103 
‘‘(C) The models selected may include those described 
in section 1115A(b)(2)(B) of the Social Security Act (42 
U.S.C. 1315a(b)(2)(B)). 
‘‘(5) In selecting a model for testing, the Secretary 
may consider, in addition to other factors identified in this 
subsection, the following factors: 
‘‘(A) Whether the model includes a regular 
process for monitoring and updating patient care 
plans in a manner that is consistent with the needs 
and preferences of individuals receiving benefits 
under this chapter. 
‘‘(B) Whether the model places the individual 
receiving benefits under this chapter (including fam-
ily members and other caregivers of such individual) 
at the center of the care team of such individual. 
‘‘(C) Whether the model uses technology or new 
systems to coordinate care over time and across set-
tings. 
‘‘(D) Whether the model demonstrates effective 
linkage with other public sector payers, private sec-
tor payers, or statewide payment models. 
‘‘(6)(A) Models tested under this section may not be 
designed in such a way that would allow the United States 
to recover or collect reasonable charges from a Federal 
health care program for care or services furnished by the 
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Secretary to a veteran under pilot programs carried out 
under this section. 
‘‘(B) In this paragraph, the term ‘Federal health care 
program’ means— 
‘‘(i) an insurance program described in section 
1811 of the Social Security Act (42 U.S.C. 1395c) 
or established by section 1831 of such Act (42 
U.S.C. 1395j); 
‘‘(ii) a State plan for medical assistance ap-
proved under title XIX of such Act (42 U.S.C. 1396 
et seq.); or 
‘‘(iii) a TRICARE program operated under sec-
tions 1075, 1075a, 1076, 1076a, 1076c, 1076d, 
1076e, or 1076f of title 10. 
‘‘(b) DURATION.—Each pilot program carried out by 
the Secretary under this section shall terminate no later 
than five years after the date of the commencement of the 
pilot program. 
‘‘(c) LOCATION.—The Secretary shall ensure that 
each pilot program carried out under this section occurs 
in an area or areas appropriate for the intended purposes 
of the pilot program. To the extent practicable, the Sec-
retary shall ensure that the pilot programs are located in 
geographically diverse areas of the United States. 
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‘‘(d) BUDGET.—Funding for each pilot program car-
ried out by the Secretary under this section shall come 
from appropriations— 
‘‘(1) provided in advance in appropriations acts 
for the Veterans Health Administration; and 
‘‘(2) provided for information technology sys-
tems. 
‘‘(e) NOTICE.—The Secretary shall— 
‘‘(1) publish information about each pilot pro-
gram under this section in the Federal Register; and 
‘‘(2) take reasonable actions to provide direct 
notice to veterans eligible to participate in such pilot 
programs. 
‘‘(f) WAIVER OF AUTHORITIES.—(1) Subject to re-
porting under paragraph (2) and approval under para-
graph (3), in implementing a pilot program under this sec-
tion, the Secretary may waive such requirements in sub-
chapters I, II, and III of this chapter as the Secretary 
determines necessary solely for the purposes of carrying 
out this section with respect to testing models described 
in subsection (a). 
‘‘(2) Before waiving any authority under paragraph 
(1), the Secretary shall submit to the Speaker of the 
House of Representatives, the minority leader of the 
House of Representatives, the majority leader of the Sen-
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ate, the minority leader of the Senate, and each standing 
committee with jurisdiction under the rules of the Senate 
and of the House of Representatives to report a bill to 
amend the provision or provisions of law that would be 
waived by the Department, a report describing in detail 
the following: 
‘‘(A) The specific authorities to be waived 
under the pilot program. 
‘‘(B) The standard or standards to be used in 
the pilot program in lieu of the waived authorities. 
‘‘(C) The reasons for such waiver or waivers. 
‘‘(D) A description of the metric or metrics the 
Secretary will use to determine the effect of the 
waiver or waivers upon the access to and quality, 
timeliness, or patient satisfaction of care and serv-
ices furnished through the pilot program. 
‘‘(E) The anticipated cost savings, if any, of the 
pilot program. 
‘‘(F) The schedule for interim reports on the 
pilot program describing the results of the pilot pro-
gram so far and the feasibility and advisability of 
continuing the pilot program. 
‘‘(G) The schedule for the termination of the 
pilot program and the submission of a final report 
on the pilot program describing the result of the 
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107 
pilot program and the feasibility and advisability of 
making the pilot program permanent. 
‘‘(H) The estimated budget of the pilot pro-
gram. 
‘‘(3)(A) Upon receipt of a report submitted under 
paragraph (2), each House of Congress shall provide cop-
ies of the report to the chairman and ranking member of 
each standing committee with jurisdiction under the rules 
of the House of Representatives or the Senate to report 
a bill to amend the provision or provisions of law that 
would be waived by the Department under this subsection. 
‘‘(B)(i) The waiver requested by the Secretary under 
paragraph (2) shall be considered approved under this 
paragraph if there is enacted into law a bill or joint resolu-
tion approving such request in its entirety. Such bill or 
joint resolution shall be passed by recorded vote to reflect 
the vote of each member of Congress thereon. 
‘‘(ii) The provisions of this paragraph are enacted by 
Congress— 
‘‘(I) as an exercise of the rulemaking power of 
the Senate and the House of Representatives and as 
such shall be considered as part of the rules of each 
House of Congress, and shall supersede other rules 
only to the extent that they are inconsistent there-
with; and 
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‘‘(II) with full recognition of the constitutional 
right of either House of Congress to change the 
rules (so far as they relate to the procedures of that 
House) at any time, in the same manner, and to the 
same extent as in the case of any other rule of that 
House. 
‘‘(C) During the 60-calendar-day period beginning on 
the date on which the Secretary submits the report de-
scribed in paragraph (2) to Congress, it shall be in order 
as a matter of highest privilege in each House of Congress 
to consider a bill or joint resolution, if offered by the ma-
jority leader of such House (or a designee), approving 
such request in its entirety. 
‘‘(g) LIMITATIONS.—(1) The Secretary may not carry 
out more than 10 pilot programs concurrently. 
‘‘(2)(A) Subject to subparagraph (B), the Secretary 
may not expend more than $50,000,000 in any fiscal year 
from amounts under subsection (d). 
‘‘(B) The Secretary may expend more than the 
amount in subparagraph (A) if— 
‘‘(i) the Secretary determines that the addi-
tional expenditure is necessary to carry out pilot 
programs under this section; 
‘‘(ii) the Secretary submits to the Committees 
on Veterans’ Affairs of the Senate and the House of 
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109 
Representatives a report setting forth the amount of 
the additional expenditure and a justification for the 
additional expenditure; and 
‘‘(iii) the Chairmen of the Committees on Vet-
erans’ Affairs of the Senate and the House of Rep-
resentatives transmit to the Secretary a letter ap-
proving of the additional expenditure. 
‘‘(3) The waiver provisions in subsection (f) shall not 
apply unless the Secretary, in accordance with the require-
ments in subsection (f), submits the first proposal for a 
pilot program not later than 18 months after the date of 
the enactment of the Caring for Our Veterans Act of 
2018. 
‘‘(4) Notwithstanding section 502 of this title, deci-
sions by the Secretary under this section shall, consistent 
with section 511 of this title, be final and conclusive and 
may not be reviewed by any other official or by any court, 
whether by an action in the nature of mandamus or other-
wise. 
‘‘(5)(A) If the Secretary determines that a pilot pro-
gram is not improving the quality of care or producing 
cost savings, the Secretary shall— 
‘‘(i) propose a modification to the pilot program 
in the interim report that shall also be considered a 
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110 
report under subsection (f)(2) and shall be subject 
to the terms and conditions of subsection (f)(2); or 
‘‘(ii) terminate such pilot program not later 
than 30 days after submitting the interim report to 
Congress. 
‘‘(B) If the Secretary terminates a pilot program 
under subparagraph (A)(ii), for purposes of subpara-
graphs (F) and (G) of subsection (f)(2), such interim re-
port will also serve as the final report for that pilot pro-
gram. 
‘‘(h) EVALUATION
AND
REPORTING
REQUIRE-
MENTS.—(1) The Secretary shall conduct an evaluation 
of each model tested, which shall include, at a minimum, 
an analysis of— 
‘‘(A) the quality of care furnished under the 
model, including the measurement of patient-level 
outcomes and patient-centeredness criteria deter-
mined appropriate by the Secretary; and 
‘‘(B) the changes in spending by reason of that 
model. 
‘‘(2) The Secretary shall make the results of each 
evaluation under this subsection available to the public in 
a timely fashion and may establish requirements for other 
entities participating in the testing of models under this 
section to collect and report information that the Sec-
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111 
retary determines is necessary to monitor and evaluate 
such models. 
‘‘(i) COORDINATION
AND ADVICE.—(1) The Sec-
retary shall obtain advice from the Under Secretary for 
Health and the Special Medical Advisory Group estab-
lished pursuant to section 7312 of this title in the develop-
ment and implementation of any pilot program operated 
under this section. 
‘‘(2) In carrying out the duties under this section, 
the Secretary shall consult representatives of relevant 
Federal agencies, and clinical and analytical experts with 
expertise in medicine and health care management. The 
Secretary shall use appropriate mechanisms to seek input 
from interested parties. 
‘‘(j) EXPANSION
OF
SUCCESSFUL
PILOT
PRO-
GRAMS.—Taking into account the evaluation under sub-
section (f), the Secretary may, through rulemaking, ex-
pand (including implementation on a nationwide basis) the 
duration and the scope of a model that is being tested 
under subsection (a) to the extent determined appropriate 
by the Secretary, if— 
‘‘(1) the Secretary determines that such expan-
sion is expected to— 
‘‘(A) reduce spending without reducing the 
quality of care; or 
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112 
‘‘(B) improve the quality of patient care 
without increasing spending; and 
‘‘(2) the Secretary determines that such expan-
sion would not deny or limit the coverage or provi-
sion of benefits for individuals receiving benefits 
under this chapter.’’. 
(b) CONFORMING AMENDMENT.—The table of sec-
tions at the beginning of such chapter, as amended by this 
title, is further amended by inserting after the item relat-
ing to section 1703D the following new item: 
‘‘1703E. Center for Innovation for Care and Payment.’’. 
SEC. 153. AUTHORIZATION TO PROVIDE FOR OPERATIONS 
ON LIVE DONORS FOR PURPOSES OF CON-
DUCTING TRANSPLANT PROCEDURES FOR 
VETERANS. 
(a) IN GENERAL.—Subchapter VIII of chapter 17 is 
amended by adding at the end the following new section: 
‘‘§ 1788. Transplant procedures with live donors and 
related services 
‘‘(a) IN GENERAL.—Subject to subsections (b) and 
(c), in a case in which a veteran is eligible for a transplant 
procedure from the Department, the Secretary may pro-
vide for an operation on a live donor to carry out such 
procedure for such veteran, notwithstanding that the live 
donor may not be eligible for health care from the Depart-
ment. 
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‘‘(b) OTHER SERVICES.—Subject to the availability 
of appropriations for such purpose, the Secretary shall 
furnish to a live donor any care or services before and 
after conducting the transplant procedure under sub-
section (a) that may be required in connection with such 
procedure. 
‘‘(c) USE
OF NON-DEPARTMENT FACILITIES.—In 
carrying out this section, the Secretary may provide for 
the operation described in subsection (a) on a live donor 
and furnish to the live donor the care and services de-
scribed in subsection (b) at a non-Department facility pur-
suant to an agreement entered into by the Secretary under 
this chapter. The live donor shall be deemed to be an indi-
vidual eligible for hospital care and medical services at a 
non-Department facility pursuant to such an agreement 
solely for the purposes of receiving such operation, care, 
and services at the non-Department facility.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 is amended by inserting 
after the item relating to section 1787 the following new 
item: 
‘‘1788. Transplant procedures with live donors and related services.’’. 
Subtitle C—Family Caregivers 
SEC. 161. EXPANSION OF FAMILY CAREGIVER PROGRAM OF 
DEPARTMENT OF VETERANS AFFAIRS. 
(a) FAMILY CAREGIVER PROGRAM.— 
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(1) EXPANSION OF ELIGIBILITY.— 
(A) IN GENERAL.—Subparagraph (B) of 
subsection (a)(2) of section 1720G is amended 
to read as follows: 
‘‘(B) for assistance provided under this sub-
section— 
‘‘(i) before the date on which the Secretary 
submits to Congress a certification that the De-
partment has fully implemented the information 
technology system required by section 162(a) of 
the Caring for Our Veterans Act of 2018, has 
a serious injury (including traumatic brain in-
jury, psychological trauma, or other mental dis-
order) incurred or aggravated in the line of 
duty in the active military, naval, or air service 
on or after September 11, 2001; 
‘‘(ii) during the two-year period beginning 
on the date on which the Secretary submitted 
to Congress the certification described in clause 
(i), has a serious injury (including traumatic 
brain injury, psychological trauma, or other 
mental disorder) incurred or aggravated in the 
line of duty in the active military, naval, or air 
service— 
‘‘(I) on or before May 7, 1975; or 
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115 
‘‘(II) on or after September 11, 2001; 
or 
‘‘(iii) after the date that is two years after 
the date on which the Secretary submits to 
Congress the certification described in clause 
(i), has a serious injury (including traumatic 
brain injury, psychological trauma, or other 
mental disorder) incurred or aggravated in the 
line of duty in the active military, naval, or air 
service; and’’. 
(B) PUBLICATION
IN
FEDERAL
REG-
ISTER.—Not later than 30 days after the date 
on which the Secretary of Veterans Affairs sub-
mits to Congress the certification described in 
subsection (a)(2)(B)(i) of section 1720G of 
such title, as amended by subparagraph (A) of 
this paragraph, the Secretary shall publish the 
date specified in such subsection in the Federal 
Register. 
(2) EXPANSION OF NEEDED SERVICES IN ELI-
GIBILITY CRITERIA.—Subsection (a)(2)(C) of such 
section is amended— 
(A) in clause (ii), by striking ‘‘; or’’ and in-
serting a semicolon; 
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(B) by redesignating clause (iii) as clause 
(iv); and 
(C) by inserting after clause (ii) the fol-
lowing new clause (iii): 
‘‘(iii) a need for regular or extensive in-
struction or supervision without which the abil-
ity of the veteran to function in daily life would 
be seriously impaired; or’’. 
(3) EXPANSION OF SERVICES PROVIDED.—Sub-
section (a)(3)(A)(ii) of such section is amended— 
(A) in subclause (IV), by striking ‘‘; and’’ 
and inserting a semicolon; 
(B) in subclause (V), by striking the period 
at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subclause: 
‘‘(VI) through the use of contracts with, or 
the provision of grants to, public or private en-
tities— 
‘‘(aa) financial planning services relat-
ing to the needs of injured veterans and 
their caregivers; and 
‘‘(bb) legal services, including legal 
advice and consultation, relating to the 
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117 
needs of injured veterans and their care-
givers.’’. 
(4) MODIFICATION
OF
STIPEND
CALCULA-
TION.—Subsection (a)(3)(C) of such section is 
amended— 
(A) by redesignating clause (iii) as clause 
(iv); and 
(B) by inserting after clause (ii) the fol-
lowing new clause (iii): 
‘‘(iii) In determining the amount and degree of per-
sonal care services provided under clause (i) with respect 
to an eligible veteran whose need for personal care services 
is based in whole or in part on a need for supervision or 
protection under paragraph (2)(C)(ii) or regular instruc-
tion or supervision under paragraph (2)(C)(iii), the Sec-
retary shall take into account the following: 
‘‘(I) The assessment by the family caregiver of 
the needs and limitations of the veteran. 
‘‘(II) The extent to which the veteran can func-
tion safely and independently in the absence of such 
supervision, protection, or instruction. 
‘‘(III) The amount of time required for the 
family caregiver to provide such supervision, protec-
tion, or instruction to the veteran.’’. 
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118 
(5) PERIODIC EVALUATION OF NEED FOR CER-
TAIN SERVICES.—Subsection (a)(3) of such section 
is amended by adding at the end the following new 
subparagraph: 
‘‘(D) In providing instruction, preparation, and train-
ing under subparagraph (A)(i)(I) and technical support 
under subparagraph (A)(i)(II) to each family caregiver 
who is approved as a provider of personal care services 
for an eligible veteran under paragraph (6), the Secretary 
shall periodically evaluate the needs of the eligible veteran 
and the skills of the family caregiver of such veteran to 
determine if additional instruction, preparation, training, 
or technical support under those subparagraphs is nec-
essary.’’. 
(6) USE OF PRIMARY CARE TEAMS.—Subsection 
(a)(5) of such section is amended, in the matter pre-
ceding subparagraph (A), by inserting ‘‘(in collabo-
ration with the primary care team for the eligible 
veteran to the maximum extent practicable)’’ after 
‘‘evaluate’’. 
(7) ASSISTANCE
FOR
FAMILY
CAREGIVERS.— 
Subsection (a) of such section is amended by adding 
at the end the following new paragraph: 
‘‘(11)(A) In providing assistance under this sub-
section to family caregivers of eligible veterans, the Sec-
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119 
retary may enter into contracts, provider agreements, and 
memoranda of understanding with Federal agencies, 
States, and private, nonprofit, and other entities to pro-
vide such assistance to such family caregivers. 
‘‘(B) The Secretary may provide assistance under 
this paragraph only if such assistance is reasonably acces-
sible to the family caregiver and is substantially equivalent 
or better in quality to similar services provided by the De-
partment. 
‘‘(C) The Secretary may provide fair compensation 
to Federal agencies, States, and other entities that provide 
assistance under this paragraph.’’. 
(b) MODIFICATION OF DEFINITION OF PERSONAL 
CARE SERVICES.—Subsection (d)(4) of such section is 
amended— 
(1) in subparagraph (A), by striking ‘‘inde-
pendent’’; 
(2) by redesignating subparagraph (B) as sub-
paragraph (D); and 
(3) by inserting after subparagraph (A) the fol-
lowing new subparagraphs: 
‘‘(B) Supervision or protection based on 
symptoms or residuals of neurological or other 
impairment or injury. 
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‘‘(C) Regular or extensive instruction or 
supervision without which the ability of the vet-
eran to function in daily life would be seriously 
impaired.’’. 
SEC. 162. IMPLEMENTATION OF INFORMATION TECH-
NOLOGY SYSTEM OF DEPARTMENT OF VET-
ERANS AFFAIRS TO ASSESS AND IMPROVE 
THE FAMILY CAREGIVER PROGRAM. 
(a) IMPLEMENTATION OF NEW SYSTEM.— 
(1) IN GENERAL.—Not later than October 1, 
2018, the Secretary of Veterans Affairs shall imple-
ment an information technology system that fully 
supports the Program and allows for data assess-
ment and comprehensive monitoring of the Program. 
(2) ELEMENTS OF SYSTEM.—The information 
technology system required to be implemented under 
paragraph (1) shall include the following: 
(A) The ability to easily retrieve data that 
will allow all aspects of the Program (at the 
medical center and aggregate levels) and the 
workload trends for the Program to be assessed 
and comprehensively monitored. 
(B) The ability to manage data with re-
spect to a number of caregivers that is more 
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121 
than the number of caregivers that the Sec-
retary expects to apply for the Program. 
(C) The ability to integrate the system 
with other relevant information technology sys-
tems of the Veterans Health Administration. 
(b) ASSESSMENT OF PROGRAM.—Not later than 180 
days after implementing the system described in sub-
section (a), the Secretary shall, through the Under Sec-
retary for Health, use data from the system and other rel-
evant data to conduct an assessment of how key aspects 
of the Program are structured and carried out. 
(c) ONGOING MONITORING OF AND MODIFICATIONS 
TO PROGRAM.— 
(1) MONITORING.—The Secretary shall use the 
system implemented under subsection (a) to monitor 
and assess the workload of the Program, including 
monitoring and assessment of data on— 
(A) the status of applications, appeals, and 
home visits in connection with the Program; 
and 
(B) the use by caregivers participating in 
the Program of other support services under 
the Program such as respite care. 
(2) MODIFICATIONS.—Based on the monitoring 
and assessment conducted under paragraph (1), the 
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122 
Secretary shall identify and implement such modi-
fications to the Program as the Secretary considers 
necessary to ensure the Program is functioning as 
intended and providing veterans and caregivers par-
ticipating in the Program with services in a timely 
manner. 
(d) REPORTS.— 
(1) INITIAL REPORT.— 
(A) IN GENERAL.—Not later than 90 days 
after the date of the enactment of this Act, the 
Secretary shall submit to the Committee on 
Veterans’ Affairs of the Senate, the Committee 
on Veterans’ Affairs of the House of Represent-
atives, and the Comptroller General of the 
United States a report that includes— 
(i) the status of the planning, develop-
ment, and deployment of the system re-
quired to be implemented under subsection 
(a), including any changes in the timeline 
for the implementation of the system; and 
(ii) an assessment of the needs of 
family caregivers of veterans described in 
subparagraph (B), the resources needed 
for the inclusion of such family caregivers 
in the Program, and such changes to the 
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123 
Program as the Secretary considers nec-
essary to ensure the successful expansion 
of the Program to include such family 
caregivers. 
(B) VETERANS DESCRIBED.—Veterans de-
scribed in this subparagraph are veterans who 
are eligible for the Program under clause (ii) or 
(iii) of section 1720G(a)(2)(B) of title 38, 
United States Code, as amended by section 
161(a)(1) of this title, solely due to a serious 
injury (including traumatic brain injury, psy-
chological trauma, or other mental disorder) in-
curred or aggravated in the line of duty in the 
active military, naval, or air service before Sep-
tember 11, 2001. 
(2) NOTIFICATION
BY
COMPTROLLER
GEN-
ERAL.—The Comptroller General shall review the re-
port submitted under paragraph (1) and notify the 
Committee on Veterans’ Affairs of the Senate and 
the Committee on Veterans’ Affairs of the House of 
Representatives with respect to the progress of the 
Secretary in— 
(A) fully implementing the system required 
under subsection (a); and 
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(B) implementing a process for using such 
system to monitor and assess the Program 
under subsection (c)(1) and modify the Pro-
gram as considered necessary under subsection 
(c)(2). 
(3) FINAL REPORT.— 
(A) IN GENERAL.—Not later than October 
1, 2019, the Secretary shall submit to the Com-
mittee on Veterans’ Affairs of the Senate, the 
Committee on Veterans’ Affairs of the House of 
Representatives, and the Comptroller General a 
report on the implementation of subsections (a) 
through (c). 
(B) ELEMENTS.—The report required by 
subparagraph (A) shall include the following: 
(i) A certification by the Secretary 
that the information technology system de-
scribed in subsection (a) has been imple-
mented. 
(ii) A description of how the Secretary 
has implemented such system. 
(iii) A description of the modifications 
to the Program, if any, that were identified 
and implemented under subsection (c)(2). 
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125 
(iv) A description of how the Sec-
retary is using such system to monitor the 
workload of the Program. 
(e) DEFINITIONS.—In this section: 
(1) ACTIVE MILITARY, NAVAL, OR AIR SERV-
ICE.—The term ‘‘active military, naval, or air serv-
ice’’ has the meaning given that term in section 101 
of title 38, United States Code. 
(2) PROGRAM.—The term ‘‘Program’’ means 
the program of comprehensive assistance for family 
caregivers under section 1720G(a) of title 38, 
United States Code, as amended by section 161 of 
this title. 
SEC. 163. MODIFICATIONS TO ANNUAL EVALUATION RE-
PORT ON CAREGIVER PROGRAM OF DEPART-
MENT OF VETERANS AFFAIRS. 
(a) BARRIERS TO CARE AND SERVICES.—Subpara-
graph (A)(iv) of section 101(c)(2) of the Caregivers and 
Veterans Omnibus Health Services Act of 2010 (Public 
Law 111–163; 38 U.S.C. 1720G note) is amended by in-
serting ‘‘, including a description of any barriers to access-
ing and receiving care and services under such programs’’ 
before the semicolon. 
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(b) SUFFICIENCY OF TRAINING FOR FAMILY CARE-
GIVER PROGRAM.—Subparagraph (B) of such section is 
amended— 
(1) in clause (i), by striking ‘‘; and’’ and insert-
ing a semicolon; 
(2) in clause (ii), by striking the period at the 
end and inserting ‘‘; and’’; and 
(3) by adding at the end the following new 
clause: 
‘‘(iii) an evaluation of the sufficiency 
and consistency of the training provided to 
family caregivers under such program in 
preparing family caregivers to provide care 
to veterans under such program.’’. 
TITLE II—VA ASSET AND 
INFRASTRUCTURE REVIEW 
Subtitle A—Asset and 
Infrastructure Review 
SEC. 201. SHORT TITLE. 
This subtitle may be cited as the ‘‘VA Asset and In-
frastructure Review Act of 2018’’. 
SEC. 202. THE COMMISSION. 
(a) ESTABLISHMENT.—There is established an inde-
pendent commission to be known as the ‘‘Asset and Infra-
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structure Review Commission’’ (in this subtitle referred 
to as the ‘‘Commission’’). 
(b) DUTIES.—The Commission shall carry out the 
duties specified for it in this subtitle. 
(c) APPOINTMENT.— 
(1) IN GENERAL.— 
(A) 
APPOINTMENT.—The 
Commission 
shall be composed of 9 members appointed by 
the President, by and with the advice and con-
sent of the Senate. 
(B) TRANSMISSION
OF
NOMINATIONS.— 
The President shall transmit to the Senate the 
nominations for appointment to the Commission 
not later than May 31, 2021. 
(2) CONSULTATION IN SELECTION PROCESS.— 
In selecting individuals for nominations for appoint-
ments to the Commission, the President shall con-
sult with— 
(A) the Speaker of the House of Rep-
resentatives; 
(B) the majority leader of the Senate; 
(C) the minority leader of the House of 
Representatives; 
(D) the minority leader of the Senate; and 
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(E) congressionally chartered, membership 
based veterans service organizations concerning 
the appointment of three members. 
(3) DESIGNATION OF CHAIR.—At the time the 
President nominates individuals for appointment to 
the Commission under paragraph (1)(B), the Presi-
dent shall designate one such individual who shall 
serve as Chair of the Commission and one such indi-
vidual who shall serve as Vice Chair of the Commis-
sion. 
(4) MEMBER
REPRESENTATION.—In nomi-
nating individuals under this subsection, the Presi-
dent shall ensure that— 
(A) veterans, reflecting current demo-
graphics of veterans enrolled in the system of 
annual patient enrollment under section 1705 
of title 38, United States Code, are adequately 
represented in the membership of the Commis-
sion; 
(B) at least one member of the Commis-
sion has experience working for a private inte-
grated health care system that has annual gross 
revenues of more than $50,000,000; 
(C) at least one member has experience as 
a senior manager for an entity specified in 
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129 
clause (ii), (iii), or (iv) of section 101(a)(1)(B) 
of the Veterans Access, Choice, and Account-
ability Act of 2014 (Public Law 113–146; 38 
U.S.C. 1701 note); 
(D) at least one member— 
(i) has experience with capital asset 
management for the Federal Government; 
and 
(ii) is familiar with trades related to 
building and real property, including con-
struction, engineering, architecture, leas-
ing, and strategic partnerships; and 
(E) at least three members represent con-
gressionally chartered, membership-based, vet-
erans service organizations. 
(d) MEETINGS.— 
(1) IN GENERAL.—The Commission shall meet 
only during calendar years 2022 and 2023. 
(2) PUBLIC NATURE OF MEETINGS AND PRO-
CEEDINGS.— 
(A) PUBLIC MEETINGS.—Each meeting of 
the Commission shall be open to the public. 
(B) OPEN
PARTICIPATION.—All the pro-
ceedings, information, and deliberations of the 
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130 
Commission shall be available for review by the 
public. 
(e) VACANCIES.—A vacancy in the Commission shall 
be filled in the same manner as the original appointment, 
but the individual appointed to fill the vacancy shall serve 
only for the unexpired portion of the term for which the 
individual’s predecessor was appointed. 
(f) PAY.— 
(1) IN GENERAL.—Members of the Commission 
shall serve without pay. 
(2) OFFICERS OR EMPLOYEES OF THE UNITED 
STATES.—Each member of the Commission who is 
an officer or employee of the United States shall 
serve without compensation in addition to that re-
ceived for service as an officer or employee of the 
United States. 
(3) TRAVEL EXPENSES.—Members shall receive 
travel expenses, including per diem in lieu of subsist-
ence, in accordance with sections 5702 and 5703 of 
title 5, United States Code. 
(g) DIRECTOR OF STAFF.— 
(1) APPOINTMENT.—The Commission shall ap-
point a Director who— 
(A) has not served as an employee of the 
Department of Veterans Affairs during the one- 
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131 
year period preceding the date of such appoint-
ment; and 
(B) is not otherwise barred or prohibited 
from serving as Director under Federal ethics 
laws and regulations, by reason of post-employ-
ment conflict of interest. 
(2) RATE OF PAY.—The Director shall be paid 
at the rate of basic pay payable for level IV of the 
Executive Schedule under section 5315 of title 5, 
United States Code. 
(h) STAFF.— 
(1) PAY
OF
PERSONNEL.—Subject to para-
graphs (2) and (3), the Director, with the approval 
of the Commission, may appoint and fix the pay of 
additional personnel. 
(2) EXEMPTION
FROM
CERTAIN
REQUIRE-
MENTS.—The Director may make such appoint-
ments without regard to the provisions of title 5, 
United States Code, governing appointments in the 
competitive service, and any personnel so appointed 
may be paid without regard to the provisions of 
chapter 51 and subchapter III of chapter 53 of that 
title relating to classification and General Schedule 
pay rates, except that an individual so appointed 
may not receive pay in excess of the annual rate of 
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132 
basic pay payable for GS–15 of the General Sched-
ule. 
(3) DETAILEES.— 
(A) LIMITATION ON NUMBER.—Not more 
than two-thirds of the personnel employed by or 
detailed to the Commission may be on detail 
from the Department of Veterans Affairs. 
(B) PROFESSIONAL ANALYSTS.—Not more 
than half of the professional analysts of the 
Commission staff may be persons detailed from 
the Department of Veterans Affairs to the 
Commission. 
(C) PROHIBITION ON DETAIL OF CERTAIN 
PERSONNEL.—A person may not be detailed 
from the Department of Veterans Affairs to the 
Commission if, within 6 months before the de-
tail is to begin, that person participated person-
ally and substantially in any matter within the 
Department of Veterans Affairs concerning the 
preparation of recommendations regarding fa-
cilities of the Veterans Health Administration. 
(4) AUTHORITY TO REQUEST DETAILED PER-
SONNEL.—Subject to paragraph (3), the head of any 
Federal department or agency, upon the request of 
the Director, may detail any of the personnel of that 
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133 
department or agency to the Commission to assist 
the Commission in carrying out its duties under this 
subtitle. 
(5) INFORMATION FROM FEDERAL AGENCIES.— 
The Commission may secure directly from any Fed-
eral agency such information the Commission con-
siders necessary to carry out this subtitle. Upon re-
quest of the Chair, the head of such agency shall 
furnish such information to the Commission. 
(i) OTHER AUTHORITY.— 
(1) TEMPORARY
AND
INTERMITTENT
SERV-
ICES.—The Commission may procure by contract, to 
the extent funds are available, the temporary or 
intermittent services of experts or consultants pursu-
ant to section 3109 of title 5, United States Code. 
(2) LEASING
AND
ACQUISITION
OF
PROP-
ERTY.—To the extent funds are available, the Com-
mission may lease real property and acquire personal 
property either of its own accord or in consultation 
with the General Services Administration. 
(j) TERMINATION.—The Commission shall terminate 
on December 31, 2023. 
(k) PROHIBITION AGAINST RESTRICTING COMMU-
NICATIONS.— 
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134 
(1) IN GENERAL.—Except as provided in para-
graph (2), no person may restrict an employee of the 
Department of Veterans Affairs in communicating 
with the Commission. 
(2) UNLAWFUL COMMUNICATIONS.—Paragraph 
(1) does not apply to a communication that is un-
lawful. 
SEC. 203. PROCEDURE FOR MAKING RECOMMENDATIONS. 
(a) SELECTION CRITERIA.— 
(1) PUBLICATION.—The Secretary shall, not 
later than February 1, 2021, and after consulting 
with veterans service organizations, publish in the 
Federal Register and transmit to the Committees on 
Veterans’ Affairs of the Senate and the House of 
Representatives the criteria proposed to be used by 
the Department of Veterans Affairs in assessing and 
making recommendations regarding the moderniza-
tion or realignment of facilities of the Veterans 
Health Administration under this subtitle. Such cri-
teria shall include the preferences of veterans re-
garding health care furnished by the Department. 
(2) PUBLIC
COMMENT.—The Secretary shall 
provide an opportunity for public comment on the 
proposed criteria under paragraph (1) for a period 
of at least 90 days and shall include notice of that 
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135 
opportunity in the publication required under such 
paragraph. 
(3) PUBLICATION
OF
FINAL
CRITERIA.—The 
Secretary shall, not later than May 31, 2021, pub-
lish in the Federal Register and transmit to the 
Committees on Veterans’ Affairs of the Senate and 
the House of Representatives the final criteria to be 
used in making recommendations regarding the clo-
sure, modernization, or realignment of facilities of 
the Veterans Health Administration under this sub-
title. 
(b) RECOMMENDATIONS OF THE SECRETARY.— 
(1) PUBLICATION IN FEDERAL REGISTER.—The 
Secretary shall, not later than January 31, 2022, 
and after consulting with veterans service organiza-
tions, publish in the Federal Register and transmit 
to the Committees on Veterans’ Affairs of the Sen-
ate and the House of Representatives and to the 
Commission a report detailing the recommendations 
regarding the modernization or realignment of facili-
ties of the Veterans Health Administration on the 
basis of the final criteria referred to in subsection 
(a)(2) that are applicable. 
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136 
(2) FACTORS FOR CONSIDERATION.—In making 
recommendations under this subsection, the Sec-
retary shall consider each of the following factors: 
(A) The degree to which any health care 
delivery or other site for providing services to 
veterans reflect the metrics of the Department 
of Veterans Affairs regarding market area 
health system planning. 
(B) The provision of effective and efficient 
access to high-quality health care and services 
for veterans. 
(C) The extent to which the real property 
that no longer meets the needs of the Federal 
Government could be reconfigured, repurposed, 
consolidated, realigned, exchanged, outleased, 
replaced, sold, or disposed. 
(D) The need of the Veterans Health Ad-
ministration to acquire infrastructure or facili-
ties that will be used for the provision of health 
care and services to veterans. 
(E) The extent to which the operating and 
maintenance costs are reduced through consoli-
dating, colocating, and reconfiguring space, and 
through realizing other operational efficiencies. 
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137 
(F) The extent and timing of potential 
costs and savings, including the number of 
years such costs or savings will be incurred, be-
ginning with the date of completion of the pro-
posed recommendation. 
(G) The extent to which the real property 
aligns with the mission of the Department of 
Veterans Affairs. 
(H) The extent to which any action would 
impact other missions of the Department (in-
cluding education, research, or emergency pre-
paredness). 
(I) Local stakeholder inputs and any fac-
tors identified through public field hearings. 
(J) The assessments under paragraph (3). 
(K) The extent to which the Veterans 
Health Administration has appropriately staffed 
the medical facility, including determinations 
whether there has been insufficient resource al-
location or deliberate understaffing. 
(L) Any other such factors the Secretary 
determines appropriate. 
(3) CAPACITY AND COMMERCIAL MARKET AS-
SESSMENTS.— 
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138 
(A) ASSESSMENTS.—The Secretary shall 
assess the capacity of each Veterans Integrated 
Service Network and medical facility of the De-
partment to furnish hospital care or medical 
services to veterans under chapter 17 of title 
38, United States Code. Each such assessment 
shall— 
(i) identify gaps in furnishing such 
care or services at such Veterans Inte-
grated Service Network or medical facility; 
(ii) identify how such gaps can be 
filled by— 
(I) entering into contracts or 
agreements with network providers 
under this section or with entities 
under other provisions of law; 
(II) making changes in the way 
such care and services are furnished 
at such Veterans Integrated Service 
Network or medical facility, includ-
ing— 
(aa) extending hours of op-
eration; 
(bb) adding personnel; or 
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139 
(cc) 
expanding 
space 
through the construction, leasing, 
or sharing of health care facili-
ties; and 
(III) the building or realignment 
of Department resources or personnel; 
(iii) forecast, based on future projec-
tions and historical trends, both the short- 
and long-term demand in furnishing care 
or services at such Veterans Integrated 
Service Network or medical facility and as-
sess how such demand affects the needs to 
use such network providers; 
(iv) include a commercial health care 
market 
assessment 
of 
designated 
catchment areas in the United States con-
ducted by a non-governmental entity; and 
(v) consider the unique ability of the 
Federal Government to retain a presence 
in an area otherwise devoid of commercial 
health care providers or from which such 
providers are at risk of leaving. 
(B) CONSULTATION.—In carrying out the 
assessments under subparagraph (A), the Sec-
retary shall consult with veterans service orga-
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140 
nizations and veterans served by each such Vet-
erans Integrated Service Network and medical 
facility. 
(C) SUBMITTAL.—The Secretary shall sub-
mit such assessments to the Committees on 
Veterans’ Affairs of the House of Representa-
tives and the Senate with the recommendations 
of the Secretary under this subsection and 
make the assessments publicly available. 
(4) SUMMARY
OF
SELECTION
PROCESS.—The 
Secretary shall include, with the list of recommenda-
tions published and transmitted pursuant to para-
graph (1), a summary of the selection process that 
resulted in the recommendation for each facility of 
the Veterans Health Administration, including a jus-
tification for each recommendation. The Secretary 
shall transmit the matters referred to in the pre-
ceding sentence not later than 7 days after the date 
of the transmittal to the Committees on Veterans’ 
Affairs of the Senate and the House of Representa-
tives and the Commission of the report referred to 
in paragraph (1). 
(5) TREATMENT OF FACILITIES.—In assessing 
facilities of the Veterans Health Administration, the 
Secretary shall consider all such facilities equally 
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141 
without regard to whether the facility has been pre-
viously considered or proposed for reuse, closure, 
modernization, or realignment by the Department of 
Veterans Affairs. 
(6) AVAILABILITY OF INFORMATION TO CON-
GRESS.—In addition to making all information used 
by the Secretary to prepare the recommendations 
under this subsection available to Congress (includ-
ing any committee or Member of Congress), the Sec-
retary shall also make such information available to 
the Commission and the Comptroller General of the 
United States. 
(7) CERTIFICATION OF ACCURACY.— 
(A) IN GENERAL.—Each person referred to 
in subparagraph (B), when submitting informa-
tion to the Secretary or the Commission con-
cerning the modernization or realignment of a 
facility of the Veterans Health Administration, 
shall certify that such information is accurate 
and complete to the best of that person’s knowl-
edge and belief. 
(B) COVERED
PERSONS.—Subparagraph 
(A) applies to the following persons: 
(i) Each Under Secretary of the De-
partment of Veterans Affairs. 
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(ii) Each director of a Veterans Inte-
grated Service Network. 
(iii) Each director of a medical center 
of the Department of Veterans Affairs. 
(iv) Each director of a program office 
of the Department of Veterans Affairs. 
(v) Each person who is in a position 
the duties of which include personal and 
substantial involvement in the preparation 
and submission of information and rec-
ommendations concerning the moderniza-
tion or realignment of facilities of the Vet-
erans Health Administration. 
(c) REVIEW AND RECOMMENDATIONS BY THE COM-
MISSION.— 
(1) PUBLIC HEARINGS.— 
(A) IN GENERAL.—After receiving the rec-
ommendations from the Secretary pursuant to 
subsection (b), the Commission shall conduct 
public hearings on the recommendations. 
(B) LOCATIONS.—The Commission shall 
conduct public hearings in regions affected by a 
recommendation of the Secretary to close a fa-
cility of the Veterans Health Administration. 
To the greatest extent practicable, the Commis-
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143 
sion shall conduct public hearings in regions af-
fected by a recommendation of the Secretary to 
modernize or realign such a facility. 
(C) REQUIRED WITNESSES.—Witnesses at 
each public hearing shall include at a min-
imum— 
(i) a veteran— 
(I) enrolled under section 1705 
of title 38, United States Code; and 
(II) identified by a local veterans 
service organization; and 
(ii) a local elected official. 
(2) TRANSMITTAL TO PRESIDENT.— 
(A) IN GENERAL.—The Commission shall, 
not later than January 31, 2023, transmit to 
the President a report containing the Commis-
sion’s findings and conclusions based on a re-
view and analysis of the recommendations made 
by the Secretary, together with the Commis-
sion’s recommendations, for modernizations and 
realignments of facilities of the Veterans Health 
Administration. 
(B) AUTHORITY
TO
MAKE
CHANGES
TO 
RECOMMENDATIONS.—Subject to subparagraph 
(C), in making its recommendations, the Com-
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144 
mission may change any recommendation made 
by the Secretary if the Commission— 
(i) determines that the Secretary devi-
ated substantially from the final criteria 
referred to in subsection (a)(2) in making 
such recommendation; 
(ii) determines that the change is con-
sistent with the final criteria referred to in 
subsection (a)(2); 
(iii) publishes a notice of the proposed 
change in the Federal Register not less 
than 45 days before transmitting its rec-
ommendations to the President pursuant 
to subparagraph (A); and 
(iv) conducts public hearings on the 
proposed change. 
(3) JUSTIFICATION FOR CHANGES.—The Com-
mission shall explain and justify in its report sub-
mitted to the President pursuant to paragraph (2) 
any recommendation made by the Commission that 
is different from the recommendations made by the 
Secretary pursuant to subsection (b). The Commis-
sion shall transmit a copy of such report to the 
Committees on Veterans’ Affairs of the Senate and 
the House of Representatives on the same date on 
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146 
President’s reasons for disapproval, shall then trans-
mit to the President, not later than March 15, 2023, 
a report containing— 
(A) the Commission’s findings and conclu-
sions based on a review and analysis of those 
reasons for disapproval provided by the Presi-
dent; and 
(B) recommendations that the Commission 
determines are appropriate for modernizations 
and realignments of facilities of the Veterans 
Health Administration. 
(4) TRANSMITTAL OF RECOMMENDATIONS TO 
CONGRESS.—If the President approves all rec-
ommendations of the Commission transmitted to the 
President under paragraph (3), the President shall 
transmit a copy of such recommendations to the 
Congress, together with a certification of such ap-
proval. 
(5) FAILURE TO TRANSMIT.—If the President 
does not transmit to the Congress an approval and 
certification described in paragraph (2) or (4) by 
March 30, 2023, the process by which facilities of 
the Veterans Health Administration may be selected 
for modernization or realignment under this subtitle 
shall be terminated. 
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147 
SEC. 204. ACTIONS REGARDING INFRASTRUCTURE AND FA-
CILITIES OF THE VETERANS HEALTH ADMIN-
ISTRATION. 
(a) IN GENERAL.—Subject to subsection (b), the Sec-
retary shall begin to implement the recommended mod-
ernizations and realignments in the report under section 
203(d) not later than three years after the date on which 
the President transmits such report to Congress. In any 
fiscal year, such implementation includes— 
(1) the planning of modernizations and realign-
ments of facilities of the Veterans Health Adminis-
tration as recommended in such report; and 
(2) providing detailed information on the budg-
et for such modernizations or realignments in docu-
ments submitted to Congress by the Secretary in 
support of the President’s budget for that fiscal 
year. 
(b) CONGRESSIONAL DISAPPROVAL.— 
(1) IN GENERAL.—The Secretary may not carry 
out any modernization or realignment recommended 
by the Commission in a report transmitted from the 
President pursuant to section 203(d) if a joint reso-
lution is enacted, in accordance with the provisions 
of section 207, disapproving such recommendations 
of the Commission before the earlier of— 
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148 
(A) the end of the 45-day period beginning 
on the date on which the President transmits 
such report; or 
(B) the adjournment of Congress sine die 
for the session during which such report is 
transmitted. 
(2) COMPUTATION OF PERIOD.—For purposes 
of paragraph (1) and subsections (a) and (c) of sec-
tion 207, the days on which either House of Con-
gress is not in session because of an adjournment of 
more than three days to a day certain shall be ex-
cluded in the computation of a period. 
SEC. 205. IMPLEMENTATION. 
(a) IN GENERAL.— 
(1) MODERNIZING
AND
REALIGNING
FACILI-
TIES.—In modernizing or realigning any facility of 
the Veterans Health Administration under this sub-
title, the Secretary may— 
(A) take such actions as may be necessary 
to modernize or realign any such facility, in-
cluding the alteration of such facilities, the ac-
quisition of such land, the leasing or construc-
tion of such replacement facilities, the disposi-
tion of such land or facilities, the performance 
of such activities, and the conduct of such ad-
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vance planning and design as may be required 
to transfer functions from a facility of the Vet-
erans Health Administration to another such 
facility, and may use for such purpose funds in 
the Account or funds appropriated to the De-
partment of Veterans Affairs for such purposes; 
(B) carry out activities for the purposes of 
environmental mitigation, abatement, or res-
toration at any such facility, and shall use for 
such purposes funds in the Account; 
(C) reimburse other Federal agencies for 
actions performed at the request of the Sec-
retary with respect to any such closure or re-
alignment, and may use for such purpose funds 
in the Account or funds appropriated to the De-
partment of Veterans Affairs and available for 
such purpose; and 
(D) exercise the authority of the Secretary 
under subchapter V of chapter 81 of title 38, 
United States Code. 
(2) ENVIRONMENTAL RESTORATION; HISTORIC 
PRESERVATION.—In carrying out any closure or re-
alignment under this subtitle, the Secretary, with re-
gards to any property made excess to the needs of 
the Department of Veterans Affairs as a result of 
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such closure or realignment, shall carry out, as soon 
as possible with funds available for such purpose, 
any of the following for which the Secretary is re-
sponsible: 
(A) Environmental mitigation. 
(B) Environmental abatement. 
(C) Environmental restoration. 
(D) Compliance with historic preservation 
requirements. 
(b) MANAGEMENT AND DISPOSAL OF PROPERTY.— 
(1) EXISTING
DISPOSAL
AUTHORITIES.—To 
transfer or dispose of surplus real property or infra-
structure located at any facility of the Veterans 
Health Administration that is modernized or re-
aligned under this title, the Secretary may exercise 
the authorities of the Secretary under subchapters I 
and II of chapter 81 of title 38, United States Code, 
or the authorities delegated to the Secretary by the 
Administrator of General Services under subchapter 
III of chapter 5 of title 40, United States Code. 
(2) EFFECTS ON LOCAL COMMUNITIES.— 
(A) CONSULTATION
WITH
STATE
AND 
LOCAL GOVERNMENT.—Before any action may 
be taken with respect to the disposal of any 
surplus real property or infrastructure located 
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151 
at any facility of the Veterans Health Adminis-
tration to be closed or realigned under this sub-
title, the Secretary of Veterans Affairs shall 
consult with the Governor of the State and the 
heads of the local governments concerned for 
the purpose of considering any plan for the use 
of such property by the local community con-
cerned. 
(B) TREATMENT
OF
ROADS.—If infra-
structure or a facility of the Veterans Health 
Administration to be closed or realigned under 
this subtitle includes a road used for public ac-
cess through, into, or around the facility, the 
Secretary— 
(i) shall consult with the Government 
of the State and the heads of the local gov-
ernments concerned for the purpose of con-
sidering the continued availability of the 
road for public use after the recommended 
action is complete; and 
(ii) may exercise the authority of the 
Secretary under section 8108 of title 38, 
United States Code. 
(3) LEASES; CERCLA.— 
(A) LEASE AUTHORITY.— 
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(i) TRANSFER
TO
REDEVELOPMENT 
AUTHORITY
FOR
LEASE.—The Secretary 
may transfer title to a facility of the Vet-
erans Health Administration approved for 
closure or realignment under this subtitle 
(including property at a facility of the Vet-
erans Health Administration approved for 
realignment which will be retained by the 
Department of Veterans Affairs or another 
Federal agency after realignment) to the 
redevelopment authority for the facility if 
the redevelopment authority agrees to 
lease, directly upon transfer, one or more 
portions of the property transferred under 
this subparagraph to the Secretary or to 
the head of another department or agency 
of the Federal Government. 
(ii) TERM OF LEASE.—A lease under 
clause (i) shall be for a term of not to ex-
ceed 50 years, but may provide for options 
for renewal or extension of the term by the 
department or agency concerned. 
(iii) 
LIMITATION.—A 
lease 
under 
clause (i) may not require rental payments 
by the United States. 
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(iv) TREATMENT
OF
REMAINDERED 
LEASE TERMS.—A lease under clause (i) 
shall include a provision specifying that if 
the department or agency concerned ceases 
requiring the use of the leased property be-
fore the expiration of the term of the lease, 
the remainder of the lease term may be 
satisfied by the same or another depart-
ment or agency of the Federal Government 
using the property for a use similar to the 
use under the lease. Exercise of the au-
thority provided by this clause shall be 
made in consultation with the redevelop-
ment authority concerned. 
(v) 
FACILITY
SERVICES.—Notwith-
standing clause (iii), if a lease under clause 
(i) involves a substantial portion of the fa-
cility, the department or agency concerned 
may obtain facility services for the leased 
property and common area maintenance 
from the redevelopment authority or the 
redevelopment authority’s assignee as a 
provision of the lease. The facility services 
and common area maintenance shall be 
provided at a rate no higher than the rate 
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charged to non-Federal tenants of the 
transferred property. Facility services and 
common area maintenance covered by the 
lease shall not include— 
(I) municipal services that a 
State or local government is required 
by law to provide to all landowners in 
its jurisdiction without direct charge; 
or 
(II) firefighting or security-guard 
functions. 
(B) APPLICATION OF CERCLA.—The provi-
sions of section 120(h) of the Comprehensive 
Environmental Response, Compensation, and 
Liability Act of 1980 (42 U.S.C. 9620(h)) shall 
apply to any transfer of real property under 
this paragraph. 
(C) ADDITIONAL
TERMS
AND
CONDI-
TIONS.—The Secretary may require any addi-
tional terms and conditions in connection with 
a transfer under this paragraph as such Sec-
retary considers appropriate to protect the in-
terests of the United States. 
(4) APPLICATION OF MCKINNEY-VENTO HOME-
LESS
ASSISTANCE
ACT.—Nothing in this subtitle 
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155 
shall limit or otherwise affect the application of the 
provisions of the McKinney-Vento Homeless Assist-
ance Act (42 U.S.C. 11301 et seq.) to facilities of 
the Veterans Health Administration closed under 
this subtitle. 
(c) APPLICABILITY OF NATIONAL ENVIRONMENTAL 
POLICY ACT OF 1969.— 
(1) IN GENERAL.—The provisions of the Na-
tional Environmental Policy Act of 1969 (42 U.S.C. 
4321 et seq.) shall not apply to the actions of the 
President, the Commission, and, except as provided 
in paragraph (2), the Department of Veterans Af-
fairs in carrying out this subtitle. 
(2) DEPARTMENT OF VETERANS AFFAIRS.— 
(A) COVERED ACTIVITIES.—The provisions 
of the National Environmental Policy Act of 
1969 shall apply to actions of the Department 
of Veterans Affairs under this subtitle— 
(i) during the process of property dis-
posal; and 
(ii) during the process of relocating 
functions from a facility of the Veterans 
Health Administration being closed or re-
aligned to another facility after the receiv-
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156 
ing facility has been selected but before the 
functions are relocated. 
(B) OTHER ACTIVITIES.—In applying the 
provisions of the National Environmental Policy 
Act of 1969 to the processes referred to in sub-
paragraph (A), the Secretary shall not have to 
consider— 
(i) the need for closing or realigning 
the facility of the Veterans Health Admin-
istration as recommended by the Commis-
sion; 
(ii) the need for transferring functions 
to any facility of the Veterans Health Ad-
ministration which has been selected as the 
receiving facility; or 
(iii) facilities of the Veterans Health 
Administration alternative to those rec-
ommended or selected. 
(d) WAIVER.— 
(1) RESTRICTIONS
ON
USE
OF
FUNDS.—The 
Secretary may close or realign facilities of the Vet-
erans Health Administration under this subtitle 
without regard to any provision of law restricting 
the use of funds for closing or realigning facilities of 
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157 
the Veterans Health Administration included in any 
appropriation or authorization Act. 
(2) RESTRICTIONS ON AUTHORITIES.—The Sec-
retary may close or realign facilities of the Veterans 
Health Administration under this subtitle without 
regard to the restrictions of section 8110 of title 38, 
United States Code. 
(e) TRANSFER AUTHORITY IN CONNECTION WITH 
PAYMENT OF ENVIRONMENTAL REMEDIATION COSTS.— 
(1) IN GENERAL.— 
(A) TRANSFER
BY
DEED.—Subject to 
paragraph (2) of this subsection and section 
120(h) of the Comprehensive Environmental 
Response, Compensation, and Liability Act of 
1980 (42 U.S.C. 9620(h)), the Secretary may 
enter into an agreement to transfer by deed a 
facility of the Veterans Health Administration 
with any person who agrees to perform all envi-
ronmental restoration, waste management, and 
environmental compliance activities that are re-
quired for the property or facilities under Fed-
eral and State laws, administrative decisions, 
agreements (including schedules and mile-
stones), and concurrences. 
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158 
(B) 
ADDITIONAL
TERMS
OR
CONDI-
TIONS.—The Secretary may require any addi-
tional terms and conditions in connection with 
an agreement authorized by subparagraph (A) 
as the Secretary considers appropriate to pro-
tect the interests of the United States. 
(2) LIMITATION.—A transfer of a facility of the 
Veterans Health Administration may be made under 
paragraph (1) only if the Secretary certifies to Con-
gress that— 
(A) the costs of all environmental restora-
tion, waste management, and environmental 
compliance activities otherwise to be paid by the 
Secretary with respect to the facility of the Vet-
erans Health Administration are equal to or 
greater than the fair market value of the prop-
erty or facilities to be transferred, as deter-
mined by the Secretary; or 
(B) if such costs are lower than the fair 
market value of the facility of the Veterans 
Health Administration, the recipient of such 
transfer agrees to pay the difference between 
the fair market value and such costs. 
(3) PAYMENT BY THE SECRETARY FOR CER-
TAIN TRANSFERS.—In the case of a facility of the 
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159 
Veterans Health Administration covered by a certifi-
cation under paragraph (2)(A), the Secretary may 
pay the recipient of such facility an amount equal to 
the lesser of— 
(A) the amount by which the costs in-
curred by the recipient of the facility of the 
Veterans Health Administration for all environ-
mental restoration, waste, management, and en-
vironmental compliance activities with respect 
to such facility exceed the fair market value of 
such property as specified in such certification; 
or 
(B) the amount by which the costs (as de-
termined by the Secretary) that would other-
wise have been incurred by the Secretary for 
such restoration, management, and activities 
with respect to such facility of the Veterans 
Health Administration exceed the fair market 
value of property as so specified. 
(4) DISCLOSURE.—As part of an agreement 
under paragraph (1), the Secretary shall disclose to 
the person to whom the facility of the Veterans 
Health Administration will be transferred any infor-
mation of the Secretary regarding the environmental 
restoration, waste management, and environmental 
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160 
compliance activities described in paragraph (1) that 
relate to the facility of the Veterans Health Admin-
istration. The Secretary shall provide such informa-
tion before entering into the agreement. 
(5) APPLICABILITY
OF
CERTAIN
ENVIRON-
MENTAL LAWS.—Nothing in this subsection shall be 
construed to modify, alter, or amend the Com-
prehensive Environmental Response, Compensation, 
and Liability Act of 1980 (42 U.S.C. 9601 et seq.) 
or the Solid Waste Disposal Act (42 U.S.C. 6901 et 
seq.). 
SEC. 206. DEPARTMENT OF VETERANS AFFAIRS ASSET AND 
INFRASTRUCTURE REVIEW ACCOUNT. 
(a) ESTABLISHMENT.—There is hereby established in 
the ledgers of the Treasury an account to be known as 
the ‘‘Department of Veterans Affairs Asset and Infra-
structure Review Account’’ which shall be administered by 
the Secretary as a single account. 
(b) CREDITS TO ACCOUNT.—There shall be credited 
to the Account the following: 
(1) Funds authorized for and appropriated to 
the Account. 
(2) Proceeds received from the lease, transfer, 
or disposal of any property at a facility of the Vet-
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erans Health Administration closed or realigned 
under this subtitle. 
(c) USE OF ACCOUNT.—The Secretary may use the 
funds in the Account only for the following purposes: 
(1) To carry out this subtitle. 
(2) To cover property management and disposal 
costs incurred at facilities of the Veterans Health 
Administration closed, modernized, or realigned 
under this subtitle. 
(3) To cover costs associated with supervision, 
inspection, overhead, engineering, and design of con-
struction projects undertaken under this subtitle, 
and subsequent claims, if any, related to such activi-
ties. 
(4) Other purposes that the Secretary deter-
mines support the mission and operations of the De-
partment of Veterans Affairs. 
(d) CONSOLIDATED BUDGET JUSTIFICATION DIS-
PLAY FOR ACCOUNT.— 
(1) CONSOLIDATED BUDGET INFORMATION RE-
QUIRED.—The Secretary shall establish a consoli-
dated budget justification display in support of the 
Account that for each fiscal year— 
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162 
(A) details the amount and nature of cred-
its to, and expenditures from, the Account dur-
ing the preceding fiscal year; 
(B) separately details the environmental 
remediation costs associated with facility of the 
Veterans Health Administration for which a 
budget request is made; 
(C) specifies the transfers into the Account 
and the purposes for which these transferred 
funds will be further obligated, to include care-
taker and environment remediation costs associ-
ated with each facility of the Veterans Health 
Administration; and 
(D) details any intra-budget activity trans-
fers 
within 
the 
Account 
that 
exceeded 
$1,000,000 during the preceding fiscal year or 
that are proposed for the next fiscal year and 
will exceed $1,000,000. 
(2) SUBMISSION.—The Secretary shall include 
the information required by paragraph (1) in the 
materials that the Secretary submits to Congress in 
support of the budget for a fiscal year submitted by 
the President pursuant to section 1105 of title 31, 
United States Code. 
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163 
(e) CLOSURE OF ACCOUNT; TREATMENT OF REMAIN-
ING FUNDS.— 
(1) CLOSURE.—The Account shall be closed at 
the time and in the manner provided for appropria-
tion accounts under section 1555 of title 31, United 
States Code, except that unobligated funds which re-
main in the Account upon closure shall be held by 
the Secretary of the Treasury until transferred to 
the Secretary of Veterans Affairs by law after the 
Committees on Veterans’ Affairs of the Senate and 
the House of Representatives receive the final report 
transmitted under paragraph (2). 
(2) FINAL
REPORT.—No later than 60 days 
after the closure of the Account under paragraph 
(1), the Secretary shall transmit to the Committees 
on Veterans’ Affairs of the Senate and the House of 
Representatives and the Committees on Appropria-
tions of the House of Representatives and the Sen-
ate a report containing an accounting of— 
(A) all the funds credited to and expended 
from the Account or otherwise expended under 
this subtitle; and 
(B) any funds remaining in the Account. 
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164 
SEC. 207. CONGRESSIONAL CONSIDERATION OF COMMIS-
SION REPORT. 
(a) DISAPPROVAL RESOLUTION.—For purposes of 
section 204(b), the term ‘‘joint resolution’’ means only a 
joint resolution which is introduced within the 5-day pe-
riod beginning on the date on which the President trans-
mits the report to the Congress under section 203(d), 
and— 
(1) which does not have a preamble; 
(2) the matter after the resolving clause of 
which is as follows: ‘‘that Congress disapproves the 
recommendations of the VHA Asset and Infrastruc-
ture Review Commission as submitted by the Presi-
dent on lll’’, the blank space being filled with 
the appropriate date; and 
(3) the title of which is as follows: ‘‘Joint reso-
lution disapproving the recommendations of the 
VHA Asset and Infrastructure Review Commis-
sion.’’. 
(b) CONSIDERATION IN THE HOUSE OF REPRESENT-
ATIVES.— 
(1) REPORTING
AND
DISCHARGE.—Any com-
mittee of the House of Representatives to which a 
joint resolution is referred shall report it to the 
House without amendment not later than 15 legisla-
tive days after the date of introduction thereof. If a 
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165 
committee fails to report the joint resolution within 
that period, the committee shall be discharged from 
further consideration of the joint resolution. 
(2) PROCEEDING TO CONSIDERATION.—It shall 
be in order at any time after the third legislative day 
after each committee authorized to consider a joint 
resolution has reported or has been discharged from 
consideration of a joint resolution, to move to pro-
ceed to consider the joint resolution in the House. 
All points of order against the motion are waived. 
Such a motion shall not be in order after the House 
has disposed of a motion to proceed on a joint reso-
lution addressing a particular submission. The pre-
vious question shall be considered as ordered on the 
motion to its adoption without intervening motion. 
The motion shall not be debatable. A motion to re-
consider the vote by which the motion is disposed of 
shall not be in order. 
(3) 
CONSIDERATION.—The 
joint 
resolution 
shall be considered as read. All points of order 
against the joint resolution and against its consider-
ation are waived. The previous question shall be con-
sidered as ordered on the joint resolution to its pas-
sage without intervening motion except two hours of 
debate equally divided and controlled by the pro-
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166 
ponent and an opponent. A motion to reconsider the 
vote on passage of the joint resolution shall not be 
in order. 
(c) CONSIDERATION IN THE SENATE.— 
(1) REFERRAL.—A joint resolution introduced 
in the Senate shall be referred to the Committee on 
Veterans’ Affairs. 
(2) REPORTING
AND
DISCHARGE.—Any com-
mittee of the Senate to which a joint resolution is 
referred shall report it to the Senate without amend-
ment not later than 15 session days after the date 
of introduction of a joint resolution described in sub-
section (a). If a committee fails to report the joint 
resolution within that period, the committee shall be 
discharged from further consideration of the joint 
resolution and the joint resolution shall be placed on 
the calendar. 
(3) FLOOR CONSIDERATION.— 
(A) IN GENERAL.—Notwithstanding Rule 
XXII of the Standing Rules of the Senate, it is 
in order at any time after the third session day 
on which the Committee on Veterans’ Affairs 
has reported or has been discharged from con-
sideration of a joint resolution described in sub-
section (a) (even though a previous motion to 
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167 
the same effect has been disagreed to) to move 
to proceed to the consideration of the joint reso-
lution, and all points of order against the joint 
resolution (and against consideration of the 
joint resolution) are waived. The motion to pro-
ceed is not debatable. The motion is not subject 
to a motion to postpone. A motion to reconsider 
the vote by which the motion is agreed to or 
disagreed to shall not be in order. If a motion 
to proceed to the consideration of the resolution 
is agreed to, the joint resolution shall remain 
the unfinished business until disposed of. 
(B) CONSIDERATION.—Consideration of 
the joint resolution, and on all debatable mo-
tions and appeals in connection therewith, shall 
be limited to not more than 2 hours, which 
shall be divided equally between the majority 
and minority leaders or their designees. A mo-
tion further to limit debate is in order and not 
debatable. An amendment to, or a motion to 
postpone, or a motion to proceed to the consid-
eration of other business, or a motion to recom-
mit the joint resolution is not in order. 
(C) VOTE ON PASSAGE.—If the Senate has 
voted to proceed to a joint resolution, the vote 
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168 
on passage of the joint resolution shall occur 
immediately following the conclusion of consid-
eration of the joint resolution, and a single 
quorum call at the conclusion of the debate if 
requested in accordance with the rules of the 
Senate. 
(D) RULINGS OF THE CHAIR ON PROCE-
DURE.—Appeals from the decisions of the Chair 
relating to the application of the rules of the 
Senate, as the case may be, to the procedure re-
lating to a joint resolution shall be decided 
without debate. 
(d) AMENDMENT NOT IN ORDER.—A joint resolution 
of disapproval considered pursuant to this section shall not 
be subject to amendment in either the House of Rep-
resentatives or the Senate. 
(e) COORDINATION
WITH
ACTION
BY
OTHER 
HOUSE.— 
(1) IN GENERAL.—If, before passing the joint 
resolution, one House receives from the other a joint 
resolution— 
(A) the joint resolution of the other House 
shall not be referred to a committee; and 
(B) the procedure in the receiving House 
shall be the same as if no joint resolution had 
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169 
been received from the other House until the 
vote on passage, when the joint resolution re-
ceived from the other House shall supplant the 
joint resolution of the receiving House. 
(2) TREATMENT
OF
JOINT
RESOLUTION
OF 
OTHER HOUSE.—If the Senate fails to introduce or 
consider a joint resolution under this section, the 
joint resolution of the House shall be entitled to ex-
pedited floor procedures under this section. 
(3) TREATMENT OF COMPANION MEASURES.— 
If, following passage of the joint resolution in the 
Senate, the Senate then receives the companion 
measure from the House of Representatives, the 
companion measure shall not be debatable. 
(f) RULES OF THE HOUSE OF REPRESENTATIVES 
AND SENATE.—This section is enacted by Congress— 
(1) as an exercise of the rulemaking power of 
the Senate and House of Representatives, respec-
tively, and as such it is deemed a part of the rules 
of each House, respectively, but applicable only with 
respect to the procedure to be followed in that 
House in the case of a joint resolution, and it super-
sedes other rules only to the extent that it is incon-
sistent with such rules; and 
VerDate Sep 11 2014 
04:11 May 09, 2018
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H5674
lotter on DSKBCFDHB2PROD with BILLS