99–006 

112TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 112–209 

VETERANS HEALTH CARE FACILITIES CAPITAL 

IMPROVEMENT ACT OF 2011 

SEPTEMBER 15, 2011.—Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 

Mr. MILLER of Florida, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

[To accompany H.R. 2646] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Veterans’ Affairs, to whom was referred the 

bill (H.R. 2646) to authorize certain Department of Veterans Affairs major medical facility projects and leases, to extend certain 

expiring provisions of law, and to modify certain authorities of the 

Secretary of Veterans Affairs, and for other purposes, having considered the same, report favorably thereon with an amendment and 

recommend that the bill as amended do pass. 

CONTENTS 

Page 

Amendments ............................................................................................................ 2 

Purpose and Summary ............................................................................................ 4 

Background and Need for Legislation .................................................................... 5 

Hearings ................................................................................................................... 11 

Subcommittee Consideration .................................................................................. 11 

Committee Consideration ........................................................................................ 12 

Committee Votes ...................................................................................................... 12 

Committee Oversight Findings ............................................................................... 12 

Statement of General Performance Goals and Objectives .................................... 12 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 12 

Earmarks and Tax and Tariff Benefits .................................................................. 12 

Committee Cost Estimate ....................................................................................... 13 

Congressional Budget Office Estimate ................................................................... 13 

Federal Mandates Statement ................................................................................. 15 

Advisory Committee Statement .............................................................................. 15 

Constitutional Authority Statement ...................................................................... 15 

Applicability to Legislative Branch ........................................................................ 15 

Section-by-Section Analysis of the Legislation ...................................................... 15 

Changes in Existing Law Made by the Bill as Reported ...................................... 17 


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AMENDMENT

The amendment is as follows: 

Strike all after the enacting clause and insert the following: 

SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Veterans Health Care Facilities Capital Improvement Act of 2011’’. 

SEC. 2. AUTHORIZATION OF FISCAL YEAR 2012 MAJOR MEDICAL FACILITY PROJECTS. 

The Secretary of Veterans Affairs may carry out the following major medical facility projects in fiscal year 2012, with each project to be carried out in the amount 

specified for each project: 

(1) Construction of seismic corrections for Building 100 at the Department of 

Veterans Affairs Medical Center in Seattle, Washington, in an amount not to 

exceed $51,800,000. 

(2) Construction of seismic corrections and renovation of various buildings to 

include Building 209 for housing facilities for homeless veterans at the Department of Veterans Affairs Medical Center in West Los Angeles, California, in an 

amount not to exceed $35,500,000. 

SEC. 3. MODIFICATION OF AUTHORIZATION FOR CERTAIN MAJOR MEDICAL FACILITY CONSTRUCTION PROJECTS PREVIOUSLY AUTHORIZED. 

(a) MODIFICATION OF AUTHORIZATION OF FISCAL YEAR 2007 MAJOR MEDICAL FA- CILITY PROJECT AT DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER IN FAY- ETTEVILLE, ARKANSAS.—Section 803(3) of the Veterans Benefits, Health Care, and 

Information Technology Act of 2006 (Public Law 109–461) is amended— 

(1) by inserting ‘‘and a parking garage’’ after ‘‘clinical addition’’; and 

(2) by striking ‘‘$56,163,000’’ and inserting ‘‘$90,600,000’’. 

(b) MODIFICATION OF EXTENSION OF AUTHORIZATION FOR MAJOR MEDICAL FACIL- ITY CONSTRUCTION PROJECT IN ORLANDO, FLORIDA, PREVIOUSLY AUTHORIZED IN

CONNECTION WITH CAPITAL ASSET REALIGNMENT INITIATIVE.—Section 802(11) of the 

Veterans Benefits, Health Care, and Information Technology Act of 2006 (Public 

Law 109–461), as amended by section 702(b)(4) of the Veterans’ Mental Health and 

Other Care Improvements Act of 2008 (Public Law 110–387; 122 Stat. 4137), is 

amended by inserting ‘‘, including a Simulation, Learning, Education, and Research 

Network Center,’’ after ‘‘Florida, area’’. 

(c) INCREASE IN AMOUNT OF AUTHORIZATION OF FISCAL YEAR 2008 MAJOR MED- ICAL FACILITY PROJECT AT DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER IN

PALO ALTO, CALIFORNIA.—The Secretary of Veterans Affairs may carry out the 

major medical facility project at the Department of Veterans Affairs Medical Center 

in Palo Alto, California, for which amounts were appropriated under chapter 3 of 

title I of the Supplemental Appropriations Act, 2008 (Public Law 110–252; 122 Stat. 

2326) under the heading ‘‘CONSTRUCTION, MAJOR PROJECTS’’ under the heading ‘‘DE- PARTMENT OF VETERANS AFFAIRS’’ in an amount not to exceed $716,600,000. 

(d) INCREASE IN AMOUNT OF AUTHORIZATION OF FISCAL YEAR 2009 MAJOR MED- ICAL FACILITY PROJECT AT DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, SAN JUAN, PUERTO RICO.—Section 701(3) of the Veterans’ Mental Health and Other 

Care Improvements Act of 2008 (Public Law 110–387; 122 Stat. 4137) is amended 

by striking ‘‘$225,900,000’’ and inserting ‘‘$277,000,000’’. 

(e) INCREASE IN AMOUNT OF AUTHORIZATION OF FISCAL YEAR 2007 MAJOR MED- ICAL FACILITY PROJECT AT DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, ST. LOUIS, MISSOURI.—Section 803(5) of the Veterans Benefits, Health Care, and Information Technology Act of 2006 (Public Law 109–461) is amended by striking 

‘‘$69,053,000’’ and inserting ‘‘$346,300,000’’. 

SEC. 4. AUTHORIZATION OF FISCAL YEAR 2012 MAJOR MEDICAL FACILITY LEASES. 

The Secretary of Veterans Affairs may carry out the following fiscal year 2012 

major medical facility leases at the locations specified, in an amount not to exceed 

the amount shown for that location: 

(1) Columbus, Georgia, Community-Based Outpatient Clinic, in an amount 

not to exceed $5,335,000. 

(2) Fort Wayne, Indiana, Outpatient Clinic, in an amount not to exceed 

$2,845,000. 

(3) Mobile, Alabama, Outpatient Clinic, in an amount not to exceed 

$6,565,000. 

(4) Rochester, New York, Outpatient Clinic, in an amount not to exceed 

$9,232,000. 

(5) Salem, Oregon, Community-Based Outpatient Clinic, in an amount not to 

exceed $2,549,000. 


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(6) San Jose, California, Outpatient Clinic, in an amount not to exceed 

$9,546,000. 

(7) South Bend, Indiana, Outpatient Clinic, in an amount not to exceed 

$6,731,000. 

(8) Springfield, Missouri, Community-Based Outpatient Clinic, in an amount 

not to exceed $6,489,000. 

SEC. 5. AUTHORIZATION OF APPROPRIATIONS. 

(a) AUTHORIZATION OF APPROPRIATIONS FOR CONSTRUCTION.—There is authorized 

to be appropriated to the Secretary of Veterans Affairs for fiscal year 2012 or the 

year in which funds are appropriated for the Construction, Major Projects account 

$87,300,000 for the projects authorized in section 2. 

(b) MODIFICATION OF AUTHORIZATION FOR CERTAIN MAJOR MEDICAL FACILITY

CONSTRUCTION PROJECTS PREVIOUSLY AUTHORIZED.—There is authorized to be appropriated to the Secretary of Veterans Affairs for fiscal year 2012 or the year in 

which funds are appropriated for the Construction, Major Projects account 

$850,070,000 for the projects authorized in section 3. 

(c) AUTHORIZATION OF APPROPRIATIONS FOR MEDICAL FACILITY LEASES.—There is 

authorized to be appropriated to the Secretary of Veterans Affairs for fiscal year 

2012 or the year in which funds are appropriated for the Medical Facilities account 

$49,292,000 for the leases authorized in section 4. 

(d) LIMITATION.—The projects authorized in sections 2, 3, and 4 may only be carried out using— 

(1) funds appropriated for fiscal year 2012 pursuant to the authorization of 

appropriations in subsection (a) of this section; 

(2) funds available for Construction, Major Projects, for a fiscal year before 

fiscal year 2012 that remain available for obligation; 

(3) funds available for Construction, Major Projects, for a fiscal year after fiscal year 2012 that remain available for obligation; 

(4) funds appropriated for Construction, Major Projects, for fiscal year 2012 

for a category of activity not specific to a project; 

(5) funds appropriated for Construction, Major Projects, for a fiscal year before 2012 for a category of activity not specific to a project; and 

(6) funds appropriated for Construction, Major Projects, for a fiscal year after 

2012 for a category of activity not specific to a project. 

SEC. 6. MODIFICATION OF REQUIREMENTS RELATING TO CONGRESSIONAL APPROVAL OF 

CERTAIN MEDICAL FACILITY ACQUISITIONS. 

Section 8104 of title 38, United States Code, is amended— 

(1) in subsection (b)— 

(A) in paragraph (1)— 

(i) by striking ‘‘detailed description’’ and inserting ‘‘detailed estimate 

of the total costs’’; 

(ii) by striking ‘‘a description of the consideration’’ and inserting ‘‘a 

detailed report of the consideration’’; and 

(iii) by adding at the end the following: ‘‘Such detailed estimate shall 

include an identification of each of the following: 

‘‘(A) Total construction costs. 

‘‘(B) Activation costs. 

‘‘(C) Special purpose alterations (lump-sum payment) costs. 

‘‘(D) Number of personnel. 

‘‘(E) Total costs of ancillary services, equipment, and all other items.’’; 

(B) by striking paragraphs (2) and (3) and redesignating paragraphs (4) 

through (8) as paragraphs (2) through (6), respectively; 

(C) in paragraph (2), as so redesignated, by striking ‘‘a five-year period 

and a ten-year period’’ and inserting ‘‘a five-year period, a ten-year period, 

and a twenty-year period’’; 

(D) in paragraph (3), as so redesignated, by inserting before the period 

at the end the following: ‘‘, including information on projected changes in 

workload and utilization over a five-year period, a ten-year period, and a 

twenty-year period’’; 

(E) in paragraph (4), as so redesignated— 

(i) by striking ‘‘Current and projected’’ and inserting ‘‘Projected’’; and 

(ii) by inserting before the period at the end the following: ‘‘(including 

and identifying both recurring and non-recurring costs (including activation costs and total costs of ancillary services, equipment and all 

other items)) over a five-year period, a ten-year period, and a twentyyear period’’; and 

(F) in paragraph (6), as so redesignated— 


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(i) by striking ‘‘a description of each alternative to construction of the 

facility that was considered.’’ and inserting ‘‘each of the following:’’; and 

(ii) by adding at the end the following new subparagraphs: 

‘‘(A) A detailed estimate of the total costs (including total construction 

costs, activation costs, special purpose alterations (lump-sum payment) 

costs, number of personnel and total costs of ancillary services, equipment 

and all other items) for each alternative to construction of the facility that 

was considered. 

‘‘(B) A comparison of total costs to total benefits for each such alternative. 

‘‘(C) An explanation of why the preferred alternative is the most effective 

means to achieve the stated project goals and the most cost-effective alternative.’’; and 

(2) in subsection (d)— 

(A) by striking ‘‘major medical facility project’’ each place it appears and 

inserting ‘‘major construction project’’; and 

(B) in paragraph (2)— 

(i) in subparagraph (A), by striking ‘‘major medical facility projects’’ 

and inserting ‘‘major construction projects’’; and 

(ii) in subparagraph (B), by striking ‘‘major medical facility’’ and inserting ‘‘major construction project’’. 

SEC. 7. NAME OF DEPARTMENT OF VETERANS AFFAIRS TELEHEALTH CLINIC, CRAIG, COLORADO. 

The Department of Veterans Affairs telehealth clinic in Craig, Colorado, shall 

after the date of the enactment of this Act be known and designated as the ‘‘Major 

William Edward Adams Department of Veterans Affairs Clinic’’. Any reference to 

such clinic in any law, regulation, map, document, record, or other paper of the 

United States shall be considered to be a reference to the ‘‘Major William Edward 

Adams Department of Veterans Affairs Clinic’’. 

SEC. 8. EXTENSION OF CERTAIN EXPIRING AUTHORITIES. 

(a) RECOVERY AUDITS FOR CERTAIN CONTRACTS.—Section 1703(d)(4) of title 38, 

United States Code, is amended by striking ‘‘September 30, 2013’’ and inserting 

‘‘September 30, 2020’’. 

(b) TREATMENT AND REHABILITATION FOR SERIOUSLY MENTALLY ILL AND HOMELESS VETERANS.—Section 2031(b) of such title is amended by striking ‘‘December 31, 

2011’’ and inserting ‘‘December 31, 2012’’. 

(c) ADDITIONAL SERVICES FOR SERIOUSLY MENTALLY ILL AND HOMELESS VETERANS.—Section 2033(d) of such title is amended by striking ‘‘December 31, 2011’’ 

and inserting ‘‘December 31, 2012’’. 

(d) HOUSING ASSISTANCE FOR HOMELESS VETERANS.—Section 2041(c) of such title 

is amended by striking ‘‘December 31, 2011’’ and inserting ‘‘December 31, 2012’’. 

(e) ADVISORY COMMITTEE ON HOMELESS VETERANS.—Section 2066(d) of such title 

is amended by striking ‘‘December 30, 2011’’ and inserting ‘‘December 31, 2012’’. 

(f) AUTHORITY TO TRANSFER REAL PROPERTY.—Section 8118(a)(5) of such title is 

amended by striking ‘‘the date that is seven years after the date of the enactment 

of this section’’ and inserting ‘‘December 31, 2018’’. 

SEC. 9. GEORGE H. O’BRIEN, JR., DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER. 

(a) DESIGNATION.—The Department of Veterans Affairs medical center located in 

Big Spring, Texas, shall be known and designated as the ‘‘George H. O’Brien, Jr., 

Department of Veterans Affairs Medical Center’’. 

(b) REFERENCES.—Any reference in a law, map, regulation, document, paper, or 

other record of the United States to the Department of Veterans Affairs medical 

center referred to in subsection (a) shall be deemed to be a reference to the ‘‘George 

H. O’Brien, Jr., Department of Veterans Affairs Medical Center’’. 

PURPOSE AND SUMMARY

H.R. 2646, the ‘‘Veterans Health Care Facilities Capital Improvement Act of 2011’’, was introduced by Representative Bill Johnson 

of Ohio, Chairman of the Subcommittee on Oversight and Investigations of the Committee on Veterans’ Affairs, on July 26, 2011. 

H.R. 2646, as amended, would: (1) authorize a major medical facility project in Seattle, WA, in an amount not to exceed $51,800,000 

and in West Los Angeles, CA, in an amount not to exceed 

$35,500,000; (2) modify the authorization for the following major 

medical facility projects previously authorized: Fayetteville, AR, inVerDate Mar 15 2010 06:09 Sep 16, 2011 Jkt 099006 PO 00000 Frm 00004 Fmt 6659 Sfmt 6602 E:\HR\OC\HR209.XXX HR209

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creasing the authorization amount from $56,163,000 to 

$90,600,000; Orlando, FL, including the addition of a Simulation, 

Learning, Education, and Research Network Center; Palo Alto, CA, 

authorizing an amount not to exceed $716,600,000, San Juan, PR, 

increasing the authorization amount from $225,900,000 to 

$277,000,000; and St. Louis, MO, increasing the authorization 

amount from $69,053,000 to $346,300,000; (3) authorize major 

medical facility leases for Community-Based Outpatient Clinics 

(CBOC) in Columbus, GA, in an amount not to exceed $5,335,000; 

Salem, OR in an amount not to exceed $2,549,000; and Springfield, 

MO, in an amount not to exceed $6,489,000 and Outpatient Clinics 

(OC) in Fort Wayne, IN, in an amount not to exceed $2,845,000; 

Mobile, AL, in an amount not to exceed $6,565,000; Rochester, NY, 

in an amount not to exceed $9,232,000; San Jose, CA, in an amount 

not to exceed $9,546,000; and South Bend, IN, in an amount not 

to exceed $6,731,000; (4) modify requirements for information VA 

must provide to Congress when seeking authorization for a major 

medical facility project or lease; (5) name the VA telehealth clinic 

in Craig, CO, the ‘‘Major William Edward Adams Department of 

Veterans Affairs Clinic’’; (6) extend certain expiring authorities related to recovery audits for certain contracts, treatment and rehabilitation for seriously mentally ill and homeless veterans, additional services for seriously mentally ill and homeless veterans, 

housing assistance for homeless veterans, and the Advisory Committee on Homeless Veterans, through December 31, 2012; and the 

authority to transfer real property, through December 31, 2018; 

and, (7) name the VA Medical Center in Big Spring, TX, the 

‘‘George H. O’Brien, Jr., Department of Veterans Affairs Medical 

Center.’’ 

BACKGROUND AND NEED FOR LEGISLATION

Section 8104(2) of title 38, U.S.C., requires Congressional authorization for VA major medical facility projects and major medical facility leases. A major medical facility project is defined as a project 

involving construction, alteration, or acquisition of a medical facility involving a total expenditure of more than $10,000,000. A major 

medical facility lease is defined as a lease for space for use as a 

new medical facility at an average annual rental of more than 

$1,000,000. Along with each major medical facility project or lease 

funding request, section 8104(b) of title 38 U.S.C. requires VA to 

submit a prospectus of the proposed medical facility to include a 

detailed description of the medical facility and an estimate of the 

cost for the construction, alteration, lease, or other acquisition as 

well as an estimate of the cost of the equipment required for operation of such facility, demographic data, current and projected 

workload and utilization data, current and projected operating 

costs, the priority score assigned to the project under the VA’s 

prioritization methodology, and a description of each alternative 

that was considered in the case of a new or replacement medical 

ideology. 

Administration request for authorization to carry out the following 

VA major medical facility projects in fiscal year 2012 

Seattle, Washington: seismic corrections for Building 100 at the 

Seattle Veterans Affairs Medical Center (VAMC) in an amount not 


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to exceed $51,800,000. On the Seattle VAMC campus, building 100 

houses a nursing tower and nursing home care unit. Providing seismic strengthening of this structure would allow for the continued 

operation of these programs throughout renovation of the existing 

building, and, therefore, offer aggregated safety, functional, and fiscal advantages to the project. 

West Los Angeles, California: seismic corrections and renovation 

of various buildings to include Building 209 for housing facilities 

for homeless veterans at the West Los Angeles VAMC, in an 

amount not to exceed $35,500,000. Building 209 currently sits vacant on the West LA campus. However, seismic corrections, utilizing $20,000,000 from existing prior year bid savings funds, 

would allow for the development of a therapeutic and supportive 

homeless housing program, to include long-term transitional housing to aid homeless veterans, especially those with on-going medical and/or mental health needs, in both obtaining and maintaining 

supportive employment. 

Fayetteville, Arkansas: modification of the FY 2007 authorization 

for a major medical facility project at the Fayetteville VAMC raising the authorization level from $56,163,000 to $90,600,000, an increase of $34,437,000. The modification of the initial authorization 

would expand the scope of the project to include a new clinical addition with minor renovations, as well as the construction of a new 

parking facility. No additional appropriation is required to complete this project. 

Orlando, Florida: modification of extension of the authorization 

for a major medical facility construction project in Orlando, Florida, 

previously authorized in connection with the Capital Asset Realignment Initiative by authorizing a Simulation, Learning, Education, 

and Research Network Center (SIMLEARN Center). The 

SIMLEARN Center would encompass a clinical simulation program 

to support clinical training, an essential component of education, 

training, competency assessment, and maintenance of professional 

certification throughout the VA health care system. SIMLEARN 

would provide expert ‘train-the-trainer’ simulation experiences, national curricula for high priority clinical topics, and acquisition support to VA medical facilities to facilitate local simulation training 

deployment. This modification of the original authorization amount 

would also provide VA with the opportunity to fund the installation 

of renewable energy opportunities and source energy through a cogeneration energy installation. No additional appropriation is required to complete this project. 

Palo Alto, California: increase in the amount of the FY 2008 authorization for a major medical facility project at the Palo Alto 

VAMC, in an amount not to exceed $716,600,000. Such an increase 

would provide seismic upgrade to the main hospital building, as 

well as provide the necessary emergency sustainment features including fire sprinklers and an abatement of existing asbestos. In 

addition, a new administrative building, parking structure, and an 

expansion of the outpatient clinic would be constructed. 

San Juan, Puerto Rico: increase in the amount of the FY 2009 

authorization for a major medical facility project at the San Juan 

VAMC from $225,900,000 to $277,000,000, an increase of 

$51,100,000. With these funds, VA would construct a new administrative building, parking structure, and an expansion of the outVerDate Mar 15 2010 06:09 Sep 16, 2011 Jkt 099006 PO 00000 Frm 00006 Fmt 6659 Sfmt 6602 E:\HR\OC\HR209.XXX HR209

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patient clinic as well as provide seismic upgrades to the main hospital building, emergency sustainment features including fire sprinklers, and an abatement of existing asbestos. 

St. Louis, Missouri: increase in the amount of the FY 2007 authorization for a major medical facility project at the Jefferson Barracks division of the St. Louis VAMC from $69,053,000 to 

$346,300,000, an increase of $277,247,000. Such an increase in authorization would allow for a five phase project aimed at demolishing deteriorated and unsuitable medical center facilities and 

new construction to consolidate operations and free approximately 

30 acres to extend operations at the adjacent VA National Cemetery. 

Administration request for authorization to carry out the following 

VA major medical facility leases in fiscal year 2012 

Columbus, Georgia: CBOC in an amount not to exceed 

$5,335,000, to provide mental health services to Georgia veterans. 

Fort Wayne, Indiana: OC in an amount not to exceed $2,845,000. 

The Fort Wayne OC would support the VA Northern Indiana 

Health Care System and serve Northern Indiana’s veteran population while expanding mental health service space and accommodating support services to meet increased veteran demand. This 

project would allow VA to continue to provide timely access to 

state-of-the-art mental health care, including care for substance 

abuse and post-traumatic stress disorder in an adequately-sized facility to meet increased workload. 

Mobile, Alabama: OC in an amount not to exceed $6,565,000. 

The current lease is housed in a functionally obsolete building that 

has space, safety and functional deficiencies. The new lease would 

provide for administrative and clinical space and would provide 

greater capacity for medical staff in a more appropriately sized, 

modern facility. This replacement OC would ensure continued provision of current and expanded medical services to veterans residing in or near Mobile, AL. 

Rochester, New York: OC in an amount not to exceed $9,232,000. 

The current lease is set to expire in 2016 and cannot be renewed. 

The new lease would provide expanded outpatient services to address current utilization and space gaps. This lease would allow for 

VA to serve a greater number of veterans, reduce travel time for 

clinical services, and consolidate three single leases—Mt. Hope Avenue, Clinton Crossings, and Rochester—into one state-of-the-art 

facility. 

Salem, Oregon: CBOC in an amount not to exceed $2,549,000 for 

a replacement lease for the existing 10,000 net usable square feet 

(NUSF) CBOC in Salem, OR, which supports the parent facility in 

Portland, OR. The current leased space is too small to support the 

projected workload growth in the Salem area. The new lease would 

continue to provide primary and specialty care, mental health and 

ancillary services. Expanded high demand VA specialty care services that would be provided in the new leased space include eye 

care, rehabilitation, audiology, and speech pathology. The new 

CBOC will allow for relocation to an area of higher veteran population. 

San Jose, California: OC in an amount not to exceed $9,546,000 

for a replacement lease for existing 72,000 NUSF CBOC in San 


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Jose, which supports the parent facility of the VA Palo Alto Health 

Care System. The current lease is set to expire in 2016 with no additional option years remaining on the existing lease. The lease 

would address the need to provide ongoing primary care, mental 

health, and specialty care services to veterans residing in San Jose, 

CA. 

South Bend, Indiana: OC in an amount not to exceed $6,731,000 

to replace existing CBOC. The new leased facility would enable VA 

to expand services to include outpatient primary care and mental 

health services. This lease would provide infrastructure that supports increased integration of services, coordination of care, provider productivity, efficiency, and patient satisfaction. This lease 

would allow VA to respond to the changing needs of veterans and 

their families in South Bend. 

Springfield, Missouri: CBOC in an amount not to exceed 

$6,489,000 for a replacement lease for existing 41,000 NUSF 

CBOC, supporting the parent facility of the Veterans Health Care 

System of the Ozarks (VHSO) in Fayetteville, AR. The new CBOC 

would relocate and expand Gene Taylor OC from Mount Vernon, 

Missouri. The State of Missouri has elected to close the Missouri 

Rehabilitation Center (MRC) in Mount Vernon, where the current 

clinic is located, and will be unable to continue to support the current lease agreement. Moving the CBOC to Springfield would better support the VHSO strategic initiatives. The new CBOC would 

continue to provide primary and specialty care, mental health and 

ancillary services and would also provide sleep studies, radiology, 

Magnetic Resonance Imaging (MRI), laboratory, and dental services to veterans. 

Modification of requirements relating to Congressional approval of 

certain medical facility acquisitions 

VA holds a substantial real property inventory that includes a 

medical infrastructure of over 5,400 owned buildings, 1,300 leases, 

33,000 acres of land, and approximately 159 million gross square 

feet (owned and leased). 

This nationwide infrastructure is a critically important resource 

enabling VA to provide the best possible care to our veterans. Such 

an enormous structural network, however, generates a great deal 

of costly construction, which the Department must address even as 

it faces unprecedented challenges in providing our Nation’s heroes 

with access to care. 

The Administration has identified 4,808 necessary capital 

projects with an estimated total cost between $53 billion and $65 

billion to correct infrastructure gaps over the next ten years. This 

estimate does not include activation or life cycle costs. 

Congress takes an oversight role for this decision-making process 

in section 8104(a)(1) of title 38 U.S.C., whose purpose is ‘‘to enable 

Congress to ensure the equitable distribution of medical facilities 

throughout the United States, taking into consideration the comparative urgency of the need for the services to be provided in the 

case of each particular facility.’’ 

So that Congress can adequately fulfill its oversight responsibilities, section 8104 directs VA to submit a prospectus for all major 

medical facility projects. This prospectus is intended to provide a 

clear understanding of the project costs and benefits and include 


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detailed information such as construction costs, alternatives to construction considered, equipment costs for the proposed facility and 

data on projected utilization and operating costs. 

However, the Committee remains concerned that VA does not 

provide this information in sufficient detail for Congress to accurately evaluate proposed Department projects. Without accurate 

and complete information as required by the law, Congress cannot 

carry out its statutory mission of ensuring the ‘‘equitable distribution’’ of medical facilities and access to care for our veterans. 

Section 6 of the bill would modify requirements for information 

VA must provide to Congress when seeking authorization for a 

major medical facility project or lease by specifying the level of detailed information related to the total cost of the project including 

construction costs, activation costs, special purpose alterations 

(lump-sum payments) costs, personnel costs, ancillary services 

costs, equipment costs, and all other costs; demographic data extending over a twenty-year period; current and project workload 

and utilization data for the proposed facility or lease including information on any and all projected changes over a five-, ten-, and 

twenty-year period; projected operating costs to include an identification of recurring and non-recurring costs including activation 

costs and total costs of ancillary services, equipment and all other 

items over a five-year period, a ten-year period and a twenty-year 

period; and, in the case of a prospective proposing the construction 

of a new or replacement medical facility, a detailed estimate of the 

total costs including total construction costs, activation costs, special purpose alterations (lump-sum payments) costs, personnel 

costs, and ancillary services costs, equipment costs, and all other 

costs for each alternative as well as total benefits for each alternative and a detailed explanation of why the preferred alternative 

is both the most effective means to achieve the stated project goals 

and the most cost-effective alternative. 

Name of Department of Veterans Affairs telehealth clinic, Craig, 

Colorado 

On May 25th, 1971, Major Adams willingly volunteered for a helicopter rescue mission to fly into a remote fire base that was under 

heavy attack to pick up three critically wounded soldiers. While directing and coordinating fire support from other attack helicopters, 

Maj. Adams landed his aircraft and picked up the three wounded 

soldiers. As he began his return flight, his helicopter was bombarded with enemy rocket and gunfire. Though Maj. Adams prepared to make an emergency landing, his helicopter exploded before he could touch down. For his brave actions, Maj. Adams posthumously received the Medal of Honor. Section 7 of the bill would 

appropriately memorialize his brave service in battle and his commitment to both his country and his fellow veterans by naming the 

VA telehealth clinic in Craig, Colorado, as ‘‘Major William Edward 

Adams Department of Veterans Affairs Clinic.’’ The Colorado Congressional delegation and the major veterans’ organizations in the 

State of Colorado are unanimous in their support of this provision. 

Extension of certain expiring authorities 

Current law authorizes VA to establish an inpatient recovery 

audit program for fee basis and other medical services contracts. 


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This authority, which is set to expire on September 30, 2013, allows VA to identify and collect overpayments made through the 

VA’s Purchased Care Program and redirect the recovered funds to 

provide health care services to eligible veterans and their families. 

Through this program, VA has identified an estimated $111 million 

in overpayments. If VA’s recovery audit authority were to lapse, VA 

may lose the incentive to aggressively pursue improper payments 

as recovered funds would be redirected to the United States Treasury rather than to VA facilities to provide health care services to 

veterans. Further, in order to prevent disruptions to the recovery 

audit program, VA must have sufficient time to plan for a contract 

competition and award. As such, section 8(a) of the bill would 

amend § 1703(d)(4) of title 38 U.S.C. to extend VA’s authority to 

conduct recovery audits for fee basis and other medical service contracts until September 30, 2020. 

Current law authorizes VA to provide seriously mentally ill veterans, including homeless veterans, with: (1) outreach services, (2) 

care, treatment, rehabilitation, and other services, and (3) therapeutic transitional housing assistance. This authority, which is currently set to expire on December 31, 2011, allows VA to conduct 

specialized programs and services for veterans struggling with serious mental illness and homelessness to target those most at-risk 

and in need in the veteran population. Section 8(b) would amend 

§ 2031(b) of title 38 U.S.C. to extend VA’s authority regarding 

treatment and rehabilitation for seriously mentally ill and homeless veterans through December 31, 2012. 

Current law authorizes VA, subject to appropriations, to operate 

a program to expand and improve the provision of benefits and 

services to homeless veterans, including establishing sites under 

VA jurisdiction to be centers for the provision of comprehensive 

services to homeless veterans in, at a minimum, each of the 20 

largest metropolitan statistical areas. Given the prevalence of veterans in the homeless population, it is vitally important for VA to 

provide appropriate programs and services to assist those struggling with homelessness. This authority is currently set to expire 

on December 31, 2011. Section 8(c) would amend § 2033(d) of title 

38 U.S.C. to extend VA’s authority to expand and improve benefits 

to homeless veterans through September 30, 2012. 

Similarly, § 2041(c) of title 38, U.S.C. provides VA the authority 

to enter into agreements with homeless providers for the purpose 

of selling, leasing, or donating homes acquired through the guaranteed loan program. This authority is currently set to expire on December 31, 2011. Section 8(d) would amend § 2041(c) of title 38, 

U.S.C. to extend this authority until December 31, 2012. 

Though VA provides more direct assistance to the homeless than 

any other Federal agency, veterans continue to be overrepresented 

in the homeless population. Public Law 107–95 mandated the creation of an Advisory Committee on Homeless Veterans. The purpose of the Advisory Committee is to provide advice and make recommendations to VA regarding the provision of benefits and services to homeless veterans, to assess the effectiveness of policies and 

programs relating to homeless veterans, to identify gaps in programs serving homeless veterans, highlight barriers in law and 

Federal policy that hinder homeless veterans programs, and liaise 

with other Federal, State and local agencies that work on homeless 


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issues. This authority is currently set to expire on December 30, 

2011. Section 8(e) would amend § 2066(d) of title 38 U.S.C. to extend Congressional authority to continue the Advisory Committee 

on Homeless Veterans until December 31, 2018. 

Current law provides VA the authority to transfer real property 

under VA jurisdiction and control to other Federal agencies, State 

agencies, public or private entities, or Indian tribes. Such authority 

provides the Department with the flexibility to make efficient and 

effective use of VA’s extensive real property holdings, including 

vacant or underutilized property. This authority is currently set 

to expire on December 31, 2011. Section 8(f) would amend 

§ 8118(a)(5) of title 38, U.S.C. to extend this authority through December 31, 2012. 

Name of Department of Veterans Affairs Medical Center, Big 

Spring, Texas 

George H. O’Brien, Jr., was a Korean War veteran from Big 

Spring, TX. While wounded, Mr. O’Brien led his Marine unit in an 

uphill assault on a heavily defended position. After relief arrived, 

Mr. O’Brien refused medical evacuation and remained to cover his 

unit’s withdrawal. For his heroism, Mr. O’Brien was awarded the 

Medal of Honor by President Eisenhower. After returning to Big 

Spring, Mr. O’Brien lent his services as a volunteer at the Big 

Spring VAMC. He died in 2005 at the age of 78. 

Section 9 of the bill would appropriately memorialize his brave 

service in battle and his commitment to both his country and his 

fellow veterans by naming the VA Medical Center in Big Spring, 

TX, the ‘‘George H. O’Brien, Jr., Department of Veterans Affairs 

Medical Center.’’ The Texas Congressional delegation and the 

major veterans’ organizations in the State of Texas are unanimous 

in their support of this provision. 

HEARINGS

On July 25, 2011, the Subcommittee on Health held a legislative 

hearing on several bills introduced in the 112th Congress, including a draft bill which was later introduced as H.R. 2646. The following witnesses testified: the Honorable Michael G. Grimm of 

New York; the Honorable John R. Carter of Texas, the Honorable 

Timothy J. Walz of Minnesota; the Honorable Larry Bucshon of Indiana; Shane Barker, Senior Legislative Associate, National Veterans Service, Veterans of Foreign Wars of the United States; Joy 

J. Ilem, Deputy National Legislative Director, Disabled American 

Veterans; Thomas J. Berger, Ph.D., Executive Director, Veterans 

Health Council, Vietnam Veterans of America; Carl Blake, National Legislative Director, Paralyzed Veterans of America: Christina M. Roof, National Acting Legislative Director, AMVETS; and 

Robert L. Jesse, M.D., Ph.D., Principal Deputy Under Secretary for 

Health, Veterans Health Administration, U.S. Department of Veterans Affairs. 

SUBCOMMITTEE CONSIDERATION

On July 28, 2011, the Subcommittee on Health met in open 

markup session, a quorum being present. An amendment was offered by Chairwoman Ann Marie Buerkle of New York to amend 


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H.R. 2646. Ms. Buerkle’s amendment modified the extensions of 

§ 1703(d)(4), recovery audits for certain contracts, § 2031(b), treatment and rehabilitation for seriously mentally ill and homeless veterans, § 2033(d), additional services for seriously mentally ill and 

homeless veterans, § 2041(c), housing assistance for homeless veterans, and § 2066(d), Advisory Committee on Homeless Veterans 

from 2018 to 2012. The amendment was agreed to by voice vote. 

Ranking Member Michaud of Maine offered a motion to report H.R. 

2646, as amended, favorably to the full Committee. His motion was 

agreed to by voice vote. 

COMMITTEE CONSIDERATION

On September 8, 2011, the full Committee met in an open markup session, a quorum being present. An Amendment was offered by 

Representative Bill Flores of Texas to insert a new section 9 to 

name the George H. O’Brien VA Medical Center. The amendment 

was adopted and H.R. 2646, as amended, was reported favorably 

to the House of Representatives, by voice vote. 

COMMITTEE VOTES

Clause 3(b) of rule XIII of the Rules of the House of Representatives requires the Committee to list the record votes on the motion 

to report the legislation and amendments thereto. There were no 

record votes taken on amendments or in connection with ordering 

H.R. 2646 reported to the House. A motion by Mr. Filner of California to order H.R. 2646, as amended, reported favorably to the 

House of Representatives was agreed to by voice vote. 

COMMITTEE OVERSIGHT FINDINGS

In compliance with clause 3(c)(1) of rule XIII and clause 2(b)(1) 

of rule X of the Rules of the House of Representatives, the Committee’s oversight findings and recommendations are reflected in the 

descriptive portions of this report. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

In accordance with clause 3(c)(4) of rule XIII of the Rules of the 

House of Representatives, the Committee’s performance goals and 

objectives are reflected in the descriptive portions of this report. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND

TAX EXPENDITURES

In compliance with clause 3(c)(2) of rule XIII of the Rules of the 

House of Representatives, the Committee adopts as its own the estimate of new budget authority, entitlement authority, or tax expenditures or revenues contained in the cost estimate prepared by 

the Director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

EARMARKS AND TAX AND TARIFF BENEFITS

H.R. 2646, as amended, does not contain any congressional earmarks, limited tax benefits, or limited tariff benefits as defined in 

clause 9 of rule XXI of the Rules of the House of Representatives. 


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COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate on H.R. 2646 

prepared by the Director of the Congressional Budget Office pursuant to section 402 of the Congressional Budget Act of 1974. 

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

Pursuant to clause 3(c)(3) of rule XIII of the Rules of the House 

of Representatives, the following is the cost estimate for H.R. 2646 

provided by the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974: 

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, September 15, 2011. 

Hon. JEFF MILLER, 

Chairman, Committee on Veterans’ Affairs, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 2646, the Veterans 

Health Care Facilities Capital Improvement Act of 2011. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Ann E. Futrell. 

Sincerely, 

DOUGLAS W. ELMENDORF. 

Enclosure. 

H.R. 2646—Veterans Health Care Facilities Capital Improvement 

Act of 2011 

Summary: H.R. 2646 would authorize the Department of Veterans Affairs (VA) to build and lease several medical facilities and 

extend programs for homeless veterans. In total, CBO estimates 

that implementing the bill would cost $1.2 billion over the 2012– 

2016 period, assuming appropriation of the necessary amounts. 

CBO estimates that enacting the bill would have no effect on direct 

spending or revenues; therefore, pay-as-you-go procedures do not 

apply. 

H.R. 2646 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA). 

Estimated cost to the Federal Government: The estimated budgetary impact of H.R. 2646 is summarized in the following table. 

The costs of this legislation fall within budget function 700 (veterans benefits and services). 

Basis of estimate: For this estimate, CBO assumes the legislation 

will be enacted near the start of fiscal year 2012, that the necessary amounts will be appropriated each year, and that outlays 

will follow historical patterns for similar and existing programs. 

H.R. 2646 would authorize appropriations for major construction 

and leasing of VA medical facilities. The bill also would extend the 

authority for several programs for homeless veterans. CBO estimates that implementing H.R. 2646 would cost $1.2 billion over the 

2012–2016 period, assuming appropriation of the necessary 

amounts. 


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By fiscal year, in millions of dollars— 

2012 2013 2014 2015 2016 2012– 

2016 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

Major Construction Projects: 

Authorization Level .................................................. 850 0 0 0 0 850 

Estimated Outlays ................................................... 37 229 277 204 77 824 

Leases for Medical Facilities: 

Estimated Authorization Level ................................. 50 22 22 22 22 138 

Estimated Outlays ................................................... 45 22 22 22 22 133 

Seismic Corrections and Renovations: 

Estimated Authorization Level ................................. 68 0 0 0 0 68 

Estimated Outlays ................................................... 3 18 22 16 6 65 

Extension of Certain Authorities for Homeless Veterans: 

Estimated Authorization Level ................................. 107 37 0 0 0 144 

Estimated Outlays ................................................... 96 43 4 0 0 143 

Total Changes: 

Estimated Authorization Level ........................ 1,075 59 22 22 22 1,200 

Estimated Outlays .......................................... 181 312 325 242 105 1,165 

Major construction projects 

Section 3 would authorize the appropriation of $850 million to 

construct and modify medical facilities in Palo Alto, California; St. 

Louis, Missouri; and San Juan, Puerto Rico. CBO estimates that if 

appropriated, that authorization would result in discretionary costs 

of $824 million over the 2012–2016 period. 

Leases for medical facilities 

Section 4 would authorize the appropriation of $50 million for 

leasing eight medical facilities. Based on information from VA’s 

2012 budget request, CBO expects that VA would enter into 20- 

year lease agreements for those facilities. CBO estimates that in 

addition to the specified amounts authorized to be appropriated in 

2012, entering into those leases would cost $22 million a year starting in 2013. (Costs would be higher in the first year because VA 

would pay up front for necessary improvements and upgrades.) 

CBO estimates that entering into those leases would cost $133 million over the 2012–2016 period, assuming appropriation of the authorized and estimated amounts. 

Seismic corrections and renovations 

Section 2 would authorize the appropriation of $87 million for 

seismic corrections and renovations at facilities in Los Angeles, 

California, and Seattle, Washington. Based on VA’s current estimate for construction costs and the amounts that have already 

been appropriated for those projects, CBO estimates that VA would 

require additional funding of $68 million in 2012. We estimate that 

implementing those projects would cost a total of $65 million over 

the 2012–2016 period, assuming appropriation of the estimated 

amounts. 

Extension of certain authorities for homeless veterans 

Section 8 would extend, for various periods, the expiring authorities for several programs that provide services to homeless veterans. CBO estimates that extending such programs would cost 

$143 million over the 2012–2016 period, assuming appropriation of 

the necessary amounts. 


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Pay-as-you-go considerations: None. 

Intergovernmental and private-sector impact: H.R. 2646 contains 

no intergovernmental or private-sector mandates as defined in 

UMRA. Public hospitals that contract with VA to provide hospital 

care or medical services to veterans would be required to comply 

with auditing procedures extended under the bill. Any costs to 

those hospitals would be incurred voluntarily. 

Previous CBO estimate: On August 30, 2011, CBO transmitted 

a cost estimate for S. 914, the Veterans Programs Improvement Act 

of 2011, as ordered reported by the Senate Committee on Veterans’ 

Affairs on June 29, 2011. Sections 2, 3, 4, and 8 of H.R. 2646 contain language similar to sections 601, 602, 603, and 205 of S. 914, 

respectively, and their estimated costs are the same. 

Estimate prepared by: Federal costs: Ann E. Futrell; Impact on 

State, local, and Tribal Governments: Lisa Ramirez-Branum; Impact on the Private Sector: Elizabeth Bass. 

Estimate approved by: Theresa Gullo, Deputy Assistant Director 

for Budget Analysis. 

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of Federal mandates regarding H.R. 2646 prepared by the Director of the Congressional Budget Office pursuant to section 423 of the Unfunded Mandates Reform Act. 

ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act would be created by H.R. 2646. 

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee finds that the Constitutional authority for H.R. 2646 is provided by Article I, section 8 of the Constitution of the United States. 

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that the legislation does not relate to the 

terms and conditions of employment or access to public services or 

accommodations within the meaning of section 102(b)(3) of the Congressional Accountability Act. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

Section 1 of the bill would name the Act the ‘‘Veterans Health 

Care Facilities Capital Improvement Act of 2011.’’ 

Section 2. Authorization of fiscal year 2012 major medical facility 

projects 

Section 2(1) of the bill would authorize a major medical facility 

project in Seattle, WA, in an amount not to exceed $51,800,000. 

Section 2(2) of the bill would authorize a major medical facility 

project in West Los Angeles, CA, in an amount not to exceed 

$35,500,000. 


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Section 3. Modification of authorization for certain major medical 

facility construction projects previously authorized 

Section 3(a) of the bill would modify the authorization of fiscal 

year 2007 major medical facility project at the VAMC in Fayetteville, AR, by inserting the addition of a parking garage and increasing the authorization amount from $56,163,000 to $90,600,000. 

Section 3(b) of the bill would modify the extension of authorization for major medical facility construction in Orlando, FL, by inserting the addition of a Simulation, Learning, Education, and Research Network Center. 

Section 3(c) of the bill would increase the amount of authorization of fiscal year 2008 Major Medical Facility Project at VAMC in 

Palo Alto, CA, in an amount not to exceed $716,600,000. 

Section 3(d) of the bill would increase the authorization of fiscal 

year 2009 major medical facility project at the VAMC in San Juan, 

PR, increasing the authorization amount from $225,900,000 to 

$277,000,000. 

Section 3(e) of the bill would increase the amount of authorization of fiscal year 2007 major medical facility project at the VAMC 

in St. Louis, MO, by increasing the authorization amount from 

$69,053,000 to $346,300,000. 

Section 4. Authorization of fiscal year 2012 major medical facility 

leases 

Section 4(1) of the bill would authorize VA to carry out a major 

medical facility lease for a CBOC in Columbus, GA, in an amount 

not to exceed $5,335,000. 

Section 4(2) of the bill would authorize VA to carry out a major 

medical facility lease for an OC in Fort Wayne, IN, in an amount 

not to exceed $2,845,000. 

Section 4(3) of the bill would authorize VA to carry out a major 

medical facility lease for an OC in Mobile, AL, in an amount not 

to exceed $6,565,000. 

Section 4(4) of the bill would authorize VA to carry out a major 

medical facility lease for an OC in Rochester, NY, in an amount not 

to exceed $9,232,000. 

Section 4(5) of the bill would authorize VA to carry out a major 

medical facility lease for a CBOC in Salem, OR, in an amount not 

to exceed $2,549,000. 

Section 4(6) of the bill would authorize VA to carry out a major 

medical facility lease for an OC in San Jose, CA, in an amount not 

to exceed $9,546,000. 

Section 4(7) of the bill would authorize VA to carry out a major 

medical facility lease for an OC in South Bend, IN, in an amount 

not to exceed $6,731,000. 

Section 4(8) of the bill would authorize VA to carry out a major 

medical facility lease for a CBOC in Springfield, MO, in an amount 

not to exceed $6,489,000. 

Section 5. Authorization of appropriations 

Section 5(a) of the bill would authorize $87,300,000 in appropriations for the Construction, Major Projects account for the projects 

authorized in section 2. 


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Section 5(b) of the bill would authorize $850,070,000 in appropriations for the Construction, Major Projects account for the 

projects authorized in Section 3. 

Section 5(c) of the bill would authorize $49,292,000 in appropriations for the Medical Facilities account for the leases authorized in 

Section 4. 

Section 6. Modification of requirements relating to Congressional 

approval of certain medical facility acquisitions 

Section 6 of the bill would amend Section 8104 of title 38, United 

States Code, to clarify the level of detailed information VA must 

provide when requesting authorization for a major medical facility 

project or lease. 

Section 7. Name of Department of Veterans Affairs telehealth clinic, 

Craig, Colorado 

Section 7 of the bill would name the VA telehealth clinic in 

Craig, CO, the ‘‘Major William Edward Adams Department of Veterans Affairs Clinic.’’ 

Section 8. Extension of certain expiring authorities 

Section 8(a) of the bill would amend § 1703(d)(4) of title 38 U.S.C. 

to extend VA’s authority to conduct recovery audits for fee basis 

and other medical service contracts through September 30, 2020. 

Section 8(b) of the bill would amend § 2031(b) of title 38 U.S.C. 

to extend VA’s authority regarding treatment and rehabilitation for 

seriously mentally ill and homeless veterans through December 31, 

2012. 

Section 8(c) of the bill would amend § 2033(d) of title 38 U.S.C. 

to extend VA’s authority to expand and improve benefits to homeless veterans through September 30, 2012. 

Section 8(d) of the bill would amend § 2041(c) of title 38 U.S.C. 

to extend VA’s authority to enter into agreements with homeless 

providers for the purpose of selling, leasing, or donating homes acquired through the guaranteed loan program through December 31, 

2012. 

Section 8(e) of the bill would amend § 2066(d) of title 38 U.S.C. 

to extend Congressional authority to continue the Advisory Committee for Homeless Veterans through December 31, 2012. 

Section 8(f) of the bill would amend § 8118(a) of title 38 U.S.C. 

to extend VA’s authority to transfer real property under VA jurisdiction and control to other Federal agencies, State agencies, public 

or private entities, or Indian tribes through December 31, 2018. 

Section 9. George H. O’Brien, Jr. Department of Veterans Affairs 

Medical Center 

Section 9 of the bill would name the VA medical center located 

in Big Spring, TX, the ‘‘George H. O’Brien, Jr. Department of Veterans Affairs Medical Center.’’ 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitVerDate Mar 15 2010 06:09 Sep 16, 2011 Jkt 099006 PO 00000 Frm 00017 Fmt 6659 Sfmt 6602 E:\HR\OC\HR209.XXX HR209

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ted is enclosed in black brackets, new matter is printed in italic, 

existing law in which no change is proposed is shown in roman): 

VETERANS BENEFITS, HEALTH CARE, AND 

INFORMATION TECHNOLOGY ACT OF 2006 

* * * * * * * 

TITLE VIII—CONSTRUCTION MATTERS 

Subtitle A—Construction and Lease 

Authorities 

* * * * * * * 

SEC. 802. EXTENSION OF AUTHORIZATION FOR CERTAIN MAJOR 

MEDICAL FACILITY CONSTRUCTION PROJECTS PREVIOUSLY AUTHORIZED IN CONNECTION WITH CAPITAL 

ASSET REALIGNMENT INITIATIVE. 

The Secretary of Veterans Affairs may carry out the following 

major medical facility projects, with each such project to be carried 

out in the amount specified for that project: 

(1) * * * 

* * * * * * * 

(11) Construction of a new medical center facility in the Orlando, Florida, area, including a Simulation, Learning, Education, and Research Network Center, in an amount not to exceed $377,700,000. 

* * * * * * * 

SEC. 803. AUTHORIZATION OF FISCAL YEAR 2007 MAJOR MEDICAL 

FACILITY PROJECTS. 

The Secretary of Veterans Affairs may carry out the following 

major medical facility projects in fiscal year 2007 in the amount 

specified for each project: 

(1) * * * 

* * * * * * * 

(3) Construction of a new clinical addition and a parking 

garage at the Department of Veterans Affairs Medical Center, 

Fayetteville, Arkansas, in an amount not to exceed 

ø$56,163,000¿ $90,600,000. 

* * * * * * * 

(5) Medical facility improvements and cemetery expansion of 

Jefferson Barracks at the Department of Veterans Affairs Medical Center, St. Louis, Missouri, in an amount not to exceed 

ø$69,053,000¿ $346,300,000. 

* * * * * * * 

VETERANS’ MENTAL HEALTH AND OTHER CARE 

IMPROVEMENTS ACT OF 2008 

* * * * * * * 


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TITLE VII—AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND 

MAJOR MEDICAL FACILITY LEASES 

SEC. 701. AUTHORIZATION FOR FISCAL YEAR 2009 MAJOR MEDICAL 

FACILITY PROJECTS. 

The Secretary of Veterans Affairs may carry out the following 

major medical facility projects in fiscal year 2009 in the amount 

specified for each project: 

(1) * * * 

* * * * * * * 

(3) Seismic corrections, Building 1, at the Department of Veterans Affairs Medical Center, San Juan, Puerto Rico, in an 

amount not to exceed ø$225,900,000¿ $277,000,000. 

* * * * * * * 

TITLE 38, UNITED STATES CODE 

* * * * * * * 

PART II—GENERAL BENEFITS 

* * * * * * * 

CHAPTER 17—HOSPITAL, NURSING HOME, 

DOMICILIARY, AND MEDICAL CARE 

SUBCHAPTER I—GENERAL 

* * * * * * * 

§ 1703. Contracts for hospital care and medical services in 

non-Department facilities 

(a) * * * 

* * * * * * * 

(d)(1) * * * 

* * * * * * * 

(4) The authority of the Secretary under this subsection terminates on øSeptember 30, 2013¿ September 30, 2020. 

* * * * * * * 

CHAPTER 20—BENEFITS FOR HOMELESS VETERANS 

* * * * * * * 

SUBCHAPTER IV—TREATMENT AND REHABILITATION FOR 

SERIOUSLY MENTALLY ILL AND HOMELESS VETERANS 

§ 2031. General treatment 

(a) * * * 


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(b) The authority of the Secretary under subsection (a) expires on 

øDecember 31, 2011¿ December 31, 2012. 

* * * * * * * 

§ 2033. Additional services at certain locations 

(a) * * * 

* * * * * * * 

(d) The program under this section shall terminate on øDecember 

31, 2011¿ December 31, 2012. 

* * * * * * * 

SUBCHAPTER V—HOUSING ASSISTANCE 

§ 2041. Housing assistance for homeless veterans 

(a) * * * 

* * * * * * * 

(c) The Secretary may not enter into agreements under subsection (a) after øDecember 31, 2011¿ December 31, 2012. 

* * * * * * * 

SUBCHAPTER VII—OTHER PROVISIONS 

* * * * * * * 

§ 2066. Advisory Committee on Homeless Veterans 

(a) * * * 

* * * * * * * 

(d) TERMINATION.—The Committee shall cease to exist øDecember 30, 2011¿ December 31, 2012. 

* * * * * * * 

PART VI—ACQUISITION AND DISPOSITION OF 

PROPERTY 

* * * * * * * 

CHAPTER 81—ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT 

AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY 

SUBCHAPTER I—ACQUISITION AND OPERATION OF 

MEDICAL FACILITIES 

* * * * * * * 

§ 8104. Congressional approval of certain medical facility 

acquisitions 

(a) * * * 

(b) Whenever the President or the Secretary submit to the Congress a request for the funding of a major medical facility project 

(as defined in subsection (a)(3)(A)) or a major medical facility lease 


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(as defined in subsection (a)(3)(B)), the Secretary shall submit to 

each committee, on the same day, a prospectus of the proposed 

medical facility. Any such prospectus shall include the following: 

(1) A ødetailed description¿ detailed estimate of the total 

costs of the medical facility to be constructed, altered, leased, 

or otherwise acquired under this subchapter, including a description of the location of such facility and, in the case of a 

prospectus proposing the construction of a new or replacement 

medical facility, øa description of the consideration¿ a detailed 

report of the consideration that was given to acquiring an existing facility by lease or purchase and to the sharing of healthcare resources with the Department of Defense under section 

8111 of this title. Such detailed estimate shall include an identification of each of the following: 

(A) Total construction costs. 

(B) Activation costs. 

(C) Special purpose alterations (lump-sum payment) 

costs. 

(D) Number of personnel. 

(E) Total costs of ancillary services, equipment, and all 

other items. 

ø(2) An estimate of the cost to the United States of the construction, alteration, lease, or other acquisition of such facility 

(including site costs, if applicable). 

ø(3) An estimate of the cost to the United States of the 

equipment required for the operation of such facility.¿ 

ø(4)¿ (2) Demographic data applicable to such facility, including information on projected changes in the population of 

veterans to be served by the facility over øa five-year period 

and a ten-year period¿ a five-year period, a ten-year period, 

and a twenty-year period. ø(5)¿ (3) Current and projected workload and utilization data 

regarding the facility, including information on projected 

changes in workload and utilization over a five-year period, a 

ten-year period, and a twenty-year period. ø(6) Current and projected¿ (4) Projected operating costs of 

the facility, including both recurring and non-recurring costs 

(including and identifying both recurring and non-recurring 

costs (including activation costs and total costs of ancillary 

services, equipment and all other items)) over a five-year period, 

a ten-year period, and a twenty-year period. 

* * * * * * * 

ø(7)¿ (5) The priority score assigned to the project or lease 

under the Department’s prioritization methodology and, if the 

project or lease is being proposed for funding before a project 

or lease with a higher score, a specific explanation of the factors other than the priority score that were considered and the 

basis on which the project or lease is proposed for funding 

ahead of projects or leases with higher priority scores. 

ø(8)¿ (6) In the case of a prospectus proposing the construction of a new or replacement medical facility, øa description of 

each alternative to construction of the facility that was considered.¿ each of the following: 

(A) A detailed estimate of the total costs (including total 

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ations (lump-sum payment) costs, number of personnel and 

total costs of ancillary services, equipment and all other 

items) for each alternative to construction of the facility 

that was considered. 

(B) A comparison of total costs to total benefits for each 

such alternative. 

(C) An explanation of why the preferred alternative is the 

most effective means to achieve the stated project goals and 

the most cost-effective alternative. 

* * * * * * * 

(d)(1) * * * 

(2)(A) In any fiscal year, unobligated amounts in the Construction, Major Projects account that are a direct result of bid savings 

from a ømajor medical facility project¿ major construction project 

may only be obligated for ømajor medical facility projects¿ major 

construction projects authorized for that fiscal year or a previous 

fiscal year. 

(B) Whenever the Secretary obligates amounts for a ømajor medical facility¿ major construction project under subparagraph (A), 

the Secretary shall submit to the Committee on Veterans’ Affairs 

and the Committee on Appropriations of the Senate and the Committee on Veterans’ Affairs and the Committee on Appropriations 

of the House of Representatives notice of the following: 

(i) The ømajor medical facility project¿ major construction 

project that is the source of the bid savings. 

(ii) The other ømajor medical facility project¿ major construction project for which the amounts are being obligated. 

(iii) The amounts being obligated for such other ømajor medical facility project¿ major construction project. 

* * * * * * * 

§ 8118. Authority for transfer of real property; Department 

of Veterans Affairs Capital Asset Fund 

(a)(1) * * * 

* * * * * * * 

(5) The authority of the Secretary under paragraph (1) expires on 

øthe date that is seven years after the date of the enactment of this 

section¿ December 31, 2018. 

* * * * * * * 

Æ 


jbell on DSK7SPTVN1PROD with REPORTS