Veterans' Benefits and Services Act of 1988
PL 100-322 (H.R.2616), enacted 05/20/1988

PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 487 
Public Law 100-322 
100th Congress 
An Act 
To amend title 38, United States Code, to revise, improve, and extend various 
May 20,1988 
veterans' programs, and for other purposes. 
[H.R. 2616] 
Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled. 
Veterans' 
Benefits and 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
Services Act of 
(a) SHORT TITLE.—This Act may be cited as the "Veterans' Bene- 33 ugQ ^QI note 
fits and Services Act of 1988". 
(b) TABLE OF CONTENTS.—The table of contents for this Act is as 
follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. References to title 38, United States Code. 
Sec. 3. Definition of Administrator. 
TITLE I-HEALTH-CARE PROGRAMS 
PART A—BENEFITS 
Sec. 101. Eligibility for outpatient services. 
Sec. 102. Eligibility for domiciliary care. 
Sec. 103. Definition of nursing home care. 
Sec. 104. Expansion of contract-care authority. 
Sec. 105. Health care outside the United States for veterans with service-connected 
disabilities. 
Sec. 106. Internment period required for eligibility for dental care for former pris-
oners of war. 
Sec. 107. Readjustment counseling program. 
Sec. 108. Beneficiary travel program. 
PART B—PILOT PROGRAMS AND REPORTS 
Sec. 111. Adult day health-care program. 
Sec. 112. Report on use of contract-care authorities. 
Sec. 113. Pilot program of mobile health-care clinics. 
Sec. 114. Modification of report on care furnished to veterans having chronic 
mental illness disabilities. 
Sec. 115. Pilot program of community-based residential care for homeless chroni-
cally mentally ill and other veterans. 
Sec. 116. Reports on assistance to homeless veterans. 
PART C^MATTERS RELATING TO AIDS 
Sec. 121. Confidentiality of medical records. 
Sec. 122. Nondiscrimination. 
Sec. 123. Information and training concerning AIDS prevention. 
Sec. 124. Restriction on testing for infection with the human immunodeficiency 
virus. 
PART D—OTHER MATTERS 
Sec. 131. Definition of Veterans' Administration medical facilities to include certain 
recreational facilities. 
Sec. 132. Veterans' Administration assistance with rehabilitation activities. 
Sec. 133. Rules and regulations relating to Veterans' Administration health care. 
Sec. 134. Per diem rates for care in State homes. 
Sec. 135. Medical research. 
Sec. 136. Conversion of underused space to domiciliary care beds. 
102 STAT. 488 
PUBLIC LAW 100-322—MAY 20, 1988 
TITLE II—HEALTH-CARE ADMINISTRATION AND PERSONNEL MATTERS 
PART A—ADMINISTRATION 
Sec. 201. Health-care quality assurance activities. 
Sec. 202. Hospital cost collections. 
Sec. 203. Tort claims. 
Sec. 204. Nonprofit research corporations. 
Sec. 205. Nursing home revolving fund. 
Sec. 206. State home construction grants. 
PART B—PAY AND OTHER PERSONNEL BENEFITS 
Sec. 211. Additional pay authorities for nurses to be available for pharmacists and 
occupational therapists. 
Sec. 212. Recruitment and retention bonus pay. 
Sec. 213. On-call pay. 
Sec. 214. Premium pay for Saturday work. 
Sec. 215. Report on effect of certain pay and benefits amendments. 
Sec. 216. Health Professionals Educational Assistance Program. 
Sec. 217. Pay scales and awards for Department of Medicine and Surgery 
employees. 
PART C—PERSONNEL ADMINISTRATION 
Sec. 221. Disciplinary matters as to certain appointees. 
Sec. 222. Personnel ceilings for noncareer research personnel. 
Sec. 223. Authority to waive licensure and internship requirements for certain 
health-care personnel. 
Sec. 224. Nurse representation on policymaking committees. 
PART D—REPORTS 
Sec. 231. Study of pay and other personnel management practices. 
Sec. 232. Report on certain activities relating to training in geriatrics of medical 
and other health-professional schools affiliated with the Veterans' 
Administration. 
TITLE III—VETERANS' BENEFITS 
PART A—BENEFITS BASED ON SERVICE-CONNECTED DISABILITIES 
Sec. 301. Specially adapted housing assistance. 
Sec. 302. Automobile assistance allowance. 
Sec. 303. Burial benefit for service-connected deaths. 
Sec. 304. Effective date. 
PART B—COMPENSATION-RELATED PROVISIONS 
Sec. 311. Definition of former prisoner of war. 
Sec. 312. Presumption of service connection for certain disabilities for former pris-
oners of war. 
Sec. 313. Presumption of service connection for lupus. 
Sec. 314. Reinstated entitlement for certain survivors. 
PART C—EDUCATION PROVISIONS 
Sec. 321. Measurement of laboratory instruction. 
Sec. 322. Authority to waive compliance surveys. 
Sec. 323. Effective date of awards under the post-Vietnam era veterans' education 
assistance program. 
PART D—INSURANCE PROVISIONS 
Sec. 331. Authority for annuity adjustments. 
Sec. 332. Exemptions from State taxation. 
Sec. 333. Direct administration of veterans' mortgage life insurance. 
PART E—MEMORIAL AFFAIRS 
Sec. 341. National cemetery grave markers. 
Sec. 342. Contributions for certain projects. 
Sec. 343. State veterans' cemetery construction grants. 
Sec. 344. Grave liners. 
Sec. 345. American Battle Monuments Commission foreign currency fluctuations. 
Sec. 346. Transfer of the Arizona Veterans Memorial Cemetery to the Veterans' 
Administration. 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 489 
TITLE IV—VETERANS' ADMINISTRATION MANAGEMENT AND 
ADMINISTRATION 
PART A—PROCUREMENT POUCY 
Sec. 401. Integrity of contracting out process at health-care facilities. 
Sec. 402. Standardization of medical and pharmaceutical items. 
Sec. 403. Requirements for the procurement of health-care items. 
Sec. 404. Multiyear procurement of certain medical items. 
PART B—GENERAL ADMINISTRATIVE AND FINANCIAL MATTERS 
Sec. 411. Sequestration rules applicable to veterans' programs. 
Sec. 412. Child-care services at Veterans' Administration facilities. 
Sec. 413. Advisory Committee on Native-American Veterans. 
Sec. 414. Management of canteen service. 
Sec. 415. Technical amendments to chapter 37. 
PART C—REAL PROPERTY 
Sec. 421. Limitation on transfer of property to other agencies. 
Sec. 422. Congressional procedures for approval of medical facility acquisition and 
construction. 
Sec. 423. Use of former hospital in Minot, North Dakota. 
Sec. 424. Naming of Veterans' Administration Medical Center in Shreveport, 
Louisiana. 
SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE. 
Except as otherwise expressly provided, whenever in this Act an 
amendment or repeal is expressed in terms of an amendment to, or 
repeal of, a section or other provision, the reference shall be consid-
ered to be made to a section or other provision of title 38, United 
States Code. 
SEC. 3. DEFINITION OF ADMINISTRATOR. 
38 USC 101 note. 
For purposes of this Act, the term "Administrator" means the 
Administrator of Veterans' Affairs. 
TITLE I—HEALTH-CARE PRCXIRAMS 
PART A—BENEFITS 
SEC. 101. ELIGIBILITY FOR OUTPATIENT SERVICES. 
(a) CERTAIN VETERANS WITH SERVICE-CONNECTED DISABILITIES.— 
Paragraph (1) of section 612(a) is amended— 
(1) in the matter preceding clause (A), by striking out "may 
furnish" and inserting in lieu thereof "shall furnish on an 
ambulatory or outpatient basis"; 
(2) by striking out "and" at the end of clause (A); 
(3) by striking out the period at the end of clause (B) and 
inserting in lieu thereof "; and"; and 
(4) by adding at the end the following new clause: 
"(C) to any veteran for a disability for which the veteran is in 
receipt of compensation under section 351 of this title or for 
which the veteran would be entitled to compensation under that 
section but for a suspension pursuant to that section (but in the 
case of such a suspension, such medical services may be fur-
nished only to the extent that such person's continuing eligi-
bility for medical services is provided for in the judgment or 
settlement described in that section).". 
(b) OTHER VETERANS.—Section 612(a) is further amended— 
(1) by striking out paragraph (2); 
(2) by redesignating paragraph (3) as paragraph (6); and 
(3) by inserting after paragraph (1) the following: 
102 STAT. 490 
PUBLIC LAW 100-322—MAY 20, 1988 
"(2) The Administrator shall furnish on an ambulatory or out-
patient basis medical services for a purpose described in paragraph 
(5) of this subsection— 
"(A) to any veteran who has a service-connected disability 
rated at 30 percent or 40 percent; and 
"(B) to £uiy veteran who is eligible for hospital care under 
section 610(a) of this title and whose annual income (as deter-
mined under section 503 of this title) does not exceed the 
maximum annual rate of pension that would be applicable to 
the veteran if the veteran were eligible for pension under 
section 521(d) of this title. 
"(3) The Administrator may furnish on an ambulatory or out-
patient basis medical services which the Administrator determines 
are needed— 
"(A) to any veteran who is a former prisoner of war; 
"(B) to any veteran of the Mexican border period or of World 
War I; and 
"(C) to any veteran who is in receipt of increased pension or 
additional compensation or allowances based on the need of 
regular aid and attendance or by reason of being permanently 
housebound (or who, but for the receipt of retired pay, would be 
in receipt of such pension, compensation, or allowance). 
"(4) Subject to subsection (f) of this section, the Administrator may 
furnish on an ambulatory or outpatient basis medical services for a 
purpose described in paragraph (5) of this subsection to any veteran 
who is eligible for hospital care under section 610 of this title and 
who is not otherwise eligible for such services under this subsection. 
"(5XA) Medical services for a purpose described in this paragraph 
are medical services reasonably necessary in preparation for hos-
pital admission or to obviate the need of hospital admission. In the 
case of a veteran described in paragraph (4) of this subsection, 
services to obviate the need of hospital admission may be furnished 
only to the extent that facilities are available. 
(B) In the case of a vetersm who has been furnished hospital care, 
nursing home care, or domiciliary care, medical services for a 
purpose described in this paragraph include medical services reason-
ably necessary to complete treatment incident to such care. Such 
medical services may not be provided for a period in excess of 12 
months after discharge from such care. However, the Administrator 
may authorize a longer period in any case if the Administrator finds 
that a longer period is required by reason of the disability being 
treated.". 
(c) PRIORITY FOR OUTPATIENT SERVICES.—Section 612(i) is amended 
by striking out paragraphs (1) through (6) and inserting in lieu 
thereof the following: 
"(1) To a veteran who is entitled to such services under 
paragraph (1) or (2) of subsection (a) of this section. 
"(2) To a veteran (A) who has a service-connected disability 
rated at less than 30-percent disabling, or (B) who is being 
examined to determine the existence or severity of a service-
connected disability. 
"(3) To a veteran (A) who is a former prisoner of war, or (B) 
who is eligible for hospital care under section 610(e) of this title. 
"(4) To a veteran eligible for medical services under subsec-
tion (aX3XB) or (aX3XC) of this section. 
"(5) To a veteran not covered by paragraphs (1) through (4) of 
this subsection who is unable to defray the expenses of nee-
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 491 
essary care as determined under section 622(aXl)(C) of this 
title.". 
(d) HOME HEALTH SERVICES.—(1) Section 617 is amended— 
(A) by redesignating subsections (a) and Qoi) as subsections (b) 
and (c), respectively; and 
(B) by inserting after the section heading the following new 
subsection (a): 
"(aXl) As part of medical services furnished to a veteran under 
section 612(a) of this title, the Administrator may furnish such home 
health services as the Administrator finds to be necessary or appro-
priate for the effective and economical treatment of the veteran's 
disability. 
"(2) Improvements and structural alterations may be furnished as 
part of such home health services only as necessary to assure the 
continuation of treatment for the veteran's disability or to provide 
access to the home or to essential lavatory and sanitary facilities. 
The cost of such improvements and structural alterations (or the 
amount of reimbursement therefor) under this subsection may not 
exceed— 
"(A) $2,500 in the case of medical services furnished under 
paragraph (1) of section 612(a) of this title; or 
"(B) $600 in the case of medical services furnished under any 
other provision of section 612 of this title.". 
(2) Subsection (k) of section 612 is transferred to section 617 (as 
amended by paragraph (1)), inserted at the end of subsection (a) (as 
added by paragraph (1)), and redesignated as paragraph (3). 
(3) The heading of section 617 is amended to read as follows: 
*'§617. Home health services; invalid lifts and other devices". 
(e) CONFORMING AMENDMENTS.—(1) Section 612(f) is amended— 
(A) by striking out paragraphs (1), (2), and (3); 
(B) by striking out "(4XA) The Administrator may not furnish 
medical services under this subsection (including home health 
services under paragraph (2) of this subsection)" and inserting 
in lieu thereof "(1) The Administrator may not furnish medical 
services under subsection (a) of this section (including home 
health services under section 617 of this title)"; 
(C) by striking out "subparagraph (B) of this paragraph" and 
inserting in lieu thereof "paragraph (2) of this subsection"; 
(D) by redesignating subparagraphs (B) through (G) as para-
graphs (2) through (7), respectively; 
(E) by striking out "this paragraph" each place it appears in 
such paragraphs and inserting in lieu thereof "this subsection"; 
(F) in paragraph (2) (as so redesignated), by striking out "this 
subsection and who is required under subparagraph (A)" and 
inserting in lieu thereof "subsection (a) of this section and who 
is required under paragraph (1)"; 
(G) in paragraph (3) (as so redesignated), by striking out 
"furnished under this subsection" and inserting in lieu thereof 
"furnished under subsection (a) of this section"; and 
(H) in paragraph (5) (as so redesignated), by striking out 
"under this subsection" and inserting in lieu thereof "under 
section 617 of this title". 
(2) Section 612 is further amended— 
(A) in the first sentence of subsection (b)(4), by striking out 
"subsections (a) and (f) of this section" and inserting in lieu 
102 STAT. 492 
PUBLIC LAW 100-322—MAY 20, 1988 
thereof "subsection (a) of this section (other than paragraphs 
(3XB) and (3XC) of that subsection)"; and 
CB) by striking out subsection (g). 
(3) Section 603(aX2) is amended— 
(A) in clause (B), by striking out "section 612(fKlXAXii) of this 
title" and inserting in lieu thereof "section 612(a)(4) of this title, 
for a purpose described in section 612(aX5) of this title"; and 
(B) in clause (C), by striking out "section 612(g)" and inserting 
in lieu thereof "section 612(aX3) (other than a veteran who is a 
former prisoner of war)". 
(f) TECHNICAL AMENDMENTS.—Section 612(bXl)(B) is amended— 
(1) in clause (i), by striking out "at time of" and inserting in 
lieu thereof "at the time of the veteran's"; 
(2) in clause (ii), by striking out "one hundred and eighty 
days" and inserting in lieu thereof "180 days"; 
(3) in clause (iii), by striking out "ninety days" each place it 
appears and inserting in lieu thereof "90 days"; and 
(4) in clause (iv), by striking out "ninety-day" and inserting in 
lieu thereof "90-day'\ 
(g) REPEAL OF DATED PROVISIONS; GRANDFATHER PROVISION.—(1) 
Section 612 is amended— 
(A) in subsection (bXD, by striking out subparagraph (F) and 
redesignating subparagraphs (G) and (H) as subparagraphs (F) 
and (G), respectively; and 
(B) by striking out subsection (e). 
38 use 612 note. 
(2) Any disability of a veteran of the Spanish-American War, upon 
application for outpatient medical services under section 612 or 624 
of title 38, United States Code, shall be considered for the purposes 
thereof to be a service-connected disabilty and, for the purposes of 
section 612(b) of such title, to be compensable in degree. 
(h) CLERICAL AMENDMENTS.—(1) The heading of section 612 is 
amended to read as follows: 
"§ 612. Eligibility for outpatient services". 
(2) The table of sections at the beginning of chapter 17 is 
amended— 
(A) by striking out the item relating to section 612 and 
inserting in lieu thereof the following: 
"612. Eligibility for outpatient services."; 
and 
(B) by striking out the item relating to section 617 and 
inserting in lieu thereof the following: 
"617. Home health services; invalid lifts and other devices.". 
38 use 603 note. 
(i) EFFECTIVE DATE.—The amendments made by this section shall 
apply with respect to the furnishing of medical services to veterans 
who apply for such services after June 30,1988. 
SEC. 102. ELIGIBILITY FOR DOMICILIARY CARE. 
(a) REVISED EUGIBIIJTY.—Subsection (b) of section 610 is amended 
to read as follows: 
"(bXD The Administrator may furnish to a veteran described in 
paragraph (2) of this subsection such domiciliary care as the 
Administrator determines is needed for the purpose of the furnish-
ing of medical services to the veteran. 
(2) This subsection applies in the case of the following veterans: 
"(A) Any veteran whose annual income (as determined under 
section 503 of this title) does not exceed the maximum annual 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 493 
rate of pension that would be applicable to the veteran if the 
veteran were eligible for pension under section 521(d) of this 
title. 
"(B) Any veteran who the Administrator determines has no 
adequate means of support.". 
(b) CONFORMING AMENDMENT.—Section 622(g) is amended by 
striking out "sections 610(bX2) and" and inserting in lieu thereof 
"section". 
(c) SAVINGS PROVISION.—The amendment made by subsection (a) 38 use 6io note. 
shall not limit or restrict the eligibility for domiciliary care of a 
veteran who was a patient or a resident in a State home facility or a 
Veterans' Administration domiciliary facility during the period 
beginning on January 1,1987, and ending on April 1,1988. 
SEC. 103. DEFINITION OF NURSING HOME CARE. 
(a) CLARIFICATION OF DEFINITION.—Section 101(28) is amended— 
(1) by striking out "skilled" in the first sentence; and 
(2) by striking out the second sentence and inserting in lieu 
thereof the following: "Such term includes services furnished in 
skilled nursing care facilities, in intermediate care facilities, 
and in combined facilities. It does not include domiciliary care.". 
(b) CONFORMING AMENDMENTS.—Section 620(eXl) is amended— 
(1) by striking out the first sentence; and 
(2) by striking out "(as defined in section 101(28) of this title)". 
SEC. 104. EXPANSION OF CONTRACT-CARE AUTHORITY. 
(a) ADDITIONAL COVERED SERVICES.—Section 603(a) is amended— 
(1) in clause (3), by inserting "or nursing home care under 
section 620 of this title" after "Veterans' Administration facil-
ity" the first place it appears; and 
(2) by adding at the end the following new paragraph: 
"(8) Diagnostic services (on an inpatient or outpatient basis) 
for observation or examination of a person to determine eligi-
bility for a benefit or service under laws administered by the 
Veterans' Administration.". 
(b) STYLISTIC AMENDMENTS.—Section 603(a) is further amended— 
(1) in the matter preceding clause (1), by striking out "fur-
nish—" and inserting in lieu thereof "furnish any of the 
following:"; 
(2) in each of clauses (1) through (7), by capitalizing the first 
letter of the first word; 
(3) at the end of each of clauses (1) through (5), by striking out 
the semicolon and inserting in lieu thereof a period; and 
(4) at the end of clause (6), by striking out "; or" and inserting 
in lieu thereof a period. 
SEC. 105. HEALTH CARE OUTSIDE THE UNITED STATES FOR VETERANS 
WITH SERVICE-CONNECTED DISABILITIES. 
Section 624(b) is amended to read as follows: 
"(bXD The Administrator may furnish hospital care and medical 
services outside a State to a veteran who is otherwise eligible to 
receive hospital care and medical services if the Administrator 
determines that such care and services are needed for the treatment 
of a service-connected disability of the veteran or as part of a 
rehabilitation program under chapter 31 of this title. 
102 STAT. 494 
PUBLIC LAW 100-322—MAY 20, 1988 
"(2) Care and services for a service-connected disability of a 
veteran who is not a citizen of the United States may be furnished 
under this subsection only— 
"(A) if the veteran is in the Republic of the Philippines or in 
Canada; or 
"(B) if the Administrator determines, as a matter of discretion 
and pursuant to regulations which the Administrator shall 
prescribe, that it is appropriate and feasible to furnish such care 
and services.". 
SEC. 106. INTERNMENT PERIOD 
REQUIRED FOR 
ELIGIBILITY FOR 
DENTAL CARE FOR FORMER PRISONERS OF WAR. 
Section 612(bXlXF) (as redesignated by section 101(g)(1)) is 
amended by striking out "six months" and inserting in lieu thereof 
"90 days". 
SEC. 107. READJUSTMENT COUNSELING PROGRAM. 
(a) REPEAL OF TRANSITION REQUIREMENT.—Subsection (g)(1) of sec-
tion 612A is amended to read as follows: 
"(gXl)(A) The Administrator may close or relocate a center in 
existence on January 1, 1988, only as described in the national plan 
required by paragraph (3) of this subsection (or in a revision to such 
plan under paragraph (4) of this subsection in which the closure or 
relocation of that center is proposed). 
"(B) A closure or relocation of a center which is proposed in such 
national plan may be carried out only after the end of the 120-day 
period beginning on the date on which the national plan is submit-
ted. A closure or relocation of a center not proposed in such plan 
may be carried out only after the end of the 60-day period beginning 
on the date the Administrator submits a revision to such plan in 
which the closure or relocation of that center is proposed.". 
(b) CHANGE IN REPORT DEADUNE.—Paragraph (2XA) of section 
612A(g) is amended— 
(1) by striking out "April 1,1987" and inserting in lieu thereof 
"April 1,1988"; and 
(2) by striking out "(or" and all that follows through 
"available)". 
(c) REQUIREMENT FOR A NATIONAL PLAN.—Section 612A(g) is fur-
ther amended by striking out paragraphs (3) and (4) and inserting in 
lieu thereof the following: 
Reports. 
"(3XA) The Administrator, after considering the recommendations 
of the Chief Medical Director, shall submit to such committees a 
report setting forth a national plan for all centers in existence on 
January 1, 1988. Such national plan shall set forth the Administra-
tor's proposals as to each such center for a period (to be determined 
by the Administrator) of not less than 12 months beginning on the 
date of the submission of the report. The plan shall include, as to 
each center, whether the Administrator proposes to relocate the 
center to a general Veterans' Administration facility, relocate the 
center to a new location away from a general Veterans' Administra-
tion facility, expand the center in the same location, or close the 
center. The plan shall also set forth any proposal of the Adminis-
trator to open additional centers. 
"(B) The plan shall include the Administrator's evaluation as to 
how, in light of each of the criteria described in subparagraph (C) of 
this paragraph, the proposal set forth in the plan for each center 
covered by the plan would ensure the continued availability and 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 495 
effective furnishing of readjustment counseling services to eligible 
veterans needing such services in the geographic area served by that 
center. 
"(C) The Administrator shall make the evaluation described in 
subparagraph (B) of this paragraph with respect to any center in 
light of the following: 
"(i) The distribution of Vietnam-era veterans in the geo-
graphic area served by the center and the relationships between 
the location of such center and the general Veterans' Adminis-
tration facility and such distribution. 
"(ii) The distance between the center and the general Veter-
ans' Administration facility. 
"(iii) The availability of other entities (such as State, local, or 
private outreach facilities) which provide assistance to Vietnam-
era veterans in the area served by the center. 
"(iv) The availability of transportation to, and parking at, the 
center and the general Veterans' Administration facility. 
"(v) The availability, cost, and suitability of the space at the 
general Veterans' Administration facility. 
"(vi) The overall cost impact of the proposed closure or reloca-
tion, including a comparison of the recurring nonpersonnel 
costs of providing readjustment counseling to the same esti-
mated number of veterans at the center and the general Veter-
ans' Administration facility. 
"(vii) The workload trends over the two previous fiscal years, 
and projected over the next fiscal year (or longer), at the center, 
"(viii) Such other factors as the Administrator determines to 
be relevant to making the evaluation described in subparagraph 
(B) of this paragraph. 
"(D) For the purposes of this paragraph, the term 'general Veter-
ans' Administration facility' means a Veterans' Administration 
facility which is not a center and at which readjustment counseling 
would be furnished in a particular geographic area upon the closure 
or relocation of a center. 
"(4) After submitting the plan required by paragraph (3) of this 
subsection, the Administrator may submit to the committees a 
revision to such plan in order to modify the proposal set forth in the 
plan as to any center. Any such revision shall include, with respect 
to each center addressed in the revision, a description of the 
Administrator's evaluation of the matters specified in paragraphs 
(3XB) and (3)(C) of this subsection. 
"(5) For purposes of determining a period of time under paragraph 
(IXB) of this subsection, if the national plan (or a revision to the 
national plan) is submitted to the committees during the 121-day 
period beginning 60 days before and ending 60 days after the final 
day of a session of the (ingress, it shall be deemed to have been 
submitted on the sixty-first day after the final day of such session.", 
(d) DEFINITIONS.—Action 612A is further amended by adding at 
the end the following new subsection: 
"(i) For the purposes of this section: 
"(1) The term 'center' means a facility (including a Resource 
Center designated under subsection (hX3XA) of this section) 
which is operated by the Veterans' Administration for the 
provision of services under this section and which (A) is situated 
apart from Veterans' Administration general health-care facili-
ties, or (B) was so situated but has been relocated to a Veterans' 
Administration general health-care facility. 
102 STAT. 496 
PUBLIC LAW 100-322—MAY 20, 1988 
"(2) The term 'Veterans' Administration general health-care 
facility' means a health-care facility which is operated by the 
Veterans' Administration for the furnishing of health-care serv-
ices under this chapter, not limited to services provided through 
the program established under this section.". 
(e) CONFORMING AMENDMENTS.—(1) Subsection (gX2XB) of section 
612A is amended— 
(A) in clause (i), by striking out "a program" and all that 
follows through "health-care facilities" and inserting in lieu 
thereof "centers"; and 
(B) in clause (ii), by striking out "paragraph (1) of". 
(2) Subsection (h) of such section is amended— 
(A) in paragraph (3XB), by striking out " 'Centers'" and 
inserting in lieu thereof " 'Resource Centers' "; and 
(B) in paragraphs (4XA), (4XB), and (5), by striking out 
"Center" and inserting in lieu thereof "Resource Center". 
38 use 612A 
(f) PROHIBITION OF DELEGATION OF DUTIES.—The Chief Medical 
note. 
Director of the Veterans' Administration may not delegate the 
function of making recommendations under section 612A(gX3XA) of 
title 38, United States Code, as amended by subsection (c). 
SEC. 108. BENEFICIARY TRAVEL PROGRAM. 
(a) PROGRAM REVISIONS.—Section 111 is amended— 
(1) by redesignating subsections 0)), (c), (d), and (e) as subsec-
tions (a), (e), (f), and (g), respectively; and 
(2) by inserting after subsection (a) the following new subsec-
tions (b) and (c): 
"(bXD Except as provided in subsection (c) of this section and 
notwithstanding subsection (gX2XA) of this section or any other 
provision of law, if, with respect to any fiscal year, the Adminis-
trator exercises the authority under this section to make any papr-
ments, the Administrator shall make the payments provided for in 
this section to or for the following persons for travel during such 
fiscal year for examination, treatment, or care for which the person 
is eligible: 
"(A) A veteran or other person whose travel is in connection 
with treatment or care for a service-connected disability. 
"(B) A veteran with a service-connected disability rated at 30 
percent or more. 
"(C) A veteran receiving pension under section 521 of this 
title. 
"(D) A veteran (i) whose annual income (as determined under 
section 503 of this title) does not exceed the maximum annual 
rate of pension which would be payable to such veteran if such 
veteran were eligible for pension under section 521 of this title, 
or (ii) who is determined, under regulations prescribed by the 
Administrator, to be unable to defray the expenses of the travel 
for which payment under this section is claimed. 
"(E) Subject to paragraph (3) of this subsection, a veteran or 
other person whose travel to or from a Veterans' Administra-
tion facility is medically required to be performed by a special 
mode of travel and who is determined under such regulations to 
be unable to defray the expenses of the travel for which pay-
ment under this section is claimed. 
"(F) A veteran whose travel to a Veterans' Administration 
facility is incident to a scheduled compensation and pension 
examination. 
PUBLIC LAW 100-322~MAY 20, 1988 
102 STAT. 497 
"(2) The Administrator may make payments provided for in this 
section to or for any person not covered by paragraph (1) of this 
subsection for travel by such person for examination, treatment, or 
care. Such payments shall be made in accordance with regulations 
which the Administrator shall prescribe. 
"(3XA) Except as provided in subparagraph (B) of this paragraph, 
the Administrator shall not make payments under this section for 
travel performed by a special mode of travel unless (i) the travel by 
such mode is medically required and is authorized by the Adminis-
trator before the travel begins, or (ii) the travel by such mode is in 
connection with a medical emergency of such a nature that the 
delay incident to obtaining authorization from the Administrator to 
use that mode of travel would have been hazardous to the person's 
life or health. 
"(B) In the case of travel by a person to or from the Veteran's 
Administration facility by special mode of travel, the Administrator 
may provide payment under this section to the provider of the 
transportation by special mode before determining the eligibility of 
such person for such pajmtient if the Administrator determines that 
providing such pa3rment is in the best interest of furnishing care and 
services. Such a payment shall be made subject to subsequently 
recovering from such person the amount of the payment if such 
person is determined to have been ineligible for payment for such 
travel. 
"(cXD Except as otherwise provided in this subsection, the 
Administrator, in making a pa5rment under this section to or for a 
person described in subparagraph (A), (B), (C), or (D) of subsection 
(bXD of this section for travel for examination, treatment, or care, 
shall deduct from the amount otherwise payable an amount equal to 
$3 for each one-way trip. 
"(2) In the case of a person who is determined by the Adminis-
trator to be a person who is required to make six or more one-way 
trips for needed examination, treatment, or care during the remain-
der of the calendar month in which the determination is made or 
during any subsequent calendar month during the one-year period 
following the last day of the month in which the determination is 
made, the amount deducted by the Administrator pursuant to para-
graph (1) of this subsection from payments for trips made to or from 
such facility during any such month shall not, except as provided in 
paragraph (5) of this subsection, exceed $18. 
"(3) No deduction shall be made pursuant to paragraph (1) of this 
subsection in the case of a person whose travel to or from a 
Veterans' Administration facility is performed by a special mode of 
travel for which payment under this section is authorized under 
subsection (bX3) of this section. 
"(4) The Administrator may waive the deduction requirement of 
paragraph (1) of this subsection in the case of the travel of any 
veteran for whom the imposition of the deduction would cause 
severe Hnemcial hardship. The Administrator shall prescribe in Regulations. 
regulations the conditions under which a finding of severe financial 
hardship is warranted for purposes of this paragraph. 
"(5) Whenever the Administrator increases or decreases the rates 
of allowances or reimbursement to be paid under this section, the 
Administrator shall, effective on the date on which such increase or 
decrease takes effect, adjust proportionately the dollar amounts 
specified in paragraphs (1) and (2) of this subsection as such amounts 
102 STAT. 498 
PUBLIC LAW 100-322—MAY 20, 1988 
may have been increased or decreased pursuant to this paragraph 
before such date.". 
(b) VOLUNTEER TRANSPORTATION.—(1) Such section is further 
amended by adding at ihe end the following new subsection: 
"(h) The Administrator, in consultation and coordination with the 
Secretary of Transportation and appropriate representatives of vet-
erans' service organizations, shall take all appropriate steps to 
facilitate the establishment and maintenance of a program under 
which such organizations, or individuals who are volunteering their 
services to the Veterans' Administration, would take responsibility 
for the transportation, without reimbursement from the Veterans' 
Administration, to Veterans' Administration facilities of veterans 
(primarily those residing in areas which are geographically acces-
sible to such facilities) who seek services or benefits from the 
Veterans' Administration under chapter 17 or other provisions of 
this title.". 
Reports. 
(2) Not later than six months after the date of the enactment of 
this Act, the Administrator shall submit to the Committees on 
Veterans' Affairs of the Senate and the House of Representatives a 
report on the implementation of subsection (h) of section 111 of title 
38, United States Code, as added by paragraph (1). 
(c) CONFORMING AMENDMENTS.—Paragraph (4) of subsection (g) of 
such section (as redesignated by subsection (aXD) is amended— 
(1) by inserting "or adjusting amounts" after "rates" the first 
place it appears; and 
(2) by inserting "and amounts" after "rates" the third place it 
appears. 
(d) STYUSTIC AMENDMENTS.—Subsection (d) of such section (as 
redesignated by subsection (aXD) is amended— 
(1) in paragraph (1)— 
(A) by striking out "the" and inserting in lieu thereof 
"The"; and 
(B) by striking out "hereof;" and inserting in lieu thereof 
"of this section."; 
(2) in paragraph (2)— 
(A) by striking out "actual" and inserting in lieu thereof 
"Actual"; and 
(B) by striking out the semicolon at the end and inserting 
in lieu thereof a period; and 
(3) in paragraph (3), by striking out "the expense" and insert-
ing in lieu thereof "The expense". 
(e) CLERICAL AMENDMENTS.—(1) The heading of section 111 is 
amended to read as follows: 
"§ 111. Payments or allowances for beneHciary travel". 
(2) The item relating to such section in the table of sections at the 
beginning of chapter 1 is amended to read as follows: 
"111. Pa3rments or allowances for beneficiary travel.". 
38 use 111 note. 
(f) TRANSITION PROVISION.—In determining for the purposes of 
subsection (bXD of section 111 of title 38, United States Code, as 
amended by subsection (a), whether during fiscal year 1988 the 
Administrator has exercised the authority under that section to 
make pajrments there shall be disregarded any exercise of authority 
under that section before the date of the enactment of this Act. 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 499 
(g) EFFECTIVE DATE.—The amendments made by subsection (a) 
shall take effect with respect to travel performed after June 30, 
1988. 
PART B—PILOT PROGRAMS AND REPORTS 
SEC. 111. ADULT DAY HEALTH-CARE PROGRAM. 
(a) THREE-YEAR EXTENSION.—Section 620(f)(3) is amended by strik-
ing out "September 30, 1988" and inserting in lieu thereof "Septem-
ber 30,1991". 
(b) STUDY REQUIREMENT.—The Administrator shall conduct a 
38 use 620 note, 
study of— 
(1) the medical efficacy and the cost-effectiveness of furnish-
ing adult day health care under section 620(f) of title 38, United 
States Code, as an alternative to nursing home care; and 
(2) the comparative advantages and disadvantages of provid-
ing such care through facilities that are not under the direct 
jurisdiction of the Administrator and through facilities that are 
under the direct jurisdiction of the Administrator. 
(c) 
REPORTS.—(1) The Administrator 
shall 
submit to the 
Committees on Veterans' Affairs of the Senate and House of Rep-
resentatives— 
(A) an interim report on the study under subsection (b) not 
later than February 1,1988; and 
(B) a final report on such study not later than February 1, 
1991. 
(2) Each such report shall include— 
(A) the results of the study under subsection Ot)) through 
September 30 of the year preceding the deadline under para-
graph (1) for submission of the report; and 
_^ 
(B) any other recommendation that the Administrator con- ^~~" 
siders appropriate for legislative or administrative action with 
respect to the furnishing of adult day health care under section 
620(f) of title 38, United States Code. 
(d) REPEAL OF EXISTING STUDY AND REPORT REQUIREMENTS.— 
Subsections (b) and (c) of section 103 of Public Law 98-160 (38 U.S.C. 
620 note) are repealed. 
SEC. 
1
1
2
. 
REPORT 
ON 
USE 
OF 
CONTRACT-CARE 
AUTHORITIES. 
(a) REVISED REPORT REQUIREMENT.—Section 603 is amended by 
adding at the end the following new subsection: 
"(c) The Administrator shall include in the budget documents 
which the Administrator submits to Congress for any fiscal year a 
detailed report on the furnishing of contract care and services 
during the most recently completed fiscal year under this section, 
sections 612A, 620, 620A, 624, and 632 of this title, and section 115 of 
the Veterans' Benefits and Services Act of 1988.". 
Ot)) REPEAL OF PREVIOUS REQUIREMENT.—Section 2010)) of the Vet-
erans' Health Care Amendments of 1979 (Public Law 96-22; 93 Stat. 
54) is repealed. 
38 use 601 note. 
SEC. 113. PILOT PROGRAM OF MOBILE HEALTH-CARE CLINICS. 
38 USC 612 note. 
(a) PROGRAM.—(1) In order to evaluate the desirability of using Rural areas, 
mobile health-care clinics to increase the access to Veterans' 
Administration health-care services of veterans who reside in iso-
lated rural areas, the Administrator may conduct a pilot program 
under which eligible veterans residing in areas which are at least 
102 STAT. 500 
PUBLIC LAW 100-322—MAY 20, 1988 
100 miles from the nearest Veterans' Administration health-care 
facility are furnished health-care services at a location convenient to 
their residences by Veterans' Administration employees furnishing 
such services through the use of appropriately equipped mobile 
health-care clinics. The pilot program shall be conducted for a 
period of not less than 24 months. 
(2) The pilot program authorized by paragraph (1) shall be carried 
out using at least two mobile health-care clinics in each of the 
following geographic areas of the United States: the Northeast, the 
Midwest, the South, and the West. 
Appropriation 
Q)) FUNDING.—There is authorized to be appropriated $5,000,000 
authorization. 
for 
each of fiscal years 1989 and 1990 in order to carry out this 
section. No funds may be used for the pilot program unless specifi-
cally appropriated for that purpose. 
(c) EVALUATION.—In carrjdng out the pilot program, the Adminis-
trator shall evaluate the efficacy and cost-effectiveness of furnishing 
care to eligible veterans through the use of mobile health-care 
clinics. 
(d) REPORTS.—Not later than 20 months after the first health-care 
service under the pilot program is furnished, the Administrator 
shall submit to the Committees on Veterans' Affairs of the Senate 
and House of Representatives an interim report on the implementa-
tion, operation, and results of the first 17 months' experience under 
the pilot program. Not later than 27 months after the beginning of 
the pilot program, the Administrator shall submit to such commit-
tees a final such report. Each such report shall include the 
following: 
(1) Information on the health-care services that were fur-
nished under such pilot program and a detailed specification of 
the costs of furnishing such services. 
(2) Information describing the veterans who were furnished 
services under the pilot program, including a detailed descrip-
tion with respect to service connection, age, prior access to and 
use of Veterans' Administration care and services, and the 
financial need of such veterans. 
(3) The preliminary or final results of the Administrator's 
evaluation. 
(4) Any plans for administrative action, and any recommenda-
tions for legislation, that the Administrator considers appro-
priate to include in the report. 
38 use 612 note. 
SEC. 114. MODIFICATION OF REPORT ON CARE FURNISHED TO VETERANS 
HAVING CHRONIC MENTAL ILLNESS DISABILITIES. 
(a) REPORT ON INSTITUTIONAL CARE FURNISHED MENTALLY I I I 
VETERANS.—The report required by section 235 of the Veterans' 
Benefits Improvement and Health Care Authorization Act of 1986 
(Public Law 99-576; 100 Stat. 3266) shall, to the extent feasible, 
include (1) information on the number of veterans being treated by 
the Veterans' Administration for mental illness disabilities who 
were furnished hospital, domiciliary, or nursing home care by the 
Administrator during each of fiscal years 1986, 1987, and 1988, 
shown by type of care furnished and the duration of such care, and 
(2) the Administrator's analysis of any change in the numbers of 
veterans being furnished any type of such care during such fiscal 
vears, with particular emphasis on the effect of the implementation 
by 
t^e 
Veterans' 
Administration 
of a 
resource 
allocation 
methodology. 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 501 
(b) DEADLINE FOR SUBMISSION OF REPORT.—Notwithstanding the 
date specified in subsection (c) of such section, the report required by 
such section shall be submitted not later than December 15, 1988. 
SEC. 115. PILOT PROGRAM OF COMMUNITY-BASED RESIDENTIAL CARE 
38 USC 612 note. 
FOR HOMELESS CHRONICALLY MENTALLY ILL AND OTHER 
VETERANS. 
(a) AUTHORITY FOR PROGRAM.—(1) The Administrator shall con-
duct a pilot program to provide care and treatment and rehabilita-
tive services (directly or by contract) in halfway houses, therapeutic 
communities, psychiatric residential treatment centers, and other 
community-based treatment facilities to homeless veterans suffering 
from chronic mental illness disabilities who are eligible for care 
under section 610(aXl) of title 38, United States Code. 
(2) As part of the pilot program, the Administrator may also 
provide such care and treatment and rehabilitative services— 
(A) to veterans being furnished hospital or nursing home care 
by the Administrator for a chronic mental illness disability; and 
(B) to veterans with service-connected chronic mental illness 
disabilities. 
(b) CRITERIA FOR FACIUTIES.—Before furnishing care and treat 
ment and rehabilitative services by contract under subsection (a) to 
a veteran through a facility described in subsection (a), the Adminis-
trator shall approve (in accordance with criteria which the Adminis-
trator shall prescribe) the quality and effectiveness of the program 
operated by such facility for the purpose for which such veteran is to 
be furnished such care and services. 
(c) IN-KIND ASSISTANCE.—The Administrator may provide in-kind 
assistance (through the services of Veterans' 
Administration 
employees and the sharing of other Veterans' Administration re-
sources) to a facility described in subsection (a) under this section. 
Any such in-kind assistance shall be provided under a contract Contracts, 
between the Veterans' Administration and the contract facility. The 
Administrator may provide such assistance only for use solely in the 
furnishing of appropriate care and services under this section and 
only if, under such contract, the Veterans' Administration receives 
reimbursement for the full cost of such assistance, including the cost 
of services and supplies and normal depreciation and amortization 
of equipment. Such reimbursement may be made by reduction in the 
charges to the United States or by payment to the United States. 
Any funds received through such reimbursement shall be credited to 
funds allotted to the Veterans' Administration facility that provided 
the assistance. 
(d) DURATION OF PROGRAM.—The authority for the pilot program 
Termination 
authorized by this section expires on September 30,1989. 
date. 
(e) REPORT.—Not later than February 1, 1989, the Administrator 
shall submit to the Committees on Veterans' Affairs of the Senate 
and House of Representatives a report on the experience of the 
Veterans' Administration under the pilot program through Septem-
ber 30, 1988, and the recommendation of the Administrator (to-
gether with the reasons for such recommendation) as to whether the 
pilot program should be continued. 
(f) FUNDING.—(1) There is authorized to be appropriated for the Appropriation 
pilot program under this section $6,000,000 for each of fiscal years authorization. 
1988 and 1989. 
(2) Of the amounts appropriated for the pilot program for each 
such fiscal year, not less than $250,000 shall be expended for 
102 STAT. 502 
PUBLIC LAW 100-322—MAY 20, 1988 
management and monitoring of the program to ensure that a high 
quality of care is provided under the program and to ensure an 
accurate accounting of funds for the program. 
(3) During fiscal year 1989, funds may not be obligated for the 
pilot program under this section other than funds specifically appro-
priated for that program. 
(g) REPEAL OF CONTRACT AUTHORITY IN TITLE 38.—(1) Section 620C 
is repealed. 
(2) The table of sections at the beginning of chapter 17 is amended 
by striking out the item relating to that section. 
38 use 214 note. 
SEC. 116. REPORTS ON ASSISTANCE TO HOMELESS VETERANS. 
Not later than December 15 of each of 1988, 1989, and 1990, the 
Administrator shall submit to the Committees on Veterans' Affairs 
of the Senate and House of Representatives a report on the activities 
(including outreach activities and delivery of medical benefits and 
other benefits) of the Veterans' Administration during the preced-
ing fiscal year to assist homeless veterans. The report shall include 
any suggestions of the Administrator for changes in those activities. 
PART C—MATTERS RELATING TO AIDS 
SEC. 121. CONFIDENTIALITY OF MEDICAL RECORDS. 
(a) GENERAL RULE.—Subsection (a) of section 4132 is amended— 
(1) by inserting "(1)" before "Records"; 
(2) bv inserting "infection with the human immunodeficiency 
virus,' after "alcohol abuse,"; and 
(3) by adding at the end the following new paragraph: 
"(2) Paragraph (1) of this subsection prohibits the disclosure to any 
person or entity other than the patient or subject concerned of the 
fact that a special written consent is required in order for such 
records to be disclosed.". 
(b) PUBLIC HEALTH EXCEPTION.—Subsection (b) of such section is 
amended— 
(1) in paragraph (1), by striking out "pursuant to section 4134 
of this title"; and 
(2) in paragraph (2)— 
(A) by redesignating subparagraph (C) as subparagraph 
(D); and 
(B) by inserting after subparagraph (B) the following new 
subparagraph (C): 
State and local 
"(CXD In the case of any record which is maintained in 
governments. 
Connection with the performance of any program or activity 
relating to infection with the human immunodeficiency virus, 
to a Federal, State, or local public-health authority, charged 
under Federal or State law with the protection of the public 
health, and to which Federal or State law requires disclosure of 
such record, if a qualified representative of such authority has 
made a written request that such record be provided as required 
pursuant to such law for a purpose authorized by such law. 
"(ii) A person to whom a record is disclosed under this para-
graph may not redisclose or use such record for a purpose other 
than that for which the disclosure was made.". 
(c) DISCLOSURE TO SPOUSE OR SEXUAL PARTNER.—Such section is 
further amended— 
(1) by redesignating subsection (f) as subsection (g); and 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 503 
(2) by inserting after subsection (e) the following new subsec-
tion (f): 
"(fKD Notwithstanding subsection (a) of this section but subject to Health care 
paragraph (2) of this subsection, a physician or a professional coun- professionals, 
selor may disclose information or records indicating that a patient 
or subject is infected with the human immunodeficiency virus if the 
disclosure is made to (A) the spouse of the patient or subject, or (B) 
to an individual whom the patient or subject has, during the process 
of professional counseling or of testing to determine whether the 
patient or subject is infected with such virus, identified as being a 
sexual partner of such patient or subject. 
"(2XA) A disclosure under paragraph (1) of this subsection may be 
made only if the physician or counselor, after making reasonable 
efforts to counsel and encourage the patient or subject to provide the . 
information to the spouse or sexual partner, reasonably believes 
that the patient or subject will not provide the information to the 
spouse or sexual partner and that the disclosure is necessary to 
protect the health of the spouse or sexual partner. 
"(B) A disclosure under such paragraph may be made by a physi-
cian or counselor other than the physician or counselor referred to 
in subparagraph (A) of this paragraph if such physician or counselor 
is unavailable by reason of absence or termination of employment to 
make the disclosure. 
(d) PENALTY FOR UNAUTHORIZED DISCLOSURE.—Subsection (g) of 
such section (as redesignated by paragraph (4XA)) is amended by 
striking out "shall be fined" and all that follows and inserting in 
lieu thereof "shall be fined, in the case of a first offense, up to the 
maximum amount provided under section 3301(f) of this title for a 
first offense under that section and, in the case of a subsequent 
offense, up to the maximum amount provided under section 3301(f) 
of this title for a subsequent offense under that section.". 
(e) CROSS-REFERENCE AMENDMENTS.—(1) Subsection (a) of such 
section is amended by striking out "subsection (e)" and inserting in 
lieu thereof "subsections (e) and (f)". 
(2) Subsection (c) of such section is amended by striking out 
"subsection (bX2)(C)" and inserting in lieu thereof "subsection 
OaX2XD)". 
SEC. 122. NONDISCRIMINATION. 
(a) ADMISSION AND TREATMENT OF PERSONS INFECTED WITH THE 
HUMAN IMMUNODEFICIENCY VIRUS.—-Sections 4133 and 4134 
are 
amended to read as follows: 
"§ 4133. Nondiscrimination against alcohol and drug abusers and 
persons infected with the human immunodeficiency 
virus 
"(a) Veterans eligible for treatment under chapter 17 of this title 
who are alcohol or drug abusers or who are infected with the human 
immunodeficiency virus shall not be discriminated against in admis-
sion or treatment by any Veterans' Administration health-care 
facility solely because of their alcohol or drug abuse or dependency 
or because of their viral infection. 
"(b) The Administrator shall prescribe regulations for the enforce- Regulations, 
ment of this section. Such regulations, with respect to the admission 
and treatment of such veterans who are alcohol or drug abusers, 
shall be prescribed in accordance with section 4134 of this title. 
102 STAT. 504 
PUBLIC LAW 100-322—MAY 20, 1988 
*'§ 4134. Regulations 
Research and 
"(a) Regulations prescribed by the Administrator under section 
development. 
4131 of this title, section 4132 of this title with respect to the 
confidentiality of alcohol and drug abuse medical records, and sec-
tion 4133 of this title with respect to alcohol or drug abusers shall, to 
the maximum extent feasible consistent with other provisions of this 
title, make applicable the regulations described in subsection (b) of 
this section to the conduct of research and to the provision of 
hospital care, nursing home care, domiciliary care, and medical 
services under this title. 
"(b) The regulations referred to in subsection (a) of this section 
are— 
"(1) regulations governing human experimentation and in-
formed consent prescribed by the Secretary of Health and 
Human Services, based on the recommendations of the National 
Commission for the Protection of Human Subjects of Biomedical 
and Behavioral Research, established by section 201 of the 
National Research Act (Public Law 93-348; 88 Stat. 348); and 
"(2) regulations governing (A) the confidentiality of drug and 
alcohol abuse medical records, and (B) the admission of drug 
and alcohol abusers to private and public hospitals, prescribed 
pursuant to the Comprehensive Alcohol Abuse and Alcoholism 
Prevention, Treatment, and Rehabilitation Act of 1970 (42 
U.S.C. 4551 et seq.) and the Drug Abuse Office and Treatment 
Act of 1972 (21 U.S.C. 1101 et seq.). 
"(c) Regulations prescribed by the Administrator under sections 
4131, 4132, and 4133 of this title may contain such definitions, and 
may provide for such safeguards and procedures (including proce-
dures and criteria for the issuance and scope of court orders under 
section 4132(bX2XC) of this title), as are necessary to prevent cir-
cumvention or evasion of such regulations or to facilitate compli-
ance with such regulations. 
"(d) In prescribing and implementing such regulations, the 
Administrator shall, from time to time, consult with the Secretary 
of Health and Human Services and, as appropriate, with the Presi-
dent (or the delegate of the President) in order to achieve the 
maximum possible coordination of the regulations, and 
the 
implementation of the regulations, which they and the Adminis-
trator prescribe.". 
(b) CLERICAL AMENDMENT.—The items relating to sections 4133 
and 4134 in the table of sections at the beginning of chapter 73 of 
such title are amended to read as follows: 
"4133. Nondiscrimination against alcohol and drug abusers and persons infected 
with human immunodeficiency virus. 
"4134. Regulations.". 
38 use 210 note. 
SEC. 123. INFORMATION AND TRAINING CONCERNING AIDS PREVENTION. 
(a) INFORMATION PROGRAM.—The Administrator shall establish 
and carry out an information program relating to the acquired 
immune deficiency S3nidrome (hereineifter in this section referred to 
as "AIDS"). The information program shall be for employees and 
consultants of the Veterans' Administration, for other persons 
providing services in Veterans' Administration facilities to bene-
ficiaries of programs administered by the Veterans' Administration, 
and for such beneficiaries. 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 505 
(b) REQUIRED ELEMENTS OF INFORMATION PROGRAM.—In conduct-
ing the program under subsection (a), the Administrator shall— 
(1) develop, in consultation with the Surgeon General of the 
United States and the Director of the Centers for Disease 
Control, publications and other materials containing informa-
tion on AIDS, including information on the prevention of infec-
tion with the human immunodeficiency virus; 
(2) provide for periodic dissemination of publications (includ-
ing the Surgeon General's Report on AIDS) and other materials 
containing such information; 
(3) make publications and other suitable materials containing 
such information readily available in Veterans' Administration 
health-care facilities and such other Veterans' Administration 
facilities as the Administrator considers appropriate; and 
(4) disseminate information (including the Surgeon General's 
Report on AIDS) on the risk of transmission of the human 
immunodeficiency virus, and information on preventing the 
transmission of such virus, to Veterans' Administration sub-
stance abuse treatment personnel, to each person being fur-
nished treatment by the Veterans' Administration for drug 
abuse, and to each person receiving care or services from the 
Veterans' Administration whom the Administrator believes to 
be at high risk for AIDS. 
(c) TRAINING IN AIDS PREVENTION.—The Administrator shall 
establish and carry out a program that provides for education, 
training, and other activities (including continuing education and 
infection control programs) regarding AIDS and the human 
immunodeficiency virus designed to improve the effectiveness and 
safety of all health-care personnel and all health-care support 
personnel involved in the furnishing of care under programs 
administered by the Veterans' Administration. 
SEC. 124. RESTRICTION ON TESTING FOR INFECTION WITH THE HUMAN 
IMMUNODEFICIENCY VIRUS. 
(a) GENERAL RULE.—Except as provided in subsection (b), the 
Administrator may not during any fiscal year conduct a widespread 
testing program to determine infection of humans with the human 
immunodeficiency virus unless funds have been appropriated to the 
Veterans' Administration specifically for such a program during 
that fiscal year. 
(b) VOLUNTARY TESTING.—(1) The Administrator shall provide for 
a program under which the Veterans' Administration offers each 
patient to whom the Veterans' Administration is furnishing health 
care or services and who is described in paragraph (2) the oppor-
tunity to be tested to determine whether such patient is infected 
with the human immunodeficiency virus. 
(2) Patients referred to in paragraph (1) are— 
(A) patients who are receiving treatment for intravenous drug 
abuse, 
(B) patients who are receiving treatment for a disease associ-
ated with the human immunodeficiency virus, and 
(C) patients who are otherwise at high risk for infection with 
such virus. 
(3) Subject to the consent requirement in paragraph (4) and unless 
medically contraindicated, the test shall be administered to each 
patient requesting to be tested for infection with such virus. 
Education. 
38 u s e 4133 
note. 
Drugs and 
drug abuse. 
Diseases. 
102 STAT. 506 
PUBLIC LAW 100-322—MAY 20, 1988 
(4) A test may not be conducted under this subsection without the 
prior informed and separate written consent of the patient tested. 
The Administrator shall provide pre- and post-test counseling 
regarding the acquired immune deficiency s3mdrome and the test to 
each patient who is administered the test. 
PART D—OTHER MATTERS 
SEC. 131. DEFINITION OF VETERANS' ADMINISTRATION MEDICAL FACILI-
TIES TO INCLUDE CERTAIN RECREATIONAL FACILITIES. 
Section 601(4) is amended— 
(1) by striking out "and" at the end of clause (A); 
(2) by striking out the period at the end of clause (B) and 
inserting in lieu thereof "; and"; and 
(3) by adding at the end the following: 
"(C) public or private facilities at which the Administrator 
provides recreational activities for patients receiving care under 
section 610 of this title.". 
SEC. 132. VETERANS' ADMINISTRATION ASSISTANCE WITH REHABILITA-
TION ACTIVITIES. 
(a) IN GENERAL.—Chapter 3 is amended by inserting after section 
215 the following new section: 
38 use 216. 
"§ 216. Assistance to certain rehabilitation activities 
"(a) The Administrator may assist any organization named in or 
approved under section 3402 of this title in providing recreational 
activities which would further the rehabilitation of disabled vet-
erans. Such assistance may be provided only i
f
— 
"(1) the activities are available to disabled veterans on a 
national basis; and 
"(2) a significant percentage of the individuals participating 
in the activities are eligible for rehabilitative services under 
chapter 17 of this title. 
"(b) The Administrator may accept from any appropriate source 
contributions of funds and of other assistance to support the 
Administrator's provision of assistance for such activities. 
"(cXD Subject to paragraph (2) of this subsection, the Adminis-
trator may authorize the use, for purposes approved by the Adminis-
trator in connection with the activity involved, of the seal and other 
official S3anbols of the Veterans' Administration and the name 
'Veterans' Administration' by— 
"(A) any organization which provides an activity described in 
subsection (a) of this section with assistsmce from the Adminis-
trator; and 
"(B) any individual or entity from which the Administrator 
accepts a significant contribution under subsection (b) of this 
section or an offer of such a contribution. 
"(2) The use of such seal or name or any official sjonbol of the 
Veterans' Administration in an advertisement may be authorized by 
the Administrator under this subsection only i
f
— 
"(A) the Administrator has approved the advertisement; and 
"(B) the advertisement contains a clear statement that no 
product, project, or commercial line of endeavor referred to 
in 
the 
advertisement 
is endorsed 
by the 
Veterans' 
Administration.". 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 507 
(b) CLERICAL AMENDMENT.—The table of sections at the beginning 
of such chapter is amended by inserting after the item relating to 
section 215 the following new item: 
"216. Assistance to certain rehabilitation activities.". 
SEC. 
1
3
3
. 
RULES 
AND 
REGULATIONS 
RELATING 
TO 
VETERANS' 
HEALTH 
CARE. 
The text of section 621 is amended to read as follows: 
"Rules and regulations prescribed under section 210(cXl) of this 
title shall include rules and regulations to promote good conduct on 
the part of persons who are receiving hospital, nursing home, and 
domiciliary care and medical services in Veterans' Administration 
facilities. The Administrator may prescribe in rules and regulations 
under such section limitations in connection with the furnishing of 
such care and services during a period of national emergency (other 
than a period of war or an emergency described in section 5011A of 
this title).". 
SEC. 134. PER DIEM RATES FOR CARE IN STATE HOMES. 
(a) INCREASES IN RATES.—Section 641 is amended— 
(1) in subsection (a), by striking out clauses (1) through (3) and 
inserting in lieu thereof the following: 
"(1) $8.70 for domiciliary care; and 
"(2) $20.35 for nursing home care and hospital care,"; and 
(2) by adding at the end the following new subsection: 
"(d) Whenever the Administrator makes a determination pursu-
ant to section 620(aX2XA) of this title that the cost of care furnished 
by the Veterans' Administration in a general hospital under the 
direct jurisdiction of the Administrator has increased, the Adminis-
trator may, effective no earlier than the date of such determination, 
increase the rates paid under subsection (a) of this section by a 
percentage not greater than the percentage by which the Adminis-
trator has determined that such cost of care has increased.". 
(b) EFFECTIVE DATES.—(1) The amendment made by subsection 
(a)(1) shall take effect as of January 1,1988. 
(2) The amendment made by subsection (a)(2) shall take effect on 
October 1,1988. 
SEC. 135. MEDICAL RESEARCH. 
Section 4101(cXl) is amended by striking out the parenthetical 
phrEise and inserting in lieu thereof "(including biomedical, mental 
illness, prosthetic and other rehabilitative, and health-care-services 
research and stressing research into spinal-cord injuries and other 
diseases that lead to paralysis of the lower extremities and research 
into injuries and illnesses particularly related to service)". 
SEC. 136. CONVERSION OF UNDERUSED SPACE TO DOMICILIARY-CARE 
BEDS. 
(a) IN GENERAL.—(1) Subject to subsection Ot)), the Administrator 
shall, not later than June 1, 1988, in urban areas in which there are 
significant numbers of homeless veterans, convert underused space 
located in facilities under the jurisdiction of the Administrator to 
500 domiciliary-care beds to be used for the care of veterans in need 
of domiciliary care, primarily homeless veterans. 
(2) If the Administrator determines that it is impractical to under-
take the conversions required in paragraph (1) to the extent 
required in that paragraph— 
38 use 641 note. 
38 u s e 5010 
note. 
Urban areas. 
Homeless 
persons. 
19-194 O—91—Part 1 
18 : QL 3 
102 STAT. 508 
PUBLIC LAW 100-322—MAY 20, 1988 
(A) because appropriate space for the conversions is not avail-
able in sufficient quantity, or 
(B) because in areas in which there is sufficient space the 
numbers of homeless veterans in need of domiciliary care who 
would likely use the beds are not sufficient to warrant the 
conversions, 
the Administrator shall carry out paragraph (1) only to the extent 
that the Administrator has not determined that it is impractical to 
do so. 
(b) PROHIBITION AGAINST DIMINUTION OF CERTAIN OTHER CONVER-
SIONS.—Nothing in this section shall result in the diminution of the 
conversion of hospital-care beds to nursing-home-care beds by the 
Veterans' Administration. 
(c) FUNDING.—The Administrator shall carry out subsection (a) 
within the limits of available appropriations. 
TITLE II—HEALTH-CARE ADMINISTRATION AND 
PERSONNEL MATTERS 
PART A—ADMINISTRATION 
38 use 4151 
SEC. 201. HEALTH CARE QUALITY ASSURANCE ACTIVITIES. 
(a) ACTIONS TO IMPROVE QUALITY ASSURANCE ACTIVITIES.—Not 
later than 60 days after the date of the enactment of this Act, the 
Administrator shall take actions to improve the operation of health-
care quality assurance programs and activities in the Veterans' 
Administration, including actions to achieve the following purposes: 
(1) Upgrading the Office of Quality Assurance within the 
Department of Medicine and Surgery Central Office and assign-
ing responsibility for risk-management activities (to be carried 
out with the concurrence of the General Counsel) to it. 
(2) Expanding, and assigning higher priority and greater 
resources to, quality-assurance programs and activities at each 
Veterans' Administration health-care facility, including im-
plementation of the review (known as "occurrence screening") 
of patient records for adverse events which are not the natural 
consequence of the patient's disease, injury, or treatment and 
the maximum use of the facility's computerized management 
information system for such activities. 
(3) Upgrading and expanding the office of the Medical Inspec-
tor in the Department of Medicine and Surgery Central Office, 
including increasing the number of employees assigned to such 
office on a full-time basis, so as to ensure that each medical 
inspection carried out by that office includes at least one such 
full-time employee and otherwise ensuring such adequate num-
bers of, and such skills and training on the part of, the employ-
ees assigned to that office as are necessary to ensure the 
independence, objectivity, and accountability of that office. 
(4) Upgrading and expanding the activities of the Veterans' 
Administration s Office of Inspector General in overseeing, 
monitoring, and evaluating the operations of the Department of 
Medicine and Surgery's quality-assurance programs and activi-
ties and its Medical Inspector office so as to provide the Chief 
Medical Director, the Administrator, and the Congress with 
clear and objective assessments of the effectiveness of those 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 509 
programs and operations, including ensuring such numbers of, 
and such skills and training on the part of, employees assigned 
to the Office of the Inspector General as are necessary to carry 
out such oversight, monitoring, and evaluation effectively, 
(b) REPORT.—Not later than 75 days after the date of the enact-
ment of this Act, the Administrator shall submit to the Committees 
on Veterans' Affairs of the Senate and the House of Representa-
tives, a report describing the actions taken pursuant to subsection 
(a), includJjig reports of the Chief Medical Director and the Inspector 
General of the Veterans' Administration on such actions, and any 
future actions planned (and a timetable therefor) in connection with 
such actions. The report shall include— 
(1) the Administrator's views on (A) the effectiveness of qual-
ity assurance and risk management and medical inspection 
programs and activities in the Department of Medicine and 
Surgery and of the oversight, monitoring, and evaluation of 
those programs and activities before the implementation of the 
actions described in the preceding sentence, and (B) how those 
actions will improve the effectiveness of these programs and 
activities; and 
(2) a description of actions that have been or will be taken 
(and the justification for those actions) by the Administrator, 
the Inspector General, and the Chief Medical Director, as ap-
propriate, to make other improvements in such programs 
and activities and the oversight, monitoring, and evaluation 
therefor. 
SEC. 202. HOSPITAL COST COLLECTIONS. 
Section 629(bX2) is amended by adding at the end the following 
new subparagraph: 
"(C) A proceeding under subparagraph (B) of this paragraph may 
not be brought after the end of the six-year period beginning on the 
last day on which the care or services for which recovery is sought 
are furnished.". 
SEC. 203. TORT CLAIMS. 
(a) INAPPOCABIHTY OF AN EXCEPTION RELATING TO FEDERAL TORT 
CLAIMS IN MEDICAL MALPRACTICE AND NEGUGENCE CASES.—(1) Sec-
tion 4116 is amended by adding at the end the following new 
subsection: 
"(f) The exception provided in section 2680(h) of title 28 shall not 
apply to any claim arising out of a negligent or wrongful act or 
omission of any person described in subsection (a) of this section in 
furnishing medical care or treatment (including medical care or 
treatment furnished in the course of a clinical study or investiga-
tion) while in the exercise of such person's duties in or for the 
Department of Medicine and Surgery. . 
(2) The amendment made by paragraph (1) shall apply with 38USC4116 
respect to claims as to which a final Judgment has not been rendered i^o^-
as of the date of the enactment of this Act. 
(b) INCREASED AUTHORITY TO ADJUST TORT CLAIMS ADMINISTRA-
TIVELY.—(1) Subchapter II of chapter 3 is amended by adding at the 
end the following new section: 
'*§ 223. Administrative settlement of tort claims 
38 USC 223. 
"(a) Notwithstanding the limitations contained in section 2672 of 
title 28, the Administrator may settle any claim for money damages 
102 STAT. 510 
PUBLIC LAW 100-322—MAY 20, 1988 
against the United States cognizable under section 1346(b) or 2672 of 
title 28 or section 4116 of this title to the extent the authority to do 
so is delegated to the Administrator by the Attorney General. Such 
delegation may not exceed the authority delegated by the Attorney 
Greneral to United States attorneys to settle claims for money 
damages against the United States. 
"(b) For purposes of this subsection, the term 'settle', with respect 
to a claim, means consider, ascertain, adjust, determine, and dispose 
of the claim, whether by full or partial allowance or by 
disallowance.". 
(2) The table of sections at the beginning of chapter 3 is amended 
by inserting after the item relating to section 222 the following: 
"223. Administrative settlement of tort claims.". 
SEC. 204. NONPROFIT RESEARCH CORPORATIONS. 
(a) AUTHORITY OF ADMINISTRATOR.—Chapter 73 is amended by 
adding at the end the following new subchapter: 
"SUBCHAPTER VI—RESEARCH CORPORATIONS 
38 use 4161. 
"§ 4161. Authority to establish; status 
"(a) The Administrator may authorize the establishment at any 
Veterans' Administration medical center of a nonprofit corporation 
to provide a flexible funding mechanism for the conduct of approved 
research at the medical center. Except as otherwise required in this 
subchapter or under regulations prescribed by the Administrator, 
any such corporation, and its directors and employees, shall be 
required to comply only with those Federal laws, regulations, and 
executive orders and directives which apply generally to private 
nonprofit corporations. 
"(b) If by the end of the three-year period beginning on the date of 
the establishment of a corporation under this subchapter the cor-
poration is not recognized as an entity the income of which is 
exempt from taxation under section 501(c)(3) of the Internal Reve-
nue Code of 1986, the Administrator shall dissolve the corporation. 
38 use 4162. 
"§ 4162. Purpose of corporations 
"Any corporation established under this subchapter shall be 
established solely to facilitate research as described in section 
4101(c)(1) of this title in conjunction with the applicable Veterans' 
Administration medical center. Any funds received by the Adminis-
trator for the conduct of research at the medical center other than 
funds appropriated to the Veterans' Administration may be trans-
ferred to and administered by the corporation for that purpose. 
38 use 4163. 
"§ 4163. Board of directors; executive director 
"(a) The Administrator shall provide for the appointment of a 
board of directors for any corporation established under this sub-
chapter. The board shall include— 
"(1) the director of the medical center, the chief of staff of the 
medical center, and the assistant chief of staff for research of 
the medical center; and 
"(2) subject to subsection (c) of this section, members who are 
not officers or employees of the Federal Government and who 
are familiar with issues involving medical and scientific 
research. 
PUBLIC LAW 100-322—MAY 20,1988 
102 STAT. 511 
"(b) Each such corporation shall have an executive director who 
shall be appointed by the board of directors with the concurrence of 
the Chief Medical Director of the Veterans' Administration. The 
executive director of a corporation shall be responsible for the 
operations of the corporation and shall have such specific duties and 
responsibilities as the board may prescribe. 
"(c) An individual appointed under subsection (aX2) of this section 
to the board of directors of a corporation established under this 
subchapter may not be affiliated with, employed by, or have any 
other financial relationship with any entity that is a source of 
funding for research by the Veterans' Administration unless that 
source of funding is a governmental entity or an entity the income 
of which is exempt from tsixation under section 501(cX3) of the 
Internal Revenue Code of 1986. 
"§ 4164. General powers 
"(a) A corporation established under this subchapter may— 
"(1) accept gifts and grants from, and enter into contracts 
with, individuals and public and private entities solely to carry 
out the purposes of this subchapter; and 
"(2) employ such employees as it considers necessary for such 
purposes and fix the compensation of such employees. 
"(b) A corporation established under this subchapter may not 
spend funds for a research project unless the project is approved in 
accordance with procedures prescribed by the Chief Medical Direc-
tor for research carried out with Veterans' Administration funds. 
Such procedures shall include a peer review process. 
"§ 4165. Applicable State law 
"Any corporation established under this subchapter shall be 
established in accordance with the nonprofit corporation laws of the 
State in which the applicable medical center is located and shall, to 
the extent not inconsistent with any Federal law, be subject to the 
laws of such State. 
"§ 4166. Accountability and oversight 
"(aXlXA) The records of a corporation established under this 
subchapter shall be available to the Administrator. 
"(B) For the purposes of sections 4(aXl) and 6(aXl) of the Inspector 
General Act of 1978, the programs and operations of such a corpora-
tion shall be considered to be programs and operations of the 
Veterans' Administration with respect to which the Inspector Gen-
eral of the Veterans' Administration has responsibilities under such 
Act. 
"(2) Such a corporation shall be considered an agency for the 
purposes of section 716 of title 31 (relating to availability of informa-
tion and inspection of records by the Comptroller General). 
"(b) Each such corporation shall submit to the Administrator an 
annual report providing a detailed statement of its operations, 
activities, and accomplishments during that year. The corporation 
shall obtain a report of independent auditors concerning the receipts 
and expenditures of funds by the corporation during that year and 
shall include that report in the corporation's report to the Adminis-
trator for that year. 
"(c) E^ch member of the board of directors of a corporation 
established imder this subchapter, each employee of such a corpora-
38 use 4164. 
Gifts. 
Grants. 
Contracts. 
38 use 4165. 
38 use 4166. 
Records. 
Reports. 
102 STAT. 512 
PUBLIC LAW 100-322—MAY 20, 1988 
tion, and each employee of the Veterans' Administration who is 
involved in the functions of the corporation during any year— 
"(1) shall be subject to Federal laws and 
regulations 
applicable to Federal employees with respect to conflicts of 
interest in the performance of official functions; and 
"(2) shall submit to the Administrator an annual statement 
signed by the director or employee certifying that the director 
or employee is aware of, and has complied with, such laws and 
regulations in the same manner as Federal employees are 
required to. 
"(d) The Administrator shall submit to the Committees on Veter-
ans' Affairs of the Senate and House of Representatives an annual 
report on the number and location of corporations established and 
the amount of the contributions made to each such corporation. 
38 use 4167. 
"§ 4167. Report to Congress 
"Not later than February 1, 1991, the Administrator shall submit 
to Congress a report on the experience through the end of fiscal year 
1990 under this subchapter. The report shall include such rec-
ommendations as the Administrator considers appropriate. 
38 use 4168. 
"§ 4168. Expiration of authority 
"No corporation may be established under this subchapter after 
September 30,1991.". 
(b) CLERICAL AMENDMENT.—The table of sections at the beginning 
of such chapter is amended by adding at the end the following: 
"SUBCHAPTER VI—RESEARCH CORPORATIONS 
"4161. Authority to establish; status. 
"4162. Purpose of corporations. 
"4163. Board of directors; executive director. 
"4164. General powers. 
"4165. Applicable State law. 
"4166. Accountability and oversight. 
"4167. Report to Congress. 
"4168. Expiration of authority.". 
SEC. 205. NURSING HOME REVOLVING FUND. 
(a) EsTABusHMENT OF FuND.—Chapter 81 is amended by inserting 
after section 5015 the following new section: 
38 use 5016. 
"§ 5016. Nursing home revolving fund 
"(aXD Amounts realized from a transfer pursuant to section 
5022(aX2XC) of this title shall be administered as a revolving fund 
and shall be available without fiscal year limitation*. 
"(2) The revolving fund shall be deposited in a checking account 
with the Treasurer of the United States. 
"(bXD The expenditure of funds from the revolving fund may be 
made only for the construction, alteration, and acquisition (includ-
ing site acquisition) of nursing home facilities and may be made only 
as provided for in appropriation Acts. 
(2) For the purpose of section 5004(aX2) of this title, a bill, 
resolution, or amendment which provides that funds in the revolv-
ing fund may be expended for a project involving a total expenditure 
of more than $2,000,000 for the construction, alteration, or acquisi-
tion (including site acquisition) of a nursing home facility shall be 
considered to be a bill, resolution, or amendment making an appro-
priation which may be expended for a major medical facility 
project". 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 513 
(b) CLERICAL AMENDMENT.—The table of sections at the beginning 
of such chapter is amended by adding at the end the following new 
item: 
"5016. Nursing home revolving fund.". 
SEC. 206. STATE HOME CONSTRUCTION GRANTS. 
(a) DATE OF LIST OF APPROVED PROJECTS.—Section 5035(b)(4) is 
amended by striking out "July 1" and inserting in lieu thereof 
"August 15^'. 
(b) CONDITIONAL APPROVAL OF APPLICATIONS.—Section 5035(b) is 
amended— 
(1) in paragraph (4), by inserting "(including projects that 
have been conditionally approved under paragraph (6) of this 
subsection)" after "projects'; and 
(2) by adding at the end the following new paragraphs: 
"(6XA) The Administrator may conditionally approve a project 
under this section, conditionally award a grant for the project, and 
obligate funds for the grant if the Administrator determines that 
the application for the grant is sufficiently complete to warrant 
awarding the grant and that, based on assurances provided by the 
State submitting the application, the State will complete the ap-
plication and meet all the requirements referred to in paragraph 
(IXA) of this subsection by the date, not later than 90 days after the 
date of the conditional approval, specified by the Administrator. 
"(B) If a State does not complete the application and meet all the 
requirements referred to in such paragraph by the date specified by 
the Administrator under subparagraph (A) of this paragraph, the 
Administrator shall rescind the conditional approval and award 
under such subparagraph and deobligate the funds previously obli-
gated in connection with the application. 
"(7XA) Subject to subparagraph (B) of this paragraph, the 
Administrator may increase the amount of any grant awarded to 
any State for a project under this section by an amount by which the 
Administrator determines that the estimated cost of the construc-
tion or acquisition has increased from the estimated cost on which 
the Administrator based the determination to award the grant, 
without regard to the position of such project on the list established 
under paragraph (4) of this subsection, if the Administrator deter-
mines that the grant was awarded before the State entered into a 
contract for the construction or acquisition provided for in such 
project. 
"(B) A grant may not be increased under subparagraph (A) of this 
paragraph by more than 10 percent of the amount of the grant 
initially awarded for such project, and the amount of such grant, as 
incresised, may not exceed 65 percent of the cost of the project.". 
PART B—PAY AND OTHER PERSONNEL BENEFITS 
SEC. 211. ADDITIONAL PAY AUTHORITIES FOR NURSES TO BE AVAILABLE 
FOR PHARMACISTS AND OCCUPATIONAL THERAPISTS. 
(a) CATEGORY OF APPOINTMENT.—Section 4104 is amended— 
(1) in paragraph (2), by striking out "Pharmacists" and all 
that follows through "therapists" and inserting in lieu thereof 
"Psychologists (other than those described in paragraph (3) of 
this section)"; and 
(2) in paragraph (3)— 
102 STAT. 514 
PUBLIC LAW 100-322-MAY 20, 1988 
(A) by striking out "and"; and 
(B) by inserting ", pharmacists, and occupational thera-
pists" after "nurses" . 
O
b
) AUTHORITY FOR PREMIUM PAY.—The second sentence of section 
4107(f) is amended— 
(1) by striking out "or licensed" and inserting in lieu thereof 
"licensed"; and 
(2) inserting "pharmacists, or occupational therapists," after 
"nurses,". 
SEC. 212. RECRUITMENT AND RETENTION BONUS PAY. 
(a) AUTHORITY TO PAY BONUS.—Chapter 73 is amended by insert-
ing after section 4119 the following new section: 
38 use 4120. 
"§ 4120. Recruitment and retention bonus pay for nurses and 
certain other health-care personnel 
Contracts. 
"(a)(1) In order to recruit and retain registered nurses, the 
Administrator may enter into agreements under this section. Such 
an agreement may be entered into with any registered nurse who is 
employed at, or who agrees to accept employment with the Veter-
ans' Administration at, a Veterans' Administration health-care 
facility that is designated by the Administrator as a health-care 
facility with a significant shortage in registered nurses in any 
clinical service. 
"(2) A registered nurse entering into an agreement under this 
section shall agree to remain employed by the Veterans' Adminis-
tration as a registered nurse for a period of time to be specified in 
the agreement and to serve during that period in a specific health-
care facility that is designated by the Administrator as a health-care 
facility with a significant shortage of registered nurses in that 
nurse s clinical service. Such period may not be less than two years 
or more than four years. Such employment during such period may 
be on a full-time basis or a part-time basis, as specified in the 
agreement. Part-time employment as specified in such an agree-
ment may not be less than half-time. 
"(b)(1) The Administrator shall pay to any nurse entering into an 
agreement under this section bonus pay in an amount specified in 
the agreement. The amount of such bonus pay may not exceed— 
"(A) $2,000 per year, in the case of an agreement for two 
years, 
"(B) $3,000 per year, in the case of an agreement for three 
years, and 
"(C) $4,000 per year, in the case of an agreement for four 
years. 
"(2) In the case of an agreement for employment on less than a 
full-time basis, the amount of bonus pay shall be pro rated 
accordingly. 
"(cXD Except as provided in paragraph (2) of this subsection, a 
bonus under this section shall be paid in equal installments after 
each year of service is completed throughout the period of obligated 
service specified in the agreement. 
"(2XA) The Administrator 
may make a payment 
in 
an 
amount not in excess of 25 percent of the total bonus in a lump sum 
at the time that the period of obligated service commences under 
the agreement. 
"(B) If the Administrator makes a lump-sum payment under 
subparagraph (A) of this paragraph, the remaining balance of the 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 515 
bonus shall be paid in equal installments after each year of service 
is completed throughout the period of obligated service specified in 
the agreement. 
"(dXl) A bonus paid to any individual under this section shall be 
in addition to any pay or allowance to which the individual is 
entitled. 
"(2) The amount of a bonus paid under this section shall not be 
considered to be basic pay for the purposes of sections 5551, 5552, 
and 5595 of title 5, chapters 81, 83, 84, and 87 of such title, or any 
other provision of law creating an entitlement to benefits based on 
basic pay. 
"(e) At least once each year the Administrator, upon the rec-
ommendation of the Chief Medical Director, shall determine the 
specific health-care facilities and clinical services, if any, as to which 
there are significant problems with respect to the recruitment and 
retention of registered nurses. Upon making any such determina-
tion, the Administrator shall promptly notify the Committees on 
Veterans' Affairs of the Senate and the House of Representatives of 
the determination and the basis for the determination. 
"(f) The Administrator may enter into agreements under this CJontracts. 
section with individuals in a health profession other than nursing 
(and other than a health profession for which special pay may be 
provided under section 4118 of this title) if the Administrator deter-
mines that there are significant problems with respect to recruit-
ment and retention of employees in that health profession. The 
Administrator's authority to enter into any such agreement under 
this section, and such agreement, shall be subject to the provisions 
of this section in the same manner as are the authority to enter into 
an agreement under this section with a registered nurse and such 
an agreement. 
"(gXD Except as provided in paragraph (2) of this subsection, an 
individual who voluntarily, or because of misconduct, fails to per-
form services as assigned by the Administrator for the period of 
obligated service provided in an agreement under this section shall 
refund to the United States the amount by which the total amount 
of bonus payments received by that individual under this section 
exceeds the amount that such individual would have received under 
an agreement under this section to serve for the period of obligated 
service actually served (as determined at the time the agreement is 
entered into). If the period actually served is less than two years, the 
amount to be refunded is the entire amount paid to the individual. 
"(2) An individual shall not be required to make a refund under 
paragraph (1) of this subsection if the Administrator determines, in 
accordance with regulations prescribed under subsection (h) of this 
section, that the individual's failure to perform services for the 
period of obligated service is due to circumstances (not including 
separation for cause) beyond the control of the individual. 
"(3) An obligation to refund any portion of a bonus payment under 
this subsection is, for all purposes, a debt owed to the United States. 
"(4) The provisions of this subsection and the specific amounts 
that the individual could be required to refund shall be disclosed to 
the individual at the time the agreement is entered into and shall be 
clearly set forth in the contract. 
"(h) The Administrator shall prescribe regulations to carry out Regulations, 
this section.". 
102 STAT. 516 
PUBLIC LAW 100-322—MAY 20, 1988 
(2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 4119 the 
following: 
"4210. Recruitment and retention bonus pay for nurses and certain other health-
care personnel.". 
(b) CONFORMING AMENDMENT.—Section 4107(d) is amended by 
striking out "section 4118" and inserting in lieu thereof "sections 
4118 and 4120". 
SEC. 213. ON-CALL PAY. 
Section 4107 is amended by adding at the end the following new 
subsection: 
"(jXD The Administrator may pay an employee to whom this 
subsection applies pay at the rate provided in subsection (eX8) of this 
section except for such time as the employee may be called back to 
work. 
"(2) This subsection applies to an employee who meets each of the 
following criteria: 
"(A) The employee is employed in a position listed in para-
graph (3) of section 4104 of this title or meets the criteria 
specified in subclauses (i), (ii), and (iii) of subsection (gXlXB) of 
this section. 
"(B) The employee is employed in a work unit for which on-
call premium pay is authorized. 
"(C) The employee is officially scheduled to be on call outside 
such employee's regular hours or on a holiday designated by 
Federal statute or Executive order. 
"(3) An employee who is eligible for on-call pay under paragraph 
(1) of this subsection and who was receiving standby premium pay 
pursuant to section 5545 of title 5 on the date of the enactment of 
this subsection shall, as long as such employee is employed in the 
same position and work unit and remains eligible for such standby 
pay, receive pay for any period of on-call duty at the rate equal to 
the greater of (A) the rate of pay which such employee would receive 
if being paid the rate of standby pay pursuant to such section that 
such individual would be entitled to receive if such individual were 
not scheduled to be on call instead, or (B) the rate of pay which such 
employee is entitled to receive including on-call premium pay 
described in paragraph (1) of this subsection.". 
SEC. 214. PREMIUM PAY FOR SATURDAY WORK. 
(a) EXTENSION OF SUNDAY WORK PREMIUM PAY.—Paragraph (3) of 
section 4107(e) is amended by striking out "Saturday" and inserting 
in lieu thereof "Friday". 
(b) CONFORMING AMENDMENTS.—(1) Subparagraph (A) of para-
graph (10) of such section is amended to read as follows: 
"(A) Notwithstanding any other provision of law and subject to 
subparagraph (B) of this paragraph, the Administrator may increase 
the rates of additional pay authorized under paragraphs (2) through 
(8) of this subsection if the Administrator determines that it is 
necessary to do so in order to obtain or retain the services of 
nurses.". 
(2) Such paragraph is further amended— 
(A) in subpara^aph (B), by striking out "subparagraph (AXi)" 
and inserting in lieu thereof "subparagraph (A)"; and 
(B) by striking out subparagraph (C). 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 517 
(c) EFFECTIVE DATE.—The amendments made by this section shall 
38 use 4107 
apply with respect to tours of duty performed by nurses which begin 
note, 
on or after the first day of the first pay period beginning on or after 
the date of the enactment of this Act. 
SEC. 215. REPORT ON EFFECT OF CERTAIN PAY AND BENEFITS 38 USC 4104 
AMENDMENTS. 
"o^ 
Not later than one year after the date of the enactment of this 
Health care 
Act, the Administrator shall submit to the Committees on Veterans' 
professionals. 
Affairs of the Senate and House of Representatives a report on the 
implementation of the amendments made by sections 211 through 
214, relating to pay and benefits for various health care profes-
sionals in the Department of Medicine and Surgery. The report— 
(1) shall particularly describe the effect of such amendments 
and other provisions of law on the ability of the Veterans' 
Administration to meet its requirements for nurses, phar-
macists, occupational therapists, and physical therapists; and 
(2) shall include such recommendations for further legislative 
action as the Administrator considers appropriate. 
SEC. 216. HEALTH 
PROFESSIONALS 
EDUCATIONAL 
ASSISTANCE 
PROGRAM. 
(a) REPEAL OF OLD PROGRAM.—Subchapter IV of chapter 73 is 
repealed. 
(b) IMPROVED AND EXPANDED PROGRAM.—Part V is amended by 
adding at the end the following new chapter: 
"CHAPTER 76—HEALTH PROFESSIONALS 
EDUCATIONAL ASSISTANCE PROGRAM 
"SUBCHAPTER I—GENERAL 
"Sec. 
"4301. Establishment of program; purpose. 
"4302. Eligibility. 
"4303. Application and acceptance. 
"4304. Terms of agreement. 
"SUBCHAPTER II—SCHOLARSHIP PROGRAM 
"4311. Authority for program. 
"4312. Eligibility; application; agreement. 
"4313. Scholarship. 
"4314. Part-time students. 
"4315. Status of participants. 
"4316. Obligated service. 
"4317. Breach of agreement: liability. 
"4318. Expiration of program. 
"SUBCHAPTER III—TUITION REIMBURSEMENT PROGRAM 
"4321. Authority for program. 
"4322. Eligibility; application; agreement. 
"4323. Obligated service. 
"4324. Breach of agreement: liability. 
"4325. Allocation and distribution of funding. 
"SUBCHAPTER IV—ADMINISTRATIVE MATTERS 
"4331. Periodic adjustments in amount of assistance. 
"4332. Annual report. 
"4333. Regulations. 
"4334. Breach of agreement; waiver of liability. 
"4335. Service in other agencies. 
"4336. Exemption of educational assistance payments from taxation. 
102 STAT. 518 
PUBLIC LAW 100-322—MAY 20, 1988 
"SUBCPIAPTER I—GENERAL 
38 use 4301. 
"§ 4301. Establishment of program; purpose 
"(a) There is hereby established a program to be known as the 
Veterans' Administration Health Professionals Educational Assist-
ance Program (hereinafter in this chapter referred to as the 
'Educational Assistance Program'). The program consists of— 
"(1) the scholarship program provided for in subchapter II of 
this chapter, and 
"(2) the tuition reimbursement program provided for in sub-
chapter III of this chapter. 
"(b) 'The purpose of the Educational Assistance Program is to 
assist in providing an adequate supply of trained health-care person-
nel for the Veterans' Administration and the Nation. 
38 use 4302. 
"§ 4302. Eligibility 
"(aXD To be eligible to participate in the Educational Assistance 
Program, an individual must be accepted for enrollment or be 
currently enrolled as a student at a qualifying educational institu-
tion in a course of education or training that is approved by the 
Administrator and that leads toward completion of a degree in a 
field of education or training for which a scholarship may be 
awarded under subchapter II of this chapter or for which tuition 
reimbursement may be provided under subchapter III of this 
chapter. 
"(2) A qualif)dng educational institution for purposes of this sec-
tion is an educational institution that is in a State and that (as 
determined by the Administrator) is an accredited institution. 
"(b) An individual is not eligible to apply to participate in the 
Educational Assistance Program if the individual is obligated under 
any other Federal program to perform service after completion of 
the course of education or training of such individual referred to in 
subsection (a) of this section. 
38 use 4303. 
"§ 4303. Application and acceptance 
eontracts. 
"(a) To apply to participate in the Educational Assistance Pro-
gram, an individual shall submit to the Administrator an applica-
tion for such participation together with an f^eement described in 
section 4304 of this title under which the participant agrees to serve 
a period of obligated service in the Department of Medicine and 
Surgery as provided in the agreement in return for payment of 
educational assistance as provided in the agreement. 
"(bXl) An individual becomes a participant in the Educational 
Assistance Program upon the Administrator's approval of the 
individual's application and the Administrator's acceptance of the 
agreement. 
"(2) Upon the Administrator's approval of an individual's partici-
pation in the program, the Administrator shall promptly notify the 
mdividual of that approval. Such notice shall be in writing. 
"(cXD In distributing application forms and agreement forms to 
individuals desiring to participate in the Educational Assistance 
Program, the Administrator shall include with such forms the 
following: 
"(A) A fair summary of the rights and liabilities of an individ-
ual whose application is approved (and whose agreement is 
accepted) by the Administrator, including a clear explanation of 
PUBLIC LAW 100-322—MAY 20,1988 
102 STAT. 519 
the damages to which the United States is entitled if the 
individual breaches the agreement. 
"(B) A full description of the terms and conditions that apply 
to participation in the Educational Assistance Program and 
service in the Department of Medicine and Surgery. 
"(2) The Administrator shall make such application forms and 
other information available to individuals desiring to participate in 
the Educational Assistance Program on a date sufficiently early to 
allow such individuals adequate time to prepare and submit such 
forms. 
"(d) In selecting applicants for acceptance in the Educational 
Assistance Program, the Administrator shall give priority to the 
applications of individuals who have previously received educational 
assistance under the program £ind have not completed the course of 
education or training undertaken under such program. 
"§ 4304. Terms of agreement 
38 USC 4304. 
"An agreement between the Administrator and a participant in 
the Educational Assistance Program shall be in writing, shall be 
signed by the participant, and shall include the following provisions: 
"(1) The Administrator's agreement— 
"(A) to provide the participant with educational assist-
ance as authorized in subchapter II or III of this chapter 
and specified in the agreement; and 
"(B) to afford the participant the opportunity for employ-
ment in the Department of Medicine and Surgery (subject 
to the availability of appropriated funds for such purpose 
and other qualifications established in accordance with 
section 4105 of this title). 
"(2) The participant's agreement— 
"(A) to accept such educational assistance; 
"(B) to maintain enrollment and attendance in the course 
of training until completed; 
"(C) while enrolled in such course, to maintain an accept-
able level of academic standing (as determined by the edu-
cational institution offering such course of training under 
regulations prescribed by the Administrator); and 
"(D) after completion of the course of training, to serve as 
a full-time employee in the Department of Medicine and 
Surgery as specified in the agreement in accordance with 
subchapter II or III of this chapter. 
"(3) A provision that any financial obligation of the United 
States arising out of an agreement entered into under this 
chapter, and any obligation of the participant which is condi-
tioned on such agreement, is contingent upon funds being 
appropriated for educational assistance under this chapter. 
"(4) A statement of the damages to which the United States is 
entitled under this chapter for the participant's breach of the 
agreement. 
"(5) Such other terms as are required to be included in the 
agreement under subchapter II or III of this chapter or as the 
Administrator may require consistent with the provisions of 
this chapter. 
102 STAT. 520 
PUBLIC LAW 100-322—MAY 20, 1988 
"SUBCHAPTER II—SCHOLARSHIP PROGRAM 
38 use 4311. 
"§ 4311. Authority for program 
"As part of the Educational Assistance Program, the Adminis-
trator shall carry out a scholarship program under this subchapter. 
The program shall be known as the Veterans' Administration 
Health Professional Scholarship Program (hereinafter in this chap-
ter referred to as the "Scholarship Program"). 
38 use 4312. 
"§ 4312. Eligibility; application; agreement 
"(aXD Except as provided in paragraph (2) of this subsection, an 
individual must be accepted for enrollment or be enrolled (as de-
scribed in section 4302 of this title) as a full-time student to be 
eligible to participate in the Scholarship Program. 
"(2) An individual who is an eligible Veterans' Administration 
employee may be accepted as a participant if accepted for enroll-
ment or enrolled (as described in section 4302 of this title) for study 
on less than a full-time but not less than a half-time bsisis. (Such a 
participant is hereinafter in this subchapter referred to as a "part-
time student".) 
"(3) For the purposes of paragraph (2) of this subsection, an 
eligible Veterans' Administration employee is a full-time Veterans' 
Administration employee who is permanently assigned to a Veter-
ans' Administration health-care facility on the date on which the 
individual submits the application referred to in section 4303 of this 
title and on the date on which the individual becomes a participant 
in the Scholarship Program. 
"(bXD A scholarship may be awarded under this subchapter only 
in a qualifying field of education or training. 
"(2) A qualifying field of education or training for purposes of this 
subchapter is education or training leading to employment (under 
section 4104 of this title) as any of the following: 
"(A) A physician, dentist, podiatrist, optometrist, nurse, 
physician assistant, or expanded function dental auxiliary. 
"(B) A psychologist described in section 4104(3) of this title or 
a certified or registered respiratory therapist, licensed physical 
therapist, or licensed practical or vocational nurse. 
"(3) The Administrator may designate additional fields of edu-
cation or training as qualifying fields of education or training if the 
education or training leads to employment in a position which 
would qualify the individual for increased basic pay under section 
4107(gXlXB) of this title. 
"(4) Before awarding the initial scholarship in a course of edu-
cation or training other than medicine or nursing, the Adminis-
trator shall notify the Committees on Veterans' Affairs of the 
Senate and House of Representatives of the Administrator's intent 
to award a scholarship in such course of education or training. The 
notice shall include a statement of the reasons why the award of 
scholarships in that course of education or training is necessary to 
assist in providing the Veterans' Administration with an adequate 
supply of personnel in the health profession concerned. Any such 
notice shall be given not less than 60 days before the first such 
scholarship is awarded. 
"(5) In selecting applicants for the Scholarship Program, the 
Administrator shall give priority to the applications of individuals 
who will be entering their final year in a course of training. 
PUBLIC LAW 100-322—MAY 20,1988 
102 STAT. 521 
"(cXD An agreement between the Administrator and a participant 
in the Scholarship Program shall (in addition to the requirements 
set forth in section 4304 of this title) include the following: 
"(A) The Administrator's agreement to provide the partici-
pant with a scholarship under this subchapter for a specified 
number (from one to four) of school years during which the 
participant is pursuing a course of education or training de-
scribed in section 4302 of this title. 
"(B) The participant's agreement to serve £is a full-time em-
ployee in the Department of Medicine and Surgery for a period 
of time (hereinafter in this subchapter referred to as the 'period 
of obligated service') of one calendar year for each school year 
or part thereof for which the participant was provided a scholar-
ship under the Scholarship Program. 
"(2) In a case in which an extension is granted under section 
4314(3) of this title, the number of years for which a scholarship may 
be provided under this subchapter shall be the number of school 
years provided for as a result of the extension. 
"(3) In the case of a participant who is a part-time student— 
"(A) the period of obligated service shall be reduced in accord-
ance with the proportion that the number of credit hours 
carried by such participant in any such school year bears to the 
number of credit hours required to be carried by a full-time 
student in the course of training being pursued by the partici-
pant, but in no event to less than one year; and 
"(B) the agreement shall include the participant's agreement 
to maintain employment, while enrolled in such course of edu-
cation or training, as a Veterans' Administration employee 
permanently assigned to a Veterans' Administration health-
care facility. 
"(4) If a participant's period of obligated service is deferred under 
section 4316(b)(3)(AXi) of this title, the agreement terms under para-
graph (1) of this subsection shall provide for the participant to serve 
any additional period of obligated service that is prescribed by the 
Administrator under section 4316(b)(4XB) of this title. 
"§ 4313. Scholarship 
38 use 4313. 
"(a) A scholarship provided to a participant in the Scholarship 
Program for a school year under the Scholarship Program shall 
consist of pajonent of the tuition of the participant for that school 
year, payment of other reasonable educational expenses (including 
fees, books, and laboratory expenses) for that school year, and a 
stipend determined under subsection Qa) of this section. 
"(b) A stipend under this section for a school year shall be 
payment to the participant of not in excess of $485 per month 
(adjusted in accordance with section 4331 of this title) for each of the 
12 consecutive months beginning with the first month of the school 
year, except that a stipend may not be paid to a participant who is a 
full-time employee of the Veterans' Administration. The stipend of a 
participant who is a part-time student shall be adjusted as provided 
in sections 4314(1) and 4314(2) of this title. 
"(c) The Administrator may arrange with an educational institu-
tion in which a participant in the Scholarship Program is enrolled 
for the payment to the educational institution of the amounts of 
tuition and other reasonable educational expenses described in 
subsection (a) of this section. Such payments may be made without 
regard to subsections (a) and (b) of section 3324 of title 31. 
102 STAT. 522 
PUBLIC LAW 100-322—MAY 20, 1988 
38 use 4314. 
"§ 4314. Part-time Students 
"In the case of a participant who is a part-time student— 
"(1) the maximum amount of the stipend payable to the 
participant shall be reduced in accordance with the proportion 
that the number of credit hours carried by such participant 
bears to the number of credit hours required to be carried by a 
full-time student in the course of education or training being 
pursued by the participant; 
"(2) a stipend may not be paid for any month during which 
the participant is not actually attending the course of training 
in which the participant is enrolled; and 
"(3) the Administrator may extend the period for which a 
scholarship may be awarded to the participant to a maximum of 
six school years if the Administrator determines that the exten-
sion would be in the best interest of the United States. 
38 use 4315. 
"§ 4315. Status of participants 
"Participants in the Scholarship Program shall not by reason of 
their participation in such program (1) be considered to be employ-
ees of the Federal Government, or (2) be counted against any 
personnel ceiling affecting the Department of Medicine and 
Surgery. 
38 use 4316. 
"§ 4316. Obligated service 
"(a) Each participant in the Scholarship Program shall provide 
service as a full-time employee of the Veterans' Administration for 
the period of obligated service provided in the agreement of the 
participant entered into under section 4303 of this title. Such service 
shall be provided in the full-time clinical practice of such partici-
pant's profession or in another health-care position in an assign-
ment or location determined by the Administrator. 
"GJXD Not later than 60 days before the participant's service 
commencement date, the Administrator shall notify the participant 
of that service commencement date. That date is the date for the 
beginning of the participant's period of obligated service. 
"(2) As soon as possible after the participant's service commence-
ment date, the Administrator shall— 
"(A) in the case of a participant who is not a full-time 
employee in the Department of Medicine and Surgery, appoint 
such participant as such an employee; and 
"(B) in the case of a participant who is an employee in the 
Department of Medicine and Surgery but is not serving in a 
position for which such participant's course of education or 
training prepared such participant, assign such participant to 
such a position. 
"(3XA)(i) In the case of a participant receiving a degree from a 
school of medicine, osteopathy, dentistry, optometry, or podiatry, 
the participant's service commencement date is the date upon which 
the participant becomes licensed to practice medicine, osteopathy, 
dentistry, optometry, or podiatry, as the case may be, in a State. 
However, the Administrator may, at the request of such participant, 
defer such date until the end of the period of time required for the 
participant to complete an internship or residency or other ad-
vanced clinical training. If the participant requests such a deferral, 
the Administrator shall notify the participant that such deferral 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 523 
could lead to an additional period of obligated service in accordance 
with paragraph (4) of this subsection. 
"(ii) No such period of internship or residency or other advanced 
clinical training shall be counted toward satisfying a period of 
obligated service under this subchapter. 
"(B) In the case of a participant receiving a degree from a school of 
nursing, the participant's service commencement date is the later of 
(i) the participant's course completion date, or (ii) the date upon 
which the participant becomes licensed as a registered nurse in a 
State. 
"(C) In the CEise of a participant not covered by subparagraph (A) 
or (B) of this paragraph, the participant's service commencement 
date is the later of (i) the participant's course completion date, or (ii) 
the date the participant meets any applicable licensure or certifi-
cation requirements. 
"(4) A participant whose period of obligated service is deferred 
under paragraph (3)(A) of this subsection shall be required to under-
take internship or residency or other advanced clinical training in 
an accredited program in an educational institution which is an 
affiliated institution (as defined in section 4108(c)(1) of this title) and 
with respect to which the affiliation agreement provides that all or 
part of the internship or residency or other advanced clinical train-
ing will be undertaken in a Veterans' Administration health-care 
facility. Such a participant may, at the discretion of the Adminis-
trator and upon the recommendation of the Chief Medical Director, 
incur an additional period of obligated service— 
"(A) at the rate of one-half of a calendar year for each year of 
internship or residency or other advanced clinical training (or a 
proportionate ratio thereof), if the internship, residency, or 
advanced clinical training is in a medical specialty necessary to 
meet the health-care requirements of the Veterans' Administra-
tion (as determined under regulations prescribed by the 
Administrator); or 
"(B) at the rate of three-quarters of a calendar year for each 
year of internship or residency or other advanced clinical train-
ing (or a proportionate ratio thereof), if the internship, resi-
dency, or advanced clinical training is not in a medical specialty 
necessary to meet the health-care requirements of the Veterans' 
Administration (as determined under regulations prescribed by 
the Administrator). 
"(5) The Administrator shall by regulation prescribe the service Regulations, 
commencement date for participants who were part-time students. 
Such regulations shall prescribe terms as similar as practicable to 
the terms set forth in paragraph (3) of this subsection. 
"(c)(1) Except as provided in paragraph (2) of this subsection, a 
participant in the Scholarship Program shall be considered to have 
begun serving such participant's period of obligated service— 
"(A) on the date, after such participant's course completion 
date, on which such participant (in accordance with subsection 
(b) of this section) is appointed under this chapter as a full-time 
employee in the Department of Medicine and Surgery; or 
"(B) if the participant is a full-time employee in the Depart-
ment of Medicine and Surgery on such course completion date, 
on the date thereafter on which such participant is assigned to a 
position for which such participant s course of training pre-
pared such participant. 
102 STAT. 524 
PUBLIC LAW 100-322—MAY 20, 1988 
"(2) A participant in the Scholarship Program who on such 
participant's course completion date is a full-time employee in the 
Department of Medicine and Surgery serving in a capacity for which 
such participant's course of training prepared such participant shall 
be considered to have begun serving such participant's period of 
obligated service on such course completion date. 
"(3) For the purposes of this section, the term 'course completion 
date' means the date on which a participant in the Scholarship 
Program completes such participant's course of education or train-
ing under the program. 
38 use 4317. 
*'§ 4317. Breach of agreement: liability 
"(a) A participant in the Scholarship Program (other than a 
participant described in subsection (b) of this section) who fails to 
accept payment, or instructs the educational institution in which 
the participant is enrolled not to accept payment, in whole or in 
part, of a scholarship under the agreement entered into under 
section 4303 of this title shall be liable to the United States for 
liquidated damages in the amount of $1,500. Such liability is in 
addition to any period of obligated service or other obligation or 
liability under the agreement. 
"(b) A participant in the Scholarship Program shall be liable to 
the United States for the amount which has been paid to or on 
behalf of the participant under the agreement if any of the following 
occurs: 
"(1) The participant fails to maintain an acceptable level of 
academic standing in the educational institution in which the 
participant is enrolled (as determined by the educational 
institution under regulations prescribed by the Administrator). 
"(2) The participant is dismissed from such educational 
institution for disciplinary reasons. 
"(3) The participant voluntarily terminates the course of 
training in such educational institution before the completion of 
such course of training. 
"(4) The participant fails to become licensed to practice medi-
cine, osteopathy, dentistry, podiatry, or optometry in a State, 
fails to become licensed as a registered nurse in a State, or fails 
to meet any applicable licensure requirement in the case of any 
other health-care personnel who provide either direct patient-
care services or services incident to direct patient-care services, 
during a period of time determined under regulations pre-
scribed by the Administrator. 
"(5) In the case of a participant who is a part-time student, 
the participant fails to maintain emplo5nnent, while enrolled in 
the course of training being pursued by such participant, as a 
Veterans' Administration employee permanently assigned to a 
Veterans' Administration health-care facility. 
Liability under this subsection is in lieu of any service obligation 
arising under the participant's agreement. 
"(cXD If a participant in the Scholarship Program breaches the 
agreement by failing (for any reason) to complete such participant's 
period of obligated service, the United States shall be entitled to 
recover from the participant an amount determined in accordance 
with the following formula: 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 525 
A=3<I> 
In such formula: 
"(A) *A' is the amount the United States is entitled to recover. 
"(B) '<!>' is the sum of (i) the amounts paid under this sub-
chapter to or on behalf of the participant, and (ii) the interest on 
such amounts which would be payable if at the time the 
amounts were paid they were loans bearing interest at the 
maximum legal prevailing rate, as determined by the Treasurer ^ 
\ 
of the United States. 
\ 
\ ^ 
"(C) 't' is the total number of months in the participant's 
^ 
period of obligated service, including any additional period of 
obligated service in accordance with section 4316(b)(4) of this 
title. 
"(D) 's' is the number of months of such period served by the 
participant in accordance with section 4313 of this title. 
"(2) Any amount of damages which the United States is entitled to 
recover under this section shall be paid to the United States within 
the one-year period beginning on the date of the breach of the 
agreement. 
"§ 4318. Expiration of program 
38 use 4318. 
"The Administrator may not furnish scholarships to new partici-
pants in the Scholarship Program after September 30,1992. 
"SUBCHAPTER III—TUITION REIMBURSEMENT PROGRAM 
"§ 4321. Authority for program 
38 USC 4321. 
"As part of the Educational Assistance Program, the Adminis-
trator shall carry out a tuition reimbursement program under this 
subchapter. The program shall be known as the Veterans' Adminis-
tration Nurse Education Tuition Reimbursement Program (herein-
after in this chapter referred to as the "Tuition Reimbursement 
Program"). 
*•§ 4322. Eligibility; application; agreement 
38 use 4322. 
"(a) To be eligible to participate in the Tuition Reimbursement 
Program, an individual must be a full-time employee in the Veter-
ans' Administration permanently assigned to a Veterans' Adminis-
tration health-care facility and must be enrolled in a course of 
training offered by an institution approved by the Administrator 
leading toward completion of (1) an associate or higher degree in 
nursing, or (2) a masters degree or doctoral degree in nursing. 
"(b) In selecting applicants for acceptance in the Tuition Re-
imbursement Program, the Administrator (in addition to according 
priorities as set forth in section 4303(d) of this title) shall give special 
consideration and emphasis to individuals pursuing a course of 
study which will expedite an increase in the number of registered 
nurses employed by the Veterans' Administration. The Adminis-
trator shall then give priority, in the following order, to— 
"(1) individuals who have been employed as full-time em-
ployees in the Nursing Service in the Department of Medicine 
and Surgery; and 
"(2) individuals who have previously received tuition re-
imbursement under the Tuition Reimbursement Program. 
102 STAT. 526 
PUBLIC LAW 100-322—MAY 20, 1988 
"(c) An agreement between the Administrator and a participant 
in the Tuition Reimbursement Program shall (in addition to the 
requirements set forth in section 4304 of this title) contain the 
following: 
"(1) The Administrator's agreement to provide the participant 
with tuition reimbursement following successful completion (as 
determined, pursuant to regulations prescribed by the Adminis-
trator, by the educational institution involved) of (A) a course or 
courses required for the course of study described in subsection 
(a) of this section, or (B) a course or courses taken as necessary 
prerequisites for degree program enrollment if a letter regard-
ing the potential enrollment of the participant from an appro-
priate official of the institution involved includes a statement 
specifying such prerequisites. 
"(2) The participant s agreement— 
"(A) to maintain employment, while enrolled in the 
course of training being pursued by such participant, as a 
full-time Veterans' Administration employee in the Depart-
ment of Medicine and Surgery permanently assigned to a 
Veterans' Administration health-care facility; and 
"(B) to continue to serve as a full-time employee in such 
Department for one year (hereinafter in this subchapter 
referred to as the 'period of obligated service') after comple-
tion of the course for which the participant received tuition 
reimbursement. 
"(d) Tuition reimbursement provided to a participant in the Tui-
tion Reimbursement Program may not exceed $2,000 per year 
adjusted in accordance with section 4331 of this title). 
"(e) The Administrator may arrange with an educational institu-
tion pursuant to which such an institution would provide a course or 
courses at a Veterans' Administration health-care facility to partici-
pants in the Tuition Reimbursement Program. Under such an 
arrangement, the Administrator may agree to pay to the institution 
an amount not in excess of an amount determined by multiplying 
the number of participants in such a course by the amount of tuition 
reimbursement each participant would receive for enrolling and 
successfully completing such course. 
38 use 4322. 
"§ 4323. Obligated service 
"(a) Each participant in the Tuition Reimbursement Program 
shall provide service in the full-time clinical practice of such partici-
pant's profession as a full-time employee of the Veterans' Adminis-
tration for the period of obligated service provided in the agreement 
of such participant entered into under section 4303 of this title. 
"(b) A participant who on such participant's course completion 
date is a full-time employee in the Dep^ment of Medicine and 
SuiTgery shall be considered to have begun serving such participant's 
period of obligated service on the course completion date. 
"(c) Except in the case of a participant whose tuition was paid 
pursuant to section 4322(f) of this title, if a participant in the Tuition 
Reimbursement Program fails to successfully complete a course, no 
reimbursement will be provided and no period of obligated service 
will be incurred. 
"(d) In the case of a participant whose tuition was paid pursuant 
to section 4322(f) of this title and who fails to complete the course 
involved, the period of obligation shall be of the same duration as it 
would have been if the participant had successfully completed the 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 527 
course and the course completion date shall be considered to be the 
date on which the participant's failure becomes an established fact. 
"(e) For the purposes of this section, the term 'course completion 
date' means the date on which a participant in the Tuition Re-
imbursement Program completes such participant's course of train-
ing under the program. 
"§ 4324. Breach of agreement: liability 
38 USC 4324. 
"(a) A participant in the Tuition Reimbursement Program who 
fails to maintain employment as a Veterans' Administration em-
ployee permanently assigned to a Veterans' Administration health-
care facility— 
"(1) may not be provided reimbursement for tuition for the 
course or courses in which the participant is enrolled; and 
"(2) in lieu of any service obligation arising from completion 
of a course or courses in a previous semester or quarter, shall be 
liable to the United States for the amount which has been paid 
to or on behalf of the participant under the agreement. 
"(b)(1) If a participant in the Tuition Reimbursement Program 
breaches the agreement by failing (for any reason) to complete such 
participant's period of obligated service, the United States shall be 
entitled to recover from the participant an amount determined in 
accordance with the following formula: 
A=3<I> 
In such formula: 
"(A) 'A' is the amount the United States is entitled to recover. 
"(B) *
<
l
>
' is the sum of (i) the amounts paid under this sub-
chapter to or on behalf of the participant, and (ii) the interest on 
such amounts which would be payable if at the time the 
amounts were paid they were loans bearing interest at the 
maximum legal prevailing rate, as determined by the Treasurer 
of the United States. 
"(C) 't' is the total number of months in the participant's 
period of obligated service. 
"(D) 's' is the number of months of such period served by the 
participant in accordance with section 4323 of this title. 
"(2) Any amount of damages which the United States is entitled to 
recover under this section shall be paid to the United States within 
the one-year period beginning on the date of the breach of the 
agreement. 
"§ 4325. Allocation and distribution of funding 
38 USC 4325. 
"In determining the amount of funding to allocate to Veterans' 
Administration health-care facilities for any fiscal year in connec-
tion with the Tuition Reimbursement Program, the Administrator 
shall take into account (1) the personnel ceiling for that fiscal year 
for nursing personnel, and (2) the recruitment and retention needs 
of such facilities, as determined by the Administrator. 
102 STAT. 528 
PUBLIC LAW 100-322—MAY 20, 1988 
"SUBCHAPTER IV—ADMINISTRATIVE MATTERS 
38 use 4331. 
"§ 4331. Periodic adjustments in amount of assistance 
"(aXD Whenever there is a general Federal pay increase, the 
Administrator shall incresise the maximum monthly stipend 
amount and the maximum tuition reimbursement amount. Any 
such increase shall take effect with respect to any school year that 
ends in the fiscal year in which the pay increase takes effect. 
"(2) The amount of any increase under paragraph (1) of this 
subsection is the previous maximum amount under that paragraph 
multiplied by the overall percentage of the adjustment in the rates 
of pay under the General Schedule made under the general Federal 
pay increase. Such amount shall be rounded to the next lower 
multiple of $1. 
"(b) For purposes of this section: 
"(1) The term 'maximum monthly stipend amount' means the 
maximum monthly stipend that may be paid to a participant in 
the Scholarship Program specified in section 4313(b) of this title 
and as previously adjusted (if at all) in accordance with this 
subsection. 
"(2) The term 'maximum tuition reimbursement amount' 
means the maximum amount of tuition reimbursement pro-
vided to a participant in the Tuition Reimbursement Program 
specified in section 4322(e) of this title and as previously ad-
justed (if at all) in accordance with this subsection. 
"(3) The term 'general Federal pay increase' means an adjust-
ment (if an increase) in the rates of pay under the General 
Schedule under subchapter III of chapter 51 of title 5. 
38 use 4332. 
"§ 4332. Annual report 
Not later than March 1 of each year, the Administrator shall 
submit to Congress a report on the Educational Assistance Program. 
Each such report shall include the following information: 
"(1) The number of students receiving educational assistance 
under the Educational Assistance Program, showing the num-
bers of students receiving eissistance under the Scholarship 
Program and the Tuition Reimbursement Program separately, 
and the number of students enrolled in each type of health 
profession training under each program. 
"(2) The education institutions providing such training to 
students in each program. 
"(3) The number of applications filed under each program, by 
health profession category, during the school year beginning in 
such year and the total number of such applications so filed for 
all years in which the Educational Assistance Program (or 
predecessor program) has been in existence. 
"(4) The average amounts of educational assistance provided 
per participant in the Scholarship Program and per participant 
in the Tuition Reimbursement Program, 
"(5) The amount of tuition and other expenses paid, by health 
profession category, in the aggregate and at each educational 
institution for the school year beginning in such year and for 
prior school years. 
"(6) The number of scholarships accepted, by health profes-
sion category, during the school year beginning in such year 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 529 
and the number, by health profession category, which were 
offered and not accepted. 
"(7) The number of participants who complete a course or 
course of training in each program each year and for all 
years that such program (or predecessor program) has been in 
existence. 
"§ 4333. Regulations 
38 USC 4333. 
"The Administrator shall prescribe regulations to carry out the 
Educational Assistance Program. 
"§ 4334. Breach of agreement; waiver of liability 
38 USC 4334. 
"(a) An obligation under the Educational Assistance Program (or 
an agreement under the program) of a participant in the Edu-
cational Assistance Program for performance of services or payment 
of damages is canceled upon the death of the participant. 
"(b) The Administrator shall prescribe regulations providing for Regulations, 
the waiver or suspension of any obligation of a participant for 
service or payment under the Educational Assistance Program (or 
an agreement under the program) whenever noncompliance by the 
participant is due to circumstances beyond the control of the partici-
pant or whenever the Administrator determines that the waiver or 
suspension of compliance is in the best interest of the United States. 
"(c) An obligation of a participant under the Educational Assist-
ance Program (or an agreement thereunder) for payment of dam-
ages may not be released by a discharge in bankruptcy under title 11 
before the expiration of the five-year period beginning on the first 
date the payment of such damages is due. 
"§ 4335. Service in other agencies 
38 USC 4335. 
"(a) The Administrator, with the consent of the participant or 
individual involved and the consent of the head of the department 
or agency involved, may permit— 
"(1) a period of obligated service required under this chapter 
to be performed in the Department of Medicine and Surgery to 
be performed in another Federal department or agency or in the 
Armed Forces in lieu of performance of such service in the 
Department of Medicine and Surgery; and 
"(2) a period of obligated service required to be performed in 
another Federal department or agency or in the Armed Forces 
under another Federal health personnel educational Eissistance 
program to be performed in the Department of Medicine and 
Surgery. 
"(b) This section shall be carried out in cooperation with the heads 
of other appropriate departments and agencies. 
"§ 4336. Exemption of educational assistance payments from 
38 USC 4336. 
taxation 
"Notwithstanding any other law, any payment to, or on behalf of 
a participant in the Educational Assistance Program, for tuition, 
education expenses, or a stipend under this chapter shall be exempt 
from taxation.". 
(c) SAVINGS PROVISION.—The provisions of subchapter IV of chap- 38 USC 4141 
ter 73 of title 38, United States Code, as in effect on the day before note, 
the date of the enactment of this Act, shall remain in effect with 
respect to scholarships awarded under that subchapter. 
102 STAT. 530 
PUBLIC LAW 100-322—MAY 20, 1988 
38 use 4331 
(d) TRANSITION.—Section 4331 of title 38, United States Code, as 
note. 
added by subsection (b), shall not apply with respect to a school year 
ending during fiscal year 1988. 
(e) CLERICAL AMENDMENTS.—(1) The table of sections at the begin-
ning of chapter 73 is amended by striking out the items relating to 
subchapter IV and sections 4141 through 4146. 
(2) The tables of chapters before part I and at the beginning of 
part V are each amended by inserting after the item relating to 
chapter 75 the following new item: 
"76. Health Professionals Educational Assistance Progfram 
4301". 
SEC. 217. PAY SCALES AND AWARDS FOR DEPARTMENT OF MEDICINE 
AND SURGERY EMPLOYEES. 
(a) SECTION 4103 SCHEDULE.—Subsection (a) of section 4107 is 
amended to read as follows: 
"(a) The annual rates or ranges of rates of basic pay for positions 
provided in section 4103 of this title shall be prescribed from time to 
time by Executive order as authorized by chapter 53 of title 5 or as 
otherwise authorized by law.". 
Ooi) SECTION 4104(1) POSITIONS.—Subsection (bXD of section 4107 is 
amended to read as follows: 
"0>X1) The grades and annual ranges of rates of basic pay for 
positions provided for in paragraph (1) of section 4104 of this title 
shall be prescribed from time to time by Executive order as au-
thorized by chapter 53 of title 5 or as otherwise authorized by law: 
"PHYSICIAN AND DENTIST SCHEDULE 
"Director grade. 
"Executive grade. 
"Chief grade. 
"Senior grade. 
"Intermediate grade. 
"Full grade. 
"Associate grade. 
"NURSE SCHEDULE 
"Director grade. 
"Assistant Director grade. 
"Chief grade. 
"Senior grade. 
"Intermediate grade. 
"Full grade. 
"Associate grade. 
"Junior grade. 
"CuNiCAL PODIATRIST AND OPTOMETRIST SCHEDULE 
"Chief grade. 
"Senior grade. 
"Intermediate grade. 
"Full grade. 
"Associate grade.". 
(c) AWARDS FOR CAREER APPOINTEES.—Subsection (cX3) of such 
section is amended by inserting "and £my person appointed under 
section 4103 of this title who is not eligible for special pay under 
section 4118 of this title" after "applies". 
PUBLIC LAW 100-322—MAY 20,1988 
102 STAT. 531 
PART C—PERSONNEL ADMINISTRATION 
SEC. 221. DISCIPLINARY MATTERS AS TO CERTAIN APPOINTEES. 
Section 4106(g) is amended by adding at the end the foUovsring new 
paragraph: 
"(3) Notwithstanding any other provision of this title or other law, 
all matters relating to adverse actions, disciplinary actions, and 
grievance procedures involving individuals appointed to such posi-
tions (including similar actions and procedures involving an em-
ployee in a probationary status) shall be resolved under the provi-
sions of title 5 as though such individuals had been appointed under 
such title.". 
SEC. 222. PERSONNEL CEILINGS FOR NONCAREER RESEARCH PER-
SONNEL. 
(a) EXCLUSION FROM PERSONNEL CEIUNGS.—Section 5010(a) is 
amended by adding at the end the following new paragraph: 
"(6)(A) Temporary research personnel of the Department of Medi-
cine and Surgery shall be excluded from any ceiling on full-time 
equivalent employees of the Veterans' Administration or any other 
personnel ceiling otherwise applicable to employees of the Veterans' 
Administration. 
"(B) For purposes of subparagraph (A) of this paragraph, the term 
'temporary research personnel' means personnel who are employed 
in the Department of Medicine and Surgery in other than a career 
appointment for work on a research activity and who are not paid 
by the Veterans' Administration or are paid from funds appro-
priated to the Veterans' Administration to support such activity.". 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 38 use 5010 
shall apply with respect to fiscal years after fiscal year 1987. 
'
^
o
*
®
-
SEC. 223. AUTHORITY TO WAIVE LICENSURE AND INTERNSHIP REQUIRE-
MENTS FOR CERTAIN HEALTH-CARE PERSONNEL. 
Subsection (d) of section 4114 is amended to read as follows: 
"(dXl) Subject to paragraph (2) of this subsection, the Chief Medi-
cal Director may waive for the purpose of the appointment of an 
individual under this section the requirements set forth in section 
4105(a) of this title— 
"(A) that a physician, dentist, psychologist, optometrist, reg-
istered nurse, practical or vocational nurse, or physical thera-
pist be licensed or certified, as appropriate; 
"(B) that the licensure or certification of such an individual be 
in a State; and 
"(C) that a psychologist have completed an internship. 
"(2) The waivers authorized in paragraph (1) of this subsection 
may be granted— 
"(A) in the case of clauses (A) and (C) of such paragraph, if the 
individual (i) will be employed to conduct research or serve in 
an academic position, and (ii) will have no responsibility for 
furnishing direct patient care services; smd 
"(B) in the case of clause (B) of such paragraph, if the individ-
ual will be employed to serve in a country other than the 
United States and the individual's licensure or registration is in 
the country in which the individual is to serve.". 
102 STAT. 532 
PUBLIC LAW 100-322—MAY 20, 1988 
SEC. 224. NURSE REPRESENTATION ON POLICYMAKING COMMITTEES. 
(a) INCLUSION OF FACILITY CHIEF OF NURSING.—Section 4112 is 
amended by adding at the end the following new subsection: 
"(c) The Administrator shall require that the Chief of the Nursing 
Service (or the designee of the Chief) at each Veterans' Administra-
tion health-care facility be included in the membership of each 
policymaking committee at that facility. Such committees include 
(1) committees relating to matters such as budget, education, posi-
tion management, clinical executive issues, planning, and resource 
allocation, and (2) the dean's committee or other advisory committee 
established under subsection (b) of this section.". 
(b) TECHNICAL AMENDMENT.—Subsection (b) of such section is 
amended in the first sentence by striking out "deans committee" 
and inserting in lieu thereof "dean's committee". 
PART D—REPORTS 
38 use 4104 
SEC. 231. STUDY OF PAY AND OTHER PERSONNEL 
MANAGEMENT 
note. 
PRACTICES. 
(a) IN GENERAL.—The Administrator shall conduct a study in 
order to determine— 
(1) the effects of the pay and other personnel management 
practices of the Department of Medicine and Surgery of the 
Veterans' Administration on the ability of the Veterans' 
Administration to recruit and retain categories of employees (A) 
who are qualified to provide direct patient-care services, or 
services that are incident to direct patient-care services, in 
Veterans' Administration health-care facilities, and (B) as to 
which problems of recruitment and retention have arisen, and 
(2) the effects that flexible employment benefits programs 
would have on the recruitment and retention of such employees. 
(b) MATTERS REQUIRED TO BE DETERMINED.—In conducting the 
study under subsection (a), the Administrator shall make determina-
tions with respect to various factors which may affect the deter-
minations to be made under subsection (a), including determinations 
of the following: 
(1) Whether there is inappropriate pay compression between 
the rates of pay of long-time employees of the Veterans' 
Administration and either the rates of pay of their supervisors 
or the rates of pay of relatively new employees performing the 
same services as a result of the position classification and pay 
systems applicable to such long-time and relatively new em-
ployees or to their supervisors. 
(2) If any such inappropriate pay compression exists and such 
compression results from such position classification and pay 
systems, whether it is feasible to revise such system or systems 
in order to eliminate such pay compression and how much 
would be the cost to revise such system or systems for that 
purpose and to implement the revisions. 
(3) Whether the payment of pay differentials (or of increased 
pay differentials) for evening or night service is needed in order 
to improve the ability of the Veterans' Administration to re-
cruit and retain personnel to perform services referred to in 
subsection (a) on evening or night shifts, in what amounts such 
differentials should be paid, how much would be the cost of the 
payment of such differentials, and what, if any, effects the 
PUBLIC LAW 100-322—MAY 20,1988 
102 STAT. 533 
payment of such differentials would be expected to have on the 
ability of the Veterans' Administration to recruit and retain 
personnel to perform such services on a shift for which a 
differential is not paid. 
(c) CONSIDERATION OF FLEXIBLE EMPLOYEE BENEFITS PROGRAMS.— 
In conducting the study under subsection (a), the Administrator 
shall review the personnel management practices of an appropriate 
sample of employers other than the Federal Government. The 
Administrator shall consider— 
(1) the extent to which such employers provide flexible 
employment benefits under programs designed to meet the 
individual needs to their employees, 
(2) the advantages of such programs for such employers and 
employees, and 
(3) the feasibility, desirability, and appropriateness of 
establishing and carrying out any such flexible employment 
benefits program for employees of the Department of Medicine 
and Surgery of the Veterans' Administration. 
(d) REPORTS.—Not later than one year after the date of the 
enactment of this Act, the Administrator shall submit to the 
Committees on Veterans' Affairs of the Senate and House of Rep-
resentatives a report on the results of the study required by subsec-
tion (a). The report shall contain— 
(1) the determinations of the Administrator under subsections 
(a) and (b); and 
(2) any planned administrative actions, and any recommenda-
tions for legislation, that the Administrator considers appro-
priate to include in the report on the basis of the results of the 
study. 
SEC. 232. REPORT ON CERTAIN ACTIVITIES RELATING TO TRAINING IN 
GERIATRICS OF MEDICAL AND OTHER HEALTH-PROFES-
SIONAL 
SCHOOLS 
AFFILIATED 
WITH 
THE VETERANS' 
ADMINISTRATION. 
(a) REPORT.—Not later than August 1, 1988, the Administrator 
shall submit to the Committees on Veterans' Affairs of the Senate 
and House of Representatives a report regarding the Veterans' 
Administration's activities, and the success of those activities, de-
signed to promote increased efforts by affiliated institutions (1) in 
training health-care professionals to care for older patients, and (2) 
in research into the aging process and diseases and disabilities 
associated with aging. 
(b) MATTERS TO BE INCLUDED.—The report under subsection (a) 
shall include the following: 
(1) Information, for each academic year from 1980-1981 
through 1987-1988, on the number of affiliated institutions, 
shown by tjrpe of institution and type of training, that— 
(A) have a program through which students or trainees 
receive education and training in geriatrics through regular 
rotation through Veterans' Administration medical centers, 
nursing homes, domiciliary facilities, or other units provid-
ing extended care to veterans; or 
(B) have a formal program providing education and train-
ing in geriatrics; or 
(C) have both such programs. 
(2) Information on the number of affiliated 
institutions 
(shown by type of institution) that are planning to establish 
102 STAT. 534 
PUBLIC LAW 100-322—MAY 20, 1988 
programs as described in paragraph (1), together with a time-
table for such actions. 
(3) Estimates of the costs, both to the Veterans' Administra-
tion and to the affiliated institutions, of the programs described 
in paragraphs (1) and (2). 
(4) Estimates of the number of Veterans' Administration 
patients receiving care or who will receive care from the stu-
dents or trainees participating in programs described in para-
graphs (IXA) and (2). 
(5) A description of the role of the Veterans' Administration 
in encouraging the establishment and continuation of the pro-
grams described in paragraph (1). 
(6) The views of the Administrator on the feasibility and 
desirability of requiring, as a condition of the Veterans' 
Administration's entering into or continuing an affiliation 
agreement with a health-care professional training institution, 
the establishment with such institution of the appropriate type 
of arrangements described in clause (CXi) or (CXii) of section 
4101(f)(1) of title 38, United States Code. 
(c) DEFINITION.—For purposes of this section, the term "affiliated 
institutions" means medical and other health-professional training 
schools affiliated with the Veterans' Administration. 
TITLE III—VETERANS' BENEFITS 
PART A—BENEFITS BASED ON SERVICE-CONNECTED DISABIUTIES 
SEC. 301. SPECIALLY ADAPTED HOUSING ASSISTANCE. 
Section 802 is amended— 
(1) in subsection (a), by striking out "$35,500" and inserting in 
lieu thereof "$38,000"; and 
(2) in subsection (b), by striking out "$6,000" and inserting in 
lieu thereof "$6,500". 
SEC. 302. AUTOMOBILE ASSISTANCE ALLOWANCE. 
Section 1902(a) is amended by striking out "$5,000" and inserting 
in lieu thereof "$5,500". 
SEC. 
303. 
BURIAL 
BENEFIT 
FOR 
SERVICE-CONNECTED 
DEATHS. 
Section 907 is amended by striking out "$1,100" and inserting in 
lieu thereof "$1,500". 
38 u s e 802 note. 
SEC. 304. EFFECTIVE DATE. 
The amendments made by sections 301, 302, and 303 shall take 
effect on April 1,1988. 
PART B—COMPENSATION-RELATED PROVISIONS 
SEC. 311. DEFINITION OF FORMER PRISONER OF WAR 
Section 101(32XB) is amended by striking out "during a period 
other than a period of war in which such person was held'. 
SEC. 312. PRESUMPTION OF SERVICE 
CONNECTION FOR CERTAIN 
DISABILITIES FOR FORMER PRISONERS OF WAR. 
Section 312(b) is amended— 
(1) by striking out "or" at the end of clause (11); and 
(2) by inserting after clause (12) the following new clauses: 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 535 
"(13) peripheral neuropathy except where directly related to 
infectious causes, 
"(14) irritable bowel syndrome, or 
"(15) peptic ulcer disease,". 
SEC. 313. PRESUMPTION OF SERVICE CONNECTION FOR LUPUS. 
Section 301(3) is amended by inserting below "Leukemia" the 
following: "Lupus erythematosus, systemic". 
SEC. 314. REINSTATED ENTITLEMENT FOR CERTAIN SURVIVORS. 
Section 156(aXl) of Public Law 97-377 (96 Stat. 1830, 1920) is 
42 USC 402 note. 
amended— 
(1) in subparagraph (B), by inserting "or who meets the 
requirements for entitlement to the equivalent of such benefit 
provided under section 412(a) of title 38, United States Code" 
after "month"; and 
(2) in subparagraph (C), by inserting ", or to the equivalent of 
such benefit based on meeting the requirements of section 
412(a) of title 38, United States Code," after "(42 U.S.C. 402(g))". 
PART C—EDUCATION PROVISIONS 
SEC. 321. MEASUREMENT OF LABORATORY INSTRUCTION. 
(a) IN GENERAL.—Section 1788 is amended— 
(1) in clause (B) of the first sentence of the matter following 
clause (7) of subsection (a), by inserting "(or two 50-minute 
periods)" after "two hours"; and 
(2) in subsection (c), by inserting "(or two 50-minute periods)" 
after "two hours". 
(b) EFFECTIVE DATE.—The amendments made by subsection (a) 38USC1788 
shall apply to any enrollment or reenroUment commencing on or 
note, 
after the date of enactment of this Act. 
SEC. 322. AUTHORITY TO WAIVE COMPLIANCE SURVEYS. 
The text of section 1793 is amended to read as follows: 
"(a) Except as provided in subsection (b) of this section, the 
Administrator shall conduct an annual compliance survey of each 
institution offering one or more courses approved for the enrollment 
of eligible veterans or persons if at least 300 veterans or persons are 
enrolled in such course or courses under provisions of this title or if 
any such course does not lead to a standard college degree. Such 
compliance survey shall be designed to ensure that the institution 
and approved courses are in compliance with all applicable provi-
sions of chapters 30 through 36 of this title. The Administrator shall 
assign at least one education compliance specialist to work on 
compliance surveys in any year for each 40 compliance surveys 
required to be made under this section for such year. 
"(b) The Administrator may waive the requirement in subsection 
(a) of this section for an annual compliance survey with respect to 
an institution if the Administrator determines, based on the institu-
tion's demonstrated record of compliance with all the applicable 
provisions of chapters 30 through 36 of this title, that the waiver 
would be appropriate and in the best interest of the United States 
Government.". 
102 STAT. 536 
PUBLIC LAW 100-322—MAY 20, 1988 
SEC. 323. EFFECTIVE DATE OF AWARDS UNDER THE POST-VIETNAM ERA 
VETERANS* EDUCATION ASSISTANCE PROGRAM. 
Section 3013 is amended by inserting "32," after "31,". 
PART D—INSURANCE PROVISIONS 
SEC. 331. AUTHORITY FOR ANNUITY ADJUSTMENTS. 
(aXD Subchapter I of chapter 19 is amended by adding at the end 
the following new section: 
38 use 727. 
"§ 727. Authority for higher monthly installments payable to cer-
tain annuitants 
"(a) Subject to subsections (b) and (c) of this section, the Adminis-
trator may from time to time adjust the dollar amount of the 
monthly installments payable to a beneficiary of National Service 
Life Insurance, Veterans Special Life Insurance, or Veterans Re-
opened Insurance who is receiving the proceeds of such insurance 
under a life annuity settlement option. The Administrator may 
make such an adjustment only if the Administrator determines that 
the adjustment is administratively and actuarially sound for the 
program of insurance concerned. The Administrator may make such 
an adjustment without regard to the provisions of sections 702, 723, 
and 725 of this title with respect to interest rates and the use of 
mortality tables. 
"(b) The Administrator shall determine the amount in the trust 
funds in the Treasury held for payment of proceeds to National 
Service Life Insurance, Veterans Special Life Insurance, and Veter-
ans Reopened Insurance beneficiaries attributable to interest and 
mortality gains on the reserves held for annuity accounts. Such 
amount shall be available for distribution to the life annuitants 
referred to in subsection (a) of this section as a fixed percentage of, 
and in addition to, the monthly installment amount to which the 
annuitants are entitled under this subchapter. For the purposes of 
this section, gains on the reserves are defined as funds attributable 
solely to annuity accounts that are in excess of actuarial liabilities. 
"(c) The monthly amount of an annuity authorized in sections 702, 
723, and 725 of this title, as adjusted under this section, may not be 
less than the monthly amount of such annuity that would otherwise 
be applicable without regard to this section.". 
(2) The table of sections at the beginning of chapter 19 is amended 
by inserting after the item relating to section 726 the following new 
item: 
"727. Authority for higher monthly installments payable to certain annuitants.". 
(bXD Subchapter II of chapter 19 is amended by adding at the end 
the following new section: 
38 use 762. 
"§ 762. Authority for higher monthly installments payable to cer-
tain annuitants 
"(a) Subject to subsections (b) and (c) of this section, the Adminis-
trator may from time to time adjust the dollar amount of the 
monthly installments payable to a beneficiary of United States 
Government Life Insurance who is receiving the proceeds of such 
insurance under a life annuity settlement option. The Adminis-
trator may make such an adjustment only if the Administrator 
determines that the adjustment is administratively and actuarially 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 537 
sound. The Administrator may make such an adjustment without 
regard to the provisions of section 744 of this title with respect to 
interest rates and the use of mortaUty tables. 
"(b) The Administrator shall determine the amount in the trust 
fund in the Treasury held for payment of proceeds to United States 
Government Life Insurance beneficiaries attributable to interest 
and mortality gains on the reserves held for annuity accounts. Such 
amount shall be available for distribution to the life annuitants 
referred to in subsection (a) of this section as a fixed percentage of, 
and in addition to, the monthly installment amount to which the 
annuitants are entitled under this subchapter. For the purposes of 
this section, gains on the reserves are defined as funds attributable 
solely to annuity accounts that are in excess of actuarial liabilities. 
"(c) The monthly amount of an annuity authorized in section 744 
of this title, as adjusted under this section, may not be less than the 
monthly amount of such annuity that would otherwise be applicable 
without regard to this section.". 
(2) The table of sections at the beginning of chapter 19 is amended 
by inserting after the item relating to section 761 the following new 
item: 
"762. Authority for higher monthly installments payable to certain annuitants.". 
SEC. 332. EXEMPTIONS FROM STATE TAXATION. 
(a) EXEMPTION.—Section 769 is amended by adding at the end the 
following new subsection: 
"(gXD No tax, fee, or other monetary payment may be imposed or 
collected by any State, or by any political subdivision or other 
governmental authority of a State, on or with respect to any pre-
mium paid under an insurance policy purchased under this sub-
chapter. 
"(2) Paragraph (1) of this subsection shall not be construed to 
exempt any company issuing a policy of insurance under this sub-
chapter from the imposition, payment, or collection of a tax, fee, or 
other monetary payment on the net income or profit accruing to or 
realized by that company from business conducted under this sub-
chapter, if that tax, fee, or payment is applicable to a broad range of 
business activity.". 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 38 USC 769 note. 
shall take effect with respect to premiums paid for periods begin-
ning after June 30,1988. 
SEC. 333. DIRECT ADMINISTRATION OF VETERANS' MORTGAGE LIFE 
INSURANCE. 
(a) REVISION OF PROGRAM.—(1) Section 806 is amended to read as 
follows: 
"§ 806. Veterans' Mortgage Life Insurance 
"(a) The United States shall automatically insure any eligible 
veteran who is or has been granted assistance in securing a suitable 
housing unit under this chapter against the death of the veteran 
unless the veteran (1) submits to the Administrator in writing the 
veterans' election not to be insured under this section, or (2) fails to 
respond in a timely manner to a request from the Administrator for 
information on which the premium for such insurance can be based. 
"(b) The initial amount of insurance provided a veteran under this 
section may not exceed the lesser of $40,000 or the amount of the 
loan outstanding on the housing unit. The amount of such insurance 
102 STAT. 538 
PUBLIC LAW 100-322—MAY 20, 1988 
shall be reduced according to the amortization schedule of the loan 
and may not at any time exceed the amount of the outstanding loan 
with interest. If there is no outstanding loan on the housing unit, 
insurance is not payable under this section. If an eligible veteran 
elects not to be insured under this section, the veteran may there-
after be insured under this section, but only upon submission of an 
application, payment of required premiums, and compliance with 
such health requirements and other terms and conditions as may be 
prescribed by the Administrator. 
"(c) The premiums charged a veteran for insurance under this 
section shall be paid at such time and in such manner as the 
Administrator prescribes. The rates for such premiums shall be 
based on such mortality data as the Administrator considers appro-
priate to cover only the mortality cost of insuring standard lives. In 
the case of a veteran receiving compensation or other cash benefits 
paid to the veteran by the Administrator, the Administrator shall 
deduct from such compensation or other benefits the premiums 
charged the veteran under this section. 
"(dKD The United States shall bear the costs of insurance under 
this section to the extent that such costs exceed premiums estab-
lished by the Administrator. Premiums collected on insurance 
under this section shall be credited to the 'Veterans Insurance and 
Indemnities' appropriation account, and all disbursements of insur-
ance proceeds under this section shall be made from that account. 
Appropriation 
"(2) There are authorized to be appropriated to the Administrator 
authorization. 
for such account such amounts as may be necessary to carry out this 
section. 
"(e) Any amount of insurance in force under this section on the 
date of the death of an eligible veteran insured under this section 
shall be paid to the holder of the mortgage loan, for payment of 
which the insurance was granted, for credit on the loan indebted-
ness. Any liability of the United States under such insurance shall 
be satisfied when such payment is made. If the Administrator is the 
holder of the mortgage loan, the insurance proceeds shall be cred-
ited to the loan indebtedness and, as appropriate, deposited in either 
the direct loan or loan guaranty revolving fund established by 
section 1823 or 1824 of this title, respectively. 
"(f) The Administrator may prescribe such regulations relating to 
eligibility for insurance under this section, the maximum amount of 
insurance, the effective date of insurance, the maximum duration of 
insurance, and other pertinent matters not specifically provided for 
in this section as the Administrator determines are in the best 
interest of veterans or the United States. 
"(g) The amount of the insurance in force at any time shall be the 
amount necessary to pay the mortgage indebtedness in full, except 
as otherwise limited by subsection (b) of this section or regulations 
prescribed by the Administrator under this section. 
"(h) The Administrator shall issue to each veteran insured under 
this section a certificate setting forth the benefits to which the 
veteran is entitled under the insurance. 
"(i) Insurance under this section shall terminate upon whichever 
of the following events first occurs: 
"(1) Satisfaction of the veteran's indebtedness under the loan 
upon which the insurance is based. 
"(2) The veteran's seventieth birthday. 
"(3) Termination of the veteran's ownership of the property 
securing the loan. 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 539 
"(4) Discontinuance of payment of premiums by the veteran. 
"(j) Termination of life insurance under this section shall not 
affect the guaranty or insurance of the loan by the Administrator.". 
(2) The item relating to section 806 in the table of sections at the 
beginning of chapter 21 is amended to read as follows: 
"806. Veteran's mortgage life insurance.". 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 38 USC 806 note. 
shall take effect on the first day of the fourth month beginning after 
the date of the enactment of this Act. 
(c) SAVINGS PROVISION.—Mortgage protection life insurance 
38 use 806 note. 
granted to any veteran under the former section 806 shall continue 
in force with the United States as insurer, subject to the terms of 
subsection (d). Nothing in that subsection shall impair any rights of 
any veteran or mortgage loan holder under the former section 806 
that matured before the effective date specified in subsection (b). 
(d) DISCONTINUANCE OF CONTRACT PROGRAM.—(1) Effective as of 
the effective date specified in subsection O
t
>
)
, the Administrator shall 
discontinue the policy of insurance purchased in accordance with 
the former section 806. 
(2) All premiums collected or received by the insurer on or after 
such effective date under a policy purchased under the former 
section 806 shall be promptly forwarded to the Administrator and 
shall be credited to the "Veterans Insurance and Indemnities" 
appropriation account. Any positive balance of the contingency 
reserve maintained by the insurer under such policy remaining 
after all charges have been made shall be payable to the Adminis-
trator and shall be deposited by the Administrator in such account, 
except that such balance may, upon the election of the insurer, be 
paid by the insurer in equal monthly installments over a period of 
not more than two years beginning on the date, after such effective 
date, that the Administrator specifies. 
(e) FORMER SECTION 806 DEFINED.—For the purpose of subsections 
(c) and (d), the term "former section 806" means section 806 of title 
38, United States Code, as in effect on the day before the effective 
date specified in subsection O^)-
PART E—MEMORIAL AFFAIRS 
SEC, 341. NATIONAL CEMETERY GRAVE MARKERS. 
Va) IN GENERAL.—Section 1004(cX2) is amended— 
(1) by striking out "and" at the end of clause (A); 
(2) by striking out the period at the end and inserting in lieu 
thereof a semicolon; and 
(3) by adding at the end the following new clauses: 
"(C) in the case of any cemetery located on the grounds of or 
adjacent to a Veterans' Administration health-care facility, the 
Administrator may provide for flat grave markers; and 
"(D) in the case of grave sites of cremated remains that are 
interred in the ground, the Administrator may provide for flat 
grave markers.". 
0)) GRAVE MARKERS IN CERTAIN LOCATIONS.—Notwithstanding sec- State 
tion 1004(cX2) of title 38, United States Code, the Administrator may ^^^\^ . „„. 
provide for flat grave markers in the cases of the national ceme- note 
teries in Riverside, California; Bourne, Massachusetts; Augusta, 
Michigan; and Indiantown Gap, Pennsylvania; and the proposed 
19-194 O—91—Part 1 
19 : QL 3 
102 STAT. 540 
PUBLIC LAW 100-322—MAY 20, 1988 
national cemetery approved by the Administrator, as of July 31, 
1987, for Northern California. 
SEC. 342. CONTRIBUTIONS FOR CERTAIN PROJECTS. 
Section 1004(f) is amended— 
(1) by striking out "The" and inserting in lieu thereof "(1) 
The"; and 
(2) by adding at the end the following new paragraph: 
"(2) The Administrator may, to the extent of appropriated funds 
available for such purpose, make a contribution to local authorities 
for the construction of road improvements or traffic controls or 
other devices on land adjacent to a national cemetery if the 
Administrator determines that such a contribution is essential to 
ensure safe ingress to or egress from the cemetery.". 
SEC. 343. STATE VETERANS' CEMETERY CONSTRUCTION GRANTS. 
Section 1008(b) is amended— 
(1) by striking out paragraph (1); 
(2) by redesignating paragraphs (2), (3), and (4) as paragraphs 
(1), (2), and (3), respectively; 
(3) in paragraphs (1) and (2) (as so redesignated), by striking 
out "per centum" and inserting in Ueu thereof "percent"; and 
(4) in paragraph (2) (as so redesignated), by striking out 
"paragraph (2)" and inserting in lieu thereof "paragraph (1)". 
SEC. 344. GRAVE LINERS. 
(a) AUTHORITY TO PROVIDE.—Section 906 is amended by adding at 
the end the following new subsection: 
"(e)(1) The Administrator may provide a grave liner for any grave 
in a cemetery within the National Cemetery System in which 
remains are interred in a ceisket. The Secretary of the Army may 
provide a grave liner for such a grave in the Arlington National 
Cemetery. 
"(2) The use of grave liners in a cemetery within the National 
Cemetery System or in the Arlington National (Demetery shall be in 
accordance with specifications and procedures approved by the 
Administrator or the Secretary, respectively.". 
(b) CLERICAL AMENDMENTS.—(1) The heading of such section is 
amended to read as follows: 
"§ 906. Headstones, markers, and grave liners". 
(2) The item relating to such section in the table of sections at the 
beginning of chapter 23 is amended to read as follows: 
"906. Headstones, markers, and grave liners.". 
SEC. 345. AMERICAN BATTLE MONUMENTS COMMISSION FOREIGN CUR-
RENCY FLUCTUATIONS. 
(a) ESTABLISHMENT OF FOREIGN CURRENCY FLUCTUATIONS AC-
COUNT.—The Act entitled "An Act for the creation of an American 
Battle Monuments Commission to erect suitable 
memorials 
commemorating the services of the American soldier in Europe, and 
for other purposes", approved March 4, 1923 (36 U.S.C. 121 et seq.), 
is amended by adding at the end the following new section: 
36 use 138c. 
"SEC. 13. (a) There is hereby established in the Treasury an 
account to be known as the 'Foreign Currency Fluctuations, Amer-
ican Battle Monuments Commission, Account. The account shall be 
used to provide funds, in addition to funds appropriated for salaries 
PUBLIC LAW 100-322—MAY 20,1988 
102 STAT. 541 
and expenses of the American Battle Monuments Commission, to 
pay the costs of such salaries and expenses that exceed the amount 
appropriated therefor as a result of fluctuations in currency ex-
change rates of foreign countries occurring after a budget request 
for the Commission is submitted to Congress. The account may not 
be used for any other purpose. Funds in the account may be 
transferred to funds appropriated for salaries and expenses of the 
Commission. 
"(b) Funds transferred under subsection (a) shall be merged with 
and available for the same time period as the appropriation to which 
they are applied. A provision of law limiting the amount of funds 
the Commission may obligate in any fiscal year shall be increased to 
the extent necessary to reflect fluctuations in exchange rates from 
those used in preparing the budget submission. 
"(c) An obligation of the Commission payable in the currency of a 
foreign country may be recorded as an obligation based upon ex-
change rates used in preparing a budget submission. A change 
reflecting fluctuations in exchange rates may be recorded as a 
disbursement is made. 
"(d) Funds transferred from the Foreign Currency Fluctuations, 
American Battle Monuments Commission, Account may be trans-
ferred back to that account— 
"(1) if the funds are not needed to pay obligations incurred 
because of fluctuations in currency exchange rates of foreign 
countries in the appropriation to which the funds were origi-
nally transferred; or 
"(2) because of subsequent favorable fluctuations in the rates 
or because other funds are, or become, available to pay such 
obligations. 
"(e) A transfer back to the account under subsection (d) may not 
be made after the end of the second fiscal year after the fiscal year 
in which the appropriation to which the funds were originally 
transferred is available for obligation. 
"(f) Not later than the end of the second fiscal year following the 
fiscal year for which appropriations for salaries and expenses have 
been made available to the Commission, unobligated balances of 
such appropriation provided for a fiscal year may be transferred 
into the Foreign Currency Fluctuations, American Battle Monu-
ments Commission, Account, to be merged with and available for 
the same period and purposes as that account. 
"(g) The Commission shall submit to the appropriate committees Reports, 
of the Congress each year a report on funds transferred under this 
section.". 
(b) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be 
36 use I38c 
appropriated to the Foreign Currency Fluctuations, American note. 
Battle Monuments Commission, Account the sum of $3,000,000. 
(c) EFFECTIVE DATE.—The amendment made by subsection (a) 36USCl38c 
applies with respect to each fiscal year after fiscal year 1988. note. 
SEC. 346. TRANSFER OF THE ARIZONA VETERANS MEMORIAL CEMETERY 
TO THE VETERANS' ADMINISTRATION. 
(a) IN GENERAL.—Not later than six months after the date of the 
enactment of this Act, the Administrator shall enter into an agree-
ment with the State of Arizona that— 
(1) provides for the conveyance to the United States, without 
consideration, of all right, title, and interest in and to the 
Contracts. 
Real property. 
102 STAT. 542 
PUBLIC LAW 100-322—MAY 20, 1988 
Arizona Veterans Memorial Cemetery in the State of Arizona, 
consisting of approximately 225 acres; and 
(2) commits the State to provide to the Veterans' Administra-
tion in a timely manner funding in the amount necessary to 
supplement Federal funding so that the level of operation and 
maintenance of the cemetery as of the date the agreement is 
entered into can be maintained during the three-year period 
beginning on the date of the conveyance of the cemetery under 
the agreement. 
(b) CEMETERY TO BECOME PART OF THE NATIONAL CEMETERY 
SYSTEM.—After acceptance by the Administrator, the Arizona Vet-
erans Memorial Cemetery shall become part of the National Ceme-
tery System and shall be administered in accordance with the 
provisions of chapter 24 of title 38, United States Code. 
(c) LEGAL DESCRIPTION.—The exact acreage and legal description 
of the real property to be conveyed under subsection (a) shall be 
determined by a survey that is conducted at no charge to the United 
States and is satisfactory to the Administrator of Veterans' Affairs. 
(d) TERMS AND CONDITIONS.—The Administrator may require such 
terms and conditions with respect to the conveyance authorized by 
this section £is the Administrator considers appropriate to protect 
the interests of the United States. 
(e) WAIVER OF LIABILITY FOR REPAYMENT OF VETERANS' ADMINIS-
TRATION GRANT.—The State of Arizona is not required to repay the 
Veterans' Administration, by reason of the conveyance of the Ari-
zona Veterans Memorial Cemetery under this section, the amount of 
any grant made to such State with respect to such cemetery under 
section 1008 of title 38, United States Code. 
(f) EXPENDITURES.—(1) During each of the one-year periods occur-
ring during the three-year period beginning on the date on which 
the conveyance under subsection (a) is made, the Administrator may 
not obligate appropriated funds for the operation and maintenance 
of the Arizona Veterans Memorial Cemetery in excess of the greater 
of— 
(A) the amount that the Administrator estimates would have 
been obligated for pa3mtient during the one-year period involved 
to the State pursuant to section 903(b)(1) of title 38, United 
States Code, in connection with the burial of deceased veterans 
had the cemetery not been transferred to the Veterans' 
Administration; or 
(B) the amount obligated for such purpose during fiscal year 
1987. 
(2XA) Subject to subparagraph (B), in each of the fiscal years 
occurring during the three-year period described in paragraph (1), 
the Administrator shall use amounts available for payments under 
such section 903(b)(1) for the operation and maintenance of such 
cemetery. 
(B) Expenditures under subparagraph (A) shall not exceed the 
applicable limitation under paragraph (1). 
(3) The Administrator shall use all funding received from the 
State, as described in subsection (aX2), for the operation and mainte-
nance of such cemetery. 
(g) ACCEPTANCE OF GIFTS.—The Administrator may accept devises, 
bequests, and gifts made in any manner by any person or entity for 
the purpose of the operation, maintenance, or improvement of the 
Arizona Veterans Memorial Cemetery after the Administrator has 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 543 
accepted title thereto pursuant to subsection (a) and shall use the 
funds or property involved for the intended purpose. 
(h) GRAVE MARKERS.—Notwithstanding section 1004(cX2) of title 
38, United States Code, the Administrator shall provide for the use 
of flat grave markers for interments at the Arizona Veterans Memo-
rial Cemetery after the conveyance of the cemetery to the United 
States. 
TITLE IV—VETERANS' ADMINISTRATION MANAGEMENT 
AND ADMINISTRATION 
PART A—PROCUREMENT POUCY 
SEC. 401. INTEGRITY OF CONTRACTING OUT PROCESS AT HEALTH-CARE 
FACILITIES. 
(a) REQUIREMENT FOR TWO BIDDERS.—Section 5010(cX2) is amended 
by inserting "responsive bids are received from at least two respon-
sible, financially autonomous bidders and" after "only if. 
(b) APPUCABILITY.—The amendment made by subsection (a) shall 
38 use 5010 
apply only with respect to the awarding of contracts under solicita- note, 
tions issued after the date of the enactment of this Act. 
SEC. 402. STANDARDIZATION 
OF MEDICAL 
AND PHARMACEUTICAL 38 USC 5025 
ITEMS. 
note. 
Not later than October 1, 1989, the Administrator shall develop 
and fully implement an agency-wide plan for the cost-effective 
standardization, in a manner consistent with the effective furnish-
ing of health-care services, of medical and pharmaceutical items 
procured by the Veterans' Administration. The plan shall provide 
for the procurement of generic pharmaceutical items when such 
procurement is more economical than procurement of a name-brand 
pharmaceutical item unless the Chief Medical Director of the Veter-
ans' Administration (1) determines, after consultation with the 
Commissioner of the Food and Drug Administration, that an equiva-
lent generic item is not available, or (2) determines that the procure-
ment of a name-brand item is necessary in the interests of effective 
patient care. 
SEC. 403. REQUIREMENTS FOR THE PROCUREMENT OF HEALTH-CARE 
ITEMS. 
(a) IN GENERAL.—(1) Subchapter II of chapter 81 is amended by 
adding at the end the following new section: 
"§ 5025. Procurement of health-care items 
38 USC 5025. 
"(a) Except as provided in subsections (b) and (c) of this section, 
the Administrator may not procure health-care items under local 
contracts. 
"(b)(1) A health-care item for use by the Veterans' Administration 
may be procured under a local contract if— 
"(A) the procurement is within the limits prescribed in para-
graph (3) of this subsection; and 
"(BXi) the item is not otherwise available to the Veterans' 
Administration medical center concerned, 
"(ii) procurement of the item by a local contract is necessary 
for the effective furnishing of health-care services or the con-
duct of a research or education program at a Veterans' 
Administration medical center, sis determined by the director of 
102 STAT. 544 
PUBLIC LAW 100-322—MAY 20, 1988 
Contracts. 
Reports. 
Reports. 
the center in accordance with regulations which the Chief 
Medical Director shall prescribe, or 
"(iii) procurement under a local contract is demonstrably 
more cost-effective for the item. 
"(2) In the case of the need for an emergency procurement of a 
health-care item, such item may be procured under a local contract, 
but no greater quantity of such item may be procured by a local 
contract than is reasonably necessary to meet the emergency need 
and the reasonably foreseeable need for the item at the medical 
center concerned until resupply can be achieved through procure-
ment actions other than emergency procurement. 
"(3XA) Except as provided in subparagraphs (C) and (D) of this 
paragraph, not more than 20 percent of the total of all health-care 
items procured by the Veterans' Administration in any fiscal year 
(measured as a percent of the total cost of all such health-care items 
procured by the Veterans' Administration in that fiscal year) may 
be procured under local contracts. 
"(B) Local contracts for the procurement of health-care items 
shall, to the maximum extent feasible, be awarded to regular 
dealers or manufacturers engaged in the wholesale supply of such 
items. 
"(C) The Administrator may increase for a fiscal year the percent-
age specified in subparagraph (A) of this section to a percentage not 
greater than 30 percent if the Administrator, based on the experi-
ence of the Veterans' Administration during the two fiscal years 
preceding such fiscal year, determines that the increase and the 
amount of the increase are necessary in the interest of the effective 
furnishing of health-care services by the Veterans' Administration. 
The authority to increase such percentage may not be delegated. 
"(D) Items procured through an emergency procurement shall not 
be counted for the purpose of this paragraph. 
"(c) A provision of law that is inconsistent with subsection (a) or 
(b) of this section shall not apply, to the extent of the inconsistency, 
to the procurement of a health-care item for use by the Veterans' 
Administration. 
"(d)(1) Not later than December 1 of each year, the director of 
each Veterans' Administration medical center shall transmit to the 
Administrator a report containing a list indicating the quantity of 
each health-care item procured at that medical center under a local 
contract during the preceding fiscal year and the total amount paid 
for such item during such fiscal year. 
"(2) Not later than February 1 of each year, the Administrator 
shall submit to the Committees on Veterans' Affairs of the Senate 
and the House of Representatives a report on the experience in 
carrying out this section during the preceding fiscal year. 
"(e) For the purposes of this section: 
"(1) The term 'health-care item' includes any item listed in, or 
(as determined by the Administrator) of the same nature as an 
item listed in. Federal Supply Classification (FSC) Group 65, 66, 
or 73. Such term does not include perishable items. 
"(2) The term 'local contract' means a contract entered into 
by a Veterans' Administration medical center for procurement 
of an item for use by that medical center. 
"(3) The term 'emergency procurement' means a procurement 
necessary to meet an emergency need, affecting the health or 
safety of a person being furnished health-care services by the 
Veterans' Administration, for an item.". 
PUBLIC LAW 100-322—MAY 20,1988 
102 STAT. 545 
(2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 5024 the 
following new item: 
"5025. Procurement of health-care items.". 
(b) EFFECTIVE DATES.—(1) Subsection QaXD of section 5025 of title 38 use 5025 
38, United States Code (as added by subsection (a)), shall take effect note-
one year after the date of the enactment of this Act. 
(2) Subsection (bX3) of such section shall apply to health-care items 
procured for use by the Veterans' Administration after Septem-
ber 30,1990. 
SEC. 404. MULTIYEAR PROCUREMENT OF CERTAIN MEDICAL ITEMS. 
(a) AUTHORITY FOR MULTIYEAR CONTRACTS.—Chapter 1 is amended 
by adding at the end the following new section: 
"§ 114. Multiyear procurement for certain medical items 
38 USC 114. 
"(a) The Administrator may enter into a multiyear contract for 
the procurement of supplies or services for use in Veterans' 
Administration health-care facilities if the Administrator makes 
each of the following determinations: 
"(1) Appropriations are available for obligations that are 
necessary for total payments that would be required during the 
fiscal year in which the contract is entered into, plus the 
estimated amount of any cancellation charge payable under 
the contract. 
"(2) The contract is in the best interest of the United States by 
reason of the effect that use of a multiyear, rather than one-
year, contract would have in— 
"(A) reducing costs; 
"(B) achieving economies in contract administration or in 
any other Veterans' Administration activities; 
"(C) increasing quality of performance by or service from 
the contractors; or 
"(D) encouraging effective competition. 
"(3) During the proposed contract period— 
"(A) there will be a continuing or recurring need for the 
supplies or services being procured; 
"(B) there is not a substantial likelihood of substantial 
changes in the need for such supplies or services in terms of 
the total quantity of such supplies or services or of the rate 
of delivery of such supplies or services; and 
"(C) the specifications for the supplies or services are 
expected to be reasonably stable. 
"(4) The risks relating to the prospective contractor's ability 
to perform in accordance with the specifications and other 
terms of the contract are not excessive. 
"(5) The use of a multiyear contract will not inhibit small 
business concerns in competing for the contract. 
"(6) In the case of the procurement of a pharmaceutical item 
for which a patent has expired less than four years before the 
date on which the solicitation of offers is issued, there is no 
substantial likelihood that increased competition among poten-
tial contractors would occur during the term of the contract as 
the result of the availability of generic equivalents increasing 
during the term of the contract. 
102 STAT. 546 
PUBLIC LAW 100-322—MAY 20, 1988 
"(bXD A multiyear contract authorized by this section shall 
contain— 
"(A) a provision that the obligation of the United States under 
the contract during any fiscal year which is included in the 
contract period and is subsequent to the fiscal year during 
which the contract is entered into is contingent on the availabil-
ity of sufficient appropriations (as determined by the Adminis-
trator pursuant to paragraph (2)(A) of this subsection) if, at the 
time the contract is entered into, appropriations are not avail-
able to cover the total estimated payments that will be required 
during the full term of the contract; and 
"(B) notwithstanding section 1502(a) of title 31, a provision for 
th6 payment of reasonable cancellation charges to compensate 
the contractor for nonrecurring, unrecovered costs, if any, if the 
performance is cancelled pursuant to the provision required by 
subparagraph (A) of this paragraph. 
"(2)(A) If, during a fiscal year aftfer the fiscal year during which a 
multiyear contract is entered into under this section, the Adminis-
trator determines that, in light of other funding needs involved in 
the operation of Veterans' Administration health-care programs, 
the amount of funds appropriated for such subsequent fiscal year is 
not sufficient for such contract, the Administrator shall cancel such 
contract pursuant to the provisions required by paragraph (1)(A) of 
this subsection. 
"(B) Cancellation charges under a multiyear contract shall be paid 
from the appropriated funds which were originally available for 
performance of the contract or the payment of cancellation costs 
unless such funds are not available in an amount sufficient to pay 
the entire amount of the cancellation charges payable under the 
contract. In a case in which such funds are not available in such 
amount, funds available for the procurement of supplies and serv-
ices for use for the same purposes as the supplies or services 
procured through such contract shall be used to the extent nec-
essary to pay such cost. 
"(c) Nothing in this section shall be construed so as to restrict the 
Administrator's exercise of the right to terminate for convenience a 
contract under any other provision of law which authorizes 
multiyear contracting. 
Regulations. 
"(d) The Administrator shall prescribe regulations for the im-
plementation of this section. 
"(e) For the purposes of this section: 
"(1) The term 'appropriations' has the meaning given that 
term in section 1511 of title 31. 
"(2) The term 'cancel' or 'cancellation' refers to the termi-
nation of a contract by the Administrator as required under 
paragraph (2)(BXi) of this subsection. 
"(3) The term 'multiyear contract' means a contract which by 
its terms is to remain in effect for a period which extends 
beyond the end of the fiscal year during which the contract is 
entered into but not beyond the end of the fourth fiscal year 
following such fiscal year. Such term does not include a contract 
for construction or for a lease of real property. 
"(4) The term 'nonrecurring, unrecovered costs' means those 
costs reasonably incurred by the contractor in performing a 
multiyear contract which (as determined under regulations pre-
scribed under subsection (d) of this section) are generally in-
curred on a one-time basis." 
PUBLIC LAW 100-322—MAY 20,1988 
102 STAT. 547 
(b) CLERICAL AMENDMENT.—The table of sections at the be^nning 
of such chapter is amended by adding at the end the following new 
item: 
"114. Multiyear procurement for certain medical items.". 
PART B—GENERAL ADMINISTRATIVE AND FINANCIAL MATTERS 
SEC. 411. SEQUESTRATION 
RULES 
APPLICABLE 
TO 
VETERANS* 
PROGRAMS. 
(a) RESTORATION OF CERTAIN REVOLVING FUNDS.—(1) Notwith- 38 use 113 note. 
standing section 601(b) of the Veterans' Benefits Improvement and 
Health-Care Authorization Act of 1986 (Public Law 99-576), section 
113(bK2) of title 38, United States Code, shall apply with respect to a 
sequestration order issued, or a sequestration law enacted, for any 
fiscal year after fiscal year 1985. 
(2) The Secretary of the Treasury shall take such action as is 
necessary to implement paragraph (1). Not later than 60 days after 
Reports, 
the date of the enactment of this Act, the Secretary shall submit to 
the Committees on Veterans' Affairs of the Senate and House of 
Representatives a report on the action taken by the Secretary 
pursuant to that paragraph. 
(b) EXTENSION OF EXEMPTION FOR CERTAIN SERVICE-C^ONNECTED 
REHABIUTATION 
AND EDUCATION 
BENEFITS.—Section 
113(a) is 
amended by striking out "(but only with respect to fiscal year 1987)" 
each place it appears in paragraphs (4) and (5). 
(c) TECHNICAL AMENDMENTS.—Subsection (d) of such section is Reports, 
amended by striking out "a joint report of the Directors of the Office 
of Management and Budget and the Congressional Budget Office" 
and inserting in lieu thereof "a report of the Director of the Office of 
Management and Budget". 
SEC. 412. CHILD-CARE 
SERVICES 
AT VETERANS' 
ADMINISTRATION 
FACILITIES. 
(a) OPERATION BY VETERANS' CANTEEN SERVICE.—Chapter 75 is 
amended by adding at the end the following new section: 
"§ 4209. Child-care centers 
"(aXl) The Administrator, through the Service, shall provide for 
the operation of child care centers at Veterans' Administration 
facilities in accordance with this section. The operation of such 
centers shall be carried out to the extent that the Administrator 
determines, based on the demand for the care involved, that such 
operation is in the.best interest of the Veterans' Administration and 
that is practicable to do so. The centers shall be available for the 
children of Veterans' Administration employees and, to the extent 
space is available, the children of other employees of the Federal 
Government and the children of employees of affiliated schools and 
corporations created under section 4161 of this title. 
' (2) There shall be in the Service an official who is responsible for 
all matters relating to the provision of child care services under the 
authority of this section. 
"(b) The Service shall establish reasonable charges for child-care 
services provided at each child-care center operated under this 
section. 'The charges shall be subject to the approval of the Adminis-
trator. In the case of a center operated directly by the Service, the 
charges with respect to the center shall be sufficient to provide for 
38 use 4209. 
Government 
organization and 
employees. 
102 STAT. 548 
PUBLIC LAW 100-322—MAY 20, 1988 
the operating expenses of the center, including the expenses of 
personnel assigned to the center. In the case of a center operated by 
a contractor which is a for-profit entity, the charges shall be estab-
lished by taking into consideration the value of the space and 
services furnished with respect to the center under subsection (cXD 
of this section. 
"(c) In connection with the establishment and operation of any 
child care center under this section, the Administrator— 
"(1) shall furnish, at no cost to the center, space in existing 
Veterans' Administration facilities and utilities, custodial serv-
ices, and other services and amenities necessary (as determined 
by the Administrator) for the health and safety of the children 
provided care at the center; 
"(2) may, on a reimbursable basis, convert space furnished 
under clause (1) of this subsection for use as the child care 
center and provide other items necessary for the operation of 
the center, including furniture, office machines and equipment, 
and telephone service, except that the Administrator may fur-
nish basic telephone service and surplus furniture and equip-
ment without reimbursement; 
"(3) shall provide for the participation (directly or through a 
parent advisory committee) of parents of children receiving care 
in the center in the establishment of policies to govern the 
operation of the center and in the oversight of the implementa-
tion of such policies; 
"(4) shall require the development and use of a process for 
determining the fitness and suitability of prospective employees 
of or volunteers at the center; and 
"(5) shall require in connection with the operation of the 
center compliance with all State and local laws, ordinances, and 
regulations relating to health and safety and the operation of 
child-care centers. 
Regulations. 
"(d) The Administrator shall prescribe regulations to carry out 
this section. 
"(e) For the purpose of this section, the term 'parent advisory 
committee' means a committee comprised of, and selected by, the 
parents of children receiving care in a child care center operated 
under this section.". 
(b) CLERICAL AMENDMENT.—The table of sections at the beginning 
of such chapter is amended by adding at the end the following new 
item: 
"4209. Child-care centers.". 
SEC. 413. ADVISORY COMMITTEE ON NATIVE-AMERICAN VETERANS. 
(a) NATIVE HAWAIIAN REPRESENTATION.—(1) Subsections (b) and 
(cX3XA) of section 19032 of the Veterans' Health-Care Amendments 
38 use 219 note, of 1986 (Public Law 99-272; 100 Stat. 388) are amended by striking 
out "and Alaska Natives" and inserting in lieu thereof ", Alaska 
Natives, and Native Hawaiians". 
(2) Subsection (g) of such section is amended to read as follows: 
"(g) DEFINITIONS.—For the purposes of this section: 
"(1) The term 'Alaska Native' has the meaning given the term 
'Native' in section 3(b) of the Alaska Native Claims Settlement 
Act (43 U.S.C. 1602(b)). 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 549 
"(2) The term 'Native Hawaiian' has the meaning given that 
term in section 813(3) of the Native American Programs Act of 
1974 (42 U.S.C. 2992c(3)).". 
(b) ONE-YEAR EXTENSION.—(1) Subsection (f)(1) of such section is 
amended by striking out "and February 1, 1988" and inserting in 
lieu thereof "February 1,1988, and February 1,1989". 
(2) Subsection (h) of such section is amended— 
(A) by striking out "second" and inserting in lieu thereof 
"third"; and 
(B) by striking out "the Committee" and inserting in lieu 
thereof "the Administrator". 
SEC. 414. MANAGEMENT OF CANTEEN SERVICE. 
(a) FINANCIAL MANAGEMENT.—(1) The second sentence of section 
4205 is amended by inserting "or other interest-bearing accounts" 
after "checking accounts". 
(2) Section 4206 is amended by striking out the second sentence. 
(b) EXEMPTION OF CANTEEN SERVICE FROM PERSONNEL CEILING.— 
(1) Chapter 75 is amended by adding at the end the following: 
"§ 4210. Exemption from personnel ceilings 
38 USC 4210. 
"Persons who are employed by the Service and compensated from 
the revolving fund established by section 4204 of this title may not 
be considered to be employees of the Veterans' Administration for 
the purposes of any personnel ceiling which may otherwise be 
applied to employees of the Veterans' Administration by the Presi-
dent or an official of the executive branch.". 
(2) The table of sections at the beginning of such chapter is 
amended by adding at the end the following new item: 
"4210. Exemption from personnel ceilings.". 
SEC. 415. TECHNICAL AMENDMENTS TO CHAPTER 37. 
(a) TECHNICAL REORGANIZATION OF SUBCHAPTER L—(1) Section 
1802(a) is amended— 
(A) by striking out "(a)" and inserting in lieu thereof "(aXl)"; 
(B) by striking out the first sentence and inserting in lieu 
thereof: "The veterans described in paragraph (2) of this subsec- Loans. 
tion are eligible for the housing loan benefits of this chapter."; 
(C) by striking out "in the preceding sentence, or in section 
1818 of this title," in the second sentence and inserting in lieu 
thereof "in paragraph (2)"; 
(D) by striking out "(1)" and "(2)" in the second sentence and 
inserting in lieu thereof "(A)" and "(B)", respectively; 
(E) by redesignating clauses (A) and (B) as clauses (i) and (ii), 
respectively; and 
(F) by adding at the end the following: 
"(2) The veterans referred to in the first sentence of paragraph (1) 
of this subsection are the following: 
"(A) Each veteran who served on active duty at any time 
during World War II, the Korean conflict, or the Vietnam era 
and whose total service was for 90 days or more. 
"(B) Each veteran who after September 15, 1940, was dis-
charged or released from a period of active duty for a service-
connected disability. 
"(C) Each veteran, other than a veteran described in clause 
(A) or (B) of this paragraph, who— 
102 STAT. 550 
PUBLIC LAW 100-322—MAY 20, 1988 
"(i) served after July 25, 1947, for a period of more than 
180 days and was discharged or released therefrom under 
conditions other than dishonorable; or 
"(ii) has served more than 180 days in active duty status 
and continues on active duty vsdthout a break therein. 
"(3) Any unused entitlement of World War II or Korean conflict 
veterans which expired under provisions of law in effect before 
October 23, 1970, is hereby restored and shall not expire until 
used.". 
(2) Subsection (g) of section 1802— 
(A) is amended by striking out "1801(a)" and inserting in lieu 
thereof "1801(b)"; and 
(B) £is amended by subparagraph (A) of this paragraph, is 
transferred so that it will appear at the end of subsection (a) of 
such section and is redesignated as paragraph (4) of such subsec-
tion (a). 
(3)(A) Section 1815— 
(i) is amended by striking out the section heading; 
(ii) is amended by redesignating subsection (a) as parsigraph 
(2)(A) and redesignating subsection (h) as subparagraph (B); and 
(iii) as amended by clauses (i) and (ii) of this subparagraph, is 
transferred so that it will appear as paragraph (2) of section 
1803(a), as amended by subparagraph (BXii) of this paragraph. 
(B) Section 1803 is amended— 
(i) by striking out the section heading and inserting in lieu 
thereof the following: 
"§ 1803. Basic provisions relating to loan guaranty and insur-
ance"; and 
(ii) in subsection (a) by striking out paragraph (2). 
(4) Section 1807 is repealed. 
(b) TECHNICAL REORGANIZATION OF SUBCHAPTERS II AND III.—(IXA) 
Section 1816(aX4XAXiXI) is amended by striking out "section 
1816(aX2) of this title" and inserting in lieu thereof "paragraph (2) of 
this subsection". 
(B) Section 1816(cX10) is amended— 
(i) in subparagraph (A), by inserting "(or such earlier date 
following the expiration of a reasonable period of time for such 
sale to occur as the Administrator may specify pursuant to 
regulations prescribed by the Administrator to implement this 
subsection)" after "loan"; and 
(ii) in subparagraph (BXii), by inserting "(5XA) or" after 
"under paragraph". 
(C) The heading and subsections (a), Ot)), and (c) of section 1816, as 
amended by subparagraphs (A) and (B) of this paragraph, are re-
designated as a new section 1832 and transferred to subchapter III of 
chapter 37 so that they will appear following section 1831. 
(D) Subsections (d), (e), and (f) of section 1816 are redesignated as 
subsections (a), (b), and (c), respectively, and transferred so that they 
will appear after section 1832, as transferred by subparagraph (C) of 
this paragraph with the following heading: 
"§ 1833. Property management". 
(2XA) Section 1817(a) is amended by striking out "under section 
1810" and inserting in lieu thereof "for purposes specified in section 
1810". 
XSt/^fHt" "
• ' • 
PUBLIC LAW 100-322—MAY 20,1988 
102 STAT. 551 
(B) Section 1817, as amended by subparagraph (A) of this para-
graph, and section 1817A are redesignated as sections 1813 and 1814, 
respectively, and transferred so that they will appear after section 
1812, as transferred by paragraph (4XC) of this subsection. 
(3) Section 1818 is repealed. 
(4)(A) Section 1819 is amended by striking out "under this section" 
each place it appears in subsections (aX4XC), (bXD, (cX2), (cX4), (dXD, 
(e), (f), (g) (except where it appears in the second sentence), and (hXl) 
and inserting in lieu thereof "for purposes specified in this section". 
(B) Section 1819(c) is amended— 
(i) in the first sentence of paragraph (3) by inserting before 
the period the following: "as specified in paragraph (4) of this 
subsection"; 
(ii) in the second sentence of paragraph (4), by striking out 
"under section 1810" and inserting in lieu thereof "for purposes 
specified in section 1810"; and 
(iii) in the second sentence of paragraph (4), by striking out 
"under such section 1810" and inserting in lieu thereof "for 
purposes specified in such section 1810". 
(C) Section 1819, as amended by subparagraphs (A) and (B) of this 
paragraph, is redesignated as section 1812 and transferred so that it 
will appear following section 1811. 
(5) Section 1832— 
(A) is amended by striking out the section heading; 
(B) is amended by redesignating subsection (a) as subsection 
(dXD and subsection (b) as paragraph (2); and 
(C) as amended by clause (A) and (B) of this paragraph, is 
transferred so that it will appear at the end of the new section 
1833 added by paragraph (4) of this subsection. 
(c) CONFORMING AMENDMENTS.—(1) Section 1801(a) is amended by 
striking out "1819(aXl)" and inserting in lieu thereof "1812(aXl) . 
(2) Section 1803(cX3) is amended— 
(A) in clause (A), by striking out "1819(aXlXF)" and inserting 
in lieu thereof "1812(aXlXF)"; and 
(B) in clause (E), by striking out "1819(aXlXG)" and inserting 
in lieu thereof "1812(aXlXG)". 
(3) Section 1804 is amended— 
(A) in clause (C) of subsection (cX2), by striking out 
"1819(aX5XAXi)" and inserting in lieu thereof ''l812(aX5XAXi)"; 
(B) in clause (D) of subsection (cX2), by striking out 
"1819(eX5)" and inserting in lieu thereof "1812(eX5)"; and 
(C) in subsection (f), by striking out "1817A" each place it 
appears and inserting in lieu thereof "1814". 
(4) Section 1810 is amended— 
(A) in subsection (aX9XBXii), by striking out 
"section 
1819(aX5)" and inserting in lieu thereof "section 1812(aX5)"; and 
(B) in subsection (gX2), by striking out "section 1819(eX2)" and 
inserting in lieu thereof "section 1812(eX2)". 
(5) Section 1811 is amended— 
(A) by striking out "1819" each place it appears and inserting 
in lieu thereof "1812"; and 
(B) in subsection (b), by striking out "1819(aXlXF)" and insert- 
• 
ing in lieu thereof "1812(aXlXF)". 
(6) Section 1829(d) is amended by striking out "1817A" and insert-
ing in lieu thereof "1814". 
(7) Any reference, in effect on the date of the enactment of this 
38 USC 1802 
Act, in any law, rule, or regulation to any of the sections, or parts note. 
102 STAT. 552 
PUBLIC LAW 100-322—MAY 20, 1988 
thereof, which are redesignated or transferred by this section shall 
be construed to refer to the section, or part thereof, as redesignated 
or transferred by this section, 
(d) TECHNICAL AMENDMENTS.—(1) Section 1803(aXl) is amended— 
(A) in clause (AXii), by inserting "as specified in subparagraph 
(B) of this paragraph" before the period; and 
(B) in clause (B), by striking out "under section 1810 of this 
chapter" and inserting in lieu thereof "for purposes specified in 
section 1810 of this title". 
(2) Section 1811 is amended— 
(A) in subsections (a), Ot)), and (g), by striking out "under 
section 1810 or" and inserting in lieu thereof 
for purposes 
specified in section 1810 or"; and 
(B) in subsection (d)(2XB), by striking out "under section 
1810(c)" and inserting in lieu thereof "for purposes specified in 
section 1810". 
(e) CLERICAL AMENDMENTS.—The table of sections at the beginning 
of chapter 37 is amended— 
(1) by striking out the item relating to section 1803 and 
inserting in lieu thereof the following: 
"1803. Basic provisions relating to loan guaranty and insurance."; 
(2) by striking out the item relating to section 1807; 
(3) by striking out the items relating to subchapter II and 
inserting in lieu thereof the following: 
"SUBCHAPTER II—LOANS 
"1810. Purchase or construction of homes. 
"1811. Direct loans to veterans. 
"1812. Loans to purchase manufactured homes and lots. 
"1813. Release from liability under guaranty. 
"1814. Assumptions; release from liability."; 
and 
(4) by striking out the item relating to section 1832 and 
inserting in lieu thereof the following: 
"1832. Procedure on default. 
"1833. Property management.". 
38 use 1802 
(f) TECHNICAL NATURE OF AMENDMENTS.—The status of any vet-
note, 
eran with respect to benefits under chapter 37 of title 38, United 
States Code, shall not be affected by the amendments made by, or 
other provisions of, this section. 
PART C—REAL PROPERTY 
SEC. 421. LIMITATION ON TRANSFER OF PROPERTY TO OTHER AGENCIES. 
(a) GENERAL RULE.—(1) Paragraph (2) of section 5022(a) is 
amended to read as follows: 
"(2XA) The Administrator may not during any fiscal year transfer 
to another Federal agency or to a State (or any political subdivision 
of a State) any interest in real property described in subparagraph 
(B) of this paragraph unless (i) the transfer (as proposed) w£is 
described in the budget for that fiscal year submitted to Congress 
pursuant to section 1105 of title 31, and (ii) the Veterans' Adminis-
tration receives compensation equal to the fair market value of the 
property. 
"(B) An interest in real property described in this subparagraph is 
an interest in real property that is owned by the United States and 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 553 
Reports. 
38 use 5022 
note. 
administered by the Veterans' Administration and that h£is an 
estimated value in excess of $50,000. 
"(C) Amounts realized from the transfer of any interest in real 
property described in subparagraph (B) of this paragraph shall be 
deposited in the nursing home revolving fund established under 
section 5016 of this title. . 
(2) Any proposed transfer of real property described in subpara-
graph (B) of section 5022(aX2) of title 88, United States Code, as 
amended by paragraph (1), that is described in a report submitted to 
the Committees on Veterans' Affairs of the Senate and House of 
Representatives by the Administrator not later than 30 days after 
the date of the enactment of this Act shall be deemed for purposes of 
subparagraph (A) of that section to have been described in the 
President's budget for fiscal year 1989. 
(b) SPECIAL RULE.—(1) Section 234 of Public Law 99-576 is re- l
O
O Stat. 3266. 
pealed. 
(2) The Administrator may not declare as excess to the needs of California, 
the Veterans' Administration, or otherwise take any action to dis-
pose of, the land and improvements at the Veterans' Administration 
Medical Center, West Los Angeles, California (consisting of 
approximately 109 acres), and at the Veterans' Administration 
Medical Center, Sepulveda, California (consisting of approximately 
46 acres), described in letters dated February 5, 1986 (and enclosed 
maps), from the Administrator to the Committees on Veterans' 
Affairs of the Senate and House of Representatives pursuant to 
section 5022(aK2) of title 38, United States Code, as in effect on that 
date. 
SEC. 422. CONGRESSIONAL PROCEDURES FOR APPROVAL OF MEDICAL 
FACILITY ACQUISITION AND CONSTRUCTION. 
(a) PROCEDURES.—Paragraph (2) of section 5004(a) is amended to 
read as follows: 
"(2) It shall not be in order in the Senate or in the House of 
Representatives to consider a bill, resolution, or amendment which 
would make an appropriation for any fiscal year which may be 
expended for a major medical facility project or a major medical 
facility lease unless— 
"(A) such bill, resolution, or amendment specifies the amount 
to be appropriated for that project or lease, 
"(B) the project or lease has been approved in a resolution 
adopted by the Committee on Veterans' Affairs of that House, 
and 
"(C) the amount to be appropriated for that project or lease is 
no more than the amount specified in that resolution for that 
project or lease for that fiscal year.". 
O
t
)
) DEFINITIONS.—Section 5004(a) is further amended by striking 
out paragraphs (3) and (4) and inserting in lieu thereof the following: 
"(3) For the purpose of this subsection: 
"(A) The term 'major medical facility project' means a project 
for the construction, alteration, or acquisition of a medical 
facility involving a total expenditure of more than $2,000,000, 
but such term does not include an acquisition by exchange. 
"(B) The term 'major medical facility lease' means a lease for 
space for use as a medical facility at an average annual rental 
of more than $500,000.". 
(c) COST VARIATIONS.—Subsection (c) of section 5004 is amended to 
read as follows: 
102 STAT. 554 
PUBLIC LAW 100-322—MAY 20, 1988 
"(c) Not less than 30 days before obligating funds for a major 
medical facility project approved by a resolution described in subsec-
tion (a)(2) of this section in an amount that would cause the total 
amount obligated for that project to exceed the amount specified in 
the resolution for that project (or would add to total obligations 
exceeding such specified amount) by more than 10 percent, the 
Administrator shall provide the committees with notice of the 
Administrator's intention to do so and the reasons for the specified 
amount being exceeded.". 
(d) CONFORMING REPEAL.—Such section is further amended— 
(1) by striking out subsection (d); and 
(2) by redesignating subsections (e) and (f) as subsections (d) 
and (e), respectively. 
SEC. 423. USE OF FORMER HOSPITAL IN MINOT, NORTH DAKOTA. 
(a) AGREEMENT WITH SECRETARY OF LABOR.—Upon the satisfaction 
of the conditions specified in subsection (b), the Administrator shall 
enter into an agreement with the Secretary of Labor for the use by 
the Secretary for nominal consideration of the 20.6 acres of land in 
the city of Minot, North Dakota, on which the Department of the 
Air Force on July 31, 1987, was operating, under a no-cost use 
agreement with the Veterans' Administration, the John Moses Air 
Force Hospital and on which the Veterans' Administration Hospital, 
Minot, North Dakota, was formerly located. 
(b) CONDITIONS.—The conditions referred to in subsection (a) are as 
follows: 
(1) Sufficient funds are appropriated to the Department of 
Labor by the end of fiscal year 1989 to enable the Department to 
establish a Job Corps Center in North Dakota. 
(2) The Secretary of Labor selects the property referred to in 
subsection (a) as the site for such a Job Corps Center. 
(3) The Secretary agrees to use such property as a Job Corp 
Center for the duration of the lease agreement with the 
Administrator. 
(c) RENEWALS.—The agreement between the Administrator and 
the Secretary of Labor under subsection (a) shall be renewed for 
nominal consideration for successive 10-year periods upon request of 
the Secretary of Labor. 
(d) REVERSAL OF PRIOR ADMINISTRATIVE ACTION.—The action of 
the Veterans' Administration of September 29, 1987, in declaring 
the property referred to in subsection (a) to be excess to the needs of 
the Veterans' Administration is hereby rescinded, and such prop-
erty is returned to the jurisdiction of the Veterans' Administration. 
(e) PROHIBITION ON VETERANS' ADMINISTRATION EXPENDITURES.— 
Notwithstanding any other provision of law, the Veterans' Adminis-
tration shall not expend any funds for the repair, improvement, or 
alteration of the property referred to in subsection (a) in connection 
with the use of such property by the Secretary of Labor. 
SEC. 424. NAMING OF VETERANS' ADMINISTRATION MEDICAL CENTER IN 
SHREVEPORT, LOUISIANA. 
Public buildings 
The Veterans' Administration Medical Center in Shreveport, Lou-
and grounds. 
isiana, shall after the date of the enactment of this Act be known 
PUBLIC LAW 100-322—MAY 20, 1988 
102 STAT. 555 
and designated as the "Overton Brooks Veterans' Administration 
Medical Center". Any reference to such medical center in any law, 
regulation, map, document, record, or other paper of the United 
States shall after such date be d^med to be a reference to the 
Overton Brooks Veterans' Administration Medical Center. 
Approved May 20,1988. 
LEGISLATIVE HISTORY—H.R. 2616 (S. 9): 
HOUSE REPORTS: No. 100-191 (Comm. on Veterans' Affairs) and No. 100-578 
(Comm. of C!onference). 
SENATE REPORTS: No. 100-215 accompanying S. 9 (Ck)mm. on Veterans' Affairs). 
CONGRESSIONAL RECORD: 
Vol. 133 (1987): June 29, 30, considered and passed House. 
Dec. 3, S. 9 considered in Senate. 
Dec. 4, H.R. 2616 considered and passed Senate, amended, in 
_ 
. _ 
lieu of S. 9. 
Vol. 134 (1988): Mar. 29, House concurred in Senate amendments with amend-
,. 
ments. 
_ 
Apr. 27, House agreed to conference report. 
Apr. 28, Senate agreed to conference report.