IB

Union Calendar No. 519

106TH CONGRESS

2D SESSION H. R. 5109

[Report No. 106–863]

To amend title 38, United States Code, to improve the personnel system

of the Veterans Health Administration, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 6, 2000

Mr. STEARNS (for himself, Mr. GUTIERREZ, Mr. STUMP, and Mr. EVANS) introduced the following bill; which was referred to the Committee on Veterans’ Affairs

SEPTEMBER 18, 2000

Additional sponsors: Mr. LATOURETTE, Mr. SNYDER, Mr. JENKINS, Mrs.

CAPPS, Mr. WELDON of Florida, Mr. RUSH, Ms. CARSON, Mrs. EMERSON, Mr. SIMPSON, Mr. HANSEN, Mr. PETERSON of Minnesota, Mr. GIBBONS, Ms. BERKLEY, Mrs. JONES of Ohio, Ms. HOOLEY of Oregon, Mr.

WHITFIELD, Mr. BILIRAKIS, Mr. COOKSEY, Mr. BUYER, Mr. HINOJOSA,

Mr. TIAHRT, Mr. SMITH of New Jersey, Ms. BALDWIN, Mr. REYES, Mr.

OBERSTAR, Mr. HILL of Montana, Ms. BROWN of Florida, Mr. WAMP,

Mr. JONES of North Carolina, Mr. GREEN of Texas, Mr. HAYWORTH,

Mr. LAHOOD, Mr. SAWYER, Mr. GEKAS, Mr. LEWIS of Kentucky, Mr.

HALL of Texas, Mr. DEAL of Georgia, Mr. HILLEARY, Mr. ISAKSON, Mr.

GALLEGLY, Mr. RODRIGUEZ, Mr. UDALL of New Mexico, and Mr. BAKER

SEPTEMBER 18, 2000

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

House on the State of the Union, and ordered to be printed
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[Strike out all after the enacting clause and insert the part printed in italic]

[For text of introduced bill, see copy of bill as introduced on September 6, 2000]

A BILL

To amend title 38, United States Code, to improve the

personnel system of the Veterans Health Administration,

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 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the ‘‘De5 partment of Veterans Affairs Health Care Personnel Act of

6 2000’’.

7 (b) TABLE OF CONTENTS.—The table of contents of this

8 Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. References to title 38, United States Code.

TITLE I—PERSONNEL MATTERS

Sec. 101. Annual national pay comparability adjustment for nurses employed by

Department of Veterans Affairs.

Sec. 102. Special pay for dentists.

Sec. 103. Exemption for pharmacists from ceiling on special salary rates.

Sec. 104. Physician assistant adviser to Under Secretary for Health.

Sec. 105. Temporary full-time appointments of certain medical personnel.

Sec. 106. Qualifications of social workers.

Sec. 107. Extension of voluntary separation incentive payments.

TITLE II—CONSTRUCTION AUTHORIZATION

Sec. 201. Authorization of major medical facility projects.

Sec. 202. Authorization of appropriations.

TITLE III—MILITARY SERVICE ISSUES

Sec. 301. Military service history.

Sec. 302. Study of post-traumatic stress disorder in Vietnam veterans.
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TITLE IV—MEDICAL ADMINISTRATION

Sec. 401. Pilot program for coordination of hospital benefits.

Sec. 402. Benefits for persons disabled by participation in compensated work

therapy program.

Sec. 403. Extension of authority to establish research and education corporations.

Sec. 404. Department of Veterans Affairs Fisher Houses.

Sec. 405. Extension of annual report of Committee on Mentally Ill Veterans.

Sec. 406. Exception to recapture rule.

Sec. 407. Change to enhanced use lease congressional notification period.

Sec. 408. Technical and conforming changes.

Sec. 409. Release of reversionary interest of the United States in certain real

property previously conveyed to the State of Tennessee.

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

2 Except as otherwise expressly provided, whenever in

3 this Act an amendment or repeal is expressed in terms of

4 an amendment to, or repeal of, a section or other provision,

5 the reference shall be considered to be made to a section or

6 other provision of title 38, United States Code.

7 TITLE I—PERSONNEL MATTERS

8 SEC. 101. ANNUAL NATIONAL PAY COMPARABILITY ADJUST9 MENT FOR NURSES EMPLOYED BY DEPART10 MENT OF VETERANS AFFAIRS.

11 (a) REVISED PAY ADJUSTMENT PROCEDURES.—Sec12 tion 7451 is amended—

13 (1) in subsection (d)—

14 (A) in paragraph (1)—

15 (i) by striking ‘‘The rates’’ and insert16 ing ‘‘Subject to subsection (e), the rates’’;

17 and
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1 (ii) in subparagraph (A), by inserting

2 ‘‘and to be by the same percentage’’ after

3 ‘‘to have the same effective date’’;

4 (B) in paragraph (2), by striking ‘‘Such’’

5 in the second sentence and inserting ‘‘Except as

6 provided in paragraph (1)(A), such’’;

7 (C) in paragraph (3)(B)—

8 (i) by inserting after the first sentence

9 the following new sentence: ‘‘To the extent

10 practicable, the director shall use third11 party industry wage surveys to meet the re12 quirements of the preceding sentence.’’;

13 (ii) by inserting before the penultimate

14 sentence the following new sentence: ‘‘To the

15 extent practicable, all surveys conducted

16 pursuant to this subparagraph or subpara17 graph (A) shall include the collection of sal18 ary midpoints, actual salaries, lowest and

19 highest salaries, average salaries, bonuses,

20 incentive pays, differential pays, actual be21 ginning rates of pay and such other infor22 mation needed to meet the purpose of this

23 section.’’; and

24 (iii) in the penultimate sentence, by

25 inserting ‘‘or published’’ after ‘‘completed’’;
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1 (D) by striking clause (iii) of paragraph

2 (3)(C);

3 (2) by striking subsection (e) and inserting the

4 following:

5 ‘‘(e)(1) An adjustment in a rate of basic pay under

6 subsection (d) may not reduce the rate of basic pay applica7 ble to any grade of a covered position.

8 ‘‘(2) The director of a Department health-care facility,

9 in determining whether to carry out a wage survey under

10 subsection (d)(3) with respect to rates of basic pay for a

11 grade of a covered position, may not consider as a factor

12 in such determination the absence of a current recruitment

13 or retention problem for personnel in that grade of that po14 sition. The director shall make such a determination based

15 upon whether, in accordance with criteria established by

16 the Secretary, there is a significant pay-related staffing

17 problem at that facility in any grade for a position. If the

18 director determines that there is such a problem, or that

19 such a problem is likely to exist in the near future, the Di20 rector shall provide for a wage survey in accordance with

21 paragraph (3) of subsection (d).

22 ‘‘(3) The Under Secretary for Health may, to the ex23 tent necessary to carry out the purposes of subsection (d),

24 modify any determination made by the director of a De25 partment health-care facility with respect to adjusting the
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1 rates of basic pay applicable to covered positions. Upon

2 such action by the Under Secretary, any adjustment shall

3 take effect on the first day of the first pay period beginning

4 after such action. The Secretary shall ensure that the Under

5 Secretary establishes a mechanism for the exercise of the au6 thority in the preceding sentence.

7 ‘‘(4) Each director of a Department health-care facility

8 shall provide to the Secretary, not later than July 31 each

9 year, a report on staffing for covered positions at that facil10 ity. The report shall include the following:

11 ‘‘(A) Information on turnover rates and vacancy

12 rates for each grade in a covered position, including

13 a comparison of those rates with the rates for the pre14 ceding three years.

15 ‘‘(B) The director’s findings concerning the re16 view and evaluation of the facility’s staffing situa17 tion, including whether there is, or is likely to be, in

18 accordance with criteria established by the Secretary,

19 a significant pay-related staffing problem at that fa20 cility for any grade of a covered position and, if so,

21 whether a wage survey was conducted, or will be con22 ducted with respect to that grade.

23 ‘‘(C) In any case in which the director conducts

24 such a wage survey during the period covered by the

25 report, information describing the survey and any ac-
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1 tions taken or not taken based on the survey, and the

2 reasons for taking (or not taking) such actions.

3 ‘‘(D) In any case in which the director, after

4 finding that there is, or is likely to be, in accordance

5 with criteria established by the Secretary, a signifi6 cant pay-related staffing problem at that facility for

7 any grade of a covered position, determines not to

8 conduct a wage survey with respect to that position,

9 a statement of the reasons why the director did not

10 conduct such a survey.

11 ‘‘(5) Not later than September 30 of each year, the Sec12 retary shall submit to the Committees on Veterans’ Affairs

13 of the Senate and House of Representatives a report on

14 staffing for covered positions at Department healthcare fa15 cilities. Each such report shall include the following:

16 ‘‘(A) A summary and analysis of the informa17 tion contained in the most recent reports submitted

18 by facility directors under paragraph (4).

19 ‘‘(B) The information for each such facility spec20 ified in paragraph (4).’’;

21 (3) in subsection (f)—

22 (A) by striking ‘‘February 1 of 1991, 1992,

23 and 1993’’ and inserting ‘‘March 1 of each

24 year’’; and
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1 (B) by striking ‘‘subsection (d)(1)(A)’’ and

2 inserting ‘‘subsection (d)’’; and

3 (4) by striking subsection (g) and redesignating

4 subsection (h) as subsection (g).

5 (b) REQUIRED CONSULTATIONS WITH NURSES.—(1)

6 Subchapter II of chapter 73 is amended by adding at the

7 end the following new section:

8 ‘‘§ 7323. Required consultations with nurses

9 ‘‘The Under Secretary for Health shall ensure that—

10 ‘‘(1) the director of a geographic service area, in

11 formulating policy relating to the provision of patient

12 care, shall consult regularly with a senior nurse exec13 utive or senior nurse executives; and

14 ‘‘(2) the director of a medical center shall, to the

15 extent feasible, include a registered nurse as a member

16 of any committee used at that medical center to pro17 vide recommendations or decisions on medical center

18 operations or policy affecting clinical services, clinical

19 outcomes, budget, or resources.’’.

20 (2) The table of sections at the beginning of such chap21 ter is amended by inserting after the item relating to section

22 7322 the following new item:

‘‘7323. Required consultations with nurses.’’.
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1 SEC. 102. SPECIAL PAY FOR DENTISTS.

2 (a) FULL-TIME STATUS PAY.—Paragraph (1) of sec3 tion 7435(b) is amended by striking ‘‘$3,500’’ and inserting

4 ‘‘$9,000’’.

5 (b) SPECIAL PAY FOR POST-GRADUATE TRAINING.—

6 Such section is amended by adding at the end the following

7 new paragraph:

8 ‘‘(8) For a dentist who has successfully completed

9 a post-graduate year of hospital-based training in a

10 program accredited by the American Dental Associa11 tion, an annual rate of $2,000 for each of the first

12 two years of service after successful completion of that

13 training.’’.

14 (c) TENURE PAY.—The table in paragraph (2)(A) of

15 that section is amended to read as follows:

‘‘Length of Service

Rate

Minimum Maximum

1 year but less than 2 years .......................................... $1,000 $2,000

2 years but less than 4 years ........................................ 4,000 5,000

4 years but less than 8 years ........................................ 5,000 8,000

8 years but less than 12 years ...................................... 8,000 12,000

12 years but less than 20 years .................................... 12,000 15,000

20 years or more ............................................................ 15,000 18,000.’’.

16 (d) SCARCE SPECIALTY PAY.—Paragraph (3)(A) of

17 that section is amended by striking ‘‘$20,000’’ and inserting

18 ‘‘$30,000’’.

19 (e) GEOGRAPHIC PAY.—Paragraph (6) of that section

20 is amended by striking ‘‘$5,000’’ and inserting ‘‘$12,000’’.
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1 (f) RESPONSIBILITY PAY.—(1) The table in paragraph

2 (4)(A) of that section is amended to read as follows:

‘‘Position

Rate

Minimum Maximum

Chief of Staff or in an Executive Grade ...................... $14,500 $25,000

Director Grade ............................................................... 0 25,000

Service Chief (or in a comparable position as determined by the Secretary) ............................................ 4,500 15,000.’’.

3 (2) The table in paragraph (4)(B) of that section is

4 amended to read as follows:

‘‘Position Rate

Deputy Service Director ........................................................................ $20,000

Service Director ...................................................................................... 25,000

Deputy Assistant Under Secretary for Health .................................... 27,500

Assistant Under Secretary for Health (or in a comparable position

as determined by the Secretary) ....................................................... 30,000.’’.

5 (g) CREDITING OF INCREASED TENURE PAY FOR CIVIL

6 SERVICE RETIREMENT.—Section 7438(b) is amended—

7 (1) by redesignating paragraph (5) as para8 graph (6); and

9 (2) by inserting after paragraph (4) the fol10 lowing new paragraph:

11 ‘‘(5) Notwithstanding paragraphs (1) and (2), a den12 tist employed as a dentist in the Veterans Health Adminis13 tration on the effective date of section 102 of the Department

14 of Veterans Affairs Health Care Personnel Act of 2000 shall

15 be entitled to have special pay paid to the dentist under

16 section 7435(b)(2)(A) of this title (referred to as ‘tenure
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1 pay’) considered basic pay for the purposes of chapter 83

2 or 84, as appropriate, of title 5 only as follows:

3 ‘‘(A) In an amount equal to the amount that

4 would have been so considered under such section on

5 the day before such effective date based on the rates

6 of special pay the dentist was entitled to receive

7 under that section on the day before such effective

8 date.

9 ‘‘(B) With respect to any amount of special pay

10 received under that section in excess of the amount

11 such dentist was entitled to receive under such section

12 on the day before such effective date, in an amount

13 equal to 25 percent of such excess amount for each

14 two years that the physician or dentist has completed

15 as a physician or dentist in the Veterans Health Ad16 ministration after such effective date.’’.

17 (h) EFFECTIVE DATE.—The amendments made by this

18 section shall apply with respect to agreements entered into

19 by dentists under subchapter III of chapter 74 of title 38,

20 United States Code, on or after the later of—

21 (1) the date of the enactment of this Act; and

22 (2) October 1, 2000.

23 (i) TRANSITION.—(1) In the case of an agreement en24 tered into by a dentist under subchapter III of chapter 74

25 of title 38, United States Code, before the date of the enact-
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1 ment of this Act that expires after the effective date specified

2 in subsection (h), the Secretary of Veterans Affairs and the

3 dentist concerned may agree to terminate that agreement

4 as of that effective date in order to permit a new agreement

5 in accordance with section 7435 of such title, as amended

6 by this section, to take effect as of that effective date.

7 (2) In the case of an agreement entered into under such

8 subchapter before the date of the enactment of this Act that

9 expires during the period beginning on the date of the enact10 ment of this Act and ending on the effective date specified

11 in subsection (h)(2), an extension or renewal of that agree12 ment may not extend beyond that effective date.

13 (3) In the case of a dentist who begins employment

14 with the Department of Veterans Affairs during the period

15 beginning on the date of the enactment of this Act and end16 ing on the effective date specified in subsection (h)(2) who

17 is eligible for an agreement under subchapter III of chapter

18 74 of title 38, United States Code, any such agreement may

19 not extend beyond that effective date.

20 SEC. 103. EXEMPTION FOR PHARMACISTS FROM CEILING

21 ON SPECIAL SALARY RATES.

22 Section 7455(c)(1) is amended by inserting ‘‘, phar23 macists,’’ after ‘‘anesthetists’’.
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1 SEC. 104. PHYSICIAN ASSISTANT ADVISER TO UNDER SEC2 RETARY FOR HEALTH.

3 Section 7306(f) is amended—

4 (1) by striking ‘‘and’’ at the end of paragraph

5 (1);

6 (2) by striking the period at the end of para7 graph (2) and inserting ‘‘; and’’; and

8 (3) by adding at the end the following new para9 graph:

10 ‘‘(3) a physician assistant with appropriate ex11 perience (who may have a permanent duty station at

12 a Department medical care facility in reasonable

13 proximity to Washington, DC) advises the Under Sec14 retary on all matters relating to the utilization and

15 employment of physician assistants in the Adminis16 tration.’’.

17 SEC. 105. TEMPORARY FULL-TIME APPOINTMENTS OF CER18 TAIN MEDICAL PERSONNEL.

19 (a) PHYSICIAN ASSISTANTS AWAITING CERTIFICATION

20 OR LICENSURE.—Paragraph (2) of section 7405(c) is

21 amended to read as follows:

22 ‘‘(2) A temporary full-time appointment may not be

23 made for a period in excess of two years in the case of a

24 person who—

25 ‘‘(A) has successfully completed—
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1 ‘‘(i) a full course of nursing in a recognized

2 school of nursing, approved by the Secretary; or

3 ‘‘(ii) a full course of training for any cat4 egory of personnel described in paragraph (3) of

5 section 7401 of this title, or as a physician as6 sistant, in a recognized education or training in7 stitution approved by the Secretary; and

8 ‘‘(B) is pending registration or licensure in a

9 State or certification by a national board recognized

10 by the Secretary.’’.

11 (b) MEDICAL SUPPORT PERSONNEL.—That section is

12 further amended—

13 (1) by redesignating paragraph (3) as para14 graph (4); and

15 (2) by inserting after paragraph (2) the fol16 lowing new paragraph (3):

17 ‘‘(3)(A) Temporary full-time appointments of persons

18 in positions referred to in subsection (a)(1)(D) shall not ex19 ceed three years.

20 ‘‘(B) Temporary full-time appointments under this

21 paragraph may be renewed for one or more additional peri22 ods not in excess of three years each.’’.

23 SEC. 106. QUALIFICATIONS OF SOCIAL WORKERS.

24 Section 7402(b)(9) is amended by striking ‘‘a person

25 must’’ and all that follows and inserting ‘‘a person must—
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1 ‘‘(A) hold a master’s degree in social work from

2 a college or university approved by the Secretary; and

3 ‘‘(B) be licensed or certified to independently

4 practice social work in a State, except that the Sec5 retary may waive the requirement of licensure or cer6 tification for an individual social worker for a rea7 sonable period of time recommended by the Under

8 Secretary for Health.’’.

9 SEC. 107. EXTENSION OF VOLUNTARY SEPARATION INCEN10 TIVE PAYMENTS.

11 The Department of Veterans Affairs Employment Re12 duction Assistance Act of 1999 (title XI of Public Law 106–

13 117; 5 U.S.C. 5597 note) is amended as follows:

14 (1) Section 1102(c) is amended to read as fol15 lows:

16 ‘‘(c) LIMITATION.—The plan under subsection (a) shall

17 be limited to 8,110 positions within the Department.’’.

18 (2) Section 1105(a) is amended by striking ‘‘26

19 percent’’ and inserting ‘‘15 percent’’.

20 (3) Section 1109(a) is amended by striking ‘‘De21 cember 31, 2000’’ and inserting ‘‘December 31, 2002’’.
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1 TITLE II—CONSTRUCTION

2 AUTHORIZATION

3 SEC. 201. AUTHORIZATION OF MAJOR MEDICAL FACILITY

4 PROJECTS.

5 (a) FISCAL YEAR 2001 PROJECTS.—The Secretary of

6 Veterans Affairs may carry out the following major medical

7 facility projects, with each project to be carried out in the

8 amount specified for that project:

9 (1) Construction of a psychogeriatric care build10 ing at the Department of Veterans Affairs Medical

11 Center, Palo Alto, California, in an amount not to

12 exceed $26,600,000.

13 (2) Construction of a utility plant and electrical

14 vault at the Department of Veterans Affairs Medical

15 Center, Miami, Florida, in an amount not to exceed

16 $23,600,000.

17 (3) Seismic corrections, clinical consolidation,

18 and other improvements at the Department of Vet19 erans Affairs Medical Center, Long Beach, California,

20 in an amount not to exceed $51,700,000.

21 (b) ADDITIONAL FISCAL YEAR 2000 PROJECT.—The

22 Secretary is authorized to carry out a project for the ren23 ovation of psychiatric nursing units at the Department of

24 Veterans Affairs Medical Center, Murfreesboro, Tennessee,

25 in an amount not to exceed $14,000,000.
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1 SEC. 202. AUTHORIZATION OF APPROPRIATIONS.

2 (a) IN GENERAL.—There are authorized to be appro3 priated to the Secretary of Veterans Affairs for fiscal years

4 2001 and 2002 for the Construction, Major Projects, ac5 count, $101,900,000 for the projects authorized in section

6 101(a).

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

8 101(a) may only be carried out using—

9 (1) funds appropriated for fiscal year 2001 or

10 2002 pursuant to the authorization of appropriations

11 in subsection (a);

12 (2) funds appropriated for Construction, Major

13 Projects for a fiscal year before fiscal year 2001 that

14 remain available for obligation; and

15 (3) funds appropriated for Construction, Major

16 Projects for fiscal year 2001 or 2002 for a category

17 of activity not specific to a project.

18 TITLE III—MILITARY SERVICE

19 ISSUES

20 SEC. 301. MILITARY SERVICE HISTORY.

21 (a) MILITARY HISTORIES.—The Secretary of Veterans

22 Affairs, in carrying out the responsibilities of the Secretary

23 under chapter 17 of title 38, United States Code, shall en24 sure that—

25 (1) during at least one clinical evaluation of a

26 patient in a facility of the Department, a protocol is
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1 used to identify pertinent military experiences and

2 exposures of the patient that may contribute to the

3 health status of the patient; and

4 (2) pertinent information relating to the mili5 tary history of the patient is included in the Depart6 ment’s medical records of the patient.

7 (b) REPORT.—Not later than nine months after the

8 date of the enactment of this Act, the Secretary shall submit

9 to the Committees on Veterans’ Affairs of the Senate and

10 House of Representatives a report on the feasibility and de11 sirability of using a computer-based system in conducting

12 clinical evaluations referred to in subsection (a)(1).

13 SEC. 302. STUDY OF POST-TRAUMATIC STRESS DISORDER

14 IN VIETNAM VETERANS.

15 (a) STUDY ON POST-TRAUMATIC STRESS DIS16 ORDER.—Not later than 10 months after the date of the en17 actment of this Act, the Secretary of Veterans Affairs shall

18 enter into a contract with an appropriate entity to carry

19 out a study on post-traumatic stress disorder.

20 (b) FOLLOW-UP STUDY.—The contract under sub21 section (a) shall provide for a follow-up study to the study

22 conducted in accordance with section 102 of the Veterans

23 Health Care Amendments of 1983 (Public Law 98–160).

24 Such follow-up study shall use the data base and sample

25 of the previous study.
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1 (c) INFORMATION TO BE INCLUDED.—The study con2 ducted pursuant to this section shall be designed to yield

3 information on—

4 (1) the long-term course of post-traumatic stress

5 disorder;

6 (2) any long-term medical consequences of post7 traumatic stress disorder;

8 (3) whether particular subgroups of veterans are

9 at greater risk of chronic or more severe problems

10 with such disorder; and

11 (4) the services used by veterans who have post12 traumatic stress disorder and the effect of those serv13 ices on the course of the disorder.

14 (d) REPORT.—The Secretary shall submit to the Com15 mittees of Veterans’ Affairs of the Senate and House of Rep16 resentatives a report on the results of the study under this

17 section. The report shall be submitted no later than October

18 1, 2004.

19 TITLE IV—MEDICAL

20 ADMINISTRATION

21 SEC. 401. PILOT PROGRAM FOR COORDINATION OF HOS22 PITAL BENEFITS.

23 (a) IN GENERAL.—Chapter 17 is amended by insert24 ing after section 1725 the following new section:
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1 ‘‘§ 1725A. Coordination of hospital benefits: pilot pro2 gram

3 ‘‘(a) The Secretary may carry out a pilot program in

4 not more than four geographic areas of the United States

5 to improve access to, and coordination of, inpatient care

6 of eligible veterans. Under the pilot program, the Secretary,

7 subject to subsection (b), may pay certain costs described

8 in subsection (b) for which an eligible veteran would other9 wise be personally liable. The authority to carry out the

10 pilot program shall expire on September 30, 2005.

11 ‘‘(b) In carrying out the program described in sub12 section (a), the Secretary may pay the costs authorized

13 under this section for hospital care and medical services

14 furnished on an inpatient basis in a non-Department hos15 pital to an eligible veteran participating in the program.

16 Such payment may cover the costs for applicable plan

17 deductibles and coinsurance and the reasonable costs of such

18 inpatient care and medical services not covered by any ap19 plicable health-care plan of the veteran, but only to the ex20 tent such care and services are of the kind authorized under

21 this chapter. The Secretary shall limit the care and services

22 for which payment may be made under the program to gen23 eral medical and surgical services and shall require that

24 such services may be provided only upon preauthorization

25 by the Secretary.
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1 ‘‘(c)(1) A veteran described in paragraph (1) or (2)

2 of section 1710(a) of this title is eligible to participate in

3 the pilot program if the veteran—

4 ‘‘(A) is enrolled to receive medical services from

5 an outpatient clinic operated by the Secretary which

6 is (i) within reasonable proximity to the principal

7 residence of the veteran, and (ii) located within the

8 geographic area in which the Secretary is carrying

9 out the program described in subsection (a);

10 ‘‘(B) has received care under this chapter within

11 the 24-month period preceding the veteran’s applica12 tion for enrollment in the pilot program;

13 ‘‘(C) as determined by the Secretary before the

14 hospitalization of the veteran (i) requires such hos15 pital care and services for a non-service-connected

16 condition, and (ii) could not receive such services

17 from a clinic operated by the Secretary; and

18 ‘‘(D) elects to receive such care under a health19 care plan (other than under this title) under which

20 the veteran is entitled to receive such care.

21 ‘‘(2) Nothing in this section shall be construed to re22 duce the authority of the Secretary to contract with non23 Department facilities for care of a service-connected dis24 ability of a veteran.
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1 ‘‘(3) Notwithstanding subparagraph (D) of paragraph

2 (1), the Secretary shall ensure that not less than 15 percent

3 of the veterans participating in the program are veterans

4 who do not have a health-care plan.

5 ‘‘(d) As part of the program under this section, the

6 Secretary shall, through provision of case-management, co7 ordinate the care being furnished directly by the Secretary

8 and care furnished under the program in non-Department

9 hospitals to veterans participating in the program.

10 ‘‘(e)(1) In designating geographic areas in which to

11 establish the program under subsection (a), the Secretary

12 shall ensure that—

13 ‘‘(A) the areas designated are geographically dis14 persed;

15 ‘‘(B) at least 70 percent of the veterans who re16 side in a designated area reside at least two hours

17 driving distance from the closest medical center oper18 ated by the Secretary which provides medical and

19 surgical hospital care; and

20 ‘‘(C) the establishment of the program in any

21 such area would not result in jeopardizing the critical

22 mass of patients needed to maintain a Department

23 medical center that serves that area.

24 ‘‘(2) Notwithstanding paragraph (1)(B), the Secretary

25 may designate for participation in the program at least one
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1 area which is in proximity to a Department medical center

2 which, as a result of a change in mission of that center,

3 does not provide hospital care.

4 ‘‘(f)(1) Not later than September 30, 2002, the Sec5 retary shall submit to the Committees on Veterans’ Affairs

6 of the Senate and House of Representatives a report on the

7 experience in implementing the pilot program under sub8 section (a).

9 ‘‘(2) Not later than September 30, 2004, the Secretary

10 shall submit to those committees a report on the experience

11 in operating the pilot program during the first two full fis12 cal years during which the pilot program is conducted.

13 That report shall include—

14 ‘‘(A) a comparison of the costs incurred by the

15 Secretary under the program and the cost experience

16 for the calendar year preceding establishment of the

17 program at each site at which the program is oper18 ated;

19 ‘‘(B) an assessment of the satisfaction of the par20 ticipants in the program; and

21 ‘‘(C) an analysis of the effect of the program on

22 access and quality of care for veterans.

23 ‘‘(g) The total amount expended for the pilot program

24 in any fiscal year (including amounts for administrative

25 costs) may not exceed $50,000,000.
24

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1 ‘‘(h) For purposes of this section, the term ‘health-care

2 plan’ has the meaning given that term in section 1725(f)(3)

3 of this title.’’.

4 (b) CLERICAL AMENDMENT.—The table of sections at

5 the beginning of such chapter is amended by inserting after

6 the item relating to section 1725 the following new item:

‘‘1725A. Coordination of hospital benefits: pilot program.’’.

7 SEC. 402. BENEFITS FOR PERSONS DISABLED BY PARTICI8 PATION IN COMPENSATED WORK THERAPY

9 PROGRAM.

10 Section 1151(a)(2) is amended—

11 (1) by inserting ‘‘(A)’’ after ‘‘proximately

12 caused’’; and

13 (2) by inserting before the period at the end the

14 following: ‘‘, or (B) by participation in a program

15 (known as a ‘compensated work therapy program’)

16 under section 1718 of this title’’.

17 SEC. 403. EXTENSION OF AUTHORITY TO ESTABLISH RE18 SEARCH AND EDUCATION CORPORATIONS.

19 Section 7368 is amended by striking ‘‘December 31,

20 2000’’ and inserting ‘‘December 31, 2005’’.

21 SEC. 404. DEPARTMENT OF VETERANS AFFAIRS FISHER

22 HOUSES.

23 (a) AUTHORITY.—Subchapter I of chapter 17 of title

24 38, United States Code, is amended by adding at the end

25 the following new section:
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1 ‘‘§ 1708. Temporary lodging

2 ‘‘(a) The Secretary may furnish persons described in

3 subsection (b) with temporary lodging in a Fisher house

4 or other appropriate facility in connection with the exam5 ination, treatment, or care of a veteran under this chapter

6 or, as provided for under subsection (e)(5), in connection

7 with benefits administered under this title.

8 ‘‘(b) Persons to whom the Secretary may provide lodg9 ing under subsection (a) are the following:

10 ‘‘(1) A veteran who must travel a significant dis11 tance to receive care or services under this title.

12 ‘‘(2) A member of the family of a veteran and

13 others who accompany a veteran and provide the

14 equivalent of familial support for such veteran.

15 ‘‘(c) In this section, the term ‘Fisher house’ means a

16 housing facility that—

17 ‘‘(1) is located at, or in proximity to, a Depart18 ment medical facility;

19 ‘‘(2) is available for residential use on a tem20 porary basis by patients of that facility and others

21 described in subsection (b)(2); and

22 ‘‘(3) is constructed by, and donated to the Sec23 retary by, the Zachary and Elizabeth M. Fisher

24 Armed Services Foundation.

25 ‘‘(d) The Secretary may establish charges for providing

26 lodging under this section. The proceeds from such charges
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1 shall be credited to the medical care account and shall be

2 available until expended for the purposes of providing such

3 lodging.

4 ‘‘(e) The Secretary shall prescribe regulations to carry

5 out this section. Such regulations shall include provisions—

6 ‘‘(1) limiting the duration of such lodging;

7 ‘‘(2) establishing standards and criteria under

8 which medical facilities may set charges for such lodg9 ing;

10 ‘‘(3) establishing criteria for persons considered

11 to be accompanying a veteran;

12 ‘‘(4) establishing criteria for the use of such

13 premises; and

14 ‘‘(5) any other limitations, conditions, and pri15 orities that the Secretary considers appropriate with

16 respect to temporary lodging under this section.’’.

17 (b) CLERICAL AMENDMENT.—The table of sections at

18 the beginning of such chapter is amended by inserting after

19 the item relating to section 1707 the following new item:

‘‘1708. Temporary lodging.’’.

20 SEC. 405. EXTENSION OF ANNUAL REPORT OF COMMITTEE

21 ON MENTALLY ILL VETERANS.

22 Section 7321(d)(2) is amended by striking ‘‘three’’ and

23 inserting ‘‘six’’.

24 SEC. 406. EXCEPTION TO RECAPTURE RULE.

25 Section 8136 is amended—
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1 (1) by inserting ‘‘(a)’’ at the beginning of the

2 text of the section; and

3 (2) by adding at the end the following new sub4 section:

5 ‘‘(b) The establishment and operation by the Secretary

6 of an outpatient clinic in facilities described in subsection

7 (a) shall not constitute grounds entitling the United States

8 to any recovery under that subsection.’’.

9 SEC. 407. CHANGE TO ENHANCED USE LEASE CONGRES10 SIONAL NOTIFICATION PERIOD.

11 Paragraph (2) of section 8163(c) is amended to read

12 as follows:

13 ‘‘(2) The Secretary may not enter into an enhanced

14 use lease until the end of the 90-day period beginning on

15 the date of the submission of notice under paragraph (1).’’.

16 SEC. 408. TECHNICAL AND CONFORMING CHANGES.

17 (a) REQUIREMENT TO PROVIDE CARE.—Section

18 1710A(a) is amended by inserting ‘‘(subject to section

19 1710(a)(4) of this title)’’ after ‘‘Secretary’’ the first place

20 it appears.

21 (b) CONFORMING AMENDMENT.—Section 1710(a)(4) is

22 amended by striking ‘‘requirement in’’ and inserting ‘‘re23 quirements in section 1710A(a) and’’.
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1 SEC. 409. RELEASE OF REVERSIONARY INTEREST OF THE

2 UNITED STATES IN CERTAIN REAL PROPERTY

3 PREVIOUSLY CONVEYED TO THE STATE OF

4 TENNESSEE.

5 (a) RELEASE OF INTEREST.—The Secretary of Vet6 erans Affairs shall execute such legal instruments as nec7 essary to release the reversionary interest of the United

8 States described in subsection (b) in a certain parcel of real

9 property conveyed to the State of Tennessee pursuant to the

10 Act entitled ‘‘An Act authorizing the transfer of certain

11 property of the Veterans’ Administration (in Johnson City,

12 Tennessee) to the State of Tennessee’’, approved June 6,

13 1953 (67 Stat. 54).

14 (b) SPECIFIED REVERSIONARY INTEREST.—Subsection

15 (a) applies to the reversionary interest of the United States

16 required under section 2 of the Act referred to in subsection

17 (a), requiring use of the property conveyed pursuant to that

18 Act to be primarily for training of the National Guard and

19 for other military purposes.

20 (c) CONFORMING AMENDMENT.—Section 2 of such Act

21 is repealed.

Union Calendar No. 519

106TH CONGRESS

2D SESSION H. R. 5109

[Report No. 106–863]

A BILL

To amend title 38, United States Code, to improve

the personnel system of the Veterans Health Administration, and for other purposes.

SEPTEMBER 18, 2000

Reported with an amendment, committed to the Committee of the Whole House on the State of the Union,

and ordered to be printed