Department of Veterans Affairs Real Property and Facilities Management Improvement Act of 2004
DEPARTMENT OF VETERANS AFFAIRS REAL PROPERTY AND FACILITIES MANAGEMENT IMPROVEMENT ACT OF 2004
Mr. SPECTER. Mr. President, I have sought recognition to comment on a substitute amendment I propose to make to S. 2485, the "Veterans Health Programs Improvements Act of 2004," as part of my request that the bill, as so amended, be approved by the Senate. The underlying bill, S. 2485, was reported by the Senate Committee on Veterans' Affairs on July 20, 2004, and is explained in detail in Senate Report 108-358. My comments at this time are limited to explaining how the proposed substitute amendment, which reflects a bipartisan agreement between Senate and House Veterans' Affairs Committees on veterans' medical benefits-related issues, differs from the provisions of S. 2485, as reported.
The House has approved a number of bills-H.R. 1318, H.R. 4231, H.R. 4248, H.R. 4317, H.R. 4608, H.R. 4768, and H.R. 4836-that overlap with provisions drawn from various Senate bills that are contained in S. 2485, as reported. The language of the substitute amendment, in some cases, fine tunes language to harmonize these overlapping provisions without significant or substantive modification. Further, the substitute amendment adds provisions that are drawn from House-approved bills that had not been considered by the Senate. Among those provisions are measures which will assist the Department of Veterans Affairs-VA-and State veterans homes in procuring needed nursing services; provisions which authorize VA major medical facility leases and grant programs to assist providers of services to homeless veterans; and measures requiring VA reports on historic properties and medical waste management activities. Also included are VA facility "naming" provisions which, in addition to a measure already approved by the Veterans' Committee, would name VA facilities in Amarillo, TX; Peoria, IL; Lufkin, TX; and Sunnyside, Queens, NY. All of these additional provisions, and all clarifications and modifications to language contained in the reported bill, are outlined in the "Explanatory Statement" which I will append to this statement.
Each of the additions to S. 2485 that have resulted from negotiations with our colleagues in the House are all useful and productive. The bill as it would be modified by the managers' amendment, then, merits the Senate's approval.
I yield the floor and ask unanimous consent that the Explanatory Statement be printed in the RECORD.
There being no objection, the material was ordered to be printed in the RECORD, as follows:
EXPLANATORY STATEMENT ON S. 2485, AS AMENDED
S. 2485, as amended, (hereinafter, the "Compromise Agreement") reflects a negotiated agreement reached by the House of Representatives and Senate Committees on Veterans' Affairs concerning provisions from a number of bills considered by the House and the Senate during the 108th Congress. Legislative provisions contained in the compromise were derived from: H.R. 1318, H.R. 4231, H.R. 4248, H.R. 4317, H.R. 4608, H.R. 4658, H.R. 4768, H.R. 4836, and S. 2485, as reported by the Senate Committee on Veterans' Affairs on July 20, 2004 (hereinafter, "S 2485, as reported").
The House and Senate Committees on Veterans' Affairs have prepared the following explanation of the Compromise Agreement. Differences between the provisions of the Compromise Agreement and the related provisions originally contained in House or Senate bills are noted, except for clerical corrections, conforming changes made necessary by the Compromise Agreement, and minor drafting, technical, and clarifying changes.
TITLE I-ASSISTANCE TO HOMELESS VETERANS
SEC. 101-AUTHORIZATION OF APPROPRIATIONS
Current Law
Public Law 107-95, the Homeless Veterans Comprehensive Assistance Act of 2001, authorized appropriations of $75 million per year for a program to make grants to providers of comprehensive services for homeless veterans. The program expires on September 30, 2005.
House Bill
Section 2 of H.R. 4248, as reported on June 9, 2004, would increase the annual authorized appropriation for this program to $100 million and extends the program through September 30, 2008.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 101 of the Compromise Agreement increases the authorization level to $99,000,000 and removes the section from the House Bill that would have extended this program through 2008.
TITLE II-VETERANS LONG-TERM CARE PROGRAMS
SEC. 201-ASSISTANCE FOR HIRING AND RETENTION OF NURSES AT STATE VETERANS HOMES
Current Law
Subchapter V, chapter 17 of title 38, United States Code, authorizes the Department of Veterans Affairs (hereinafter, "VA") to make payments to State homes for veterans receiving care in a State home.
House Bill
Section 5 of H.R. 4231, as amended, would amend subchapter V, chapter 17 of title 38, United States Code, to add a new section 1744 to authorize the Secretary of Veterans Affairs (hereinafter, "the Secretary") to make payments to States for the purpose of assisting State homes in the hiring and retention of registered nurses.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 201 of the Compromise Agreement follows the House language.
SEC. 202-TREATMENT OF DEPARTMENT OF VETERANS AFFAIRS PER DIEM PAYMENTS TO STATE HOMES FOR VETERANS
Current Law
Section 1741 of title 38, United States Code, establishes criteria for VA payments to State homes for veterans receiving care in a State home.
House Bill
The House Bill contains no comparable provision.
Senate Bill
Section 203 of S. 2485, as reported, would amend section 1741 of title 38, United States Code, to add a new subsection (e) to clarify that per diem payments made by VA to State veterans' homes would not be used to offset or reduce other third party payments made to assist veterans.
Compromise Agreement
Section 202 of the Compromise Agreement follows the Senate language.
SEC. 203-EXTENSION OF AUTHORITY TO PROVIDE CARE UNDER LONG-TERM CARE PILOT PROGRAMS
Current Law
Section 102 of Public Law 106-117, The Veterans Millennium Health Care and Benefits Act, directed VA to carry-out three pilot programs over a three-year period to determine the feasibility and practicability of different models for providing long-term care. The authority for the pilot program expires on December 31, 2004.
House Bill
Section 107 of H.R. 4768, as amended, would extend VA's authority to provide health care services under the long-term care pilot programs authorized in Public Law 106-117 until December 31, 2005.
Senate Bill
Section 206 of S. 2485, as reported, would extend VA's authority to provide health care services under the long-term care pilot programs authorized in Public Law 106-117 until December 31, 2005.
Compromise Agreement
Section 203 of the Compromise Agreement follows the language of the House and Senate Bills.
SEC. 204-PROHIBITION ON COLLECTION OF COPAYMENTS FOR HOSPICE CARE
Current Law
Section 1710B© of title 38, United States Code, requires certain veterans to pay a copayment for extended care services furnished under Section 1710B.
House Bill
The House Bills contain no comparable provision.
Senate Bill
Section 201 of S. 2485, as reported, would exempt all veterans being furnished hospice care under Section 1710B from copayment obligations that would otherwise apply.
Compromise Agreement
Section 204 of the Compromise Agreement follows the Senate language.
TITLE-III MEDICAL CARE
SEC. 301-SEXUAL TRAUMA COUNSELING PROGRAM
Current Law
Public Law 103-452 authorized VA to provide counseling services to servicemembers who were victims of sexual trauma while on active duty in service. This authority expires on December 31, 2004.
House Bill
H.R. 4248 would make permanent the program authorized under Public Law 103-452 to provide sexual trauma counseling services to former service-members.
Senate Bill
S. 2485, as reported, would make permanent the program authorized under Public Law 103-452, and expand the authority to include the treatment of former Members of the Reserves who were victims of sexual trauma while on active duty for training.
Compromise Agreement
Section 301 of the Compromise Agreement makes VA's authority to provide sexual trauma counseling services permanent and extends the authority to include former Reserves and Guard members who were victims of sexual trauma while on active duty for training.
SEC. 302 CENTERS FOR RESEARCH, EDUCATION, AND CLINICAL ACTIVITY ON COMPLEX MULTI-TRAUMA ASSOCIATED WITH COMBAT INJURIES
Current Law
No similar provision exists under current law.
House Bill
The House Bills contained no comparable provision.
Senate Bill
Section 205 of S. 2485, as reported, would establish at VA, in collaboration with the Department of Defense, at least one, but not more than three, War-Related Blast Injury Centers. These centers would provide comprehensive rehabilitation programs, targeted education and outreach programs, and research initiatives.
Compromise Agreement
Section 203 of the Compromise Agreement authorizes centers for research, education, and clinical activities to improve the rehabilitation services available to veterans suffering from complex multi-trauma associated with combat injuries. The Compromise Agreement incorporates successful current VA practices, including cooperation with the Department of Defense, the treatment of traumatic brain injuries, and VA's conception for the future of combat-injury rehabilitation.
SEC. 303-ENHANCEMENT OF MEDICAL PREPAREDNESS OF DEPARTMENT
Current Law
Public Law 107-287, the Department of Veterans Affairs Emergency Preparedness Act of 2002, requires the Secretary to establish four Medical Emergency Preparedness Research Centers. These centers have not been established.
House Bill
Section 202 of H.R 4768, as amended, would amend chapter 73, of title 38, United States Code to add a new section 7327, to direct the Secretary to take a series of specific actions to establish four Medical Emergency Preparedness Research Centers by dates certain.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 303 of the Compromise Agreement follows section 202(a) through (c) of the House language, but does not include section 202(d) of the House bill that would have provided a rule of construction.
TITLE IV-MEDICAL FACILITIES MANAGEMENT AND ADMINISTRATION SUBTITLE A-MAJOR MEDICAL FACILITY LEASES
SEC. 401-MAJOR MEDICAL FACILITY LEASES
Current Law
Section 8104(a)(2) of title 38, United States Code, prohibits VA from obligating or expending more than $600,000 per year for a lease unless that lease has been specifically authorized by law.
House Bill
Section 101 of H.R. 4768 would authorize major medical facility leases in the following locations and amounts: (1) Greenville, North Carolina, Outpatient Clinic, $1,220,000; (2) Wilmington, North Carolina, Outpatient Clinic, $1,320,000; (3) Oakland, California, Outpatient Clinic, $1,700,000; (4) Toledo, Ohio, Outpatient Clinic, $1,200,000; (5) Crown Point, Indiana, Outpatient Clinic, $850,000; and (6) Denver, Colorado, Health Administration Center, $1,950,000; (7) Norfolk, Virginia, Outpatient Clinic, $1,250,000; (8) Summerfield, Florida, Marion County Outpatient Clinic, $1,230,000; (9) Knoxville, Tennessee, Outpatient Clinic, $850,000; (10) Fort Worth, Texas, Tarrant County Outpatient Clinic, $3,900,000; (11) Plano, Texas, Collin County Outpatient Clinic, $3,300,000; (12) San Antonio, Texas, Northeast Central Bexar County Outpatient Clinic, $1,400,000; (13) Corpus Christi, Texas, Outpatient Clinic, $1,200,000; (14) Harlingen, Texas, Outpatient Clinic, $650,000; (15) San Diego, California, North County Outpatient Clinic, $1,300,000; and (16) San Diego, California, South County Outpatient Clinic, $1,100,000.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 401 of the Compromise Agreement follows the House language.
SEC. 402-AUTHORIZATION OF APPROPRIATIONS
Current Law
Section 8104(a)(2) of title 38, United States Code, prohibits VA from obligating or expending more than $600,000 per year for a lease unless that lease has been specifically authorized by law.
House Bill
Section 101 of H.R. 4768 authorized $24,420,000 to carry out major medical facility leases.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 402 of the Compromise Agreement follows the House language.
SEC. 403-AUTHORITY FOR LONG-TERM LEASE IN DENVER, COLORADO
Current Law
Section 8104(a)(2) of title 38, United States Code, prohibits VA from obligating or expending more than $600,000 per year for a lease unless that lease has been specifically authorized by law.
House Bill
Section 101 of H.R. 4768 authorizes VA to enter into a long-term lease of up to 75 years for land to construct a new VA
Medical Facility on the Fitzsimons Campus of the University of Colorado, Aurora, Colorado.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 403 of the Compromise Agreement follows the House language. The authority provided in this section is permissive and intended by the Committees to foster good-faith negotiations between the partners to this agreement. In the event that the Secretary of Veterans Affairs determines the terms or conditions of the lease not to be in the best interest of the United States, the Secretary should propose an alternative strategy to Congress.
Subtitle B-Facilities Management
SEC. 411-DEPARTMENT OF VETERANS AFFAIRS CAPITAL ASSET FUND
Current Law
Under current law, the Secretary is authorized to dispose of property administered by VA and retain the proceeds from such a disposal, but only if: (1) the property is considered excess to the needs of VA; (2) there is no use for it in providing services to homeless veterans; and (3) the property is valued at less than $50,000 or, in cases where it is valued at more than $50,000, the disposal was proposed in the most recent budget submitted to Congress by the President. In the event property is so transferred, all proceeds must be deposited into the Nursing Home Revolving Fund. Funds in the Nursing Home Revolving Fund may only be used for the construction, acquisition, or alteration of nursing home facilities.
House Bill
Section 102 of the H.R. 4768 would amend chapter 81 of title 38, United States Code, to add a new section 8118 to provide the Secretary with new authority to transfer by sale, exchange or lease unneeded real property currently in VA's portfolio. It would establish a new "Capital Asset Fund" to finance actions taken to facilitate the transferring of real property, including demolition, environmental restoration, maintenance and repair, and historic preservation and administrative expenses. Section 102 would also establish "fair market value" as the basis for property transfers. Further, it would require the Secretary to include in each year's budget submission to Congress a report of both the uses of the Capital Asset Fund and descriptive information on each completed, pending and planned property disposal. Finally, Section 102 would repeal the Nursing Home Revolving Fund in section 8116 of title 38, United States Code.
All of the authorities extended to the Secretary, as outlined above, would be contingent upon the Secretary certifying that VA facilities maintain long-term care capacity as required by section 1710B(b) of title 38, United States Code.
Senate Bill
Section 101 of S. 2485, as reported, would authorize VA for 5 years to dispose of excess real property by sale, transfer or exchange to a Federal agency, a State or political subdivision of a State, or to any public or private entity. Such transfers would not be subject to restrictions currently in force. Further, the Committee bill would allow VA to retain the proceeds generated by such disposals of property in a new Capital Asset Fund rather than the Nursing Home Revolving Fund. Funds in the new account could be used to perform non-recurring maintenance, develop construction proposals, or dispose of other VA property.
Compromise Agreement
The Compromise Agreement follows the House language except that the contingencies upon which the House authorization rested are no longer included. Instead, the Compromise Agreement makes the transfer of funds from, and elimination of, the Nursing Home Revolving Fund contingent on the Secretary certifying that VA facilities maintain long-term care capacity as required by section 1710B(b) of title 38, United States Code. All other authorities would take effect immediately.
SEC. 412-ANNUAL REPORT TO CONGRESS ON INVENTORY OF DEPARTMENT OF VETERANS AFFAIRS HISTORIC PROPERTY
CurrentLaw
No similar provision exists under current law.
House Bill
Section 103 of H.R. 4768 would require VA to establish a national inventory of historic VA properties and would require reports to Congress over several years on the status of such properties.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
The Compromise Agreement follows the House language.
SEC. 413-AUTHORITY TO ACQUIRE AND TRANSFER REAL PROPERTY FOR USE FOR HOMELESS VETERANS
Current Law
Section 8103 of title 38, United States Code, authorizes the Secretary to acquire such land as is necessary for the purpose of providing medical services.
House Bill
The House Bills contains no comparable provision.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
The Compromise Agreement permits the Secretary to acquire land, in the District of Columbia, suitable for providing services to homeless veterans if the Secretary has identified a homeless assistance provider that is prepared to acquire the property from the Secretary promptly following the acquisition of the land by the Secretary.
SEC. 414-LIMITATION ON IMPLEMENTATION OF MISSION CHANGES FOR SPECIFIED VETERANS HEALTH ADMINISTRATION FACILITIES
Current Law
Section 401 of Public Law 108-193, the "Veterans Health Care Authorities Extension and Improvement Act of 2003," requires VA to notify Congress of facility closings proposed under the Capital Asset Realignment for Enhanced Services initiative, and prohibits such closings from occurring until the lapse of 60 days following the notification or 30 days of continuous session of Congress, whichever is longer.
House Bill
The House Bills contains no comparable provision.
Senate Bill
Section 104 of S. 2485, as reported, would prohibit the Secretary from implementing a mission change for a medical facility (other than a mission change prescribed by the Secretary in his Capital Asset Realignment for Enhanced Services initiative Final Report) until 90 days after the date on which the Secretary submits to the Committees on Veterans' Affairs written notice of the mission change.
Compromise Agreement
Section 414 of the Compromise Agreement prohibits the Secretary from implementing a mission change until the lapse of 60 days following notification or 30 days of continuous session of Congress, whichever is longer, at VA Medical Centers in the following locations: Boston, Massachusetts; New York City, New York; Big Springs, Texas; Dublin, Georgia; Montgomery, Alabama; Louisville, Kentucky; Muscogee (including the outpatient clinic in Tulsa), Oklahoma; Poplar Bluff, Missouri; Ft. Wayne, Indiana; Waco, Texas; Walla Walla, Washington.
SEC. 415-AUTHORITY TO USE PROJECT FUNDS TO CONSTRUCT OR RELOCATE SURFACE PARKING INCIDENTAL TO A CONSTRUCTION OR NONRECURRING MAINTENANCE PROJECT
Current Law
Under current law, all money spent for the construction of VA parking lots must be derived from the Parking Revolving Fund which receives all of its deposits from fees charged for parking. VA may not spend "construction" funds on parking lots because those funds are not drawn from the Parking Revolving Fund.
House Bill
Section 104 of H.R. 4768 would authorize the use of funds in a construction or capital account for the relocation of a surface parking facility if the relocation is necessitated by a construction or non-recurring maintenance project.
Senate Bill
Section 103 of S. 2485, as reported, would authorize the use of funds in a construction or capital account for the relocation of a surface parking facility if the relocation is necessitated by a construction or non-recurring maintenance project.
Compromise Agreement
Section 415 of the Compromise Agreement follows the language of the House and Senate Bills.
SEC. 416-INAPPLICABILITY OF LIMITATION ON USE OF ADVANCE PLANNING FUNDS TO AUTHORIZED MAJOR MEDICAL FACILITY PROJECTS
Current Law
Under current law, VA may not spent more than $500,000 from its Advanced Planning Fund for the development of a construction proposal unless it notifies Congress of its intention to do so and waits for a period of 30 days.
House Bill
Section 105 of H.R. 4768 would provide more flexibility to VA by eliminating the "notice and wait" provision if the project VA is planning has already been authorized by law.
Senate Bill
Section 105 of S. 2485, as reported, also would eliminate the "notice and wait" provision if the project VA is planning has already been authorized by law.
Compromise Agreement
Section 416 of the Compromise Agreement follows the language of the House and Senate Bills.
SEC. 417-ENHANCEMENT TO ENHANCE-USE LEASE AUTHORITY
Current Law
Under current law, VA is authorized to lease real property administered by VA to non-Federal entities in cases where VA determines that such a lease will advance the mission of VA and enhance the use of the property. In making the determination to enter into such an "enhanced-use lease", VA may only consider the needs of the Veterans Health Administration as outlined in business plans set forth by the Under Secretary for Health. Further, Section 8166 of title 38, United States Code, provides the Secretary permissive authority to disregard State and local laws relating to building codes, permits or inspections that would regulate or restrict construction, alternation, repair, remodeling or improvement of VA property associated with an enhanced-use lease under section 8162 of title 38, United States Code.
House Bill
Section 106 of H.R. 4758 would add to existing exemptions from State and local laws for enhanced-use leases any land-use laws.
Senate Bill
Section 102 of S. 2485, as reported, would allow VA, as part of making a determination to enter into an enhanced-use lease, to consider the needs of the Veterans Benefits Administration or the National Cemetery Administration, as outlined in business plans developed by the respective Under Secretaries of those Administrations.
Compromise Agreement
Section 417 of the Compromise Agreement includes the language from the House Bill.
SEC. 418-FIRST OPTION FOR COMMONWEALTH OF KENTUCKY ON DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, LOUISVILLE, KENTUCKY
Current Law
Under current law, VA generally may not transfer any property to a State unless VA receives compensation equal to the fair market value of the property and the transfer, as proposed, is described in the VA budget for the fiscal year within which the proposed transfer will take place. However, VA may transfer property to a State for use as a State nursing home or domiciliary.
House Bill
The House Bills contains no comparable provision.
Senate Bill
Section 131 of S. 2485, as reported, would require VA for one year, if it determines that it will convey, lease, or otherwise dispose of all or part of the Louisville VA Medical Center, to negotiate for the conveyance, lease, or other disposal of the Medical Center to the Commonwealth of Kentucky for its use to provide services for veterans or for other purposes. The bill would not relieve the Commonwealth from the burden of paying fair market value for the land.
Compromise Agreement
Section 418 of the Compromise Agreement follows the Senate language.
SEC. 419-TRANSFER OF JURISDICTION, GENERAL SERVICES ADMINISTRATION PROPERTY, BOISE, IDAHO
Current Law
No similar provision exists under current law.
House Bill
The House Bills contains no comparable provision.
Senate Bill
Section 111 of S. 2485, as reported, would direct the transfer of certain land in Boise, Idaho, administered by the General Services Administration to VA.
Compromise Agreement
Section 419 of the Compromise Agreement follows the Senate language.
Subtitle C-Designation of Facilities
SEC. 421-THOMAS E. CREEK DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
Current Law
No similar provision exists under current law.
House Bill
H.R. 4836 would designate the Department of Veterans Affairs Medical Center in Amarillo, Texas, the "Thomas E. Creek Department of Veterans Affairs Medical Center".
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 421 of the Compromise Agreement follows the House language.
SEC. 422-JAMES J. PETERS DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
Current Law
No similar provision exists under current law.
House Bill
The House Bills contain no comparable provision.
Senate Bill
Section 121 of S. 2485, as reported, would designate the Department of Veterans Affairs Medical Center in the Bronx, New York, the "James J. Peters Department of Veterans Affairs Medical Center"
Compromise Agreement
Section 422 of the Compromise Agreement follows the Senate language.
SEC. 423-BOB MICHEL DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC
Current Law
No similar provision exists under current law.
House Bill
H.R. 4608 would designate the Department of Veterans Affairs outpatient clinic in Peoria, Illinois, the "Bob Michel Department of Veterans Affairs Outpatient Clinic".
Senate Bill
S. 2596 would designate the Department of Veterans Affairs outpatient clinic in Peoria, Illinois, the "Bob Michel Department of Veterans Affairs Outpatient Clinic".
Compromise Agreement
Section 423 of the Compromise Agreement follows the language of the House and Senate Bills.
SEC. 424.-CHARLES WILSON DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC
Current Law
No similar provision exists under current law.
House Bill
H.R. 4317 would designate the Department of Veterans Affairs outpatient clinic in Lufkin Texas the "Charles Wilson Department of Veterans Affairs Outpatient Clinic".
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 424 of the Compromise Agreement follows the House language.
SEC. 425-THOMAS P. NOONAN, JR. DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC
Current Law
No similar provision exists under current law.
House Bill
H.R. 1318 would designate the Department of Veterans Affairs outpatient clinic in Sunnyside, Queens, New York, the "Thomas P. Noonan, Jr. Department of Veterans Affairs Outpatient Clinic".
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Bill
Section 425 of the Compromise Agreement follows the House language.
TITLE V-PERSONNEL ADMINISTRATION
SEC. 501-PILOT PROGRAM TO STUDY INNOVATIVE RECRUITMENT TOOLS TO ADDRESS NURSING SHORTAGES AT DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE FACILITIES
Current Law
No similar provision exists under current law.
House Bill
Section 2 of H.R. 4231 would establish a pilot program within VA to study the use of outside recruitment, advertising and communications agencies, and the use of interactive and online technologies, to improve VA's program for recruiting nursing personnel.
Senate Bill
The Senate bill contains no comparable provision.
Compromise Agreement
Section 501 of the Compromise Agreement follows the House language.
SEC. 502-CORRECTION TO LISTING OF CERTAIN HYBRID POSITIONS IN THE VETERANS HEALTH ADMINISTRATION
Current Law
Section 7401 of title 38, United States Code, authorizes VA to appoint medical care personnel, under title 5, United States Code, or title 38, United States Code, depending on the duties of such personnel.
House Bill
Section 4 of H.R. 4231, as amended, would authorize the appointment under title 38, United State Code, of blind rehabilitation specialists and blind rehabilitation outpatient specialists.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 502 of the Compromise Agreement follows the House language.
SEC. 503 UNDER SECRETARY FOR HEALTH
Current Law
Section 305(A)(2) of title 38, United States Code, requires that the Under Secretary for Health be a "doctor of medicine."
House Bill
Section 7 of H.R. 4231, as amended, would repeal the requirement that VA's Under Secretary for Health be a medical doctor.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 503 of the Compromise Agreement follows the House language.
TITLE VI-OTHER MATTERS
SEC 601-EXTENSION AND CODIFICATION OF AUTHORITY FOR RECOVERY AUDITS
Current Law
Public Law 108-199, the "Fiscal Year 2004 VA-HUD and Independent Agencies Appropriations Act," requires VA to conduct a program of recovery audits for fee basis contracts and other medical services contracts for the care of veterans.
House Bill
The House Bill contains no comparable provision.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 601 of the Compromise Agreement requires VA to enter into a contract with a private entity or entities to conduct a program of recovery audits for fee basis contracts and other medical services contracts for the care of veterans. The requirement expires on September 30, 2008.
The Committee is concerned that third-party health insurers are not following the regular process for handling third-party claim appeals throughout the Veterans Health Administration. The Committee encourages the Secretary to assist third-party insurers in processing disputed claims. Further, the Committee encourages the Secretary, should he deem it to be in the interest of the United States, to use an automated and electronic system of downloading information in a standardized format to ensure third-party insurer compliance with the rules and regulations of dispute resolution through the appeals process.
SEC. 602-INVENTORY OF MEDICAL WASTE MANAGEMENT ACTIVITIES AT DEPARTMENT OF
VETERANS AFFAIRS HEALTH CARE FACILITIES
Current Law
No similar provision exists under current law.
House Bill
Section 401 of H.R. 4658 requires the Secretary to establish and maintain an inventory of medical waste management activities in VA medical facilities and submit a report on such activities by April 15, 2005.
Senate Bill
The Senate bill contains no comparable provision.
Compromise Agreement
Section 602 of the Compromise Agreement follows the House language, except that the required report would be due on June 30, 2005.
SEC. 603-INCLUSION OF ALL ENROLLED VETERANS AMONG PERSONS ELIGIBLE TO USE CANTEENS OPERATED BY VETERANS' CANTEEN SERVICE
Current Law
Section 7803 of title 38, United States Code, defines those persons eligible to use the Veterans' Canteen Service.
House Bill
Section 201 of H.R 4768, as amended, would expand the definition of persons eligible to use the Veterans' Canteen Service to include all individuals enrolled in VA health care under section 1705 of title 38, United States Code, or such individuals' families, and persons employed at VA facilities.
Senate Bill
The Senate bill contains no comparable provision.
Compromise Agreement
Section 603 of the Compromise Agreement follows the House language.
SEC. 604-ANNUAL REPORTS ON WAITING TIMES FOR APPOINTMENTS FOR SPECIALTY CARE
Current Law
No similar provision exists under current law.
House Bill
The House bills contain no comparable provision.
Senate Bill
Section 207 of S. 2485, as reported, would require VA to report annually on patient appointment waiting times, including specialty and primary care services.
Compromise Agreement
Section 604 of the Compromise Agreement requires the Secretary to report, not later than January 31 of each year through 2007, on veterans waiting more than 3 months for scheduled appointments in specialty care clinics and on the reasons for such delays. Further, the Compromise Agreement requires the Comptroller General to certify the accuracy of the report submitted under this section.
SEC. 605-TECHNICAL CLARIFICATION
Current Law
Section 8111 of title 38, United States Code, requires the Secretary and the Secretary of Defense to enter into agreements and contracts for the mutually beneficial sharing of health care resources. Section 8111 also establishes a fund, known as the "DOD-VA Health Care Sharing Incentive Fund," to provide incentives to enter into such sharing initiatives.
House Bill
Section 6 of H.R. 4231, as amended, makes the established DOD-VA Health Care Sharing Incentive Fund available for any purpose authorized by section 8111.
Senate Bill
The Senate Bill contains no comparable provision.
Compromise Agreement
Section 605 of the Compromise Agreement follows the House language.