109TH CONGRESS 
2D SESSION 
H. R. 5815
AN ACT 
To authorize major medical facility projects and major med-
ical facility leases for the Department of Veterans Affairs 
for fiscal years 2006 and 2007, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Department of Veterans Affairs Medical Facility Author-
ization Act of 2006’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows:
Sec. 1. Short title; table of contents. 
Sec. 2. Authorization of major medical facility project, Biloxi and Gulfport, 
Mississippi. 
Sec. 3. Authorization of design, construction, and operation of major medical 
facility project, New Orleans, Louisiana. 
Sec. 4. Authorization of design, construction, and operation of a major medical 
facility project, Charleston, South Carolina. 
Sec. 5. Authorization of site purchase for major medical facility project, re-
placement site, Denver Colorado. 
Sec. 6. Extension of authorization for certain major medical facility construc-
tion projects previously authorized in connection with Capital 
Asset Realignment Initiative. 
Sec. 7. Authorization of major medical facility leases. 
Sec. 8.
Authorization of appropriations. 
Sec. 9. Sense of Congress and report on option for medical facility improve-
ments in San Juan, Puerto Rico. 
Sec. 10. Land conveyance, city of Fort Thomas, Kentucky. 
Sec. 11. Establishment within the Department of Veterans Affairs of a career 
position responsible for Department-wide construction and fa-
cilities management. 
Sec. 12. Business plans for enhanced access to outpatient care in certain rural 
areas. 
Sec. 13. Report on option for construction of a Department of Veterans Affairs 
medical center in Okaloosa County, Florida.
SEC. 2. AUTHORIZATION OF MAJOR MEDICAL FACILITY 
PROJECT, 
BILOXI 
AND 
GULFPORT, 
MIS-
SISSIPPI. 
(a) PROJECT AUTHORIZATION.—The Secretary of 
Veterans Affairs may carry out a major medical facility 
project for restoration of the Department of Veterans Af-
fairs Medical Center, Biloxi, Mississippi, and consolidation
of services performed at the Department of Veterans Af-
fairs Medical Center, Gulfport, Mississippi. 
(b) COST LIMITATION.—The project authorized by 
subsection (a) shall be carried out in an amount not to 
exceed $310,000,000. 
(c) REQUIREMENT FOR JOINT-USE FACILITY.—The 
project authorized by subsection (a) may only be carried 
out as part of a joint-use facility shared by the Depart-
ment of Veterans Affairs with Keesler Air Force Base, Bi-
loxi, Mississippi. 
SEC. 3. AUTHORIZATION OF DESIGN, CONSTRUCTION, AND 
OPERATION OF MAJOR MEDICAL FACILITY 
PROJECT, NEW ORLEANS, LOUISIANA. 
(a) AGREEMENT AUTHORIZED.—The Secretary of 
Veterans Affairs may enter into an agreement with the 
Louisiana State University to design, construct, and oper-
ate a co-located, joint-use medical facility in or near New 
Orleans to replace the medical center facility for the De-
partment of Veterans Affairs Medical Center, New Orle-
ans, Louisiana, damaged by Hurricane Katrina in August 
2005. 
(b) COST LIMITATION.—Advance planning and de-
sign for a co-located, joint-use medical facility in or near 
New Orleans under subsection (a) shall be carried out in 
an amount not to exceed $100,000,000.
SEC. 4. AUTHORIZATION OF DESIGN, CONSTRUCTION, AND 
OPERATION OF A MAJOR MEDICAL FACILITY 
PROJECT, CHARLESTON, SOUTH CAROLINA. 
(a) AGREEMENT AUTHORIZED.—The Secretary of 
Veterans Affairs may enter into an agreement with the 
Medical University of South Carolina to design, construct, 
and operate a co-located joint-use medical facility in 
Charleston, South Carolina, to replace the Ralph H. John-
son Department of Veterans Affairs Medical Center, 
Charleston, South Carolina. 
(b) COST LIMITATION.—Advance planning and de-
sign for a co-located, joint-use medical facility in Charles-
ton, South Carolina, under subsection (a) shall be carried 
out in an amount not to exceed $70,000,000. 
SEC. 5. AUTHORIZATION OF SITE PURCHASE FOR MAJOR 
MEDICAL FACILITY PROJECT, REPLACEMENT 
SITE, DENVER COLORADO. 
(a) AUTHORIZATION.—The Secretary of Veterans Af-
fairs may enter into an agreement to purchase a site for 
the replacement of the Department of Veterans Affairs 
Medical Center, Denver, Colorado, in an amount not to 
exceed $98,000,000. 
(b) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Veterans 
Affairs shall submit to the Committees on Veterans’ Af-
fairs of the Senate and House of Representatives a report
identifying and outlining the various options available to 
the Department for replacing the current Department of 
Veterans Affairs Medical Center, Denver, Colorado. The 
report shall include the following: 
(1) The feasibility of entering into a partner-
ship with a Federal, State, or local governmental 
agency, or a suitable non-profit organization, for the 
construction and operation of a new facility. 
(2) The medical, legal, and financial implica-
tions of each of the options identified, including rec-
ommendations regarding any statutory changes nec-
essary for the Department to carry out any of the 
options identified. 
(3) A detailed cost-benefit analysis of each of 
the options identified. 
(4) Estimates regarding the length of time and 
associated costs needed to complete such a facility 
under each of the options identified. 
SEC. 6. EXTENSION OF AUTHORIZATION FOR CERTAIN 
MAJOR MEDICAL FACILITY CONSTRUCTION 
PROJECTS 
PREVIOUSLY 
AUTHORIZED 
IN 
CONNECTION WITH CAPITAL ASSET REALIGN-
MENT INITIATIVE. 
The Secretary of Veterans Affairs may carry out the 
following major medical facility projects, with each such
project to be carried out in the amount specified for that 
project: 
(1) Construction of an outpatient clinic and re-
gional office at the Department of Veterans Affairs 
Medical Center, Anchorage, Alaska, in an amount 
not to exceed $75,270,000. 
(2) Consolidation of clinical and administrative 
functions of the Department of Veterans Affairs 
Medical Center, Cleveland, Ohio, and the Depart-
ment 
of 
Veterans 
Affairs 
Medical 
Center, 
Brecksville, Ohio, in an amount not to exceed 
$102,300,000. 
(3) Construction of the extended care building 
at the Department of Veterans Affairs Medical Cen-
ter, Des Moines, Iowa, in an amount not to exceed 
$25,000,000. 
(4) Renovation of patient wards at the Depart-
ment of Veterans Affairs Medical Center, Durham, 
North Carolina, in an amount not to exceed 
$9,100,000. 
(5) Correction of patient privacy deficiencies at 
the Department of Veterans Affairs Medical Center, 
Gainesville, Florida, in an amount not to exceed 
$85,200,000.
(6) 7th and 8th floor wards modernization addi-
tion at the Department of Veterans Affairs Medical 
Center, Indianapolis, Indiana, in an amount not to 
exceed $27,400,000. 
(7) Construction of a new medical center facil-
ity at the Department of Veterans Affairs Medical 
Center, Las Vegas, Nevada, in an amount not to ex-
ceed $406,000,000. 
(8) Construction of an ambulatory surgery/out-
patient diagnostic support center in the Gulf South 
Submarket of Veterans Integrated Service Network 
(VISN) 8 and completion of Phase I land purchase, 
Lee County, Florida, in an amount not to exceed 
$65,100,000. 
(9) Seismic corrections, Buildings 7 and 126, 
Department of Veterans Affairs Medical Center, 
Long Beach, California, in an amount not to exceed 
$107,845,000. 
(10) Seismic corrections, Buildings 500 and 
501, Department of Veterans Affairs Medical Cen-
ter, Los Angeles, California, in an amount not to ex-
ceed $79,900,000. 
(11) Construction of a new medical center facil-
ity, Orlando, Florida, to be located at the site in 
Lake Nona known as site selection C, which is di-
rectly south of the interchange between SR-417 and 
Lake Nona Boulevard and is part of a science and 
research park that is likely to include the proposed 
campus of the medical school of the University of 
Central Florida, in an amount not to exceed 
$377,700,000. 
(12) Consolidation of campuses at the Univer-
sity Drive and H. John Heinz III divisions, Pitts-
burgh, Pennsylvania, in an amount not to exceed 
$189,205,000. 
(13) Ward upgrades and expansion at the De-
partment of Veterans Affairs Medical Center, San 
Antonio, Texas, in an amount not to exceed 
$19,100,000. 
(14) Construction of a spinal cord injury cen-
ter, Department of Veterans Affairs Medical Center, 
Syracuse, New York, in an amount not to exceed 
$77,700,000. 
(15) Upgrade essential electrical distribution 
systems, Department of Veterans Affairs Medical 
Center, Tampa, Florida, in an amount not to exceed 
$49,000,000. 
(16) Expansion of the spinal cord injury center 
addition, Department of Veterans Affairs Medical
Center, Tampa, Florida, in an amount not to exceed 
$7,100,000. 
(17) Blind rehabilitation and psychiatric bed 
renovation and new construction project, Depart-
ment of Veterans Affairs Medical Center, Temple, 
Texas, in an amount not to exceed $56,000,000. 
SEC. 7. AUTHORIZATION OF MAJOR MEDICAL FACILITY 
LEASES. 
(a) FISCAL YEAR 2006 LEASES.—The Secretary of 
Veterans Affairs may carry out the following major med-
ical facility leases in fiscal year 2006 at the locations spec-
ified, in an amount for each lease not to exceed the 
amount specified for that location: 
(1) For an outpatient clinic, Baltimore, Mary-
land, $10,908,000. 
(2) For an outpatient clinic, Evansville, Indi-
ana, $8,989,000. 
(3) For an outpatient clinic, Smith County, 
Texas, $5,093,000. 
(b) FISCAL YEAR 2007 LEASES.—The Secretary of 
Veterans Affairs may carry out the following major med-
ical facility leases in fiscal year 2007 at the locations spec-
ified, in an amount for each lease not to exceed the 
amount specified for that location:
(1) For an outpatient and specialty care clinic, 
Austin, Texas, $6,163,000. 
(2) For an outpatient clinic, Lowell, Massachu-
setts, $2,520,000. 
(3) For an outpatient clinic, Grand Rapids, 
Michigan, $4,409,000. 
(4) For up to four outpatient clinics, Las 
Vegas, Nevada, $8,518,000. 
(5) For an outpatient clinic, Parma, Ohio, 
$5,032,000. 
SEC. 8. AUTHORIZATION OF APPROPRIATIONS. 
(a) AUTHORIZATION OF APPROPRIATIONS FOR FIS-
CAL YEAR 2006 MAJOR MEDICAL FACILITY PROJECTS.—
There is authorized to be appropriated to the Secretary 
of Veterans Affairs for fiscal year 2006 for the Construc-
tion, Major Projects, account, a total of $578,000,000, of 
which—
(1) $310,000,000 is for the project authorized 
in section 2; 
(2) $100,000,000 is for the advance planning 
and design authorized in section 3; 
(3) $70,000,000 is for the advanced planning 
authorized in section 4; and 
(4) $98,000,000 is for the purchase of a site 
authorized in section 5.
(b) AUTHORIZATION
OF
APPROPRIATIONS
FOR 
MAJOR MEDICAL FACILITY PROJECTS UNDER CAPITAL 
ASSET REALIGNMENT INITIATIVE.—There is authorized 
to be appropriated for the Secretary of Veterans Affairs 
for fiscal year 2007 for the Construction, Major Projects, 
account, $1,758,920,000 for the projects specified in sec-
tion 6. 
(c) AUTHORIZATION
OF
APPROPRIATIONS
FOR 
MAJOR MEDICAL FACILITY LEASES.—
(1) FISCAL YEAR 2006 LEASES.—There is au-
thorized to be appropriated for the Secretary of Vet-
erans Affairs for fiscal year 2006 for the Medical 
Care account, $24,990,000 for the leases authorized 
in section 7(a). 
(2) FISCAL YEAR 2007 LEASES.—There is au-
thorized to be appropriated for the Secretary of Vet-
erans Affairs for fiscal year 2007 for the Medical 
Care account, $26,642,000 for the leases authorized 
in section 7(b). 
(d) LIMITATION.—The projects authorized in sections 
2, 3, 4, 5, and 6 may only be carried out using—
(1) funds appropriated for fiscal year 2006 or 
2007 pursuant to the authorization of appropria-
tions in subsections (a), (b), and (c);
(2) funds available for Construction, Major 
Projects, for a fiscal year before fiscal year 2006 
that remain available for obligation; 
(3) funds available for Construction, Major 
Projects, for a fiscal year after fiscal year 2006 or 
2007 that are available for obligation; and 
(4) funds appropriated for Construction, Major 
Projects, for fiscal year 2006 or 2007 for a category 
of activity not specific to a project. 
SEC. 9. SENSE OF CONGRESS AND REPORT ON OPTION FOR 
MEDICAL FACILITY IMPROVEMENTS IN SAN 
JUAN, PUERTO RICO. 
(a) SENSE OF CONGRESS.—Recognizing that concern 
for the need for medical facility improvements in San 
Juan, Puerto Rico, is not being adequately addressed, it 
is the sense of Congress that the Secretary of Veterans 
Affairs should take steps to explore all options for address-
ing that concern, including the option of a public/private 
partnership to construct and operate a facility that would 
replace the current Department of Veterans Affairs med-
ical center in San Juan, Puerto Rico. 
(b) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Veterans 
Affairs shall submit to the Committees on Veterans’ Af-
fairs of the Senate and House of Representatives a report
identifying and outlining the various options available to 
the Department for replacing the current Department of 
Veterans Affairs Medical Center, San Juan, Puerto Rico. 
The report shall include the following: 
(1) The feasibility of entering into a partner-
ship with a Federal, Commonwealth, or local govern-
mental agency, or a suitable non-profit organization, 
for the construction and operation of a new facility. 
(2) The medical, legal, and financial implica-
tions of each of the options identified, including rec-
ommendations regarding any statutory changes nec-
essary for the Department to carry out any of the 
options identified. 
(3) A detailed cost-benefit analysis of each of 
the options identified. 
(4) Estimates regarding the length of time and 
associated costs needed to complete such a facility 
under each of the options identified. 
SEC. 10. LAND CONVEYANCE, CITY OF FORT THOMAS, KEN-
TUCKY. 
(a) CONVEYANCE AUTHORIZED.—The Secretary of 
Veterans Affairs may convey to the city of Fort Thomas, 
Kentucky (in this section referred to as the ‘‘City’’), all 
right, title, and interest of the United States in and to 
a parcel of real property, including the 15 structures lo-
cated thereon, consisting of approximately 11.75 acres 
that is managed by the Department of Veterans Affairs 
and located in the northeastern portion of Tower Park in 
Fort Thomas, Kentucky. Any such conveyance shall be 
subject to valid existing rights, easements, and rights-of-
way. 
(b) CONSIDERATION.—As consideration for the con-
veyance under subsection (a), the City shall pay to the 
United States an amount equal to the fair market value 
of the conveyed real property, as determined by the Sec-
retary. 
(c) TREATMENT OF CONSIDERATION.—The consider-
ation received under subsection (b) shall be deposited, at 
the discretion of the Secretary, in the ‘‘Medical facilities’’ 
account or the ‘‘Construction, minor projects’’ account (or 
a combination of those accounts) and shall be available 
to the Secretary, without limitation and until expended—
(1) to cover costs incurred by the Secretary as-
sociated with the environmental remediation of the 
real property before conveyance under subsection 
(a); and 
(2) with any funds remaining after the Sec-
retary has covered costs as required under para-
graph (1), for acquisition of a site for use as a park-
ing facility, or contract (by lease or otherwise) for
the operation of a parking facility, to be used in con-
nection with the Department of Veterans Affairs 
Medical Facility, Cincinnati, Ohio. 
(d) RELEASE FROM LIABILITY.—Effective on the 
date of the conveyance under subsection (a), the United 
States shall not be liable for damages arising out of any 
act, omission, or occurrence relating to the conveyed real 
property, but shall continue to be liable for damages 
caused by acts of negligence committed by the United 
States or by any employee or agent of the United States 
before the date of conveyance, consistent with chapter 171 
of title 28, United States Code. 
(e) PAYMENT OF COSTS OF CONVEYANCE.—
(1) PAYMENT REQUIRED.—The Secretary shall 
require the City to cover costs to be incurred by the 
Secretary, or to reimburse the Secretary for costs in-
curred by the Secretary, to carry out the conveyance 
under subsection (a), including survey costs, costs 
related to environmental documentation, and other 
administrative costs related to the conveyance. If 
amounts are collected from the City in advance of 
the Secretary incurring the actual costs, and the 
amount collected exceeds the costs actually incurred 
by the Secretary to carry out the conveyance, the
Secretary shall refund the excess amount to the 
City. 
(2) TREATMENT
OF
AMOUNTS
RECEIVED.—
Amounts received as reimbursement under para-
graph (1) shall be credited to the fund or account 
that was used to cover the costs incurred by the Sec-
retary in carrying out the conveyance. Amounts so 
credited shall be merged with amounts in such fund 
or account and shall be available for the same pur-
poses, and subject to the same conditions and limita-
tions, as amounts in such fund or account. 
(f) DESCRIPTION OF PROPERTY.—The exact acreage 
and legal description of the real property to be conveyed 
under subsection (a) shall be determined by a survey satis-
factory to the Secretary. 
(g) ADDITIONAL TERMS
AND CONDITIONS.—The 
Secretary may require such additional terms and condi-
tions in connection with the conveyance under subsection 
(a) as the Secretary considers necessary to protect the in-
terests of the United States.
SEC. 11. ESTABLISHMENT WITHIN THE DEPARTMENT OF 
VETERANS AFFAIRS OF A CAREER POSITION 
RESPONSIBLE FOR DEPARTMENT-WIDE CON-
STRUCTION AND FACILITIES MANAGEMENT. 
(a) ESTABLISHMENT OF POSITION.—Chapter 3 of 
title 38, United States Code, is amended by inserting after 
section 312 the following new section: 
‘‘§ 312A. Director, Construction and Facilities Man-
agement 
‘‘(a) CAREER POSITION.—There is in the Depart-
ment the position of Director, Construction and Facilities 
Management. The position of Director, Construction and 
Facilities Management, is a career position with responsi-
bility for construction and facilities management across 
the Department, including responsibility for all major and 
minor construction projects. The individual appointed as 
Director shall be appointed by the Secretary and shall pro-
vide direct support to the Secretary and report to the Dep-
uty Secretary of the Department. 
‘‘(b) QUALIFICATIONS.—The individual appointed to 
the position of Director, Construction and Facilities Man-
agement, shall be an individual who—
‘‘(1) holds an undergraduate or master’s degree 
in architectural design or engineering; and 
‘‘(2) has substantive professional experience in 
the area of construction project management.
‘‘(c) RESPONSIBILITIES.—The individual appointed 
to the position of Director, Construction and Facilities 
Management, shall be responsible for overseeing and man-
aging the planning, design, construction, and facilities op-
eration, including infrastructure, of the Department’s 
major and minor construction projects and performing 
such other functions as the Secretary prescribes. Such 
oversight and management responsibilities shall include 
each of the following: 
‘‘(1) Developing and updating short and long-
range strategic capital investment strategies and 
plans. 
‘‘(2) Planning, designing, and building facilities, 
determining architectural and engineering require-
ments as well as ensuring compliance with all appli-
cable laws relating to the Department’s construction 
program. 
‘‘(3) Overseeing and managing the construction 
of Department facilities. 
‘‘(4) Managing the Department’s short and 
long-term leasing activity. 
‘‘(5) Repairing and maintaining the Depart-
ment’s facilities, including custodial services, build-
ing management and administration, and mainte-
nance of roads, grounds, and infrastructure.
‘‘(6) Managing the procurement and acquisition 
processes, including contract award related to de-
sign, construction, furnishing, and supplies and 
equipment.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after the item relating to section 312 the following new 
item:
‘‘312A. Director, Construction and Facilities Management.’’.
SEC. 12. BUSINESS PLANS FOR ENHANCED ACCESS TO OUT-
PATIENT CARE IN CERTAIN RURAL AREAS. 
(a) REQUIREMENT.—Not later than 180 days after 
the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall submit to the Committees on Vet-
erans’ Affairs of the Senate and House of Representatives 
a business plan for enhanced access to outpatient care (as 
described in subsection (b)) for primary care, mental 
health care, and specialty care in each of the following 
areas: 
(1) The Lewiston-Auburn area of Maine. 
(2) The area of Houlton, Maine. 
(3) The area of Dover-Foxcroft, Maine. 
(4) Whiteside County, Illinois. 
(b) MEANS OF ENHANCED ACCESS.—The means of 
enhanced access to outpatient care to be covered by the 
business plans under subsection (a) are, with respect to
each area specified in that subsection, one or more of the 
following: 
(1) New sites of care. 
(2) Expansions at existing sites of care. 
(3) Use of existing authority and policies to 
contract for care where necessary. 
(4) Increased use of telemedicine. 
SEC. 13. REPORT ON OPTION FOR CONSTRUCTION OF A DE-
PARTMENT OF VETERANS AFFAIRS MEDICAL 
CENTER IN OKALOOSA COUNTY, FLORIDA. 
Not later than 180 days after the date of the enact-
ment of this Act, the Secretary of Veterans Affairs shall 
submit to the Committees on Veterans’ Affairs of the Sen-
ate and House of Representatives a report identifying and 
outlining the various options available to the Department 
for the placement of a Department of Veterans Affairs 
Medical Center in Okaloosa County, Florida. The report 
shall include the following: 
(1) The feasibility of entering into a partner-
ship with Eglin Air Force Base for the construction 
and operation of a new, joint Department of Vet-
erans Affairs-Department of Defense facility. 
(2) The medical, legal, and financial implica-
tions of each of the options identified, including rec-
ommendations regarding any statutory changes nec-
essary for the Department to carry out any of the 
options identified. 
(3) A detailed cost-benefit analysis of each of 
the options identified. 
(4) Estimates regarding the length of time and 
associated costs needed to complete such a facility 
under each of the options identified. 
Passed the House of Representatives September 13, 
2006. 
Attest:
Clerk.
109TH CONGRESS 
2D SESSION 
H. R. 5815
AN ACT 
To authorize major medical facility projects and 
major medical facility leases for the Department 
of Veterans Affairs for fiscal years 2006 and 
2007, and for other purposes.