HR 4425 EH
SEC. 304. DEFINITION OF MAJOR MEDICAL FACILITY
PROJECT.
Subparagraph (A) of section 8104(a)(3) of title 38,
United States Code, is amended by inserting before the
period at the end the following: ‘‘, and, in the case of a
project which is principally for the alteration of a medical
facility to provide additional space for provision of ambula-
tory care, such term means a project involving a total ex-
penditure of more than $5,000,000’’.
TITLE IV—STATE HOME
PROGRAM
SEC. 401. PER DIEM FOR ADULT DAY HEALTH CARE.
(a) IN GENERAL.—Subsection (a) of section 1741 of
title 38, United States Code, 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 sub-
section is as follows:
‘‘(A) For domiciliary care, $15.11 for each day.
‘‘(B) For nursing home care and hospital care,
$35.37 for each day.
HR 4425 EH
‘‘(C) For adult day health care, $16.28 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, 1994.
SEC. 402. CONSTRUCTION ASSISTANCE PROGRAM.
(a) IN GENERAL.—Subchapter III of chapter 81 of
title 38, United States Code, 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 partici-
pating 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 ‘‘domi-
ciliary beds’’; and
(B) in paragraph (3)(A), by inserting ‘‘, or
would involve expansion, remodeling, or alter-
ation of existing buildings for the furnishing of
adult day health care’’ after ‘‘buildings’’.
HR 4425 EH
(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 such chapter 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 en-
actment of this Act.
TITLE V—MISCELLANEOUS
SEC. 501. DEPARTMENT OF VETERANS AFFAIRS RESEARCH
ADVISORY COMMITTEES.
(a) STATUTORY BASIS
FOR RESEARCH ADVISORY
COMMITTEES.—Chapter 5 of title 38, United States Code,
is amended by adding at the end of subchapter III the
following new section:
HR 4425 EH
‘‘§ 544. Veterans research advisory committees
‘‘(a) Congress declares that each of the veterans re-
search 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 relat-
ed to the successful completion by the Department of its
statutory duties. Each such committee shall, for all pur-
poses, operate as though such committee had been estab-
lished 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’ re-
search advisory committee specified in subsection (c) un-
less 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 congres-
sional veterans’ affairs committees a report on the pro-
posed 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 re-
sponsibilities under section 7303 of this title in the ab-
sence of the committee.
HR 4425 EH
‘‘(c) For purposes of this section, each of the follow-
ing committees and boards, as established by the Sec-
retary 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 Coop-
erative Studies Evaluation Committee.
‘‘(3) The Merit Review Board for Basic
Sciences Programs.
‘‘(4) The Merit Review Board for Cardio-
vascular Programs.
‘‘(5) The Merit Review Board for Clinical Phar-
macology, Alcoholism, and Drug Dependence Pro-
grams.
‘‘(6) The Merit Review Board for Endocrinol-
ogy Programs.
‘‘(7) The Merit Review Board for Gastro-
enterology 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.
HR 4425 EH
‘‘(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 such chapter is amended by inserting
after the item relating to section 543 the following new
item:
‘‘544. Veterans research advisory committees.’’.
SEC. 502. CHILD CARE SERVICES.
(a) REVISED CHILD CARE AUTHORITY.—Chapter 81
of title 38, United States Code, is amended by inserting
after section 8116 the following new section:
HR 4425 EH
‘‘(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 con-
structing or acquiring space for the center, the ex-
penses of converting existing space into the center,
and the expenses of equipment and services fur-
nished 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 staff-
ing 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 cen-
HR 4425 EH
ter 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 oper-
ation of a child care center under this section, the Sec-
retary—
‘‘(1) may construct or alter space in any De-
partment facility, and may lease space in a non-De-
partment 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 estab-
HR 4425 EH
lishment 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 oper-
ation 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 of such
title is repealed.
(c) CLERICAL AMENDMENTS.—(1) The table of sec-
tions at the beginning of chapter 81 of such title is amend-
ed by inserting after the item relating to section 8116 the
following new item:
‘‘8117. Child care centers.’’.
HR 4425 EH
(2) The table of sections at the beginning of chapter
78 of such title is amended by striking out the item relat-
ing to section 7809.
SEC. 503. CONTRACTS FOR UTILITIES, AUDIE L. MURPHY
MEMORIAL HOSPITAL.
(a) AUTHORITY TO CONTACT.—Subject to subsection
(b), the Secretary of Veterans Affairs may enter into con-
tracts for the provision of utilities (including steam and
chilled water) to the Audie L. Murphy Memorial Hospital
in San Antonio, Texas. Each such contract may—
(1) be for a period not to exceed 35 years;
(2) provide for the construction and operation
of a production facility on or near property under
the jurisdiction of the Secretary;
(3) require capital contributions by the parties
involved for the construction of such a facility, such
contribution to be in the form of cash, equipment,
or other in-kind contribution; and
(4) provide for a predetermined formula to
compute the cost of providing such utilities to the
parties for the duration of the contract.
(b) FUNDS.—A contract may be entered into under
subsection (a) only to the extent and in the amount pro-
vided in advance in appropriations Acts.
HR 4425 EH
(c) ADDITIONAL TERMS.—The Secretary may include
in a contract under subsection (a) such additional provi-
sions as the Secretary considers necessary to secure the
provision of utilities and to protect the interests of the
United States.
SEC. 504. FACILITIES IN REPUBLIC OF THE PHILIPPINES.
Notwithstanding section 1724 of title 38, United
States Code, the Secretary of Veterans Affairs, during the
period from February 28, 1994, through June 1, 1994,
may contract with facilities in the Republic of the Phil-
ippines other than the Veterans Memorial Medical Center
to furnish hospital care and medical services to veterans
for nonservice-connected disabilities if such veterans are
unable to defray the expenses of necessary hospital care.
When the Secretary determines it to be most feasible, the
Secretary may provide medical services to such veterans
at the Department of Veterans Affairs Outpatient Clinic
at Manila, Republic of the Philippines.
SEC. 505. WAIVER OF CONGRESSIONAL WAITING PERIOD
REQUIREMENT FOR A SPECIFIED ADMINIS-
TRATIVE REORGANIZATION.
(a) WAIVER.—The Secretary of Veterans Affairs may
undertake the administrative reorganization described in
subsection (b) of this section without regard to the waiting
HR 4425 EH
period requirement of section 510(b) of title 38, United
States Code.
(b) COVERED ADMINISTRATIVE REORGANIZATION.—
The administrative reorganization referred to in sub-
section (a) of this section is a reorganization at the De-
partment of Veterans Affairs Medical Center in Sepul-
veda, California, necessitated by the January 1994 earth-
quake damage at that location, as described in the letters
dated April 25, 1994, and the accompanying detailed plan
and justification, submitted by the Secretary of Veterans
Affairs to the chairmen of the House and Senate Commit-
tees on Veterans’ Affairs pursuant to section 510(b) of
title 38, United States Code.
SEC. 506. TECHNICAL AMENDMENT.
Section 7363(c) of title 38, United States Code, is
amended by striking out ‘‘section 501(c)(3) of’’.
Passed the House of Representatives May 23, 1994.
Attest:
Clerk.