II

103D CONGRESS

1ST SESSION H. R. 2034

IN THE SENATE OF THE UNITED STATES

MAY 19 (legislative day, APRIL 19), 1993

Received; read twice and referred to the Committee on Veterans’ Affairs

JULY 14 (legislative day, JUNE 30), 1993

Committee discharged

AN ACT

To amend title 38, United States Code, 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,

3 SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38,

4 UNITED STATES CODE; TABLE OF CONTENTS.

5 (a) SHORT TITLE.—This Act may be cited as the

6 ‘‘Veterans’ Health Programs Amendments of 1993’’.

7 (b) REFERENCES TO TITLE 38, UNITED STATES

8 CODE.—Except as otherwise expressly provided, whenever

9 in this Act an amendment or repeal is expressed in terms

10 of an amendment to, or repeal of, a section or other provi-
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1 sion, the reference shall be considered to be made to a

2 section or other provision of title 38, United States Code.

3 (c) TABLE OF CONTENTS.—The table of contents of

4 this Act is as follows:

Sec. 1. Short title; references to title 38, United States Code; table of contents.

TITLE I—HEALTH CARE PLANNING AND PROGRAMS

Sec. 101. Health care facilities missions.

Sec. 102. Pilot program for noninstitutional alternatives to nursing home care.

TITLE II—MEDICAL FACILITIES ACQUISITION

Sec. 201. Major construction projects authorization.

Sec. 202. Revision to prospectus requirements.

Sec. 203. Prioritization methodology.

Sec. 204. Assessment of need for nursing home beds in Chesapeake network

area.

TITLE III—ADMINISTRATION

Sec. 301. Authority for expedited reorganization of medical facilities in event of

a life-threatening emergency.

Sec. 302. Clarification of contracting limitation.

TITLE IV—STATE HOME PROGRAM

Sec. 401. Per diem for adult day health care.

Sec. 402. Construction assistance program.

Sec. 403. Sharing of resources with State homes.

TITLE V—MISCELLANEOUS

Sec. 501. Department of Veterans Affairs research advisory committees.

Sec. 502. Limitation on claims for copayments.

Sec. 503. Child care services.

5 TITLE I—HEALTH CARE

6 PLANNING AND PROGRAMS

7 SEC. 101. HEALTH CARE FACILITIES MISSIONS.

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

9 shall prescribe a specific, detailed statement of the mission

10 of, and the clinical programs to be operated at, each health

11 care facility of the Department, determined based upon
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1 a requirement that each such facility operate within a net2 work of Department facilities in the same geographic area

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

4 veterans.

5 (b) PURPOSES OF MISSION STATEMENTS.—The mis6 sion statements shall be designed so as to permit—

7 (1) effective planning;

8 (2) reduction in duplication of services and pro9 grams in the same geographic area;

10 (3) realignment of services among facilities

11 within each network;

12 (4) improved means of resource distribution;

13 and

14 (5) more efficient delivery of needed services.

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

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

17 shall review the existing missions and clinical programs

18 at each health care facility of the Department.

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

20 later than nine months after the date of the enactment

21 of this Act, shall—

22 (1) prescribe the mission statements required

23 by subsection (a); and

24 (2) submit to the Committees on Veterans’ Af25 fairs of the Senate and House of Representatives a
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1 report on the implementation of this section and on

2 the timetable and projected milestones for imple3 menting actions to enable each such facility to carry

4 out fully its prescribed missions.

5 SEC. 102. PILOT PROGRAM FOR NONINSTITUTIONAL AL6 TERNATIVES TO NURSING HOME CARE.

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

8 section 1720C is amended by striking out ‘‘During the

9 four-year period beginning on October 1, 1990,’’ and in10 serting in lieu thereof ‘‘During the period through Sep11 tember 30, 1997,’’.

12 (b) VETERANS ELIGIBLE TO PARTICIPATE IN PRO13 GRAM.—Such subsection is further amended by striking

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

15 The Secretary shall give priority for participation in such

16 program to veterans who—’’.

17 (c) PROGRAM FUNDING.—Such section is further

18 amended by adding at the end the following new sub19 section:

20 ‘‘(f) The Secretary shall carry out the pilot program

21 under this section using funds available for the community

22 nursing home program under section 1720 of this title.’’.

23 (d) REPORT DEADLINES.—Section 201(b) of the De24 partment of Veterans Affairs Nurse Pay Act of 1990

25 (Public Law 101–366; 104 Stat. 438) is amended—
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1 (1) by striking out ‘‘February 1, 1994,’’ and in2 serting in lieu thereof ‘‘February 1, 1997,’’; and

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

4 inserting in lieu thereof ‘‘September 30, 1996,’’.

5 TITLE II—MEDICAL FACILITIES

6 ACQUISITION

7 SEC. 201. AUTHORIZATION OF MAJOR MEDICAL FACILITY

8 PROJECTS AND MAJOR MEDICAL FACILITY

9 LEASES.

10 (a) AUTHORIZATION OF PROJECTS AND LEASES IN

11 BUDGET.—Except as provided in subsection (b), the Sec12 retary of Veterans Affairs may carry out the major medi13 cal facility projects for the Department of Veterans Af14 fairs, and may carry out the major medical facility leases

15 for that Department, for which funds are requested in the

16 budget of the President for fiscal year 1994.

17 (b) NONAUTHORIZED PROJECTS.—The Secretary is

18 not authorized to carry out the project for which funds

19 are requested in the budget of the President for fiscal year

20 1994 for the construction of a nursing home facility in

21 Baltimore, Maryland.

22 (c) AUTHORIZATION OF DESIGN FOR CERTAIN FU23 TURE PROJECTS.—In addition to the projects authorized

24 in subsection (a), the Secretary may carry out design of
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1 the following major medical facility projects, in the

2 amounts specified:

3 (1) Construction of an outpatient care addition

4 at the Department of Veterans Affairs Medical Cen5 ter in San Juan, Puerto Rico, $3,970,000.

6 (2) Construction of a spinal cord injury unit

7 and energy center at the Department of Veterans

8 Affairs Medical Center in Tampa, Florida,

9 $4,490,000.

10 (3) Construction of an outpatient care addition

11 at the Department of Veterans Affairs Medical

12 Center in West Haven, Connecticut, $4,860,000.

13 (d) AUTHORIZATION OF APPROPRIATIONS.—There is

14 hereby authorized to be appropriated to the Secretary of

15 Veterans Affairs for fiscal year 1994—

16 (1) $110,420,000 for the major medical facility

17 projects authorized in subsections (a) and (c); and

18 (2) $50,123,105 for the major medical facility

19 leases authorized in subsection (a).

20 (e) LIMITATION.—The projects authorized in sub21 sections (a) and (c) may only be carried out using—

22 (1) funds appropriated for fiscal year 1994 pur23 suant to the authorization of appropriations in sub24 section (d);
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1 (2) funds appropriated for Construction, Major

2 Projects for a fiscal year before fiscal year 1994 that

3 remain available for obligation; and

4 (3) funds appropriated for Construction, Major

5 Projects for fiscal year 1994 for a category of activ6 ity not specific to a project.

7 SEC. 202. REVISION TO PROSPECTUS REQUIREMENTS.

8 (a) ADDITIONAL INFORMATION.—Section 8104(b) is

9 amended—

10 (1) by striking out ‘‘shall include—’’ and insert11 ing in lieu thereof ‘‘shall include:’’;

12 (2) in paragraph (1)—

13 (A) by striking out ‘‘a detailed’’ and insert14 ing in lieu thereof ‘‘A detailed’’; and

15 (B) by striking out the semicolon at the

16 end and inserting in lieu thereof a period;

17 (3) in paragraph (2)—

18 (A) by striking out ‘‘an estimate’’ and in19 serting in lieu thereof ‘‘An estimate’’; and

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

21 in lieu thereof a period;

22 (4) in paragraph (3), by striking out ‘‘an esti23 mate’’ and inserting in lieu thereof ‘‘An estimate’’;

24 and
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1 (5) by adding at the end the following new

2 paragraphs:

3 ‘‘(4) Demographic data applicable to the

4 project.

5 ‘‘(5) Current and projected workload and utili6 zation data.

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

8 the facility and the missions and capabilities of other

9 nearby Department facilities and, as applicable, the

10 availability or lack of availability of alternative

11 sources of service in the community and the cost12 effectiveness of using such alternative sources.

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

14 the facility.

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

16 under the Department’s prioritization methodology

17 and, if the project is being proposed for funding

18 ahead of a project with a higher score, a comprehen19 sive explanation of the specific factors on the basis

20 of which the project is being proposed for funding

21 ahead of each such higher-scored project.

22 ‘‘(9) A listing of each alternative to construc23 tion of the facility that has been considered.’’.

24 (b) APPLICABILITY.—The amendments made by sub25 section (a) shall apply with respect to any prospectus sub-
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1 mitted by the Secretary of Veterans Affairs after the date

2 of the enactment of this Act.

3 SEC. 203. PRIORITIZATION METHODOLOGY.

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

5 Veterans Affairs shall conduct a review of the methodology

6 used by the Department for establishing the relative prior7 ity for major construction projects under consideration in

8 the Department.

9 (b) REVISION.—Based upon the review under sub10 section (a), the Secretary shall revise the prioritization

11 methodology so as to give additional weight, as determined

12 appropriate by the Secretary taking into consideration

13 particularly the needs of the aging veteran population, to

14 projects intended to expand long-term care and ambula15 tory care programs.

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

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

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

19 House of Representatives a report on the actions of the

20 Secretary in carrying out this section.

21 SEC. 204. ASSESSMENT OF NEED FOR NURSING HOME BEDS

22 IN CHESAPEAKE NETWORK AREA.

23 (a) ASSESSMENT.—The Secretary of Veterans Affairs

24 shall conduct an assessment of the need for nursing home

25 beds operated by the Secretary in the area (referred to
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1 as the ‘‘Chesapeake network’’) served by the Department

2 of Veterans Affairs medical centers in Baltimore, Mary3 land; Fort Howard, Maryland; Martinsburg, West Vir4 ginia; Perry Point, Maryland; and Washington, D.C.

5 (b) MATTERS TO BE DETERMINED BY SEC6 RETARY.—In conducting the assessment, the Secretary

7 shall determine—

8 (1) what the specific mission of each medical

9 center operated by the Secretary in the Chesapeake

10 network should be to achieve the purposes identified

11 in section 101;

12 (2) whether there is a need for expansion and

13 modernization of the nursing home care unit at the

14 medical center at Fort Howard, Maryland; and

15 (3) what effect the construction of nursing

16 home beds in Baltimore, Maryland, as proposed in

17 the President’s budget for the Department of Veter18 ans Affairs for fiscal year 1994, would have for the

19 missions of each of the other medical centers oper20 ated by the Secretary in the Chesapeake network.

21 (c) REPORT ON ASSESSMENT.—Not later than 90

22 days after the date of the enactment of this Act, the Sec23 retary shall submit to the Committees on Veterans’ Affairs

24 of the Senate and House of Representatives a report on

25 the assessment under subsection (a). The Secretary shall
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1 include in the report a statement of each determination

2 made by the Secretary under subsection (b).

3 TITLE III—ADMINISTRATION

4 SEC. 301. AUTHORITY FOR EXPEDITED REORGANIZATION

5 OF MEDICAL FACILITIES IN EVENT OF A LIFE6 THREATENING EMERGENCY.

7 Section 510 is amended—

8 (1) by redesignating subsections (e) and (f) as

9 subsections (f) and (g), respectively; and

10 (2) by inserting after subsection (d) the follow11 ing new subsection (e):

12 ‘‘(e)(1) The limitation in subsection (b) does not

13 apply with respect to an administrative reorganization at

14 a medical facility if the Secretary determines that the reor15 ganization is necessary to respond to an emergency situa16 tion at that facility.

17 ‘‘(2) The Secretary may determine that there is an

18 emergency situation at a medical facility for purposes of

19 paragraph (1) only if the Secretary determines (A) that

20 circumstances at the facility are such that patients and

21 employees at the facility face imminent danger because of

22 conditions at the facility that are permanent in nature,

23 and (B) that those conditions are not susceptible to repair

24 or that it is not feasible to repair those conditions.
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1 ‘‘(3) For purposes of this subsection, an emergency

2 situation may not be considered to exist in anticipation

3 of, but before the occurrence of an event giving rise to

4 any consideration of an administrative reorganization.

5 ‘‘(4) Whenever the Secretary determines under para6 graph (1) that it is necessary to carry out an administra7 tive reorganization at a medical facility without regard to

8 the limitation in subsection (b), the Secretary shall

9 promptly submit to the Committees on Veterans’ Affairs

10 of the Senate and House of Representatives a report de11 scribing the administrative reorganization. The report

12 shall provide the same information as is provided in a de13 tailed plan and justification under subsection (g)(2). The

14 Secretary shall include in the report an explanation of

15 each alternative to the proposed administrative reorga16 nization that was considered and each factor that was con17 sidered in the decision to reject each such alternative.’’.

18 SEC. 302. CLARIFICATION OF CONTRACTING LIMITATION.

19 Section 8110(c)(3) is amended—

20 (1) by striking out ‘‘or’’ at the end of subpara21 graph (A);

22 (2) by redesignating subparagraph (B) as sub23 paragraph (C) and in that subparagraph striking

24 out ‘‘section 213 or 4117’’ and inserting in lieu

25 thereof ‘‘section 7409’’; and
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1 (3) by inserting after subparagraph (A) the fol2 lowing new subparagraph (B):

3 ‘‘(B) to a contract under section 513 of this

4 title if the Under Secretary for Health certifies to

5 the Secretary in writing, before the contract is en6 tered into, that the contract is necessary in order to

7 provide services to eligible veterans at a Department

8 health-care facility that could not otherwise be pro9 vided at such facility; or’’.

10 TITLE IV—STATE HOME

11 PROGRAM

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

13 (a) IN GENERAL.—Subsection (a) of section 1741 is

14 amended to read as follows:

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

16 diem amount for each veteran receiving domiciliary care,

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

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

19 care in a Department facility.

20 ‘‘(2) The per diem rate to be paid under this sub21 section is as follows:

22 ‘‘(A) For domiciliary care, $11.79 for each day.

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

24 $27.61 for each day.
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1 ‘‘(C) For adult day health care, $16.50 for each

2 day.’’.

3 (b) EFFECTIVE DATE.—The amendment made by

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

5 care provided in a State home after September 30, 1993.

6 SEC. 402. CONSTRUCTION ASSISTANCE PROGRAM.

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

8 amended as follows:

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

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

11 (2) Section 8132 is amended by inserting ‘‘or

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

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

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

15 than 25 percent of the number of patients partici16 pating in that program,’’ after ‘‘occupancy’’.

17 (4) Section 8135(b) is amended—

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

19 adult day health care facilities’’ after ‘‘domi20 ciliary beds’’; and

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

22 would involve expansion, remodeling, or alter23 ation of existing buildings for the furnishing of

24 adult day health care’’ after ‘‘buildings’’.
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1 (5) Section 8136 is amended by inserting ‘‘or

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

3 (6) The heading of such subchapter is amended

4 to read as follows:

5 ‘‘SUBCHAPTER III—STATE HOME FACILITIES

6 FOR FURNISHING DOMICILIARY CARE,

7 NURSING HOME CARE, ADULT DAY HEALTH

8 CARE, AND HOSPITAL CARE’’.

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

10 subchapter III in the table of sections at the beginning

11 of chapter 81 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’’.

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

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

14 States using funds appropriated after the date of the

15 enactment of this Act.

16 SEC. 403. SHARING OF RESOURCES WITH STATE HOMES.

17 (a) PURPOSE.—Section 8151 is amended by adding

18 at the end the following: ‘‘It is further the purpose of this

19 subchapter to improve the provision of care to veterans

20 under this title by authorizing the Secretary to enter into

21 agreements with State veterans facilities for the sharing

22 of health-care resources.’’.

23 (b) DEFINITION.—Section 8152 is amended—
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1 (1) by redesignating paragraph (3) as para2 graph (4); and

3 (2) by inserting after paragraph (2) the follow4 ing new paragraph (3):

5 ‘‘(3) The term ‘health-care resource’ includes

6 hospital care, medical services, and rehabilitative

7 services, as those terms are defined in paragraphs

8 (5), (6), and (8), respectively, of section 1701 of this

9 title, any other health-care service, and any health10 care support or administrative resource.’’.

11 (c) SHARING OF HEALTH-CARE RESOURCES.—Sec12 tion 8153(a) is amended—

13 (1) by inserting ‘‘(1)’’ after ‘‘(a)’’; and

14 (2) by striking out ‘‘other form of agreement,’’

15 and all that follows and inserting in lieu thereof

16 ‘‘other form of agreement for the mutual use, or ex17 change of use, of—

18 ‘‘(A) specialized medical resources between De19 partment health-care facilities and other health-care

20 facilities (including organ banks, blood banks, or

21 similar institutions), research centers, or medical

22 schools; and

23 ‘‘(B) health-care resources between Department

24 health-care facilities and State home facilities recog25 nized under section 1742(a) of this title.
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1 ‘‘(2) The Secretary may execute a contract or other

2 agreement under paragraph (1) only if (A) such an agree3 ment will obviate the need for a similar resource to be

4 provided in a Department health care facility, or (B) the

5 Department resources which are the subject of the agree6 ment and which have been justified on the basis of

7 veterans’ care are not used to their maximum effective

8 capacity.’’.

9 TITLE V—MISCELLANEOUS

10 SEC. 501. DEPARTMENT OF VETERANS AFFAIRS RESEARCH

11 ADVISORY COMMITTEES.

12 (a) STATUTORY BASIS FOR RESEARCH ADVISORY

13 COMMITTEES.—Chapter 5 is amended by adding at the

14 end of subchapter III the following new section:

15 ‘‘§ 544. Veterans research advisory committees

16 ‘‘(a) Congress declares that each of the veterans re17 search advisory committees specified in subsection (c)

18 (previously established by the Secretary in carrying out

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

20 has a continuing, ongoing function that is integrally relat21 ed to the successful completion by the Department of its

22 statutory duties. Each such committee shall, for all pur23 poses, operate as though such committee had been estab24 lished by, and chartered pursuant to, law. The objectives

25 and scope of the activities of each such committee and the
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1 duties for which the committee is responsible, as specified

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

3 effect as of that date.

4 ‘‘(b) The Secretary may not terminate a veterans re5 search advisory committee specified in subsection (c) un6 less the Secretary finds that the committee is no longer

7 needed. Not less than 120 days before terminating such

8 a committee, the Secretary shall submit to the congres9 sional veterans’ affairs committees a report on the pro10 posed termination. The report shall include an explanation

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

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

13 in which the Secretary will carry out the Secretary’s re14 sponsibilities under section 7303 of this title in the ab15 sence of the committee.

16 ‘‘(c) For purposes of this section, each of the follow17 ing committees and boards, as established by the Sec18 retary as of March 1, 1993, shall be considered to be a

19 veterans research advisory committee:

20 ‘‘(1) The Career Development Committee.

21 ‘‘(2) The Department of Veterans Affairs Coop22 erative Studies Evaluation Committee.

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

24 Sciences Programs.
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1 ‘‘(4) The Merit Review Board for Cardio2 vascular Programs.

3 ‘‘(5) The Merit Review Board for Clinical Phar4 macology, Alcoholism, and Drug Dependence Pro5 grams.

6 ‘‘(6) The Merit Review Board for Endocrinol7 ogy Programs.

8 ‘‘(7) The Merit Review Board for Gastro9 enterology Programs.

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

11 Programs.

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

13 Programs.

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

15 Diseases Programs.

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

17 Health and Behavioral Sciences Programs.

18 ‘‘(12) The Merit Review Board for Nephrology

19 Programs.

20 ‘‘(13) The Merit Review Board for

21 Neurobiology Programs.

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

23 Programs.

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

25 Programs.
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1 ‘‘(16) The Merit Review Board for Surgery

2 Programs.

3 ‘‘(17) The Scientific Review Evaluation Board

4 for Health Services Research and Development.

5 ‘‘(18) The Scientific Review Evaluation Board

6 for Rehabilitation Research and Development.’’.

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

8 at the beginning of chapter 5 is amended by inserting

9 after the item relating to section 543 the following new

10 item:

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

11 SEC. 502. LIMITATION ON CLAIMS FOR COPAYMENTS.

12 (a) HOSPITAL CARE AND NURSING HOME CARE.—

13 Section 1710(f) is amended by adding at the end the fol14 lowing new paragraph:

15 ‘‘(6) A veteran may not be required to make a pay16 ment under this subsection for any day of care if the Sec17 retary does not notify the veteran in writing of the amount

18 owed for that care before the end of the two-year period

19 beginning on the date on which the care is provided, unless

20 the reason the Secretary did not notify the veteran within

21 such period was due to reliance by the Secretary on infor22 mation furnished by the veteran to the Secretary which

23 was subsequently determined to be erroneous.’’.
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1 (b) OUTPATIENT MEDICAL SERVICES.—Section

2 1712(f) is amended by adding at the end the following

3 new paragraph:

4 ‘‘(5) A veteran may not be required to make a pay5 ment under this subsection for any medical services if the

6 Secretary does not notify the veteran in writing of the

7 amount owed for those services before the end of the two8 year period beginning on the date on which the services

9 were provided, unless the reason the Secretary did not no10 tify the veteran within such period was due to reliance

11 by the Secretary on information furnished by the veteran

12 to the Secretary which was subsequently determined to be

13 erroneous.’’.

14 (c) MEDICATIONS.—Section 1722A(a) is amended by

15 adding at the end the following new paragraph:

16 ‘‘(4) A veteran may not be required to make a pay17 ment under this subsection for any supply of medication

18 if the Secretary does not notify the veteran in writing of

19 the amount owed for that medication before the end of

20 the two-year period beginning on the date on which the

21 medication is supplied, unless the reason the Secretary did

22 not notify the veteran within such period was due to reli23 ance by the Secretary on information furnished by the vet24 eran to the Secretary which was subsequently determined

25 to be erroneous.’’.
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1 SEC. 503. CHILD CARE SERVICES.

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

3 is amended by inserting after section 8116 the following

4 new section:

5 ‘‘§ 8117. Child care centers

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

7 child care centers at Department facilities. The operation

8 of such centers under this section shall be carried out to

9 the extent that the Secretary determines, based on the de10 mand of employees of the Department for the care in11 volved, that such operation is in the best interest of the

12 Department and that it is practicable to do so.

13 ‘‘(b)(1) In offering child care services under this sec14 tion, the Secretary shall give priority (in the following

15 order) to employees of—

16 ‘‘(A) the Department;

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

18 Federal Government, and

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

20 corporations created under section 7361 of this title.

21 ‘‘(2) To the extent that space is available, the Sec22 retary may provide child care services to members of the

23 public at a child care center operated under this section

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

25 assure the financial success of that center.
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1 ‘‘(c)(1) The Secretary shall establish reasonable

2 charges for child care services provided at each child care

3 center operated under this section. Such charges may be

4 established at different rates for different centers.

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

6 provided at a center, the Secretary—

7 ‘‘(A) shall (except as provided in paragraph (3))

8 establish the charges so as to ensure that the sum

9 of all charges for child care services at that center

10 is sufficient to meet the staffing expenses of that

11 center; and

12 ‘‘(B) may also may consider the expenses of

13 constructing or acquiring space for the center, the

14 expenses of converting existing space into the center,

15 and the expenses of equipment and services fur16 nished to the center under subsection (d)(2).

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

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

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

20 care services at that center is sufficient to meet the staff21 ing expenses of that center if the Secretary determines

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

23 that—
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1 ‘‘(A) the operation of a child care center at that

2 facility would help overcome serious recruitment or

3 retention problems;

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

5 charges for child care services at that center at rates

6 sufficient to meet the staffing expenses of that cen7 ter would make the operation of a child care center

8 at that facility unfeasible; and

9 ‘‘(C) there are no other practical alternatives to

10 meeting the needs of employees at that facility for

11 child care services.

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

13 shall be credited to the applicable Department of Veterans

14 Affairs account and shall be allotted to the facility served

15 by the child care center and shall remain available until

16 expended.

17 ‘‘(d) In connection with the establishment and oper18 ation of a child care center under this section, the Sec19 retary—

20 ‘‘(1) may construct or alter space in any De21 partment facility, and may lease space in a non22 Department facility for a term not to exceed 20

23 years, for use as a child care center;

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

25 items and services necessary for the operation of the
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1 center, including furniture, office machines and

2 equipment, utility and custodial services, and other

3 necessary services and amenities;

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

5 or through a parent advisory committee) of parents

6 of children receiving care in the center in the estab7 lishment of policies to govern the operation of the

8 center and in the oversight of the implementation of

9 such policies;

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

11 process for determining the fitness and suitability of

12 prospective employees of or volunteers at the center;

13 and

14 ‘‘(5) shall require in connection with the oper15 ation of the center compliance with all State and

16 local laws, ordinances, and regulations relating to

17 health and safety and the operation of child care

18 centers.

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

20 out this section.

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

22 advisory committee’ means a committee comprised of, and

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

24 child care center operated under this section.’’.
26

•HR 2034 CDS

1 (b) CONFORMING REPEAL.—Section 7809 is re2 pealed.

3 (c) CLERICAL AMENDMENTS.—(1) The table of sec4 tions at the beginning of chapter 81 is amended by insert5 ing after the item relating to section 8116 the following

6 new item:

‘‘8117. Child care centers.’’.

7 (2) The table of sections at the beginning of chapter

8 78 is amended by striking out the item relating to section

9 7809.

Passed the House of Representatives May 18, 1993.

Attest: DONNALD K. ANDERSON,

Clerk.

HR 2034 CDS——2