-CITE- 38 USC CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY -HEAD- CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY -MISC1- SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES Sec. 8101. Definitions. 8102. Acquisition of medical facilities. 8103. Authority to construct and alter, and to acquire sites for, medical facilities. 8104. Congressional approval of certain medical facility acquisitions. 8105. Structural requirements. 8106. Construction contracts. 8107. Operational and construction plans for medical facilities. 8108. Contributions to local authorities. 8109. Parking facilities. 8110. Operation of medical facilities. 8111. Sharing of Department of Veterans Affairs and Department of Defense health care resources. 8111A. Furnishing of health-care services to members of the Armed Forces during a war or national emergency. 8112. Partial relinquishment of legislative jurisdiction. 8113. Property formerly owned by National Home for Disabled Volunteer Soldiers. 8114. Use of federally owned facilities; use of personnel. 8115. Acceptance of certain property. 8116. Nursing home revolving fund. 8117. Emergency preparedness. 8118. Authority for transfer of real property; Department of Veterans Affairs Capital Asset Fund. SUBCHAPTER II - PROCUREMENT AND SUPPLY 8121. Revolving supply fund. 8122. Authority to procure and dispose of property and to negotiate for common services. 8123. Procurement of prosthetic appliances. 8124. Grant of easements in Government-owned lands. 8125. Procurement of health-care items. 8126. Limitation on prices of drugs procured by Department and certain other Federal agencies. SUBCHAPTER III - STATE HOME FACILITIES FOR FURNISHING DOMICILIARY, NURSING HOME, AND HOSPITAL CARE 8131. Definitions. 8132. Declaration of purpose. 8133. Authorization of appropriations. 8134. General regulations. 8135. Applications with respect to projects; payments. 8136. Recapture provisions. 8137. State control of operations. SUBCHAPTER IV - SHARING OF MEDICAL FACILITIES, EQUIPMENT, AND INFORMATION 8151. Statement of congressional purpose. 8152. Definitions. 8153. Sharing of health-care resources. 8154. Exchange of medical information. 8155. Pilot programs; grants to medical schools. 8156. Coordination with health services development activities carried out under the National Health Planning and Resources Development Act of 1974. 8157. Joint title to medical equipment. 8158. Deposit in escrow. SUBCHAPTER V - ENHANCED-USE LEASES OF REAL PROPERTY 8161. Definitions. 8162. Enhanced-use leases. 8163. Hearing and notice requirements regarding proposed leases. 8164. Authority for disposition of leased property. 8165. Use of proceeds. 8166. Construction standards. 8167. Exemption from State and local taxes. [8168. Repealed.] 8169. Expiration. -STATAMEND- AMENDMENT OF ANALYSIS Pub. L. 108-422, title IV, Sec. 411(c)(2), (f), Nov. 30, 2004, 118 Stat. 2389, 2390, provided that, effective 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 section 1710B(b) of this title, this analysis is amended by striking out item 8116. -MISC2- AMENDMENTS 2004 - Pub. L. 108-422, title IV, Sec. 411(a)(2), Nov. 30, 2004, 118 Stat. 2389, added item 8118. 2003 - Pub. L. 108-170, title II, Sec. 202(d)(2), Dec. 6, 2003, 117 Stat. 2048, substituted "Hearing and notice requirements regarding proposed leases" for "Designation of property to be leased" in item 8163. 2002 - Pub. L. 107-314, div. A, title VII, Sec. 721(a)(2), Dec. 2, 2002, 116 Stat. 2595, substituted "Sharing of Department of Veterans Affairs and Department of Defense health care resources" for "Sharing of Department and Department of Defense health-care resources" in item 8111. Pub. L. 107-287, Sec. 6(a)(2), Nov. 7, 2002, 116 Stat. 2032, added item 8117. 1997 - Pub. L. 105-114, title II, Sec. 205(b)(2), Nov. 21, 1997, 111 Stat. 2289, struck out item 8168 "Limitation on number of agreements". 1996 - Pub. L. 104-262, title III, Sec. 301(d)(2), Oct. 9, 1996, 110 Stat. 3193, substituted "Sharing of health-care resources" for "Specialized medical resources" in item 8153. 1994 - Pub. L. 103-446, title XII, Sec. 1201(h)(5), (6), Nov. 2, 1994, 108 Stat. 4688, inserted "ENHANCED-USE" before "LEASES OF REAL" in chapter heading and "and certain other Federal agencies" after "Department" in item 8126. 1992 - Pub. L. 102-585, title VI, Sec. 603(a)(2), Nov. 4, 1992, 106 Stat. 4975, added item 8126. Pub. L. 102-405, title I, Sec. 103(a)(2), Oct. 9, 1992, 106 Stat. 1975, added items 8157 and 8158. 1991 - Pub. L. 102-86, title IV, Sec. 401(b)(1), (3), Aug. 14, 1991, 105 Stat. 422, inserted "; LEASES OF REAL PROPERTY" in chapter heading and added analysis for subchapter V. Pub. L. 102-83, Sec. 4(a)(3), (4), Aug. 6, 1991, 105 Stat. 404, substituted "Department and" for "Veterans' Administration and" in item 8111. Pub. L. 102-54, Sec. 14(f)(1), June 13, 1991, 105 Stat. 287, amended the table of sections as in effect immediately before the enactment of Pub. L. 102-40 by transferring item 5016 so as to appear immediately after item 5015 and by substituting "payments" for "Payments" in item 5035. Pub. L. 102-40, title IV, Sec. 402(c)(1), May 7, 1991, 105 Stat. 239, renumbered items 5001 to 5056 as 8101 to 8156, respectively. 1988 - Pub. L. 100-322, title II, Sec. 205(b), May 20, 1988, 102 Stat. 513, added at end item 5016. Pub. L. 100-322, title IV, Sec. 403(a)(2), May 20, 1988, 102 Stat. 545, added item 5025. 1986 - Pub. L. 99-576, title II, Secs. 223(a)(2), 231(c)(2)(B), Oct. 28, 1986, 100 Stat. 3261, 3264, substituted "Parking facilities" for "Garages and parking facilities" in item 5009 and struck out item 5057 "Reports to Congress". 1985 - Pub. L. 99-166, title III, Sec. 302(c)(2), Dec. 3, 1985, 99 Stat. 955, substituted "Operational and construction plans for medical facilities" for "Reports to congressional committees" in item 5007. 1982 - Pub. L. 97-174, Secs. 3(b)(2), 4(b), May 4, 1982, 96 Stat. 74, 75, substituted "Sharing of Veterans' Administration and Department of Defense health-care resources" for "Use of Armed Forces facilities" in item 5011, and added item 5011A. 1979 - Pub. L. 96-22, title III, Sec. 301(c), June 13, 1979, 93 Stat. 61, substituted "ACQUISITION AND OPERATION OF MEDICAL FACILITIES" for "PROVISIONS RELATING TO HOSPITALS AND HOMES" in heading for subchapter I, substituted "Definitions" for "Hospital and domiciliary facilities" in item 5001, "Acquisition of medical facilities" for "Construction and repair of buildings" in item 5002, "Authority to construct and alter, and acquire sites for, medical facilities" for "Use of Armed Forces facilities" in item 5003, "Congressional approval of certain medical facility acquisitions" for "Garages and parking facilities" in item 5004, "Structural requirements" for "Acceptance of certain property" in item 5005, "Construction contracts" for "Property formerly owned by National Home for Disabled Volunteer Soldiers" in item 5006, and "Reports to congressional committees" for "Partial relinquishment of legislative jurisdiction" in item 5007, added items 5008 to 5015, and redesignated former items 5011 to 5014 as 5021 to 5024, respectively. 1977 - Pub. L. 95-62, Sec. 4(c), July 5, 1977, 91 Stat. 263, substituted "DOMICILIARY, NURSING HOME, AND HOSPITAL CARE" for "NURSING HOME CARE" in heading for subchapter III. 1976 - Pub. L. 94-581, title I, Sec. 115(b), Oct. 21, 1976, 90 Stat. 2853, substituted "health services development activities carried out under the National Health Planning and Resources Development Act of 1974" for "programs carried out under the Heart Disease, Cancer, and Stroke Amendments of 1965" in item 5056. 1973 - Pub. L. 93-82, title III, Sec. 302(3), Aug. 2, 1973, 87 Stat. 195, added item 5007. 1966 - Pub. L. 89-785, title II, Secs. 201(b), 202(c), 2, Nov. 7, 1966, 80 Stat. 1372, 1373, 1376, substituted "Garages and parking facilities" for "Garages on hospital and domiciliary reservations" in item 5004, inserted "and to negotiate for common services" in item 5012, and added heading for subchapter IV and items 5051 to 5056 and 5075. 1964 - Pub. L. 88-450, Sec. 4(b), Aug. 19, 1964, 78 Stat. 503, added heading for subchapter III and items 5031 to 5037. -End- -CITE- 38 USC SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -End- -CITE- 38 USC Sec. 8101 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8101. Definitions -STATUTE- For the purposes of this subchapter: (1) The term "alter", with respect to a medical facility, means to repair, remodel, improve, or extend such medical facility. (2) The terms "construct" and "alter", with respect to a medical facility, include such engineering, architectural, legal, fiscal, and economic investigations and studies and such surveys, designs, plans, construction documents, specifications, procedures, and other similar actions as are necessary for the construction or alteration, as the case may be, of such medical facility and as are carried out after the completion of the advanced planning (including the development of project requirements and design development) for such facility. (3) The term "medical facility" means any facility or part thereof which is, or will be, under the jurisdiction of the Secretary for the provision of health-care services (including hospital, nursing home, or domiciliary care or medical services), including any necessary building and auxiliary structure, garage, parking facility, mechanical equipment, trackage facilities leading thereto, abutting sidewalks, accommodations for attending personnel, and recreation facilities associated therewith. (4) The term "committee" means the Committee on Veterans' Affairs of the House of Representatives or the Committee on Veterans' Affairs of the Senate, and the term "committees" means both such committees. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 55, Sec. 5001; renumbered Sec. 8101, Pub. L. 102-40, title IV, Sec. 402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102- 83, Sec. 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 104-262, title II, Sec. 207(a), Oct. 9, 1996, 110 Stat. 3190.) -MISC1- AMENDMENTS 1996 - Par. (2). Pub. L. 104-262 substituted "construction documents" for "working drawings" and "design development" for "preliminary plans". 1991 - Pub. L. 102-40 renumbered section 5001 of this title as this section. Par. (3). Pub. L. 102-83 substituted "Secretary" for "Administrator". EFFECTIVE DATE Section 302 of Pub. L. 96-22 provided that: "(a) Except as provided in subsection (b) of this section, the amendments made by section 301 [enacting this subchapter, redesignating sections 5011 to 5014 of this title as sections 5021 to 5024 [now 8121 to 8124], respectively, and amending section 5022 [now 8122] of this title as so redesignated] shall take effect on October 1, 1979. "(b)(1) The amendments made by section 301 shall not apply with respect to the acquisition, construction, or alteration of any medical facility (as defined in section 5001(3) [now 8101(3)] of title 38, United States Code, as amended by section 301(a) of this Act) if such acquisition, construction, or alteration (not including exchange) was approved before October 1, 1979, by the President. "(2) The provisions of section 5007(a) [now 8107(a)] of title 38, United States Code, as amended by section 301(a) of this Act, shall take effect on the date of the enactment of this Act [June 13, 1979]." -End- -CITE- 38 USC Sec. 8102 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8102. Acquisition of medical facilities -STATUTE- (a) The Secretary shall provide medical facilities for veterans entitled to hospital, nursing home, or domiciliary care or medical services under this title. (b) No medical facility may be constructed or otherwise acquired or altered except in accordance with the provisions of this subchapter. (c) In carrying out this subchapter, the Secretary - (1) shall provide for the construction and acquisition of medical facilities in a manner that results in the equitable distribution of such facilities throughout the United States, taking into consideration the comparative urgency of the need for the services to be provided in the case of each particular facility; and (2) shall give due consideration to excellence of architecture and design. (d) In considering the need for any project for the construction, alteration, or acquisition (other than by exchange) of a medical facility which is expected to involve a total expenditure of more than $2,000,000, the Secretary shall give consideration to the sharing of health-care resources with the Department of Defense under section 8111 of this title as an alternative to all or part of such project. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 55, Sec. 5002; amended Pub. L. 99-576, title II, Sec. 221(a), Oct. 28, 1986, 100 Stat. 3259; renumbered Sec. 8102 and amended Pub. L. 102-40, title IV, Sec. 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102-54, Sec. 14(f)(2), June 13, 1991, 105 Stat. 287; Pub. L. 102-83, Sec. 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.) -MISC1- AMENDMENTS 1991 - Pub. L. 102-40, Sec. 402(b)(1), renumbered section 5002 of this title as this section. Subsecs. (a), (c). Pub. L. 102-83 substituted "Secretary" for "Administrator". Subsec. (d). Pub. L. 102-83 substituted "Secretary" for "Administrator". Pub. L. 102-54 amended subsec. (d) as in effect immediately before the enactment of Pub. L. 102-40 by substituting "section 5011" for "section 5001". Pub. L. 102-40, Sec. 402(d)(1), amended subsec. (d), as amended by Pub. L. 102-54, by substituting "8111" for "5011". See above. 1986 - Subsec. (d). Pub. L. 99-576 added subsec. (d). -End- -CITE- 38 USC Sec. 8103 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8103. Authority to construct and alter, and to acquire sites for, medical facilities -STATUTE- (a) Subject to section 8104 of this title, the Secretary - (1) may construct or alter any medical facility and may acquire, by purchase, lease, condemnation, donation, exchange, or otherwise, such land or interests in land as the Secretary considers necessary for use as the site for such construction or alteration; (2) may acquire, by purchase, lease, condemnation, donation, exchange, or otherwise, any facility (including the site of such facility) that the Secretary considers necessary for use as a medical facility; and (3) in order to assure compliance with section 8110(a)(2) of this title, in the case of any outpatient medical facility for which it is proposed to lease space and for which a qualified lessor and an appropriate leasing arrangement are available, shall execute a lease for such facility within 12 months after funds are made available for such purpose. (b) Whenever the Secretary considers it to be in the interest of the United States to construct a new medical facility to replace an existing medical facility, the Secretary (1) may demolish the existing facility and use the site on which it is located for the site of the new medical facility, or (2) if in the judgment of the Secretary it is more advantageous to construct such medical facility on a different site in the same locality, may exchange such existing facility and the site of such existing facility for the different site. (c) Whenever the Secretary determines that any site acquired for the construction of a medical facility is not suitable for that purpose, the Secretary may exchange such site for another site to be used for that purpose or may sell such site. (d)(1) The Secretary may provide for the acquisition of not more than three facilities for the provision of outpatient services or nursing home care through lease-purchase arrangements on real property under the jurisdiction of the Department of Veterans Affairs. (2)(A) In carrying out this subsection and notwithstanding any other provision of law, the Secretary may lease, with or without compensation and for a period of not to exceed 35 years, to another party any of the real property described in paragraph (1) of this subsection. (B) Such real property shall be used as the site of a facility referred to in paragraph (1) of this subsection - (i) constructed and owned by the lessee of such real property; and (ii) leased under paragraph (3)(A) of this subsection to the Department for such use and for such other activities as the Secretary determines are appropriate. (3)(A) The Secretary may enter into a lease for the use of any facility described in paragraph (2)(B) of this subsection for not more than 35 years under such terms and conditions as may be in the best interests of the Department. (B) Each agreement to lease a facility under subparagraph (A) of this paragraph shall include a provision that - (i) the obligation of the United States to make payments under the agreement is subject to the availability of appropriations for that purpose; and (ii) the ownership of such facility shall vest in the United States at the end of such lease. (4)(A) The Secretary may sublease any space in such a facility to another party at a rate not less than - (i) the rental rate paid by the Secretary for such space under paragraph (3) of this subsection; plus (ii) the amount the Secretary pays for the costs of administering such facility (including operation, maintenance, utility, and rehabilitation costs) which are attributable to such space. (B) In any such sublease, the Secretary shall include such terms relating to default and nonperformance as the Secretary considers appropriate to protect the interests of the United States. (5) The Secretary shall use the receipts of any payment for the lease of real property under paragraph (2) for the payment of the lease of a facility under paragraph (3). (6) The authority to enter into an agreement under this subsection - (A) shall not take effect until the Secretary has entered into agreements under section 316 of this title to carry out at least three collocations; and (B) shall expire on October 1, 1993. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 56, Sec. 5003; amended Pub. L. 101-237, title VI, Sec. 603(b), Dec. 18, 1989, 103 Stat. 2097; renumbered Sec. 8103 and amended Pub. L. 102-40, title IV, Sec. 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102-83, Sec. 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 103-446, title XII, Sec. 1201(d)(16), Nov. 2, 1994, 108 Stat. 4684.) -MISC1- AMENDMENTS 1994 - Subsec. (d)(6)(A). Pub. L. 103-446 substituted "section 316" for "section 230(c)". 1991 - Pub. L. 102-40, Sec. 402(b)(1), renumbered section 5003 of this title as this section. Subsec. (a). Pub. L. 102-83 substituted "Secretary" for "Administrator" wherever appearing. Pub. L. 102-40, Sec. 402(d)(1), substituted "8104" for "5004" in introductory provisions and "8110(a)(2)" for "5010(a)(2)" in par. (3). Subsecs. (b), (c). Pub. L. 102-83 substituted "Secretary" for "Administrator" wherever appearing. 1989 - Subsec. (d). Pub. L. 101-237 added subsec. (d). DEVELOPMENT OF MEDICAL-FACILITY MODULAR COMPONENTS Pub. L. 99-166, title III, Sec. 304, Dec. 3, 1985, 99 Stat. 956, directed Administrator of Veterans' Affairs, not later than one year after Dec. 3, 1985, to develop a modular approach to planning and design of an appropriate Veterans' Administration medical facility for furnishing of hospital care. -End- -CITE- 38 USC Sec. 8104 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8104. Congressional approval of certain medical facility acquisitions -STATUTE- (a)(1) The purpose of this subsection is to enable Congress to ensure the equitable distribution of medical facilities throughout the United States, taking into consideration the comparative urgency of the need for the services to be provided in the case of each particular facility. (2) No funds may be appropriated for any fiscal year, and the Secretary may not obligate or expend funds (other than for advance planning and design), for any major medical facility project or any major medical facility lease unless funds for that project or lease have been specifically authorized by law. (3) For the purpose of this subsection: (A) The term "major medical facility project" means a project for the construction, alteration, or acquisition of a medical facility involving a total expenditure of more than $7,000,000, but such term does not include an acquisition by exchange. (B) The term "major medical facility lease" means a lease for space for use as a new medical facility at an average annual rental of more than $600,000. (b) Whenever the President or the Secretary submit to the Congress a request for the funding of a major medical facility project (as defined in subsection (a)(3)(A)) or a major medical facility lease (as defined in subsection (a)(3)(B)), the Secretary shall submit to each committee, on the same day, a prospectus of the proposed medical facility. Any such prospectus shall include the following: (1) A detailed description of the medical facility to be constructed, altered, leased, or otherwise acquired under this subchapter, including a description of the location of such facility and, in the case of a prospectus proposing the construction of a new or replacement medical facility, a description of the consideration that was given to acquiring an existing facility by lease or purchase and to the sharing of health-care resources with the Department of Defense under section 8111 of this title. (2) An estimate of the cost to the United States of the construction, alteration, lease, or other acquisition of such facility (including site costs, if applicable). (3) An estimate of the cost to the United States of the equipment required for the operation of such facility. (4) Demographic data applicable to such facility, including information on projected changes in the population of veterans to be served by the facility over a five-year period and a ten-year period. (5) Current and projected workload and utilization data regarding the facility. (6) Current and projected operating costs of the facility, including both recurring and non-recurring costs. (7) The priority score assigned to the project or lease under the Department's prioritization methodology and, if the project or lease is being proposed for funding before a project or lease with a higher score, a specific explanation of the factors other than the priority score that were considered and the basis on which the project or lease is proposed for funding ahead of projects or leases with higher priority scores. (8) In the case of a prospectus proposing the construction of a new or replacement medical facility, a description of each alternative to construction of the facility that was considered. (c) Not less than 30 days before obligating funds for a major medical facility project approved by a law described in subsection (a)(2) of this section in an amount that would cause the total amount obligated for that project to exceed the amount specified in the law for that project (or would add to total obligations exceeding such specified amount) by more than 10 percent, the Secretary shall provide the committees with notice of the Secretary's intention to do so and the reasons for the specified amount being exceeded. (d) In any case in which the Secretary proposes that funds be used for a purpose other than the purpose for which such funds were appropriated, the Secretary shall promptly notify each committee, in writing, of the particulars involved and the reasons why such funds were not used for the purpose for which appropriated. (e) The Secretary may accept gifts or donations for any of the purposes of this subchapter. (f) The Secretary may not obligate funds in an amount in excess of $500,000 from the Advance Planning Fund of the Department toward design or development of a major medical facility project (as defined in subsection (a)(3)(A)) until - (1) the Secretary submits to the committees a report on the proposed obligation; and (2) a period of 30 days has passed after the date on which the report is received by the committees. (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). -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 56, Sec. 5004; amended Pub. L. 99-166, title III, Secs. 301, 303, Dec. 3, 1985, 99 Stat. 954, 955; Pub. L. 99-576, title II, Sec. 221(b), Oct. 28, 1986, 100 Stat. 3259; Pub. L. 100-322, title IV, Sec. 422, May 20, 1988, 102 Stat. 553; renumbered Sec. 8104 and amended Pub. L. 102-40, title IV, Sec. 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102-83, Sec. 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 102-405, title III, Sec. 301(a), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 103-79, Sec. 3(a), Aug. 13, 1993, 107 Stat. 771; Pub. L. 104-262, title II, Secs. 205(a), 206(a), (c), Oct. 9, 1996, 110 Stat. 3189, 3190; Pub. L. 105-368, title VII, Sec. 704, Nov. 11, 1998, 112 Stat. 3350; Pub. L. 108-170, title II, Sec. 201, Dec. 6, 2003, 117 Stat. 2047; Pub. L. 108-422, title IV, Sec. 416, Nov. 30, 2004, 118 Stat. 2393.) -MISC1- AMENDMENTS 2004 - Subsec. (g). Pub. L. 108-422 added subsec. (g). 2003 - Subsec. (a)(3)(A). Pub. L. 108-170 substituted "$7,000,000" for "$4,000,000". 1998 - Subsec. (a)(3)(B). Pub. L. 105-368 substituted "$600,000" for "$300,000". 1996 - Subsec. (a)(3)(A). Pub. L. 104-262, Sec. 206(a), substituted "$4,000,000" for "$3,000,000". Subsec. (b). Pub. L. 104-262, Sec. 205(a)(1), inserted introductory provisions and struck out former introductory provisions which read as follows: "In the event that the President or the Secretary proposes to the Congress the funding of any construction, alteration, lease, or other acquisition to which subsection (a) of this section is applicable, the Secretary shall submit to each committee, on the same day, a prospectus of the proposed medical facility. Such prospectus shall include - ". Subsec. (b)(1) to (3). Pub. L. 104-262, Sec. 205(a)(2)-(4), substituted "A detailed" for "a detailed" and "title." for "title;" in par. (1), "An estimate" for "an estimate" and "applicable)." for "applicable); and" in par. (2), and "An estimate" for "an estimate" in par. (3). Subsec. (b)(4) to (8). Pub. L. 104-262, Sec. 205(a)(5), added pars. (4) to (8). Subsec. (f). Pub. L. 104-262, Sec. 206(c), added subsec. (f). 1993 - Subsec. (a)(3)(A). Pub. L. 103-79 substituted "$3,000,000" for "$2,000,000". 1992 - Subsec. (a)(2). Pub. L. 102-405, Sec. 301(a)(1), amended par. (2) generally. Prior to amendment, par. (2) read as follows: "It shall not be in order in the Senate or in the House of Representatives to consider a bill, resolution, or amendment which would make an appropriation for any fiscal year which may be expended for a major medical facility project or a major medical facility lease unless - "(A) such bill, resolution, or amendment specifies the amount to be appropriated for that project or lease, "(B) the project or lease has been approved in a resolution adopted by the Committee on Veterans' Affairs of that House, and "(C) the amount to be appropriated for that project or lease is no more than the amount specified in that resolution for that project or lease for that fiscal year." Subsec. (a)(3)(B). Pub. L. 102-405, Sec. 301(a)(2), inserted "new" after "as a" and substituted "$300,000" for "$500,000". Subsec. (c). Pub. L. 102-405, Sec. 301(a)(3), substituted "law" for "resolution" in two places. 1991 - Pub. L. 102-40, Sec. 402(b)(1), renumbered section 5004 of this title as this section. Subsec. (b). Pub. L. 102-83 substituted "Secretary" for "Administrator" in two places in introductory provisions. Subsec. (b)(1). Pub. L. 102-40, Sec. 402(d)(1), substituted "8111" for "5011". Subsec. (c). Pub. L. 102-83 substituted "Secretary" for "Administrator" and "Secretary's" for "Administrator's". Subsecs. (d), (e). Pub. L. 102-83 substituted "Secretary" for "Administrator" wherever appearing. 1988 - Subsec. (a)(2). Pub. L. 100-322, Sec. 422(a), amended par. (2) generally. Prior to amendment, par. (2) read as follows: "After the adoption by the committees during a fiscal year of resolutions with identical texts approving major medical facility projects, it shall not be in order in the House of Representatives or in the Senate to consider a bill, resolution, or amendment making an appropriation for that fiscal year or for the next fiscal year which may be expended for a major medical facility project - "(A) if the project for which the appropriation is proposed to be made is not approved in those resolutions; or "(B) in the event that the project is approved in the resolutions, if either - "(i) the bill, resolution, or amendment making the appropriation does not specify - "(I) the medical facility project for which the appropriation is proposed to be made; and "(II) the amount proposed to be appropriated for the project; or "(ii) the amount proposed to be appropriated for the project (when added to any amount previously appropriated for the project) exceeds the amount approved for the project." Subsec. (a)(3), (4). Pub. L. 100-322, Sec. 422(b), added par. (3) and struck out former pars. (3) and (4) which read as follows: "(3) No appropriation may be made for the lease of any space for use as a medical facility at an average annual rental of more than $500,000 unless each committee has first adopted a resolution approving such lease and setting forth the estimated cost thereof. "(4) For the purpose of this subsection, the term 'major medical facility project' means a project for the construction, alteration, or acquisition of a medical facility involving a total expenditure of more than $2,000,000. Such term does not include an acquisition by exchange." Subsec. (c). Pub. L. 100-322, Sec. 422(c), amended subsec. (c) generally. Prior to amendment, subsec. (c) read as follows: "The estimated cost of any construction, alteration, lease, or other acquisition that is approved under this section, as set forth in the pertinent resolutions described in subsection (a) of this section, may be increased by the Administrator in the contract for such construction, alteration, lease, or other acquisition by an amount equal to the percentage increase, if any, as determined by the Administrator, in construction, alteration, lease, or other acquisition costs, as the case may be, from the date of such approval to the date of contract, but in no event may the amount of such increase exceed 10 per centum of such estimated cost." Subsecs. (d) to (f). Pub. L. 100-322, Sec. 422(d), redesignated subsecs. (e) and (f) as (d) and (e), respectively, and struck out former subsec. (d) which read as follows: "In the case of any medical facility approved for construction, alteration, lease, or other acquisition by each committee under subsection (a) of this section for which funds have not been appropriated within one year after the date of such approval, either such committee may by resolution rescind its approval at any time thereafter before such funds are appropriated." 1986 - Subsec. (b)(1). Pub. L. 99-576 inserted "and to the sharing of health-care resources with the Department of Defense under section 5011 of this title" at end. 1985 - Subsec. (a). Pub. L. 99-166, Sec. 301, amended subsec. (a) generally. Prior to amendment, subsec. (a) read as follows: "In order to ensure the equitable distribution of medical facilities throughout the United States, taking into consideration the comparative urgency of the need for the services to be provided in the case of each particular facility - "(1) no appropriation may be made for the construction, alteration, or acquisition (not including exchanges) of any medical facility which involves a total expenditure of more than $2,000,000 unless each committee has first adopted a resolution approving such construction, alteration, or acquisition and setting forth the estimated cost thereof; and "(2) no appropriation may be made for the lease of any space for use as a medical facility at an average annual rental of more than $500,000 unless each committee has first adopted a resolution approving such lease and setting forth the estimated cost thereof." Subsec. (b)(1). Pub. L. 99-166, Sec. 303, inserted "and, in the case of a prospectus proposing the construction of a new or replacement medical facility, a description of the consideration that was given to acquiring an existing facility by lease or purchase" after "such facility". EFFECTIVE DATE OF 1996 AMENDMENT Section 205(b) of Pub. L. 104-262 provided that: "The amendments made by subsection (a) [amending this section] shall apply with respect to any prospectus submitted by the Secretary of Veterans Affairs after the date of the enactment of this Act [Oct. 9, 1996]." EFFECTIVE DATE OF 1992 AMENDMENT Section 206(b)(2) of Pub. L. 104-262 provided that: "The amendments made by subsection (a) of such section [meaning section 301(a) of Pub. L. 102-405, amending this section] shall apply with respect to any major medical facility project or any major medical facility lease of the Department of Veterans Affairs, regardless of when funds are first appropriated for that project or lease, except that in the case of a project for which funds were first appropriated before October 9, 1992, such amendments shall not apply with respect to amounts appropriated for that project for a fiscal year before fiscal year 1998." Section 301(b) of Pub. L. 102-405 provided that the amendments made by section 301(a) of Pub. L. 102-405, amending this section, were not applicable with respect to any project for which funds were appropriated before Oct. 9, 1992, prior to repeal by Pub. L. 104-262, title II, Sec. 206(b)(1), Oct. 9, 1996, 110 Stat. 3190. -End- -CITE- 38 USC Sec. 8105 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8105. Structural requirements -STATUTE- (a) Each medical facility (including each nursing home facility for which the Secretary contracts under section 1720 of this title and each State home facility constructed or altered under subchapter III of this chapter) shall be of fire, earthquake, and other natural disaster resistant construction in accordance with standards which the Secretary shall prescribe on a State or regional basis after surveying appropriate State and local laws, ordinances, and building codes and climatic and seismic conditions pertinent to each such facility. When an existing structure is acquired for use as a medical facility, it shall be altered to comply with such standards. (b)(1) In order to carry out this section, the Secretary shall appoint an advisory committee to be known as the "Advisory Committee on Structural Safety of Department Facilities", on which shall serve at least one architect and one structural engineer who are experts in structural resistance to fire, earthquake, and other natural disasters and who are not employees of the Federal Government. (2) Such advisory committee shall advise the Secretary on all matters of structural safety in the construction and altering of medical facilities in accordance with the requirements of this section and shall review and make recommendations to the Secretary on the regulations prescribed under this section. (3) The Associate Deputy Secretary, the Under Secretary for Health or the designee of the Under Secretary for Health, and the Department official charged with the responsibility for construction shall be ex officio members of such advisory committee. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 57, Sec. 5005; amended Pub. L. 96-128, title V, Sec. 501(e), Nov. 28, 1979, 93 Stat. 987; renumbered Sec. 8105, Pub. L. 102-40, title IV, Sec. 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102- 83, Secs. 4(a)(3), (4), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404-406; Pub. L. 102-405, title III, Sec. 302(c)(1), Oct. 9, 1992, 106 Stat. 1984.) -MISC1- AMENDMENTS 1992 - Subsec. (b)(3). Pub. L. 102-405 substituted "Under Secretary for Health" for "Chief Medical Director" in two places. 1991 - Pub. L. 102-40 renumbered section 5005 of this title as this section. Subsec. (a). Pub. L. 102-83, Sec. 5(c)(1), substituted "1720" for "620". Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places. Subsec. (b). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing. Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing. 1979 - Subsec. (a). Pub. L. 96-128 substituted "subchapter III of this chapter" for "section 5031 of this title". EFFECTIVE DATE OF 1979 AMENDMENT Amendment by Pub. L. 96-128 effective Nov. 28, 1979, see section 601(b) of Pub. L. 96-128, set out as a note under section 1114 of this title. TERMINATION OF ADVISORY COMMITTEES Advisory committees established after Jan. 5, 1973, to terminate not later than the expiration of the 2-year period beginning on the date of their establishment, unless, in the case of a committee established by the President or an officer of the Federal Government, such committee is renewed by appropriate action prior to the expiration of such 2-year period, or in the case of a committee established by the Congress, its duration is otherwise provided for by law. See section 14 of Pub. L. 92-463, Oct. 6, 1972, 86 Stat. 776, set out in the Appendix to Title 5, Government Organization and Employees. -End- -CITE- 38 USC Sec. 8106 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8106. Construction contracts -STATUTE- (a) The Secretary may carry out any construction or alteration authorized under this subchapter by contract if the Secretary considers it to be advantageous to the United States to do so. (b)(1) The Secretary may obtain, by contract or otherwise, the services of individuals who are architects or engineers and of architectural and engineering corporations and firms, to the extent that the Secretary may require such services for any medical facility authorized to be constructed or altered under this subchapter. (2) No corporation, firm, or individual may be employed under the authority of paragraph (1) of this subsection on a permanent basis. (c) Notwithstanding any other provision of this section, the Secretary shall be responsible for all construction authorized under this subchapter, including the interpretation of construction contracts, the approval of materials and workmanship supplied pursuant to a construction contract, approval of changes in the construction contract, certification of vouchers for payments due the contractor, and final settlement of the contract. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 58, Sec. 5006; renumbered Sec. 8106, Pub. L. 102-40, title IV, Sec. 402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102- 83, Sec. 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.) -MISC1- AMENDMENTS 1991 - Pub. L. 102-40 renumbered section 5006 of this title as this section. Pub. L. 102-83 substituted "Secretary" for "Administrator" wherever appearing. -End- -CITE- 38 USC Sec. 8107 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8107. Operational and construction plans for medical facilities -STATUTE- (a) In order to promote effective planning for the efficient provision of care to eligible veterans, the Secretary, based on the analysis and recommendations of the Under Secretary for Health, shall submit to each committee an annual report regarding long- range health planning of the Department. The report shall be submitted each year not later than the date on which the budget for the next fiscal year is submitted to the Congress under section 1105 of title 31. (b) Each report under subsection (a) shall include the following: (1) A five-year strategic plan for the provision of care under chapter 17 of this title to eligible veterans through coordinated networks of medical facilities operating within prescribed geographic service-delivery areas, such plan to include provision of services for the specialized treatment and rehabilitative needs of disabled veterans (including veterans with spinal cord dysfunction, blindness, amputations, and mental illness) through distinct programs or facilities of the Department dedicated to the specialized needs of those veterans. (2) A description of how planning for the networks will be coordinated. (c) The Secretary shall submit to each committee not later than January 31 of each year a report showing the location, space, cost, and status of each medical facility (1) the construction, alteration, lease, or other acquisition of which has been approved under section 8104(a) of this title, and (2) which was uncompleted as of the date of the last preceding report made under this subsection. (d)(1) The Secretary shall submit to each committee, not later than January 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 and the projected cost of such project (including the projected operating costs, including both recurring and nonrecurring costs). 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. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 58, Sec. 5007; amended Pub. L. 99-166, title III, Sec. 302(a)- (c)(1), Dec. 3, 1985, 99 Stat. 955; Pub. L. 99-576, title II, Sec. 222, Oct. 28, 1986, 100 Stat. 3259; renumbered Sec. 8107 and amended Pub. L. 102-40, title IV, Sec. 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102-54, Sec. 14(f)(3), June 13, 1991, 105 Stat. 287; Pub. L. 102-83, Sec. 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 102-405, title III, Sec. 302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 104-262, title II, Sec. 204, Oct. 9, 1996, 110 Stat. 3188; Pub. L. 105-368, title X, Sec. 1005(b)(18), Nov. 11, 1998, 112 Stat. 3365; Pub. L. 108-170, title II, Sec. 203, Dec. 6, 2003, 117 Stat. 2048.) -MISC1- AMENDMENTS 2003 - Subsec. (b)(3), (4). Pub. L. 108-170 struck out pars. (3) and (4), which required annual reports to include profiles regarding networks of medical facilities and status reports for each facility. 1998 - Subsec. (b)(3)(E). Pub. L. 105-368 substituted "section 7306(f)(1)(A)" for "section 7305". 1996 - Subsec. (a). Pub. L. 104-262, Sec. 204(2), added subsec. (a) and struck out former subsec. (a) which directed the Secretary to submit an annual report on the construction, replacement, alteration, and operation of medical facilities. Subsecs. (b), (c). Pub. L. 104-262, Sec. 204(1), (2), added subsec. (b) and redesignated former subsec. (b) as (c). Subsec. (d). Pub. L. 104-262, Sec. 204(3), added subsec. (d). 1992 - Subsec. (a)(1), (2)(B). Pub. L. 102-405 substituted "Under Secretary for Health" for "Chief Medical Director". 1991 - Pub. L. 102-40, Sec. 402(b)(1), renumbered section 5007 of this title as this section. Subsec. (a)(1). Pub. L. 102-83 substituted "Secretary" for "Administrator". Subsec. (a)(2)(B). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator". Pub. L. 102-54 amended subsec. (a)(2)(B) as in effect immediately before the enactment of Pub. L. 102-40 by striking out the second comma before "are most in need of". Subsec. (b). Pub. L. 102-83 substituted "Secretary" for "Administrator". Pub. L. 102-40, Sec. 402(d)(1), substituted "8104(a)" for "5004(a)". 1986 - Subsec. (a). Pub. L. 99-576 inserted ", after considering the analysis and recommendations of the Chief Medical Director," after "Administrator" in pars. (1) and (2)(B). 1985 - Pub. L. 99-166, Sec. 302(c)(1), substituted "Operational and construction plans for medical facilities" for "Reports to congressional committees" in section catchline. Subsec. (a)(1). Pub. L. 99-166, Sec. 302(a)(1)-(3), designated existing provisions as par. (1), substituted "an annual report on the construction, replacement, alteration, and operation of medical facilities" for "an annual report on the construction, replacement, and alteration of medical facilities", and struck out provisions relating to the content of the reports to be submitted to congressional committees and the time such reports were to be submitted. Subsec. (a)(2), (3). Pub. L. 99-166, Sec. 302(a)(4), added pars. (2) and (3). Subsec. (b). Pub. L. 99-166, Sec. 302(b), struck out "(beginning in 1981)" before "a report", designated existing provisions as cl. (1), and substituted cl. (2) designation for ", in the case of the second and each succeeding report made under this subsection,". -End- -CITE- 38 USC Sec. 8108 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8108. Contributions to local authorities -STATUTE- The Secretary may make contributions to local authorities toward, or for, the construction of traffic controls, road improvements, or other devices adjacent to a medical facility if considered necessary for safe ingress or egress. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 58, Sec. 5008; renumbered Sec. 8108, Pub. L. 102-40, title IV, Sec. 402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102- 83, Sec. 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.) -MISC1- PRIOR PROVISIONS Provisions similar to those comprising this section were contained in former section 5001(g) of this title prior to the general revision of this subchapter by Pub. L. 96-22. AMENDMENTS 1991 - Pub. L. 102-40 renumbered section 5008 of this title as this section. Pub. L. 102-83 substituted "Secretary" for "Administrator". -End- -CITE- 38 USC Sec. 8109 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8109. Parking facilities -STATUTE- (a) For the purpose of this section - (1) The term "garage" means a structure (or part of a structure) in which vehicles may be parked. (2) The term "parking facility" includes - (A) a surface parking lot; and (B) a garage. (3) The term "eligible person" means an individual to whom the Secretary is authorized to furnish medical examination or treatment. (b) In order to accommodate the vehicles of employees of medical facilities, vehicles used to transport veterans and eligible persons to or from such facilities for the purpose of examination or treatment, and the vehicles of visitors and other individuals having business at such facilities, the Secretary - (1) may construct or alter parking facilities, and may acquire, by purchase, lease, condemnation, donation, exchange, or otherwise, such land or interests in land as the Secretary considers necessary for use as the site for any such construction or alteration; (2) may acquire, by purchase, lease, condemnation, donation, exchange, or otherwise, any facility that the Secretary considers necessary for use as a parking facility; and (3) may operate and maintain parking facilities. (c)(1) Except as provided in paragraph (2) of this subsection, each employee, visitor, and other individual having business at a medical facility for which parking fees have been established under subsection (d) or (e) of this section shall be charged the applicable parking fee for the use of a parking facility at such medical facility. (2) A parking fee shall not be charged under this subsection for the accommodation of any vehicle used to transport to or from a medical facility - (A) a veteran or eligible person in connection with such veteran or eligible person seeking examination or treatment; or (B) a volunteer worker (as determined in accordance with regulations which the Secretary shall prescribe) in connection with such worker performing services for the benefit of veterans receiving care at a medical facility. (3) The Secretary shall collect (or provide for the collection of) parking fees charged under this subsection. (d)(1) For each medical facility where funds from the revolving fund described in subsection (h) of this section are expended for - (A) a garage constructed or acquired by the Department at a cost exceeding $500,000 (or, in the case of acquisition by lease, $100,000 per year); or (B) a project for the alteration of a garage at a cost exceeding $500,000, the Secretary shall prescribe a schedule of parking fees to be charged at all parking facilities used in connection with such medical facility. (2) The parking fee schedule prescribed for a medical facility referred to in paragraph (1) of this subsection shall be designed to establish fees which the Secretary determines are reasonable under the circumstances. (e) The Secretary may prescribe a schedule of parking fees for the parking facilities at any medical facility not referred to in subsection (d) of this section. Any such schedule shall be designed to establish fees which the Secretary determines to be reasonable under the circumstances and shall cover all parking facilities used in connection with such medical facility. (f) The Secretary may contract (by lease or otherwise) for the operation of parking facilities at medical facilities under such terms and conditions as the Secretary prescribes and may do so without regard to laws requiring full and open competition. (g) Subject to subsections (h) and (i) of this section, there are authorized to be appropriated such amounts as are necessary to finance (in whole or in part) the construction, alteration, and acquisition (including site acquisition) of parking facilities at medical facilities. (h)(1) Amounts appropriated pursuant to subsection (g) of this section and parking fees collected under subsection (c) of this section shall be administered as a revolving fund and shall be available without fiscal year limitation. (2) The revolving fund shall be deposited in a checking account with the Treasurer of the United States. (3)(A) Except as provided in subparagraph (B) of this paragraph, no funds other than funds from the revolving fund may be expended for the construction, alteration, or acquisition (including site acquisition) of a garage at a medical facility after September 30, 1986. (B) Subparagraph (A) of this paragraph does not apply to the use of funds for investigations and studies, surveys, designs, plans, construction documents, specifications, and similar actions not directly involved in the physical construction of a structure. (i)(1) The expenditure of funds from the revolving fund may be made only for the construction, alteration, and acquisition (including site acquisition) of parking facilities at medical facilities and may be made only as provided for in appropriation Acts. (2) For the purpose of section 8104(a)(2) of this title, a bill, resolution, or amendment which provides that funds in the revolving fund (including any funds proposed in such bill, resolution, or amendment to be appropriated to the revolving fund) may be expended for a project involving a total expenditure of more than $4,000,000 for the construction, alteration, or acquisition (including site acquisition) of a parking facility or facilities at a medical facility shall be considered to be a bill, resolution, or amendment making an appropriation which may be expended for a major medical facility project. (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. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 59, Sec. 5009; amended Pub. L. 99-576, title II, Sec. 223(a)(1), Oct. 28, 1986, 100 Stat. 3259; renumbered Sec. 8109 and amended Pub. L. 102-40, title IV, Sec. 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102-83, Sec. 4(a)(3), (4), (b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 103-79, Sec. 3(b), Aug. 13, 1993, 107 Stat. 771; Pub. L. 104-262, title II, Sec. 207(b), Oct. 9, 1996, 110 Stat. 3190; Pub. L. 105-368, title VII, Sec. 705, Nov. 11, 1998, 112 Stat. 3350; Pub. L. 108-422, title IV, Sec. 415, Nov. 30, 2004, 118 Stat. 2393.) -MISC1- PRIOR PROVISIONS Provisions similar to those comprising this section were contained in former section 5004 of this title prior to the general revision of this subchapter by Pub. L. 96-22. AMENDMENTS 2004 - Subsec. (j). Pub. L. 108-422 added subsec. (j). 1998 - Subsec. (i)(2). Pub. L. 105-368 substituted "$4,000,000" for "$3,000,000". 1996 - Subsec. (h)(3)(B). Pub. L. 104-262 substituted "construction documents" for "working drawings". 1993 - Subsec. (i)(2). Pub. L. 103-79 substituted "$3,000,000" for "$2,000,000". 1991 - Pub. L. 102-40, Sec. 402(b)(1), renumbered section 5009 of this title as this section. Subsecs. (a) to (c). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing. Subsec. (d)(1). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in concluding provisions. Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Department" for "Veterans' Administration" in subpar. (A). Subsecs. (d)(2), (e), (f). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing. Subsec. (i)(2). Pub. L. 102-40, Sec. 402(d)(1), substituted "8104(a)(2)" for "5004(a)(2)". 1986 - Pub. L. 99-576 amended section generally, substituting "Parking facilities" for "Garages and parking facilities" in section catchline and substituting present provisions consisting of subsecs. (a) to (i) for former provisions consisting of subsecs. (a) to (c), and generally revising and expanding section to require VA to establish and collect reasonable parking fees at all facilities where a garage is constructed or acquired or altered at a cost of more than $500,000 (or leased for more than $100,000 per year), and allowing discretionary paid parking at all other facilities. EFFECTIVE DATE OF 1986 AMENDMENT Section 223(b) of Pub. L. 99-576 provided that: "(1) Except as provided in paragraphs (2) and (3), the amendments made by this section [amending this section] shall take effect on the date of the enactment of this Act [Oct. 28, 1986]. "(2)(A) The amendments made by this section shall not abrogate the provisions of a collective bargaining agreement which, on the date of the enactment of this Act, is in effect and includes a provision which specifies a termination date for such agreement. "(B) After the date of the enactment of this Act, if a collective bargaining agreement described in subparagraph (A) is modified, extended, or renewed, such subparagraph shall no longer, as of the date of the modification, extension, or renewal, apply to such agreement. "(C) In the case of a collective bargaining agreement which on such date of enactment is in effect but has no provision which specifies a termination date, the authorities and requirements in section 5009 [now 8109] of title 38, United States Code, as amended by subsection (a)(1) of this section, to establish and collect parking fees shall take effect on January 1, 1988. "(3) Section 5009 [now 8109] of title 38, United States Code, as amended by subsection (a)(1) of this section, shall not apply to the expenditure of funds appropriated for a fiscal year prior to fiscal year 1987 for the construction, alteration, or acquisition (including site acquisition) of a parking facility at a Veterans' Administration [now Department of Veterans Affairs] medical facility." -End- -CITE- 38 USC Sec. 8110 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8110. Operation of medical facilities -STATUTE- (a)(1) The Secretary shall establish the total number of hospital beds and nursing home beds in medical facilities over which the Secretary has direct jurisdiction for the care and treatment of eligible veterans. The Secretary shall establish the total number of such beds so as to maintain a contingency capacity to assist the Department of Defense in time of war or national emergency to care for the casualties of such war or national emergency. Of the number of beds authorized pursuant to the preceding sentence, the Secretary shall maintain the availability of such additional beds and facilities in addition to the operating bed level as the Secretary considers necessary for such contingency purposes. The President shall include in the Budget transmitted to the Congress for each fiscal year pursuant to section 1105 of title 31, an amount for medical care and amounts for construction sufficient to maintain the availability of the contingency capacity referred to in the second sentence of this paragraph. The Secretary shall staff and maintain, in such a manner as to ensure the immediate acceptance and timely and complete care of patients, and in a manner consistent with the policies of the Secretary on overtime, sufficient beds and other treatment capacities to accommodate, and provide such care to, eligible veterans applying for admission and found to be in need of hospital care or medical services. (2) The Secretary shall maintain the bed and treatment capacities of all Department medical facilities, including the staffing required to maintain such capacities, so as to ensure the accessibility and availability of such beds and treatment capacities to eligible veterans in all States, to minimize delays in admissions and in the provision of hospital, nursing home, and domiciliary care, and of medical services furnished pursuant to section 1710(a) of this title, and to ensure that eligible veterans are provided such care and services in an appropriate manner. (3)(A) The Under Secretary for Health shall at the end of each fiscal year (i) analyze agencywide admission policies and the records of those eligible veterans who apply for hospital care, medical services, and nursing home care, but are rejected or not immediately admitted or provided such care or services, and (ii) review and make recommendations regarding the adequacy of staff levels for compliance with the policy established under subparagraph (C), the adequacy of the established operating bed levels, the geographic distribution of operating beds, the demographic characteristics of the veteran population and the associated need for medical care and nursing home facilities and services in each State, and the proportion of the total number of operating beds that are hospital beds and that are nursing home beds. (B) After considering the analyses and recommendations of the Under Secretary for Health pursuant to subparagraph (A) of this paragraph for any fiscal year, the Secretary shall report to the committees, on or before December 1 after the close of such fiscal year, on the results of the analysis of the Under Secretary for Health and on the numbers of operating beds and level of treatment capacities required to enable the Department to carry out the primary function of the Veterans Health Administration. The Secretary shall include in each such report recommendations for (i) the numbers of operating beds and the level of treatment capacities required for the health care of veterans and the maintenance of the contingency capacity referred to in paragraph (1) of this subsection, and (ii) the appropriate staffing and funds therefor. (C) The Secretary shall, in consultation with the Under Secretary for Health, establish a nationwide policy on the staffing of Department medical facilities in order to ensure that such facilities have adequate staff for the provision to veterans of appropriate, high-quality care and services. The policy shall take into account the staffing levels and mixture of staff skills required for the range of care and services provided veterans in Department facilities. (4)(A) With respect to each law making appropriations for the Department for any fiscal year (or any part of a fiscal year), there shall be provided to the Department the funded personnel ceiling defined in subparagraph (C) of this paragraph and the funds appropriated therefor. (B) In order to carry out the provisions of subparagraph (A) of this paragraph, the Director of the Office of Management and Budget shall, with respect to each such law (i) provide to the Department for the fiscal year (or part of a fiscal year) concerned such funded personnel ceiling and the funds necessary to achieve such ceiling, and (ii) submit to the appropriate committees of the Congress and to the Comptroller General of the United States certification that the Director has so provided such ceiling. Not later than the thirtieth day after the enactment of such a law or, in the event of the enactment of such a law more than thirty days prior to the fiscal year for which such law makes such appropriations, not later than the tenth day of such fiscal year, the certification required in the first sentence of this subparagraph shall be submitted, together with a report containing complete information on the personnel ceiling that the Director has provided to the Department for the employees described in subparagraph (C) of this paragraph. (C) For the purposes of this paragraph, the term "funded personnel ceiling" means, with respect to any fiscal year (or part of a fiscal year), the authorization by the Director of the Office of Management and Budget to employ (under the appropriation accounts for medical care, medical and prosthetic research, and medical administration and miscellaneous operating expenses) not less than the number of employees for the employment of which appropriations have been made for such fiscal year (or part of a fiscal year). (5) Notwithstanding any other provision of this title or of any other law, funds appropriated for the Department under the appropriation accounts for medical care, medical and prosthetic research, and medical administration and miscellaneous operating expenses may not be used for, and no employee compensated from such funds may carry out any activity in connection with, the conduct of any study comparing the cost of the provision by private contractors with the cost of the provision by the Department of commercial or industrial products and services for the Veterans Health Administration unless such funds have been specifically appropriated for that purpose. (6)(A) Temporary research personnel of the Veterans Health Administration shall be excluded from any ceiling on full-time equivalent employees of the Department or any other personnel ceiling otherwise applicable to employees of the Department. (B) For purposes of subparagraph (A) of this paragraph, the term "temporary research personnel" means personnel who are employed in the Veterans Health Administration in other than a career appointment for work on a research activity and who are not paid by the Department or are paid from funds appropriated to the Department to support such activity. (b) When the Secretary determines, in accordance with regulations which the Secretary shall prescribe, that a Department facility serves a substantial number of veterans with limited English- speaking ability, the Secretary shall establish and implement procedures, upon the recommendation of the Under Secretary for Health, to ensure the identification of sufficient numbers of individuals on such facility's staff who are fluent in both the language most appropriate to such veterans and in English and whose responsibilities shall include providing guidance to such veterans and to appropriate Department staff members with respect to cultural sensitivities and bridging linguistic and cultural differences. (c) The Secretary shall include in the materials submitted to Congress each year in support of the budget of the Department for the next fiscal year a report on activities and proposals involving contracting for performance by contractor personnel of work previously performed by Department employees. The report shall - (1) identify those specific activities that are currently performed at a Department facility by more than 10 Department employees which the Secretary proposes to study for possible contracting involving conversion from performance by Department employees to performance by employees of a contractor; and (2) identify those specific activities that have been contracted for performance by contractor employees during the prior fiscal year (shown by location, subject, scope of contracts, and savings) and shall describe the effect of such contracts on the quality of delivery of health services during such year. (d) The Secretary may not in any fiscal year close more than 50 percent of the beds within a bed section (of 20 or more beds) of a Department medical center unless the Secretary first submits to the Committees on Veterans' Affairs of the Senate and the House of Representatives a report providing a justification for the closure. No action to carry out such closure may be taken after the submission of such report until the end of the 21-day period beginning on the date of the submission of the report. (e) The Secretary shall submit to the Committees on Veterans' Affairs of the Senate and the House of Representatives, not later than January 20 of each year, a report documenting by network for the preceding fiscal year the following: (1) The number of medical service and surgical service beds, respectively, that were closed during that fiscal year and, for each such closure, a description of the changes in delivery of services that allowed such closure to occur. (2) The number of nursing home beds that were the subject of a mission change during that fiscal year and the nature of each such mission change. (f) For purposes of this section: (1) The term "closure", with respect to beds in a medical center, means ceasing to provide staffing for, and to operate, those beds. Such term includes converting the provision of such bed care from care in a Department facility to care under contract arrangements. (2) The term "bed section", with respect to a medical center, means psychiatric beds (including beds for treatment of substance abuse and post-traumatic stress disorder), intermediate, neurology, and rehabilitation medicine beds, extended care (other than nursing home) beds, and domiciliary beds. (3) The term "justification", with respect to closure of beds, means a written report that includes the following: (A) An explanation of the reasons for the determination that the closure is appropriate and advisable. (B) A description of the changes in the functions to be carried out and the means by which such care and services would continue to be provided to eligible veterans. (C) A description of the anticipated effects of the closure on veterans and on their access to care. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 59, Sec. 5010; amended Pub. L. 96-151, title III, Sec. 301(a), Dec. 20, 1979, 93 Stat. 1095; Pub. L. 97-66, title VI, Sec. 601(b), Oct. 17, 1981, 95 Stat. 1033; Pub. L. 97-72, title I, Sec. 108, Nov. 3, 1981, 95 Stat. 1053; Pub. L. 97-306, title IV, Sec. 409(b), Oct. 14, 1982, 96 Stat. 1446; Pub. L. 97-452, Sec. 2(e)(4), Jan. 12, 1983, 96 Stat. 2479; Pub. L. 98-160, title VII, Sec. 702(19), Nov. 21, 1983, 97 Stat. 1010; Pub. L. 98-528, title I, Sec. 102, Oct. 19, 1984, 98 Stat. 2688; Pub. L. 99-576, title VII, Sec. 702(15), Oct. 28, 1986, 100 Stat. 3302; Pub. L. 100-322, title II, Sec. 222(a), title IV, Sec. 401(a), May 20, 1988, 102 Stat. 531, 543; renumbered Sec. 8110 and amended Pub. L. 102-40, title IV, Sec. 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102-83, Secs. 4(a)(3), (4), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404-406; Pub. L. 102-405, title III, Sec. 302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 103-446, title XI, Sec. 1103, title XII, Sec. 1201(b)(1), (d)(17), (g)(7), Nov. 2, 1994, 108 Stat. 4681, 4682, 4684, 4687; Pub. L. 104-66, title I, Sec. 1141(c), Dec. 21, 1995, 109 Stat. 726; Pub. L. 104-262, title I, Sec. 101(e)(4), title III, Sec. 305, Oct. 9, 1996, 110 Stat. 3181, 3194; Pub. L. 106-117, title III, Sec. 301, Nov. 30, 1999, 113 Stat. 1571; Pub. L. 107-135, title I, Sec. 124, Jan. 23, 2002, 115 Stat. 2452; Pub. L. 107-314, div. A, title VII, Sec. 726(a), Dec. 2, 2002, 116 Stat. 2599.) -MISC1- PRIOR PROVISIONS Provisions similar to those comprising this section were contained in former section 5001(a)(2), (3), (h) of this title prior to the general revision of this subchapter by Pub. L. 96-22. AMENDMENTS 2002 - Subsec. (a)(1). Pub. L. 107-314 struck out "at not more than 125,000 and not less than 100,000" before period at end of first sentence, "shall operate and maintain a total of not less than 90,000 hospital beds and nursing home beds and" before "shall maintain the availability" in third sentence, and "to enable the Department to operate and maintain a total of not less than 90,000 hospital and nursing home beds in accordance with this paragraph and" after "construction sufficient" in fourth sentence. Pub. L. 107-135, Sec. 124(a)(1), inserted "and in a manner consistent with the policies of the Secretary on overtime," after "complete care of patients," in fifth sentence. Subsec. (a)(2). Pub. L. 107-135, Sec. 124(a)(2), inserted ", including the staffing required to maintain such capacities," after "all Department medical facilities", substituted ", to minimize" for "and to minimize", and inserted before period at end ", and to ensure that eligible veterans are provided such care and services in an appropriate manner". Subsec. (a)(3)(A). Pub. L. 107-135, Sec. 124(b)(1), inserted "the adequacy of staff levels for compliance with the policy established under subparagraph (C)," after "regarding". Subsec. (a)(3)(C). Pub. L. 107-135, Sec. 124(b)(2), added subpar. (C). 1999 - Subsecs. (d) to (f). Pub. L. 106-117 added subsecs. (d) to (f). 1996 - Subsec. (a)(2). Pub. L. 104-262, Sec. 101(e)(4), substituted "section 1710(a)" for "section 1712". Subsec. (c). Pub. L. 104-262, Sec. 305, amended subsec. (c) generally, substituting provisions consisting of an introductory par. and pars. (1) and (2), relating to reports on activities and proposals involving contracting for performance by contractor personnel of work previously performed by Department employees for provisions consisting of pars. (1) to (9), relating to conversion of activities at health-care facilities from those performed by Federal employees to those performed by Government contractors. 1995 - Subsec. (a)(4). Pub. L. 104-66 substituted "subparagraph (C)" for "subparagraph (D)" in subpars. (A) and (B), redesignated subpar. (D) as (C), and struck out former subpar. (C) which read as follows: "Whenever the Director of the Office of Management and Budget is required to submit a certification under subparagraph (B) of this paragraph, the Comptroller General shall submit to the appropriate committees of the Congress a report stating the Comptroller General's opinion as to whether the Director has complied with the requirements of that subparagraph. The Comptroller General shall submit the report not later than fifteen days after the end of the period specified in such subparagraph for the Director to submit the certification." 1994 - Subsec. (a)(3)(B), (5), (6). Pub. L. 103-446, Sec. 1201(b)(1), substituted "Veterans Health Administration" for "Department of Medicine and Surgery" wherever appearing. Subsec. (c)(3)(B). Pub. L. 103-446, Sec. 1201(d)(17), substituted "section 513 or 7409" for "section 213 or 4117". Subsec. (c)(7). Pub. L. 103-446, Sec. 1201(g)(7), which provided for striking out obsolete or executed provisions and directed the amendment of subsec. (c) by striking out par. (7), was not executed because of the prior amendment of subsec. (c) by Pub. L. 103-446, Sec. 1103. See below. Pub. L. 103-446, Sec. 1103, added par. (7) and struck out former par. (7) which read as follows: "Not later than February 1, 1984, and February 1 of each of the five succeeding years, the Secretary shall submit a written report to Congress describing the extent to which activities at Department health-care facilities were performed by contractors during the preceding fiscal year and the actual cost savings resulting from such contracts." Subsec. (c)(8), (9). Pub. L. 103-446, Sec. 1103, added pars. (8) and (9). 1992 - Subsecs. (a)(3), (b), (c)(1), (3)(B). Pub. L. 102-405 substituted "Under Secretary for Health" for "Chief Medical Director" wherever appearing. 1991 - Pub. L. 102-40, Sec. 402(b)(1), renumbered section 5010 of this title as this section. Subsec. (a). Pub. L. 102-83, Sec. 5(c)(1), substituted "1712" for "612" in par. (2). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing. Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing. Subsec. (b). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing. Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Department" for "Veterans' Administration" in two places. Subsec. (c). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" and "Secretary's" for "Administrator's" wherever appearing. Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing. Pub. L. 102-40, Sec. 402(d)(1), substituted "8111, 8111A, or 8153" for "5011, 5011A, or 5053" in par. (3)(A). 1988 - Subsec. (a)(6). Pub. L. 100-322, Sec. 222(a), added par. (6). Subsec. (c)(2). Pub. L. 100-322, Sec. 401(a), inserted "responsive bids are received from at least two responsible, financially autonomous bidders and" after "only if". 1986 - Subsec. (a)(1). Pub. L. 99-576 substituted "125,000 and not less than 100,000" for "one hundred and twenty-five thousand and not less than one hundred thousand" and "90,000" for "ninety thousand" in two places. 1984 - Subsec. (a)(4)(C). Pub. L. 98-528 substituted provision requiring the Comptroller General to submit a report stating the Comptroller General's opinion as to whether the Director has complied with subpar. (B) not later than fifteen days after end of period specified in that subparagraph for Director to submit required certification for provision which had required the Comptroller General to submit a report stating the Comptroller General's opinion as to whether the Director has complied with the requirements of any law making appropriations for the Veterans' Administration for any fiscal year or any part thereof regarding funded personnel ceilings not later than forty-fifth day after enactment of each such law. 1983 - Subsec. (a)(1). Pub. L. 97-452 substituted "section 1105 of title 31" for "section 201(a) of the Budget and Accounting Act, 1921 (31 U.S.C. 11(a))". Subsec. (c)(2)(B). Pub. L. 98-160 substituted "quantity and quality" for "quantity or quality". 1982 - Subsec. (c). Pub. L. 97-306 added subsec. (c). 1981 - Subsec. (a)(1). Pub. L. 97-72, Sec. 108(a)(1), struck out provision authorizing the Administrator, subject to the approval of the President to establish and operate not less than 125,000 hospital beds in medical facilities over which the Administrator has direct jurisdiction for the care and treatment of eligible veterans and substituted therefor provisions directing the Administrator to establish a total number of hospital beds and nursing home beds in medical facilities over which the Administrator has direct jurisdiction for the care and treatment of eligible veterans at not more than one hundred and twenty-five thousand and not less than one hundred thousand, and provided that the Administrator establish the total number of such beds so as to maintain a contingency capacity to assist the Department of Defense in time of war or national emergency to care for the casualties of such war or national emergency, that of the number of beds authorized pursuant to the preceding sentence, the Administrator operate and maintain a total of not less than ninety thousand hospital beds and nursing home beds and maintain the availability of such additional beds and facilities in addition to the operating bed level as the Administrator considers necessary for such contingency purposes, and that the President include in the Budget transmitted to the Congress for each fiscal year pursuant to section 201(a) of the Budget and Accounting Act, 1921 (31 U.S.C. 11(a)), an amount for medical care and amounts for construction. Subsec. (a)(3). Pub. L. 97-72, Sec. 108(a)(2), struck out provision requiring that the Chief Medical Director periodically analyze agencywide admission policies and the records of those eligible veterans who apply for hospital care and medical services and annually advise each committee of the results and the added requirements which those results indicate and substituted therefor provisions that the Chief Medical Director, at the end of each fiscal year, (i) analyze agencywide admission policies and the records of those eligible veterans who apply for hospital care, medical services and nursing home care, but are rejected or not immediately admitted or provided such care or services, and (ii) review and made recommendations regarding the adequacy of the established operating bed levels, the geographic distribution of operating beds, the demographic characteristics of the veteran population and the associated need for medical care and nursing home facilities and services in each State, and the proportion of the total number of operating beds that are hospital beds and that are nursing home beds, and that, after considering the analyses and recommendations of the Chief Medical Director pursuant to subparagraph (A) of this paragraph for any fiscal year, the Administrator report to the committees, on or before December 1 after the close of such fiscal year, on the results of the analysis of the Chief Medical Director and on the required number of beds and the level of treatment capacities required. Subsec. (a)(4)(A). Pub. L. 97-66, Sec. 601(b)(1)(A), inserted "for any fiscal year (or any part of a fiscal year)" after "With respect to each law making appropriations for the Veterans' Administration". Subsec. (a)(4)(B). Pub. L. 97-66, Sec. 601(b)(1)(B), inserted "(or part of a fiscal year)" after "provide to the Veterans' Administration for the fiscal year". Subsec. (a)(4)(D). Pub. L. 97-66, Sec. 601(b)(1)(B), inserted "(or part of a fiscal year)" after "fiscal year" in two places. Subsec. (a)(5). Pub. L. 97-66, Sec. 601(b)(2), added par. (5). Subsecs. (b), (c). Pub. L. 97-72, Sec. 108(b), redesignated subsec. (c) as (b). Former subsec. (b), authorizing the Administrator to establish, subject to the approval of the President, not less than twelve thousand beds during fiscal year 1980, and during each fiscal year thereafter, for the furnishing of nursing home care to eligible veterans in facilities over which the Administrator has direct jurisdiction, was struck out. 1979 - Subsec. (a)(4). Pub. L. 96-151 added par. (4). EFFECTIVE DATE OF 2002 AMENDMENT Pub. L. 107-314, div. A, title VII, Sec. 726(b), Dec. 2, 2002, 116 Stat. 2599, provided that: "The amendments made by subsection (a) [amending this section] shall take effect on October 1, 2003." EFFECTIVE DATE OF 1988 AMENDMENT Section 222(b) of Pub. L. 100-322 provided that: "The amendment made by subsection (a) [amending this section] shall apply with respect to fiscal years after fiscal year 1987." Section 401(b) of Pub. L. 100-322 provided that: "The amendment made by subsection (a) [amending this section] shall apply only with respect to the awarding of contracts under solicitations issued after the date of the enactment of this Act [May 20, 1988]." EFFECTIVE DATE OF 1981 AMENDMENT Amendment by section 601(b)(1) of Pub. L. 97-66 effective Oct. 1, 1981, see section 701(b)(4) of Pub. L. 97-66, set out as a note under section 1114 of this title. Amendment by section 601(b)(2) of Pub. L. 97-66 effective Oct. 17, 1981, see section 701(b)(1) of Pub. L. 97-66, set out as a note under section 1114 of this title. EFFECTIVE DATE OF 1979 AMENDMENT Section 301(b) of Pub. L. 96-151 provided that: "The amendment made by subsection (a) [amending this section] shall take effect with respect to Public Law 96-103 [Nov. 5, 1979, 93 Stat. 771], but, with respect to such Public Law, the certification and report required by subparagraph (B) of paragraph (4) of section 5010 [now 8110] of title 38, United States Code (as added by such amendment), and the report required by subparagraph (C) of such paragraph (as added by such amendment) shall be submitted to the appropriate committees of the Congress not later than January 15, 1980, and February 1, 1980, respectively." INVENTORY OF MEDICAL WASTE MANAGEMENT ACTIVITIES AT DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE FACILITIES Pub. L. 108-422, title VI, Sec. 602, Nov. 30, 2004, 118 Stat. 2397, provided that: "(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." CONVERSION OF UNDERUSED SPACE TO DOMICILIARY-CARE BEDS Section 136 of Pub. L. 100-322 directed Administrator, not later than June 1, 1988, to convert underused space located in facilities under jurisdiction of Administrator in urban areas with significant numbers of homeless veterans into 500 domiciliary-care beds to be used for care of veterans in need of domiciliary care, primarily homeless veterans. POLICY OF COMPREHENSIVE VETERANS' HEALTH-CARE SYSTEM Section 409(a) of Pub. L. 97-306 provided that: "It is the policy of the United States that the Veterans' Administration - "(1) shall maintain a comprehensive, nationwide health-care system for the direct provision of quality health-care services to eligible veterans; and "(2) shall operate such system through cost-effective means that are consistent with carrying out fully the functions of the Department of Medicine and Surgery of the Veterans' Administration under title 38, United States Code." -End- -CITE- 38 USC Sec. 8111 01/02/2006 -EXPCITE- TITLE 38 - VETERANS' BENEFITS PART VI - ACQUISITION AND DISPOSITION OF PROPERTY CHAPTER 81 - ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY SUBCHAPTER I - ACQUISITION AND OPERATION OF MEDICAL FACILITIES -HEAD- Sec. 8111. Sharing of Department of Veterans Affairs and Department of Defense health care resources -STATUTE- (a) Required Coordination and Sharing of Health Care Resources. - The Secretary of Veterans Affairs and the Secretary of Defense shall enter into agreements and contracts for the mutually beneficial coordination, use, or exchange of use of the health care resources of the Department of Veterans Affairs and the Department of Defense with the goal of improving the access to, and quality and cost effectiveness of, the health care provided by the Veterans Health Administration and the Military Health System to the beneficiaries of both Departments. (b) Joint Requirements for Secretaries of Veterans Affairs and Defense. - To facilitate the mutually beneficial coordination, use, or exchange of use of the health care resources of the two Departments, the two Secretaries shall carry out the following functions: (1) Develop and publish a joint strategic vision statement and a joint strategic plan to shape, focus, and prioritize the coordination and sharing efforts among appropriate elements of the two Departments and incorporate the goals and requirements of the joint sharing plan into the strategic and performance plan of each Department under the Government Performance and Results Act of 1993. (2) Jointly fund the Department of Veterans Affairs-Department of Defense Joint Executive Committee under section 320 of this title. (3) Continue to facilitate and improve sharing between individual Department of Veterans Affairs and Department of Defense health care facilities, but giving priority of effort to initiatives (A) that improve sharing and coordination of health resources at the intraregional and nationwide levels, and (B) that improve the ability of both Departments to provide coordinated health care. (4) Establish a joint incentive program under subsection (d). [(c) Repealed. Pub. L. 108-136, div. A, title V, Sec. 583(b)(1), Nov. 24, 2003, 117 Stat. 1491.] (d) Joint Incentives Program. - (1) Pursuant to subsection (b)(4), the two Secretaries shall carry out a program to identify, provide incentives to, implement, fund, and evaluate creative coordination and sharing initiatives at the facility, intraregional, and nationwide levels. The program shall be administered by the Department of Veterans Affairs-Department of Defense Joint Executive Committee, under procedures jointly prescribed by the two Secretaries. (2) To facilitate the incentive program, effective October 1, 2003, there is established in the Treasury a fund to be known as the "DOD-VA Health Care Sharing Incentive Fund". Each Secretary shall annually contribute to the fund a minimum of $15,000,000 from the funds appropriated to that Secretary's Department. Such funds shall remain available until expended and shall be available for any purpose authorized by this section. (3) The program under this subsection shall terminate on September 30, 2007. (e) Guidelines and Policies for Implementation of Coordination and Sharing Recommendations, Contracts, and Agreements. - (1) To implement the recommendations made by the Department of Veterans Affairs-Department of Defense Joint Executive Committee with respect to health care resources, as well as to carry out other health care contracts and agreements for coordination and sharing initiatives as they consider appropriate, the two Secretaries shall jointly issue guidelines and policy directives. Such guidelines and policies shall provide for coordination and sharing that - (A) is consistent with the health care responsibilities of the Department of Veterans Affairs under this title and with the health care responsibilities of the Department of Defense under chapter 55 of title 10; (B) will not adversely affect the range of services, the quality of care, or the established priorities for care provided by either Department; and (C) will not reduce capacities in certain specialized programs of the Department of Veterans Affairs that the Secretary is required to maintain in accordance with section 1706(b) of this title. (2) To facilitate the sharing and coordination of health care services between the two Departments, the two Secretaries shall jointly develop and implement guidelines for a standardized, uniform payment and reimbursement schedule for those services. Such schedule shall be implemented no later than October 1, 2003, and shall be revised periodically as necessary. The two Secretaries, following implementation of the schedule, may on a case-by-case basis waive elements of the schedule if they jointly agree that such a waiver is in the best interests of both Departments. (3)(A) The guidelines established under paragraph (1) shall authorize the heads of individual Department of Defense and Department of Veterans Affairs medical facilities and service regions to enter into health care resources coordination and sharing agreements. (B) Under any such agreement, an individual who is a primary beneficiary of one Department may be provided health care, as provided in the agreement, at a facility or in the service region of the other Department that is a party to the sharing agreement. (C) Each such agreement shall identify the health care resources to be shared. (D) Each such agreement shall provide, and shall specify procedures designed to ensure, that the availability of direct health care to individuals who are not primary beneficiaries of the providing Department is (i) on a referral basis from the facility or service region of the other Department, and (ii) does not (as determined by the head of the providing facility or region) adversely affect the range of services, the quality of care, or the established priorities for care provided to the primary beneficiaries of the providing Department. (E) Each such agreement shall provide that a providing Department or service region shall be reimbursed for the cost of the health care resources provided under the agreement and that the rate of such reimbursement shall be as determined in accordance with paragraph (2). (F) Each proposal for an agreement under this paragraph shall be effective (i) on the 46th day after the receipt of such proposal by the Committee, unless earlier disapproved, or (ii) if earlier approved by the Committee, on the date of such approval. (G) Any funds received through such a uniform payment and reimbursement schedule shall be credited to funds that have been allotted to the facility of either Department that provided the care or services, or is due the funds from, any such agreement. (f) Annual Joint Report. - (1) At the time the President's budget is transmitted to Congress in any year pursuant to section 1105 of title 31, the two Secretaries shall submit to Congress a joint report on health care coordination and sharing activities under this section during the fiscal year that ended during the previous calendar year. (2) Each report under this section shall include the following: (A) The guidelines prescribed under subsection (e) (and any revision of such guidelines). (B) The assessment of further opportunities identified by the Department of Veterans Affairs-Department of Defense Joint Executive Committee under subsection (d)(3) of section 320 of this title for the sharing of health-care resources between the two Departments. (C) Any recommendation made by that committee under subsection (c)(2) of that section during that fiscal year. (D) A review of the sharing agreements entered into under subsection (e) and a summary of activities under such agreements during such fiscal year and a description of the results of such agreements in improving access to, and the quality and cost effectiveness of, the health care provided by the Veterans Health Administration and the Military Health System to the beneficiaries of both Departments. (E) A summary of other planning and activities involving either Department in connection with promoting the coordination and sharing of Federal health-care resources during the preceding fiscal year. (F) Such recommendations for legislation as the two Secretaries consider appropriate to facilitate the sharing of health-care resources between the two Departments. (3) In addition to the matters specified in paragraph (2), the two Secretaries shall include in the annual report under this subsection an overall status report of the progress of health resources sharing between the two Departments as a consequence of subtitle C of title VII of the Bob Stump National Defense Authorization Act for Fiscal Year 2003 (Public Law 107-314) and of other sharing initiatives taken during the period covered by the report. Such status report shall indicate the status of such sharing and shall include appropriate data as well as analyses of that data. The annual report shall include the following: (A) Enumerations and explanations of major policy decisions reached by the two Secretaries during the period covered by the report period with respect to sharing between the two Departments. (B) A description of progress made in new ventures or particular areas of sharing and coordination that would be of policy interest to Congress consistent with the intent of such subtitle. (C) A description of enhancements of access to care of beneficiaries of both Departments that came about as a result of new sharing approaches brought about by such subtitle. (D) A description of proposals for which funds are provided through the joint incentives program under subsection (d), together with a description of their results or status at the time of the report, including access improvements, savings, and quality-of-care enhancements they brought about, and a description of any additional use of funds made available under subsection (d). (4) In addition to the matters specified in paragraphs (2) and (3), the two Secretaries shall include in the annual report under this subsection for each year through 2008 the following: (A) A description of the measures taken, or planned to be taken, to implement the health resources sharing project under section 722 of the Bob Stump National Defense Authorization Act for Fiscal Year 2003 (Public Law 107-314) and any cost savings anticipated, or cost sharing achieved, at facilities participating in the project, including information on improvements in access to care, quality, and timeliness, as well as impediments encountered and legislative recommendations to ameliorate such impediments. (B) A description of the use of the waiver authority provided by section 722(d)(1) of the Bob Stump National Defense Authorization Act for Fiscal Year 2003 (Public Law 107-314), including - (i) a statement of the numbers and types of requests for waivers under that section of administrative policies that have been made during the period covered by the report and, for each such request, an explanation of the content of each request, the intended purpose or result of the requested waiver, and the disposition of each request; and (ii) descriptions of any new administrative policies that enhance the success of the project. (5) In addition to the matters specified in paragraphs (2), (3), and (4), the two Secretaries shall include in the annual report under this subsection for each year through 2009 a report on the pilot program for graduate medical education under section 725 of the Bob Stump National Defense Authorization Act for Fiscal Year 2003 (Public Law 107-314), including activities under the program during the preceding year and each Secretary's assessment of the efficacy of providing education and training under that program. (g) Definitions. - For the purposes of this section: (1) The term "beneficiary" means a person who is a primary beneficiary of the Department of Veterans Affairs or of the Department of Defense. (2) The term "direct health care" means health care provided to a beneficiary in a medical facility operated by the Department of Veterans Affairs or the Department of Defense. (3) The term "head of a medical facility" (A) with respect to a medical facility of the Department of Veterans Affairs, means the director of the facility, and (B) with respect to a medical facility of the Department of Defense, means the medical or dental officer in charge or the contract surgeon in charge. (4) The term "health-care resource" includes hospital care, medical services, and rehabilitative services, as those terms are defined in paragraphs (5), (6), and (8), respectively, of section 1701 of this title, services under sections 1782 and 1783 of this title, any other health-care service, and any health-care support or administrative resource. (5) The term "primary beneficiary" (A) with respect to the Department means a person who is eligible under this title (other than under section 1782, 1783, or 1784 or subsection (d) of this section) or any other provision of law for care or services in Department medical facilities, and (B) with respect to the Department of Defense, means a member or former member of the Armed Forces who is eligible for care under section 1074 of title 10. (6) The term "providing Department" means the Department of Veterans Affairs, in the case of care or services furnished by a facility of the Department of Veterans Affairs, and the Department of Defense, in the case of care or services furnished by a facility of the Department of Defense. (7) The term "service region" means a geographic service area of the Veterans Health Administration, in the case of the Department of Veterans Affairs, and a service region, in the case of the Department of Defense. -SOURCE- (Added Pub. L. 96-22, title III, Sec. 301(a), June 13, 1979, 93 Stat. 60, Sec. 5011; amended Pub. L. 97-174, Sec. 3(a), (b)(1), May 4, 1982, 96 Stat. 70, 73; Pub. L. 97-452, Sec. 2(e)(4), Jan. 12, 1983, 96 Stat. 2479; renumbered Sec. 8111 and amended Pub. L. 102- 40, title IV, Sec. 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102-83, Secs. 4(a)(3), (4), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404-406; Pub. L. 102-405, title III, Sec. 302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 103-446, title XII, Sec. 1201(g)(8), (i)(10), Nov. 2, 1994, 108 Stat. 4687, 4688; Pub. L. 107-135, title II, Sec. 208(e)(6), Jan. 23, 2002, 115 Stat. 2464; Pub. L. 107-314, div. A, title VII, Sec. 721(a)(1), Dec. 2, 2002, 116 Stat. 2589; Pub. L. 108-136, div. A, title V, Sec. 583(b), (c), Nov. 24, 2003, 117 Stat. 1491, 1492; Pub. L. 108-422, title VI, Sec. 605, Nov. 30, 2004, 118 Stat. 2399; Pub. L. 109-163, div. A, title VII, Sec. 747(a), title X, Sec. 1056(g), Jan. 6, 2006, 119 Stat. 3363, 3440.) -REFTEXT- REFERENCES IN TEXT The Government Performance and Results Act of 1993, referred to in subsec. (b)(1), is Pub. L. 103-62, Aug. 3, 1993, 107 Stat. 285, which enacted section 306 of Title 5, Government Organization and Employees, sections 1115 to 1119, 9703, and 9704 of Title 31, Money and Finance, and sections 2801 to 2805 of Title 39, Postal Service, amended section 1105 of Title 31, and enacted provisions set out as notes under sections 1101 and 1115 of Title 31. For complete classification of this Act to the Code, see Short Title of 1993 Amendment note set out under section 1101 of Title 31 and Tables. The Bob Stump National Defense Authorization Act for Fiscal Year 2003, referred to in subsec. (f)(3), is Pub. L. 107-314, Dec. 2, 2002, 116 Stat. 2458. Subtitle C (Secs. 721-726) of title VII of division A of the Act amended this section, section 8110 of this title, and section 1104 of Title 10, Armed Forces, enacted provisions set out as notes under this section, section 8110 of this title, and sections 1074g and 1094a of Title 10, and repealed provisions set out as a note under section 1094a of Title 10. Section 722 of the Act is set out as a note under this section. Section 725 of the Act is set out as a note under section 1094a of Title 10. For complete classification of this Act to the Code, see Tables. -MISC1- PRIOR PROVISIONS Provisions similar to those comprising this section were contained in former section 5003 of this title prior to the general revision of this subchapter by Pub. L. 96-22. AMENDMENTS 2006 - Subsec. (b)(1). Pub. L. 109-163, Sec. 1056(g), inserted "of 1993" after "Government Performance and Results Act". Subsec. (d)(3), (4). Pub. L. 109-163, Sec. 747(a), redesignated par. (4) as (3) and struck out former par. (3) which provided for an annual review and report by the Comptroller General of the implementation and effectiveness of the incentives program under this subsection. 2004 - Subsec. (d)(2). Pub. L. 108-422 inserted "and shall be available for any purpose authorized by this section" before period at end. 2003 - Subsec. (b)(2). Pub. L. 108-136, Sec. 583(b)(2)(A), substituted "the Department of Veterans Affairs-Department of Defense Joint Executive Committee under section 320 of this title" for "the interagency committee provided for under subsection (c)". Subsec. (c). Pub. L. 108-136, Sec. 583(b)(1), struck out subsec. (c) which related to establishment of Department of Veterans Affairs-Department of Defense Health Executive Committee. Subsec. (d)(1). Pub. L. 108-136, Sec. 583(b)(2)(B), substituted "Department of Veterans Affairs-Department of Defense Joint Executive Committee" for "Committee established in subsection (c)". Subsec. (e)(1). Pub. L. 108-136, Sec. 583(b)(2)(C), substituted "Department of Veterans Affairs-Department of Defense Joint Executive Committee with respect to health care resources" for "Committee under subsection (c)(2)" in introductory provisions. Subsec. (f)(2)(B), (C). Pub. L. 108-136, Sec. 583(b)(2)(D), added subpars. (B) and (C) and struck out former subpars. (B) and (C) which read as follows: "(B) The assessment of further opportunities identified under subparagraph (C) of subsection (c)(5) for the sharing of health- care resources between the two Departments. "(C) Any recommendation made under subsection (c)(4) during such fiscal year." Subsec. (f)(3), (4)(A), (B), (5). Pub. L. 108-136, Sec. 583(c), inserted "(Public Law 107-314)" after "for Fiscal Year 2003". 2002 - Pub. L. 107-314 amended section catchline and text generally. Prior to amendment, text related to agreements and contracts for mutual use or exchange of use of hospital and domiciliary facilities and other resources by the Secretary of Veterans Affairs and the Secretary of the Army, the Secretary of the Air Force, and the Secretary of the Navy and provided for establishment of the Department/Department of Defense Health-Care Resources Sharing Committee. Subsec. (g)(4). Pub. L. 107-135, Sec. 208(e)(6)(A), inserted "services under sections 1782 and 1783 of this title" after "of this title,". Subsec. (g)(5). Pub. L. 107-135, Sec. 208(e)(6)(B), substituted "section 1782, 1783, or 1784" for "section 1711(b) or 1713". 1994 - Subsec. (b)(2). Pub. L. 103-446, Sec. 1201(g)(8)(A), in concluding provisions, substituted "During odd-numbered fiscal years" for "During fiscal years 1982 and 1983" and "During even- numbered fiscal years" for "During fiscal year 1984" and struck out after third sentence "Thereafter, the chairmanship of the Committee shall alternate each fiscal year between the Under Secretary for Health and the Assistant Secretary." Subsec. (b)(4). Pub. L. 103-446, Sec. 1201(g)(8)(B), substituted "At such times as" for "Within nine months of the date of the enactment of this subsection and at such times thereafter as". Subsec. (f)(6). Pub. L. 103-446, Sec. 1201(i)(10), inserted "of Defense" after second reference to "Secretary". 1992 - Subsecs. (b)(2), (d)(5), (e). Pub. L. 102-405 substituted "Under Secretary for Health" for "Chief Medical Director" wherever appearing. 1991 - Pub. L. 102-40, Sec. 402(b)(1), renumbered section 5011 of this title as this section. Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Sharing of Department" for "Sharing of Veterans' Administration" in section catchline. Subsec. (a). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places. Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Department" for "Veterans' Administration" in two places. Pub. L. 102-40, Sec. 402(d)(1), substituted "8110(a)(1)" for "5010(a)(1)". Subsec. (b). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in par. (4). Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing in pars. (1) and (2)(A). Subsec. (c)(1). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator". Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Department" for "Veterans' Administration". Subsec. (f). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in introductory provisions and in par. (6). Subsec. (g). Pub. L. 102-83, Sec. 5(c)(1), substituted "1701" for "601" in par. (4) and "1711(b) or 1713" for "611(b) or 613" in par. (5). Pub. L. 102-83, Sec. 4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing. 1983 - Subsec. (f). Pub. L. 97-452 substituted "section 1105 of title 31" for "section 201(a) of the Budget and Accounting Act, 1921 (31 U.S.C. 11(a))". 1982 - Pub. L. 97-174, Sec. 3(b)(1), substituted "Sharing of Veterans' Administration and Department of Defense health-care resources" for "Use of Armed Forces facilities" in section catchline. Subsec. (a). Pub. L. 97-174, Sec. 3(a)(1), (2), designated existing provisions as subsec. (a) and substituted "material, and other resources as may be needed to operate such facilities properly, except that the Administrator may not enter into an agreement that would result (1) in a permanent reduction in the total number of authorized Veterans' Administration hospital beds and nursing home beds to a level below the minimum number of such beds required by section 5010(a)(1) of this title to be authorized, or (2) in a permanent reduction in the total number of such beds operated and maintained to a level below the minimum number of such beds required by such section to be operated and maintained" for "and material as may be needed to operate such facilities properly, or for the transfer, without reimbursement of appropriations, of facilities, supplies, equipment, or material necessary and proper for authorized care for veterans, except that at no time shall the Administrator enter into any agreement which will result in a permanent reduction of Veterans' Administration hospital and domiciliary beds below the number established or approved on June 22, 1944, plus the estimated number required to meet the load of eligibles under this title,". Subsecs. (b) to (g). Pub. L. 97-174, Sec. 3(a)(3), added subsecs. (b) to (g). EFFECTIVE DATE OF 2002 AMENDMENT Pub. L. 107-314, div. A, title VII, Sec. 721(c), Dec. 2, 2002, 116 Stat. 2595, provided that: "The amendments made by this section [amending this section and section 1104 of Title 10, Armed Forces] shall take effect on October 1, 2003." CONSIDERATION OF COMBINATION OF MILITARY MEDICAL TREATMENT FACILITIES AND HEALTH CARE FACILITIES OF DEPARTMENT OF VETERANS AFFAIRS Pub. L. 108-375, div. B, title XXVIII, Sec. 2811, Oct. 28, 2004, 118 Stat. 2128, provided that: "(a) Department of Defense Consideration of Joint Construction. - When considering any military construction project for the construction of a new military medical treatment facility in the United States or a territory or possession of the United States, the Secretary of Defense shall consult with the Secretary of Veterans Affairs regarding the feasibility of carrying out a joint project to construct a medical facility that - "(1) could serve as a facility for health-resources sharing between the Department of Defense and the Department of Veterans Affairs; and "(2) would be no more costly to each Department to construct and operate than separate facilities for each Department. "(b) Department of Veterans Affairs Consideration of Joint Construction. - When considering the construction of a new or replacement medical facility for the Department of Veterans Affairs, the Secretary of Veterans Affairs shall consult with the Secretary of Defense regarding the feasibility of carrying out a joint project to construct a medical facility that - "(1) could serve as a facility for health-resources sharing between the Department of Veterans Affairs and the Department of Defense; and "(2) would be no more costly to each Department to construct and operate than separate facilities for each Department." HEALTH CARE RESOURCES SHARING AND COORDINATION PROJECT Pub. L. 107-314, div. A, title VII, Sec. 722, Dec. 2, 2002, 116 Stat. 2595, as amended by Pub. L. 109-163, div. A, title VII, Sec. 747(b), Jan. 6, 2006, 119 Stat. 3363, provided that: "(a) Establishment. - (1) The Secretary of Veterans Affairs and the Secretary of Defense shall conduct a health care resources sharing project to serve as a test for evaluating the feasibility, and the advantages and disadvantages, of measures and programs designed t