[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3936 Enrolled Bill (ENR)]
H.R.3936
One Hundred Eighth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Tuesday,
the twentieth day of January, two thousand and four
An Act
To amend title 38, United States Code, to increase the authorization of
appropriations for grants to benefit homeless veterans, to improve
programs for management and administration of veterans' facilities and
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,

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(a) Short Title.--This Act may be cited as the ``Veterans Health
Programs Improvement Act of 2004''.
(b) Table of Contents.--The table of contents of this Act is as
follows:

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TITLE II

-VETERANS LONG-TERM CARE PROGRAMS

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complex multi-trauma associated with combat injuries.

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TITLE III

-MEDICAL CARE

Affairs.
Subtitle A--Major Medical Facility Leases

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of Colorado.
Subtitle B--Facilities Management

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TITLE IV

-MEDICAL FACILITIES MANAGEMENT AND ADMINISTRATION

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Veterans Health Administration facilities.

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surface parking incidental to a construction or nonrecurring
maintenance project.

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to authorized major medical facility projects.

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Veterans Affairs Medical Center, Louisville, Kentucky.

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property, Boise, Idaho.
Subtitle C--Designation of Facilities

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nursing shortages at Department of Veterans Affairs health
care facilities.

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TITLE V

-PERSONNEL ADMINISTRATION

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of Veterans Affairs health care facilities.

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TITLE VI

-OTHER MATTERS

use canteens operated by Veterans' Canteen Service.

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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 considered to
be made to a section or other provision of title 38, United States
Code.

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Section 2013 is amended in paragraph (4) by striking
``$75,000,000'' and inserting ``$99,000,000''.

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TITLE I

-ASSISTANCE TO HOMELESS VETERANS

VETERANS' HOMES.
(a) In General.--(1) Chapter 17 is amended by inserting after
section 1743 the following new section:
``Sec. 1744. Hiring and retention of nurses: payments to assist States
``(a) Payment Program.--The Secretary shall make payments to States
under this section for the purpose of assisting State homes in the
hiring and retention of nurses and the reduction of nursing shortages
at State homes.
``(b) Eligible Recipients.--Payments to a State for a fiscal year
under this section shall, subject to submission of an application, be
made to any State that during that fiscal year--
``(1) receives per diem payments under this subchapter for that
fiscal year; and
``(2) has in effect an employee incentive scholarship program
or other employee incentive program at a State home designed to
promote the hiring and retention of nursing staff and to reduce
nursing shortages at that home.
``(c) Use of Funds Received.--A State may use an amount received
under this section only to provide funds for a program described in
subsection (b)(2). Any program shall meet such criteria as the
Secretary may prescribe. In prescribing such criteria, the Secretary
shall take into consideration the need for flexibility and innovation.
``(d) Limitations on Amount of Payment.--(1) A payment under this
section may not be used to provide more than 50 percent of the costs
for a fiscal year of the employee incentive scholarship or other
employee incentive program for which the payment is made.
``(2) The amount of the payment to a State under this section for
any fiscal year is, for each State home in that State with a program
described in subsection (b)(2), the amount equal to 2 percent of the
amount of payments estimated to be made to that State, for that State
home, under section 1741 of this title for that fiscal year.
``(e) Applications.--A payment under this section for any fiscal
year with respect to any State home may only be made based upon an
application submitted by the State seeking the payment with respect to
that State home. Any such application shall describe the nursing
shortage at the State home and the employee incentive scholarship
program or other employee incentive program described in subsection (c)
for which the payment is sought.
``(f) Source of Funds.--Payments under this section shall be made
from funds available for other payments under this subchapter.
``(g) Disbursement.--Payments under this section to a State home
shall be made as part of the disbursement of payments under section
1741 of this title with respect to that State home.
``(h) Use of Certain Receipts.--The Secretary shall require as a
condition of any payment under this section that, in any case in which
the State home receives a refund payment made by an employee in breach
of the terms of an agreement for employee assistance that used funds
provided under this section, the payment shall be returned to the State
home's incentive program account and credited as a non-Federal funding
source.
``(i) Annual Report From Payment Recipients.--Any State home
receiving a payment under this section for any fiscal year, shall, as a
condition of the payment, be required to agree to provide to the
Secretary a report setting forth in detail the use of funds received
through the payment, including a descriptive analysis of how effective
the incentive program has been on nurse staffing in the State home
during that fiscal year. The report for any fiscal year shall be
provided to the Secretary within 60 days of the close of the fiscal
year and shall be subject to audit by the Secretary. Eligibility for a
payment under this section for any later fiscal year is contingent upon
the receipt by the Secretary of the annual report under this subsection
for the previous fiscal year in accordance with this subsection.
``(j) Regulations.--The Secretary shall prescribe regulations to
carry out this section. The regulations shall include the establishment
of criteria for the award of payments under this section.''.
(2) The table of sections at the beginning of such chapter is
amended by inserting after section 1743 the following new item:
``1744. Hiring and retention of nurses: payments to assist States.''.
(b) Implementation.--The Secretary of Veterans Affairs shall
implement section 1744 of title 38, United States Code, as added by
subsection (a), as expeditiously as possible. The Secretary shall
establish such interim procedures as necessary so as to ensure that
payments are made to eligible States under that section commencing not
later than June 1, 2005, notwithstanding that regulations under
subsection (j) of that section may not have become final.

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TO STATE HOMES FOR VETERANS.
Section 1741 is amended by adding at the end the following new
subsection:
``(e) Payments to States pursuant to this section shall not be
considered a liability of a third party, or otherwise be used to offset
or reduce any other payment made to assist veterans.''.

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PILOT PROGRAMS.
Subsection (h) of section 102 of the Veterans Millennium Health
Care and Benefits Act (38 U.S.C. 1710B note) is amended--
(1) by inserting ``(1)'' before ``The authority of''; and
(2) by adding at the end the following new paragraph:
``(2) In the case of a veteran who is participating in a pilot
program under this section as of the end of the three-year period
applicable to that pilot program under paragraph (1), the Secretary may
continue to provide to that veteran any of the services that could be
provided under the pilot program. The authority to provide services to
any veteran under the preceding sentence applies during the period
beginning on the date specified in paragraph (1) with respect to that
pilot program and ending on December 31, 2005.''.

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Section 1710B(c)(2) is amended--
(1) by striking ``or'' at the end of subparagraph (A);
(2) by redesignating subparagraph (B) as subparagraph (C); and
(3) by inserting after subparagraph (A) the following new
subparagraph (B):
``(B) to a veteran being furnished hospice care under this
section; or''.

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(a) Permanent Authority for Program.--Section 1720D(a) is amended--
(1) in paragraph (1), by striking ``During the period through
December 31, 2004, the'' and inserting ``The''; and
(2) in paragraph (2), by striking ``, during the period through
December 31, 2004,''.
(b) Extension to Cover Active Duty for Training.--Such section is
further amended by inserting ``or active duty for training'' in
paragraph (1) before the period at the end.

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COMPLEX MULTI-TRAUMA ASSOCIATED WITH COMBAT INJURIES.
(a) In General.--(1) Subchapter II of chapter 73 of title 38,
United States Code, is amended by adding at the end the following new
section:
``Sec. 7327. Centers for research, education, and clinical activities
on complex multi-trauma associated with combat injuries
``(a) Purpose.--The purpose of this section is to provide for the
improvement of the provision of health care services and related
rehabilitation and education services to eligible veterans suffering
from complex multi-trauma associated with combat injuries through--
``(1) the development of improved models and systems for the
furnishing by the Department of health care, rehabilitation, and
education services to veterans;
``(2) the conduct of research to support the provision of such
services in accordance with the most current evidence on multi-
trauma injuries; and
``(3) the education and training of health care personnel of
the Department with respect to the provision of such services.
``(b) Designation of Centers.--(1) The Secretary shall designate an
appropriate number of cooperative centers for clinical care,
consultation, research, and education activities on combat injuries.
``(2) Each center designated under paragraph (1) shall function as
a center for--
``(A) research on the long-term effects of injuries sustained
as a result of combat in order to support the provision of services
for such injuries in accordance with the most current evidence on
complex multi-trauma;
``(B) the development of rehabilitation methodologies for
treating individuals with complex multi-trauma; and
``(C) the continuous and consistent coordination of care from
the point of referral throughout the rehabilitation process and
ongoing follow-up after return to home and community.
``(3) The Secretary shall designate one of the centers designated
under paragraph (1) as the lead center for activities referred to in
that paragraph. As the lead center for such activities, such center
shall--
``(A) develop and provide periodic review of research
priorities, and implement protocols, to ensure that projects
contribute to the activities of the centers designated under
paragraph (1);
``(B) oversee the coordination of the professional and
technical activities of such centers to ensure the quality and
validity of the methodologies and statistical services for research
project leaders;
``(C) develop and ensure the deployment of an efficient and
cost-effective data management system for such centers;
``(D) develop and distribute educational materials and products
to enhance the evaluation and care of individuals with combat
injuries by medical care providers of the Department who are not
specialized in the assessment and care of complex multi-trauma;
``(E) develop educational materials for individuals suffering
from combat injuries and for their families; and
``(F) serve as a resource for the clinical and research
infrastructure of such centers by disseminating clinical outcomes
and research findings to improve clinical practice.
``(4) The Secretary shall designate centers under paragraph (1)
upon the recommendation of the Under Secretary for Health.
``(5) The Secretary may designate a center under paragraph (1) only
if the center meets the requirements of subsection (c).
``(c) Requirements for Centers.--To be designated as a center under
this section, a facility shall--
``(1) be a regional lead center for the care of traumatic brain
injury;
``(2) be located at a tertiary care medical center and have on-
site availability of primary and subspecialty medical services
relating to complex multi-trauma;
``(3) have, or have the capacity to develop, the capability of
managing impairments associated with combat injuries;
``(4) be affiliated with a school of medicine;
``(5) have, or have experience with, participation in clinical
research trials;
``(6) provide amputation care and rehabilitation;
``(7) have pain management programs;
``(8) provide comprehensive brain injury rehabilitation; and
``(9) provide comprehensive general rehabilitation.
``(d) Additional Resources.--The Secretary shall provide each
center designated under this section such resources as the Secretary
determines to be required by such center to achieve adequate capability
of managing individuals with complex multi-trauma, including--
``(1) the upgrading of blind rehabilitation services by
employing or securing the services of blind rehabilitation
specialists;
``(2) employing or securing the services of occupational
therapists with blind rehabilitation training;
``(3) employing or securing the services of additional mental
health services providers; and
``(4) employing or securing additional rehabilitation nursing
staff to meet care needs.
``(e) Cooperation With Department of Defense.--(1) The Secretary of
Veterans Affairs may assist the Secretary of Defense in the care of
members of the Armed Forces with complex multi-trauma at military
treatment facilities by--
``(A) making available, in a manner that the Secretary of
Veterans Affairs considers appropriate, certified rehabilitation
registered nurses of the Department of Veterans Affairs to such
facilities to assess and coordinate the care of such members; and
``(B) making available, in a manner that the Secretary of
Veterans Affairs considers appropriate, blind rehabilitation
specialists of the Department of Veterans Affairs to such
facilities to consult with the medical staff of such facilities on
the special needs of such members who have visual impairment as a
consequence of combat injury.
``(2) Assistance shall be provided under this subsection through
agreements for the sharing of health-care resources under section 8111
of this title.
``(f) Award of Funding.--Centers designated under this section may
compete for the award of funding from amounts appropriated for the
Department for medical and prosthetics research.
``(g) Dissemination of Information.--(1) The Under Secretary for
Health shall ensure that information produced by the centers designated
under this section that may be useful for other activities of the
Veterans Health Administration is disseminated throughout the
Administration.
``(2) Information shall be disseminated under this subsection
through publications, through programs of continuing medical and
related education provided through regional medical education centers
under subchapter VI of chapter 74 of this title, and through other
means.
``(h) National Oversight.--The Under Secretary for Health shall
designate an appropriate officer to oversee the operation of the
centers designated under this section and provide for periodic
evaluation of the centers.
``(i) Authorization of Appropriations.--(1) There are authorized to
be appropriated to the Department of Veterans Affairs for the centers
designated under this section amounts as follows:
``(A) $7,000,000 for fiscal year 2005.
``(B) $8,000,000 for each of fiscal years 2006 through 2008.
``(2) In addition to amounts authorized to be appropriated by
paragraph (1) for a fiscal year, the Under Secretary for Health may
allocate to each center designated under this section, from other funds
authorized to be appropriated for such fiscal year for the Department
generally for medical and for medical and prosthetic research, such
amounts as the Under Secretary for Health determines appropriate to
carry out the purposes of this section.''.
(2) The table of sections at the beginning of chapter 73 is amended
by inserting after the item relating to section 7326 the following new
item:
``7327. Centers for research, education, and clinical activities on
complex multi-trauma associated with combat injuries.''.
(b) Designation of Centers.--The Secretary of Veterans Affairs
shall designate the centers for research, education, and clinical
activities on complex multi-trauma associated with combat injuries
required by section 7327 of title 38, United States Code (as added by
subsection (a)), not later than 120 days after the date of the
enactment of this Act.
(c) Annual Reports.--(1) Not later than eighteen months after the
date of the designation of centers for research, education, and
clinical activities on complex multi-trauma associated with combat
injuries required by section 7327 of title 38, United States Code (as
so added), and annually thereafter through 2008, the Secretary shall
submit to the Committees on Veterans' Affairs of the Senate and House
of Representatives a report on the status and activities of such
centers during the one-year period beginning on the date of such
designation, for the first such report, and for successive one-year
periods, for subsequent reports.
(2) Each such report shall include, for the period covered by such
report, the following:
(A) A description of the activities carried out at each center,
and the funding provided for such activities.
(B) A description of any advances made in the participating
programs of each center in research, education, training, and
clinical activities on complex multi-trauma associated with combat
injuries.
(C) A description of the actions taken by the Under Secretary
for Health pursuant to subsection (g) of that section (as so added)
to disseminate throughout the Veterans Health Administration
information derived from such activities.

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AFFAIRS.
(a) Peer Review Panel.--In order to assist the Secretary of
Veterans Affairs in selecting facilities of the Department of Veterans
Affairs to serve as sites for centers under section 7328 of title 38,
United States Code, as added by subsection (c), the Secretary shall
establish a peer review panel to assess the scientific and clinical
merit of proposals that are submitted to the Secretary for the
selection of such facilities. The panel shall be established not later
than 90 days after the date of the enactment of this Act and shall
include experts in the fields of toxicological research, infectious
diseases, radiology, clinical care of veterans exposed to such hazards,
and other persons as determined appropriate by the Secretary. Members
of the panel shall serve as consultants to the Department of Veterans
Affairs. Amounts available to the Secretary for Medical Care may be
used for purposes of carrying out this subsection. The panel shall not
be subject to the Federal Advisory Committee Act (5 U.S.C. App.).
(b) Proposals.--The Secretary shall solicit proposals for
designation of facilities as described in subsection (a). The
announcement of the solicitation of such proposals shall be issued not
later than 60 days after the date of the enactment of this Act, and the
deadline for the submission of proposals in response to such
solicitation shall be not later than 90 days after the date of such
announcement. The peer review panel established under subsection (a)
shall complete its review of the proposals and submit its
recommendations to the Secretary not later than 60 days after the date
of the deadline for the submission of proposals. The Secretary shall
then select the four sites for the location of such centers not later
than 45 days after the date on which the peer review panel submits its
recommendations to the Secretary.
(c) Revised Section.--(1) Subchapter II of chapter 73 is amended by
inserting after section 7327, as added by section 302(a)(1) of this
Act, a new section with--
(A) a heading as follows:
``Sec. 7328. Medical preparedness centers''; and
(B) a text consisting of the text of subsections (a) through
(h) of section 7325 of title 38, United States Code, and a
subsection (i) at the end as follows:
``(i) Funding.--(1) There are authorized to be appropriated for the
centers under this section $10,000,000 for each of fiscal years 2005
through 2007.
``(2) In addition to any amounts appropriated for a fiscal year
specifically for the activities of the centers pursuant to paragraph
(1), the Under Secretary for Health shall allocate to the centers from
other funds appropriated for that fiscal year generally for the
Department medical care account and the Department medical and
prosthetic research account such amounts as the Under Secretary
determines necessary in order to carry out the purposes of this
section.''.
(2) The table of sections at the beginning of chapter 73 is amended
by inserting after the item relating to section 7327, as added by
section 302(a)(2) of this Act, the following new item:
``7328. Medical preparedness centers.''.
Subtitle A--Major Medical Facility Leases

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The Secretary of Veterans Affairs may enter into contracts for
major medical facility leases at the following locations, in an amount
for each facility lease not to exceed the amount shown for that
location:
(1) Wilmington, North Carolina, Outpatient Clinic, $1,320,000.
(2) Greenville, North Carolina, Outpatient Clinic, $1,220,000.
(3) Norfolk, Virginia, Outpatient Clinic, $1,250,000.
(4) Summerfield, Florida, Marion County Outpatient Clinic,
$1,230,000.
(5) Knoxville, Tennessee, Outpatient Clinic, $850,000.
(6) Toledo, Ohio, Outpatient Clinic, $1,200,000.
(7) Crown Point, Indiana, Outpatient Clinic, $850,000.
(8) Fort Worth, Texas, Tarrant County Outpatient Clinic,
$3,900,000.
(9) Plano, Texas, Collin County Outpatient Clinic, $3,300,000.
(10) San Antonio, Texas, Northeast Central Bexar County
Outpatient Clinic, $1,400,000.
(11) Corpus Christi, Texas, Outpatient Clinic, $1,200,000.
(12) Harlingen, Texas, Outpatient Clinic, $650,000.
(13) Denver, Colorado, Health Administration Center,
$1,950,000.
(14) Oakland, California, Outpatient Clinic, $1,700,000.
(15) San Diego, California, North County Outpatient Clinic,
$1,300,000.
(16) San Diego, California, South County Outpatient Clinic,
$1,100,000.

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There is authorized to be appropriated to the Secretary of Veterans
Affairs for fiscal year 2005 for the Medical Care account, $24,420,000
for the leases authorized in section 401.

5137570c85f4db01394106eb398eafbfa50e7fd0be0c2a95041b5d810b1dbc12

OF COLORADO.
Notwithstanding section 8103 of title 38, United States Code, the
Secretary of Veterans Affairs may enter into a lease for real property
located at the Fitzsimmons Campus of the University of Colorado for
purposes of a medical facility (as that term is defined in section 8101
of title 38, United States Code) for a period of up to 75 years.
Subtitle B--Facilities Management

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(a) Establishment of Fund.--(1) Subchapter I of chapter 81 is
amended by adding at the end the following new section:
``Sec. 8118. Authority for transfer of real property; Department of
Veterans Affairs Capital Asset Fund
``(a)(1) The Secretary may transfer real property under the
jurisdiction or control of the Secretary (including structures and
equipment associated therewith) to another department or agency of the
United States, to a State (or a political subdivision of a State), or
to any public or private entity, including an Indian tribe. Such a
transfer may be made only if the Secretary receives compensation of not
less than the fair market value of the property, except that no
compensation is required, or compensation at less than fair market
value may be accepted, in the case of a transfer to a grant and per
diem provider (as defined in section 2002 of this title). When a
transfer is made to a grant and per diem provider for less than fair
market value, the Secretary shall require in the terms of the
conveyance that if the property transferred is used for any purpose
other than a purpose under chapter 20 of this title, all right, title,
and interest to the property shall revert to the United States.
``(2) The Secretary may exercise the authority provided by this
section notwithstanding sections 521, 522, and 541 through 545 of title
40. Any such transfer shall be in accordance with this section and
section 8122 of this title.
``(3) The authority provided by this section may not be used in a
case to which section 8164 of this title applies.
``(4) The Secretary may enter into partnerships or agreements with
public or private entities dedicated to historic preservation to
facilitate the transfer, leasing, or adaptive use of structures or
properties specified in subsection (b)(3)(D).
``(5) The authority of the Secretary under paragraph (1) expires on
the date that is seven years after the date of the enactment of this
section.
``(b)(1) There is established in the Treasury of the United States
a revolving fund to be known as the Department of Veterans Affairs
Capital Asset Fund (hereinafter in this section referred to as the
`Fund'). Amounts in the Fund shall remain available until expended.
``(2) Proceeds from the transfer of real property under this
section shall be deposited into the Fund.
``(3) To the extent provided in advance in appropriations Acts,
amounts in the Fund may be expended for the following purposes:
``(A) Costs associated with the transfer of real property under
this section, including costs of demolition, environmental
remediation, maintenance and repair, improvements to facilitate the
transfer, and administrative expenses.
``(B) Costs, including costs specified in subparagraph (A),
associated with future transfers of property under this section.
``(C) Costs associated with enhancing medical care services to
veterans by improving, renovating, replacing, updating, or
establishing patient care facilities through construction projects
to be carried out for an amount less than the amount specified in
8104(a)(3)(A) for a major medical facility project.
``(D) Costs, including costs specified in subparagraph (A),
associated with the transfer, lease, or adaptive use of a structure
or other property under the jurisdiction of the Secretary that is
listed on the National Register of Historic Places.
``(c) The Secretary shall include in the budget justification
materials submitted to Congress for any fiscal year in support of the
President's budget for that fiscal year for the Department
specification of the following:
``(1) The real property transfers to be undertaken in
accordance with this section during that fiscal year.
``(2) All transfers completed under this section during the
preceding fiscal year and completed and scheduled to be completed
during the fiscal year during which the budget is submitted.
``(3) The deposits into, and expenditures from, the Fund that
are incurred or projected for each of the preceding fiscal year,
the current fiscal year, and the fiscal year covered by the
budget.''.
(2) The table of sections at the beginning of such chapter is
amended by inserting after the item relating to section 8117 the
following new item:
``8118. Authority for transfer of real property; Department of Veterans
Affairs Capital Asset Fund.''.
(b) Initial Authorization of Appropriations.--There is authorized
to be appropriated to the Department of Veterans Affairs Capital Asset
Fund established under section 8118 of title 38, United States Code (as
added by subsection (a)), the amount of $10,000,000.
(c) Termination of Nursing Home Revolving Fund.--(1) Section 8116
is repealed.
(2) The table of sections at the beginning of chapter 81 is amended
by striking the item relating to section 8116.
(d) Transfer of Unobligated Balances to Capital Asset Fund.--Any
unobligated balances in the nursing home revolving fund under section
8116 of title 38, United States Code, as of the date of the enactment
of this Act shall be deposited in the Department of Veterans Affairs
Capital Asset Fund established under section 8118 of title 38, United
States Code (as added by subsection (a)).
(e) Procedures Applicable to Transfers.--(1) Paragraph (2) of
section 8122(a) is amended to read as follows:
``(2) Except as provided in paragraph (3), the Secretary may not
during any fiscal year transfer to any other department or agency of
the United States or to any other entity real property that is owned by
the United States and administered by the Secretary unless the proposed
transfer is described in the budget submitted to Congress pursuant to
section 1105 of title 31 for that fiscal year.''.
(2) Section 8122(d) is amended--
(A) by inserting ``(1)'' before ``Real property''; and
(B) by adding at the end the following new paragraph:
``(2) The Secretary may transfer real property under this section,
or under section 8118 of this title, if the Secretary--
``(A) places a notice in the real estate section of local
newspapers and in the Federal Register of the Secretary's intent to
transfer that real property (including land, structures, and
equipment associated with the property);
``(B) holds a public hearing;
``(C) provides notice to the Administrator of General Services
of the Secretary's intention to transfer that real property and
waits for 30 days to elapse after providing that notice; and
``(D) after such 30-day period has elapsed, notifies the
congressional veterans' affairs committees of the Secretary's
intention to dispose of the property and waits for 60 days to
elapse from the date of that notice.''.
(3) Section 8164(a) is amended by inserting ``8118 or'' after
``rather than under section''.
(4) Section 8165(a)(2) is amended by striking ``nursing home
revolving fund'' and inserting ``Department of Veterans Affairs Capital
Asset Fund established under section 8118 of this title''.
(f) Contingent Effectiveness.--Subsection (d) and the amendments
made by subsection (c) shall take effect at the end of the 30-day
period beginning on the date on which the Secretary of Veterans Affairs
certifies to Congress that the Secretary is in compliance with
subsection (b) of section 1710B of title 38, United States Code.
(g) Annual Update.--Following a certification under subsection (f),
the Secretary shall submit to Congress an annual update on that
certification.

dd39748d9909a61473485e71d72b1591b7e1b6c65256d1e9087a928107fd44a2

VETERANS AFFAIRS HISTORIC PROPERTIES.
(a) In General.--Not later than December 15 of 2005, 2006, and
2007, the Secretary of Veterans Affairs shall submit to the Committees
on Veterans' Affairs of the Senate and House of Representatives a
report on the historic properties administered or controlled by the
Secretary.
(b) Initial Report.--In the initial report under subsection (a),
the Secretary shall set forth a complete inventory of the historic
structures and property under the jurisdiction of the Secretary. The
report shall include a description and classification of each such
property based upon historical nature, current physical condition, and
potential for transfer, leasing, or adaptive use.
(c) Subsequent Reports.--In reports under subsection (a) after the
initial report, the Secretary shall provide an update of the status of
each property identified in the initial report, with the proposed and
actual disposition, if any, of each property. Each such report shall
include any recommendation of the Secretary for legislation to enhance
the transfer, leasing, or adaptive use of such properties.

f1cfb812f49b7cef04c42cfbf33260cfbad66517cfc7e77dde17365f2c449259

HOMELESS VETERANS.
(a) Authority.--Upon identification of a parcel of real property
meeting the description in subsection (b), the Secretary of Veterans
Affairs may acquire that property (with the structures and improvements
thereon) or, in the case of property owned by the United States and
administered by another Federal department or agency, may accept
administrative jurisdiction over that property, with the expectation of
promptly transferring that property to a homeless assistance provider
identified under paragraph (2) of subsection (b), subject to the
condition that the primary purpose for which the property shall be used
is to provide housing for homeless veterans.
(b) Specified Property.--A parcel of real property referred to in
subsection (a) is a parcel in the District of Columbia--
(1) that the Secretary determines to be suitable for use for
housing for homeless veterans; and
(2) for which there is an identified homeless assistance
provider that is prepared to acquire the property for such purpose
from the Secretary promptly upon the acquisition of the property by
the Secretary.
(c) Transfer of Property.--Upon acquiring real property under
subsection (a), the Secretary shall immediately transfer all right,
title, and interest of the United States (other than the reversionary
interest retained under subsection (e)) to the homeless assistance
provider identified under subsection (b)(2). Such transfer shall be for
such consideration as the Secretary determines appropriate.
(d) Terms and Conditions.--The acquisition and transfer of real
property under this section shall be made upon such terms and
conditions as the Secretary may specify not inconsistent with other
applicable provisions of law.
(e) Reverter.--The terms of the transfer shall provide that if the
property is no longer used for the purpose for which conveyed by the
Secretary, title to the property shall revert to the United States.

b47b8fc0bb840a2846a6355df830bb3453dc0b77dcb0c865e9ceaed8cde6028e

VETERANS HEALTH ADMINISTRATION FACILITIES.
(a) Limitation.--The Secretary of Veterans Affairs may not
implement a mission change for a medical facility of the Department of
Veterans Affairs specified in subsection (c) until--
(1) the Secretary submits to the Committees on Veterans'
Affairs of the Senate and House of Representatives a written notice
of the mission change; and
(2) the period prescribed by subsection (b) has elapsed.
(b) Congressional Review Period.--(1) The period referred to in
subsection (a)(2) is the period beginning on the date of the receipt of
the notice under subsection (a)(1) by the committees specified in that
subsection and ending on the later of--
(A) the end of the 60-day period beginning on the date on which
the notice is received by those committees; or
(B) the end of a period of 30 days of continuous session of
Congress beginning on the date on which the notification is
received by those committees or, if either House of Congress is not
in session on such date, the first day after such date that both
Houses of Congress are in session.
(2) For the purposes of paragraph (1)(B)--
(A) the continuity of a session of Congress is broken only by
an adjournment of Congress sine die; and
(B) any day on which either House is not in session because of
an adjournment of more than three days to a day certain is excluded
in the computation of any period of time in which Congress is in
continuous session.
(c) Specified Facilities.--A facility referred to in subsection (a)
as being specified in this subsection is any of the following
facilities of the Department of Veterans Affairs:
(1) The Department of Veterans Affairs medical centers in
Boston, Massachusetts.
(2) The Department of Veterans Affairs medical centers in New
York City, New York.
(3) The Department of Veterans Affairs medical center in Big
Spring, Texas.
(4) The Carl Vinson Department of Veterans Affairs Medical
Center, Dublin, Georgia.
(5) The Department of Veterans Affairs medical center in
Montgomery, Alabama.
(6) The Department of Veterans Affairs medical center in
Louisville, Kentucky.
(7) The Department of Veterans Affairs medical center in
Muskogee, Oklahoma, and the outpatient clinic in Tulsa, Oklahoma.
(8) The John J. Pershing Department of Veterans Affairs Medical
Center, Poplar Bluff, Missouri.
(9) The Department of Veterans Affairs medical center in Ft.
Wayne, Indiana.
(10) The Department of Veterans Affairs Medical Center in Waco,
Texas.
(11) The Jonathan M. Wainwright Department of Veterans Affairs
Medical Center, Walla Walla, Washington.
(d) Covered Mission Changes.--For purposes of this section, a
mission change for a medical facility shall consist of any of the
following:
(1) Closure of the facility.
(2) Consolidation of the facility.
(3) An administrative reorganization of the facility covered by
section 510(b) of title 38, United States Code.
(e) Required Content of Notice of Mission Change.--Written notice
of a mission change for a medical facility under subsection (a) shall
include the following:
(1) An assessment of the effect of the mission change on the
population of veterans served by the facility.
(2) A description of the availability and quality of health
care, including long-term care, mental health care, and substance
abuse programs, available in the area served by the facility.
(3) An assessment of the effect of the mission change on the
economy of the community in which the facility is located.
(4) An analysis of any alternatives to the mission change
proposed by--
(A) the community in which the facility is located;
(B) organizations recognized by the Secretary under section
5902 of title 38, United States Code;
(C) organizations that represent Department employees in
such community; or
(D) the Department.
(f) Medical Facility Consolidation.--For the purposes of subsection
(d)(2), the term ``consolidation'' means an action that closes one or
more medical facilities within a geographic service area for the
purpose of relocating those activities to another medical facility or
facilities.
(g) Coordination of Provisions.--In the case of a mission change
covered by subsection (a) that is also an administrative reorganization
covered by section 510(b) of title 38, United States Code, both this
section and such section 510(b) shall apply with respect to the
implementation of that mission change.

225498a77b2d3d666d627adf3306abfe50449a94162061e0cc6d612489d025d4

SURFACE PARKING INCIDENTAL TO A CONSTRUCTION OR
NONRECURRING MAINTENANCE PROJECT.
Section 8109 is amended by adding at the end the following new
subsection:
``(j) Funds in a construction account or capital account that are
available for a construction project or a nonrecurring maintenance
project may be used for the construction or relocation of a surface
parking lot incidental to that project.''.

9f54807538561b934ca6b51bc0f22bf3e456eb674935cf8b6249a78d24dceacc

FUNDS TO AUTHORIZED MAJOR MEDICAL FACILITY PROJECTS.
Section 8104 is amended by adding at the end the following new
subsection:
``(g) The limitation in subsection (f) does not apply to a project
for which funds have been authorized by law in accordance with
subsection (a)(2).''.

75ee86ba2cba17643b9dd78a591266ef541b48747c9d8cda78047542a68f400a

Section 8166(a) is amended by inserting ``land use,'' in the second
sentence after ``relating to''.

85e3cfe010fce5f55f84bba81aed82a9fe6ec9f87cfde466947958d384e4eb6a

VETERANS AFFAIRS MEDICAL CENTER, LOUISVILLE, KENTUCKY.
(a) Requirement.--Upon determining to convey, lease, or otherwise
dispose of the Department of Veterans Affairs Medical Center,
Louisville, Kentucky, or any portion thereof, the Secretary of Veterans
Affairs shall engage in negotiations for the conveyance, lease, or
other disposal of the Medical Center or portion thereof solely with the
Commonwealth of Kentucky.
(b) Duration of Requirement.--The requirement for negotiations
under subsection (a) shall remain in effect for one year after the date
of the determination referred to in that subsection.
(c) Scope of Negotiations.--The negotiations under subsection (a)
shall address the use of the medical center referred to in subsection
(a), or portion thereof, by the Commonwealth of Kentucky for the
primary purpose of the provision of services for veterans and related
activities, including use for a State veterans' home.

97d1ecac983cb37aeadf514d78f30f51ce440703be25127f9a173f1ba2360ac2

PROPERTY, BOISE, IDAHO.
(a) Transfer.--The Administrator of General Services shall transfer
to the Secretary of Veterans Affairs, under such terms and conditions
as the Administrator and the Secretary agree, jurisdiction, custody,
and control over the parcel of real property, including any
improvements thereon, consisting of approximately 2.3 acres located at
the General Services Administration facility immediately north of the
Army Reserve facility in Boise, Idaho.
(b) Utilization.--The Secretary of Veterans Affairs shall utilize
the property transferred under subsection (a) for purposes relating to
the delivery of benefits to veterans.
Subtitle C--Designation of Facilities

161afc49dab9ec827b1fe76679d8ab6f888699517997f212a5f3e79ac7093e0c

CENTER.
(a) In General.--The Department of Veterans Affairs medical center
in Amarillo, Texas, shall after the date of the enactment of this Act
be known and designated as the ``Thomas E. Creek Department of Veterans
Affairs Medical Center''.
(b) References.--Any reference in any law, regulation, map,
document, record, or other paper of the United States to the medical
center referred to in subsection (a) shall be considered to be a
reference to the Thomas E. Creek Department of Veterans Affairs Medical
Center.

dcd033567746c6f4dfa0320194136057c5a2536b846585f88f2a050887c8992d

CENTER.
(a) In General.--The Department of Veterans Affairs medical center
in the Bronx, New York, shall after the date of the enactment of this
Act be known and designated as the ``James J. Peters Department of
Veterans Affairs Medical Center''.
(b) References.--Any reference in any law, regulation, map,
document, record, or other paper of the United States to the medical
center referred to in subsection (a) shall be considered to be a
reference to the James J. Peters Department of Veterans Affairs Medical
Center.

9fdbfaa420084035a4ef3ed4549a1596e6f39a76456297a157260abfb5869dc7

(a) In General.--The Department of Veterans Affairs outpatient
clinic located in Peoria, Illinois, shall after the date of the
enactment of this Act be known and designated as the ``Bob Michel
Department of Veterans Affairs Outpatient Clinic''.
(b) References.--Any reference in any law, regulation, map,
document, record, or other paper of the United States to the outpatient
clinic referred to in subsection (a) shall be considered to be a
reference to the Bob Michel Department of Veterans Affairs Outpatient
Clinic.

495f419b4132c58c8eb36bdaea80d85939026ae8d7977310f06b44454775d00b

CLINIC.
(a) In General.--The Department of Veterans Affairs outpatient
clinic located in Lufkin, Texas, shall after the date of the enactment
of this Act be known and designated as the ``Charles Wilson Department
of Veterans Affairs Outpatient Clinic''.
(b) References.--Any reference in any law, regulation, map,
document, record, or other paper of the United States to the outpatient
clinic referred to in subsection (a) shall be considered to be a
reference to the Charles Wilson Department of Veterans Affairs
Outpatient Clinic.

06900144cff0f63937326e74d2becddcf8a7e401bae699fff7cd20e6793d3eb7

OUTPATIENT CLINIC.
(a) In General.--The Department of Veterans Affairs outpatient
clinic in Sunnyside, Queens, New York, shall after the date of the
enactment of this Act be known and designated as the ``Thomas P.
Noonan, Jr. Department of Veterans Affairs Outpatient Clinic''.
(b) References.--Any reference in any law, map, regulation,
document, paper, or other record of the United States to the outpatient
clinic referred to in subsection (a) shall be considered to be a
reference to the Thomas P. Noonan, Jr. Department of Veterans Affairs
Outpatient Clinic.

dfadbc19ed467631e5491977eb0ea4c2bef5a2d07f47dcb78fc7551691ab3cfc

ADDRESS NURSING SHORTAGES AT DEPARTMENT OF VETERANS
AFFAIRS HEALTH CARE FACILITIES.
(a) Pilot Program.--(1) Not later than 90 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs shall
designate a health care service region, or a section within such a
region, in which health care facilities of the Department of Veterans
Affairs are adversely affected by a shortage of qualified nurses.
(2) The Secretary shall conduct a pilot program in the region or
section designated under paragraph (1) to determine the effectiveness
of the use of innovative human capital tools and techniques in the
recruitment of qualified nurses for positions at Department health care
facilities in such region or section and for the retention of nurses at
such facilities. In carrying out the pilot program, the Secretary shall
enter into a contract with a private sector entity for services under
the pilot program for recruitment of qualified nurses.
(b) Private Sector Recruitment Practices.--For purposes of the
pilot program under this section, the Secretary shall identify and use
recruitment practices that have proven effective for placing qualified
individuals in positions that are difficult to fill due to shortages of
qualified individuals or other factors. Recruitment practices to be
reviewed by the Secretary for use in the pilot program shall include--
(1) employer branding and interactive advertising strategies;
(2) Internet technologies and automated staffing systems; and
(3) the use of recruitment, advertising, and communication
agencies.
(c) Streamlined Hiring Process.--In carrying out the pilot program
under this section, the Secretary shall, at health care facilities of
the Department in the region or section in which the pilot program is
conducted, revise procedures and systems for selecting and hiring
qualified nurses to reduce the length of the hiring process. If the
Secretary identifies measures to streamline and automate the hiring
process that can only be implemented if authorized by law, the
Secretary shall submit to the Committees on Veterans' Affairs of the
Senate and House of Representatives recommendations for such changes in
law as may be necessary to enable such measures to be implemented.
(d) Report.--Not later than one year 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 extent to which the pilot program achieved the goal of improving
the recruitment and retention of nurses in Department of Veterans
Affairs health care facilities.

0ea90c2ca8936b01bd1527e67c9888edf1594b03c22e9e2c93abb82658aa4092

IN VETERANS HEALTH ADMINISTRATION.
Section 7401(3) is amended--
(1) by striking ``and dental technologists'' and inserting
``technologists, dental hygienists, dental assistants''; and
(2) by striking ``technicians, therapeutic radiologic
technicians, and social workers'' and inserting ``technologists,
therapeutic radiologic technologists, social workers, blind
rehabilitation specialists, and blind rehabilitation outpatient
specialists''.

919eb891ef8db8a7e2efe2f985729d21b9575efad2e291cff1084b474057c640

Section 305(a)(2) is amended--
(1) in the matter preceding subparagraph (A), by striking
``shall be a doctor of medicine and''; and
(2) in subparagraph (A), by striking ``and in health-care'' and
inserting ``or in health-care''.

172380ca189184a7456446f22c8e2069e861a417e2aa916d5e40ee01af38caf1

Section 1703 is amended by adding at the end the following new
subsection:
``(d)(1) The Secretary shall conduct a program of recovery audits
for fee basis contracts and other medical services contracts for the
care of veterans under this section, and for beneficiaries under
sections 1781, 1782, and 1783 of this title, with respect to
overpayments resulting from processing or billing errors or fraudulent
charges in payments for non-Department care and services. The program
shall be conducted by contract.
``(2) Amounts collected, by setoff or otherwise, as the result of
an audit under the program conducted under this subsection shall be
available for the purposes for which funds are currently available to
the Secretary for medical care and for payment to a contractor of a
percentage of the amount collected as a result of an audit carried out
by the contractor.
``(3) The Secretary shall allocate all amounts collected under this
subsection with respect to a designated geographic service area of the
Veterans Health Administration, net of payments to the contractor, to
that region.
``(4) The authority of the Secretary under this subsection
terminates on September 30, 2008.''.

5a298d032208d1201904c6ce3e422935239c85dee89fce642a3d749d9e45c8eb

DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE FACILITIES.
(a) Inventory.--The Secretary of Veterans Affairs shall establish
and maintain a national inventory of medical waste management
activities in the health care facilities of the Department of Veterans
Affairs. The inventory shall include the following:
(1) A statement of the current national policy of the
Department on managing and disposing of medical waste, including
regulated medical waste in all its forms.
(2) A description of the program of each geographic service
area of the Department to manage and dispose of medical waste,
including general medical waste and regulated medical waste, with a
description of the primary methods used in those programs and the
associated costs of those programs, with cost information shown
separately for in-house costs (including full-time equivalent
employees) and contract costs.
(b) Report.--Not later than June 30, 2005, the Secretary of
Veterans Affairs shall submit to the Committees on Veterans' Affairs of
the Senate and House of Representatives a report on medical waste
management activities in the facilities of the Department of Veterans
Affairs. The report shall include the following:
(1) The inventory established under subsection (a), including
all the matters specified in that subsection.
(2) A listing of each violation of medical waste management and
disposal regulations reported at any health care facility of the
Department over the preceding five years by any Federal or State
agency, along with an explanation of any remedial or other action
taken by the Secretary in response to each such reported violation.
(3) A description of any plans to modernize, consolidate, or
otherwise improve the management of medical waste and disposal
programs at health care facilities of the Department, including the
projected costs associated with such plans and any barriers to
achieving goals associated with such plans.
(4) An assessment or evaluation of the available methods of
disposing of medical waste and identification of which of those
methods are more desirable from an environmental perspective in
that they would be least likely to result in contamination of air
or water or otherwise cause future cleanup problems.

89e37ffa6d5d38480a3ab1213a65d73823bfa80da16634bd2484ee98db6af071

USE CANTEENS OPERATED BY VETERANS' CANTEEN SERVICE.
The text of section 7803 is amended to read as follows:
``(a) Primary Beneficiaries.--Canteens operated by the Service
shall be primarily for the use and benefit of--
``(1) veterans hospitalized or domiciled at the facilities at
which canteen services are provided; and
``(2) other veterans who are enrolled under section 1705 of
this title.
``(b) Other Authorized Users.--Service at such canteens may also be
furnished to--
``(1) personnel of the Department and recognized veterans'
organizations who are employed at a facility at which canteen
services are provided and to other persons so employed;
``(2) the families of persons referred to in paragraph (1) who
reside at the facility; and
``(3) relatives and other persons while visiting a person
specified in this section.''.

8d57d4568db1d765794a6c4805d8ceb387b36f622c49c23ea2934ddd2eaa7977

SPECIALTY CARE.
(a) Annual Reports.--Not later than January 31 each year through
2007, the Secretary of Veterans Affairs shall submit to the Committees
on Veterans' Affairs of the Senate and the House of Representatives a
report on waiting times for appointments for specialty health care from
the Department of Veterans Affairs under chapter 17 of title 38, United
States Code, during the preceding year.
(b) Report Elements.--Each report under subsection (a) shall
specify, for the year covered by the report, the following:
(1) A tabulation of the number of veterans whose appointment
for specialty health care furnished by the Department was more than
three months after the date of the scheduling of such appointment,
and the waiting times of such veterans for such appointments, for
each category of specialty care furnished by the Department, broken
out by Veterans Integrated Service Network.
(2) An identification of the categories of specialty care
furnished by the Department for which there were delays of more
than three months between the scheduling date of appointments and
appointments in each Veterans Integrated Service Network.
(3) A discussion of the reasons for the delays identified under
paragraph (2) for each category of care for each Veterans
Integrated Service Network so identified, including lack of
personnel, financial resources, or other resources.
(c) Certification on Report Information.--The Comptroller General
of the United States shall certify to the committees of Congress
referred to in subsection (a) whether or not each report under this
section is accurate.

5ba09477bea9f871ad0c16b87f6baa08d4b7638f7f8a5dee2b5b84cda67770db

Section 8111(d)(2) is amended by inserting before the period at the
end of the last sentence the following: ``and shall be available for
any purpose authorized by this section''.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.

906b7f9a0a3641837e01c8b3a021f6a582189bb31db6d7c8d55ea2c24812d020

Veterans Health Programs Improvement Act of 2004 — HR. 3936

Other Sections