I

103D CONGRESS

2D SESSION H. R. 4425

To authorize major medical facility construction projects for the Department

of Veterans Affairs for fiscal year 1995, to revise and improve veterans’

health programs, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

MAY 16, 1994

Mr. ROWLAND (for himself and Mr. SMITH of New Jersey) introduced the

following bill; which was referred to the Committee on Veterans’ Affairs

A BILL

To authorize major medical facility construction projects for

the Department of Veterans Affairs for fiscal year 1995,

to revise and improve veterans’ health programs, 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,
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1 TITLE I—CONSTRUCTION

2 AUTHORIZATION

3 SEC. 101. AUTHORIZATION OF MAJOR MEDICAL FACILITY

4 PROJECTS AND MAJOR MEDICAL FACILITY

5 LEASES.

6 (a) PROJECTS IN PRESIDENT’S BUDGET.—(1) Ex7 cept as provided in paragraph (2), the Secretary of Veter8 ans Affairs may carry out the major medical facility

9 projects for the Department of Veterans Affairs, and may

10 carry out the major medical facility leases for that Depart11 ment, for which funds are requested in the budget of the

12 President for fiscal year 1995.

13 (2) The Secretary is not authorized to carry out—

14 (A) the project described in the budget of the

15 President for fiscal year 1995 for the construction of

16 a research addition at Huntington, West Virginia; or

17 (B) the project described in the budget of the

18 President for fiscal year 1995 for the construction of

19 a research addition at Portland, Oregon.

20 (b) ADDITIONAL PROJECTS.—In addition to the

21 projects authorized in subsection (a), the Secretary may

22 carry out the following major medical facility projects, in

23 the amounts specified:

24 (1) The projects for ambulatory care facilities

25 that are proposed in the budget for fiscal year 1995
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1 to be financed with funds from the Health Care

2 Investment Fund.

3 (2) Construction of a nursing home facility at

4 the Department of Veterans Affairs Medical Center

5 in Charleston, South Carolina, $7,300,000.

6 (3) A lease/purchase of a nursing home facility

7 near Ft. Myers, Florida, $18,630,000.

8 (4) Construction of an outpatient care addition

9 at the Department of Veterans Affairs medical cen10 ter in Phoenix, Arizona, in the amount of

11 $50,000,000.

12 (c) PROJECTS FOR WHICH FUNDS APPROPRIATED.—

13 In addition to the projects authorized in subsections (a)

14 and (b), the Secretary may carry out the following major

15 medical facility projects for which funds were appropriated

16 in the Emergency Supplemental Appropriations Act of

17 1994 (Public Law 103–211) in the amounts specified:

18 (1) Construction of an ambulatory care/support

19 services facility at the Department of Veterans Af20 fairs Medical Center in Sepulveda, California,

21 $53,700,000.

22 (2) Other major medical facility projects re23 quired to repair, restore, or replace earthquake-dam24 aged facilities at the Department of Veterans Affairs
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1 Medical Center in Sepulveda, California,

2 $50,000,000.

3 SEC. 102. AUTHORIZATION OF APPROPRIATIONS.

4 (a) IN GENERAL.—There is hereby authorized to be

5 appropriated to the Secretary of Veterans Affairs for fiscal

6 year 1995—

7 (1) $343,800,000 for the major medical facility

8 projects authorized in subsections (a) and (b) of sec9 tion 101; and

10 (2) $15,800,000 for the major medical facility

11 leases authorized in section 101(a).

12 (b) LIMITATION.—The projects authorized in sub13 sections (a) and (b) of section 101 may only be carried

14 out using—

15 (1) funds appropriated for fiscal year 1995 pur16 suant to the authorization of appropriations in sub17 section (a);

18 (2) funds appropriated for Construction, Major

19 Projects for a fiscal year before fiscal year 1995 that

20 remain available for obligation; and

21 (3) funds appropriated for Construction, Major

22 Projects for fiscal year 1995 for a category of activ23 ity not specific to a project.
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1 (c) LIMITATION ON CERTAIN PROJECTS.—The

2 projects authorized in subsection (c) of section 101 may

3 only be carried out using—

4 (1) funds appropriated, as well as funds trans5 ferred by the President, to the Construction, Major

6 Projects account pursuant to the Emergency Supple7 mental Appropriations Act of 1994 (Public Law

8 103–211);

9 (2) funds appropriated to the Medical Care ac10 count by the Emergency Supplemental Appropria11 tions Act of 1994 (Public Law 103–211) that are

12 transferred by law to the Construction, Major

13 Projects account;

14 (3) funds appropriated to the Construction,

15 Major Projects account for a fiscal year before fiscal

16 year 1994 that remain available for obligation; and

17 (4) funds appropriated to the Construction,

18 Major Projects account for fiscal year 1994 for a

19 category of activity not specific to a project.

20 TITLE II—HEALTH CARE

21 PLANNING AND PROGRAMS

22 SEC. 201. HEALTH CARE FACILITIES MISSIONS.

23 (a) IN GENERAL.—The Secretary of Veterans Affairs

24 shall prescribe a specific, detailed statement of the mission

25 of, and the clinical programs to be operated at, each health
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1 care facility of the Department, determined based upon

2 a requirement that each such facility operate within a net3 work of Department facilities in the same geographic area

4 which, taken together, provide a full range of services for

5 veterans.

6 (b) PURPOSES OF MISSION STATEMENTS.—The mis7 sion statements shall be designed so as to permit—

8 (1) effective planning;

9 (2) reduction in duplication of services and pro10 grams in the same geographic area;

11 (3) realignment of services among facilities

12 within each network;

13 (4) improved means of resource distribution;

14 and

15 (5) more efficient delivery of needed services.

16 (c) REVIEW OF CURRENT MISSIONS.—In preparing

17 the mission statements under subsection (a), the Secretary

18 shall review the existing missions and clinical programs

19 at each health care facility of the Department.

20 (d) DEADLINE AND REPORT.—The Secretary, not

21 later than nine months after the date of the enactment

22 of this Act, shall—

23 (1) prescribe the mission statements required

24 by subsection (a); and
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1 (2) submit to the Committees on Veterans’ Af2 fairs of the Senate and House of Representatives a

3 report on the implementation of this section and on

4 the timetable and projected milestones for imple5 menting actions to enable each such facility to carry

6 out fully its prescribed missions.

7 SEC. 202. PILOT PROGRAM FOR NONINSTITUTIONAL AL8 TERNATIVES TO NURSING HOME CARE.

9 (a) EXTENSION OF PROGRAM.—Subsection (a) of

10 section 1720C of title 38, United States Code, is amended

11 by striking out ‘‘During the four-year period beginning on

12 October 1, 1990,’’ and inserting in lieu thereof ‘‘During

13 the period through September 30, 1997,’’.

14 (b) VETERANS ELIGIBLE TO PARTICIPATE IN PRO15 GRAM.—Such subsection is further amended by striking

16 out ‘‘care and who—’’ and inserting in lieu thereof ‘‘care.

17 The Secretary shall give priority for participation in such

18 program to veterans who—’’.

19 (c) REPORT DEADLINES.—Section 201(b) of the De20 partment of Veterans Affairs Nurse Pay Act of 1990

21 (Public Law 101–366; 104 Stat. 438) is amended—

22 (1) by striking out ‘‘February 1, 1994,’’ and in23 serting in lieu thereof ‘‘February 1, 1997,’’; and

24 (2) by striking out ‘‘September 30, 1993,’’ and

25 inserting in lieu thereof ‘‘September 30, 1996,’’.
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1 TITLE III—MEDICAL FACILITIES

2 ACQUISITION

3 SEC. 301. REVISION TO PROSPECTUS REQUIREMENTS.

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

5 title 38, United States Code, is amended—

6 (1) by striking out ‘‘shall include—’’ and insert7 ing in lieu thereof ‘‘shall include:’’;

8 (2) in paragraph (1)—

9 (A) by striking out ‘‘a detailed’’ and insert10 ing in lieu thereof ‘‘A detailed’’; and

11 (B) by striking out the semicolon at the

12 end and inserting in lieu thereof a period;

13 (3) in paragraph (2)—

14 (A) by striking out ‘‘an estimate’’ and in15 serting in lieu thereof ‘‘An estimate’’; and

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

17 in lieu thereof a period;

18 (4) in paragraph (3), by striking out ‘‘an esti19 mate’’ and inserting in lieu thereof ‘‘An estimate’’;

20 and

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

22 paragraphs:

23 ‘‘(4) Demographic data applicable to the

24 project.
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1 ‘‘(5) Current and projected workload and utili2 zation data.

3 ‘‘(6) The relationship between the mission of

4 the facility and the missions and capabilities of other

5 nearby Department facilities and, as applicable, the

6 availability or lack of availability of alternative

7 sources of service in the community and the cost-ef8 fectiveness of using such alternative sources.

9 ‘‘(7) Current and projected operating costs of

10 the facility.

11 ‘‘(8) The raw score assigned to the proposal

12 under the Department’s prioritization methodology

13 and, if the project is being proposed for funding

14 ahead of a project with a higher score, a comprehen15 sive explanation of the specific factors on the basis

16 of which the project is being proposed for funding

17 ahead of each such higher-scored project.

18 ‘‘(9) A listing of each alternative to construc19 tion of the facility that has been considered.’’.

20 (b) APPLICABILITY.—The amendments made by sub21 section (a) shall apply with respect to any prospectus sub22 mitted by the Secretary of Veterans Affairs after the date

23 of the enactment of this Act.
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1 SEC. 302. PRIORITIZATION METHODOLOGY.

2 (a) REVIEW OF METHODOLOGY.—The Secretary of

3 Veterans Affairs shall conduct a review of the methodology

4 used by the Department for establishing the relative prior5 ity for major construction projects under consideration in

6 the Department.

7 (b) REVISION.—Based upon the review under sub8 section (a), the Secretary shall revise the prioritization

9 methodology so as to give additional weight, as determined

10 appropriate by the Secretary taking into consideration

11 particularly the needs of the aging veteran population, to

12 projects intended to expand long-term care and ambula13 tory care programs.

14 (c) REPORT.—Not later than 120 days after the date

15 of the enactment of this Act, the Secretary shall submit

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

17 House of Representatives a report on the actions of the

18 Secretary in carrying out this section.

19 SEC. 303. SEMIANNUAL COMPILATION OF CONSTRUCTION

20 PRIORITIES.

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

22 amended by adding at the end the following new sub23 section:

24 ‘‘(c)(1) The Secretary shall submit to each commit25 tee, not later than January 31 and July 31 of each year,

26 a report showing the current priorities of the Department
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1 for proposed major medical construction projects. Each

2 such report shall identify the 20 projects, from within all

3 the projects in the Department’s inventory of proposed

4 projects, that have the highest priority and, for those 20

5 projects, the relative priority and rank scoring of each

6 such project. The 20 projects shall be compiled, and their

7 relative rankings shall be shown, by category of project

8 (including the categories of ambulatory care projects,

9 nursing home care projects, and such other categories as

10 the Secretary determines).

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

12 each project listed, a description of the specific factors

13 that account for the relative ranking of that project in re14 lation to other projects within the same category.

15 ‘‘(3) In a case in which the relative ranking of a pro16 posed project has changed since the last report under this

17 subsection was submitted, the Secretary shall also include

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

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

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

21 system for proposed major medical construction projects.

22 SEC. 304. DEFINITION OF MAJOR MEDICAL FACILITY

23 PROJECT.

24 Subparagraph (A) of section 8104(a)(3) of title 38,

25 United States Code, is amended by inserting before the
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1 period at the end the following: ‘‘, and, in the case of a

2 project which is principally for the alteration of a medical

3 facility to provide additional space for provision of ambula4 tory care, such term means a project involving a total ex5 penditure of more than $5,000,000’’.

6 TITLE IV—STATE HOME

7 PROGRAM

8 SEC. 401. PER DIEM FOR ADULT DAY HEALTH CARE.

9 (a) IN GENERAL.—Subsection (a) of section 1741 of

10 title 38, United States Code, is amended to read as

11 follows:

12 ‘‘(a)(1) The Secretary shall pay to each State a per

13 diem amount for each veteran receiving domiciliary care,

14 nursing home care, hospital care, or adult day health care

15 in a State home if the veteran is eligible to receive that

16 care in a Department facility.

17 ‘‘(2) The per diem rate to be paid under this sub18 section is as follows:

19 ‘‘(A) For domiciliary care, $15.11 for each day.

20 ‘‘(B) For nursing home care and hospital care,

21 $35.37 for each day.

22 ‘‘(C) For adult day health care, $16.28 for each

23 day.’’.
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1 (b) EFFECTIVE DATE.—The amendment made by

2 subsection (a) shall apply with respect to adult day health

3 care provided in a State home after September 30, 1994.

4 SEC. 402. CONSTRUCTION ASSISTANCE PROGRAM.

5 (a) IN GENERAL.—Subchapter III of chapter 81 of

6 title 38, United States Code, is amended as follows:

7 (1) Section 8131(3) is amended by inserting

8 ‘‘or adult day health care’’ after ‘‘hospital care’’.

9 (2) Section 8132 is amended by inserting

10 ‘‘adult day health care’’ after ‘‘hospital care’’.

11 (3) Section 8135(a)(4) is amended by inserting

12 ‘‘and, in the case of adult day health care, not more

13 than 25 percent of the number of patients partici14 pating in that program,’’ after ‘‘occupancy’’.

15 (4) Section 8135(b) is amended—

16 (A) in paragraph (2)(C), by inserting ‘‘or

17 adult day health care facilities’’ after ‘‘domi18 ciliary beds’’; and

19 (B) in paragraph (3)(A), by inserting ‘‘, or

20 would involve expansion, remodeling, or alter21 ation of existing buildings for the furnishing of

22 adult day health care’’ after ‘‘buildings’’.

23 (5) Section 8136 is amended by inserting

24 ‘‘adult day health care’’ after ‘‘hospital care’’.
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1 (6) The heading of such subchapter is amended

2 to read as follows:

3 ‘‘SUBCHAPTER III—STATE HOME FACILITIES

4 FOR FURNISHING DOMICILIARY CARE,

5 NURSING HOME CARE, ADULT DAY HEALTH

6 CARE, AND HOSPITAL CARE’’.

7 (b) CLERICAL AMENDMENT.—The item relating to

8 subchapter III in the table of sections at the beginning

9 of such chapter is amended to read as follows:

‘‘SUBCHAPTER III—STATE HOME FACILITIES FOR FURNISHING

DOMICILIARY CARE, NURSING HOME CARE, ADULT DAY

HEALTH CARE, AND HOSPITAL CARE’’.

10 (c) EFFECTIVE DATE.—The amendments made by

11 subsection (a) shall apply with respect to grants made to

12 States using funds appropriated after the date of the en13 actment of this Act.

14 TITLE V—MISCELLANEOUS

15 SEC. 501. DEPARTMENT OF VETERANS AFFAIRS RESEARCH

16 ADVISORY COMMITTEES.

17 (a) STATUTORY BASIS FOR RESEARCH ADVISORY

18 COMMITTEES.—Chapter 5 of title 38, United States Code,

19 is amended by adding at the end of subchapter III the

20 following new section:

21 ‘‘§ 544. Veterans research advisory committees

22 ‘‘(a) Congress declares that each of the veterans re23 search advisory committees specified in subsection (c)
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1 (previously established by the Secretary in carrying out

2 the duties of the Secretary under section 7303 of this title)

3 has a continuing, ongoing function that is integrally relat4 ed to the successful completion by the Department of its

5 statutory duties. Each such committee shall, for all pur6 poses, operate as though such committee had been estab7 lished by, and chartered pursuant to, law. The objectives

8 and scope of the activities of each such committee and the

9 duties for which the committee is responsible, as specified

10 by the Secretary as of March 1, 1993, shall be those in

11 effect as of that date.

12 ‘‘(b) The Secretary may not terminate a veterans’ re13 search advisory committee specified in subsection (c) un14 less the Secretary finds that the committee is no longer

15 needed. Not less than 120 days before terminating such

16 a committee, the Secretary shall submit to the congres17 sional veterans’ affairs committees a report on the pro18 posed termination. The report shall include an explanation

19 of (1) the basis for the Secretary’s determination that

20 such committee is no longer needed, and (2) the manner

21 in which the Secretary will carry out the Secretary’s re22 sponsibilities under section 7303 of this title in the ab23 sence of the committee.

24 ‘‘(c) For purposes of this section, each of the follow25 ing committees and boards, as established by the Sec-
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1 retary as of March 1, 1993, shall be considered to be a

2 veterans’ research advisory committee:

3 ‘‘(1) The Career Development Committee.

4 ‘‘(2) The Department of Veterans Affairs Coop5 erative Studies Evaluation Committee.

6 ‘‘(3) The Merit Review Board for Basic

7 Sciences Programs.

8 ‘‘(4) The Merit Review Board for Cardio9 vascular Programs.

10 ‘‘(5) The Merit Review Board for Clinical Phar11 macology, Alcoholism, and Drug Dependence Pro12 grams.

13 ‘‘(6) The Merit Review Board for Endocrinol14 ogy Programs.

15 ‘‘(7) The Merit Review Board for Gastro16 enterology Programs.

17 ‘‘(8) The Merit Review Board for Hematology

18 Programs.

19 ‘‘(9) The Merit Review Board for Immunology

20 Programs.

21 ‘‘(10) The Merit Review Board for Infectious

22 Diseases Programs.

23 ‘‘(11) The Merit Review Board for Mental

24 Health and Behavioral Sciences Programs.
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1 ‘‘(12) The Merit Review Board for Nephrology

2 Programs.

3 ‘‘(13) The Merit Review Board for

4 Neurobiology Programs.

5 ‘‘(14) The Merit Review Board for Oncology

6 Programs.

7 ‘‘(15) The Merit Review Board for Respiration

8 Programs.

9 ‘‘(16) The Merit Review Board for Surgery

10 Programs.

11 ‘‘(17) The Scientific Review Evaluation Board

12 for Health Services Research and Development.

13 ‘‘(18) The Scientific Review Evaluation Board

14 for Rehabilitation Research and Development.’’.

15 (b) CLERICAL AMENDMENT.—The table of sections

16 at the beginning of such chapter is amended by inserting

17 after the item relating to section 543 the following new

18 item:

‘‘544. Veterans research advisory committees.’’.

19 SEC. 502. CHILD CARE SERVICES.

20 (a) REVISED CHILD CARE AUTHORITY.—Chapter 81

21 of title 38, United States Code, is amended by inserting

22 after section 8116 the following new section:

23 ‘‘§ 8117. Child care centers

24 ‘‘(a) The Secretary may provide for the operation of

25 child care centers at Department facilities. The operation
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1 of such centers under this section shall be carried out to

2 the extent that the Secretary determines, based on the de3 mand of employees of the Department for the care in4 volved, that such operation is in the best interest of the

5 Department and that it is practicable to do so.

6 ‘‘(b)(1) In offering child care services under this sec7 tion, the Secretary shall give priority (in the following

8 order) to employees of—

9 ‘‘(A) the Department;

10 ‘‘(B) other departments and agencies of the

11 Federal Government, and

12 ‘‘(C) schools affiliated with the Department and

13 corporations created under section 7361 of this title.

14 ‘‘(2) To the extent that space is available, the Sec15 retary may provide child care services to members of the

16 public at a child care center operated under this section

17 if the Secretary determines that to do so is necessary to

18 assure the financial success of that center.

19 ‘‘(c)(1) The Secretary shall establish reasonable

20 charges for child care services provided at each child care

21 center operated under this section. Such charges may be

22 established at different rates for different centers.

23 ‘‘(2) In establishing charges for child care services

24 provided at a center, the Secretary—
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1 ‘‘(A) shall (except as provided in paragraph (3))

2 establish the charges so as to ensure that the sum

3 of all charges for child care services at that center

4 is sufficient to meet the staffing expenses of that

5 center; and

6 ‘‘(B) may also consider the expenses of con7 structing or acquiring space for the center, the ex8 penses of converting existing space into the center,

9 and the expenses of equipment and services fur10 nished to the center under subsection (d)(2).

11 ‘‘(3) The Secretary may establish charges for child

12 care services provided at a center at rates less than those

13 necessary to ensure that the sum of all charges for child

14 care services at that center is sufficient to meet the staff15 ing expenses of that center if the Secretary determines

16 (with respect to a particular facility of the Department)

17 that—

18 ‘‘(A) the operation of a child care center at that

19 facility would help overcome serious recruitment or

20 retention problems;

21 ‘‘(B) adherence to the requirement to establish

22 charges for child care services at that center at rates

23 sufficient to meet the staffing expenses of that cen24 ter would make the operation of a child care center

25 at that facility unfeasible; and
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1 ‘‘(C) there are no other practical alternatives to

2 meeting the needs of employees at that facility for

3 child care services.

4 ‘‘(4) Proceeds from charges for child care services

5 shall be credited to the applicable Department of Veterans

6 Affairs account and shall be allotted to the facility served

7 by the child care center and shall remain available until

8 expended.

9 ‘‘(d) In connection with the establishment and oper10 ation of a child care center under this section, the Sec11 retary—

12 ‘‘(1) may construct or alter space in any De13 partment facility, and may lease space in a non-De14 partment facility for a term not to exceed 20 years,

15 for use as a child care center;

16 ‘‘(2) may provide, out of operating funds, other

17 items and services necessary for the operation of the

18 center, including furniture, office machines and

19 equipment, utility and custodial services, and other

20 necessary services and amenities;

21 ‘‘(3) shall provide for the participation (directly

22 or through a parent advisory committee) of parents

23 of children receiving care in the center in the estab24 lishment of policies to govern the operation of the
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1 center and in the oversight of the implementation of

2 such policies;

3 ‘‘(4) shall require the development and use of a

4 process for determining the fitness and suitability of

5 prospective employees of or volunteers at the center;

6 and

7 ‘‘(5) shall require in connection with the oper8 ation of the center compliance with all State and

9 local laws, ordinances, and regulations relating to

10 health and safety and the operation of child care

11 centers.

12 ‘‘(e) The Secretary shall prescribe guidelines to carry

13 out this section.

14 ‘‘(f) For the purpose of this section, the term ‘parent

15 advisory committee’ means a committee comprised of, and

16 selected by, the parents of children receiving care in a

17 child care center operated under this section.’’.

18 (b) CONFORMING REPEAL.—Section 7809 of such

19 title is repealed.

20 (c) CLERICAL AMENDMENTS.—(1) The table of sec21 tions at the beginning of chapter 81 of such title is amend22 ed by inserting after the item relating to section 8116 the

23 following new item:

‘‘8117. Child care centers.’’.
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1 (2) The table of sections at the beginning of chapter

2 78 of such title is amended by striking out the item relat3 ing to section 7809.

4 SEC. 503. CONTRACTS FOR UTILITIES, AUDIE L. MURPHY

5 MEMORIAL HOSPITAL.

6 (a) AUTHORITY TO CONTACT.—Subject to subsection

7 (b), the Secretary of Veterans Affairs may enter into con8 tracts for the provision of utilities (including steam and

9 chilled water) to the Audie L. Murphy Memorial Hospital

10 in San Antonio, Texas. Each such contract may—

11 (1) be for a period not to exceed 35 years;

12 (2) provide for the construction and operation

13 of a production facility on or near property under

14 the jurisdiction of the Secretary;

15 (3) require capital contributions by the parties

16 involved for the construction of such a facility, such

17 contribution to be in the form of cash, equipment,

18 or other in-kind contribution; and

19 (4) provide for a predetermined formula to

20 compute the cost of providing such utilities to the

21 parties for the duration of the contract.

22 (b) FUNDS.—A contract may be entered into under

23 subsection (a) only to the extent and in the amount pro24 vided in advance in appropriations Acts.
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1 (c) ADDITIONAL TERMS.—The Secretary may include

2 in a contract under subsection (a) such additional provi3 sions as the Secretary considers necessary to secure the

4 provision of utilities and to protect the interests of the

5 United States.

6 SEC. 504. FACILITIES IN REPUBLIC OF THE PHILIPPINES.

7 Notwithstanding section 1724 of title 38, United

8 States Code, the Secretary of Veterans Affairs, during the

9 period from February 28, 1994, through June 1, 1994,

10 may contract with facilities in the Republic of the Phil11 ippines other than the Veterans Memorial Medical Center

12 to furnish hospital care and medical services to veterans

13 for nonservice-connected disabilities if such veterans are

14 unable to defray the expenses of necessary hospital care.

15 When the Secretary determines it to be most feasible, the

16 Secretary may provide medical services to such veterans

17 at the Department of Veterans Affairs Outpatient Clinic

18 at Manila, Republic of the Philippines.

19 SEC. 505. WAIVER OF CONGRESSIONAL WAITING PERIOD

20 REQUIREMENT FOR A SPECIFIED ADMINIS21 TRATIVE REORGANIZATION.

22 (a) WAIVER.—The Secretary of Veterans Affairs may

23 undertake the administrative reorganization described in

24 subsection (b) of this section without regard to the waiting
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1 period requirement of section 510(b) of title 38, United

2 States Code.

3 (b) COVERED ADMINISTRATIVE REORGANIZATION.—

4 The administrative reorganization referred to in sub5 section (a) of this section is a reorganization at the De6 partment of Veterans Affairs Medical Center in Sepul7 veda, California, necessitated by the January 1994 earth8 quake damage at that location, as described in the letters

9 dated April 25, 1994, and the accompanying detailed plan

10 and justification, submitted by the Secretary of Veterans

11 Affairs to the chairmen of the House and Senate Commit12 tees on Veterans’ Affairs pursuant to section 510(b) of

13 title 38, United States Code.

14 SEC. 506. TECHNICAL AMENDMENT.

15 Section 7363(c) of title 38, United States Code, is

16 amended by striking out ‘‘section 501(c)(3) of’’.

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