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[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2034 Reported in House (RH)]

                                                  Union Calendar No. 47

103d CONGRESS

  1st Session

                               H. R. 2034

                          [Report No. 103-92]

_______________________________________________________________________

                                 A BILL

To amend title 38, United States Code, to revise and improve veterans' 
                health programs, and for other purposes.

_______________________________________________________________________

                              May 13, 1993

Committed to the Committee of the Whole House on the State of the Union 
                       and ordered to be printed

                                                  Union Calendar No. 47
103d CONGRESS
  1st Session
                                H. R. 2034

                          [Report No. 103-92]

To amend title 38, United States Code, to revise and improve veterans' 
                health programs, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                              May 6, 1993

 Mr. Rowland (for himself and Mr. Smith of New Jersey) introduced the 
   following bill; which was referred to the Committee on Veterans' 
                                Affairs

                              May 13, 1993

            Additional sponsors: Mr. Kennedy, and Mr. Bishop

                              May 13, 1993

Committed to the Committee of the Whole House on the State of the Union 
                       and ordered to be printed

_______________________________________________________________________

                                 A BILL

 
To amend title 38, United States Code, to revise and improve veterans' 
                health programs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES CODE; 
              TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans' Health 
Programs Amendments of 1993''.
    (b) References to Title 38, United States Code.--Except as 
otherwise expressly provided, whenever in this Act an amendment or 
repeal is expressed in terms of an amendment to, or repeal of, a 
section or other provision, the reference shall be considered to be 
made to a section or other provision of title 38, United States Code.
    (c) Table of Contents.--The table of contents of 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.

               TITLE I--HEALTH CARE PLANNING AND PROGRAMS

SEC. 101. HEALTH CARE FACILITIES MISSIONS.

    (a) In General.--The Secretary of Veterans Affairs shall prescribe 
a specific, detailed statement of the mission of, and the clinical 
programs to be operated at, each health care facility of the 
Department, determined based upon a requirement that each such facility 
operate within a network of Department facilities in the same 
geographic area which, taken together, provide a full range of services 
for veterans.
    (b) Purposes of Mission Statements.--The mission statements shall 
be designed so as to permit--
            (1) effective planning;
            (2) reduction in duplication of services and programs in 
        the same geographic area;
            (3) realignment of services among facilities within each 
        network;
            (4) improved means of resource distribution; and
            (5) more efficient delivery of needed services.
    (c) Review of Current Missions.--In preparing the mission 
statements under subsection (a), the Secretary shall review the 
existing missions and clinical programs at each health care facility of 
the Department.
    (d) Deadline and Report.--The Secretary, not later than nine months 
after the date of the enactment of this Act, shall--
            (1) prescribe the mission statements required by subsection 
        (a); and
            (2) submit to the Committees on Veterans' Affairs of the 
        Senate and House of Representatives a report on the 
        implementation of this section and on the timetable and 
        projected milestones for implementing actions to enable each 
        such facility to carry out fully its prescribed missions.

SEC. 102. PILOT PROGRAM FOR NONINSTITUTIONAL ALTERNATIVES TO NURSING 
              HOME CARE.

    (a) Extension of Program.--Subsection (a) of section 1720C is 
amended by striking out ``During the four-year period beginning on 
October 1, 1990,'' and inserting in lieu thereof ``During the period 
through September 30, 1997,''.
    (b) Veterans Eligible To Participate in Program.--Such subsection 
is further amended by striking out ``care and who--'' and inserting in 
lieu thereof ``care. The Secretary shall give priority for 
participation in such program to veterans who--''.
    (c) Program Funding.--Such section is further amended by adding at 
the end the following new subsection:
    ``(f) The Secretary shall carry out the pilot program under this 
section using funds available for the community nursing home program 
under section 1720 of this title.''.
    (d) Report Deadlines.--Section 201(b) of the Department of Veterans 
Affairs Nurse Pay Act of 1990 (Public Law 101-366; 104 Stat. 438) is 
amended--
            (1) by striking out ``February 1, 1994,'' and inserting in 
        lieu thereof ``February 1, 1997,''; and
            (2) by striking out ``September 30, 1993,'' and inserting 
        in lieu thereof ``September 30, 1996,''.

                TITLE II--MEDICAL FACILITIES ACQUISITION

SEC. 201. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS AND MAJOR 
              MEDICAL FACILITY LEASES.

    (a) Authorization of Projects and Leases in Budget.--Except as 
provided in subsection (b), the Secretary of Veterans Affairs may carry 
out the major medical facility projects for the Department of Veterans 
Affairs, and may carry out the major medical facility leases for that 
Department, for which funds are requested in the budget of the 
President for fiscal year 1994.
    (b) Nonauthorized Projects.--The Secretary is not authorized to 
carry out the project for which funds are requested in the budget of 
the President for fiscal year 1994 for the construction of a nursing 
home facility in Baltimore, Maryland.
    (c) Authorization of Design for Certain Future Projects.--In 
addition to the projects authorized in subsection (a), the Secretary 
may carry out design of the following major medical facility projects, 
in the amounts specified:
            (1) Construction of an outpatient care addition at the 
        Department of Veterans Affairs Medical Center in San Juan, 
        Puerto Rico, $3,970,000.
            (2) Construction of a spinal cord injury unit and energy 
        center at the Department of Veterans Affairs Medical Center in 
        Tampa, Florida, $4,490,000.
            (3) Construction of an outpatient care addition at the 
        Department of Veterans Affairs Medical Center in West Haven, 
        Connecticut, $4,860,000.
    (d) Authorization of Appropriations.--There is hereby authorized to 
be appropriated to the Secretary of Veterans Affairs for fiscal year 
1994--
            (1) $110,420,000 for the major medical facility projects 
        authorized in subsections (a) and (c); and
            (2) $50,123,105 for the major medical facility leases 
        authorized in subsection (a).
    (e) Limitation.--The projects authorized in subsections (a) and (c) 
may only be carried out using--
            (1) funds appropriated for fiscal year 1994 pursuant to the 
        authorization of appropriations in subsection (d);
            (2) funds appropriated for Construction, Major Projects for 
        a fiscal year before fiscal year 1994 that remain available for 
        obligation; and
            (3) funds appropriated for Construction, Major Projects for 
        fiscal year 1994 for a category of activity not specific to a 
        project.

SEC. 202. REVISION TO PROSPECTUS REQUIREMENTS.

    (a) Additional Information.--Section 8104(b) is amended--
            (1) by striking out ``shall include--'' and inserting in 
        lieu thereof ``shall include:'';
            (2) in paragraph (1)--
                    (A) by striking out ``a detailed'' and inserting in 
                lieu thereof ``A detailed''; and
                    (B) by striking out the semicolon at the end and 
                inserting in lieu thereof a period;
            (3) in paragraph (2)--
                    (A) by striking out ``an estimate'' and inserting 
                in lieu thereof ``An estimate''; and
                    (B) by striking out ``; and'' and inserting in lieu 
                thereof a period;
            (4) in paragraph (3), by striking out ``an estimate'' and 
        inserting in lieu thereof ``An estimate''; and
            (5) by adding at the end the following new paragraphs:
            ``(4) Demographic data applicable to the project.
            ``(5) Current and projected workload and utilization data.
            ``(6) The relationship between the mission of the facility 
        and the missions and capabilities of other nearby Department 
        facilities and, as applicable, the availability or lack of 
        availability of alternative sources of service in the community 
        and the cost-effectiveness of using such alternative sources.
            ``(7) Current and projected operating costs of the 
        facility.
            ``(8) The raw score assigned to the proposal under the 
        Department's prioritization methodology and, if the project is 
        being proposed for funding ahead of a project with a higher 
        score, a comprehensive explanation of the specific factors on 
        the basis of which the project is being proposed for funding 
        ahead of each such higher-scored project.
            ``(9) A listing of each alternative to construction of the 
        facility that has been considered.''.
    (b) Applicability.--The amendments made by subsection (a) shall 
apply with respect to any prospectus submitted by the Secretary of 
Veterans Affairs after the date of the enactment of this Act.

SEC. 203. PRIORITIZATION METHODOLOGY.

    (a) Review of Methodology.--The Secretary of Veterans Affairs shall 
conduct a review of the methodology used by the Department for 
establishing the relative priority for major construction projects 
under consideration in the Department.
    (b) Revision.--Based upon the review under subsection (a), the 
Secretary shall revise the prioritization methodology so as to give 
additional weight, as determined appropriate by the Secretary taking 
into consideration particularly the needs of the aging veteran 
population, to projects intended to expand long-term care and 
ambulatory care programs.
    (c) Report.--Not later than 120 days after the date of the 
enactment of this Act, the Secretary shall submit to the Committees on 
Veterans' Affairs of the Senate and House of Representatives a report 
on the actions of the Secretary in carrying out this section.

SEC. 204. ASSESSMENT OF NEED FOR NURSING HOME BEDS IN CHESAPEAKE 
              NETWORK AREA.

    (a) Assessment.--The Secretary of Veterans Affairs shall conduct an 
assessment of the need for nursing home beds operated by the Secretary 
in the area (referred to as the ``Chesapeake network'') served by the 
Department of Veterans Affairs medical centers in Baltimore, Maryland; 
Fort Howard, Maryland; Martinsburg, West Virginia; Perry Point, 
Maryland; and Washington, DC.
    (b) Matters To Be Determined By Secretary.--In conducting the 
assessment, the Secretary shall determine--
            (1) what the specific mission of each medical center 
        operated by the Secretary in the Chesapeake network should be 
        to achieve the purposes identified in section 101;
            (2) whether there is a need for expansion and modernization 
        of the nursing home care unit at the medical center at Fort 
        Howard, Maryland; and
            (3) what effect the construction of nursing home beds in 
        Baltimore, Maryland, as proposed in the President's budget for 
        the Department of Veterans Affairs for fiscal year 1994, would 
        have for the missions of each of the other medical centers 
        operated by the Secretary in the Chesapeake network.
    (c) Report on Assessment.--Not later than 90 days after the date of 
the enactment of this Act, the Secretary shall submit to the Committees 
on Veterans' Affairs of the Senate and House of Representatives a 
report on the assessment under subsection (a). The Secretary shall 
include in the report a statement of each determination made by the 
Secretary under subsection (b).

                       TITLE III--ADMINISTRATION

SEC. 301. AUTHORITY FOR EXPEDITED REORGANIZATION OF MEDICAL FACILITIES 
              IN EVENT OF A LIFE-THREATENING EMERGENCY.

    Section 510 is amended--
            (1) by redesignating subsections (e) and (f) as subsections 
        (f) and (g), respectively; and
            (2) by inserting after subsection (d) the following new 
        subsection (e):
    ``(e)(1) The limitation in subsection (b) does not apply with 
respect to an administrative reorganization at a medical facility if 
the Secretary determines that the reorganization is necessary to 
respond to an emergency situation at that facility.
    ``(2) The Secretary may determine that there is an emergency 
situation at a medical facility for purposes of paragraph (1) only if 
the Secretary determines (A) that circumstances at the facility are 
such that patients and employees at the facility face imminent danger 
because of conditions at the facility that are permanent in nature, and 
(B) that those conditions are not susceptible to repair or that it is 
not feasible to repair those conditions.
    ``(3) For purposes of this subsection, an emergency situation may 
not be considered to exist in anticipation of, but before the 
occurrence of an event giving rise to any consideration of an 
administrative reorganization.
    ``(4) Whenever the Secretary determines under paragraph (1) that it 
is necessary to carry out an administrative reorganization at a medical 
facility without regard to the limitation in subsection (b), the 
Secretary shall promptly submit to the Committees on Veterans' Affairs 
of the Senate and House of Representatives a report describing the 
administrative reorganization. The report shall provide the same 
information as is provided in a detailed plan and justification under 
subsection (g)(2). The Secretary shall include in the report an 
explanation of each alternative to the proposed administrative 
organization that was considered and each factor that was considered in 
the decision to reject each such alternative.''.

SEC. 302. CLARIFICATION OF CONTRACTING LIMITATION.

    Section 8110(c)(3) is amended--
            (1) by striking out ``or'' at the end of subparagraph (A);
            (2) by redesignating subparagraph (B) as subparagraph (C) 
        and in that subparagraph striking out ``section 213 or 4117'' 
        and inserting in lieu thereof ``section 7409''; and
            (3) by inserting after subparagraph (A) the following new 
        subparagraph (B):
            ``(B) to a contract under section 513 of this title if the 
        Under Secretary for Health certifies to the Secretary in 
        writing, before the contract is entered into, that the contract 
        is necessary in order to provide services to eligible veterans 
        at a Department health-care facility that could not otherwise 
        be provided at such facility; or''.

                      TITLE IV--STATE HOME PROGRAM

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

    (a) In General.--Subsection (a) of section 1741 is amended to read 
as follows:
    ``(a)(1) The Secretary shall pay to each State a per diem amount 
for each veteran receiving domiciliary care, nursing home care, 
hospital care, or adult day health care in a State home if the veteran 
is eligible to receive that care in a Department facility.
    ``(2) The per diem rate to be paid under this subsection is as 
follows:
            ``(A) For domiciliary care, $11.79 for each day.
            ``(B) For nursing home care and hospital care, $27.61 for 
        each day.
            ``(C) For adult day health care, $16.50 for each day.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to adult day health care provided in a State home 
after September 30, 1993.

SEC. 402. CONSTRUCTION ASSISTANCE PROGRAM.

    (a) In General.--Subchapter III of chapter 81 is amended as 
follows:
            (1) Section 8131(3) is amended by inserting ``or adult day 
        health care'' after ``hospital care''.
            (2) Section 8132 is amended by inserting ``adult day health 
        care'' after ``hospital care''.
            (3) Section 8135(a)(4) is amended by inserting ``and, in 
        the case of adult day health care, not more than 25 percent of 
        the number of patients participating in that program,'' after 
        ``occupancy''.
            (4) Section 8135(b) is amended--
                    (A) in paragraph (2)(C), by inserting ``or adult 
                day health care facilities'' after ``domiciliary 
                beds''; and
                    (B) in paragraph (3)(A), by inserting ``, or would 
                involve expansion, remodeling, or alteration of 
                existing buildings for the furnishing of adult day 
                health care'' after ``buildings''.
            (5) Section 8136 is amended by inserting ``adult day health 
        care'' after ``hospital care''.
            (6) The heading of such subchapter 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''.

    (b) Clerical Amendment.--The item relating to subchapter III in the 
table of sections at the beginning 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''.

    (c) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to grants made to States using funds appropriated 
after the date of the enactment of this Act.

SEC. 403. SHARING OF RESOURCES WITH STATE HOMES.

    (a) Purpose.--Section 8151 is amended by adding at the end the 
following: ``It is further the purpose of this subchapter to improve 
the provision of care to veterans under this title by authorizing the 
Secretary to enter into agreements with State veterans facilities for 
the sharing of health-care resources.''.
    (b) Definition.--Section 8152 is amended--
            (1) by redesignating paragraph (3) as paragraph (4); and
            (2) by inserting after paragraph (2) the following new 
        paragraph (3):
            ``(3) The term `health-care resource' includes hospital 
        care, medical services, and rehabilitative services, as those 
        terms are defined in paragraphs (5), (6), and (8), 
        respectively, of section 1701 of this title, any other health-
        care service, and any health-care support or administrative 
        resource.''.
    (c) Sharing of Health-Care Resources.--Section 8153(a) is amended--
            (1) by inserting ``(1)'' after ``(a)''; and
            (2) by striking out ``other form of agreement,'' and all 
        that follows and inserting in lieu thereof
``other form of agreement for the mutual use, or exchange of use, of--
            ``(A) specialized medical resources between Department 
        health-care facilities and other health-care facilities 
        (including organ banks, blood banks, or similar institutions), 
        research centers, or medical schools; and
            ``(B) health-care resources between Department health-care 
        facilities and State home facilities recognized under section 
        1742(a) of this title.
    ``(2) The Secretary may execute a contract or other agreement under 
paragraph (1) only if (A) such an agreement will obviate the need for a 
similar resource to be provided in a Department health care facility, 
or (B) the Department resources which are the subject of the agreement 
and which have been justified on the basis of veterans' care are not 
used to their maximum effective capacity.''.

                         TITLE V--MISCELLANEOUS

SEC. 501. DEPARTMENT OF VETERANS AFFAIRS RESEARCH ADVISORY COMMITTEES.

    (a) Statutory Basis for Research Advisory Committees.--Chapter 5 is 
amended by adding at the end of subchapter III the following new 
section:
``Sec. 544. Veterans research advisory committees
    ``(a) Congress declares that each of the veterans research advisory 
committees specified in subsection (c) (previously established by the 
Secretary in carrying out the duties of the Secretary under section 
7303 of this title) has a continuing, ongoing function that is 
integrally related to the successful completion by the Department of 
its statutory duties. Each such committee shall, for all purposes, 
operate as though such committee had been established by, and chartered 
pursuant to, law. The objectives and scope of the activities of each 
such committee and the duties for which the committee is responsible, 
as specified by the Secretary as of March 1, 1993, shall be those in 
effect as of that date.
    ``(b) The Secretary may not terminate a veterans' research advisory 
committee specified in subsection (c) unless the Secretary finds that 
the committee is no longer needed. Not less than 120 days before 
terminating such a committee, the Secretary shall submit to the 
congressional veterans' affairs committees a report on the proposed 
termination. The report shall include an explanation of (1) the basis 
for the Secretary's determination that such committee is no longer 
needed, and (2) the manner in which the Secretary will carry out the 
Secretary's responsibilities under section 7303 of this title in the 
absence of the committee.
    ``(c) For purposes of this section, each of the following 
committees and boards, as established by the Secretary as of March 1, 
1993, shall be considered to be a veterans' research advisory 
committee:
            ``(1) The Career Development Committee.
            ``(2) The Department of Veterans Affairs Cooperative 
        Studies Evaluation Committee.
            ``(3) The Merit Review Board for Basic Sciences Programs.
            ``(4) The Merit Review Board for Cardiovascular Programs.
            ``(5) The Merit Review Board for Clinical Pharmacology, 
        Alcoholism, and Drug Dependence Programs.
            ``(6) The Merit Review Board for Endocrinology Programs.
            ``(7) The Merit Review Board for Gastroenterology Programs.
            ``(8) The Merit Review Board for Hematology Programs.
            ``(9) The Merit Review Board for Immunology Programs.
            ``(10) The Merit Review Board for Infectious Diseases 
        Programs.
            ``(11) The Merit Review Board for Mental Health and 
        Behavioral Sciences Programs.
            ``(12) The Merit Review Board for Nephrology Programs.
            ``(13) The Merit Review Board for Neurobiology Programs.
            ``(14) The Merit Review Board for Oncology Programs.
            ``(15) The Merit Review Board for Respiration Programs.
            ``(16) The Merit Review Board for Surgery Programs.
            ``(17) The Scientific Review Evaluation Board for Health 
        Services Research and Development.
            ``(18) The Scientific Review Evaluation Board for 
        Rehabilitation Research and Development.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 5 is amended by inserting after the item relating to section 
543 the following new item:

``544. Veterans research advisory committees.''.

SEC. 502. LIMITATION ON CLAIMS FOR COPAYMENTS.

    (a) Hospital Care and Nursing Home Care.--Section 1710(f) is 
amended by adding at the end the following new paragraph:
    ``(6) A veteran may not be required to make a payment under this 
subsection for any day of care if the Secretary does not notify the 
veteran in writing of the amount owed for that care before the end of 
the two-year period beginning on the date on which the care is 
provided, unless the reason the Secretary did not notify the veteran 
within such period was due to reliance by the Secretary on information 
furnished by the veteran to the Secretary which was subsequently 
determined to be erroneous.''.
    (b) Outpatient Medical Services.--Section 1712(f) is amended by 
adding at the end the following new paragraph:
    ``(5) A veteran may not be required to make a payment under this 
subsection for any medical services if the Secretary does not notify 
the veteran in writing of the amount owed for those services before the 
end of the two-year period beginning on the date on which the services 
were provided, unless the reason the Secretary did not notify the 
veteran within such period was due to reliance by the Secretary on 
information furnished by the veteran to the Secretary which was 
subsequently determined to be erroneous.''.
    (c) Medications.--Section 1722A(a) is amended by adding at the end 
the following new paragraph:
    ``(3) A veteran may not be required to make a payment under this 
subsection for any supply of medication if the Secretary does not 
notify the veteran in writing of the amount owed for that medication 
before the end of the two-year period beginning on the date on which 
the medication is supplied, unless the reason the Secretary did not 
notify the veteran within such period was due to reliance by the 
Secretary on information furnished by the veteran to the Secretary 
which was subsequently determined to be erroneous.''.

SEC. 503. CHILD CARE SERVICES.

    (a) Revised Child Care Authority.--Chapter 81 is amended by 
inserting after section 8116 the following new section:
``Sec. 8117. Child care centers
    ``(a) The Secretary may provide for the operation of child care 
centers at Department facilities. The operation of such centers under 
this section shall be carried out to the extent that the Secretary 
determines, based on the demand of employees of the Department for the 
care involved, that such operation is in the best interest of the 
Department and that it is practicable to do so.
    ``(b)(1) In offering child care services under this section, the 
Secretary shall give priority (in the following order) to employees 
of--
            ``(A) the Department;
            ``(B) other departments and agencies of the Federal 
        Government, and
            ``(C) schools affiliated with the Department and 
        corporations created under section 7361 of this title.
    ``(2) To the extent that space is available, the Secretary may 
provide child care services to members of the public at a child care 
center operated under this section if the Secretary determines that to 
do so is necessary to assure the financial success of that center.
    ``(c)(1) The Secretary shall establish reasonable charges for child 
care services provided at each child care center operated under this 
section. Such charges may be established at different rates for 
different centers.
    ``(2) In establishing charges for child care services provided at a 
center, the Secretary--
            ``(A) shall (except as provided in paragraph (3)) establish 
        the charges so as to ensure that the sum of all charges for 
        child care services at that center is sufficient to meet the 
        staffing expenses of that center; and
            ``(B) may also consider the expenses of constructing or 
        acquiring space for the center, the expenses of converting 
        existing space into the center, and the expenses of equipment 
        and services furnished to the center under subsection (d)(2).
    ``(3) The Secretary may establish charges for child care services 
provided at a center at rates less than those necessary to ensure that 
the sum of all charges for child care services at that center is 
sufficient to meet the staffing expenses of that center if the 
Secretary determines (with respect to a particular facility of the 
Department) that--
            ``(A) the operation of a child care center at that facility 
        would help overcome serious recruitment or retention problems;
            ``(B) adherence to the requirement to establish charges for 
        child care services at that center at rates sufficient to meet 
        the staffing expenses of that center would make the operation 
        of a child care center at that facility unfeasible; and
            ``(C) there are no other practical alternatives to meeting 
        the needs of employees at that facility for child care 
        services.
    ``(4) Proceeds from charges for child care services shall be 
credited to the applicable Department of Veterans Affairs account and 
shall be allotted to the facility served by the child care center and 
shall remain available until expended.
    ``(d) In connection with the establishment and operation of a child 
care center under this section, the Secretary--
            ``(1) may construct or alter space in any Department 
        facility, and may lease space in a non-Department facility for 
        a term not to exceed 20 years, for use as a child care center;
            ``(2) may provide, out of operating funds, other items and 
        services necessary for the operation of the center, including 
        furniture, office machines and equipment, utility and custodial 
        services, and other necessary services and amenities;
            ``(3) shall provide for the participation (directly or 
        through a parent advisory committee) of parents of children 
        receiving care in the center in the establishment of policies 
        to govern the operation of the center and in the oversight of 
        the implementation of such policies;
            ``(4) shall require the development and use of a process 
        for determining the fitness and suitability of prospective 
        employees of or volunteers at the center; and
            ``(5) shall require in connection with the operation of the 
        center compliance with all State and local laws, ordinances, 
        and regulations relating to health and safety and the operation 
        of child care centers.
    ``(e) The Secretary shall prescribe guidelines to carry out this 
section.
    ``(f) For the purpose of this section, the term `parent advisory 
committee' means a committee comprised of, and selected by, the parents 
of children receiving care in a child care center operated under this 
section.''.
    (b) Conforming Repeal.--Section 7809 is repealed.
    (c) Clerical Amendments.--(1) The table of sections at the 
beginning of chapter 81 is amended by inserting after the item relating 
to section 8116 the following new item:

``8117. Child care centers.''.
    (2) The table of sections at the beginning of chapter 78 is amended 
by striking out the item relating to section 7809.
HR 2034 RH----2
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