I 
117TH CONGRESS 
1ST SESSION 
H. R. 291 
To direct the Secretary of Veterans Affairs to use on-site regulated medical 
waste treatment systems at certain Department of Veterans Affairs facili-
ties, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 13, 2021 
Mr. BOST introduced the following bill; which was referred to the Committee 
on Veterans’ Affairs 
A BILL 
To direct the Secretary of Veterans Affairs to use on-site 
regulated medical waste treatment systems at certain 
Department of Veterans Affairs facilities, 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. 
This Act may be cited as the ‘‘Department of Vet-
erans Affairs Creation of On-Site Treatment Systems Af-
fording Veterans Improvements and Numerous General 
Safety Enhancements Act’’ or the ‘‘VA COST SAVINGS 
Enhancements Act’’. 
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SEC. 2. USE OF ON-SITE REGULATED MEDICAL WASTE 
TREATMENT SYSTEMS AT DEPARTMENT OF 
VETERANS AFFAIRS FACILITIES. 
(a) IDENTIFICATION OF FACILITIES.—The Secretary 
of Veterans Affairs shall identify Department of Veterans 
Affairs facilities that would benefit from cost savings asso-
ciated with the use of an on-site regulated medical waste 
treatment system over a five-year period. 
(b) REGULATED MEDICAL WASTE COST ANALYSIS 
MODEL.—For purposes of carrying out subsection (a), the 
Secretary shall develop a uniform regulated medical waste 
cost analysis model to be used to determine the cost sav-
ings associated with the use of an on-site regulated med-
ical waste treatment system at Department facilities. Such 
model shall be designed to calculate savings based on— 
(1) the cost of treating regulated medical waste 
at an off-site location under a contract with a non- 
Department entity; compared to 
(2) the cost of treating regulated medical waste 
on-site, based on the equipment specification of 
treatment system manufacturers, with capital costs 
amortized over a ten-year period. 
(c) INSTALLATION.—At each Department facility 
identified under subsection (a), the Secretary shall secure, 
install, and operate an on-site regulated medical waste 
treatment system. 
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(d) USE OF BLANKET PURCHASE AGREEMENT.— 
Any medical waste treatment system purchased pursuant 
to this section shall be purchased under the blanket pur-
chase agreement known as the ‘‘VHA Regulated Medical 
Waste On-Site Treatment Equipment Systems Blanket 
Purchase Agreement’’ or any successor, contract, agree-
ment, or other arrangement. 
(e) REGULATED MEDICAL WASTE DEFINED.—In 
this section, the term ‘‘regulated medical waste’’ has the 
meaning given such term under section 173.134(a)(5) of 
title 49, Code of Federal Regulations, concerning regu-
lated medical waste and infectious substances, or any suc-
cessor regulation, except that, in the case of an applicable 
State law that is more expansive, the definition in the 
State law shall apply. 
SEC. 3. NO ADDITIONAL FUNDS AUTHORIZED. 
No additional funds are authorized to be appro-
priated to carry out the requirements of this Act. Such 
requirements shall be carried out using amounts otherwise 
authorized to be appropriated. 
Æ 
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