† HR 3967 EAS 
(26) Lease for an outpatient clinic in the vicin-
ity of Salt Lake City, Utah, in an estimated amount 
of $29,466,000. 
(27) Lease for an outpatient clinic in the vicin-
ity of Sarasota, Florida, in an estimated amount of 
$36,517,000. 
(28) Lease for an outpatient clinic in the vicin-
ity of Springfield, Massachusetts, in an estimated 
amount of $30,918,000. 
(29) Lease for a community living center in the 
vicinity of Tampa, Florida, in an estimated amount 
of $51,682,000. 
(30) Lease for an outpatient clinic in the vicin-
ity of The Villages, Florida, in an estimated amount 
of $48,267,000. 
(31) Lease for an outpatient clinic in the vicin-
ity of Tri-Cities, Washington, in an estimated 
amount of $36,136,000. 
(b) TREATMENT OF AUTHORIZATIONS.—The author-
ization of leases under subsection (a) shall be considered to 
be a specific authorization by law of the funds for such 
leases for purposes of section 8104(a)(2) of title 38, United 
States Code, as in effect on the day before the date of the 
enactment of this Act.
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(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to the Secretary of Veterans 
Affairs for fiscal year 2023, or the year in which funds are 
appropriated 
for 
the 
Medical 
Facilities 
account, 
$998,137,000 for the leases authorized in subsection (a). 
SEC. 703. TREATMENT OF MAJOR MEDICAL FACILITY 
LEASES OF THE DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) CONGRESSIONAL APPROVAL OF MAJOR MEDICAL 
FACILITY LEASES.—Paragraph (2) of subsection (a) of sec-
tion 8104 of title 38, United States Code, is amended— 
(1) by striking ‘‘No funds’’ and inserting ‘‘(A) 
No funds’’; 
(2) by striking ‘‘or any major medical facility 
lease’’; 
(3) by striking ‘‘or lease’’; and 
(4) by adding at the end the following new sub-
paragraph: 
‘‘(B) No funds may be appropriated for any fis-
cal year, and the Secretary may not obligate or ex-
pend funds (other than for advance planning and de-
sign), for any major medical facility lease unless the 
Committee on Veterans’ Affairs of the Senate and the 
Committee on Veterans’ Affairs of the House of Rep-
† HR 3967 EAS 
resentatives each adopt a resolution approving the 
lease.’’. 
(b) MODIFICATION OF DEFINITION OF MAJOR MED-
ICAL FACILITY LEASE.—Subparagraph (B) of paragraph 
(3) of such subsection is amended to read as follows: 
‘‘(B) The term ‘major medical facility lease’— 
‘‘(i) means a lease for space for use as a 
new medical facility approved through the Gen-
eral Services Administration under section 
3307(a) of title 40 at an average annual rent 
equal to or greater than the appropriate dollar 
threshold described in such section, which shall 
be subject to annual adjustment in accordance 
with section 3307(h) of such title; and 
‘‘(ii) does not include a lease for space for 
use as a shared Federal medical facility for 
which the Department’s estimated share of the 
lease costs does not exceed such dollar threshold.’’. 
(c) SEPARATE
PROSPECTUS
REQUIREMENT
FOR 
MAJOR MEDICAL FACILITY LEASES.—Subsection (b) of 
such section is amended— 
(1) by striking paragraph (7); 
(2) in paragraph (1), by redesignating subpara-
graphs (A) through (E) as clauses (i) through (v), re-
spectively;
† HR 3967 EAS 
(3) in paragraph (6), by redesignating subpara-
graphs (A) through (C) as clauses (i) through (iii), re-
spectively; 
(4) by redesignating paragraphs (1) through (6) 
as subparagraphs (A) through (F), respectively; 
(5) in the matter preceding subparagraph (A), as 
redesignated by paragraph (4)— 
(A) by striking ‘‘Whenever the President’’ 
and inserting ‘‘(1) Whenever the President’’; 
(B) by striking ‘‘the Congress’’ and insert-
ing ‘‘Congress’’; and 
(C) by striking ‘‘or a major medical facility 
lease (as defined in subsection (a)(3)(b))’’; 
(6) in subparagraph (A), as redesignated by 
paragraph (4), by striking ‘‘leased,’’; 
(7) in subparagraph (E), as redesignated by 
paragraph (4)— 
(A) by striking ‘‘or lease’’ each place it ap-
pears; and 
(B) by striking ‘‘or leases’’; and 
(8) by adding at the end the following new para-
graph: 
‘‘(2) Whenever the President or the Secretary submit 
to Congress a request for the funding of a major medical 
facility lease (as defined in subsection (a)(3)(B)), the Sec-
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† HR 3967 EAS 
retary shall submit to each committee, on the same day, 
a prospectus of the proposed medical facility. Any such pro-
spectus shall include the following: 
‘‘(A) A description of the facility to be leased. 
‘‘(B) An estimate of the cost to the Federal Gov-
ernment of the facility to be leased. 
‘‘(C) An estimate of the energy performance of 
the proposed lease space, to include a description of 
anticipated utilization of renewable energy, energy ef-
ficient and climate resilient elements, and related 
matters. 
‘‘(D) Current and projected workload and utili-
zation data regarding the facility to be leased, includ-
ing information on projected changes in workload and 
utilization over a five-year period, a ten-year period, 
and a twenty-year period. 
‘‘(E) A detailed analysis of how the lease is ex-
pected to comply with Office of Management and 
Budget Circular A–11 and section 1341 of title 31 
(commonly referred to as the ‘Anti-Deficiency Act’). 
Any such analysis shall include— 
‘‘(i) an analysis of the classification of the 
lease as a ‘lease purchase’, a ‘capital lease’, or an 
‘operating lease’ as those terms are defined in
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† HR 3967 EAS 
Office of Management and Budget Circular A– 
11; 
‘‘(ii) an analysis of the obligation of budg-
etary resources associated with the lease; and 
‘‘(iii) an analysis of the methodology used 
in determining the asset cost, fair market value, 
and cancellation costs of the lease.’’. 
(d) INTERIM LEASING ACTIONS.—Such section is fur-
ther amended by adding at the end the following new sub-
section: 
‘‘(i)(1) Notwithstanding subsection (a)(2)(B), the Sec-
retary may carry out interim leasing actions as the Sec-
retary considers necessary for the following leases: 
‘‘(A) Major medical facility leases (as defined in 
subsection (a)(3)(B)) approved pursuant to this sec-
tion and for which a prospectus for a replacement 
lease has been submitted to Congress pursuant to sub-
section (b)(2). 
‘‘(B) Replacement leases that do not require ap-
proval under this section and for which a prospectus 
has been submitted to Congress pursuant to subsection 
(b)(2). 
‘‘(2) In this subsection, the term ‘interim leasing ac-
tions’ has the meaning given that term by the Adminis-
trator of the General Services Administration.’’.
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† HR 3967 EAS 
(e) PURCHASE OPTIONS.—Such section is further 
amended by adding at the end the following new subsection: 
‘‘(j) The Secretary may obligate and expend funds to 
exercise a purchase option included in any major medical 
facility lease (as defined in subsection (a)(3)(B)).’’. 
(f) APPLICABILITY.—The amendments made by this 
section shall apply with respect to any lease that has not 
been specifically authorized by law on or before the date 
of the enactment of this Act. 
SEC. 704. AUTHORITY TO ENTER INTO AGREEMENTS WITH 
ACADEMIC AFFILIATES AND OTHER ENTITIES 
TO ACQUIRE SPACE FOR THE PURPOSE OF 
PROVIDING HEALTH-CARE RESOURCES TO 
VETERANS. 
Section 8103 of title 38, United States Code, is amend-
ed by adding at the end the following new subsection: 
‘‘(h)(1) Notwithstanding any other provision of law re-
quiring the use of competitive procedures, including section 
2304 of title 10, when the Secretary determines it to be in 
the best interest of the Department, the Secretary may enter 
into a lease with an academic affiliate or covered entity 
to acquire space for the purpose of providing health-care 
resources to veterans. 
‘‘(2) In this subsection:
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† HR 3967 EAS 
‘‘(A) The term ‘academic affiliate’ means an in-
stitution or organization described in section 7302(d) 
of this title. 
‘‘(B) The term ‘covered entity’ means a unit or 
subdivision of a State, local, or municipal govern-
ment, public or nonprofit agency, institution, or orga-
nization, or other institution or organization as the 
Secretary considers appropriate that owns property 
controlled by an academic affiliate to be leased under 
this subsection. 
‘‘(C) The term ‘health -care resource’ has the 
meaning given that term in section 8152(1) of this 
title. 
‘‘(D) The term ‘space’ means any room, unit, 
floor, wing, building, parking facility, or other sub-
division of a building or facility owned or controlled 
by an academic affiliate.’’. 
SEC. 705. MODIFICATIONS TO ENHANCED-USE LEASE AU-
THORITY OF DEPARTMENT OF VETERANS AF-
FAIRS. 
(a) MODIFICATIONS TO AUTHORITY.—Paragraph (2) 
of section 8162(a) of title 38, United States Code, is amend-
ed to read as follows:
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† HR 3967 EAS 
‘‘(2)(A) The Secretary may enter into an enhanced- 
use lease on or after the date of the enactment of this para-
graph only if the Secretary determines— 
‘‘(i) that the lease will not be inconsistent with, 
and will not adversely affect— 
‘‘(I) the mission of the Department; or 
‘‘(II) the operation of facilities, programs, 
and services of the Department in the area of the 
leased property; and 
‘‘(ii) that— 
‘‘(I) the lease will enhance the use of the 
leased property by directly or indirectly benefit-
ting veterans; or 
‘‘(II) the leased property will provide sup-
portive housing. 
‘‘(B) The Secretary shall give priority to enhanced-use 
leases that, on the leased property— 
‘‘(i) provide supportive housing for veterans; 
‘‘(ii) provide direct services or benefits targeted 
to veterans; or 
‘‘(iii) provide services or benefits that indirectly 
support veterans.’’. 
(b) EXTENSION OF MAXIMUM TERM OF ENHANCED- 
USE LEASE.—Section 8162(b)(2) of such title is amended 
by striking ‘‘75 years’’ and inserting ‘‘99 years’’.
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† HR 3967 EAS 
(c) MODIFICATION OF USE OF PROCEEDS.—Section 
8165(a)(1) of such title is amended by striking ‘‘shall be 
deposited in the Department of Veterans Affairs Medical 
Care Collections Fund established under section 1729A of 
this title.’’ and inserting ‘‘shall, at the discretion of the Sec-
retary, be deposited in— 
‘‘(A) the Department of Veterans Affairs Medical 
Care Collections Fund established under section 
1729A of this title; or 
‘‘(B) the Medical Facilities or Construction, 
Minor Projects account of the Department to be used 
to defray the costs of administration, maintenance, 
repair, and related expenses incurred by the Depart-
ment with respect to property that is owned by or 
under the jurisdiction or control of the Department.’’. 
(d) REPEAL OF SUNSET.—Section 8169 of such title 
is repealed. 
(e) APPROPRIATION.—In addition to amounts other-
wise available, there is appropriated for fiscal year 2022, 
out of any funds in the Treasury not otherwise appro-
priated, $922,000,000 for an additional amount for the De-
partment of Veterans Affairs, to remain available until ex-
pended, to enter into enhanced-use leases pursuant to sec-
tion 8162 of title 38, United States Code, as amended by 
this section.
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SEC. 706. AUTHORITY FOR JOINT LEASING ACTIONS OF DE-
PARTMENT OF DEFENSE AND DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) DEPARTMENT OF DEFENSE.—Section 1104A of 
title 10, United States Code, is amended— 
(1) by inserting ‘‘, or the leasing,’’ after ‘‘design, 
and construction’’ each place it appears; and 
(2) in subsection (c)(2), by inserting ‘‘, or the 
leasing,’’ after ‘‘design’’. 
(b) DEPARTMENT OF VETERANS AFFAIRS.—Section 
8111B of title 38, United States Code, is amended— 
(1) in subsection (a), by inserting ‘‘, or the leas-
ing,’’ after ‘‘design, and construction’’; 
(2) in subsection (b), by adding at the end the 
following new paragraph: 
‘‘(3) The Secretary of Veterans Affairs may transfer 
to the Department of Defense amounts appropriated to the 
‘Medical Facilities’ account of the Department of Veterans 
Affairs for the purpose of leasing space for a shared medical 
facility if the estimated share of the Department of Veterans 
Affairs for the lease costs does not exceed the amount speci-
fied in section 8104(a)(3)(B) of this title.’’; and 
(3) in subsection (c), by adding at the end the 
following new paragraph: 
‘‘(3) Any amount transferred to the Secretary of Vet-
erans Affairs by the Secretary of Defense for the purpose
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† HR 3967 EAS 
of leasing space for a shared medical facility may be cred-
ited to the ‘Medical Facilities’ account of the Department 
of Veterans Affairs and may be used for such purpose.’’. 
SEC. 707. APPROPRIATION OF AMOUNTS FOR MAJOR MED-
ICAL FACILITY LEASES. 
(a) FISCAL YEAR 2023.—In addition to amounts oth-
erwise available, there is appropriated for fiscal year 2023, 
out of any funds in the Treasury not otherwise appro-
priated, $1,880,000,000 for an additional amount for the 
Medical Facilities account of the Department of Veterans 
Affairs, to remain available until expended, for major med-
ical facility leases authorized by section 702. 
(b) ADDITIONAL YEARS.—In addition to amounts oth-
erwise available, there is appropriated, out of any funds 
in the Treasury not otherwise appropriated, for an addi-
tional amount for the Medical Facilities account of the De-
partment of Veterans Affairs, to remain available until ex-
pended, for major medical facility leases authorized by sec-
tion 702 or approved pursuant to subchapter I of chapter 
81 of title 38, United States Code, as amended by section 
703— 
(1) $100,000,000 for fiscal year 2024; 
(2) $200,000,000 for fiscal year 2025; 
(3) $400,000,000 for fiscal year 2026; 
(4) $450,000,000 for fiscal year 2027;