IB 
Union Calendar No. 672 
115TH CONGRESS 
2D SESSION 
H. R. 5974 
[Report No. 115–869] 
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 
MAY 25, 2018 
Mr. DENHAM (for himself, Mr. BOST, Ms. KUSTER of New Hampshire, and 
Mr. CRIST) introduced the following bill; which was referred to the Com-
mittee on Veterans’ Affairs 
JULY 24, 2018 
Additional sponsor: Mr. RODNEY DAVIS of Illinois 
JULY 24, 2018 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on May 25, 2018] 
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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. 
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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 Veterans 
Affairs Creation of On-Site Treatment Systems Affording 
Veterans Improvements and Numerous General Safety En-
hancements Act’’ or the ‘‘VA COST SAVINGS Enhance-
ments Act’’. 
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 Af-
fairs facilities that would benefit from cost savings associ-
ated 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 savings 
associated with the use of an on-site regulated medical 
waste treatment system at Department facilities. Such 
model shall be designed to calculate savings based on— 
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(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 treat-
ment system manufacturers, with capital costs amor-
tized over a ten-year period. 
(c) INSTALLATION.—At each Department facility iden-
tified under subsection (a), the Secretary shall secure, in-
stall, and operate an on-site regulated medical waste treat-
ment system. 
(d) USE OF BLANKET PURCHASE AGREEMENT.—Any 
medical waste treatment system purchased pursuant to this 
section shall be purchased under the blanket purchase agree-
ment known as the ‘‘VHA Regulated Medical Waste On- 
Site Treatment Equipment Systems Blanket Purchase 
Agreement’’ or any successor, contract, agreement, or other 
arrangement. 
(e) REGULATED MEDICAL WASTE DEFINED.—In this 
section, the term ‘‘regulated medical waste’’ has the mean-
ing given such term under section 173.134(a)(5) of title 49, 
Code of Federal Regulations, concerning regulated medical 
waste and infectious substances, or any successor regula-
tion, except that, in the case of an applicable State law 
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that is more expansive, the definition in the State law shall 
apply. 
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