< Back to H.R. 4425 (103rd Congress, 1993–1994)

Text of To authorize major medical facility construction projects for the Department of Veterans Affairs for fiscal year 1995, to revise and ...

...to revise and improve veterans’ health programs, and for other purposes.

This bill was introduced in a previous session of Congress and was passed by the House on May 23, 1994 but was never passed by the Senate. The text of the bill below is as of May 25, 1994 (Referred to Senate Committee).

Source: GPO

HR 4425 RFS

103d CONGRESS

2d Session

H. R. 4425

IN THE SENATE OF THE UNITED STATES

May 25 (legislative day, MAY 16), 1994

Received; read twice and referred to the Committee on Veterans’ Affairs


AN ACT

To authorize major medical facility construction projects for the Department of Veterans Affairs for fiscal year 1995, to revise and improve veterans’ health programs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

TITLE I--CONSTRUCTION AUTHORIZATION

SEC. 101. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS AND MAJOR MEDICAL FACILITY LEASES.

    (a) PROJECTS IN PRESIDENT’S BUDGET- (1) Except as provided in paragraph (2), the Secretary of Veterans Affairs may carry out the major medical facility projects for the Department of Veterans Affairs, and may carry out the major medical facility leases for that Department, for which funds are requested in the budget of the President for fiscal year 1995.

    (2) The Secretary is not authorized to carry out--

      (A) the project described in the budget of the President for fiscal year 1995 for the construction of a research addition at Huntington, West Virginia; or

      (B) the project described in the budget of the President for fiscal year 1995 for the construction of a research addition at Portland, Oregon.

    (b) ADDITIONAL PROJECTS- In addition to the projects authorized in subsection (a), the Secretary may carry out the following major medical facility projects, in the amounts specified:

      (1) The projects for ambulatory care facilities that are proposed in the budget for fiscal year 1995 to be financed with funds from the Health Care Investment Fund.

      (2) Construction of a nursing home facility at the Department of Veterans Affairs Medical Center in Charleston, South Carolina, $7,300,000.

      (3) A lease/purchase of a nursing home facility near Ft. Myers, Florida, $18,630,000.

      (4) Construction of an outpatient care addition at the Department of Veterans Affairs medical center in Phoenix, Arizona, in the amount of $50,000,000.

    (c) PROJECTS FOR WHICH FUNDS APPROPRIATED- In addition to the projects authorized in subsections (a) and (b), the Secretary may carry out the following major medical facility projects for which funds were appropriated in the Emergency Supplemental Appropriations Act of 1994 (Public Law 103-211) in the amounts specified:

      (1) Construction of an ambulatory care/support services facility at the Department of Veterans Affairs Medical Center in Sepulveda, California, $53,700,000.

      (2) Other major medical facility projects required to repair, restore, or replace earthquake-damaged facilities at the Department of Veterans Affairs Medical Center in Sepulveda, California, $50,000,000.

SEC. 102. AUTHORIZATION OF APPROPRIATIONS.

    (a) IN GENERAL- There is hereby authorized to be appropriated to the Secretary of Veterans Affairs for fiscal year 1995--

      (1) $343,800,000 for the major medical facility projects authorized in subsections (a) and (b) of section 101; and

      (2) $15,800,000 for the major medical facility leases authorized in section 101(a).

    (b) LIMITATION- The projects authorized in subsections (a) and (b) of section 101 may only be carried out using--

      (1) funds appropriated for fiscal year 1995 pursuant to the authorization of appropriations in subsection (a);

      (2) funds appropriated for Construction, Major Projects for a fiscal year before fiscal year 1995 that remain available for obligation; and

      (3) funds appropriated for Construction, Major Projects for fiscal year 1995 for a category of activity not specific to a project.

    (c) LIMITATION ON CERTAIN PROJECTS- The projects authorized in subsection (c) of section 101 may only be carried out using--

      (1) funds appropriated, as well as funds transferred by the President, to the Construction, Major Projects account pursuant to the Emergency Supplemental Appropriations Act of 1994 (Public Law 103-211);

      (2) funds appropriated to the Medical Care account by the Emergency Supplemental Appropriations Act of 1994 (Public Law 103-211) that are transferred by law to the Construction, Major Projects account;

      (3) funds appropriated to the Construction, Major Projects account for a fiscal year before fiscal year 1994 that remain available for obligation; and

      (4) funds appropriated to the Construction, Major Projects account for fiscal year 1994 for a category of activity not specific to a project.

TITLE II--HEALTH CARE PLANNING AND PROGRAMS

SEC. 201. HEALTH CARE FACILITIES MISSIONS.

    (a) IN GENERAL- The Secretary of Veterans Affairs shall prescribe a specific, detailed statement of the mission of, and the clinical programs to be operated at, each health care facility of the Department, determined based upon a requirement that each such facility operate within a network of Department facilities in the same geographic area which, taken together, provide a full range of services for veterans.

    (b) PURPOSES OF MISSION STATEMENTS- The mission statements shall be designed so as to permit--

      (1) effective planning;

      (2) reduction in duplication of services and programs in the same geographic area;

      (3) realignment of services among facilities within each network;

      (4) improved means of resource distribution; and

      (5) more efficient delivery of needed services.

    (c) REVIEW OF CURRENT MISSIONS- In preparing the mission statements under subsection (a), the Secretary shall review the existing missions and clinical programs at each health care facility of the Department.

    (d) DEADLINE AND REPORT- The Secretary, not later than nine months after the date of the enactment of this Act, shall--

      (1) prescribe the mission statements required by subsection (a); and

      (2) submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the implementation of this section and on the timetable and projected milestones for implementing actions to enable each such facility to carry out fully its prescribed missions.

SEC. 202. PILOT PROGRAM FOR NONINSTITUTIONAL ALTERNATIVES TO NURSING HOME CARE.

    (a) EXTENSION OF PROGRAM- Subsection (a) of section 1720C of title 38, United States Code, is amended by striking out ‘During the four-year period beginning on October 1, 1990,’ and inserting in lieu thereof ‘During the period through September 30, 1997,’.

    (b) VETERANS ELIGIBLE TO PARTICIPATE IN PROGRAM- Such subsection is further amended by striking out ‘care and who--’ and inserting in lieu thereof ‘care. The Secretary shall give priority for participation in such program to veterans who--’.

    (c) REPORT DEADLINES- Section 201(b) of the Department of Veterans Affairs Nurse Pay Act of 1990 (Public Law 101-366; 104 Stat. 438) is amended--

      (1) by striking out ‘February 1, 1994,’ and inserting in lieu thereof ‘February 1, 1997,’; and

      (2) by striking out ‘September 30, 1993,’ and inserting in lieu thereof ‘September 30, 1996,’.

TITLE III--MEDICAL FACILITIES ACQUISITION

SEC. 301. REVISION TO PROSPECTUS REQUIREMENTS.

    (a) ADDITIONAL INFORMATION- Section 8104(b) of title 38, United States Code, is amended--

      (1) by striking out ‘shall include--’ and inserting in lieu thereof ‘shall include:’;

      (2) in paragraph (1)--

        (A) by striking out ‘a detailed’ and inserting in lieu thereof ‘A detailed’; and

        (B) by striking out the semicolon at the end and inserting in lieu thereof a period;

      (3) in paragraph (2)--

        (A) by striking out ‘an estimate’ and inserting in lieu thereof ‘An estimate’; and

        (B) by striking out ‘; and’ and inserting in lieu thereof a period;

      (4) in paragraph (3), by striking out ‘an estimate’ and inserting in lieu thereof ‘An estimate’; and

      (5) by adding at the end the following new paragraphs:

      ‘(4) Demographic data applicable to the project.

      ‘(5) Current and projected workload and utilization data.

      ‘(6) The relationship between the mission of the facility and the missions and capabilities of other nearby Department facilities and, as applicable, the availability or lack of availability of alternative sources of service in the community and the cost-effectiveness of using such alternative sources.

      ‘(7) Current and projected operating costs of the facility.

      ‘(8) The raw score assigned to the proposal under the Department’s prioritization methodology and, if the project is being proposed for funding ahead of a project with a higher score, a comprehensive explanation of the specific factors on the basis of which the project is being proposed for funding ahead of each such higher-scored project.

      ‘(9) A listing of each alternative to construction of the facility that has been considered.’.

    (b) APPLICABILITY- The amendments made by subsection (a) shall apply with respect to any prospectus submitted by the Secretary of Veterans Affairs after the date of the enactment of this Act.

SEC. 302. PRIORITIZATION METHODOLOGY.

    (a) REVIEW OF METHODOLOGY- The Secretary of Veterans Affairs shall conduct a review of the methodology used by the Department for establishing the relative priority for major construction projects under consideration in the Department.

    (b) REVISION- Based upon the review under subsection (a), the Secretary shall revise the prioritization methodology so as to give additional weight, as determined appropriate by the Secretary taking into consideration particularly the needs of the aging veteran population, to projects intended to expand long-term care and ambulatory care programs.

    (c) REPORT- Not later than 120 days after 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 actions of the Secretary in carrying out this section.

SEC. 303. SEMIANNUAL COMPILATION OF CONSTRUCTION PRIORITIES.

    Section 8107 of title 38, United States Code, is amended by adding at the end the following new subsection:

    ‘(c)(1) The Secretary shall submit to each committee, not later than January 31 and July 31 of each year, a report showing the current priorities of the Department for proposed major medical construction projects. Each such report shall identify the 20 projects, from within all the projects in the Department’s inventory of proposed projects, that have the highest priority and, for those 20 projects, the relative priority and rank scoring of each such project. The 20 projects shall be compiled, and their relative rankings shall be shown, by category of project (including the categories of ambulatory care projects, nursing home care projects, and such other categories as the Secretary determines).

    ‘(2) The Secretary shall include in each report, for each project listed, a description of the specific factors that account for the relative ranking of that project in relation to other projects within the same category.

    ‘(3) In a case in which the relative ranking of a proposed project has changed since the last report under this subsection was submitted, the Secretary shall also include in the report a description of the reasons for the change in the ranking, including an explanation of any change in the scoring of the project under the Department’s scoring system for proposed major medical construction projects.’.

SEC. 304. DEFINITION OF MAJOR MEDICAL FACILITY PROJECT.

    Subparagraph (A) of section 8104(a)(3) of title 38, United States Code, is amended by inserting before the period at the end the following: ‘, and, in the case of a project which is principally for the alteration of a medical facility to provide additional space for provision of ambulatory care, such term means a project involving a total expenditure of more than $5,000,000’.

TITLE IV--STATE HOME PROGRAM

SEC. 401. PER DIEM FOR ADULT DAY HEALTH CARE.

    (a) IN GENERAL- Subsection (a) of section 1741 of title 38, United States Code, is amended to read as follows:

    ‘(a)(1) The Secretary shall pay to each State a per diem amount for each veteran receiving domiciliary care, nursing home care, hospital care, or adult day health care in a State home if the veteran is eligible to receive that care in a Department facility.

    ‘(2) The per diem rate to be paid under this subsection is as follows:

      ‘(A) For domiciliary care, $15.11 for each day.

      ‘(B) For nursing home care and hospital care, $35.37 for each day.

      ‘(C) For adult day health care, $16.28 for each day.’.

    (b) EFFECTIVE DATE- The amendment made by subsection (a) shall apply with respect to adult day health care provided in a State home after September 30, 1994.

SEC. 402. CONSTRUCTION ASSISTANCE PROGRAM.

    (a) IN GENERAL- Subchapter III of chapter 81 of title 38, United States Code, is amended as follows:

      (1) Section 8131(3) is amended by inserting ‘or adult day health care’ after ‘hospital care’.

      (2) Section 8132 is amended by inserting ‘adult day health care’ after ‘hospital care’.

      (3) Section 8135(a)(4) is amended by inserting ‘and, in the case of adult day health care, not more than 25 percent of the number of patients participating in that program,’ after ‘occupancy’.

      (4) Section 8135(b) is amended--

        (A) in paragraph (2)(C), by inserting ‘or adult day health care facilities’ after ‘domiciliary beds’; and

        (B) in paragraph (3)(A), by inserting ‘, or would involve expansion, remodeling, or alteration of existing buildings for the furnishing of adult day health care’ after ‘buildings’.

      (5) Section 8136 is amended by inserting ‘adult day health care’ after ‘hospital care’.

      (6) The heading of such subchapter is amended to read as follows:

‘SUBCHAPTER III--STATE HOME FACILITIES FOR FURNISHING DOMICILIARY CARE, NURSING HOME CARE, ADULT DAY HEALTH CARE, AND HOSPITAL CARE’.

    (b) CLERICAL AMENDMENT- The item relating to subchapter III in the table of sections at the beginning of such chapter is amended to read as follows:

‘SUBCHAPTER III--STATE HOME FACILITIES FOR FURNISHING DOMICILIARY CARE, NURSING HOME CARE, ADULT DAY HEALTH CARE, AND HOSPITAL CARE’.

    (c) EFFECTIVE DATE- The amendments made by subsection (a) shall apply with respect to grants made to States using funds appropriated after the date of the enactment of this Act.

TITLE V--MISCELLANEOUS

SEC. 501. DEPARTMENT OF VETERANS AFFAIRS RESEARCH ADVISORY COMMITTEES.

    (a) STATUTORY BASIS FOR RESEARCH ADVISORY COMMITTEES- Chapter 5 of title 38, United States Code, is amended by adding at the end of subchapter III the following new section:

‘Sec. 544. Veterans research advisory committees

    ‘(a) Congress declares that each of the veterans research advisory committees specified in subsection (c) (previously established by the Secretary in carrying out the duties of the Secretary under section 7303 of this title) has a continuing, ongoing function that is integrally related to the successful completion by the Department of its statutory duties. Each such committee shall, for all purposes, operate as though such committee had been established by, and chartered pursuant to, law. The objectives and scope of the activities of each such committee and the duties for which the committee is responsible, as specified by the Secretary as of March 1, 1993, shall be those in effect as of that date.

    ‘(b) The Secretary may not terminate a veterans’ research advisory committee specified in subsection (c) unless the Secretary finds that the committee is no longer needed. Not less than 120 days before terminating such a committee, the Secretary shall submit to the congressional veterans’ affairs committees a report on the proposed termination. The report shall include an explanation of (1) the basis for the Secretary’s determination that such committee is no longer needed, and (2) the manner in which the Secretary will carry out the Secretary’s responsibilities under section 7303 of this title in the absence of the committee.

    ‘(c) For purposes of this section, each of the following committees and boards, as established by the Secretary as of March 1, 1993, shall be considered to be a veterans’ research advisory committee:

      ‘(1) The Career Development Committee.

      ‘(2) The Department of Veterans Affairs Cooperative Studies Evaluation Committee.

      ‘(3) The Merit Review Board for Basic Sciences Programs.

      ‘(4) The Merit Review Board for Cardiovascular Programs.

      ‘(5) The Merit Review Board for Clinical Pharmacology, Alcoholism, and Drug Dependence Programs.

      ‘(6) The Merit Review Board for Endocrinology Programs.

      ‘(7) The Merit Review Board for Gastroenterology Programs.

      ‘(8) The Merit Review Board for Hematology Programs.

      ‘(9) The Merit Review Board for Immunology Programs.

      ‘(10) The Merit Review Board for Infectious Diseases Programs.

      ‘(11) The Merit Review Board for Mental Health and Behavioral Sciences Programs.

      ‘(12) The Merit Review Board for Nephrology Programs.

      ‘(13) The Merit Review Board for Neurobiology Programs.

      ‘(14) The Merit Review Board for Oncology Programs.

      ‘(15) The Merit Review Board for Respiration Programs.

      ‘(16) The Merit Review Board for Surgery Programs.

      ‘(17) The Scientific Review Evaluation Board for Health Services Research and Development.

      ‘(18) The Scientific Review Evaluation Board for Rehabilitation Research and Development.’.

    (b) CLERICAL AMENDMENT- The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 543 the following new item:

      ‘544. Veterans research advisory committees.’.

SEC. 502. CHILD CARE SERVICES.

    (a) REVISED CHILD CARE AUTHORITY- Chapter 81 of title 38, United States Code, is amended by inserting after section 8116 the following new section:

‘Sec. 8117. Child care centers

    ‘(a) The Secretary may provide for the operation of child care centers at Department facilities. The operation of such centers under this section shall be carried out to the extent that the Secretary determines, based on the demand of employees of the Department for the care involved, that such operation is in the best interest of the Department and that it is practicable to do so.

    ‘(b)(1) In offering child care services under this section, the Secretary shall give priority (in the following order) to employees of--

      ‘(A) the Department;

      ‘(B) other departments and agencies of the Federal Government, and

      ‘(C) schools affiliated with the Department and corporations created under section 7361 of this title.

    ‘(2) To the extent that space is available, the Secretary may provide child care services to members of the public at a child care center operated under this section if the Secretary determines that to do so is necessary to assure the financial success of that center.

    ‘(c)(1) The Secretary shall establish reasonable charges for child care services provided at each child care center operated under this section. Such charges may be established at different rates for different centers.

    ‘(2) In establishing charges for child care services provided at a center, the Secretary--

      ‘(A) shall (except as provided in paragraph (3)) establish the charges so as to ensure that the sum of all charges for child care services at that center is sufficient to meet the staffing expenses of that center; and

      ‘(B) may also consider the expenses of constructing or acquiring space for the center, the expenses of converting existing space into the center, and the expenses of equipment and services furnished to the center under subsection (d)(2).

    ‘(3) The Secretary may establish charges for child care services provided at a center at rates less than those necessary to ensure that the sum of all charges for child care services at that center is sufficient to meet the staffing expenses of that center if the Secretary determines (with respect to a particular facility of the Department) that--

      ‘(A) the operation of a child care center at that facility would help overcome serious recruitment or retention problems;

      ‘(B) adherence to the requirement to establish charges for child care services at that center at rates sufficient to meet the staffing expenses of that center would make the operation of a child care center at that facility unfeasible; and

      ‘(C) there are no other practical alternatives to meeting the needs of employees at that facility for child care services.

    ‘(4) Proceeds from charges for child care services shall be credited to the applicable Department of Veterans Affairs account and shall be allotted to the facility served by the child care center and shall remain available until expended.

    ‘(d) In connection with the establishment and operation of a child care center under this section, the Secretary--

      ‘(1) may construct or alter space in any Department facility, and may lease space in a non-Department facility for a term not to exceed 20 years, for use as a child care center;

      ‘(2) may provide, out of operating funds, other items and services necessary for the operation of the center, including furniture, office machines and equipment, utility and custodial services, and other necessary services and amenities;

      ‘(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 implementation 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.

    ‘(e) The Secretary shall prescribe guidelines to carry out this section.

    ‘(f) 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) CONFORMING REPEAL- Section 7809 of such title is repealed.

    (c) CLERICAL AMENDMENTS- (1) The table of sections at the beginning of chapter 81 of such title is amended by inserting after the item relating to section 8116 the following new item:

      ‘8117. Child care centers.’.

    (2) The table of sections at the beginning of chapter 78 of such title is amended by striking out the item relating to section 7809.

SEC. 503. CONTRACTS FOR UTILITIES, AUDIE L. MURPHY MEMORIAL HOSPITAL.

    (a) AUTHORITY TO CONTACT- Subject to subsection (b), the Secretary of Veterans Affairs may enter into contracts for the provision of utilities (including steam and chilled water) to the Audie L. Murphy Memorial Hospital in San Antonio, Texas. Each such contract may--

      (1) be for a period not to exceed 35 years;

      (2) provide for the construction and operation of a production facility on or near property under the jurisdiction of the Secretary;

      (3) require capital contributions by the parties involved for the construction of such a facility, such contribution to be in the form of cash, equipment, or other in-kind contribution; and

      (4) provide for a predetermined formula to compute the cost of providing such utilities to the parties for the duration of the contract.

    (b) FUNDS- A contract may be entered into under subsection (a) only to the extent and in the amount provided in advance in appropriations Acts.

    (c) ADDITIONAL TERMS- The Secretary may include in a contract under subsection (a) such additional provisions as the Secretary considers necessary to secure the provision of utilities and to protect the interests of the United States.

SEC. 504. FACILITIES IN REPUBLIC OF THE PHILIPPINES.

    Notwithstanding section 1724 of title 38, United States Code, the Secretary of Veterans Affairs, during the period from February 28, 1994, through June 1, 1994, may contract with facilities in the Republic of the Philippines other than the Veterans Memorial Medical Center to furnish hospital care and medical services to veterans for nonservice-connected disabilities if such veterans are unable to defray the expenses of necessary hospital care. When the Secretary determines it to be most feasible, the Secretary may provide medical services to such veterans at the Department of Veterans Affairs Outpatient Clinic at Manila, Republic of the Philippines.

SEC. 505. WAIVER OF CONGRESSIONAL WAITING PERIOD REQUIREMENT FOR A SPECIFIED ADMINISTRATIVE REORGANIZATION.

    (a) WAIVER- The Secretary of Veterans Affairs may undertake the administrative reorganization described in subsection (b) of this section without regard to the waiting period requirement of section 510(b) of title 38, United States Code.

    (b) COVERED ADMINISTRATIVE REORGANIZATION- The administrative reorganization referred to in subsection (a) of this section is a reorganization at the Department of Veterans Affairs Medical Center in Sepulveda, California, necessitated by the January 1994 earthquake damage at that location, as described in the letters dated April 25, 1994, and the accompanying detailed plan and justification, submitted by the Secretary of Veterans Affairs to the chairmen of the House and Senate Committees on Veterans’ Affairs pursuant to section 510(b) of title 38, United States Code.

SEC. 506. TECHNICAL AMENDMENT.

    Section 7363(c) of title 38, United States Code, is amended by striking out ‘section 501(c)(3) of’.

Passed the House of Representatives May 23, 1994.

Attest:

DONNALD K. ANDERSON,

Clerk.