Veterans' Administration Health-Care Amendments of 1985
PL 99-166 (H.R.505), enacted 12/03/1985

PUBLIC LAW 99-166—DEC. 3, 1985 
99 STAT. 941 
Public Law 99-166 
99th Congress 
An Act 
To amend title 38, United States Code, to establish, extend, and improve certain 
Veterans' Administration health-care programs, and for other purposes. 
Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the "Veterans' 
Administration Health-Care Amendments of 1985". 
(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. 
TITLE I—HEALTH-CARE PROGRAMS 
Sec. 101. Alcohol and drug treatment and rehabilitation. 
Sec. 102. Special contract-care authority outside the 48 contiguous States. 
Sec. 103. Extension of interim health-care eligibility based on exposure to dioxin or 
other toxic substances in Vietnam or to nuclear radiation. 
Sec. 104. Outpatient and ambulatory services following nursing home or domicili-
ary care. 
Sec. 105. Vietnam Veteran Resource Centers pilot program. 
Sec. 106. Technical amendment relating to continuing availability of readjustment 
counseling. 
Sec. 107. Counseling for former prisoners of war. 
Sec. 108. Transfers for nursing home care. 
Sec. 109. Chiropractic services pilot program. 
TITLE II—HEALTH-CARE ADMINISTRATION 
Sec. 201. Medical quality-assurance records. 
Sec. 202. Authority to expand Geriatric Research, Education, and Clinical Centers 
program. 
Sec. 203. Revision of authority for appointment of student nurses and graduate 
nurses. 
Sec. 204. Quality assurance and credentialing. 
Sec. 205. Availability of State financial support for approved State home projects. 
Sec. 206. Procedures for reduction or revocation of clinical privileges. 
TITLE III—VETERANS' ADMINISTRA-nON MEDICAL FACILITIES 
Sec. 301. Clarification of requirement of congressional approval of construction and 
acquisition projects. 
Sec. 302. Operational and construction planning requirement. 
Sec. 303. Major facility prospectus requirement. 
Sec. 304. Development of medical-facility modular components. 
Sec. 305. Feasibility study of and plan for the purchase of a facility for furnishing 
hospital and nursing home care. 
•HTLE IV—MISCELLANEOUS PROVISIONS 
Sec 
Sec 
401. 
402. 
Servicemen's Group Life Insurance and Veterans' Group Life Insurance. 
Extension of authority to operate an office in the Republic of the Philip-
pines. 
Veterans' Administration grade reduction. 
Land transfer. Phoenix, Arizona. 
Sec. 405. Modification of restrictions on real property, Milwaukee County, Wiscon-
sin. 
Sec 
Sec 
403. 
404. 
Dec. 3, 1985 
[H.R. 505] 
Veterans' 
Administration 
Health-Care 
Amendments of 
1985. 
38 u s e 101 note. 
99 STAT. 942 
PUBLIC LAW 99-166—DEC. 3, 1985 
TITLE IV—MISCELLANEOUS PROVISIONS—Continued 
Sec. 406. Authority to release limitation on use of real property, McKinney, Texas. 
Sec. 407. Modification of restrictions on real property and conveyance of a fence on 
such property, Salt Lake City, Utah. 
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 
' a repeal of, a section or other provision, the reference shall be 
considered to be made to a section or other provision of title 38, 
United States Code. 
TITLE I—HEALTH-CARE PROGRAMS 
SEC. 101. ALCOHOL AND DRUG TREATMENT AND REHABILITATION. 
Ante, p. 481. 
(a) EXTENSION OF SPECIAL CONTRACT AUTHORITY.—Section 620A is 
38 use 620A. 
amended— 
(1) in subsection (a)(1)— 
(A) by striking out "may conduct a pilot program under 
which the Administrator" in the first sentence; and 
(B) by striking out the second sentence; 
(2) by striking out "October 31, 1985" in subsection (e) and 
inserting in lieu thereof "September 30,1988"; and 
(3) by striking out subsection (f) and inserting in lieu thereof 
the following: 
"(f)(1) The Administrator shall monitor the performance of each 
contract facility furnishing care and services under the program 
carried out under subsection (a) of this section. 
"(2) The Administrator shall use the results of such monitoring to 
determine— 
"(A) with respect to the program, the medical advantages and 
cost-ejffectiveness that result from furnishing such care and 
services; and 
"(B) with respect to such contract facilities generally, the 
level of success under the program, considering— 
"(i) the rate of successful rehabilitation for veterans fur-
nished care and services under the program; 
"(ii) the rate of readmission to contract facilities under 
the program or to Veterans' Administration health-care 
facilities by such veterans for care or services for disabil-
ities referred to in subsection (a) of this section; 
"(iii) whether the care and services furnished under the 
program obviated the need of such veterans for hospitaliza-
tion for such disabilities; 
"(iv) the average duration of the care and services fur-
nished such veterans under the program; 
"(v) the ability of the program to aid in the transition of 
such veterans back into their communities; and 
"(vi) any other factor that the Administrator considers 
appropriate. 
Records. 
"(3) The Administrator shall maintain records of— 
"(A) the total cost for the care and services furnished by each 
contract facility under the program; 
"(B) the average cost per veteran for the care and services 
furnished under the program; and 
"(C) the appropriateness of such costs, by comparison to— 
"(i) the average charges for the same types of care and 
services furnished generally by other comparable halfway 
PUBLIC LAW 99-166—DEC. 3, 1985 
STAT. 943 
houses, therapeutic communities, psychiatric residential 
treatment centers, and other community-based treatment 
facilities; and 
"(ii) the historical costs for such care and services for the 
period of time that the program carried out under subsec-
tion (a) of this section was a pilot program, taking into 
account economic inflation. 
"(4) Not later than February 1, 1988, the Administrator shall 
submit to the Committees on Veterans' Affairs of the Senate and 
House of Representatives a report on the experience under the 
program carried out under this section during fiscal years 1984 
through 1987. The report shall include— 
"(A) a description of the care and services furnished; 
"(B) the matters referred to in paragraphs (1), (2), and (3) of 
this subsection; and 
"(C) the Administrator's findings, assessment, and rec-
ommendations regarding the program under this section.", 
(b) CONFORMING AMENDMENTS.—(1) The heading for such section 
is amended by striking out the semicolon and the last two words. 
(2) The item relating to such section in the table of sections at the 
beginning of chapter 17 is amended by striking out the semicolon 
and the last two words. 
SEC. 102. SPECIAL CONTRACT-CARE AUTHORITY OUTSIDE THE 48 CONTIG-
UOUS STATES. 
(a) REVISION OF SPECIAL CONTRACT CARE AUTHORITY.—Section 
601(4XC)(v) is amended— 
(1) by striking out "(except with respect to Aleiska and 
Hawaii) shall expire on October 31, 1985" and inserting in lieu 
thereof "with respect to the Commonwealth of Puerto Rico shall 
expire on September 30,1988"; and 
(2) by striking out "and to the Virgin Islands". 
(b) PHASE-OUT OF SPECIAL AUTHORITY IN PUERTO RICO.—(1) Effec-
tive on October 1,1988, such section is amended— 
(A) by inserting "(other than the Commonwealth of Puerto 
Rico)" after "in a State"; and 
(B) by striking out "contiguous States" the second place it 
appears and all that follows through "medical services;" and 
inserting in lieu thereof "contiguous States and the Common-
wealth of Puerto Rico;". 
(2) During fiscal year 1986, the obligations incurred for Puerto 
Rico contract care may not exceed 85 percent of the obligations 
incurred for such care for fiscal year 1985. 
(3) During fiscal year 1987, the obligations incurred for Puerto 
Rico contract care may not exceed 50 percent of the obligations 
incurred for such care for fiscal year 1985. 
(4) During fiscal year 1988, the obligations incurred for Puerto 
Rico contract care may not exceed 25 percent of the obligations 
incurred for such care for fiscal year 1985. 
(5) For the purpose of this subsection, the term "obligations 
incurred for Puerto Rico contract care" means the total obliga-
tions incurred during a fiscal year for medical services for veterans 
residing in the Commonwealth of Puerto Rico under the Adminis-
trator's authority to contract for hospital care or medical services 
under clause (v) of section 601(4)(C) of title 38, United States Code, in 
the Commonwealth of Puerto Rico. 
Report. 
Puerto Rico. 
Ante, p. 481. 
Alaska. 
Hawaii. 
Virgin Islands. 
Effective 
date. 
Prohibition. 
38 u s e 601 note. 
38 u s e 601 note. 
38 u s e 601 note. 
38 u s e 601 note. 
99 STAT. 944 
PUBLIC LAW 99-166—DEC. 3, 1985 
38 use 610. 
38 use 612A. 
Employment 
and 
unemployment. 
38 use 2003, 
2003A. 
Drugs and drug 
abuse. 
SEC. 103. EXTENSION OF INTERIM HEALTH-CARE ELIGIBILITY BASED ON 
EXPOSURE TO DIOXIN OR OTHER TOXIC SUBSTANCES IN VIET-
NAM OR TO NUCLEAR RADIATION. 
Section 610(e)(3) is amended by striking out "after the end o f and 
all that follows and inserting in lieu thereof "after September 30, 
1989.". 
SEC. 104. OUTPATIENT AND AMBULATORY SERVICES FOLLOWING NURS-
ING HOME OR DOMICILIARY CARE. 
Section 612(f)(1) is amended— 
(1) by striking out "where" the first two places it appears and 
inserting in lieu thereof "if; 
(2) by inserting a comma and "nursing home care, or domi-
ciliary care" after "hospital care" the second place it appears; 
(3) by striking out "hospital" the fourth place it appears; and 
(4) by striking out "in-hospital" and inserting in lieu thereof 
"such'\ 
SEC. 105. VIETNAM VETERAN RESOURCE CENTERS PILOT PROGRAM. 
Section 612A is amended by adding at the end the following new 
subsection: 
"(h)(1) During the period beginning on January 1, 1986, and 
ending on September 30, 1988, the Administrator shall conduct a 
pilot program to provide and coordinate the provision of services 
described in paragraph (2) of this subsection. The pilot program 
shall be carried out in order to evaluate the effectiveness, feasibility, 
and desirability of providing veterans eligible for readjustment 
counseling under this section with additional services through facili-
ties furnishing such counseling. 
"(2) The services referred to in paragraph (1) of this subsection 
are— 
"(A) counseling with respect to, and assistance in applying 
for, all benefits and services under laws administered by the 
Veterans' Administration for which veterans participating in 
the pilot program may be eligible; 
"(B) employment counseling, training, placement, and related 
services described in sections 2003 and 2003A of this title or 
provided under any other law administered by the Secretary of 
Labor; 
"(C) initial intake and referral services with respect to disabil-
ities related to alcohol or drug dependence or abuse and follow-
up services for veterans who have received treatment for such 
disabilities; and 
"(D) assistance in coordinating the provision of benefits and 
services to veterans participating in the pilot program with 
respect to such veterans' receipt of— 
"(i) services provided under the pilot program; and 
"(ii) other benefits and services provided under laws 
administered by the Veterans' Administration, the Sec-
retary of Labor, or any other Federal agency or official. 
"(3)(A) In order to carry out the pilot program, the Administrator 
shall— 
"(i) designate £is sites for demonstration projects 10 facilities 
which on the date of the enactment of this section are providing 
readjustment counseling under this section; and 
"(ii) assign such staff and other resources to such facilities as 
are necessary to enable such facilities to provide the services 
PUBLIC LAW 99-166—DEC. 3, 1985 
99 STAT. 945 
38 use 2003A. 
38 use 2004. 
Report. 
referred to in subparsigraphs (A) and (C) of paragraph (2) of this 
subsection. 
"(B) Facilities designated under subparagraph (A) of this para-
graph shall be known as Vietnam Veteran Resource Centers 
(hereinafter in this subsection referred to as 'Centers')-
"(4) The Administrator— 
"(A) shall be responsible for coordinating the assignment and 
use of employees, on full- or part-time bases, as appi opriate, in 
each Center; and 
"(B) shall, in carrying out that responsibility, make mciximum 
feasible use of the Veterans' Administration employees who are 
providing services at each facility on the date it is designated as 
a Center under this subsection. 
"(5) The Secretary of Labor shall provide for the assignment to 
each Center, on full- or part-time bases, as the Secretary considers 
appropriate, of disabled veterans' outreach specialists appointed 
under section 2003A of this title or employees on the staffs of local 
employment service offices who are assigned to perform services 
under section 2004 of this title. 
"(6) Not later thein April 1, 1987, the Administrator shall submit 
to the Committees on Veterans' Affairs of the Senate and House of 
Representatives a report on the experience under the pilot program 
during its first 15 months of operation. The report shall include— 
"(A) the Administrator's assessment of— 
"(i) the effectiveness of the pilot program in providing 
and coordinating the provision of the services described in 
pars^aph (2) of this subsection and counseling and services 
furnished under subsections (a) and (b) of this section; and 
"(ii) the appropriateness of the use of the personnel 
assigned to the program; 
"(B) a description of any administrative action that the 
Administrator plans to take generally to increase the coordina-
tion of the provision of such services to veterans eligible for 
readjustment counseling services under this section; 
"(C) any recommendation that the Administrator considers 
appropriate; and 
(D) a comparison of such assessment, plans, and rec-
ommendations with the evaluation of and the recommendations 
relating to the readjustment counseling program included in 
the report required by subsection (gX2) of this section. 
"(7) Not later than January 1, 1989, the Administrator shall 
submit to such Committees a final report on the pilot program. The 
report shall include— 
"(A) updates of all information provided in the report submit-
ted pursuant to paragraph (6) of this subsection; and 
"(B) the Administrator's final assessment of the pilot program 
based on 33 months of operation.". 
SEC. 106. TECHNICAL AMENDMENT RELATING TO CONTINUING AVAIL-
ABILITY OF READJUSTMENT COUNSELING, 
Section 612A(gXlXB) is amended by striking out "who requested 
38 USC 612A. 
counseling before such date" £ind inserting in lieu thereof "who 
request such counseling". 
SEC. 107. COUNSELING FOR FORMER PRISONERS OF WAR. 
(a) IN GENERAL.—Subchapter II of chapter 17 is amended by 
inserting after section 612A the following new section: 
Report. 
99 STAT. 946 
PUBLIC LAW 99-166—DEC. 3, 1985 
38 use 612B. 
"§ 612B. Counseling for former prisoners of war 
"The Administrator may establish a program under which, upon 
the request of a veteran who is a former prisoner of war, the 
Administrator, within the limits of Veterans' Administration facili-
ties, furnishes counseling to such veteran to assist such veteran in 
overcoming the psychological effects of the veteran's detention or 
internment as a prisoner of war.". 
O
b
) CLERICAL AMENDMENT.—The table of sections at the beginning 
of such chapter is amended by inserting after the item relating to 
section 612A the following new item: 
"612B. Counseling for former prisoners of war.". 
SEC. 108. TRANSFERS FOR NURSING HOME CARE. 
38 use 620. 
(a) IN GENERAL.—Subsection (a) of section 620 is amended to read 
as follows: 
"(a)(1) Subject to subsection (b) of this section, the Administrator 
may transfer to a non-Veterans' Administration nursing home, for 
care at the expense of the United States— 
"(A) a veteran— 
"(i) who has been furnished hospital care, nursing home 
care, or domiciliary care by the Administrator in a facility 
under the direct jurisdiction of the Administrator; and 
"(ii) who the Administrator determines— 
"(I) requires a protracted period of nursing home care 
which can be furnished in the non-Veterans' Adminis-
tration nursing home; and 
"(II) in the case of a veteran who has been furnished 
hospital care in a facility under the direct jurisdiction 
of the Administrator, has received maximum benefits 
from such care; and 
"(B) a member of the Armed Forces— 
"(i) who has been furnished care in a hospital of the 
Armed Forces; 
"(ii) who the Secretary concerned determines has 
received maximum benefits from such care but requires a 
protracted period of nursing home care; and 
"(iii) who upon discharge from the Armed Forces will 
become a veteran. 
"(2) The Administrator may transfer a person to a nursing home 
under this subsection only if the Administrator determines that the 
cost to the United States of the care of such person in the nursing 
home will not exceed— 
"(A) the amount equal to 45 percent of the cost of care 
furnished by the Veterans' Administration in a general hospital 
under the direct jurisdiction of the Administrator (as such cost 
may be determined annually by the Administrator); or 
"(B) the amount equal to 50 percent of such cost, if such 
higher amount is determined to be necessary by the Adminis-
trator (upon the recommendation of the Chief Medical Director) 
to provide adequate care. 
Prohibition. 
"(3) Nursing homo care may not be furnished under this subsec-
tion at the expense of the United States for more than six months in 
the aggregate in connection with any one transfer except— 
"(A) in the case of a veteran— 
PUBLIC LAW 99-166—DEC. 3, 1985 
99 STAT. 947 
Alaska. 
Hawaii. 
"(i) who is transferred to a non-Veterans' Administration 
nursing home from a hospital under the direct jurisdiction 
of the Administrator; and 
"(ii) whose hospitalization was primarily for a service-
connected disability; 
"(B) in a case in which the nursing home care is required for a 
service-connected disability; or 
"(C) in a case in which, in the judgment of the Administrator, 
a longer period of nursing home care is warranted. 
"(4) A veteran who is furnished care by the Administrator in a 
hospital or domiciliary facility in Alaska or Hawaii may be fur-
nished nursing home care at the expense of the United States under 
this subsection even if such hospital or domiciliary facility is not 
under the direct jurisdiction of the Administrator.". 
C
o
) ADMISSION T
O CONTRACT NURSING HOMES OF CERTAIN VETER-
ANS.—Subsection (d) of such section is amended— 
(1) by inserting "(1)" after "(d)"; 
(2) by striking out "to any public or private institution not 
under the jurisdiction of the Administrator which furnishes 
nursing home care" in the first sentence and inserting in heu 
thereof "to any non-Veterans' Administration nursing home"; 
(3) by inserting after the first sentence the following new 
sentence: "The Administrator may also authorize a direct 
admission to such a nursing home for nursing home care for any 
veteran who has been discharged from a hospital under the 
direct jurisdiction of the Administrator and who is currently 
receiving medical services as part of home health services from 
the Veterans' Administration. ; 
(4) by striking out the sentence beginning "Such admission" 
and inserting in lieu thereof the following: 
"(2) Direct admission authorized by paragraph (1) of this subsec- Physicians. 
tion may be authorized upon determination of need therefor— 
"(A) by a physician employed by the Veterans' Administra-
tion; or 
"(B) in areas where no such physician is available, by a 
physician carrying out such function under contract or fee 
arrangement, 
based on an examination by such physician."; and 
(5) by designating the last sentence as paragraph (3). 
(c) 
DEFINITION 
OF NON-VETERANS' 
ADMINISTRATION 
NURSING 
HOME.—Subsection (e) of such section is amended— 
(1) by inserting "(1)" after "(e)"; 
(2) by striking out "subsection (a)(ii)" in the second sentence 
and inserting in lieu thereof "subsection (a)(2XB)"; and 
(3) by adding at the end the following: 
"(2) For the purposes of this section, the term 'non-Veterans' 
Administration nursing home' means a public or private institution 
not under the direct jurisdiction of the Administrator which fur-
nishes nursing home care.". 
(d) IMPROVEMENT IN PENSION PROGRAM ADMINISTRATION.—(1) In 
order to improve the timeliness of adjustments made pursuant to 
section 3203(a) of title 38, United States Code, in the amount of 
pension being paid to a veteran who is being furnished nursing 
home care by the Veterans' Administration, the Chief Medical 
Director of the Veterans' Administration shall develop improved 
procedures for notifying the Chief Benefits Director of the Veterans' 
Administration when a veteran is admitted to a nursing home. 
38 use 3203 
note. 
98 Stat. 43. 
99 STAT. 948 
PUBLIC LAW 99-166—DEC. 3, 1985 
Report. 
(2) The Administrator shall submit to the Committees on Veter-
ans' Affairs of the Senate and House of Representatives a report on 
the development and implementation of such procedures. The report 
shall be submitted not later than 90 days after the date of the 
enactment of this Act. 
38 u s e 610 note. 
SEC. 109. CHIROPRACTIC SERVICES PILOT PROGRAM. 
(a) EsTABUSHMENT OF PiLOT PROGRAM.—(1) The Administrator of 
Veterans' Affairs shall conduct a pilot program to evaluate the 
therapeutic benefits and the cost-effectiveness of furnishing certain 
chiropractic services to veterans eligible for medical services under 
38 use 601 
chapter 17 of title 38, United States Code. Such a veteran is eligible 
etseq. 
to receive chiropractic services under the pilot program if the 
veteran was furnished hospital care or medical services by the 
Veterans' Administration for a neuromusculoskeletal condition of 
the spine within the 12-month period immediately preceding the 
commencement of the furnishing of such chiropractic services. 
(2) The pilot program shall consist of not less than one demonstra-
tion project in each of five geographic regions of the United States 
designated by the Administrator for the purpose of this section. 
(3) The pilot program shall be carried out during the period 
beginning on January 1, 1986, and ending on December 31, 1988. 
(b) CONSULTATION AND COORDINATION.—In developing the pilot 
program, the Administrator shall consult with the Secretary of 
Defense regarding the demonstration projects carried out by the 
Secretary under section 632(b) of the Department of Defense 
98 Stat. 2543. 
Authorization Act, 1985 (10 U.S.C. 1092 note). In designing, conduct-
ing, and evaluating the pilot program, the Administrator shall 
obtain advice and recommendations from recognized medical or 
scientific authorities in the treatment of neuromusculoskeletal 
conditions of the spine. The Administrator shall ensure that there is 
adequate participation by chiropractors in the design and evaluation 
of the demonstration projects, including participation by representa-
tives from chiropractic colleges recognized by an approved accredit-
ing organization. 
(c) PAYMENT FOR CHIROPRACTIC SERVICES UNDER THE PILOT PRO-
GRAM.—(1)(A) The Administrator shall pay the reasonable charge 
for chiropractic services furnished to eligible veterans under the 
pilot program. 
Insurance. 
(B) The Administrator may not pay for such services to the extent 
Contracts. 
that the veteran is entitled to such services (or reimbursement for 
the expenses of such services) under— 
(i) an insurance policy or contract; 
(ii) a medical or hospital service agreement or membership or 
subscription contract; or 
(iii) a similar arrangement for the purpose of providing, 
pajdng for, or reimbursing expenses for such services. 
(2) The Administrator— 
(A) shall reimburse the veteran for such reasonable charges if 
the veteran has paid for such services; or 
(B) in lieu of reimbursing a veteran for a charge for chiroprac-
tic services under subparagraph (A), may pay the reasonable 
charge for such chiropractic services directly to the chiropractor 
who furnished the services. 
(3) The amount paid for chiropractic services under this subsec-
tion may not exceed the amount for such services prescribed under 
the scheidule of reasonable charges established under subsection (d). 
PUBLIC LAW 99-166—DEC. 3, 1985 
99 STAT. 949 
(4) Chiropractic services may be provided in private facilities or 
chiropractic colleges approved in guidelines issued by the Adminis-
trator. 
(5) Reimbursement of veterans and pa3mients to chiropractors 
under this subsection shall be carried out under regulations which 
the Administrator shall prescribe. 
(d) SCHEDULE OF REASONABLE CHARGES.—Tlie Administrator shall 
establish a schedule of reasonable charges for chiropractic services 
furnished under the pilot program. Such schedule shall— 
(1) be consistent with the reasonable charges allowed under 
section 1842 of the Social Security Act (42 U.S.C. 1395u); and 
(2) be established in consultation with— 
(A) appropriate public and nonprofit private organiza-
tions; and 
(B) other Federal departments and sigencies that provide 
reimbursement for chiropractic services. 
(e) PROGRAM CAP.—The amount spent in any calendar year for 
chiropractic services under the pilot program may not exceed 
$2,000,000. 
(f) REPORT.—Not later than April 1, 1989, the Administrator shcill 
submit to the Committees on Veterans' Affairs of the Senate and 
House of Representatives a report on the implementation, oper-
ation, and results of the pilot program. The report shall include— 
(1) the number of requests made by eligible veterans for 
reimbursement or payment for chiropractic services under this 
section and the number of such veterans who made such 
requests; 
(2) the number of such reimbursements and payments made 
and the number of veterans to (or for whom) such reimburse-
ments and payments were made; and 
(3) the total amount spent for such reimbursements and 
pajnnents. 
(g) DEFINITIONS.—For the purposes of this section: 
(1) The term "chiropractic services" means the manual 
manipulation of the spine performed by a chiropractor to cor-
rect a subluxation of the spine. Such term does not include 
physical examinations, laboratory tests, radiologic services, and 
any other tests or services determined by the Administrator to 
be excluded. 
(2) The term "chiropractor" means an individual who is 
licensed as such by the State in which the individual performs 
chiropractic services and who meets the uniform minimum 
standards promulgated for chiropractors under 
section 
1861(rX5) of the Social Security Act (42 U.S.C. 1395x(rX5)). 
TITLE II—HEALTH-CARE ADMINISTRATION 
Schools and 
colleges. 
Regulations. 
Prohibition. 
SEC. 201. MEDICAL QUALITY-ASSURANCE RECORDS. 
Section 3305 is amended— 
(1) by inserting "(other than reports submitted pursuant to 38 use 3305. 
section 4152(b) of this title)" in subsection (a) after "program"; 
and 
(2) by adding at the end of subsection (b) the following new 
paragraph: 
"(6) Nothing in this section shall be construed as authorizing or 
requiring withholding from any person or entity the disclosure of 
99 STAT. 950 
PUBLIC LAW 99-166—DEC. 3, 1985 
statistical information regarding Veterans' Administration health-
care programs (including such information as aggregate morbidity 
and mortality rates associated with specific activities at individual 
Veterans' Administration health-care facilities) that does not implic-
itly or explicitly identify individual Veterans' Administration 
patients or employees or individuals who participated in the conduct 
of a medical quality-assurance review.". 
SEC. 202. AUTHORITY TO EXPAND GERIATRIC RESEARCH, EDUCATION, 
AND CLINICAL CENTERS PROGRAM. 
38 use 4101. 
Section 4101(fXlXA) is amended by striking out "fifteen" and 
inserting in lieu thereof "25". 
SEC. 2
0
3
. 
REVISION OF AUTHORITY FOR APPOINTMENT OF STUDENT 
NURSES 
AND 
GRADUATE 
NURSES. 
Section 4114(aX3) is amended— 
(1) by striking out "one year" in the second sentence of 
subparagraph (A) and inserting in lieu thereof "two years"; and 
(2) by adding at the end the following new subparagraph: 
"(C) A student nurse who has a temporary appointment under 
this paragraph and who is pursuing a full course of nursing in a 
recognized school of nursing approved by the Administrator may be 
reappointed for one year. Other personnel whose appointments are 
limited by this section to one year may not be reappointed under 
this subsection.". 
SEC. 204. QUALITY ASSURANCE AND CREDENTIALING. 
(a) 
IMPROVEMENTS IN PROGRAMS TO EVALUATE AND ASSURE 
HEALTH-CARE QUALITY.—(1) Chapter 73 is amended by adding at the 
end the following new subchapter: 
"Subchapter V—Quality Assurance 
38 use 4151. 
*'§ 4151. Quality assurance program 
"(a) The Administrator shall— 
"(1) establish and conduct a comprehensive program to mon-
itor and evaluate the quality of health care furnished by the 
Department of Medicine and Surgery (hereinafter in this sec-
tion referred to as the 'quality-assuremce progrsun'); and 
"(2) delineate the responsibilities of the Chief Medical Direc-
tor with respect to the quality-assurance program, including the 
duties prescribed in this section. 
"(bXl) As part of the quality-assurance program, the Chief Medi-
cal Director shall periodically evaluate— 
"(A) whether there are significant deviations in mortality and 
morbidity rates for surgical procedures performed by the 
Department of Medicine and Surgery from prevailing national 
mortality and morbidity standards for similar procedures; and 
"(B) if there are such deviations, whether they indicate defi-
ciencies in the quality of health care provided by the Depart-
ment of Medicine and Surgery. 
"(2) The evaluation under paragraph (IXA) of this subsection shall 
be made using the information compiled under subsection (cXD of 
this section. The evaluation under paragraph (IXB) of this subsec-
tion shall be made taking into account the factors described in 
subsection (cX2XB) of this subsection. 
PUBLIC LAW 99-166—DEC. 3, 1985 
99 STAT. 951 
"(3) If, based upon an evaluation under paragraph (IXA) of this 
subsection, the Chief Medical Director determines that there is a 
deviation referred to in that paragraph, the Chief Medical Director 
shall explain the deviation in the next report submitted under 
section 4152 of this title. 
Infra. 
"(c)(1) The Chief Medical Director shall— 
"(A) determine the prevailing national mortality and morbid-
ity standards for each type of surgical procedure performed by 
the Department of Medicine and Surgery; and 
"(B) collect data and other information on mortality and 
morbidity rates in the Department of Medicine and Surgery for 
each type of surgical procedure performed by the Department 
and (with respect to each such procedure) compile the data and 
other information so collected— 
"(i) for each medical facility of the Veterans* Administra-
tion, in the case of cardiac surgery, heart transplant, and 
renal transplant programs; and 
"(ii) in the aggregate, for each other type of surgical 
procedure. 
"(2) The Chief Medical Director shall— 
"(A) compare the mortality and morbidity rates compiled 
under paragraph (1)(B) of this subsection with the national 
mortality and morbidity standards determined under para-
graph (1)(A) of this subsection; and 
"(B) analyze any deviation between such rates and such 
standards in terms of— 
"(i) the characteristics of the respective patient popu-
lations; 
"(ii) the level of risk for the procedure involved, based 
on— 
"(I) patient age; 
"(II) the type and severity of the disease; 
"(III) the effect of any complicating diseases; and 
"(IV) the degree of difficulty of the procedure; and 
"(iii) any other factor that the Chief Medical Director 
considers appropriate. 
"(d) Based on the information compiled and the comparisons, 
analyses, evaluations, and explanations made under subsections (b) 
and (c) of this section, the Chief Medical Director, in each report 
under section 4152 of this title, shall make such recommendations 
with respect to quality assurance as the Chief Medic£il Director 
considers appropriate. 
"(eXD The Administrator shall allocate sufficient 
resources 
(including sufficient personnel with the necessary skills and quali-
fications) to enable the Department of Medicine and Surgery to 
carry out its responsibilities under this section. 
"(2) The Inspector General of the Veterans' Administration shall 
allocate sufficient resources (including sufficient personnel with the 
necessary skills and qualifications) to enable the Inspector General 
to monitor the quality-assurance program. 
"§ 4152. Quality-assurance reports 
38 use 4152. 
"(aXD Not later than February 1 of 1987,1989, and 1991, the Chief 
Medical Director shall submit to the Administrator a report on the 
experience through the end of the preceding fiscal year under the 
quality-assurance program carried out under section 4151 cf this 
title. 
Ante, p. 950. 
99 STAT. 952 
PUBLIC LAW 99-166—DEC. 3, 1985 
"(2) Each such report shall include— 
"(A) the data and other information compiled and the 
comparisons, analyses, and evaluations made under subsections 
(b) and (c) of such section with respect to the period covered by 
the report; and 
"(B) recommendations under subsection (d) of such section. 
"(b) Not later than 60 days after receiving each such report, the 
Administrator shall submit to the Committees on Veterans' Affairs 
of the Senate and House of Representatives a copy of the report, 
together with any comment concerning the report that the Adminis-
trator considers appropriate. 
"(c) A report submitted under subsection (b) of this section shall 
not be considered to be a record or document as described in section 
38 use 3305. 
3305(a) of this title.". 
(2) The table of sections at the beginning of chapter 73 is amended 
by adding at the end the following: 
"SUBCHAPTER V—QUALITY ASSURANCE 
"4151. Quality assurance program. 
"4152. Quality-assurance reports.". 
(b) REPORT ON CREDENTIALS OF HEALTH-CARE PROFESSIONALS.—(1) 
The Administrator of Veterans' Affairs shall submit to the C!ommit-
tees on Veterans' Affairs of the Senate and House of Representa-
tives a report describing in detail the current efforts and procedures 
and future plans of the Veterans' Administration for determining 
and monitoring the credentials of health-care professionals in 
connection with their furnishing care to veterans under chapter 17 
38 use 601 
of title 38, United States C!ode. 
et seq- 
(2XA) TTie report shall include a description of each current and 
planned Veterans' Administration policy or procedure regarding, or 
arrangement for, credentialing information exchanges. 
(B) With reference to any such policy, procedure, or arrangement 
that is planned and has not been implemented at the time the 
report required by paragraph (1) is submitted, the Administrator 
shall— 
(i) include in the report a timetable for such implementation; 
and 
(ii) report to the committees on progress toward such im-
plementation every three months thereafter until implementa-
tion of each such policy, procedure, and arrangement is 
achieved. 
Upon implementation of each such policy, procedure, and arrange-
ment, a final report on such implementation shall be submitted to 
the Committees. 
(3) For the purposes of this subsection, the term "credentialing 
information exchanges" includes the exchange of relevant informa-
tion with a license issuing or monitoring entity— 
(A) in order to determine, with respect to an individual who is 
seeking employment with, or who is employed by, the Veterans' 
Administration as a health-care professional for the furnishing 
of care to veterans under chapter 17 of title 38, United States 
Code— 
(i) whether the individual has completed medical or other 
health-care professional education satisfactorily; 
(ii) the current and past licensure and clinical privilege 
status of the individual; or 
(iii) the full employment history of the individual; or 
PUBLIC LAW 99-166—DEC. 3, 1985 
99 STAT. 953 
(B) in order to provide appropriate information to such an 
entity about an individual whose emplojnnent with the 
Veterans' Administration as a health-care professional is 
terminated— 
(i) following the completion of a disciplinary action relat-
ing to such individual's clinical competence; 
(ii) voluntarily after having had such individual's clinical 
privileges restricted or revoked; or 
(iii) voluntarily after serious concerns about such individ-
ual's clinical competence have been raised but not resolved. 
(4) For the purposes of this subsection, the term "license issuing or 
monitoring entity" means— 
(A) an appropriate State medical or other health-professional 
licensing body; 
(B) the Federation of State Medical Boards; 
(C) the American Medical Association; and 
(D) any other public or private entity that the Administrator 
considers appropriate that is involved with the issuance or 
monitoring of health-care professional licenses. 
(5) The report required by this subsection shall be submitted not 
later than 90 days after the date of the enactment of this Act. 
SEC. 205. AVAILABILITY OF STATE FINANCIAL SUPPORT FOR APPROVED 
STATE HOME PROJECTS. 
(a) DEADUNE FOR AVAILABIUTY OF STATE CONSTRUCTION FUNDS.— 
Subsection (a)(6) of section 5035 is amended by inserting "by July 1 
of the fiscal year for which the application is approved" before "smd 
for its maintenance". 
(b) DEFERRAL OF CERTAIN APPUCATIONS.—Subsection (b) of such 
section is amended— 
(1) by inserting "(1)" after "(b)"; 
(2) by redesignating clauses (1) through (4) as clauses (A) 
through (D), respectively; and 
(3) by adding at the end the following new paragraph: 
"(2XA) The Administrator shall defer approval of an application 
that meets the requirements of this section if the State submitting 
the application does not, by the July 1 deadline (as defined in 
subparagraph (C) of this paragraph), demonstrate to the satisfaction 
of the Administrator that the State has provided adequate financial 
support for construction of the project. 
"(B) In a case in which approval of an application is deferred 
under subparagraph (A) of this paragraph— 
"(i) the Administrator, in accordance with guidelines estab-
lished by the Administrator, shall select for award of a grant or 
grants under this section an application or applications for a 
nursing home project or projects that the Administrator 
determines— 
"(I) to be most in need; 
"(II) would, but for the deferral, not have been approved 
during the fiscal year in which the deferral occurred; 
and 
"(III) have been provided adequate financial support by 
the State and are otherwise qualified for approval during 
the fiscal year; and 
"(ii) during the next fiscal year, the application with respect 
to which approval was deferred shall be accorded priority for 
Report. 
98 Stat. 2689. 
38 use 5035. 
Grants. 
Nursing home. 
99 STAT. 954 
PUBLIC LAW 99-166—DEC. 3, 1985 
approval ahead of applications that had not been approved 
before the first day of such fiscal year. 
"(C) For the purposes of this paragraph, the term 'July 1 deadline' 
means July 1 of the fiscal year in which the State is notified by the 
Administrator of the availability of funding for a grant for such 
project.". 
SEC. 206. PROCEDURES FOR REDUCTION OR REVOCATION OF CLINICAL 
PRIVILEGES. 
38 use 4110 
(a) GuiDEUNES.—Not later than April 1, 1986, the Administrator 
note. 
of Veterans' Affairs shall prescribe uniform guidelines establishing 
administrative procedures to be followed in any case in which a 
reduction or revocation of the clinical privileges of any person 
employed in a position described in paragraph (1) of section 4104 of 
title 38, United States Code, is proposed on the basis of a deficiency 
in the employee's performance of professional responsibilities. 
(b) REPORT.—Not later than May 1, 1986, the Administrator shall 
submit to the Committees on Veterans' Affairs of the Senate and 
House of Representatives a report (containing a copy of such guide-
lines) on the implementation of this section. 
TITLE m—VETERANS' ADMINISTRATION MEDICAL 
FACILITIES 
SEC. 301. CLARIFICATION OF REQUIREMENT OF CONGRESSIONAL AP-
PROVAL OF CONSTRUCTION AND ACQUISITION PROJECTS. 
38 use 5004. 
Subsection (a) of section 5004 is amended to read as follows: 
"(aXD The purpose of this subsection is to enable Congress to 
ensure the equitable distribution of medical facilities throughout 
the United States, taking into consideration the comparative ur-
gency of the need for the services to be provided in the case of each 
particular facility. 
"(2) After the adoption by the committees during a fiscal year of 
resolutions vdth identical texts approving major medical facility 
projects, it shall not be in order in the House of Representatives or 
in the Senate to consider a bill, resolution, or amendment making 
an appropriation for that fiscal year or for the next fiscal year which 
may be expended for a major medical facility project— 
"(A) if the project for which the appropriation is proposed to 
be made is not approved in those resolutions; or 
"(B) in the event that the project is approved in the resolu-
tions, if either— 
"(i) the bill, resolution, or amendment making the appro-
priation does not specify— 
"(I) the mecUcal facility project for which the appro-
priation is proposed to be made; and 
"(11) the amount proposed to be appropriated for the 
project; or 
"(ii) the amount proposed to be appropriated for the 
project (when added to any amount previously appropriated 
for the project) exceeds the amount approved for the 
project. 
Prohibition. 
"(3) No appropriation may be made for the lease of any space for 
use as a medical facility at an average annual rental of more than 
$500,000 unless each committee has first adopted a resolution 
approving such lease and setting forth the estimated cost thereof. 
PUBLIC LAW 99-166—DEC. 3, 1985 
99 STAT. 955 
"(4) For the purpose of this subsection, 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. Such term does not include an acquisition by 
exchange.". 
SEC. 302. OPERATIONAL AND CONSTRUCTION PLANNING REQUIREMENT. 
(a) REQUIREMENT FOR IMPROVED PLANNING.—Subsection (a) of sec-
tion 5007 is amended— 
38 use 5007. 
(1) by inserting "(D" after "(a)"; 
(2) by striking out "and alteration" the second place it 
appears in the first sentence and inserting in lieu thereof 
"alteration, and operation"; 
(3) by striking out the second and third sentences; and 
(4) by adding at the end the following new paragraphs: 
"(2) Each such report shall contain— 
Report. 
"(A) a five-year strategic plan for the operation and construc-
tion of medical facilities— 
"(i) setting forth— 
"(I) the mission of each existing or proposed medical 
facility; 
"(II) any planned change in such mission; and 
"(III) the operational steps needed to achieve the 
facility's mission and the dates by which such steps are 
planned to be completed; and 
"(ii) a five-year plan, based on the factors set out in 
subclause (i) of this clause, for construction, replacement, or 
alteration projects for each such facility; 
"(B) a list, in order of priority, of not less than 10 hospitals 
Hospitals, 
that, in the judgment of the Administrator, are most in need of 
construction or replacement; and 
"(C) general plans (including projected costs, site location, 
and, if appropriate, necessary land acquisition) for each medical 
facility for which construction, replacement, or alteration is 
planned under clause (A)(ii) of this paragraph. 
"(3) The report under this subsection shall be submitted not later 
Report. 
than June 30 of each year.". 
Ot)) TECHNICAL AMENDMENTS.—Subsection (b) of such section is 
amended— 
(1) by striking out "(beginning in 1981)"; 
(2) by inserting "(1)" after "medical facility"; and 
(3) by striking out "title and, in the case of the second and 
each succeeding report made under this subsection," and insert-
ing in lieu thereof title, and (2)". 
(c) CLERICAL AMENDMENTS.—(1) The heading for such section is 
amended to read as follows: 
"§ 5007. Operational and construction plans for medical facilities". 
(2) The item relating to such section in the table of sections at the 
beginning of chapter 81 is amended to read as follows: 
"5007. Operational and construction plans for medical facilities.". 
SEC. 303. MAJOR FACILITY PROSPECTUS REQUIREMENT. 
Section 5004(b)(1) is amended by inserting "and, in the case of a 
38 use 5004. 
prospectus proposing the construction of a new or replacement 
medical facility, a description of the consideration that was given to 
99 STAT. 956 
PUBLIC LAW 99-166—DEC. 3, 1985 
acquiring an existing facility by lease or purchase" after "such 
facility". 
38 u s e 5003 
SEC. 304. DEVELOPMENT OF MEDICAL-FACILITY MODULAR COMPONENTS. 
In order to evaluate the applicability to the Veterans' Administra-
tion of the use of modular components in the design and construc-
tion of medical facilities for the furnishing of hospital care and to 
determine the efficiency and cost-effectiveness of that approach, the 
Administrator of Veterans' Affairs shall, not later than one year 
after the date of the enactment of this Act, develop a modular 
approach to the planning and design of an appropriate Veterans' 
Administration medical facility for the furnishing of hospital care. 
SEC. 305. FEASIBILITY STUDY OF AND PLAN FOR THE PURCHASE OF A 
FACILITY FOR FURNISHING HOSPITAL AND NURSING HOME 
CARE. 
President o
f U.S. 
In the documents submitted by the Administrator of Veterans' 
Florida. 
Affairs to the appropriate committees of the Congress at the time of 
and in connection with the submission, pursuant to section 1105 of 
98 Stat. 2324. 
title 31, United States Code, of the Budget for fiscal year 1987, the 
Administrator shall include the results of a feasibility study which 
he shall conduct of, and if indicated by such study provide a 
feasibility plan for, the purchase for Veterans' Administration use 
of a medical facility that is located in an urban area and is suitable 
for furnishing both hospital and nursing home care services, and 
meets the current and projected needs and specifications of the 
Veterans' Administration for furnishing health care to eligible vet-
erans. In such Budget, the President, as warranted by such feasibil-
ity plan, shall include a request for an appropriate amount to 
purchase such a facility which meets those needs and specifications: 
Provided, That this section shall not be construed to require the 
Administrator to provide a feasibility plan with respect to the 
purchase of a facility that would have the effect of making it 
infeasible to construct, acquire, or lease a medical facility in the 
Florida panhandle or to expand the Biloxi/Gulfport Veterans' 
Administration Medical Center to furnish health care to veterans in 
the area. 
TITLE IV—MISCELLANEOUS PROVISIONS 
SEC. 401. SERVICEMEN'S GROUP LIFE INSURANCE AND VETERANS' GROUP 
LIFE INSURANCE. 
(a) SERVICEMEN'S GROUP LIFE INSURANCE.—(1) Subsection (a) of 
38 use 767. 
section 767 is amended— 
(A) by striking out "$35,000" and inserting in lieu thereof 
"$50,000"; and 
(B) by striking out "the amount of $30,000, $25,000, $20,000, 
$15,000, $10,000 or $5,000" and inserting in lieu thereof "an 
amount less than $50,000 that is evenly divisible by $10,000". 
(2) Subsection (c) of such section is amended by striking out "the 
amount of" the first place it appears and all that follows through 
"as the case may be," and inserting in lieu thereof "any amount less 
than $50,000, such member may thereafter be insured under this 
subchapter in the amount of $50,000 or any lesser amount evenly 
divisible by $10,000". 
(3) Subsection (d) of such section is amended— 
PUBLIC LAW 99-166—DEC. 3, 1985 
99 STAT. 957 
(A) by striking out "the effective date of this subsection" each 
place it appears and inserting in lieu thereof "January 1,1986"; 
and 
(B) by striking out "up to a maximum of $35,000 (in any 
amount divisible by $5,000)" and inserting in lieu thereof "in 
the amount of $50,000 or any lesser amount evenly divisible by 
$10,000". 
(b) VETERANS' GROUP LIFE INSURANCE.—(1) Subsection (a) of sec-
tion 777 of such title is amended— 
(A) by striking out the first sentence and inserting in lieu 
thereof the following: "Veterans' Group Life Insurance shall be 
issued in the amounts specified in section 767(a) of this title. In 
the case of any individual, the amount of Veterans' Group Life 
Insurance may not exceed the amount of Servicemen's Group 
Life Insurance coverage continued in force after the expiration 
of the period of duty or travel under section 767(b) or 768(a) of 
this title."; and 
(B) by striking out "$35,000" in the sentence immediately 
following the matter inserted by clause (A) and both places it 
appears in the last sentence and inserting in lieu thereof 
"$50,000". 
(2) Such section is further amended by adding at the end the 
following new subsection: 
"(h)(1) Notwithstanding any other provision of law, members of 
the Individual Ready Reserve and the Inactive National Guard are 
eligible to be insured under Veterans' Group Life Insurance. Any 
such member shall be so insured upon submission of an application 
in the manner prescribed by the Administrator and the payment of 
premiums as required under this section. 
"(2) Notwithstanding subsection (bX2) of this section. Veterans' 
Group Life Insurance coverage under this subsection shall be issued 
on a renewable five-year term basis, but the person insured must 
remain a member of the Individual Ready Reserve or Inactive 
National Guard throughout the period of the insurance in order for 
the insurance of such person to be renewed. 
"(3) For the purpose of this subsection, the terms 'Individual 
Ready Reserve' and 'Inactive National Guard' shall have the mean-
ings prescribed by the Administrator in consultation with the Sec-
retary of Defense.". 
(c) EFFECTIVE DATE.—The amendments made by subsections (a) 
and (b) shall take effect on January 1,1986. 
SEC. 402. EXTENSION OF AUTHORITY TO OPERATE AN OFFICE IN THE 
REPUBLIC OF THE PHILIPPINES. 
Section 230(b) is amended by striking out "October 31, 1985" and 
inserting in lieu thereof "September 30,1988". 
SEC. 403. VETERANS' ADMINISTRATION GRADE REDUCTION. 
(a) Section 210G>) is amended by adding at the end the following 
new paragraphs: 
"(3)(A) The Administrator may not implement a grade reduction 
described in subparagraph (B) of this paragraph unless the Adminis-
trator first submits to the Committees on Veterans' Affairs of the 
Senate and House of Representatives a report containing a detailed 
plan for such reduction and a detailed justification for the plan. 
Such report shall include a determination by the Administrator 
(together with data supporting such determination) that, in the 
38 use 777. 
Ante, p. 956. 
38 use 767, 768. 
Individual 
Ready Reserve. 
Inactive 
National 
Guard. 
38 u s e 767 note. 
Ante, p. 481. 
38 use 210. 
Report. 
99 STAT. 958 
PUBLIC LAW 99-166—DEC. 3, 1985 
personnel area concerned, the Veterans' Administration has a dis-
proportionate number of employees at the salary grade or grades 
selected for reduction in comparison to the number of such employ-
ees at the salary levels involved who perform comparable functions 
in other departments and agencies of the Federal Government and 
Effective date. 
in non-Federal entities. Any grade reduction described in such 
report may not take effect until the end of a period of 90 calendar 
days (not including any day on which either House of Congress is 
not in session) after the report is received by the committees. 
"(B) A grade reduction referred to in subparagraph (A) of this 
paragraph is a systematic reduction, for the purpose of reducing the 
average salary cost for Veterans' Administration employees de-
scribed in subparagraph (C) of this paragraph, in the number of such 
Veterans' Administration employees at a specific grade level. 
"(C) The employees referred to in subparagraph (B) of this para-
graph are— 
"(i) health-care personnel who are determined by the 
Administrator to be providing either direct patient-care services 
or services incident to direct patient-care services; 
"(ii) individuals who meet the definition of professional em-
ployee as set forth in section 7103(aX15) of title 5; and 
"(iii) individuals who are employed as computer specialists. 
Report. 
"(D) Not later than the forty-fifth day after the Administrator 
submits a report under subparagraph (A) of this paragraph, the 
Comptroller General shall submit to such Committees a report on 
the Administrator's compliance with such subparagraph. The 
Comptroller General shall include in the report the Comptroller 
General's opinion as to the accuracy of the Administrator's deter-
mination (and of the data supporting such determination) made 
under such subparagraph. 
Prohibition. 
"(E) In the case of Veterans' Administration employees not de-
scribed in subparagraph (C) of paragraph (3), the Administrator may 
not in any fiscal year implement a systematic reduction for the 
purpose of reducing the average salary cost for such Veterans' 
Administration employees that will result in a reduction in the 
number of such Veterans' Administration employees at any specific 
grade level at a rate greater than the rate of the reductions 
systematically being made in the numbers of employees at such 
grade level in all other agencies and departments of the Federal 
Government combined.". 
Real property. 
SEC. 404. LAND TRANSFER, PHOENIX, ARIZONA. 
(a) REQUIREMENT FOR TRANSFER.—The real property described in 
subsection (b) and the structures on such property on the date of the 
enactment of this Act shall be transferred without compensation or 
reimbursement from the control and jurisdiction of the General 
Services Administration to the control and jurisdiction of the Veter-
ans' Administration. 
(b) DESCRIPTION OF LAND.—The real property referred to in subsec-
tion (a) is a tract of land consisting of 3.4 acres, more or less, in 
Phoenix, Arizona, that— 
(1) was formerly part of the Veterans' Administration Medi-
cal Center, Phoenix, Arizona; and 
(2) was declared to be excess to the needs of the Veterans' 
Administration in a report to the General Services Administra-
tion dated September 25,1959. 
PUBLIC LAW 99-166—DEC. 3, 1985 
99 STAT. 959 
SEC. 405. MODIFICATION OF RESTRICTIONS ON REAL PROPERTY, 
MILWAUKEE COUNTY, WISCONSIN. 
(a) RELEASE OF REVERSIONARY INTEREST.—The Administrator of 
Veterans' Affairs shall execute such instruments as may be nec-
essary to modify the conditions under which the land described in 
subsection (b) will revert to the United States in order to permit 
Milwaukee County, Wisconsin, to lease all or part of such land to a 
nonprofit corporation which— 
(1) shall construct and equip on such land structures, facili-
ties, and other permanent improvements useful for public rec-
reational purposes or general civic purposes; and 
(2) shall use such land for such recreational or civic purposes. 
(b) DESCRIPTION OF LAND.—The land referred to in subsection (a) 
is— 
(1) the land conveyed to Milwaukee County, Wisconsin, pursu-
ant to the Act entitled "An Act to authorize the Administrator 
of Veterans' Affairs to convey lands and to lease certain other 
land to Milwaukee County, Wisconsin", approved September 1, 
1949 (63 Stat. 683); and 
(2) the land conveyed to Milwaukee County, Wisconsin, pursu-
ant to the Act entitled "An Act authorizing the Administrator 
of Veterans' Affairs to convey certain property to Milwaukee 
County, Wisconsin", approved August 27, 1954 (68 Stat. 366). 
(c) GENERAL LIMITATIONS.—The Administrator may carry out this 
section subject to such terms and conditions (including reservations 
of rights for the United States) as the Administrator determines to 
be necessary to protect the interests of the United States. 
SEC. 406. AUTHORITY TO RELEASE LIMITATION ON USE OF REAL PROP-
ERTY, MCKINNEY, TEXAS. 
(a) RELEASE OF LIMITATION.—The Administrator of Veterans' Af-
fairs shall execute such instruments as may be necessary to release 
the limitation to recreational purposes only on the use of the land 
described in subsection (b). 
(b) DESCRIPTION OF LAND.—The land referred to in subsection (a) is 
two parcels of land, consisting of a total of 38.741 acres, that were 
conveyed by the Administrator to the city of McKinney, TexEis, by 
deed of May 5, 1965, under the authority of Public Law 88-438 (78 
Stat. 444, approved August 14,1964). 
SEC. 
4
0
7
. MODIFICATION OF 
RESTRICTIONS 
ON REAL 
PROPERTY AND 
CONVEYANCE 
OF 
A 
FENCE 
ON 
SUCH 
PROPERTY, 
SALT 
LAKE 
CITY, 
UTAH. 
(a) MODIFICATION OF RESTRICTION.—(1) The Administrator of Vet-
erans' Affairs shall execute such instruments as may be necessary 
in order to authorize the land conveyed under the authority of the 
Act referred to in paragraph (3) to be used— 
(A) without regard to any limitation required by section 2 of 
that Act, but 
68 Stat. 580. 
(B) subject to the limitations set forth in paragraph (2). 
(2) Any instrument executed under paragraph (1) shall provide, 
with respect to the tract of land conveyed under the Act referred to 
in paragraph (3)— 
(A) that such tract may be used only for hospital, educational, 
civic, residential, or related purposes; 
(B) that, if any part of such tract is used in any manner that is 
determined by the Administrator to interfere with the care and 
99 STAT. 960 
PUBLIC LAW 99-166—DEC. 3, 1985 
treatment of any patient at a Veterans' Administration health-
care facility located in the reservation described in such Act, 
such use shall cease immediately upon notice by the Adminis-
trator of such interference to the person holding legal title to 
such part at the time such use occurs; 
(C) that, if any part of such tract is used for a purpose other 
than a purpose prescribed in clause (A), title to such part shall 
revert to the United States; and 
(D) that, if any interference referred to in clause (B) does net 
cease as required under such paragraph, title to the part of such 
land that is being used in a manner to cause such interference 
shall revert to the United States. 
Any such instrument may contain such additional terms and condi-
tions (including reservations of rights to the United States) as the 
Administrator determines to be necessary to protect the interests of 
the United States. 
(3) The Act referred to in paragraphs (1) and (2) is the Act entitled 
"An Act authorizing the Administrator of Veterans' Affairs to 
convey certain property to the Armory Board, State of Utah", 
approved July 29,1954 (68 Stat. 579). 
(b) CONVEYANCE OF FENCE.—The Administrator shall convey, 
without consideration, to the Armory Board of the State of Utah all 
right, title, and interest of the L^nited States in the fence erected as 
required by the quitclaim deed issued to the Armory Board by the 
Administrator on Octx)ber 14, 1954. under the authority of the Act 
referred to in subsection (aX3). The conveyance shall contain such 
terms and conditions as the Administrator determines to be nec-
essary to protect the interests of the United States. 
Approved December 3, 1985. 
LEGISLATIVE HISTORY—H.R. 505 (S. 876): 
HOUSE REPORT No. 99-114 (Comm. on Veterans' Affairs). 
SENATE REPORT No. 99-101 accompanying S. 876 (Comm. on Veterans' Affairs). 
CONGRESSIONAL RECORD, Vol. 131 (1985): 
May 21, considered and passed House. 
July 30, considered and passed Senate, amended, in lieu of S. 876. 
Oct. 30, House concurred in Senate amendments with amendment. 
Nov. 6, 13, Senate concurred in House amendment with amendment. 
Nov. 14, House concurred in Senate amendments.