Union Calendar No. 282

104TH CONGRESS

2D SESSION H. R. 3376

[Report No. 104–574]

A BILL

To authorize major medical facility projects and

other purposes.of Veterans Affairs for fiscal year 1997, and formajor medical facility leases for the Department

MAY 14, 1996

Reported with an amendment, committed to the Commitordered to be printed tee of the Whole House on the State of the Union, and
IB

Union Calendar No. 282

104TH CONGRESS

2D SESSION H. R. 3376

[Report No. 104–574]

To authorize major medical facility projects and major medical facility leases

for the Department of Veterans Affairs for fiscal year 1997, and for

other purposes.

IN THE HOUSE OF REPRESENTATIVES

MAY 1, 1996

Mr. STUMP (for himself, Mr. MONTGOMERY, Mr. HUTCHINSON, and Mr. EDWARDS) introduced the following bill; which was referred to the Committee on Veterans’ Affairs

MAY 14, 1996

Additional sponsors: Mr. SMITH of New Jersey, Mr. BILIRAKIS, Mr. EVERETT,

Mr. BUYER, Mr. STEARNS, Mr. FLANAGAN, Mr. WELLER, Mr. CLEMENT,

Mr. FILNER, Mr. BISHOP, and Mr. MASCARA

MAY 14, 1996

Reported with an amendment, committed to the Committee of the Whole

House on the State of the Union, and ordered to be printed

[Omit the part struck through and insert the part printed in italic]

A BILL

To authorize major medical facility projects and major medical facility leases for the Department of Veterans Affairs

for fiscal year 1997, and for other purposes.
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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 TITLE I—CONSTRUCTION

4 AUTHORIZATION

5 SEC. 101. AUTHORIZATION OF MAJOR MEDICAL FACILITY

6 PROJECTS.

7 (a) AMBULATORY CARE ADDITION PROJECTS.—The

8 Secretary of Veterans Affairs may carry out the following

9 ambulatory care addition major medical facility projects,

10 with each project to be carried out in the amount specified

11 for that project:

12 (1) Addition of ambulatory care facilities for

13 mental health enhancements at the Department of

14 Veterans Affairs medical center in Dallas, Texas,

15 $19,900,000.

16 (2) Addition of ambulatory care facilities at the

17 Department of Veterans Affairs medical center in

18 Brockton, Massachusetts, $13,500,000.

19 (3) Addition of ambulatory care facilities for

20 outpatient improvements at the Department of Vet21 erans Affairs medical center in Shreveport, Louisi22 ana, $25,000,000.

23 (4) Addition of ambulatory care facilities at the

24 Department of Veterans Affairs medical center in

25 Lyons, New Jersey, $21,100,000.
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1 (5) Addition of ambulatory care facilities at the

2 Department of Veterans Affairs medical center in

3 Tomah, Wisconsin, $12,700,000.

4 (6) Addition of ambulatory care facilities at the

5 Department of Veterans Affairs medical center in

6 Asheville, North Carolina, in the amount of

7 $28,800,000.

8 (7) Addition of ambulatory care facilities at the

9 Department of Veterans Affairs medical center in

10 Temple, Texas, in the amount of $9,800,000.

11 (8) Addition of ambulatory care facilities at the

12 Department of Veterans Affairs medical center in

13 Tucson, Arizona, in the amount of $35,500,000.

14 (b) ENVIRONMENTAL IMPROVEMENT PROJECTS.—

15 The Secretary of Veterans Affairs may carry out the fol16 lowing environmental improvement major medical facility

17 projects, with each project to be carried out in the amount

18 specified for that project:

19 (1) Environmental improvements for the ren20 ovation of nursing home facilities at the Department

21 of Veterans Affairs medical center in Lebanon,

22 Pennsylvania, in the amount of $9,500,000.

23 (2) Environmental improvements at the Depart24 ment of Veterans Affairs medical center in Marion,

25 Illinois, in the amount of $11,500,000.
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1 (3) Environmental improvements to modernize

2 patient wards at the Department of Veterans Affairs

3 medical center in Atlanta, Georgia, $28,200,000.

4 (4) Environmental improvements for the re5 placement of a psychiatric bed building at the De6 partment of Veterans Affairs medical center in Bat7 tle Creek, Michigan, $22,900,000.

8 (5) Environmental improvements for ward ren9 ovation for patient privacy at the Department of

10 Veterans Affairs medical center in Omaha, Ne11 braska, $7,700,000.

12 (6) Environmental improvements at the Depart13 ment of Veterans Affairs medical center in Pitts14 burgh, Pennsylvania, $17,400,000.

15 (7) Environmental improvements for the ren16 ovation of various buildings at the Department of

17 Veterans Affairs medical center in Waco, Texas,

18 $26,000,000.

19 (8) Environmental improvements for the re20 placement of psychiatric beds at the Department of

21 Veterans Affairs medical center in Marion, Indiana,

22 in the amount of $17,300,000.

23 (9) Environmental improvements for the ren24 ovation of psychiatric wards at the Department of
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1 Veterans Affairs medical center in Perry Point,

2 Maryland, in the amount of $15,100,000.

3 (10) Environmental enhancement at the De4 partment of Veterans Affairs medical center in

5 Salisbury, North Carolina, in the amount of

6 $18,200,000.

7 (c) SEISMIC CORRECTION PROJECTS.—The Secretary

8 of Veterans Affairs may carry out the following seismic

9 correction major medical facility projects, with each

10 project to be carried out in the amount specified for that

11 project:

12 (1) Seismic corrections at the Department of

13 Veterans Affairs medical center in Palo Alto, Cali14 fornia, in the amount of $36,000,000.

15 (2) Seismic corrections at the Department of

16 Veterans Affairs medical center in Long Beach,

17 California, in the amount of $20,200,000.

18 (3) Seismic corrections at the Department of

19 Veterans Affairs medical center in San Francisco,

20 California, $26,000,000.

21 SEC. 102. AUTHORIZATION OF MAJOR MEDICAL FACILITY

22 LEASES.

23 The Secretary of Veterans Affairs may enter into

24 leases for medical facilities as follows:
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1 (1) Lease of a satellite outpatient clinic in Al2 lentown, Pennsylvania, in an amount not to exceed

3 $2,159,000.

4 (2) Lease of a satellite outpatient clinic in

5 Beaumont, Texas, in an amount not to exceed

6 $1,940,000.

7 (3) Lease of a satellite outpatient clinic in Bos8 ton, Massachusetts, in an amount not to exceed

9 $2,358,000.

10 (4) Lease of a parking facility in Cleveland,

11 Ohio, in an amount not to exceed $1,300,000.

12 (5) Lease of a satellite outpatient clinic and

13 Veterans Benefits Administration field office in San

14 Antonio, Texas, in an amount not to exceed

15 $2,256,000.

16 (6) Lease of a satellite outpatient clinic in To17 ledo, Ohio, in an amount not to exceed $2,223,000.

18 SEC. 103. AUTHORIZATION OF APPROPRIATIONS.

19 (a) IN GENERAL.—There are authorized to be appro20 priated to the Secretary of Veterans Affairs for fiscal year

21 1997—

22 (1) for the Construction, Major Projects, ac23 count, $422,300,000 for the projects authorized in

24 section 101; and
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1 (2) for the Medical Care account, $12,236,000

2 for the leases authorized in section 102.

3 (b) LIMITATION.—The projects authorized in section

4 101 may only be carried out using—

5 (1) funds appropriated for fiscal year 1997 pur6 suant to the authorization of appropriations in sub7 section (a);

8 (2) funds appropriated for Construction, Major

9 Projects for a fiscal year before fiscal year 1997 that

10 remain available for obligation; and

11 (3) funds appropriated for Construction, Major

12 Projects for fiscal year 1997 for a category of activ13 ity not specific to a project.

14 SEC. 104. REPORT ON HEALTH CARE NEEDS OF VETERANS

15 IN EAST CENTRAL FLORIDA.

16 (a) REPORT REQUIRED.—Not later than 60 days

17 after the date of the enactment of this Act, the Secretary

18 of Veterans Affairs shall submit to the Committees on

19 Veterans’ Affairs of the Senate and House of Representa20 tives a report on the health care needs of veterans in east

21 central Florida. In preparing the report, the Secretary

22 shall consider the needs of such veterans for psychiatric

23 and long-term care. The Secretary shall include in the re24 port the Secretary’s views, based on the Secretary’s deter25 mination of such needs, as to the best means of meeting
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1 such needs using the amounts appropriated pursuant to

2 the authorization of appropriations in this Act and Public

3 Law 103–452 for projects to meet the health care needs

4 of such veterans. The Secretary may, subject to the avail5 ability of appropriations for such purpose, use an inde6 pendent contractor to assist in the determination of such

7 health care needs.

8 (b) LIMITATION.—The Secretary may not obligate

9 any funds, other than for design work, for the conversion

10 of the former Orlando Naval Training Center Hospital in

11 Orlando, Florida (now under the jurisdiction of the Sec12 retary of Veterans Affairs), to a nursing home care unit

13 until 15 days 45 days after the date on which the report

14 required by subsection (a) is submitted.

15 TITLE II—STRATEGIC PLANNING

16 FOR HEALTH CARE RESOURCES

17 SEC. 201. STRATEGIC PLANNING.

18 Section 8107 of title 38, United States Code, is

19 amended—

20 (1) by redesignating subsection (b) as sub21 section (c);

22 (2) by striking out subsection (a) and inserting

23 in lieu thereof the following new subsections:

24 ‘‘(a) In order to promote effective planning for the

25 efficient provision of care to eligible veterans, the Sec-
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1 retary, based on the analysis and recommendations of the

2 Under Secretary for Health, shall submit to each commit3 tee, not later than January 31 of each year, a report re4 garding long-range health planning of the Department.

5 ‘‘(b) Each report under subsection (a) shall include

6 the following:

7 ‘‘(1) A five-year strategic plan for the provision

8 of care under chapter 17 of this title to eligible vet9 erans through coordinated networks of medical fa10 cilities operating within prescribed geographic serv11 ice-delivery areas, such plan to include provision of

12 services for the specialized treatment and rehabilita13 tive needs of disabled veterans (including veterans

14 with spinal cord dysfunction, blindness, amputations,

15 and mental illness) through distinct programs or fa16 cilities of the Department dedicated to the special17 ized needs of those veterans.

18 ‘‘(2) A description of how planning for the net19 works will be coordinated.

20 ‘‘(3) A profile regarding each such network of

21 medical facilities which identifies—

22 ‘‘(A) the mission of each existing or pro23 posed medical facility in the network;
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1 ‘‘(B) any planned change in the mission

2 for any such facility and the rationale for such

3 planned change;

4 ‘‘(C) the population of veterans to be

5 served by the network and anticipated changes

6 over a five-year period and a ten-year period,

7 respectively, in that population and in the

8 health-care needs of that population;

9 ‘‘(D) information relevant to assessing

10 progress toward the goal of achieving relative

11 equivalency in the level of resources per patient

12 distributed to each network, such information

13 to include the plans for and progress toward

14 lowering the cost of care-delivery in the network

15 (by means such as changes in the mix in the

16 network of physicians, nurses, physician assist17 ants, and advance practice nurses);

18 ‘‘(E) the capacity of non-Federal facilities

19 in the network to provide acute, long-term, and

20 specialized treatment and rehabilitative services

21 (described in section 7305 of this title), and de22 terminations regarding the extent to which

23 services to be provided in each service-delivery

24 area and each facility in such area should be

25 provided directly through facilities of the De-
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1 partment or through contract or other arrange2 ments, including arrangements authorized

3 under sections 8111 and 8153 of this title; and

4 ‘‘(F) a five-year plan for construction, re5 placement, or alteration projects in support of

6 the approved mission of each facility in the net7 work and a description of how those projects

8 will improve access to care, or quality of care,

9 for patients served in the network.

10 ‘‘(4) A status report for each facility on

11 progress toward—

12 ‘‘(A) instituting planned mission changes

13 identified under paragraph (3)(B);

14 ‘‘(B) implementing principles of managed

15 care of eligible veterans; and

16 ‘‘(C) developing and instituting cost-effec17 tive alternatives to provision of institutional

18 care.’’; and

19 (3) by adding at the end the following new sub20 section:

21 ‘‘(d)(1) The Secretary shall submit to each commit22 tee, not later than January 31 of each year, a report show23 ing the current priorities of the Department for proposed

24 major medical construction projects. Each such report

25 shall identify the 20 projects, from within all the projects
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1 in the Department’s inventory of proposed projects, that

2 have the highest priority and, for those 20 projects, the

3 relative priority and rank scoring of each such project.

4 The 20 projects shall be compiled, and their relative

5 rankings shall be shown, by category of project (including

6 the categories of ambulatory care projects, nursing home

7 care projects, and such other categories as the Secretary

8 determines).

9 ‘‘(2) The Secretary shall include in each report, for

10 each project listed, a description of the specific factors

11 that account for the relative ranking of that project in re12 lation to other projects within the same category.

13 ‘‘(3) In a case in which the relative ranking of a pro14 posed project has changed since the last report under this

15 subsection was submitted, the Secretary shall also include

16 in the report a description of the reasons for the change

17 in the ranking, including an explanation of any change in

18 the scoring of the project under the Department’s scoring

19 system for proposed major medical construction

20 projects.’’.

21 SEC. 202. REVISION TO PROSPECTUS REQUIREMENTS.

22 (a) ADDITIONAL INFORMATION.—Section 8104(b) of

23 title 38, United States Code, is amended—

24 (1) by striking out ‘‘shall include—’’ and insert25 ing in lieu thereof ‘‘shall include the following:’’;
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1 (2) in paragraph (1)—

2 (A) by striking out ‘‘a detailed’’ and insert3 ing in lieu thereof ‘‘A detailed’’; and

4 (B) by striking out the semicolon at the

5 end and inserting in lieu thereof a period;

6 (3) in paragraph (2)—

7 (A) by striking out ‘‘an estimate’’ and in8 serting in lieu thereof ‘‘An estimate’’; and

9 (B) by striking out ‘‘; and’’ and inserting

10 in lieu thereof a period;

11 (4) in paragraph (3), by striking out ‘‘an esti12 mate’’ and inserting in lieu thereof ‘‘An estimate’’;

13 and

14 (5) by adding at the end the following new

15 paragraphs:

16 ‘‘(4) Demographic data applicable to the

17 project, including information on projected changes

18 in the population of veterans to be served by the

19 project over a five-year period and a ten-year period.

20 ‘‘(5) Current and projected workload and utili21 zation data.

22 ‘‘(6) Current and projected operating costs of

23 the facility, to include both recurring and non-recur24 ring costs.
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1 ‘‘(7) The priority score assigned to the project

2 under the Department’s prioritization methodology

3 and, if the project is being proposed for funding

4 ahead of a project with a higher score, a specific ex5 planation of the factors other than the priority that

6 were considered and the basis on which the project

7 is proposed for funding ahead of projects with high8 er priority scores.

9 ‘‘(8) A listing of each alternative to construc10 tion of the facility that has been considered.’’.

11 (b) APPLICABILITY.—The amendments made by sub12 section (a) shall apply with respect to any prospectus sub13 mitted by the Secretary of Veterans Affairs after the date

14 of the enactment of this Act.

15 SEC. 203. CONSTRUCTION AUTHORIZATION REQUIRE16 MENTS.

17 (a) DEFINITION OF MAJOR MEDICAL FACILITY

18 PROJECT.—Paragraph (3)(A) of section 8104(a) of title

19 38, United States Code, is amended by striking out

20 ‘‘$3,000,000’’ and inserting ‘‘$5,000,000’’.

21 (b) APPLICABILITY OF CONSTRUCTION AUTHORIZA22 TION REQUIREMENT.—(1) Subsection (b) of section 301

23 of the Veterans’ Medical Programs Amendments of 1992

24 (Public Law 102–405; 106 Stat. 1984) is repealed.
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1 (2) The amendments made by subsection (a) of such

2 section shall apply with respect to any major medical facil3 ity project or any major medical facility lease of the De4 partment of Veterans Affairs, regardless of when funds

5 are first appropriated for that project or lease, except that

6 in the case of a project for which funds were first appro7 priated before October 9, 1992, such amendments shall

8 not apply with respect to amounts appropriated for that

9 project for a fiscal year before fiscal year 1998.

10 (c) LIMITATION ON OBLIGATIONS FOR ADVANCE

11 PLANNING.—Section 8104 of title 38, United States Code,

12 is amended by adding at the end the following new sub13 section:

14 ‘‘(f) The Secretary may not obligate funds in an

15 amount in excess of $500,000 from the Advance Planning

16 Fund of the Department toward design or development

17 of a major medical facility project until—

18 ‘‘(1) the Secretary submits to the committees a

19 report on the proposed obligation; and

20 ‘‘(2) a period of 30 days has passed after the

21 date on which the report is received by the commit22 tees.’’.

23 SEC. 204. TERMINOLOGY CHANGES.

24 (a) DEFINITION OF ‘‘CONSTRUCT’’.—Section

25 8101(2) of title 38, United States Code, is amended—
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1 (1) by striking out ‘‘working drawings’’ and in2 serting in lieu thereof ‘‘construction documents’’;

3 and

4 (2) by striking out ‘‘preliminary plans’’ and in5 serting in lieu thereof ‘‘design development’’.

6 (b) PARKING FACILITIES.—Section 8109(h)(3)(B) of

7 such title is amended by striking out ‘‘working drawings’’

8 and inserting in lieu thereof ‘‘construction documents’’.

9 SEC. 205. VETERANS HEALTH ADMINISTRATION HEAD10 QUARTERS.

11 (a) REPEAL OF STATUTORY SPECIFICATION OF OR12 GANIZATIONAL SERVICES.—The text of section 7305 of

13 title 38, United States Code, is amended to read as fol14 lows:

15 ‘‘(a) The Veterans Health Administration shall in16 clude the Office of the Under Secretary for Health and

17 such professional and auxiliary services as the Secretary

18 may find to be necessary to carry out the functions of the

19 Administration.

20 ‘‘(b) In organizing, and appointing persons to posi21 tions in, the Office, the Under Secretary shall ensure that

22 the Office is staffed so as to provide the Under Secretary

23 with appropriate expertise, including expertise in—

24 ‘‘(1) unique programs operated by the Adminis25 tration to provide for the specialized treatment and
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1 rehabilitation of disabled veterans (including blind

2 rehabilitation, spinal cord dysfunction, mental ill3 ness, and geriatrics and long-term care); and

4 ‘‘(2) appropriate clinical care disciplines.’’.

5 (b) OFFICE OF THE UNDER SECRETARY.—Section

6 7306 of such title is amended—

7 (1) in subsection (a)—

8 (A) by striking out ‘‘and who shall be a

9 qualified doctor of medicine’’ in paragraph (2);

10 (B) by striking out paragraphs (5), (6),

11 and (7); and

12 (C) by redesignating the succeeding two

13 paragraphs as paragraphs (5) and (6), respec14 tively; and

15 (2) in subsection (b)—

16 (A) by striking out ‘‘subsection (a)(3)’’

17 and all that follows through ‘‘two may be’’ and

18 inserting in lieu thereof ‘‘subsection (a)(3), not

19 more than two may be’’;

20 (B) by striking out the semicolon after

21 ‘‘dental medicines’’ and inserting in lieu thereof

22 a period; and

23 (C) by striking out paragraphs (2) and (3).
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1 TITLE III—OTHER MATTERS

2 SEC. 301. NAME OF DEPARTMENT OF VETERANS AFFAIRS

3 MEDICAL CENTER, JACKSON, MISSISSIPPI.

4 (a) NAME.—The Department of Veterans Affairs

5 medical center in Jackson, Mississippi, shall be known and

6 designated as the ‘‘G. V. Sonny Montgomery Department

7 of Veterans Affairs Medical Center’’. Any reference to

8 such medical center in any law, regulation, map, docu9 ment, record, or other paper of the United States shall

10 be considered to be a reference to the G. V. Sonny Mont11 gomery Department of Veterans Affairs Medical Center.

12 (b) EFFECTIVE DATE.—Subsection (a) shall take ef13 fect at noon on January 3, 1997, or the first day on which

14 G. V. Sonny Montgomery otherwise ceases to be a Member

15 of the House of Representatives.

16 SEC 302. NAME OF DEPARTMENT OF VETERANS AFFAIRS

17 MEDICAL CENTER, JOHNSON CITY, TEN18 NESSEE.

19 (a) NAME.—The Mountain Home Department of

20 Veterans Affairs medical center in Johnson City, Ten21 nessee, shall after the date of the enactment of this Act

22 be known and designated as the ‘‘James H. Quillen De23 partment of Veterans Affairs Medical Center’’. Any ref24 erence to such medical center in any law, regulation, map,

25 document, record, or other paper of the United States
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1 shall be considered to be a reference to the James H. Quil2 len Department of Veterans Affairs Medical Center.

3 (b) EFFECTIVE DATE.—Subsection (a) shall take ef4 fect at noon on January 3, 1997, or the first day on which

5 James H. Quillen otherwise ceases to be a Member of the

6 House of Representatives.

7 SEC. 303. NAME OF DEPARTMENT OF VETERANS AFFAIRS

8 NURSING CARE CENTER, ASPINWALL, PENN9 SYLVANIA.

10 The Department of Veterans Affairs nursing care

11 center at the Department of Veterans Affairs medical cen12 ter in Aspinwall, Pennsylvania, shall after the date of the

13 enactment of this Act be known and designated as the ‘‘H.

14 John Heinz, III Department of Veterans Affairs Nursing

15 Care Center’’. Any reference to such nursing care center

16 in any law, regulation, map, document, record, or other

17 paper of the United States shall be considered to be a ref18 erence to the H. John Heinz, III Department of Veterans

19 Affairs Nursing Care Center.

20 SEC. 304. RESTORATION OF AUTHORITY FOR ESTABLISH21 MENT OF DEPARTMENT OF VETERANS AF22 FAIRS RESEARCH CORPORATIONS.

23 Section 7368 of title 38, United States Code, is

24 amended by striking out ‘‘December 31, 1992’’ and insert25 ing in lieu thereof ‘‘December 31, 2000’’.