39–006 

113TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 113–284 

DEPARTMENT OF VETERANS AFFAIRS MAJOR MEDICAL 

FACILITY LEASE AUTHORIZATION ACT OF 2013 

DECEMBER 9, 2013.—Committed to the Committee of the Whole House on the State 

of the Union and ordered to be printed 

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

submitted the following 

R E P O R T 

[To accompany H.R. 3521] 

[Including cost estimate of the Congressional Budget Office] 

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

bill (H.R. 3521) to authorize Department of Veterans Affairs major 

medical facility leases, and for other purposes, having considered 

the same, report favorably thereon without amendment and recommend that the bill do pass. 

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 2 

Background and Need for Legislation. ................................................................... 3 

Hearings ................................................................................................................... 10 

Committee Consideration ........................................................................................ 10 

Committee Votes ...................................................................................................... 10 

Committee Oversight Findings ............................................................................... 10 

Statement of General Performance Goals and Objectives .................................... 10 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 10 

Earmarks and Tax and Tariff Benefits .................................................................. 11 

Committee Cost Estimate ....................................................................................... 11 

Congressional Budget Office Estimate ................................................................... 11 

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

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

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

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

Statement on Duplication of Federal Programs .................................................... 15 

Disclosure of Directed Rulemaking ........................................................................ 16 

Section-by-Section Analysis of the Legislation ...................................................... 16 

Changes in Existing Law Made by the Bill as Reported ...................................... 18 


smartinez on DSK6TPTVN1PROD with REPORTS
2 

PURPOSE AND SUMMARY

H.R. 3521, the ‘‘Department of Veterans Affairs Major Medical 

Facility Lease Authorization Act of 2013,’’ was introduced by Representative Jefferson Miller of Florida, Chairman of the Committee 

on Veterans’ Affairs, on November 18, 2013. 

H.R. 3521 would: 

1. Authorize the Department of Veterans Affairs (VA) to carry 

out specified major medical facility leases (requested by the Department in the fiscal year 2014 budget submission) at the following locations: (1) Albuquerque, NM, for an amount of $9,560,000; (2) 

Brink, NJ, for an amount of $7,280,000; (3) Charleston, SC, for an 

amount of $7,070,250; (4) Cobb County, GA, for an amount of 

$6,409,000; (5) Honolulu, HI, for an amount of $15,887,370; (6) 

Johnson County, KS, for an amount of $2,263,000; (7) Lafayette, 

LA, for an amount of $2,996,000; (8) Lake Charles, LA, for an 

amount of $2,626,000; (9) New Port Richey, FL, for an amount of 

$11,927,000; (10) Ponce, PR, for an amount of $11,535,000; (11) 

San Antonio, TX, for an amount of $19,426,000; (12) San Diego, 

CA, for an amount of $11,946,100; (13) Tyler, TX, for an amount 

of $4,327,000; (14) West Haven, CT, for an amount of $4,883,000; 

(15) Worcester, MA, for an amount of $4,855,000; (16) Cape 

Girardeau, MO, for an amount of $4,232,060; (17) Chattanooga, 

TN, for an amount of $7,069,000; (18) Chico, CA, for an amount of 

$4,534,000; (19) Chula Vista, CA, for an amount of $3,714,000; (20) 

Hines, IL for an amount of $22,032,000; (21) Houston, TX, for an 

amount of $6,142,000; (22) Lincoln, NE, for an amount of 

$7,178,400; (23) Lubbock, TX, for an amount of $8,554,000; (24) 

Myrtle Beach, SC, for an amount of $8,022,000; (25) Phoenix, AZ, 

for an amount of $20,757,000; (26) Redding, CA, for an amount of 

$8,154,000; and (27) Tulsa, OK, for an amount of $13,269,200. 

2. Make the following Congressional findings: (1) VA is required 

under title 31, United States Code (U.S.C.), to record the full cost 

of its contractual obligation against funds available at the time a 

contract is executed; (2) the Office of Management and Budget 

(OMB) Circular A–11 provides guidance to agencies in meeting the 

requirements of title 31, U.S.C., with respect to leases; and, (3) 

OMB Circular A–11 requires VA to record the up-front budget authority for operating leases in the amount of the total payments 

under the full term of the lease or sufficient payments to cover the 

first year lease payments plus cancellation costs. 

3. Require VA, subject to the availability of appropriations provided in advance, to record the full cost of the contractual obligation at the time a contract is executed either in an amount equal 

to total payments required under the full term of the lease; or 

equal to an amount sufficient to cover the first year lease payments 

and any specified cancellation costs in the event that the lease is 

terminated before its full term. 

4. Require VA to provide a detailed analysis of how such lease 

is expected to comply with OMB Circular A–11 and section 1341 

of title 31, U.S.C. in a prospectus for a proposed lease. 

5. Require VA to submit to the Committees on Veterans’ Affairs 

not less than 30 days before entering into a major medical facility 

lease, the following information: (1) notice of the intent to enter 

into a lease; (2) a copy of the proposed lease; (3) an explanation of 


smartinez on DSK6TPTVN1PROD with REPORTS
3 

any difference between the prospectus and the lease submitted 

under this subsection; and (4) a scoring analysis demonstrating 

compliance with OMB Circular A–11. 

6. Require VA to submit to the Committees on Veterans’ Affairs 

a report of any material differences between the lease VA ultimately enters into and the proposed lease in VA’s prospective not 

less than 30 days after entering into a major medical facility lease. 

7. Stipulate that the legislation does not relieve VA from any 

statutory or regulatory obligation or requirements existing prior to 

the enactment of the legislation. 

BACKGROUND AND NEED FOR LEGISLATION

VA is the third largest real property owner in the Federal government, maintaining more than 170 million square feet of medical 

facilities and administrative space across approximately 7,786 

buildings located on more than 35 thousand acres of land. The Veterans Health Administration (VHA) is comprised of approximately 

5,439 buildings across more than 14.8 million square feet. VHA’s 

capital asset portfolio includes both VA-owned and VA-leased property. As of November 2012, VHA encompassed approximately 1,636 

leased assets. 

Section 8104 of title 38, U.S.C., requires that VA major medical 

facility leases, defined as ‘‘a lease for space for use as a new medical facility at an average annual rent of more than $1 million,’’ be 

specifically authorized by law. 

To obtain Congressional authorization, VA is required to submit 

a prospectus containing detailed information about each proposed 

lease. According to the statute, each prospectus should include a 

detailed description of the proposed project; the estimated total cost 

of the project; estimated equipment costs; current and projected operating costs; demographic data; current and projected workload 

and utilization data; and, the priority score assigned to the lease 

under the Department’s prioritization methodology. 

VA’s fiscal year (FY) 2013 and 2014 budget submission requested 

authorization for the following 27 major medical facility leases. 

Albuquerque, New Mexico: VA’s FY 2013 and 2014 budget submissions request $9.56 million for the replacement of the current 

leased space containing the Clinical Research Pharmacy Coordinating Center (CRPCC) in Albuquerque, New Mexico. According to 

VA, the proposed replacement lease would continue valuable and 

unique programs which include all pharmaceutical, regulatory, and 

research participant safety monitoring support for all VA Cooperative Studies Programs aimed at improving veteran health. The current lease agreement for the existing facility is set to expire on August 31, 2015. The proposed leased facility would occupy 80,000 net 

usable square feet. 

Brick, New Jersey: VA’s FY 2013 and 2014 budget submissions 

request $7.28 million for a replacement community based outpatient clinic (CBOC) in Brick, New Jersey, supporting the parent 

facility, the East Orange Campus of the New Jersey Veterans 

Health Care System. According to VA, the proposed replacement 

CBOC lease would expand the current facility by increasing the net 

usable square feet from 34,000 to 60,000, which would accommodate future workload growth and allow for expanded services inVerDate Mar 15 2010 04:46 Dec 10, 2013 Jkt 039006 PO 00000 Frm 00003 Fmt 6659 Sfmt 6602 E:\HR\OC\HR284.XXX HR284

smartinez on DSK6TPTVN1PROD with REPORTS
4 

cluding, radiology, dental, optometry, physical therapy, and ophthalmology care. 

Charleston, South Carolina: VA’s FY 2013 and 2014 budget submissions request $7.07 million for leasing of a Clinical Annex Lease 

in Charleston, South Carolina, which will allow for relocation and 

consolidation of services with another expiring lease, and expansion 

of services in support of the parent facility of the Charleston VA 

Medical Center. According to VA, the proposed lease would provide 

expanded services, increase access to care for veteran patients, and 

address future utilization, workload and space requirements. The 

proposed leased facility would occupy 75,000 net usable square feet 

and would serve approximately 20,722 veterans. 

Cobb County; Georgia: VA’s FY 2013 and 2014 budget submissions request $6.41 million for a new, leased CBOC in northern 

Cobb County, Georgia, to consolidate and expand services currently 

offered at an existing CBOC that supports the Atlanta VA Medical 

Center. According to VA, the proposed leased facility would expand 

outpatient and mental health care services, increasing access to 

veterans in Northern Cobb County. The proposed leased facility 

would occupy 64,000 net usable square feet and be expected to 

serve approximately 64,000 veterans. 

Honolulu, Hawaii: VA’s FY 2013 and 2014 budget submissions 

request $15.89 million for a new lease of an outpatient medical 

care center in Ewa Plain, Oahu, Hawaii. According to VA, the proposed leased facility would increase access to primary care, mental 

health care, specialty care, radiology care, laboratory services, 

pharmacy services, and telehealth services, while lessening the 

need for veteran travel to the Honolulu VA medical center. The 

proposed leased facility would encompass a collocated clinic for 

military branch entities, with VA and the Department of Defense 

sharing clinical, ancillary, and support functions. It would also 

allow for the collocation of several VA functions, including the Veterans Benefits Administration Honolulu Regional Office and the 

Kapolei Vet Center. The proposed leased facility would occupy 

118,823 net usable square feet. 

Johnson County, Kansas: VA’s FY 2013 and 2014 budget submissions request $2.26 million for a new CBOC lease in Johnson County, Kansas. According to VA, the proposed leased facility would increase access to care for Johnson County veterans who currently 

travel more than 30 minutes to access care at the Kansas City VA 

medical center and provide comprehensive outpatient services as 

well as ancillary and support services including radiology care and 

laboratory and pharmacy services. The proposed leased facility 

would occupy 22,910 net usable square feet and would be expected 

to serve approximately 11,327 veterans. 

Lafayette, Louisiana: VA’s FY 2013 and 2014 budget submissions 

request $2.99 million for a replacement CBOC in Lafayette, Louisiana. According to VA, the proposed leased facility would mitigate 

space and workload gaps throughout Veterans Integrated Service 

Network 16 and alleviate the need for veterans to travel 180 miles 

to the Alexandria VA medical center. It would also provide increased access to primary, specialty, mental health, and women’s 

health care and dental, imaging, physical therapy, urology, ophthalmology, and dermatology services to Louisiana veterans. The 


smartinez on DSK6TPTVN1PROD with REPORTS
5 

proposed leased facility would occupy 29,224 net usable square feet 

and serve approximately 7,227 veterans. 

Lake Charles, Louisiana: VA’s FY 2013 and 2014 budget submis- sions request $2.63 million for a new CBOC in Lake Charles, Louisiana. According to VA, the proposed leased facility would provide 

outpatient services that would alleviate current access deficiencies. 

The proposed leased facility would occupy 24,088 net usable square 

feet and would be expected to serve approximately 6,000 veterans. 

New Port Richey, Florida: VA’s FY 2013 and 2014 budget sub- missions request $11.93 million for a new CBOC in New Port 

Richey, Florida. According to VA, the proposed lease facility would 

consolidate and expand services currently offered in five different 

clinics located within 20 miles of New Port Richey into one, single 

facility and provide access to expanded outpatient services. The 

proposed leased facility would occupy 114,000 net usable space 

square feet and would be expected to serve approximately 14,845 

veterans. 

Ponce, Puerto Rico: VA’s FY 2013 and 2014 budget submissions request $11.54 million for a replacement CBOC lease in Ponce, 

Puerto Rico. According to VA, the proposed leased facility would 

provide expanded outpatient services to address utilization and 

space deficiencies and reduce patient waiting and travel times. The 

current CBOC lease will expire in February 2015. The proposed 

leased facility would occupy 114,300 net usable square feet and 

would be expected to serve approximately 11,619 veterans. 

San Antonio, Texas: VA’s FY 2013 and 2014 budget submissions request $19.43 million for a replacement Outpatient Clinic (OC) 

lease in San Antonio, Texas. According to VA, the proposed leased 

facility would replace and consolidate the current OC, two annex 

leases, three specialty care clinic leases, and one contract clinic. 

The new consolidated clinic would provide increased access to expanded services including primary, mental health, specialty, surgery, dental, vision, and women’s health care. The proposed leased 

facility would occupy 190,800 net usable square feet and would be 

expected to serve approximately 55,753 veterans. 

San Diego, California: VA’s FY 2013 and 2014 budget submissions request $11.95 million for a replacement CBOC lease in San 

Diego, California. According to VA, the proposed leased facility 

would integrate primary, mental health, and specialty care and ancillary services and provide increased access to expanded services 

including women’s health, audiology, eye, and blind rehabilitation 

care. It would also increase operational efficiencies. The proposed 

leased facility would occupy 99,986 net usable square feet and 

would be expected to serve approximately 32,832 veterans. 

Tyler, Texas: VA’s FY 2013 and 2014 budget submissions request 

$4.33 million for a replacement CBOC lease in Tyler, Texas. According to VA, the proposed leased facility would consolidate services currently offered in two existing CBOCs, which would improve 

the provision of primary, specialty, and mental health care to 

Texas veterans. It would also alleviate current primary and specialty care deficiencies in the Smith County, Texas, area and lessen 

the need for veterans to travel to the Dallas VA medical center for 

some specialty services. The proposed leased facility would occupy 

48,425 net usable square feet and would serve approximately 4,489 

veterans. 


smartinez on DSK6TPTVN1PROD with REPORTS
6 

West Haven, Connecticut: VA’s FY 2013 and 2014 budget submis- sions request $4.88 million for a new Community Care Center lease 

in West Haven, Connecticut. According to VA, the proposed leased 

facility would replace and expand the current Errera Community 

Center, which provides intensive support services, substance use 

counseling, psychosocial rehabilitation, and integrated psychosocial 

and biomedical treatment to aging veterans, at-risk veterans, and 

veterans with mental health issues. The proposed facility would occupy 45,000 net usable space square feet. 

Worcester, Massachusetts: VA’s FY 2014 budget submissions re- quest $4.86 million for a replacement CBOC lease in Worcester, 

Massachusetts. According to VA, the proposed leased facility would 

replace the current CBOC and alleviate existing space deficiencies. 

It would provide increased access to outpatient primary care and 

other services including cardiology, audiology, dermatology, geriatric, nutritional, vision, imaging, and mental health services. The 

proposed leased facility would occupy 40,000 net usable square feet. 

Cape Girardeau, Missouri: VA’s FY 2014 budget submissions re- quest $4.23 million for a new CBOC lease in Cape Girardeau, Missouri. According to VA, the proposed leased facility would enhance 

existing VA outpatient services in the Cape Girardeau area and alleviate existing patient waiting times and space, utilization, and 

parking deficiencies. It would also provide increased access to primary, specialty, women’s, and mental health care and rehabilitative, home health, and ancillary services. The proposed leased facility would occupy approximately 43,000 net usable square feet and 

would be expected to serve 4,997 veterans. 

Chattanooga, Tennessee: VA’s FY 2014 budget submissions re- quest $7.07 million for the expansion of a multispecialty CBOC in 

Chattanooga, Tennessee. According to VA, the proposed leased facility would expand clinical services and increase access to primary, 

specialty, and mental health care. It would also provide increased 

access to outpatient services and alleviate existing patient waiting 

times, and space deficiencies. The proposed leased facility would occupy 75,000 net usable square feet and would serve approximately 

18,322 veterans. 

Chico, California: VA’s FY 2014 budget submissions request 

$4.53 million for a replacement CBOC lease in Chico, California. 

According to VA, the proposed leased facility would replace the existing Chico CBOC and increase access to telemedicine services including, allergy, nephrology, rheumatology, infectious disease, and 

immunology services. It would also alleviate existing patient waiting times and projected utilization and space needs. The proposed 

leased facility would occupy 42,000 net usable square feet and 

would be expected to serve approximately 8,489 veterans. 

Chula Vista, California: VA’s FY 2014 budget submissions request $3.71 million for a replacement CBOC lease in Chula Vista, 

California. According to VA, the proposed leased facility would address current and projected space shortages and provide increased 

access to audiology, speech pathology, vision, mental health, laboratory, radiology, and primary care. The proposed leased facility 

would occupy 31,000 net usable square feet and would be expected 

to serve 7,327 veterans. 

Hines, Illinois: VA’s FY 2014 budget submissions request $22.03 

million for a new research lease in Hines, Illinois. According to VA, 


smartinez on DSK6TPTVN1PROD with REPORTS
7 

the proposed leased facility would alleviate current facility condition deficiencies and provide a safe research space in support of 

multiple VA research programs including Basic Laboratory Research and Development and Health Services Research and Development. The proposed leased facility would occupy 164,000 net usable square feet and would replace the outdated current research facility that was built in 1921. 

Houston, Texas: VA’s FY 2014 budget submissions request $6.14 

million for a replacement research lease in Houston, Texas. According to VA, the proposed leased facility would replace the existing 

research lease and support increases in grant funding and a new 

Veteran Engineering Resource Center, as well as provide space for 

research-related equipment, library, offices, and meeting rooms. 

The proposed leased facility would occupy 48,000 net usable square 

feet. 

Lincoln, Nebraska: VA’s FY 2014 budget submissions request 

$7.18 million for a new CBOC lease in Lincoln, Nebraska. According to VA, the proposed leased facility would integrate the delivery 

of primary, specialty, and mental health care and ancillary services 

and allow for the replacement of the current 84-year-old facility. 

The proposed leased facility would occupy 72,000 net usable square 

feet and would be expected to serve approximately 15,200 veterans. 

Lubbock, Texas: VA’s FY 2014 budget submissions request $8.55 

million for a new CBOC lease in Lubbock, Texas. According to VA, 

the proposed leased facility would replace the current Lubbock 

CBOC, increase access to outpatient services, and alleviate existing 

patient waiting time and space deficiencies. It would also increase 

access to endoscopy, day surgery, gastroenterology, and audiology 

care to Texas veterans. The proposed leased facility would occupy 

94,000 net usable square feet. 

Myrtle Beach, South Carolina: VA’s FY 2014 budget submissions 

request $8.02 million for a new CBOC lease in Myrtle Beach, South 

Carolina. According to VA, the new leased facility would replace 

and consolidate two existing CBOCs and accommodate projected 

workload and space needs. It would also accommodate projected 

workload increases. The proposed leased facility would occupy 

84,000 net usable square feet and would serve approximately 

11,106 veterans. 

Phoenix, Arizona: VA’s FY 2014 budget submissions request 

$20.76 million for a new CBOC lease in Phoenix, Arizona. According to VA, the proposed leased facility would enhance VA outpatient services and alleviate existing patient waiting time, and 

workload and space deficiencies. It would also allow for increased 

education, recruitment, and research initiatives in closer proximity 

to the Phoenix VA health care system’s university affiliate. The 

proposed leased facility would occupy 203,000 net usable square 

feet and would be expected to serve approximately 64,878 veterans. 

Redding, California: VA’s FY 2014 budget submissions request 

$8.15 million for a replacement CBOC lease in Redding, California. 

According to VA, the proposed leased facility would replace the current Redding CBOC and accommodate patient workload growth in 

primary, specialty, and mental health care. It would also increase 

access to telemedicine and improve clinical, administrative, and 

support function workspace. The proposed leased facility would ocVerDate Mar 15 2010 04:46 Dec 10, 2013 Jkt 039006 PO 00000 Frm 00007 Fmt 6659 Sfmt 6602 E:\HR\OC\HR284.XXX HR284

smartinez on DSK6TPTVN1PROD with REPORTS
8 

cupy 77,000 net usable square feet and would serve approximately 

14,856 veterans. 

Tulsa, Oklahoma: VA’s FY 2014 budget submissions request $13.27 million for a replacement CBOC in Tulsa, Oklahoma. According to VA, the proposed leased facility would replace the existing Tulsa OC and Tulsa Behavioral Medicine Clinic, increase access to VA outpatient services, and alleviate existing patient waiting time, utilization, and space deficiencies. It would also improve 

the provision of primary, specialty, surgical and mental health care 

and imaging, laboratory, and pharmacy services to Oklahoma veterans. The proposed leased facility would occupy 140,000 net usable square feet and would be expected to serve approximately 

25,806 veterans. 

Deficiencies in VA’s lease procurement and management process 

It is the responsibility of the Committee to ensure that VA is 

given the appropriate authority to undertake necessary capital investments for the purpose of effectively serving our nation’s veterans and ensuring access to the care and services they need. The 

Committee is deeply troubled by the ineffective management and 

deficiencies uncovered through Committee oversight of VA’s lease 

procurement process. On October 22, 2013, the VA Inspector General (IG) issued a report, entitled, ‘‘Review of VA’s Management of 

Health Care Center Leases.’’ The findings in this report substantiate the ongoing significant and serious failures in VA’s lease procurement and management. Specifically, the IG found: 

—Lack of Guidance—VA’s management of the timeliness and 

costs in the Health Care Center (HCC) lease procurement process has been ineffective due to the lack of guidance available 

for planning lease projects with such high annual rent as the 

HCCs; 

—Inaccurate Milestones—VA established identical milestones for completing the seven HCCs even though the projects 

varied in size and budget and failed to meet the milestones, in 

spite of providing Congress with an aggressive project schedule; 

—Lack of Documentation—VA could not provide documentation to support whether the Department adequately assessed 

the feasibility of accomplishing the HCCs in the promised 32– 

month time frame; and, 

—Lack of Central Tracking—VA could not provide accurate 

information on HCC spending into April 2013 as central cost 

tracking was not in place to ensure transparency and accurate 

reporting of all HCC expenditures. 

The IG recommended that VA: (1) establish adequate guidance 

for management of the procurement process of large-scale build-tolease facilities; (2) provide realistic and justifiable timelines for 

HCC completion; (3) ensure HCC project analyses and key decisions are supported and documented; and, (4) establish central cost 

tracking to ensure transparency and accurate reporting of HCC expenditures. 

VA concurred with each of the IG’s recommendations. It is the 

Committee’s expectation that VA will fully implement each of these 

recommendations prior to initiating lease procurement in the 27 

major medical facility leases included in this legislation. 


smartinez on DSK6TPTVN1PROD with REPORTS
9 

Budgetary treatment of VA Major Medical Facility Leases 

The Anti-Deficiency Act (31 U.S.C. § 1341(a)(1) prohibits federal 

employees from making or authorizing an expenditure from, or creating or authorizing an obligation under, any appropriation or fund 

in excess of the amount available in the appropriation or fund unless authorized by law, and involving the government in any obligation to pay money before funds have been appropriated for that 

purpose, unless otherwise allowed by law, in addition to other requirements. OMB Circular A–11 provides instructions to agencies 

on the budgetary treatment of lease-purchase and leases of capital 

assets consistent with the scorekeeping rules originally promulgated in connection with the Budget Enforcement Act of 1990 

(BEA) and the Anti-Deficiency Act. Agencies are required to obligate at the time they enter into a binding commitment budget authority in the amount necessary to cover the Government’s legal 

obligations, consistent with the requirements of the Anti-Deficiency 

Act and in the manner directed in OMB Circular A–11. OMB Circular A–11 and the Anti-Deficiency Act require budgeting for both 

the estimated total payments expected to arise under the full term 

of the contract or, if the contract includes a cancellation clause, an 

amount sufficient to cover the lease payments for the first year 

plus an amount sufficient to cover the costs associated with cancellation of the contract. 

After receiving information about how VA had exercised the authority provided in prior VA major medical facilities leasing authorizations, the Congressional Budget Office (CBO) has concluded that 

VA has been entering into binding obligations for the full period of 

the lease. Consistent with the longstanding laws and budget rules 

discussed above, VA is required to obligate the budget authority 

upfront for the full amount of those obligations. This is consistent 

with the plain language of the law, OMB’s A–11 guidance, and the 

underlying principle of congressional control over public spending. 

There is serious doubt as to whether VA has been properly recording the cost of its leases when using the leasing authority provided in the prior medical facilities authorizations acts. Given VA’s 

prior practice, CBO has determined that VA has implemented 

priori authorizations as if they provided contract authority, a type 

of mandatory budget authority that permits an agency to enter into 

obligations on behalf of the U.S. Government in advance of funds 

being appropriated to liquidate that obligation. This legislation includes language designed to ensure that VA exercises the authority 

provided in this legislation consistent with the express congressional intent that the agency only enter into binding commitments 

on behalf of the U.S. Government once funds have been appropriated for the purpose of that proposed commitment and that VA 

obligate the full cost of that commitment at the time it executes the 

lease. 

Specifically in furtherance of congressional intent, the legislation 

would: 

(1) require VA to comply with the Anti-Deficiency Act and 

OMB Circular A–11 in exercising the authority to enter into 

leases provided by the bill; 

(2) authorize VA to enter into obligations on behalf of the 

U.S. Government only to the extent amounts are provided in 

advance in appropriations acts; 


smartinez on DSK6TPTVN1PROD with REPORTS
10 

(3) require VA to provide a lease analysis to Congress prior 

to signing any lease agreement under the authority provided 

in this bill including detailed information on how it is exercising its leasing authorities in compliance with OMB Circular 

A–11 and the Anti-Deficiency Act; and, 

(4) require VA to submit to Congress, not more than 30 days 

after entering into a major medical facility lease, a report on 

any material differences between the lease that was entered 

into and the proposed lease, including how the lease that was 

entered into changes the previously submitted scoring analysis. 

If VA fails to faithfully execute the intent of this legislation and 

to comply with the longstanding laws governing obligations, Congress will revisit this issue in the context of future requests for 

leasing authority. 

HEARINGS

On June 27, 2013, the Full Committee held an oversight hearing 

regarding the implications of CBO’s scoring of major medical facility lease authorizations and possible alternate options for effectively meeting the care needs of veterans. 

COMMITTEE CONSIDERATION

On November 20, 2013, the Full Committee met in an open 

markup session, a quorum being present and ordered H.R. 3521 reported favorably to the House of Representatives by voice vote. 

COMMITTEE VOTES

Clause 3(b) of rule XIII of the Rules of the House of Representatives requires the Committee to list the recorded votes on the motion to report the legislation and amendments thereto. There were 

no recorded votes taken on amendments or in connection with ordering H.R. 3521 reported to the House. A Motion by Mr. Michaud 

of Maine to order H.R. 3521 reported favorably to the House of 

Representatives was agreed to by voice vote. 

COMMITTEE OVERSIGHT FINDINGS

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

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

descriptive portions of this report. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

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

House of Representatives, the Committee’s performance goals and 

objectives are reflected in the descriptive portions of this report. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

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

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


smartinez on DSK6TPTVN1PROD with REPORTS
11 

the director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

EARMARKS AND TAX AND TARIFF BENEFITS

H.R. 3521 does not contain any congressional earmarks, limited 

tax benefits, or limited tariff benefits as defined in clause 9 of rule 

XXI of the Rules of the House of Representatives. 

COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate prepared by 

the director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

CONGRESSIONAL BUDGET OFFICE ESTIMATE

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

of Representatives, the following is the cost estimate for H.R. 3521 

provided by the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, December 6, 2013. 

Hon. JEFF MILLER, 

Chairman, Committee on Veterans’ Affairs, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 3521, the Department of 

Veterans Affairs Major Medical Facility Lease Authorization Act of 

2013. 

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

to provide them. The CBO staff contact is David Newman. 

Sincerely, 

DOUGLAS W. ELMENDORF. 

Enclosure. 

H.R. 3521—Department of Veterans Affairs Major Medical Facility 

Lease Authorization Act of 2013 

Summary: H.R. 3521 would authorize the Department of Veterans Affairs (VA) to enter into leases to obtain the use of major 

medical facilities at 27 specified locations. Based on VA’s long-established practice, CBO expects that the department would implement that authorization by awarding contracts for the construction 

and long-term use of those facilities without recording the full 

amount of the government’s commitment as an obligation of its appropriated funds. Thus, H.R. 3521 would effectively be providing 

budget authority for an amount of obligations that exceeds what we 

expect VA initially would charge against its appropriation. By 

CBO’s estimate, that additional budget authority would amount to 

$1.4 billion. 

Hence, CBO estimates that enacting this bill would increase di- rect spending by about $1.4 billion over the 2014–2023 period. Because the bill would affect direct spending, pay-as-you-go procedures apply. We also estimate that, assuming appropriation of the 

necessary amounts, implementing the bill would have a discreVerDate Mar 15 2010 04:46 Dec 10, 2013 Jkt 039006 PO 00000 Frm 00011 Fmt 6659 Sfmt 6602 E:\HR\OC\HR284.XXX HR284

smartinez on DSK6TPTVN1PROD with REPORTS
12 

1For more information on the budgetary treatment of third-party financing, see Congressional 

Budget Office, Third-Party Financing of Federal Projects (June 2005), www.cbo.gov/publication/ 

16554. 

tionary cost of $124 million over the 2014–2023 period. Enacting 

H.R. 3521 would not affect federal revenues. 

H.R. 3521 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA) 

and would not affect the budgets of state, local, or tribal governments. 

Estimated cost to the Federal Government: The estimated budgetary impact of H.R. 3521 is shown in the following table. The costs 

of this legislation fall within budget function 700 (veterans benefits 

and services). 

By fiscal year, in millions of dollars— 

2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2014– 

2018 

2014– 

2023 

CHANGES IN DIRECT SPENDING 

Estimated 

Budget Authority ........ 41 0 1,378 0 0 0 0 0 0 0 1,419 1,419 

Estimated Outlays ............ 2 11 83 382 459 345 137 0 0 0 937 1,419 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION a

Estimated Authorization 

Level .......... 0 0 124 0 0 0 0 0 0 0 124 124 

Estimated Outlays ............ 0 0 87 31 6 0 0 0 0 0 124 124 

a Changes in spending subject to appropriations exclude $3 million that CBO expects would be paid from currently available appropriations. 

Basis of estimate: For this estimate, CBO assumes that the legislation will be enacted early in 2014 and that outlays will follow historical spending patterns for major construction projects carried out 

by VA. 

CBO’s Assessment: VA’s long-term obligations as purchases 

Section 2 of H.R. 3521 would authorize VA to acquire the use of 

27 medical facilities and would set a limit on the cost of each lease. 

VA classifies its contracts for acquiring similar facilities as operating leases. However, on the basis of information from VA regarding those transactions, CBO has concluded that most of them are 

akin to government purchases of facilities built specifically for VA’s 

use—but instead of being financed by the U.S. Treasury, they rely 

on third-party financing (that is, funds raised by a nonfederal entity), which is generally more expensive.1 That conclusion is based 

on those leases having many of the following key features: 

• The facilities are designed and constructed to the unique 

specifications of the government; 

• The facilities are constructed at the request of the federal 

government; 

• The leases on the newly constructed facilities are long 

term—usually 20 years; 

• Typically, payments from the federal government are the 

only or primary source of income for the facilities; 

• The term of the contractual agreements coincides with the 

term of the private partner’s financing instrument for develVerDate Mar 15 2010 04:46 Dec 10, 2013 Jkt 039006 PO 00000 Frm 00012 Fmt 6659 Sfmt 6602 E:\HR\OC\HR284.XXX HR284

smartinez on DSK6TPTVN1PROD with REPORTS
13 

2See the Statement of Robert A. Sunshine, Deputy Director, Congressional Budget Office, The 

Budgetary Treatment of Medical Facility Leases by the Department of Veterans Affairs, before 

the House Committee on Veterans’ Affairs, (June 27, 2013), www.cbo.gov/publication/44368. 

oping and constructing the facility (that is, a facility financed 

with a 20-year bond will have a 20-year lease term); • The federal government commits to make fixed annual 

payments that are sufficient to service the debt incurred to develop and construct the facility, regardless of whether the 

agency continues to occupy the facility during the guaranteed 

term of the lease; and • The fixed payments over the life of the lease are sufficient 

to retire the debt for the facility.2

Thus, although those transactions are structured as leases, they 

are essentially government purchases. Following the normal procedures governing the budgetary treatment of such purchases, budget 

authority should be available and obligations should be recorded up 

front when the acquisitions are initiated in amounts equal to the 

development and construction costs of the medical facilities. Instead, VA records a small fraction of the costs as obligations when 

it awards the contracts for such transactions. 

To the extent that the full costs of developing and constructing 

the facilities exceeds the relatively small amount that VA would 

initially record as obligations against its appropriation, CBO treats 

the legislative authorization for those transactions as contract authority—a type of budget authority that allows an agency to enter 

into a contract and incur an obligation before receiving an appropriation for those activities. Because the contract authority would 

be provided in authorizing legislation, H.R. 3521, rather than in an 

appropriation act, the resulting spending is categorized as direct 

spending (as distinguished from discretionary spending, which results from appropriation acts). 

CBO’s estimate of direct spending for H.R. 3521 shows the additional budget authority needed for the costs of developing and constructing the facilities when the contracts would be awarded, over 

and above the $127 million that CBO estimates would be charged 

against VA’s discretionary appropriations at those times. (VA 

would obligate those appropriations for certain special features of 

the facilities; the initial annual lease payments would begin later, 

after the facilities were constructed.) CBO expects that $3 million 

of the $127 million would be paid from already enacted appropriations for the special features of two facilities for which the contracts would be awarded in 2014. That amount is not included in 

this estimate. 

Documentation for the projects indicates that contracts for the 

rest of the facilities would be awarded in 2016. Thus, CBO estimates that the bill would create $41 million of additional budget 

authority in 2014 for the first two projects, and another $1.4 billion 

in 2016 for the others. Outlays are estimated to occur over the 

2014–2020 period, when the facilities would be constructed. All 

told, the bill would increase direct spending by about $1.4 billion 

over the 2014–2023 period, CBO estimates. 

VA’s Categorization: Long-term obligations as leases 

VA considers its long-term agreements for medical facilities to be 

straightforward operating leases (and not effectively purchases). 


smartinez on DSK6TPTVN1PROD with REPORTS
14 

3See the Office of Management and Budget, Preparation, Submission, and Execution of the 

Budget, Circular A–11 (August 2012), Appendix B. 

Even if that was the case, however, it appears that the department 

generally has not been properly recording its obligations for such 

leases. Circular A–11 issued by the Office of Management and 

Budget specifies that operating leases require up-front budget authority in an amount equal to total payments over the full term of 

the lease or an amount sufficient to cover first-year lease payments 

plus cancellation costs.3 But for lease contracts that do not permit 

early cancellation, VA has only recorded obligations for payments 

due in the year the lease was awarded; as a result, the government’s actual obligations for contracts have exceeded the amount 

the agency has recorded. 

H.R. 3521 would not require VA to change its current practices. 

Section 3 of the bill would require VA to record an obligation at the 

time a contract is signed in an amount equal to either the total 

payments that would be made under its full term, or an amount 

equal to the sum of the first annual lease payment and any specified cancellation costs. That requirement, however, would be contingent upon the availability of sufficient appropriations to record 

those amounts. Moreover, the amounts specified for the leases in 

section 2 of the bill are consistent only with the up-front payments 

for certain design features of the facilities and for the first annual 

lease payment. Appropriations of those amounts would not be sufficient to cover the contractual obligations under either recording 

method specified in section 3. Nevertheless, VA’s authority to enter 

into the leases under section 2 would not be constrained if appropriations were not sufficient to cover the full amount of the lease 

obligations as properly recorded. 

VA has not indicated whether it would interpret H.R. 3521 as requiring it to increase the amount of the obligations it records when 

it awards such contracts. CBO expects that when VA awards contracts for the authorized projects, the department might well determine that sufficient appropriations were not available to record 

those larger amounts, and it would continue its practice of recording obligations equal only to the payments due in the year a contract is awarded. 

Thus, even if the contracts for the 27 facilities were to be considered operating leases, CBO believes that enacting H.R. 3521 would 

have the effect of providing VA with the authority to enter into 

those leases without sufficient appropriations to cover the obligations as required by Circular A–11. If the new leases did not specify cancellation costs (as was the case for the past leases CBO has 

reviewed), obligations recorded for these 27 contracts if they were 

considered operating leases should be the total payments due over 

the term of the lease. CBO estimates that those obligations would 

total $2.3 billion. Hence, the additional budget authority provided 

by this bill—that is, the full cost of the leases other than the firstyear payments—would amount to $2.2 billion. The outlays would 

be spread over the term of the leases, so that the additional outlays 

would come to about $670 million over the 2014–2023 period, with 

the remaining $1.5 billion occurring in subsequent years. However, 

because CBO views the leases as essentially government purVerDate Mar 15 2010 04:46 Dec 10, 2013 Jkt 039006 PO 00000 Frm 00014 Fmt 6659 Sfmt 6602 E:\HR\OC\HR284.XXX HR284

smartinez on DSK6TPTVN1PROD with REPORTS
15 

chases, this estimate does not reflect those amounts but instead reflects the amounts described in the previous section. 

Pay-As-You-Go Considerations: The Statutory Pay-As-You-Go Act 

of 2010 establishes budget-reporting and enforcement procedures 

for legislation affecting direct spending or revenues. The net 

changes in outlays that are subject to those pay-as-you-go procedures are shown in the following table. 

CBO ESTIMATE OF PAY-AS-YOU-GO EFFECTS FOR H.R. 3521 AS ORDERED REPORTED BY THE 

HOUSE COMMITTEE ON VETERANS’ AFFAIRS ON NOVEMBER 20, 2013 

By fiscal year, in millions of dollars— 

2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2014– 

2018 

2014– 

2023 

NET INCREASE IN THE DEFICIT 

Statutory Pay-As-You-Go 

Impact ......................... 2 11 83 382 459 345 137 0 0 0 937 1,419 

Intergovernmental and private-sector impact: H.R. 3521 contains 

no intergovernmental or private-sector mandates as defined in 

UMRA and would not affect the budgets of state, local, or tribal 

governments. 

Estimate prepared by: Federal costs: Ann E. Futrell and David 

Newman; Impact on state, local, and tribal governments: J’nell L. 

Blanco; Impact on the private sector: Elizabeth Bass. 

Estimate approved by: Theresa Gullo, Deputy Assistant Director 

for Budget Analysis. 

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of federal mandates regarding H.R. 3521 prepared by the director of the Congressional Budget Office pursuant to section 423 of the Unfunded Mandates Reform Act. 

ADVISORY COMMITTEE STATEMENT

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

Federal Advisory Committee Act would be created by this legislation. 

CONSTITUTIONAL AUTHORITY STATEMENT

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

of Representatives, the Committee finds that the constitutional authority for this legislation is provided by Article I, section 8 of the 

United States Constitution. 

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that the legislation does not relate to the 

terms and conditions of employment, or to access to public services 

or accommodations within the meaning of the Congressional Accountability Act of 1995, 2 U.S.C. § 1302(b)(3). 

STATEMENT ON DUPLICATION OF FEDERAL PROGRAMS

Pursuant to section 3(j) of H. Res. 5, 113th Cong. (2013), the 

Committee finds that no provision of H.R. 2072, as amended, estabVerDate Mar 15 2010 04:46 Dec 10, 2013 Jkt 039006 PO 00000 Frm 00015 Fmt 6659 Sfmt 6602 E:\HR\OC\HR284.XXX HR284

smartinez on DSK6TPTVN1PROD with REPORTS
16 

lishes or reauthorizes a program of the Federal Government known 

to be duplicative of another Federal program, a program that was 

included in any report from the Government Accountability Office 

to Congress pursuant to section 21 of Public Law 111–139, or a 

program related to a program identified in the most recent Catalog 

of Federal Domestic Assistance. 

DISCLOSURE OF DIRECTED RULEMAKING

Pursuant to section 3(k) of H. Res. 5, 113th Cong. (2013), the 

Committee estimates that H.R. 2072, as amended, does not require 

any directed rule making. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

Section 1 of the bill would provide the short title of the legislation as the ‘‘Department of Veterans Affairs Major Medical Facility 

Lease Authorization Act of 2013.’’ 

Section 2. Authorization of Major Medical Facility Leases 

Section 2(1) of the bill would authorize a lease for a clinical research and pharmacy coordinating center in Albuquerque, NM, for 

an amount not to exceed $9,560,000. 

Section 2(2) of the bill would authorize a lease for a communitybased outpatient clinic in Brick, NJ, for an amount not to exceed 

$7,280,000. 

Section 2(3) of the bill would authorize a lease for a primary care 

and dental clinic annex in Charleston, SC, for an amount not to exceed $7,070,250. 

Section 2(4) of the bill would authorize a lease for a communitybased outpatient clinic in Cobb County, GA, for an amount not to 

exceed $6,409,000. 

Section 2(5) of the bill would authorize a lease for the Leeward 

Outpatient Healthcare Access Center in Honolulu, HI, for an 

amount not to exceed $15,887,370. 

Section 2(6) of the bill would authorize a lease for a communitybased outpatient clinic in Johnson County, KS, for an amount not 

to exceed $2,263,000. 

Section 2(7) of the bill would authorize a lease for a replacement 

community-based outpatient clinic in Lafayette, LA, for an amount 

not to exceed $2,996,000. 

Section 2(8) of the bill would authorize a lease for a communitybased outpatient clinic in Lake Charles, LA, for an amount not to 

exceed $2,626,000. 

Section 2(9) of the bill would authorize a lease for an outpatient 

clinic consolidation in New Port Richey, FL, for an amount not to 

exceed $11,927,000. 

Section 2(10) of the bill would authorize a lease for an outpatient 

clinic in Ponce, Puerto Rico, for an amount not to exceed 

$11,535,000. 

Section 2(11) of the bill would authorize a lease for a lease consolidation in San Antonio, TX, for an amount not to exceed 

$19,426,000. 


smartinez on DSK6TPTVN1PROD with REPORTS
17 

Section 2(12) of the bill would authorize a lease for a communitybased outpatient clinic in San Diego, CA, for an amount not to exceed $11,946,100. 

Section 2(13) of the bill would authorize a lease for an outpatient clinic in Tyler, TX, for an amount not to exceed $4,327,000. 

Section 2(14) of the bill would authorize a lease for the Errera 

Community Care Center in West Haven, CT, for an amount not to 

exceed $4,883,000. 

Section 2(15) of the bill would authorize a lease for the Worcester 

community-based outpatient clinic in Worcester, MA, for an 

amount not to exceed $4,855,000. 

Section 2(16) of the bill would authorize a lease for the expansion 

of a community-based outpatient clinic in Cape Girardeau, MO, for 

an amount not to exceed $4,232,060. 

Section 2(17) of the bill would authorize a lease for a multispecialty clinic in Chattanooga, TN, for an amount not to exceed 

$7,069,000. 

Section 2(18) of the bill would authorize a lease for the expansion 

of a community-based outpatient clinic in Chico, CA, for an amount 

not to exceed $4,534,000. 

Section 2(19) of the bill would authorize a lease for a communitybased outpatient clinic in Chula Vista, CA, for an amount not to 

exceed $3,714,000. 

Section 2(20) of the bill would authorize a new research lease in 

Hines, IL, for an amount not to exceed $22,032,000. 

Section 2(21) of the bill would authorize a replacement research lease in Houston, TX, for an amount not to exceed $6,142,000. 

Section 2(22) of the bill would authorize a community-based outpatient clinic in Lincoln, NE, for an amount not to exceed 

$7,178,400. 

Section 2(23) of the bill would authorize a community-based outpatient clinic in Lubbock, TX, for an amount not to exceed 

$8,554,000. 

Section 2(24) of the bill would authorize a community-based outpatient clinic consolidation lease in Myrtle Beach, SC, for an 

amount not to exceed $8,022,000. 

Section 2(25) of the bill would authorize a community-based outpatient clinic in Phoenix, AZ, for an amount not to exceed 

$20,757,000. 

Section 2(26) of the bill would authorize a lease for the expansion 

of a community-based outpatient clinic in Redding, CA, for an 

amount not to exceed $8,154,000. 

Section 2(27) of the bill would authorize a lease for the expansion 

of a community-based outpatient clinic in Tulsa, OK, for an amount 

not to exceed $13,269,200. 

Section 3. Budgetary treatment of Department of Veterans Affairs 

Major Medical Facilities Leases 

Section 3(a) of the bill would make the following Congressional 

findings: (1) that VA is required under title 31, U.S.C. to record the 

full cost of its contractual obligation against funds available at the 

time a contract is executed; (2) that OMB Circular A–11 provides 

guidance to agencies in meeting the requirements of title 31, 

U.S.C., with respect to leases; and, (3) that OMB Circular A–11 requires VA to record the up-front budget authority for operating 


smartinez on DSK6TPTVN1PROD with REPORTS
18 

leases in the amount of the total payments under the full term of 

the lease or sufficient payments to cover the first year lease payments plus cancellation costs. 

Section 3(b) of the bill would require VA, subject to the availability of appropriations provided in advance, to record the full cost 

of the contractual obligation at the time a contract is executed either in an amount equal to total payments required under the full 

term of the lease; or equal to an amount sufficient to cover the first 

year lease payments and any specified cancellation costs in the 

event that the lease is terminated before its full term. 

Section 3(c) of the bill would require VA to provide a detailed 

analysis of how such lease is expected to comply with OMB Circular A–11 and section 1341 of title 31, U.S.C. in a prospectus for 

a proposed lease. It would also require VA to submit to the Committees on Veterans’ Affairs not less than 30 days before entering 

into a major medical facility lease, the following information: (1) 

notice of the intent to enter into a lease; (2) a copy of the proposed 

lease; (3) an explanation of any difference between the prospectus 

and the lease submitted under this subsection; and (4) a scoring 

analysis demonstrating compliance with OMB Circular A–11; and 

also require VA to submit to the Committees on Veterans’ Affairs 

a report of any material differences between the entered lease and 

proposed lease not less than 30 days after entering into a major 

medical facility lease. 

Section 3(d) of the bill would stipulate that the legislation does 

not relieve VA from any statutory or regulatory obligation or requirements existing prior to the enactment. 

CHANGES IN EXISTING LAW MADE BY THE BILL AS REPORTED

H.R. 3521 would not make any amendments to existing law. 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

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

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

as reported, are shown as follows (new matter is printed in italic 

and existing law in which no change is proposed is shown in 

roman): 

TITLE 38, UNITED STATES CODE 

* * * * * * * 

PART VI—ACQUISITION AND DISPOSITION OF 

PROPERTY 

* * * * * * * 

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

AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY 

SUBCHAPTER I—ACQUISITION AND OPERATION OF 

MEDICAL FACILITIES 

* * * * * * * 


smartinez on DSK6TPTVN1PROD with REPORTS
19 

§ 8104. Congressional approval of certain medical facility acquisitions 

(a) * * * 

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

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

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

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

medical facility. Any such prospectus shall include the following: 

(1) * * * 

* * * * * * * 

(7) In the case of a prospectus proposing funding for a major 

medical facility lease, a detailed analysis of how the lease is expected to comply with Office of Management and Budget Circular A–11 and section 1341 of title 31 (commonly referred to 

as the ‘‘Anti-Deficiency Act’’). Any such analysis shall include— 

(A) an analysis of the classification of the lease as a 

‘‘lease-purchase’’, ‘‘capital lease’’, or ‘‘operating lease’’ as 

those terms are defined in Office of Management and Budget Circular A–11; 

(B) an analysis of the obligation of budgetary resources 

associated with the lease; and 

(C) an analysis of the methodology used in determining 

the asset cost, fair market value, and cancellation costs of 

the lease. 

* * * * * * * 

(h)(1) Not less than 30 days before entering into a major medical 

facility lease, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives— 

(A) notice of the Secretary’s intention to enter into the lease; 

(B) a copy of the proposed lease; 

(C) a description and analysis of any differences between the 

prospectus submitted pursuant to subsection (b) and the proposed lease; and 

(D) a scoring analysis demonstrating that the proposed lease 

fully complies with Office of Management and Budget Circular 

A–11. 

(2) Each committee described in paragraph (1) shall ensure that 

any information submitted to the committee under such paragraph 

is treated by the committee with the same level of confidentiality as 

is required by law of the Secretary and subject to the same statutory 

penalties for unauthorized disclosure or use as the Secretary. 

(3) Not more than 30 days after entering into a major medical facility lease, the Secretary shall submit to each committee described 

in paragraph (1) a report on any material differences between the 

lease that was entered into and the proposed lease described under 

such paragraph, including how the lease that was entered into 

changes the previously submitted scoring analysis described in subparagraph (D) of such paragraph. 

* * * * * * * 

Æ 


smartinez on DSK6TPTVN1PROD with REPORTS