I

104TH CONGRESS

2D SESSION H. R. 3376

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

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.

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,
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1 with each project to be carried out in the amount specified

2 for that project:

3 (1) Addition of ambulatory care facilities for

4 mental health enhancements at the Department of

5 Veterans Affairs medical center in Dallas, Texas,

6 $19,900,000.

7 (2) Addition of ambulatory care facilities at the

8 Department of Veterans Affairs medical center in

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

10 (3) Addition of ambulatory care facilities for

11 outpatient improvements at the Department of Vet12 erans Affairs medical center in Shreveport, Louisi13 ana, $25,000,000.

14 (4) Addition of ambulatory care facilities at the

15 Department of Veterans Affairs medical center in

16 Lyons, New Jersey, $21,100,000.

17 (5) Addition of ambulatory care facilities at the

18 Department of Veterans Affairs medical center in

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

20 (6) Addition of ambulatory care facilities at the

21 Department of Veterans Affairs medical center in

22 Asheville, North Carolina, in the amount of

23 $28,800,000.
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1 (7) Addition of ambulatory care facilities at the

2 Department of Veterans Affairs medical center in

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

4 (8) Addition of ambulatory care facilities at the

5 Department of Veterans Affairs medical center in

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

7 (b) ENVIRONMENTAL IMPROVEMENT PROJECTS.—

8 The Secretary of Veterans Affairs may carry out the fol9 lowing environmental improvement major medical facility

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

11 specified for that project:

12 (1) Environmental improvements for the ren13 ovation of nursing home facilities at the Department

14 of Veterans Affairs medical center in Lebanon,

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

16 (2) Environmental improvements at the Depart17 ment of Veterans Affairs medical center in Marion,

18 Illinois, in the amount of $11,500,000.

19 (3) Environmental improvements to modernize

20 patient wards at the Department of Veterans Affairs

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

22 (4) Environmental improvements for the re23 placement of a psychiatric bed building at the De24 partment of Veterans Affairs medical center in Bat25 tle Creek, Michigan, $22,900,000.
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1 (5) Environmental improvements for ward ren2 ovation for patient privacy at the Department of

3 Veterans Affairs medical center in Omaha, Ne4 braska, $7,700,000.

5 (6) Environmental improvements at the Depart6 ment of Veterans Affairs medical center in Pitts7 burgh, Pennsylvania, $17,400,000.

8 (7) Environmental improvements for the ren9 ovation of various buildings at the Department of

10 Veterans Affairs medical center in Waco, Texas,

11 $26,000,000.

12 (8) Environmental improvements for the re13 placement of psychiatric beds at the Department of

14 Veterans Affairs medical center in Marion, Indiana,

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

16 (9) Environmental improvements for the ren17 ovation of psychiatric wards at the Department of

18 Veterans Affairs medical center in Perry Point,

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

20 (10) Environmental enhancement at the De21 partment of Veterans Affairs medical center in

22 Salisbury, North Carolina, in the amount of

23 $18,200,000.

24 (c) SEISMIC CORRECTION PROJECTS.—The Secretary

25 of Veterans Affairs may carry out the following seismic
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1 correction major medical facility projects, with each

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

3 project:

4 (1) Seismic corrections at the Department of

5 Veterans Affairs medical center in Palo Alto, Cali6 fornia, in the amount of $36,000,000.

7 (2) Seismic corrections at the Department of

8 Veterans Affairs medical center in Long Beach,

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

10 (3) Seismic corrections at the Department of

11 Veterans Affairs medical center in San Francisco,

12 California, $26,000,000.

13 SEC. 102. AUTHORIZATION OF MAJOR MEDICAL FACILITY

14 LEASES.

15 The Secretary of Veterans Affairs may enter into

16 leases for medical facilities as follows:

17 (1) Lease of a satellite outpatient clinic in Al18 lentown, Pennsylvania, in an amount not to exceed

19 $2,159,000.

20 (2) Lease of a satellite outpatient clinic in

21 Beaumont, Texas, in an amount not to exceed

22 $1,940,000.

23 (3) Lease of a satellite outpatient clinic in Bos24 ton, Massachusetts, in an amount not to exceed

25 $2,358,000.
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1 (4) Lease of a parking facility in Cleveland,

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

3 (5) Lease of a satellite outpatient clinic and

4 Veterans Benefits Administration field office in San

5 Antonio, Texas, in an amount not to exceed

6 $2,256,000.

7 (6) Lease of a satellite outpatient clinic in To8 ledo, Ohio, in an amount not to exceed $2,223,000.

9 SEC. 103. AUTHORIZATION OF APPROPRIATIONS.

10 (a) IN GENERAL.—There are authorized to be appro11 priated to the Secretary of Veterans Affairs for fiscal year

12 1997—

13 (1) for the Construction, Major Projects, ac14 count, $422,300,000 for the projects authorized in

15 section 101; and

16 (2) for the Medical Care account, $12,236,000

17 for the leases authorized in section 102.

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

19 101 may only be carried out using—

20 (1) funds appropriated for fiscal year 1997 pur21 suant to the authorization of appropriations in sub22 section (a);

23 (2) funds appropriated for Construction, Major

24 Projects for a fiscal year before fiscal year 1997 that

25 remain available for obligation; and
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1 (3) funds appropriated for Construction, Major

2 Projects for fiscal year 1997 for a category of activ3 ity not specific to a project.

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

5 IN EAST CENTRAL FLORIDA.

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

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

8 of Veterans Affairs shall submit to the Committees on

9 Veterans’ Affairs of the Senate and House of Representa10 tives a report on the health care needs of veterans in east

11 central Florida. In preparing the report, the Secretary

12 shall consider the needs of such veterans for psychiatric

13 and long-term care. The Secretary shall include in the re14 port the Secretary’s views, based on the Secretary’s deter15 mination of such needs, as to the best means of meeting

16 such needs using the amounts appropriated pursuant to

17 the authorization of appropriations in this Act and Public

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

19 of such veterans. The Secretary may, subject to the avail20 ability of appropriations for such purpose, use an inde21 pendent contractor to assist in the determination of such

22 health care needs.

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

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

25 of the former Orlando Naval Training Center Hospital in
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1 Orlando, Florida (now under the jurisdiction of the Sec2 retary of Veterans Affairs), to a nursing home care unit

3 until 15 days after the date on which the report required

4 by subsection (a) is submitted.

5 TITLE II—STRATEGIC PLANNING

6 FOR HEALTH CARE RESOURCES

7 SEC. 201. STRATEGIC PLANNING.

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

9 amended—

10 (1) by redesignating subsection (b) as sub11 section (c);

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

13 in lieu thereof the following new subsections:

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

15 efficient provision of care to eligible veterans, the Sec16 retary, based on the analysis and recommendations of the

17 Under Secretary for Health, shall submit to each commit18 tee, not later than January 31 of each year, a report re19 garding long-range health planning of the Department.

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

21 the following:

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

23 of care under chapter 17 of this title to eligible vet24 erans through coordinated networks of medical fa25 cilities operating within prescribed geographic serv-
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1 ice-delivery areas, such plan to include provision of

2 services for the specialized treatment and rehabilita3 tive needs of disabled veterans (including veterans

4 with spinal cord dysfunction, blindness, amputations,

5 and mental illness) through distinct programs or fa6 cilities of the Department dedicated to the special7 ized needs of those veterans.

8 ‘‘(2) A description of how planning for the net9 works will be coordinated.

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

11 medical facilities which identifies—

12 ‘‘(A) the mission of each existing or pro13 posed medical facility in the network;

14 ‘‘(B) any planned change in the mission

15 for any such facility and the rationale for such

16 planned change;

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

18 served by the network and anticipated changes

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

20 respectively, in that population and in the

21 health-care needs of that population;

22 ‘‘(D) information relevant to assessing

23 progress toward the goal of achieving relative

24 equivalency in the level of resources per patient

25 distributed to each network, such information
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1 to include the plans for and progress toward

2 lowering the cost of care-delivery in the network

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

4 network of physicians, nurses, physician assist5 ants, and advance practice nurses);

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

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

8 specialized treatment and rehabilitative services

9 (described in section 7305 of this title), and de10 terminations regarding the extent to which

11 services to be provided in each service-delivery

12 area and each facility in such area should be

13 provided directly through facilities of the De14 partment or through contract or other arrange15 ments, including arrangements authorized

16 under sections 8111 and 8153 of this title; and

17 ‘‘(F) a five-year plan for construction, re18 placement, or alteration projects in support of

19 the approved mission of each facility in the net20 work and a description of how those projects

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

22 for patients served in the network.

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

24 progress toward—
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1 ‘‘(A) instituting planned mission changes

2 identified under paragraph (3)(B);

3 ‘‘(B) implementing principles of managed

4 care of eligible veterans; and

5 ‘‘(C) developing and instituting cost-effec6 tive alternatives to provision of institutional

7 care.’’; and

8 (3) by adding at the end the following new sub9 section:

10 ‘‘(d)(1) The Secretary shall submit to each commit11 tee, not later than January 31 of each year, a report show12 ing the current priorities of the Department for proposed

13 major medical construction projects. Each such report

14 shall identify the 20 projects, from within all the projects

15 in the Department’s inventory of proposed projects, that

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

17 relative priority and rank scoring of each such project.

18 The 20 projects shall be compiled, and their relative

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

20 the categories of ambulatory care projects, nursing home

21 care projects, and such other categories as the Secretary

22 determines).

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

24 each project listed, a description of the specific factors
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1 that account for the relative ranking of that project in re2 lation to other projects within the same category.

3 ‘‘(3) In a case in which the relative ranking of a pro4 posed project has changed since the last report under this

5 subsection was submitted, the Secretary shall also include

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

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

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

9 system for proposed major medical construction

10 projects.’’.

11 SEC. 202. REVISION TO PROSPECTUS REQUIREMENTS.

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

13 title 38, United States Code, is amended—

14 (1) by striking out ‘‘shall include—’’ and insert15 ing in lieu thereof ‘‘shall include the following:’’;

16 (2) in paragraph (1)—

17 (A) by striking out ‘‘a detailed’’ and insert18 ing in lieu thereof ‘‘A detailed’’; and

19 (B) by striking out the semicolon at the

20 end and inserting in lieu thereof a period;

21 (3) in paragraph (2)—

22 (A) by striking out ‘‘an estimate’’ and in23 serting in lieu thereof ‘‘An estimate’’; and

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

25 in lieu thereof a period;
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1 (4) in paragraph (3), by striking out ‘‘an esti2 mate’’ and inserting in lieu thereof ‘‘An estimate’’;

3 and

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

5 paragraphs:

6 ‘‘(4) Demographic data applicable to the

7 project, including information on projected changes

8 in the population of veterans to be served by the

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

10 ‘‘(5) Current and projected workload and utili11 zation data.

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

13 the facility, to include both recurring and non-recur14 ring costs.

15 ‘‘(7) The priority score assigned to the project

16 under the Department’s prioritization methodology

17 and, if the project is being proposed for funding

18 ahead of a project with a higher score, a specific ex19 planation of the factors other than the priority that

20 were considered and the basis on which the project

21 is proposed for funding ahead of projects with high22 er priority scores.

23 ‘‘(8) A listing of each alternative to construc24 tion of the facility that has been considered.’’.
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1 (b) APPLICABILITY.—The amendments made by sub2 section (a) shall apply with respect to any prospectus sub3 mitted by the Secretary of Veterans Affairs after the date

4 of the enactment of this Act.

5 SEC. 203. CONSTRUCTION AUTHORIZATION REQUIRE6 MENTS.

7 (a) DEFINITION OF MAJOR MEDICAL FACILITY

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

9 38, United States Code, is amended by striking out

10 ‘‘$3,000,000’’ and inserting ‘‘$5,000,000’’.

11 (b) APPLICABILITY OF CONSTRUCTION AUTHORIZA12 TION REQUIREMENT.—(1) Subsection (b) of section 301

13 of the Veterans’ Medical Programs Amendments of 1992

14 (Public Law 102–405; 106 Stat. 1984) is repealed.

15 (2) The amendments made by subsection (a) of such

16 section shall apply with respect to any major medical facil17 ity project or any major medical facility lease of the De18 partment of Veterans Affairs, regardless of when funds

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

20 in the case of a project for which funds were first appro21 priated before October 9, 1992, such amendments shall

22 not apply with respect to amounts appropriated for that

23 project for a fiscal year before fiscal year 1998.

24 (c) LIMITATION ON OBLIGATIONS FOR ADVANCE

25 PLANNING.—Section 8104 of title 38, United States Code,
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1 is amended by adding at the end the following new sub2 section:

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

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

5 Fund of the Department toward design or development

6 of a major medical facility project until—

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

8 report on the proposed obligation; and

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

10 date on which the report is received by the commit11 tees.’’.

12 SEC. 204. TERMINOLOGY CHANGES.

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

14 8101(2) of title 38, United States Code, is amended—

15 (1) by striking out ‘‘working drawings’’ and in16 serting in lieu thereof ‘‘construction documents’’;

17 and

18 (2) by striking out ‘‘preliminary plans’’ and in19 serting in lieu thereof ‘‘design development’’.

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

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

22 and inserting in lieu thereof ‘‘construction documents’’.
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1 SEC. 205. VETERANS HEALTH ADMINISTRATION HEAD2 QUARTERS.

3 (a) REPEAL OF STATUTORY SPECIFICATION OF OR4 GANIZATIONAL SERVICES.—The text of section 7305 of

5 title 38, United States Code, is amended to read as fol6 lows:

7 ‘‘(a) The Veterans Health Administration shall in8 clude the Office of the Under Secretary for Health and

9 such professional and auxiliary services as the Secretary

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

11 Administration.

12 ‘‘(b) In organizing, and appointing persons to posi13 tions in, the Office, the Under Secretary shall ensure that

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

15 with appropriate expertise, including expertise in—

16 ‘‘(1) unique programs operated by the Adminis17 tration to provide for the specialized treatment and

18 rehabilitation of disabled veterans (including blind

19 rehabilitation, spinal cord dysfunction, mental ill20 ness, and geriatrics and long-term care); and

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

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

23 7306 of such title is amended—

24 (1) in subsection (a)—

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

26 qualified doctor of medicine’’ in paragraph (2);
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1 (B) by striking out paragraphs (5), (6),

2 and (7); and

3 (C) by redesignating the succeeding two

4 paragraphs as paragraphs (5) and (6), respec5 tively; and

6 (2) in subsection (b)—

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

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

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

10 more than two may be’’;

11 (B) by striking out the semicolon after

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

13 a period; and

14 (C) by striking out paragraphs (2) and (3).

15 TITLE III—OTHER MATTERS

16 SEC. 301. NAME OF DEPARTMENT OF VETERANS AFFAIRS

17 MEDICAL CENTER, JACKSON, MISSISSIPPI.

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

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

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

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

22 such medical center in any law, regulation, map, docu23 ment, record, or other paper of the United States shall

24 be considered to be a reference to the G. V. Sonny Mont25 gomery Department of Veterans Affairs Medical Center.
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1 (b) EFFECTIVE DATE.—Subsection (a) shall take ef2 fect at noon on January 3, 1997, or the first day on which

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

4 of the House of Representatives.

5 SEC 302. NAME OF DEPARTMENT OF VETERANS AFFAIRS

6 MEDICAL CENTER, JOHNSON CITY, TEN7 NESSEE.

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

9 Veterans Affairs medical center in Johnson City, Ten10 nessee, shall after the date of the enactment of this Act

11 be known and designated as the ‘‘James H. Quillen De12 partment of Veterans Affairs Medical Center’’. Any ref13 erence to such medical center in any law, regulation, map,

14 document, record, or other paper of the United States

15 shall be considered to be a reference to the James H. Quil16 len Department of Veterans Affairs Medical Center.

17 (b) EFFECTIVE DATE.—Subsection (a) shall take ef18 fect at noon on January 3, 1997, or the first day on which

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

20 House of Representatives.

21 SEC. 303. NAME OF DEPARTMENT OF VETERANS AFFAIRS

22 NURSING CARE CENTER, ASPINWALL, PENN23 SYLVANIA.

24 The Department of Veterans Affairs nursing care

25 center at the Department of Veterans Affairs medical cen-
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1 ter in Aspinwall, Pennsylvania, shall after the date of the

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

3 John Heinz, III Department of Veterans Affairs Nursing

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

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

6 paper of the United States shall be considered to be a ref7 erence to the H. John Heinz, III Department of Veterans

8 Affairs Nursing Care Center.

9 SEC. 304. RESTORATION OF AUTHORITY FOR ESTABLISH10 MENT OF DEPARTMENT OF VETERANS AF11 FAIRS RESEARCH CORPORATIONS.

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

13 amended by striking out ‘‘December 31, 1992’’ and insert14 ing in lieu thereof ‘‘December 31, 2000’’.

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