Union Calendar No. 216
104TH CONGRESS
1ST SESSION
H. R. 2814
[Report No. 104–443]
A BILL
To authorize major medical facility projects and
major medical facility leases for the Department
of Veterans Affairs for fiscal year 1996, and for
other purposes.
DECEMBER 22, 1995
Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
IB
Union Calendar No. 216
104TH CONGRESS
1ST SESSION
H. R. 2814
[Report No. 104–443]
To authorize major medical facility projects and major medical facility leases
for the Department of Veterans Affairs for fiscal year 1996, and for
other purposes.
IN THE HOUSE OF REPRESENTATIVES
DECEMBER 20, 1995
Mr. STUMP (for himself, Mr. MONTGOMERY, Mr. HUTCHINSON, and Mr. ED-
WARDS) introduced the following bill; which was referred to the Commit-
tee on Veterans’ Affairs
DECEMBER 22, 1995
Committed to the Committee of the Whole House on the State of the Union
and ordered to be printed
A BILL
To authorize major medical facility projects and major medi-
cal facility leases for the Department of Veterans Affairs
for fiscal year 1996, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
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TITLE I—CONSTRUCTION
AUTHORIZATION
SEC. 101. AUTHORIZATION OF MAJOR MEDICAL FACILITY
PROJECTS.
(a) AUTHORIZED PROJECTS.—The Secretary of Vet-
erans Affairs may carry out the following major medical
facility projects, with each project to be carried out in the
amount specified for that project:
(1) Construction of an outpatient clinic in
Brevard County, Florida, in the amount of
$25,000,000.
(2) Construction of an outpatient clinic at
Travis Air Force Base in Fairfield, California, in the
amount of $25,000,000.
(3) Renovation of nursing home facilities at the
Department of Veterans Affairs medical center in
Lebanon, 
Pennsylvania, 
in 
the 
amount 
of
$9,000,000.
(4) Environmental improvements at the Depart-
ment of Veterans Affairs medical center in Marion,
Illinois, in the amount of $11,500,000.
(5) Replacement of psychiatric beds at the De-
partment of Veterans Affairs medical center in Mar-
ion, Indiana, in the amount of $17,300,000.
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(6) Renovation of psychiatric wards at the De-
partment of Veterans Affairs medical center in
Perry 
Point, 
Maryland, 
in 
the 
amount 
of
$15,100,000.
(7) Environmental enhancement at the Depart-
ment of Veterans Affairs medical center in Salis-
bury, 
North 
Carolina, 
in 
the 
amount 
of
$17,200,000.
(8) Construction of an ambulatory care addition
at the Department of Veterans Affairs medical cen-
ter in Asheville, North Carolina, in the amount of
$28,500,000.
(9) Construction of an ambulatory care addition
at the Department of Veterans Affairs medical cen-
ter in Temple, Texas, in the amount of $9,800,000.
(10) Construction of an ambulatory care addi-
tion at the Department of Veterans Affairs medical
center in Tucson, Arizona, in the amount of
$35,500,000.
(11) Seismic corrections at the Department of
Veterans Affairs medical center in Palo Alto, Cali-
fornia, in the amount of $36,800,000.
(12) Seismic corrections at the Department of
Veterans Affairs medical center in Long Beach,
California, in the amount of $20,200,000.
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(b) LIMITATION CONCERNING OUTPATIENT CLINIC
PROJECTS.—In the case of either of the projects for a new
outpatient clinic authorized in paragraphs (1) and (2) of
subsection (a)—
(1) the Secretary of Veterans Affairs may not
obligate any funds for that project until the Sec-
retary determines, and certifies to the Committees
on Veterans’ Affairs of the Senate and House of
Representatives, the amount required for the
project; and
(2) the amount obligated for the project may
not exceed the amount certified under paragraph (1)
with respect to that project.
SEC. 102. AUTHORIZATION OF MAJOR MEDICAL FACILITY
LEASES.
The Secretary of Veterans Affairs may enter into
leases for medical facilities as follows:
(1) Lease of a satellite outpatient clinic in Fort
Myers, Florida, in the amount of $1,736,000.
(2) Lease of a National Footwear Center in
New York, New York, in the amount of $1,054,000.
SEC. 103. AUTHORIZATION OF APPROPRIATIONS.
(a) IN GENERAL.—There are authorized to be appro-
priated to the Secretary of Veterans Affairs for fiscal year
1996—
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(1) for the Construction, Major Projects, ac-
count, $250,900,000 for the projects authorized in
section 101;
(2) for the Construction, Major Projects, ac-
count $28,000,000, for construction of an ambula-
tory care addition at the Department of Veterans
Affairs medical center in Boston, Massachusetts, as
authorized by section 201(b)(1)(A) of the Veterans
Health Programs Extension Act of 1994 (Public
Law 103–452; 108 Stat. 4787); and
(3) for the Medical Care account, $2,790,000
for the leases authorized in section 102.
(b) LIMITATION.—The projects authorized in section
101, and the project referred to in subsection (a)(2), may
only be carried out using—
(1) funds appropriated for fiscal year 1996 pur-
suant to the authorization of appropriations in sub-
section (a);
(2) funds appropriated for Construction, Major
Projects for a fiscal year before fiscal year 1996 that
remain available for obligation; and
(3) funds appropriated for Construction, Major
Projects for fiscal year 1996 for a category of activ-
ity not specific to a project.
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SEC. 104. REPORT ON HEALTH CARE NEEDS OF VETERANS
IN EAST CENTRAL FLORIDA.
(a) REPORT REQUIRED.—Not later than March 1,
1996, the Secretary of Veterans Affairs shall submit to
the Committees on Veterans’ Affairs of the Senate and
House of Representatives a report on the health care
needs of veterans in east central Florida. In preparing the
report, the Secretary shall consider the needs of such vet-
erans for psychiatric and long-term care. The Secretary
shall include in the report the Secretary’s views, based on
the Secretary’s determination of such needs, as to the best
means of meeting such needs using the amounts appro-
priated pursuant to the authorization of appropriations in
this Act and Public Law 103–452 for projects to meet
the health care needs of such veterans. The Secretary
may, subject to the availability of appropriations for such
purpose, use an independent contractor to assist in the
determination of such health care needs.
(b) LIMITATION.—The Secretary may not obligate
any funds, other than for design work, for the conversion
of the former Orlando Naval Training Center Hospital in
Orlando, Florida (now under the jurisdiction of the Sec-
retary of Veterans Affairs), to a nursing home care unit
until 15 days after the date on which the report required
by subsection (a) is submitted.
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TITLE II—STRATEGIC PLANNING
FOR HEALTH CARE RESOURCES
SEC. 201. STRATEGIC PLANNING.
Section 8107 of title 38, United States Code, is
amended—
(1) by redesignating subsection (b) as sub-
section (c);
(2) by striking out subsection (a) and inserting
in lieu thereof the following new subsections:
‘‘(a) In order to promote effective planning for the
efficient provision of care to eligible veterans, the Sec-
retary, based on the analysis and recommendations of the
Under Secretary for Health, shall submit to each commit-
tee, not later than January 31 of each year, a report re-
garding long-range health planning of the Department.
‘‘(b) Each report under subsection (a) shall include
the following:
‘‘(1) A five-year strategic plan for the provision
of care under chapter 17 of this title to eligible vet-
erans through coordinated networks of medical fa-
cilities operating within prescribed geographic serv-
ice-delivery areas, such plan to include provision of
services for the specialized treatment and rehabilita-
tive needs of disabled veterans (including veterans
with spinal cord dysfunction, blindness, amputations,
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and mental illness) through distinct programs or fa-
cilities of the Department dedicated to the special-
ized needs of those veterans.
‘‘(2) A description of how planning for the net-
works will be coordinated.
‘‘(3) A profile regarding each such network of
medical facilities which identifies—
‘‘(A) the mission of each existing or pro-
posed medical facility in the network;
‘‘(B) any planned change in the mission
for any such facility and the rationale for such
planned change;
‘‘(C) the population of veterans to be
served by the network and anticipated changes
over a five-year period and a ten-year period,
respectively, in that population and in the
health-care needs of that population;
‘‘(D) information relevant to assessing
progress toward the goal of achieving relative
equivalency in the level of resources per patient
distributed to each network, such information
to include the plans for and progress toward
lowering the cost of care-delivery in the network
(by means such as changes in the mix in the
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network of physicians, nurses, physician assist-
ants, and advance practice nurses);
‘‘(E) the capacity of non-Federal facilities
in the network to provide acute, long-term, and
specialized treatment and rehabilitative services
(described in section 7305 of this title), and de-
terminations regarding the extent to which
services to be provided in each service-delivery
area and each facility in such area should be
provided directly through facilities of the De-
partment or through contract or other arrange-
ments, 
including 
arrangements 
authorized
under sections 8111 and 8153 of this title; and
‘‘(F) a five-year plan for construction, re-
placement, or alteration projects in support of
the approved mission of each facility in the net-
work and a description of how those projects
will improve access to care, or quality of care,
for patients served in the network.
‘‘(4) A status report for each facility on
progress toward—
‘‘(A) instituting planned mission changes
identified under paragraph (3)(B);
‘‘(B) implementing principles of managed
care of eligible veterans; and
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‘‘(C) developing and instituting cost-effec-
tive alternatives to provision of institutional
care.’’; and
(3) by adding at the end the following new sub-
section:
‘‘(d)(1) The Secretary shall submit to each commit-
tee, not later than January 31 of each year, a report show-
ing the current priorities of the Department for proposed
major medical construction projects. Each such report
shall identify the 20 projects, from within all the projects
in the Department’s inventory of proposed projects, that
have the highest priority and, for those 20 projects, the
relative priority and rank scoring of each such project.
The 20 projects shall be compiled, and their relative
rankings shall be shown, by category of project (including
the categories of ambulatory care projects, nursing home
care projects, and such other categories as the Secretary
determines).
‘‘(2) The Secretary shall include in each report, for
each project listed, a description of the specific factors
that account for the relative ranking of that project in re-
lation to other projects within the same category.
‘‘(3) In a case in which the relative ranking of a pro-
posed project has changed since the last report under this
subsection was submitted, the Secretary shall also include
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in the report a description of the reasons for the change
in the ranking, including an explanation of any change in
the scoring of the project under the Department’s scoring
system 
for 
proposed 
major 
medical 
construction
projects.’’.
SEC. 202. REVISION TO PROSPECTUS REQUIREMENTS.
(a) ADDITIONAL INFORMATION.—Section 8104(b) of
title 38, United States Code, is amended—
(1) by striking out ‘‘shall include—’’ and insert-
ing in lieu thereof ‘‘shall include the following:’’;
(2) in paragraph (1)—
(A) by striking out ‘‘a detailed’’ and insert-
ing in lieu thereof ‘‘A detailed’’; and
(B) by striking out the semicolon at the
end and inserting in lieu thereof a period;
(3) in paragraph (2)—
(A) by striking out ‘‘an estimate’’ and in-
serting in lieu thereof ‘‘An estimate’’; and
(B) by striking out ‘‘; and’’ and inserting
in lieu thereof a period;
(4) in paragraph (3), by striking out ‘‘an esti-
mate’’ and inserting in lieu thereof ‘‘An estimate’’;
and
(5) by adding at the end the following new
paragraphs:
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‘‘(4) Demographic data applicable to the
project, including information on projected changes
in the population of veterans to be served by the
project over a five-year period and a ten-year period.
‘‘(5) Current and projected workload and utili-
zation data.
‘‘(6) Current and projected operating costs of
the facility, to include both recurring and non-recur-
ring costs.
‘‘(7) The priority score assigned to the project
under the Department’s prioritization methodology
and, if the project is being proposed for funding
ahead of a project with a higher score, a specific ex-
planation of the factors other than the priority that
were considered and the basis on which the project
is proposed for funding ahead of projects with high-
er priority scores.
‘‘(8) A listing of each alternative to construc-
tion of the facility that has been considered.’’.
(b) APPLICABILITY.—The amendments made by sub-
section (a) shall apply with respect to any prospectus sub-
mitted by the Secretary of Veterans Affairs after the date
of the enactment of this Act.
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SEC. 
203. 
CONSTRUCTION 
AUTHORIZATION 
REQUIRE-
MENTS.
(a) DEFINITION
OF MAJOR MEDICAL FACILITY
PROJECT.—Paragraph (3)(A) of section 8104(a) 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 ambulatory care, such term means a project involving
a total expenditure of more than $5,000,000’’.
(b) APPLICABILITY OF CONSTRUCTION AUTHORIZA-
TION REQUIREMENT.—(1) Subsection (b) of section 301
of the Veterans’ Medical Programs Amendments of 1992
(Public Law 102–405; 106 Stat. 1984) is repealed.
(2) The amendments made by subsection (a) of such
section shall apply with respect to any major medical facil-
ity project or any major medical facility lease of the De-
partment of Veterans Affairs, regardless of when funds
are first appropriated for that project or lease, except that
in the case of a project for which funds were first appro-
priated before October 9, 1992, such amendments shall
not apply with respect to amounts appropriated for that
project for a fiscal year before fiscal year 1997.
(c) LIMITATION
ON OBLIGATIONS
FOR ADVANCE
PLANNING.—Section 8104 of title 38, United States Code,
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is amended by adding at the end the following new sub-
section:
‘‘(f) The Secretary may not obligate funds in an
amount in excess of $500,000 from the Advance Planning
Fund of the Department toward design or development
of a major medical facility project until—
‘‘(1) the Secretary submits to the committees a
report on the proposed obligation; and
‘‘(2) a period of 30 days has passed after the
date on which the report is received by the commit-
tees.’’.
SEC. 204. TERMINOLOGY CHANGES.
(a) 
DEFINITION
OF
‘‘CONSTRUCT’’.—Section
8101(2) of title 38, United States Code, is amended—
(1) by striking out ‘‘working drawings’’ and in-
serting in lieu thereof ‘‘construction documents’’;
and
(2) by striking out ‘‘preliminary plans’’ and in-
serting in lieu thereof ‘‘design development’’.
(b) PARKING FACILITIES.—Section 8109(h)(3)(B) of
such title is amended by striking out ‘‘working drawings’’
and inserting in lieu thereof ‘‘construction documents’’.
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SEC. 205. VETERANS HEALTH ADMINISTRATION HEAD-
QUARTERS.
(a) REPEAL OF STATUTORY SPECIFICATION OF OR-
GANIZATIONAL SERVICES.—The text of section 7305 of
title 38, United States Code, is amended to read as fol-
lows:
‘‘(a) The Veterans Health Administration shall in-
clude the Office of the Under Secretary for Health and
such professional and auxiliary services as the Secretary
may find to be necessary to carry out the functions of the
Administration.
‘‘(b) In organizing, and appointing persons to posi-
tions in, the Office, the Under Secretary shall ensure that
the Office is staffed so as to provide the Under Secretary
with appropriate expertise, including expertise in—
‘‘(1) unique programs operated by the Adminis-
tration to provide for the specialized treatment and
rehabilitation of disabled veterans (including blind
rehabilitation, spinal cord dysfunction, mental ill-
ness, and geriatrics and long-term care); and
‘‘(2) appropriate clinical care disciplines.’’.
(b) OFFICE OF THE UNDER SECRETARY.—Section
7306 of such title is amended—
(1) in subsection (a)—
(A) by striking out ‘‘and who shall be a
qualified doctor of medicine’’ in paragraph (2);
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(B) by striking out paragraphs (5), (6),
and (7); and
(C) by redesignating the succeeding two
paragraphs as paragraphs (5) and (6), respec-
tively; and
(2) in subsection (b)—
(A) by striking out ‘‘subsection (a)(3)’’
and all that follows through ‘‘two may be’’ and
inserting in lieu thereof ‘‘subsection (a)(3), not
more than two may be’’;
(B) by striking out the semicolon after
‘‘dental medicines’’ and inserting in lieu thereof
a period; and
(C) by striking out paragraphs (2) and (3).
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