, you have also asked that we comment on 
several bills, including S. 1810, S. 2264, S. 2544, S. 2637, S. 
2827, and 3 draft bills which your staff provided late last 
week. In view of the short amount of time available for the 
formulation of this testimony, we are unable to present the 
Department's views with respect to certain provisions of the 
bills and draft proposals. However, we will be pleased to 
provide our formal written views concerning them at a later 
date once the necessary executive branch coordination is 
completed.

           *       *       *       *       *       *       *


   S. 1810 and Section 101 of Draft Bill [O:/ARM/ARM00.997--July 13, 
                         2000]--Duty to Assist

    S. 1810 would amend 38 U.S.C. Sec. 5107(a) to clarify that 
VA has a duty to assist all claimants in developing the facts 
pertinent to their claims. This would countermand precedent 
decisions of the United States Court of Appeals for Veterans 
Claims and the United States Court of Appeals for the Federal 
Circuit which have held that VA is required to assist only 
those claimants who have shown that their claims are ``well 
grounded,'' as that term has been defined by the courts.
    Section 101 of the draft bill would, similarly, eliminate 
the well-grounded claim threshold for VA's duty to assist. That 
section would also specify a number of actions VA would be 
required to take to carry out its duty to assist, including 
special requirements in claims for service-connected disability 
compensation, the most frequently claimed VA benefit. The 
required actions would include informing claimants of the type 
of evidence that would be helpful to their claims, obtaining 
service medical records, VA treatment records, and other 
records which claimants have adequately identified and 
authorized VA to obtain, and providing medical examinations or 
medical opinions when necessary.
    Section 101 also contains a provision which would permit 
readjudication of any claim that was denied as being not well 
grounded on or after July 14, 1999, the date of the CAVC's 
decision in Morton v. West, 12 Vet. App. 477 (1999). In Morton, 
the CAVC held that VA cannot assist a claimant whose claim is 
not well grounded. As a result of that decision, VA has had to 
greatly restrict assistance to claimants whose claims are not 
well grounded.
    VA supports the purpose of both proposals which is to 
clarify VA's duty to assist claimants in processing claims. 
However, we believe that a more detailed approach, such as that 
reflected in section 101 of the draft bill, is preferable 
because it would establish greater certainty concerning the 
requirements of VA's duty and would limit the need for judicial 
interpretation of these important provisions. Additionally, 
because this approach would provide a clear statutory framework 
for the claim-development process, VA would be able to 
implement those provisions more quickly and efficiently, 
without the need to rely extensively upon future rule making to 
establish uniform procedures for assisting claimants.
    However, the details in the language used in the draft bill 
could have an enormous impact on the resources of the 
Department. Once we have had more time to consider the language 
of the draft bill, we will be pleased to provide our formal 
views regarding the duty to assist provisions contained in it, 
as well as an estimate of the effect of this language on VBA's 
administrative expenses in the General Operating Expenses 
appropriation.

   S. 2544 and Draft Bill [O:/ARM/ARM00.881--June 16, 2000]--Women's 
                             Health Issues

S. 2544--Benefits for Children of Women Vietnam Veterans Who Were Born 
        With Certain Birth Defects and Section 2 of Draft Bill
    Mr. Chairman, you also asked that we provide comment 
regarding S. 2544, 106th Congress, the ``Children of Women 
Vietnam Veterans' Benefits Act of 2000,'' a bill to provide 
compensation and benefits to children of women Vietnam veterans 
who were born with certain birth defects. VA strongly supports 
the enactment of this bill.
            Background
    In March 1999, the Secretary of Veterans Affairs appointed 
a task force, headed by the Under Secretary for Health, to 
review a report issued by the National Academy of Sciences' 
(NAS) Institute of Medicine (IOM) in February entitled 
``Veterans and Agent Orange: Update 1998'' and to make 
appropriate recommendations to the Secretary regarding matters 
addressed in the report. The task force established a working 
group of knowledgeable individuals from within VA and from 
other Federal organizations who reviewed and analyzed the 
report and solicited input from veterans service organizations 
and other interested groups.
    The working group also reviewed a report, issued in October 
1998, of a study conducted by VA's Environmental Epidemiology 
Service entitled the ``Women Vietnam Veterans Reproductive 
Outcomes Health Study.'' This study was not addressed in the 
NAS report. This study represented the last of three 
epidemiologic studies of women Vietnam veterans conducted in 
response to a congressional mandate for a comprehensive study 
of any long-term adverse health effects they may have suffered. 
In the VA study, a total of 4,140 women Vietnam veterans 
surviving as of January 1, 1992, and an equal number of women 
who served during the Vietnam-era but not in Vietnam, were 
identified for a structured telephone health interview. 
Overall, almost 92 percent of these women were located and 90 
percent of those contacted participated in the study, resulting 
in a response rate of 82 percent.
    A multivariate analysis of survey results found no 
appreciable difference in reported rates of miscarriage, 
stillbirth, low birth weight, pre-term births, or infant deaths 
between the Vietnam veterans and the Vietnam-era veterans who 
did not serve in Vietnam. However, the study identified a 
statistically significant increase in birth defects (10.5 
percent vs. 7.0 percent) and severe birth defects (7.7 percent 
vs. 5.8 percent) in the offspring of women Vietnam veterans in 
comparison to the offspring of other women Vietnam-era 
veterans. The study found that the risk of a woman Vietnam 
veteran having a child with birth defects was significantly 
elevated even after adjustment for age, demographic variables, 
military characteristics, and smoking and alcohol consumption 
of the mothers.
    Following its review, the task force recommended that the 
VA study be subjected to additional peer review and submitted 
to a scientific journal for publication. This study has been 
accepted for publication; its expected release date is 
September 2000. In addition, the task force recommended that 
the Secretary seek statutory authority to provide health care 
and other benefits to women Vietnam veterans' offspring with 
birth defects. The Secretary approved both recommendations, 
and, on July 23, 1999, advised you that VA was in the process 
of developing legislation to benefit these individuals. On 
March 7, 2000, as a technical service, VA's General Counsel 
provided Senator John D. Rockefeller IV with draft bill 
language upon which S. 2544 is based.
            Provisions of S. 2544
    S. 2544 would restructure existing provisions in chapter 18 
of title 38, United States Code, and add a new subchapter 
authorizing benefits for women Vietnam veterans' children who 
were born with certain birth defects. This subchapter would 
apply with respect to birth defects, other than spina bifida, 
which result in permanent physical or mental disability, except 
for birth defects determined by the Secretary to result from 
familial disorders, birth-related injuries, or fetal or 
neonatal infirmities with well-established causes. In addition, 
the provision of health care or other benefits under this 
subchapter would not be authorized if evidence establishes that 
a particular birth defect suffered by an individual resulted 
from a cause other than the mother's service in Vietnam.
    The Secretary would be required to identify, within one 
year after the date of enactment of the Act, the birth defects 
associated with service of women Vietnam veterans in the 
Republic of Vietnam during the Vietnam era and to promulgate 
regulations delineating the birth defects identified. Certain 
categories of birth defects would be excluded because of a 
likelihood that they result from inherited disorders rather 
than as the result of the mothers' service in Vietnam. 
Similarly, defects which result from causes such as birth-
related conditions, or fetal or neonatal infirmities, would 
also be excluded.
    A key element of S. 2544 is authorization for the provision 
of comprehensive medical care, which could be provided directly 
by VA or by contract with non-VA providers. Second, because of 
the likelihood that individuals who suffer from certain 
severely disabling birth defects will encounter difficulties in 
pursuing vocational goals, the bill authorizes the Secretary to 
assist these individuals through the provision of vocational 
training benefits. Finally, in recognition of the additional 
financial needs likely to face persons suffering from disabling 
birth defects, the bill authorizes the Secretary to provide 
these individuals with a monetary allowance to help defray 
additional expenses associated with these disabilities. The 
Secretary would be required to base the amount of the allowance 
on each child's level of disability, in accordance with a 
schedule to be established for this purpose. VA would pay the 
allowance based upon four levels of disability, resulting in 
monthly payments of $100 for the lowest level of disability, 
$214 for the lower intermediate level of disability, $743 for 
the next higher intermediate level of disability, and $1,272 
for the highest level of disability. The dollar amounts for the 
upper three levels of disability would be equivalent to the 
three levels of allowance currently payable under section 1805 
of title 38, United States Code, to children of Vietnam 
veterans who suffer from spina bifida. The lower dollar amount 
of $100 would provide a limited benefit consistent with a level 
of disability that does not result in a significant economic 
burden. The legislation would be effective one year after the 
date of its enactment, in order to allow time for establishment 
of implementing regulations.
            VA's Position
    VA does not have authority to provide health care or other 
benefits to the women Vietnam veterans' children who suffer 
from birth defects other than spina bifida. Thus, enabling 
legislation is necessary to address the needs of these 
children. We believe the legislative model adopted by Congress 
in Pub. L. No. 104-204 for the benefit of Vietnam veterans' 
children born with spina bifida, which is reflected in the 
provisions of S. 2544, is an appropriate one to follow in this 
instance. As was the case with Vietnam veterans' children who 
suffer from spina bifida, the provision of assistance to women 
Vietnam veterans' children who suffer other birth defects would 
be an appropriate extension of the principle of providing 
benefits for disabilities that are incurred or aggravated as a 
result of service on active duty in the Armed Forces of the 
United States. Accordingly, we strongly support enactment of 
this legislation.
    S. 2544 is subject to the PAYGO requirements of the OBRA 
and, if enacted, would result in benefit costs of $1.7 million 
in Fiscal Year (FY) 2001 and $17 million during FYs 2001-2005.
    Section 2 of the draft bill contains provisions similar to 
S. 2544.
Special monthly compensation for service-connected loss of one or both 
        breasts due to mastectomy
    Section 3 of the draft bill would authorize special monthly 
compensation under 38 U.S.C. Sec. 1114(k) for female veterans 
who have suffered the service-connected loss of one or both 
breasts (including loss by mastectomy). VA supports this 
provision in principle, but would prefer that no distinction be 
made between male and female veterans.
    Section 1114(k) of title 38, United States Code, authorizes 
a special rate of compensation (the ``k'' rate) if a veteran, 
as the result of service-connected disability, has suffered the 
anatomical loss or loss of use of one or more creative organs, 
or one foot, or one hand, or both buttocks, or blindness of one 
eye, having only light perception, or has suffered complete 
organic aphonia with constant inability to communicate by 
speech, or deafness of both ears, having absence of air and 
bone conduction. Under current section 1114(k), a monthly award 
of $76 is payable, generally, for each such loss or loss of 
use. This special monthly compensation is payable in addition 
to the compensation payable by reason of percentage disability 
ratings assigned under the rating schedule.
    Under the current schedule for rating disabilities, the 
disability suffered following surgical removal of one breast by 
radical mastectomy is assigned a 50% disability rating. (38 
C.F.R. Sec. 4.116). The resulting disability following removal 
of both breasts by radical mastectomy is currently assigned an 
80% disability rating. The loss of one breast by modified 
radical mastectomy is rated 40% disabling, and the removal of 
both breasts by modified radical mastectomy is rated 60% 
disabling. A veteran is also compensated for at least six 
months at the total-disability level following the cessation of 
any surgical procedure to treat breast cancer.
    Special monthly compensation is currently authorized for 
certain anatomical losses or losses of use for which the rating 
schedule, which is based solely on impairment of earning 
capacity, is considered inadequate for compensation purposes. 
The statute recognizes that the loss of a hand or foot, for 
example, or loss of a creative organ, involves loss of bodily 
integrity which may negatively affect self-image and 
precipitate considerable emotional distress.
    The service-connected radical or modified-radical 
mastectomies covered by section 3 involve loss of bodily 
integrity and associated emotional trauma to a degree that is 
at least comparable to the removal of a single testicle, for 
example, for which special monthly compensation is currently 
payable regardless of its effect on a veteran's procreative 
ability and regardless of whether the veteran is still of 
procreative age. As a matter of simple equity, these 
mastectomies warrant equal compensation for the veterans who 
undergo them.
    Section 3 of the draft bill would be subject to the PAYGO 
requirement of the Omnibus Budget Reconciliation Act of 1990 
(OBRA) and, if enacted, would increase direct spending. 
According to our preliminary estimates, enactment of section 3 
(with the inclusion of male veterans) would increase benefits 
cost by less than $500,000 in FY 2001 and $2.5 million over the 
2001-2005 period.

          Omnibus Draft Bill [O:/ARM/ARM00.997--July 13, 2000]

    VA does not have positions regarding several provisions of 
the draft bill. However, we will be pleased to provide our 
formal written views concerning them at a later date once the 
necessary executive branch coordination is completed. Those 
provisions for which we have developed positions follow:

               Title I--Compensation and Pension Matters

    Our comments on section 101 of the draft bill, regarding 
VA's duty to assist veterans in the development of their 
claims, are noted above.

             Title VII--Construction and Facilities Matters

    Sections 701 and 702 of the draft bill would authorize the 
Secretary of Veterans Affairs to carry out two major medical 
facility projects for fiscal year 2001 using $40,600,000 for 
the Construction, Major Projects account.
    VA is not opposed to these provisions because they would 
authorize funding for the two major medical facility 
construction projects located in Palo Alto, California and in 
Murfreesboro, Tennessee as reflected in the President's budget. 
Last year, Congress appropriated, but did not authorize 
$14,000,000 in fiscal year 2000 funding for the Murfreesboro, 
Tennessee project. Accordingly, Section 702(a), which 
authorizes the appropriations, needs to be changed to 
specifically authorize $26,600,000 for fiscal year 2001 for the 
Palo Alto California project and $14,000,000 for fiscal year 
2000 for the Murfreesboro Tennessee project. Sections 702(a) 
and (b) refer to the authorization of funds for fiscal year 
2001. This language needs to be extended an additional year for 
fiscal year 2002. With this additional language, major 
construction projects authorized in fiscal year 2001 but not 
carried out until fiscal year 2002 would not have to be 
authorized again.
S. 2264--Establishment of Position of Advisor on PAs
    Section 2 of S. 2264 would establish a position of Advisor 
on Physician Assistants (PAs) within the Office of the Under 
Secretary for Health. Section 2 would also require such Advisor 
to advise the Under Secretary for Health on matters concerning 
the optimal use of physician assistants by the Veterans Health 
Administration (VHA) and the feasibility of establishing 
clinical privileges and practice areas for this specialty. In 
addition, this section would require the Advisor to (1) develop 
initiatives to assist the Under Secretary for Health in using 
the full range of clinical capabilities of physician assistants 
and (2) advise the Under Secretary for Health on policies 
affecting the employment of such personnel by VHA.
    VHA does not consider it necessary to enact legislation to 
require a PA advisor in Headquarters. The Chief Consultant, 
Primary and Ambulatory Care who is in direct contact with the 
Physician Assistant Field Advisory Group (PAFAG) currently 
represents PAs in VHA. The composition of the PAFAG consists of 
four PAs and two physicians. Its chairperson serves as program 
advisor to the Chief Consultant for Primary and Ambulatory 
Care. Further, one PA from that advisory group participates in 
Primary and Ambulatory Care office conferences and is routinely 
included in office communications and decisions. The current 
chairperson of the advisory group, Rebecca Goldsmith, PA-C, has 
served on the Under Secretary for Health's Work Group tasked 
with Exploring Internal Practice Barriers for Advanced Practice 
Nurses, Clinical Pharmacy Specialists and Physician Assistants. 
The work group identified barriers to hiring non-physician 
health care providers in VHA. Ms. Goldsmith also serves as the 
Co-Chair of the Multidisciplinary Practice Advisory Council. 
This group is charged with implementing changes to overcome the 
barriers to hiring non-physician health providers. VHA has 
promulgated the ``PA Employment Handbook'' which has provided 
guidance to VHA health care facilities when hiring PAs and the 
``PA Practice Issues Handbook,'' which is an educational tool 
that assists health care managers to understand the role of PAs 
in VHA. The work of Ms. Goldsmith and others on the PAFAG has 
helped VHA health facilities to recruit and retain PAs. The 
relationship between the Chief Consultant, Primary and 
Ambulatory Care and the PAFAG has worked well in supporting the 
PA Program.
S. 2637--Miles City, MT Land Transfer and S. 2827--Ft. Lyon, CO Land 
        Transfer
    S. 2637 would require VA, as soon as practicable, to 
transfer ownership of the Miles City VA Medical Center complex 
to Custer County, Montana. VA has not developed a position with 
respect to the transfer of this facility, but we will be 
pleased to provide our formal written views at a later date. 
Section 1 of S. 2827 would authorize VA to transfer the Ft. 
Lyon VA Medical Center to the State of Colorado for the purpose 
of establishing a correctional facility. VA has not developed a 
position with respect to this bill; however, we will be pleased 
to provide our formal written views at a later date.
    This concludes my formal testimony.

    Changes in Existing Law Made by the Committee Bill, 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 10--ARMED FORCES

           *       *       *       *       *       *       *


                    Subtitle E--Reserve Components

           *       *       *       *       *       *       *


  PART IV--TRAINING FOR RESERVE COMPONENTS AND EDUCATIONAL ASSISTANCE 
                                PROGRAMS

           *       *       *       *       *       *       *


   CHAPTER 1606--EDUCATIONAL ASSISTANCE FOR MEMBERS OF THE SELECTED 
                                 RESERVE

           *       *       *       *       *       *       *



Sec. 16132. Eligibility for educational assistance

    (a) A person who--
          (1) * * *
          [(2) before completing initial active duty for 
        training has completed the requirements of a secondary 
        school diploma (or an equivalency certificate), or in 
        the case of an individual who reenlists or extends an 
        enlistment as described in paragraph (1)(A) of this 
        subsection, has completed such requirements at any time 
        before such reenlistment or extension;] (2) before 
        applying for benefits under this section, has completed 
        the requirements of a secondary school diploma (or an 
        equivalency certificate);

           *       *       *       *       *       *       *


                     TITLE 38, UNITED STATES CODE

           *       *       *       *       *       *       *


                        CHAPTERS OF TITLE 38

           *       *       *       *       *       *       *



                       PART II--GENERAL BENEFITS

Chap.
11. * * *
     * * * * * * *
[18. Benefits for Children of Vietnam Veterans Who Are Born With 
              Spina Bifida........................................ 1801]
18. Benefits for Children of Vietnam Veterans.....................  1801
     * * * * * * *

                       PART I--GENERAL PROVISIONS

                          CHAPTER 1--GENERAL

           *       *       *       *       *       *       *



Sec. 107. Certain service deemed not to be active service

    (a) Service before July 1, 1946, in the organized military 
forces of the Government of the Commonwealth of the 
Philippines, while such forces were in the service of the Armed 
Forces of the United States pursuant to the military order of 
the President dated July 26, 1941, including among such 
military forces organized guerrilla forces under commanders 
appointed, designated, or subsequently recognized by the 
Commander in Chief, Southwest Pacific Area, or other competent 
authority in the Army of the United States, shall not be deemed 
to have been active military, naval, or air service for the 
purposes of any law of the United States conferring rights, 
privileges, or benefits upon any person by reason of the 
service of such person or the service of any other person in 
the Armed Forces, except benefits under--
          (1) * * *

           *       *       *       *       *       *       *

          (3) chapters 11, 13 (except section 1312(a)), and 23 
        of this title[.], and chapter 24 of this title to the 
        extent provided for in section 2402(8) of this title.

           *       *       *       *       *       *       *


                       PART II--GENERAL BENEFITS

Chap.
11. * * *
     * * * * * * *
[18. Benefits for Children of Vietnam Veterans Who Are Born With 
              Spina Bifida........................................ 1801]
1801nefits for Children of Vietnam Veterans.....................

           *       *       *       *       *       *       *


CHAPTER 11--COMPENSATION FOR SERVICE-CONNECTED DISABILITY OR DEATH

           *       *       *       *       *       *       *



Subchapter II--Wartime Disability Compensation

           *       *       *       *       *       *       *



Sec. 1112. Presumptions relating to certain diseases and disabilities

    (a) * * *

           *       *       *       *       *       *       *

    (c)(1) * * *
    (2) The diseases referred to in paragraph (1) of this 
subsection are the following:
          (A) * * *

           *       *       *       *       *       *       *

          (P) Lung cancer.
          (Q) Colon cancer.
          (R) Tumors of the brain and central nervous system.
          (S) Ovarian cancer.

           *       *       *       *       *       *       *


Sec. 1114. Rates of wartime disability compensation

    For the purposes of section 1110 of this title--
          (a) * * *

           *       *       *       *       *       *       *

          (k) if the veteran, as the result of service-
        connected disability, has suffered the anatomical loss 
        or loss of use of one or more creative organs, or one 
        foot, or one hand, or both buttocks, or blindness of 
        one eye, having only light perception, [or has 
        suffered] has suffered complete organic aphonia with 
        constant inability to communicate by speech, or 
        deafness of both ears, having absence of air and bone 
        conduction, or, in the case of a female veteran, has 
        suffered the anatomical loss of one or both breasts 
        (including loss by mastectomy), the rate of 
        compensation therefor shall be $76 per month for each 
        such loss or loss of use independent of any other 
        compensation provided in subsections (a) through (j) or 
        subsection (s) of this section but in no event to 
        exceed $2,533 per month; and in the event the veteran 
        has suffered one or more of the disabilities heretofore 
        specified in this subsection, in addition to the 
        requirement for any of the rates specified in 
        subsections (l) through (n) of this section, the rate 
        of compensation shall be increased by $76 per month for 
        each such loss or loss of use, but in no event to 
        exceed $3,553 per month;

           *       *       *       *       *       *       *


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

           *       *       *       *       *       *       *



   Subchapter III--Miscellaneous Provisions Relating to Hospital and 
Nursing Home Care and Medical Treatment of Veterans

           *       *       *       *       *       *       *



Sec. 1722A. Copayment for medications

    (a)(1) * * *

           *       *       *       *       *       *       *

    (3) Paragraph (1) does not apply--
          (A) * * *
          [(B) to a veteran whose annual income (as determined 
        under section 1503 of this title) does not exceed the 
        maximum annual rate of pension which would be payable 
        to such veteran if such veteran were eligible for 
        pension under section 1521 of this title.] (B) to a 
        veteran who is considered by the Secretary to be unable 
        to defray the expenses of necessary care under section 
        1722 of this title.

           *       *       *       *       *       *       *


  [CHAPTER 18--BENEFITS FOR CHILDREN OF VIETNAM VETERANS WHO ARE BORN 
                           WITH SPINA BIFIDA]


          CHAPTER 18_BENEFITS FOR CHILDREN OF VIETNAM VETERANS


    Subchapter I_Children of Vietnam Veterans Born With Spina Bifida

Sec.
1801. * * *
     * * * * * * *
[1806. Applicability of certain administrative provisions]

  Subchapter II_Children of Female Vietnam Veterans Born With Certain 
                              Birth Defects

1811. Definitions.
1812. Birth defects covered.
1813. Benefits and assistance.

                 ``Subchapter III_Administrative Matters

1821. Applicability of certain administrative provisions.
1822. Treatment of receipt of monetary allowance on other benefits.

    Subchapter I_Children of Vietnam Veterans Born With Spina Bifida


Sec. 1801. Definitions

    For the purposes of [this chapter] this subchapter--
          (1) * * *

           *       *       *       *       *       *       *


Sec. 1802. Spina bifida conditions covered

    [This chapter] This subchapter applies with respect to all 
forms and manifestations of spina bifida except spina bifida 
occulta.

           *       *       *       *       *       *       *


Sec. 1805. Monetary allowance

    (a) The Secretary shall pay a monthly allowance under [this 
chapter] this section to any child of a Vietnam veteran for any 
disability resulting from spina bifida suffered by such child.

           *       *       *       *       *       *       *

    [(c) Notwithstanding any other provision of law, receipt by 
a child of an allowance under this section shall not impair, 
infringe, or otherwise affect the right of the child to receive 
any other benefit to which the child may otherwise be entitled 
under any law administered by the Secretary, nor shall receipt 
of such an allowance impair, infringe, or otherwise affect the 
right of any individual to receive any benefit to which the 
individual is entitled under any law administered by the 
Secretary that is based on the child's relationship to the 
individual.
    [(d) Notwithstanding any other provision of law, the 
allowance paid to a child under this section shall not be 
considered income or resources in determining eligibility for 
or the amount of benefits under any Federal or federally 
assisted program.]

[Sec. 1806. Repealed]

 Subchapter II--Children of Female Vietnam Veterans Born With Certain 
                             Birth Defects

Sec. 1811. Definitions

    In this subchapter:
          (1) The term ``child'', with respect to a female 
        Vietnam veteran, means a natural child of the female 
        Vietnam veteran, regardless of age or marital status, 
        who was conceived after the date on which the female 
        Vietnam veteran first entered the Republic of Vietnam 
        during the Vietnam era (as specified in section 
        101(29)(A) of this title).
          (2) The term ``covered birth defect'' means each 
        birth defect identified by the Secretary under section 
        1812 of this title.
          (3) The term ``female Vietnam veteran'' means any 
        female individual who performed active military, naval, 
        or air service in the Republic of Vietnam during the 
        Vietnam era (as so specified), without regard to the 
        characterization of the individual's service.

Sec. 1812. Birth defects covered

    (a) Identification.--Subject to subsection (b), the 
Secretary shall identify the birth defects of children of 
female Vietnam veterans that--
          (1) are associated with the service of female Vietnam 
        veterans in the Republic of Vietnam during the Vietnam 
        era (as specified in section 101(29)(A) of this title); 
        and
          (2) result in the permanent physical or mental 
        disability of such children.
    (b) Limitations.--(1) The birth defects identified under 
subsection (a) may not include birth defects resulting from the 
following:
          (A) A familial disorder.
          (B) A birth-related injury.
          (C) A fetal or neonatal infirmity with well-
        established causes.
    (2) The birth defects identified under subsection (a) may 
not include spina bifida.
    (c) List.--The Secretary shall prescribe in regulations a 
list of the birth defects identified under subsection (a).

Sec. 1813. Benefits and assistance

    (a) Health Care.--(1) The Secretary shall provide a child 
of a female Vietnam veteran who was born with a covered birth 
defect such health care as the Secretary determines is needed 
by the child for such birth defect or any disability that is 
associated with such birth defect.
    (2) The Secretary may provide health care under this 
subsection directly or by contract or other arrangement with a 
health care provider.
    (3) For purposes of this subsection, the definitions in 
section 1803(c) of this title shall apply with respect to the 
provision of health care under this subsection, except that for 
such purposes--
          (A) the reference to `specialized spina bifida 
        clinic' in paragraph (2) of such section 1803(c) shall 
        be treated as a reference to a specialized clinic 
        treating the birth defect concerned under this 
        subsection; and
          (B) the reference to ``vocational training under 
        section 1804 of this title'' in paragraph (8) of such 
        section 1803(c) shall be treated as a reference to 
        vocational training under subsection (b).
    (b) Vocational Training.--(1) The Secretary may provide a 
program of vocational training to a child of a female Vietnam 
veteran who was born with a covered birth defect if the 
Secretary determines that the achievement of a vocational goal 
by the child is reasonably feasible.
    (2) Subsections (b) through (e) of section 1804 of this 
title shall apply with respect to any program of vocational 
training provided under paragraph (1).
    (c) Monetary Allowance.--(1) The Secretary shall pay a 
monthly allowance to any child of a female Vietnam veteran who 
was born with a covered birth defect for any disability 
resulting from such birth defect.
    (2) The amount of the monthly allowance paid under this 
subsection shall be based on the degree of disability suffered 
by the child concerned, as determined in accordance with a 
schedule for rating disabilities resulting from covered birth 
defects that is prescribed by the Secretary.
    (3) In prescribing a schedule for rating disabilities under 
paragraph (2), the Secretary shall establish four levels of 
disability upon which the amount of the monthly allowance under 
this subsection shall be based.
    (4) The amount of the monthly allowance paid under this 
subsection shall be as follows:
          (A) In the case of a child suffering from the lowest 
        level of disability prescribed in the schedule for 
        rating disabilities under this subsection, $100.
          (B) In the case of a child suffering from the lower 
        intermediate level of disability prescribed in the 
        schedule for rating disabilities under this subsection, 
        the greater of--
                  (i) $214; or
                  (ii) the monthly amount payable under section 
                1805(b)(3) of this title for the lowest level 
                of disability prescribed for purposes of that 
                section.
          (C) In the case of a child suffering from the higher 
        intermediate level of disability prescribed in the 
        schedule for rating disabilities under this subsection, 
        the greater of--
                  (i) $743; or
                  (ii) the monthly amount payable under section 
                1805(b)(3) of this title for the intermediate 
                level of disability prescribed for purposes of 
                that section.
          (D) In the case of a child suffering from the highest 
        level of disability prescribed in the schedule for 
        rating disabilities under this subsection, the greater 
        of--
                  (i) $1,272; or
                  (ii) the monthly amount payable under section 
                1805(b)(3) of this title for the highest level 
                of disability prescribed for purposes of that 
                section.
    (5) Amounts under subparagraphs (A), (B)(i), (C)(i), and 
(D)(i) of paragraph (4) shall be subject to adjustment from 
time to time under section 5312 of this title.
    (6) Subsections (c) and (d) of section 1805 of this title 
shall apply with respect to any monthly allowance paid under 
this subsection.
    (d) General Limitations on Availability of Benefits and 
Assistance.--(1) No individual receiving benefits or assistance 
under this section may receive any benefits or assistance under 
subchapter I of this chapter.
    (2) In any case where affirmative evidence establishes that 
the covered birth defect of a child results from a cause other 
than the active military, naval, or air service in the Republic 
of Vietnam of the female Vietnam veteran who is the mother of 
the child, no benefits or assistance may be provided the child 
under this section.
    (e) Regulations.--The Secretary shall prescribe regulations 
for purposes of the administration of the provisions of this 
section.

                 Subchapter III--Administrative Matters

Sec. 1821. Applicability of certain administrative provisions

    The provisions of sections 5101(c), 5110(a), (b)(2), (g), 
and (i), 5111, and 5112(a), (b)(1), (b)(6), (b)(9), and (b)(10) 
of this title shall apply with respect to benefits and 
assistance under this chapter in the same manner as such 
provisions apply to veterans' disability compensation.

Sec. 1822. Treatment of receipt of monetary allowance on other benefits

    (a) Notwithstanding any other provision of law, receipt by 
an individual of a monetary allowance under this chapter shall 
not impair, infringe, or otherwise affect the right of the 
individual to receive any other benefit to which the individual 
is otherwise entitled under any law administered by the 
Secretary.
    (b) Notwithstanding any other provision of law, receipt by 
an individual of a monetary allowance under this chapter shall 
not impair, infringe, or otherwise affect the right of any 
other individual to receive any benefit to which such other 
individual is entitled under any law administered by the 
Secretary based on the relationship of such other individual to 
the individual who receives such monetary allowance.
    (c) Notwithstanding any other provision of law, a monetary 
allowance paid an individual under this chapter shall not be 
considered as income or resources in determining eligibility 
for or the amount of benefits under any Federal or Federally-
assisted program.

           *       *       *       *       *       *       *


                         CHAPTER 19--INSURANCE


              Subchapter I--National Service Life Insurance

Sec.
1901. * * *
     * * * * * * *
1967. * * *
1967A. Insurance of dependents.
     * * * * * * *

Subchapter I--National Service Life Insurance

           *       *       *       *       *       *       *



Sec. 1922. Service disabled veterans' insurance

    (a) * * *

           *       *       *       *       *       *       *

    (c) The premium rate of any term insurance issued under 
this section shall not exceed the renewal age 70 premium rate.

           *       *       *       *       *       *       *


          Subchapter III--Servicemembers' Group Life Insurance


Sec. 1965. Definitions

    For the purpose of this subchapter--
          (1) * * *

           *       *       *       *       *       *       *

          (10) The term `insurable dependent', with respect to 
        a member, means the following:
                  (A) The member's spouse.
                  (B) A child of the member for so long as the 
                child is unmarried and the member is providing 
                over 50 percent of the support of the child.

           *       *       *       *       *       *       *


Sec. 1967. Persons insured; amount

    (a) Any policy of insurance purchased by the Secretary 
under section 1966 of this title shall automatically insure 
against death--
          (1) * * *
          (2) any member of the Ready Reserve of a uniformed 
        service who meets the qualifications set forth in 
        section 1965(5)(B) of this title; in the amount of 
        [$200,000] $250,000, unless such member elects in 
        writing (A) not to be insured under this subchapter, or 
        (B) to be insured in an amount less than [$200,000] 
        $250,000 that is evenly divisible by $10,000. The 
        insurance shall be effective the first day of active 
        duty or active duty for training, or the beginning of a 
        period of inactive duty training scheduled in advance 
        by competent authority, or the first day a member of 
        the Ready Reserve meets the qualifications set forth in 
        section 1965(5)(B) of this title, or the date certified 
        by the Secretary to the Secretary concerned as the date 
        Servicemembers' Group Life Insurance under this 
        subchapter for the class or group concerned takes 
        effect, whichever is the later date.

           *       *       *       *       *       *       *

    (c) If any member elects not to be insured under this 
subchapter or to be insured in any amount less than [$200,000] 
$250,000, such member may thereafter be insured under this 
subchapter in the amount of [$200,000] $250,000 or any lesser 
amount evenly divisible by $10,000 upon written application, 
proof of good health, and compliance with such other terms and 
conditions as may be prescribed by the Secretary. Any former 
member insured under Veterans' Group Life Insurance who again 
becomes eligible for Servicemembers' Group Life Insurance and 
declines such coverage solely for the purpose of maintaining 
such member's Veterans' Group Life Insurance in effect shall 
upon termination of coverage under Veterans' Group Life 
Insurance be automatically insured under Servicemembers' Group 
Life Insurance, if otherwise eligible therefor.
    (d) Whenever a member has the opportunity to make an 
election under subsection (a) not to be insured under this 
subchapter, or to be insured under this subchapter in an amount 
less than the maximum amount of [$200,000] $250,000, and at 
such other times periodically thereafter as the Secretary 
concerned considers appropriate, the Secretary concerned shall 
furnish to the member general information concerning life 
insurance. Such information shall include--
          (1) * * *

           *       *       *       *       *       *       *


Sec. 1967A. Insurance of dependents

    (a) Subject to the provisions of this section, any policy 
of insurance purchased by the Secretary under section 1966 of 
this title shall also automatically insure against death each 
insurable dependent of a member.
    (b)(1) A member insurable under this subchapter may make an 
election not to insure a spouse under this subchapter.
    (2) Except as provided in subsection (c)(3), a spouse 
covered by an election under paragraph (1) is not insured under 
this section.
    (3) Except as otherwise provided under this section, no 
insurable dependent of a member is insured under this section 
unless the member is insured under this subchapter.
    (c)(1) Subject to an election under paragraph (2), the 
amount for which a person insured under this section is insured 
under this subchapter is as follows:
          (A) In the case of a member's spouse, the lesser of--
                  (i) the amount for which the member is 
                insured under this subchapter; or
                  (ii) $50,000.
          (B) In the case of a member's child, $5,000.
    (2) A member may elect in writing to insure the member's 
spouse in an amount less than the amount provided for under 
paragraph (1)(A). The amount of insurance so elected shall be 
evenly divisible by $10,000.
    (3) If a dependent spouse eligible for insurance under this 
section is not so insured, or is insured for less than the 
maximum amount provided for under subparagraph (A) of paragraph 
(1) by reason of an election made by the member concerned under 
paragraph (2), the spouse may thereafter be insured under this 
section in the maximum amount or any lesser amount elected as 
provided for in paragraph (2) upon written application by the 
member, proof of good health of the spouse, and compliance with 
such other terms and conditions as may be prescribed by the 
Secretary.
    (d)(1) Insurance coverage under this section with respect 
to an insurable dependent of the member shall cease--
          (A) upon election made in writing by the member to 
        terminate the coverage; or
          (B) the date that is 120 days after the earlier of--
                  (i) the date of the member's death;
                  (ii) the date of termination of the insurance 
                on the member under this subchapter; or
                  (iii) the date on which the insurable 
                dependent of the member no longer meets the 
                criteria applicable to an insurable dependent 
                as specified in section 1965(10) of this title.
    (2)(A) At the election of an insured spouse whose insurance 
under this subchapter is terminated under paragraph (1), the 
insurance shall be converted to an individual policy of 
insurance upon written application for conversion made to the 
participating company selected by the insured spouse and the 
payment of the required premiums.
    (B) The individual policy of insurance of an insured spouse 
making an election under subparagraph (A) shall become 
effective on the date of the termination of the spouse's 
insurance under paragraph (1).
    (C) The second, fourth, and fifth sentences of section 
1977(e) of this title shall apply with respect to the insurance 
of an insured spouse under this paragraph.
    (e)(1) During any period in which the spouse of a member is 
insured under this section, there shall be deducted each month 
from the member's basic or other pay, or otherwise collected 
from the member, until the member's separation or release from 
active duty an amount determined by the Secretary (which shall 
be the same for all such members) as the premium allocable to 
the pay period for providing that insurance coverage.
    (2)(A) The Secretary shall determine the premium amounts to 
be charged for insurance coverage for spouses of members under 
this section.
    (B) The premium amounts shall be determined on the basis of 
sound actuarial principles and shall include an amount 
necessary to cover the administrative costs to the insurer or 
insurers providing such insurance.
    (C) Each premium rate for the first policy year shall be 
continued for subsequent policy years, except that the rate may 
be adjusted for any such subsequent policy year on the basis of 
the experience under the policy, as determined by the Secretary 
in advance of that policy year.
    (3) Any amounts deducted or collected under paragraph (1), 
together with the income derived from any dividends or premium 
rate adjustments received from insurers with respect to 
insurance under this section, shall be deposited to the credit 
of the revolving fund established by section 1969(d) of this 
title, and shall be available for payment and use in accordance 
with the provisions of that section.
    (f) Any amount of insurance in force on an insurable 
dependent of a member under this section on the date of the 
dependent's death shall be paid, upon the establishment of a 
valid claim therefor, to the member or, in the event of the 
member's death before payment to the member can be made, then 
to the person or persons entitled to receive payment of the 
proceeds of insurance on the member' life under section 1970 of 
this title.

           *       *       *       *       *       *       *


Subchapter III--Servicemembers' Group Life Insurance

           *       *       *       *       *       *       *



Sec. 1977. Veterans' Group Life Insurance

    (a)(1) Veterans' Group Life Insurance shall be issued in 
the amounts specified in section 1967(a) of this title. In the 
case of any individual, the amount of Veterans' Group Life 
Insurance may not exceed the amount of Servicemembers' Group 
Life Insurance coverage continued in force after the expiration 
of the period of duty or travel under section 1967(b) or 
1968(a) of this title. No person may carry a combined amount of 
Servicemembers' Group Life Insurance and Veterans' Group Life 
Insurance in excess of [$200,000] $250,000 at any one time.
    (2) If any person insured under Veterans' Group Life 
Insurance again becomes insured under Servicemembers' Group 
Life Insurance but dies before terminating or converting such 
person's Veterans' Group Insurance, Veterans' Group Life 
Insurance shall be payable only if such person is insured for 
less than [$200,000] $250,000 under Servicemembers' Group Life 
Insurance, and then only in an amount which, when added to the 
amount of Servicemembers' Group Life Insurance payable, does 
not exceed [$200,000] $250,000.

           *       *       *       *       *       *       *


CHAPTER 21--SPECIALLY ADAPTED HOUSING FOR DISABLED VETERANS

           *       *       *       *       *       *       *



Sec. 2102. Limitations on assistance furnished

    (a) * * *

           *       *       *       *       *       *       *

    (c) The amount of assistance afforded under subsection (a) 
for a veteran authorized assistance by section 2101(a) of this 
title shall not be reduced by reason that title to the housing 
unit, which is vested in the veteran, is also vested in any 
other person, if the veteran resides in the housing unit.

           *       *       *       *       *       *       *


CHAPTER 24--NATIONAL CEMETERIES AND MEMORIALS

           *       *       *       *       *       *       *



Sec. 2402. Persons eligible for interment in national cemeteries

    Under such regulations as the Secretary may prescribe and 
subject to the provisions of section 6105 of this title, the 
remains of the following persons may be buried in any open 
national cemetery under the control of the National Cemetery 
Administration:
          (1) * * *

           *       *       *       *       *       *       *

          (8) Any individual whose service is described in 
        section 107(a) of this title if such individual at the 
        time of death--
                  (A) was a naturalized citizen of the United 
                States; and
                  (B) resided in the United States.

           *       *       *       *       *       *       *


              PART III--READJUSTMENT AND RELATED BENEFITS

CHAPTER 30--ALL-VOLUNTEER FORCE EDUCATIONAL ASSISTANCE PROGRAM

           *       *       *       *       *       *       *



              Subchapter II--Basic Educational Assistance


Sec. 3011. Basic educational assistance entitlement for service on 
                    active duty

    (a) Except as provided in subsection (c) of this section, 
each individual--
          (1) who--
                  (A) after June 30, 1985, first becomes a 
                member of the Armed Forces or first enters on 
                active duty as a member of the Armed Forces 
                and--
                          [(i) who (I) serves, as the 
                        individual's initial obligated period 
                        of active duty, at least three years of 
                        continuous active duty in the Armed 
                        Forces, or (II) in the case of an 
                        individual whose initial period of 
                        active duty is less than three years, 
                        serves at least two years of continuous 
                        active duty in the Armed Forces; or]
                          (i) who serves an obligated period of 
                        active duty of at least two years of 
                        continuous active duty in the Armed 
                        Forces; or
                          (ii) who serves in the Armed Forces 
                        and is discharged or released from 
                        active duty (I) for a service-connected 
                        disability, for a medical condition 
                        which preexisted such service on active 
                        duty and which the Secretary determines 
                        is not service connected, for hardship, 
                        or for a physical or mental condition 
                        that was not characterized as a 
                        disability and did not result from the 
                        individual's own willful misconduct but 
                        did interfere with the individual's 
                        performance of duty, as determined by 
                        the Secretary of each military 
                        department in accordance with 
                        regulations prescribed by the Secretary 
                        of Defense or by the Secretary of 
                        Transportation with respect to the 
                        Coast Guard when it is not operating as 
                        a service in the Navy; (II) for the 
                        convenience of the Government, [in the 
                        case of an individual who completed not 
                        less than 20 months of continuous 
                        active duty, if the initial obligated 
                        period of active duty of the individual 
                        was less than three years, or in the 
                        case of an individual who completed not 
                        less than 30 months of continuous 
                        active duty if the initial obligated 
                        period of active duty of the individual 
                        was at least three years] if, in the 
                        case of an individual with an obligated 
                        period of service of two years, the 
                        individual completes not less than 20 
                        months of continuous active duty under 
                        that period of obligated service, or, 
                        in the case of an individual with an 
                        obligated period of service of three 
                        years, the individual completes not 
                        less than 30 months of continuous 
                        active duty under that period of 
                        obligated service; or (III) 
                        involuntarily for the convenience of 
                        the Government as a result of a 
                        reduction in force, as determined by 
                        the Secretary of the military 
                        department concerned in accordance with 
                        regulations prescribed by the Secretary 
                        of Defense or by the Secretary of 
                        Transportation with respect to the 
                        Coast Guard when it is not operating as 
                        a service in the Navy; or

           *       *       *       *       *       *       *

          [(2) who, except as provided in subsection (e) of 
        this section, completed the requirements of a secondary 
        school diploma (or equivalency certificate) not later 
        than--
                  [(A) the original ending date of the 
                individual's initial obligated period of active 
                duty in the case of an individual described in 
                clause (1)(A) of this subsection, regardless of 
                whether the individual is discharged or 
                released from active duty on such date;
                  [(B) December 31, 1989, in the case of an 
                individual described in clause (1)(B) of this 
                subsection; except that (i) an individual 
                described in clause (1)(B) of this subsection 
                may meet the requirement of this clause by 
                having successfully completed (or otherwise 
                received academic credit for) the equivalent of 
                12 semester hours in a program of education 
                leading to a standard college degree, and (ii) 
                an individual described in clause (1)(A) of 
                this subsection may meet such requirement by 
                having successfully completed (or otherwise 
                received academic credit for) the equivalent of 
                such 12 semester hours before the end of the 
                individual's initial obligated period of active 
                duty; and]
          (2) who completes the requirements of a secondary 
        school diploma (or equivalency certificate), or 
        successfully completes (or otherwise receives academic 
        credit for) the equivalent of 12 semester hours in a 
        program of education leading to a standard college 
        degree, before applying for benefits under this 
        section; and

           *       *       *       *       *       *       *

    (d)(1) For purposes of this chapter, any period of service 
described in paragraphs (2) and (3) of this subsection shall 
not be considered a part of an [individual's initial obligated 
period of active duty] obligated period of active duty on which 
an individual's entitlement to assistance under this section is 
based.

           *       *       *       *       *       *       *

    [(e) For the purposes of subsection (a)(2) of this section, 
an individual who was on active duty on August 2, 1990, and who 
completes the requirements of a secondary school diploma (or 
equivalency certificate) before October 28, 1994, shall be 
considered to have completed such requirements within the 
individual's initial obligated period of active duty.]
    [(f)] (e)(1) * * *

           *       *       *       *       *       *       *

    [(g)] (f) * * *
    [(h)] (g)(1) * * *
    (2) This subsection applies to a member who--
          (A) [during an initial period of active duty,] during 
        the obligated period of active duty on which 
        entitlement to assistance under this section is based, 
        commences pursuit of a course of education--
                  (i) * * *

           *       *       *       *       *       *       *

    [(i)] (h) The Secretary concerned shall inform any member 
of the Armed Forces who has not completed that member's 
[initial] obligated period of active duty (as described in 
subsection (a)(1)(A)) and who indicates the intent to be 
discharged or released from such duty for the convenience of 
the Government of the minimum active duty requirements for 
entitlement to educational assistance benefits under this 
chapter. Such information shall be provided to the member in a 
timely manner.

Sec. 3012. Basic educational assistance entitlement for service in the 
                    Selected Reserve

    (a) Except as provided in subsection (d) of this section, 
each individual--
          (1) who--
                  (A) after June 30, 1985, first becomes a 
                member of the Armed Forces or first enters on 
                active duty as a member of the Armed Forces 
                and--
                          (i) serves[, as the individual's 
                        initial obligated period of active 
                        duty, at least two years of continuous 
                        active duty in the Armed Forces] an 
                        obligated period of active duty of at 
                        least two years of continuous active 
                        duty in the Armed Forces, subject to 
                        subsection (b) of this section, 
                        characterized by the Secretary 
                        concerned as honorable service; and
                          (ii) * * *

           *       *       *       *       *       *       *

          [(2) who, except as provided in subsection (f) of 
        this section, before completion of the service 
        described in clause (1) of this subsection, has 
        completed the requirements of a secondary school 
        diploma (or an equivalency certificate), except that 
        (i) an individual described in clause (1)(B) of this 
        subsection may meet the requirement of this clause by 
        having successfully completed (or otherwise received 
        academic credit for) the equivalent of 12 semester 
        hours in a program of education leading to a standard 
        college degree, and (ii) an individual described in 
        clause (1)(A) of this subsection may meet such 
        requirement by having successfully completed (or 
        otherwise received academic credit for) the equivalent 
        of such 12 semester hours before the end of the 
        individual's initial obligated period of active duty; 
        and]
          (2) who completes the requirements of a secondary 
        school diploma (or equivalency certificate), or 
        successfully completes (or otherwise receives academic 
        credit for) the equivalent of 12 semester hours in a 
        program of education leading to a standard college 
        degree, before applying for benefits under this 
        section; and
          (3) * * *

           *       *       *       *       *       *       *

    (e)(1) An individual described in subclause (I) or (III) of 
subsection (b)(1)(B)(ii) of this section may elect entitlement 
to basic educational assistance under section 3011 of this 
title, based on an [initial] obligated period of active duty of 
two years, in lieu of entitlement to assistance under this 
section.
    (2) * * *

           *       *       *       *       *       *       *

    [(f) For the purposes of subsection (a)(2) of this section, 
an individual who was on active duty on August 2, 1990, and who 
completes the requirements of a secondary school diploma (or 
equivalency certificate) before October 28, 1994, shall be 
considered to have completed such requirements within the 
individual's initial obligated period of active duty.]
    [(g)] (f)(1) * * *

           *       *       *       *       *       *       *


Sec. 3013. Duration of basic educational assistance

    (a)(1) *  *  *
    (2) Subject to section 3695 of this title and subsection 
(d) of this section, in the case of an individual described in 
section 3011(a)(1)(A)(ii)(I) or (III) of this title who is not 
also described in section 3011(a)(1)(A)(i) of this title or an 
individual described in section 3011(a)(1)(B)(ii)(I) or (III) 
of this title who is not also described in section 
3011(a)(1)(B)(i) of this title, the individual is entitled to 
one month of educational assistance benefits under this chapter 
for eachmonth of continuous active duty served by such 
individual after June 30, 1985, as part of the [individual's initial 
obligated period of active duty] obligated period of active duty on 
which such entitlement is based in the case of an individual described 
in section 3011(a)(1)(A)(ii)(I) or (III) of this title, or in the case 
of an individual described in section 3011(a)(1)(B)(ii)(I) or (III) of 
this title, after June 30, 1985.
    (b) Subject to section 3695 of this title and subsection 
(d) of this section, each individual entitled to basic 
educational assistance under section 3012 of this title is 
entitled to (1) one month of educational assistance benefits 
under this chapter for each month of continuous active duty 
served by such individual after June 30, 1985, as part of the 
[individual's initial obligated period of active duty] 
obligated period of active duty on which such entitlement is 
based, or in the case of an individual described in section 
3012(a)(1)(B) of this title, after June 30, 1985, and (2) one 
month of educational assistance benefits under this chapter for 
each four months served by such individual in the Selected 
Reserve after the applicable date specified in clause (1) of 
this subsection (other than any month in which the individual 
served on active duty).

           *       *       *       *       *       *       *


Sec. 3015. Amount of basic educational assistance

    (a) The amount of payment of educational assistance under 
this chapter is subject to section 3032 of this title. Except 
as otherwise provided in this section, in the case of an 
individual entitled to an educational assistance allowance 
under this chapter whose obligated period of active duty on 
which such entitlement is based is three years, a basic 
educational assistance allowance under this subchapter shall be 
paid--
          (1) * * *

           *       *       *       *       *       *       *

    (b) In the case of an individual entitled to an educational 
assistance allowance under section 3011 or 3018 of this title 
[and whose initial obligated period of active duty is two 
years,] whose obligated period of active duty on which such 
entitlement is based is two years, a basic educational 
assistance allowance under this chapter shall (except as 
provided in the succeeding subsections of this section) be 
paid--
          (1) * * *

           *       *       *       *       *       *       *

    (c)(1) * * *
    (2) Paragraph (1) of this subsection applies to an 
individual entitled to an educational assistance allowance 
under section 3011 of this title--
          [(A) whose initial obligated period of active duty is 
        less than three years;
          [(B) who, beginning on the date of the commencement 
        of the person's initial obligated period of such duty, 
        serves a continuous period of active duty of not less 
        than three years; and]
          (A) whose obligated period of active duty on which 
        such entitlement is based is less than three years;
          (B) who, beginning on the date of the commencement of 
        such obligated period of active duty, serves a 
        continuous period of active duty of not less than three 
        years; and
          (C) * * *

           *       *       *       *       *       *       *


Sec. 3017. Death benefit

    (a)(1) In the event of the service-connected death of any 
individual--
          (A) who--
                  (i) * * *
                  (ii) is on active duty in the Armed Forces 
                and but for clause (1)(A)(i) or [clause (2)(A)] 
                clause (2) of section 3011(a) or clause 
                (1)(A)(i) or (ii) or clause (2) of section 
                3012(a) of this title would be eligible for 
                such basic educational assistance; and
          (B) * * *

           *       *       *       *       *       *       *


Sec. 3018. Opportunity for certain active-duty personnel to withdraw 
                    election not to enroll

    (a) * * *
    (b) An individual described in clauses (1) through (3) of 
subsection (a) of this section who made an election under 
section 3011(c)(1) or 3012(d)(1) of this title and who--
        (1) * * *

           *       *       *       *       *       *       *

          [(4) before completing such obligated period of 
        service (i) has completed the requirements of a 
        secondary school diploma (or an equivalency 
        certificate), or (ii) has successfully completed (or 
        otherwise received academic credit for) the equivalent 
        of 12 semester hours in a program of education leading 
        to a standard college degree; and] (4) before applying 
        for benefits under this section--
                  (A) completes the requirements of a secondary 
                school diploma (or equivalency certificate); or
                  (B) successfully completes (or otherwise 
                receives academic credit for) the equivalent of 
                12 semester hours in a program of education 
                leading to a standard college degree; and
          (5) * * *

           *       *       *       *       *       *       *


CHAPTER 35--SURVIVORS' AND DEPENDENTS' EDUCATIONAL ASSISTANCE

           *       *       *       *       *       *       *



Subchapter I--Definitions

           *       *       *       *       *       *       *



Sec. 3501. Definitions

    (a) For the purposes of this chapter and chapter 36 of this 
title--
          (1) * * *

           *       *       *       *       *       *       *

          (5) The term ``program of education'' means any 
        curriculum or any combination of unit courses or 
        subjects pursued at an educational institution which is 
        generally accepted as necessary to fulfill the 
        requirements for the attainment of a predetermined and 
        identified educational, professional, or vocational 
        objective. The term also includes any preparatory 
        course described in section 3002(3)(B) of this title.

Subchapter II--Eligibility and Entitlement

           *       *       *       *       *       *       *



Sec. 3512. Periods of eligibility

    (a) The educational assistance to which an eligible person 
(within the meaning of section 3501(a)(1)(A) of this title) is 
entitled under section 3511 of this title or subchapter V of 
this chapter may be afforded the person during the period 
beginning on the person's eighteenth birthday, or on the 
successful completion of the person's secondary schooling, 
whichever first occurs, and ending on the person's twenty-sixth 
birthday, except that--
          (1) * * *

           *       *       *       *       *       *       *

          (3) if the Secretary first finds that the parent from 
        whom eligibility is derived has a service-connected 
        total disability permanent in nature, or if the death 
        of the parent from whom eligibility is derived occurs, 
        after the eligible person's eighteenth birthday but 
        before the person's twenty-sixth birthday, then (unless 
        paragraph (4) applies) such period shall end [8 years 
        after, whichever date last occurs: (A) the date on 
        which the Secretary first finds that the parent from 
        whom eligibility is derived has a service-connected 
        total disability permanent in nature, or (B) the date 
        of death of the parent from whom eligibility is 
        derived;] 8 years after the date elected by the person 
        (if such election is approved as the beginning date of 
        such period by the Secretary and made during the period 
        between such birthdays) which beginning date--
                  (A) in the case of a person whose eligibility 
                is based on a parent who has a service-
                connected total disability permanent in nature 
                shall be between the dates described in 
                subsection (d) of this section; and
                  (B) in the case of a person whose eligibility 
                is based on the death of a parent shall be 
                between--
                          (i) the date of the parent's death; 
                        and
                          (ii) the date of the Secretary's 
                        decision that the death was service-
                        connected;

           *       *       *       *       *       *       *


              CHAPTER 37--HOUSING AND SMALL BUSINESS LOANS


Subchapter I--General

           *       *       *       *       *       *       *



Sec. 3703. Basic provisions relating to loan guaranty and insurance

    (a)(1)(A) Any loan to a veteran eligible for benefits under 
this chapter, if made for any of the purposes specified in 
section 3710 of this title and in compliance with the 
provisions of this chapter, is automatically guaranteed by the 
United States in an amount not to exceed the lesser of--
          (i)(I) * * *

           *       *       *       *       *       *       *

          (IV) in the case of any loan of more than $144,000 
        for a purpose specified in clause (1), (2), (3), (6), 
        or (8) of section 3710(a) of this title, the lesser of 
        [$50,750] $63,175 or 25 percent of the loan; or
          (ii) * * *
    (B) The maximum amount of guaranty entitlement available to 
a veteran for purposes specified in section 3710 of this title 
shall be $36,000, or in the case of a loan described in 
subparagraph (A)(i)(IV) of this paragraph, [$50,750] $63,175, 
reduced by the amount of entitlement previously used by the 
veteran under this chapter and not restored as a result of the 
exclusion in section 3702(b) of this title.

           *       *       *       *       *       *       *


Subchapter III--Administrative Provisions

           *       *       *       *       *       *       *



Sec. 3729. Loan fee

    (a)(1) * * *

           *       *       *       *       *       *       *

    (c)(1) * * *
    (2) A veteran who is rated eligible to receive compensation 
as a result of a pre-discharge disability examination and 
rating shall be treated as receiving compensation for purposes 
of this subsection as of the date on which the veteran is rated 
eligible to receive compensation as a result of the pre-
discharge disability examination and rating without regard to 
whether an effective date of the award of compensation is 
established as of that date.

           *       *       *       *       *       *       *


Sec. 3735. Housing assistance for homeless veterans

    (a)(1) * * *

           *       *       *       *       *       *       *

    (4) The term of any lease under this subsection may not 
exceed [three years] 20 years.

           *       *       *       *       *       *       *


CHAPTER 42--EMPLOYMENT AND TRAINING OF VETERANS

           *       *       *       *       *       *       *



Sec. 4211. Definitions

    As used in this chapter--
          (1) * * *

           *       *       *       *       *       *       *

          (6) The term ``recently separated veteran'' means any 
        veteran during the one-year period beginning on the 
        date of such veteran's discharge or release from active 
        duty.

           *       *       *       *       *       *       *


Sec. 4212. Veterans' employment emphasis under Federal contracts

    (a) Any contract in the amount of $25,000 or more entered 
into by any department or agency for the procurement of 
personal property and non-personal services (including 
construction) for the United States, shall contain a provision 
requiring that the party contracting with the United States 
shall take affirmative action to employ and advance in 
employment qualified special disabled veterans, veterans of the 
Vietnam era, recently separated veterans, and any other 
veterans who served on active duty during a war or in a 
campaign or expedition for which a campaign badge has been 
authorized. The provisions ofthis section shall apply to any 
subcontract entered into by a prime contractor in carrying out any 
contract for the procurement of personal property and non-personal 
services (including construction) for the United States. In addition to 
requiring affirmative action to employ such veterans under such 
contracts and subcontracts and in order to promote the implementation 
of such requirement, the President shall implement the provisions of 
this section by promulgating regulations which shall require that (1) 
each such contractor undertake in such contract to list immediately 
with the appropriate local employment service office all of its 
employment openings except that the contractor may exclude openings for 
executive and top management positions, positions which are to be 
filled from within the contractor's organization, and positions lasting 
three days or less, and (2) each such local office shall give such 
veterans priority in referral to such employment openings.

           *       *       *       *       *       *       *

    (d)(1) Each contractor to whom subsection (a) of this 
section applies shall, in accordance with regulations which the 
Secretary of Labor shall prescribe, report at least annually to 
the Secretary of Labor on--
          (A) the number of employees in the work force of such 
        contractor, by job category and hiring location, who 
        are special disabled veterans, veterans of the Vietnam 
        era, recently separated veterans, or other veterans who 
        served on active duty during a war or in a campaign or 
        expedition for which a campaign badge has been 
        authorized;
          (B) the total number of new employees hired by the 
        contractor during the period covered by the report and 
        the number of such employees who are special disabled 
        veterans, veterans of the Vietnam era, recently 
        separated veterans, or other veterans who served on 
        active duty during a war or in a campaign or expedition 
        for which a campaign badge has been authorized; and

           *       *       *       *       *       *       *


PART IV--GENERAL ADMINISTRATIVE PROVISIONS

           *       *       *       *       *       *       *


           CHAPTER 51--CLAIMS, EFFECTIVE DATES, AND PAYMENTS


                          Subchapter I--Claims

Sec.
[5101. Claims and forms.]
5101. Definition of ``claimant.''
5101A. Claims and forms.
     * * * * * * *
5103. * * *
5103A. Assistance to claimants.
     * * * * * * *

Sec. 5101. Definition of ``claimant''

    For purposes of this chapter, the term ``claimant'' means 
any individual who submits a claim for benefits under the laws 
administered by the Secretary.

[Sec. 5101.] Sec. 5101A. Claims and forms

    (a) * * *

           *       *       *       *       *       *       *


Sec. 5103. Incomplete applications

    (a) If a claimant's application for benefits under the laws 
administered by the Secretary is incomplete, the Secretary 
shall notify the claimant of the [evidence] information 
necessary to complete the application. If such [evidence] 
information is not received within one year from the date of 
such notification, no benefits may be paid or furnished by 
reason of such application.
    (b) * * *

           *       *       *       *       *       *       *


Sec. 5103A. Assistance to claimants

    (a) Except as provided in subsection (b), the Secretary 
shall make reasonable efforts to assist in the development of 
information and medical or lay evidence necessary to establish 
the eligibility of a claimant for benefits under the laws 
administered by the Secretary.
    (b) The Secretary is not required to provide assistance to 
a claimant under subsection (a) if no reasonable possibility 
exists, as determined in accordance with regulations prescribed 
under subsection (f), that such assistance would aid in the 
establishment of the eligibility of the claimant for benefits 
under the laws administered by the Secretary.
    (c) In any claim for benefits under the laws administered 
by the Secretary, the assistance provided by the Secretary 
under subsection (a) shall include the following:
          (1) Informing the claimant and the claimant's 
        representative, if any, of the information and medical 
        or lay evidence needed in order to aid in the 
        establishment of the eligibility of the claimant for 
        benefits under the laws administered by the Secretary.
          (2) Informing the claimant and the claimant's 
        representative, if any, if the Secretary is unable to 
        obtain any information or medical or lay evidence 
        described in paragraph (1).
    (d)(1) In any claim for disability compensation under 
chapter 11 of this title, the assistance provided by the 
Secretary under subsection (a) shall include, in addition to 
the assistance provided under subsection (c), the following:
          (A) Obtaining the relevant service and medical 
        records maintained by applicable governmental entities 
        that pertain to the veteran for the period or periods 
        of the veteran's service in the active military, naval, 
        or air service.
          (B) Obtaining existing records of relevant medical 
        treatment or examination provided at Department health-
        care facilities or at the expense of the Department, 
        but only if the claimant has furnished information 
        sufficient to locate such records.
          (C) Obtaining from governmental entities any other 
        relevant records the claimant adequately identifies and 
        authorizes the Secretary to obtain.
          (D) Making reasonable efforts to obtain from private 
        persons and entities any other relevant records the 
        claimant adequately identifies and authorizes the 
        Secretary to obtain.
          (E) Providing a medical examination needed for the 
        purpose of determining the existence of a current 
        disability if the claimant submits verifiable evidence, 
        as determined in accordance with the regulations 
        prescribed under subsection (f), establishing that the 
        claimant is unable to afford medical treatment.
          (F) Providing such other assistance as the Secretary 
        considers appropriate.
    (2) The efforts made to obtain records under subparagraphs 
(A), (B), and (C) of paragraph (1) shall continue until it is 
reasonably certain, as determined in accordance with the 
regulations prescribed under subsection (f), that such records 
do not exist.
    (e) If while obtaining or after obtaining information or 
lay or medical evidence under subsection (d) the Secretary 
determines that a medical examination or a medical opinion is 
necessary to substantiate entitlement to a benefit, the 
Secretary shall provide such medical examination or obtain such 
medical opinion.
    (f) The Secretary shall prescribe regulations for purposes 
of the administration of this section.

           *       *       *       *       *       *       *


Sec. 5106. Furnishing of information by other agencies

    The head of any Federal department or agency shall provide 
such information to the Secretary as the Secretary may request 
for purposes of determining eligibility for or amount of 
benefits, or verifying other information with respect thereto. 
The cost of providing such information shall be borne by the 
department or agency providing such information.

[Sec. 5107. Burden of proof; benefit of the doubt

    [(a) Except when otherwise provided by the Secretary in 
accordance with the provisions of this title, a person who 
submits a claim for benefits under a law administered by the 
Secretary shall have the burden of submitting evidence 
sufficient to justify a belief by a fair and impartial 
individual that the claim is well grounded. The Secretary shall 
assist such a claimant in developing the facts pertinent to the 
claim. Such assistance shall include requesting information as 
described in section 5106 of this title.
    [(b) When, after consideration of all evidence and material 
of record in a case before the Department with respect to 
benefits under laws administered by the Secretary, there is an 
approximate balance of positive and negative evidence regarding 
the merits of an issue material to the determination of the 
matter, the benefit of the doubt in resolving each such issue 
shall be given to the claimant. Nothing in this subsection 
shall be construed as shifting from the claimant to the 
Secretary the burden specified in subsection (a) of this 
section.]

Sec. 5107. Burden of proof; benefit of the doubt

    (a) Except when otherwise provided by this title or by the 
Secretary in accordance with the provisions of this title, a 
claimant shall have the burden of proof in establishing 
entitlement to benefits under the laws administered by the 
Secretary.
    (b) The Secretary shall consider all information and lay 
and medical evidence of record in a case before the Department 
with respect to benefits under laws administered by the 
Secretary, and shall give the claimant the benefit of the doubt 
when there is an approximate balance of positive and negative 
evidence regarding an issue material to the determination of 
the matter.

           *       *       *       *       *       *       *


                     Subchapter II--Effective Dates


Sec. 5113. Effective dates of educational benefits

    (a) Except as provided in [subsection (b) of this section,] 
subsections (b) and (c), effective dates relating to awards 
under chapters 30, 31, 32, 34, and 35 of this title or chapter 
106 of title 10 shall, to the extent feasible, correspond to 
effective dates relating to awards of disability compensation.
    (b)(1) In determining the effective date of an award of 
educational assistance under chapter 35 of this title for an 
individual described in paragraph (2) based on an original 
claim, the Secretary shall consider the individual's 
application under section 3513 of this title as having been 
filed on the effective date from which the Secretary, by rating 
decision, determines that the veteran from whom eligibility for 
such educational assistance is derived either died of a 
service-connected disability or established the existence of a 
total service-connected disability evaluated as permanent in 
nature if that effective date is more than one year before the 
date the rating decision is made.
    (2) An individual referred to in paragraph (1) is a person 
eligible for educational assistance under chapter 35 of this 
title by reason of subparagraph (A)(i), (A)(ii), (B), or (D) of 
section 3501(a)(1) of this title who--
          (A) submits to the Secretary an original application 
        under section 3513 of this title for educational 
        assistance under that chapter within one year after the 
        date that the Secretary issues the rating decision on 
        which the individual's eligibility for such educational 
        assistance is based;
    (B) claims such educational assistance for pursuit of an 
approved program of education during a period or periods 
preceding the one-year period ending on the date on which the 
individual's application under that section is received by the 
Secretary; and
    (C) would, without regard to this subsection, have been 
entitled to such educational assistance for pursuit of such 
approved program of education if the individual had submitted 
such application on the effective date from which the Secretary 
determined that the individual was eligible for such 
educational assistance.
    [(b)] (c) The effective date of an adjustment of benefits 
under any chapter referred to in subsection (a) [of this 
section], if made on the basis of a certification made by the 
veteran or person and accepted by the Secretary under section 
3680(g) of this title, shall be the date of the change.

           *       *       *       *       *       *       *


             PART V--BOARDS, ADMINISTRATIONS, AND SERVICES

           *       *       *       *       *       *       *


  CHAPTER 73--VETERANS HEALTH ADMINISTRATION-ORGANIZATION AND FUNCTIONS

           *       *       *       *       *       *       *



                      Subchapter I--Organization

           *       *       *       *       *       *       *



Sec. 7306. Office of the Under Secretary for Health

    (a) The Office of the Under Secretary for Health shall 
consist of the following:
          (1) * * *

           *       *       *       *       *       *       *

          (9) The Advisor on Physician Assistants, who shall 
        carry out the responsibilities set forth in subsection 
        (f).
          [(9)] (10) * * *

           *       *       *       *       *       *       *

    (e)(1) * * *
    (f) The Advisor on Physician Assistants under subsection 
(a)(9) shall--
          (1) advise the Under Secretary for Health on matters 
        regarding the optimal utilization of physician 
        assistants by the Veterans Health Administration;
          (2) advise the Under Secretary for Health on the 
        feasibility and desirability of establishing clinical 
        privileges and practice areas for physician assistants 
        in the Administration;
          (3) develop initiatives to facilitate the utilization 
        of the full range of clinical capabilities of the 
        physician assistants employed by the Administration;
          (4) provide advice on policies affecting the 
        employment of physician assistants by the 
        Administration, including policies on educational 
        requirements, national certification, recruitment and 
        retention, staff development, and the availability of 
        educational assistance (including scholarship, tuition 
        reimbursement, and loan repayment assistance); and
          (5) carry out such other responsibilities as the 
        Under Secretary for Health shall specify.
    [(f)] (g) * * *

           *       *       *       *       *       *       *


          CHAPTER 74--VETERANS HEALTH ADMINISTRATION-PERSONNEL

           *       *       *       *       *       *       *



                      Subchapter I--Appointments

           *       *       *       *       *       *       *



Sec. 7405. Temporary full-time appointments, part-time appointments, 
                    and without-compensation appointments

    (a) * * *

           *       *       *       *       *       *       *

    (c)(1) Temporary full-time appointments under this section 
of persons in positions listed in section 7401(1) of this title 
may be for a period in excess of 90 days only if the Under 
Secretary for Health finds that circumstances render it 
impracticable to obtain the necessary services through 
appointments under that section.
    (2) Temporary full-time appointments of persons who have 
successfully completed a full course of nursing in a recognized 
school of [nursing,] nursing approved by the Secretary, who 
have successfully completed a full course of training as a 
physician assistant in a recognized school approved by the 
Secretary, or who have successfully completed a full course of 
training for any category of personnel described in paragraph 
(3) of section 7401 of this title in a recognized education or 
training institution approved by the Secretary, and who are 
pending registration or licensure in a State, or certification 
by a national board recognized by the Secretary, shall not 
exceed two years.
    (3)(A) Temporary full-time appointments of persons in 
positions referred to in subsection (a)(1)(D) shall not exceed 
three years.
    (B) Temporary full-time appointments under this paragraph 
may be renewed for one or more additional periods not in excess 
of three years each.
    [(3)] (4) * * *

           *       *       *       *       *       *       *

                              ----------                              


           VETERANS MILLENNIUM HEALTH CARE AND BENEFITS ACT

           *       *       *       *       *       *       *


              TITLE IV--CONSTRUCTION AND FACILITIES MATTERS

           *       *       *       *       *       *       *


SEC. 401. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS.

    The Secretary of Veterans Affairs may carry out the 
following major medical facility projects, with each project to 
be carried out in the amount specified for that project:
          (1) * * *

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          (7) Renovation of psychiatric nursing units at the 
        Department of Veterans Affairs Medical Center, 
        Murfreesboro, Tennessee, in an amount not to exceed 
        $14,000,000.

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SEC. 403. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated to 
the Secretary of Veterans Affairs for fiscal year 2000 and for 
fiscal year 2001--
          (1) for the Construction, Major Projects, account 
        [$57,500,000 for the projects authorized in paragraphs 
        (1) through (5)] $71,500,000 for the projects 
        authorized in paragraphs (1) through (5) and (7) of 
        section 401; and
          (2) for the Medical Care account, $2,178,500 for the 
        leases authorized in section 402.
    (b) Limitation.--The projects authorized in paragraphs (1) 
through (5) and (7) of section 401 may only be carried out 
using--
          (1) * * *

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