[USC02] 38 USC PART VI, CHAPTER 81, SUBCHAPTER I: ACQUISITION AND OPERATION OF MEDICAL FACILITIES
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38 USC PART VI, CHAPTER 81, SUBCHAPTER I: ACQUISITION AND OPERATION OF MEDICAL FACILITIES
From Title 38—VETERANS' BENEFITSPART VI—ACQUISITION AND DISPOSITION OF PROPERTYCHAPTER 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

§8101. Definitions

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, or as otherwise authorized by law, for the provision of health-care services (including hospital, outpatient clinic, 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.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 55, §5001; renumbered §8101, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102–83, §4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 104–262, title II, §207(a), Oct. 9, 1996, 110 Stat. 3190; Pub. L. 115–182, title V, §503(a), June 6, 2018, 132 Stat. 1476.)

Amendments

2018—Par. (3). Pub. L. 115–182, which directed substitution of "Secretary, or as otherwise authorized by law, for the provision of health-care services (including hospital, outpatient clinic, nursing home," for "Secretary for the provision of health-care services (including hospital, nursing home," in section 8101(3), without specifying the Code title to be amended, was executed by making the substitution in par. (3) of this section, to reflect the probable intent of Congress.

1996—Par. (2). Pub. L. 104–262 substituted "construction documents" for "working drawings" and "design development" for "preliminary plans".

1991Pub. L. 102–40 renumbered section 5001 of this title as this section.

Par. (3). Pub. L. 102–83 substituted "Secretary" for "Administrator".

Effective Date

Pub. L. 96–22, title III, §302, June 13, 1979, 93 Stat. 62, 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 [former] section 5007(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]."

§8102. Acquisition of medical facilities

(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.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 55, §5002; amended Pub. L. 99–576, title II, §221(a), Oct. 28, 1986, 100 Stat. 3259; renumbered §8102 and amended Pub. L. 102–40, title IV, §402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–54, §14(f)(2), June 13, 1991, 105 Stat. 287; Pub. L. 102–83, §4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.)

Amendments

1991Pub. L. 102–40, §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, §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).

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

§8103. Authority to construct and alter, and to acquire sites for, medical facilities

(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.


(e)(1) In the case of any super construction project, the Secretary shall enter into an agreement with an appropriate non-Department Federal entity to provide full project management services for the super construction project, including management over the project design, acquisition, construction, and contract changes.

(2) An agreement entered into under paragraph (1) with a Federal entity shall provide that the Secretary shall reimburse the Federal entity for all costs associated with the provision of project management services under the agreement.

(3) In this subsection, the term "super construction project" means a project for the construction, alteration, or acquisition of a medical facility involving a total expenditure of more than $100,000,000.

(f) To the maximum extent practicable, the Secretary shall use industry standards, standard designs, and best practices in carrying out the construction of medical facilities.

(g)(1)(A) Not later than September 30 of the fiscal year following the fiscal year during which the VA Asset and Infrastructure Review Act of 2018 is enacted, the Secretary shall implement the covered training curriculum and the covered certification program.

(B) In designing and implementing the covered training curriculum and the covered certification program under paragraph (1), the Secretary shall use as models existing training curricula and certification programs that have been established under chapter 87 of title 10, United States Code, as determined relevant by the Secretary.

(2) The Secretary may develop the training curriculum under paragraph (1)(A) in a manner that provides such training in any combination of—

(A) training provided in person;

(B) training provided over an internet website; or

(C) training provided by another department or agency of the Federal Government.


(3) The Secretary may develop the certification program under paragraph (1)(A) in a manner that uses—

(A) one level of certification; or

(B) more than one level of certification, as determined appropriate by the Secretary with respect to the level of certification for different grades of the General Schedule.


(4) The Secretary may enter into a contract with an appropriate entity to provide the covered training curriculum and the covered certification program under paragraph (1)(A).

(5)(A) Not later than September 30 of the second fiscal year following the fiscal year during which the VA Asset and Infrastructure Review Act of 2018 is enacted, the Secretary shall ensure that the majority of employees subject to the covered certification program achieve the certification or the appropriate level of certification pursuant to paragraph (3), as the case may be.

(B) After carrying out subparagraph (A), the Secretary shall ensure that each employee subject to the covered certification program achieves the certification or the appropriate level of certification pursuant to paragraph (3), as the case may be, as quickly as practicable.

(6) In this subsection:

(A) The term "covered certification program" means, with respect to employees of the Department of Veterans Affairs who are members of occupational series relating to construction or facilities management, or employees of the Department who award or administer contracts for major construction, minor construction, or nonrecurring maintenance, including as contract specialists or contracting officers' representatives, a program to certify knowledge and skills relating to construction or facilities management and to ensure that such employees maintain adequate expertise relating to industry standards and best practices for the acquisition of design and construction services.

(B) The term "covered training curriculum" means, with respect to employees specified in subparagraph (A), a training curriculum relating to construction or facilities management.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 56, §5003; amended Pub. L. 101–237, title VI, §603(b), Dec. 18, 1989, 103 Stat. 2097; renumbered §8103 and amended Pub. L. 102–40, title IV, §402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–83, §4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 103–446, title XII, §1201(d)(16), Nov. 2, 1994, 108 Stat. 4684; Pub. L. 114–58, title V, §502(a), Sept. 30, 2015, 129 Stat. 537; Pub. L. 114–315, title VIII, §801(a), Dec. 16, 2016, 130 Stat. 1590; Pub. L. 115–182, title II, §211, June 6, 2018, 132 Stat. 1460.)

References in Text

The fiscal year during which the VA Asset and Infrastructure Review Act of 2018 is enacted, referred to in subsec. (g)(1)(A), (5)(A), is the fiscal year during which Pub. L. 115–182, which was approved June 6, 2018, was enacted.

Amendments

2018—Subsec. (g). Pub. L. 115–182 amended subsec. (g) generally. Prior to amendment, subsec. (g) read as follows: "The Secretary shall ensure that each employee of the Department with responsibilities, as determined by the Secretary, relating to the infrastructure construction or alteration of medical facilities, including such construction or alteration carried out pursuant to contracts or agreements, undergoes a program of ongoing professional training and development. Such program shall be designed to ensure that employees maintain adequate expertise relating to industry standards and best practices for the acquisition of design and construction services. The Secretary may provide the program under this subsection directly or through a contract or agreement with a non-Federal entity or with a non-Department Federal entity."

2016—Subsecs. (f), (g). Pub. L. 114–315 added subsecs. (f) and (g).

2015—Subsec. (e). Pub. L. 114–58 added subsec. (e).

1994—Subsec. (d)(6)(A). Pub. L. 103–446 substituted "section 316" for "section 230(c)".

1991Pub. L. 102–40, §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, §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).

Effective Date of 2015 Amendment

Pub. L. 114–58, title V, §502(b), Sept. 30, 2015, 129 Stat. 538, provided that: "The amendment made by subsection (a) [amending this section] shall apply with respect to the following:

"(1) The medical facility construction project in Denver, Colorado, specified in section 2 of the Construction Authorization and Choice Improvement Act (Public Law 114–19; 129 Stat. 215).

"(2) Any super construction project (as defined in section 8103(e)(3) of title 38, United States Code, as added by subsection (a)) that is authorized on or after the date of the enactment of this Act [Sept. 30, 2015]."

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

Communities Helping Invest Through Property and Improvements Needed for Veterans

Pub. L. 114–294, Dec. 16, 2016, 130 Stat. 1504, provided that:

"SECTION 1. SHORT TITLE.

"This Act may be cited as the 'Communities Helping Invest through Property and Improvements Needed for Veterans Act of 2016' or the 'CHIP IN for Vets Act of 2016'.

"SEC. 2. PILOT PROGRAM ON ACCEPTANCE BY THE DEPARTMENT OF VETERANS AFFAIRS OF DONATED FACILITIES AND RELATED IMPROVEMENTS.

"(a) Pilot Program Authorized.—

"(1) In general.—Notwithstanding sections 8103 and 8104 of title 38, United States Code, the Secretary of Veterans Affairs may carry out a pilot program under which the Secretary may accept donations of the following property from entities described in paragraph (2):

"(A) Real property (including structures and equipment associated therewith)—

"(i) that includes a constructed facility; or

"(ii) to be used as the site of a facility constructed by the entity.

"(B) A facility to be constructed by the entity on real property of the Department of Veterans Affairs.

"(2) Entities described.—Entities described in this paragraph are the following:

"(A) A State or local authority.

"(B) An organization that is described in section 501(c)(3) of the Internal Revenue Code of 1986 [26 U.S.C. 501(c)(3)] and is exempt from taxation under section 501(a) of such Code [26 U.S.C. 501(a)].

"(C) A limited liability corporation.

"(D) A private entity.

"(E) A donor or donor group.

"(F) Any other non-Federal Government entity.

"(3) Limitation.—The Secretary may accept not more than five donations of real property and facility improvements under the pilot program and as described in this section.

"(b) Conditions for Acceptance of Property.—The Secretary may accept the donation of a property described in subsection (a)(1) under the pilot program only if—

"(1) the property is—

"(A) a property with respect to which funds have been appropriated for a Department facility project; or

"(B) a property identified as—

"(i) meeting a need of the Department as part of the long-range capital planning process of the Department; and

"(ii) the location for a Department facility project that is included on the Strategic Capital Investment Planning process priority list in the most recent budget submitted to Congress by the President pursuant to section 1105(a) of title 31, United States Code; and

"(2) an entity described in subsection (a)(2) has entered into or is willing to enter into a formal agreement with the Secretary in accordance with subsection (c) under which the entity agrees to independently donate the real property, improvements, goods, or services, for the Department facility project in an amount acceptable to the Secretary and at no additional cost to the Federal Government.

"(c) Requirement To Enter Into an Agreement.—

"(1) In general.—The Secretary may accept real property and improvements donated under the pilot program by an entity described in subsection (a)(2) only if the entity enters into a formal agreement with the Secretary that provides for—

"(A) the donation of real property and improvements (including structures and equipment associated therewith) that includes a constructed facility; or

"(B) the construction by the entity of a facility on—

"(i) real property and improvements of the Department of Veterans Affairs; or

"(ii) real property and improvements donated to the Department by the entity.

"(2) Content of formal agreements.—With respect to an entity described in subsection (a)(2) that seeks to enter into a formal agreement under paragraph (1) of this subsection that includes the construction by the entity of a facility, the formal agreement shall provide for the following:

"(A) The entity shall conduct all necessary environmental and historic preservation due diligence, shall comply with all local zoning requirements (except for studies and consultations required of the Department under Federal law), and shall obtain all permits required in connection with the construction of the facility.

"(B) The entity shall use construction standards required of the Department when designing, repairing, altering, or building the facility, except to the extent the Secretary determines otherwise, as permitted by applicable law.

"(C) The entity shall provide the real property, improvements, goods, or services in a manner described in subsection (b)(2) sufficient to complete the construction of the facility, at no additional cost to the Federal Government.

"(d) No Payment of Rent or Usage Fees.—The Secretary may not pay rent, usage fees, or any other amounts to an entity described in subsection (a)(2) or any other entity for the use or occupancy of real property or improvements donated under this section.

"(e) Funding.—

"(1) From department.—

"(A) In general.—The Secretary may not provide funds to help the entity finance, design, or construct a facility in connection with real property and improvements donated under the pilot program by an entity described in subsection (a)(2) that are in addition to the funds appropriated for the facility as of the date on which the Secretary and the entity enter into a formal agreement under subsection (c) for the donation of the real property and improvements.

"(B) Terms and conditions.—The Secretary shall provide funds pursuant to subparagraph (A) under such terms, conditions, and schedule as the Secretary determines appropriate.

"(2) From entity.—An entity described in subsection (a)(2) that is donating a facility constructed by the entity under the pilot program shall be required, pursuant to a formal agreement entered into under subsection (c), to provide other funds in addition to the amounts provided by the Department under paragraph (1) that are needed to complete construction of the facility.

"(f) Application.—An entity described in subsection (a)(2) that seeks to donate real property and improvements under the pilot program shall submit to the Secretary an application to address needs relating to facilities of the Department, including health care needs, identified in the Construction and Long-Range Capital Plan of the Department, at such time, in such manner, and containing such information as the Secretary may require.

"(g) Information on Donations and Related Projects.—

"(1) In general.—The Secretary shall include in the budget submitted to Congress by the President pursuant to section 1105(a) of title 31, United States Code, information regarding real property and improvements donated under the pilot program during the year preceding the submittal of the budget and the status of facility projects relating to that property.

"(2) Elements.—Information submitted under paragraph (1) shall provide a detailed status of donations of real property and improvements conducted under the pilot program and facility projects relating to that property, including the percentage completion of the donations and projects.

"(h) Biennial Report of Comptroller General of the United States.—Not less frequently than once every 2 years until the termination date set forth in subsection (i), the Comptroller General of the United States shall submit to Congress a report on the donation agreements entered into under the pilot program.

"(i) Termination.—The authority for the Secretary to accept donations under the pilot program shall terminate on the date that is 5 years after the date of the enactment of this Act [Dec. 16, 2016].

"(j) Rule of Construction.—Nothing in this section shall be construed as a limitation on the authority of the Secretary to enter into other arrangements or agreements that are authorized by law and not inconsistent with this section."

Designation of Construction Agent for Certain Construction Projects by Department of Veterans Affairs

Pub. L. 114–92, div. A, title X, §1096, Nov. 25, 2015, 129 Stat. 1020, provided that:

"(a) In General.—The Secretary of Veterans Affairs shall seek to enter into an agreement subject to subsections (b), (c), and (e) of section 1535 of title 31, United States Code, with the Army Corps of Engineers or another entity of the Federal Government to serve, on a reimbursable basis, as the construction agent for the construction, alteration, or acquisition of any medical facility of the Department of Veterans Affairs specifically authorized by Congress after the date of the enactment of this Act [Nov. 25, 2015] that involves a total expenditure of more than $100,000,000, excluding any acquisition by exchange.

"(b) Agreement.—Under the agreement entered into under subsection (a), the construction agent shall provide design, procurement, and construction management services for the construction, alteration, and acquisition of medical facilities of the Department."

Development of Medical-Facility Modular Components

Pub. L. 99–166, title III, §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.

§8104. Congressional approval of certain medical facility acquisitions

(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 purposes 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 $20,000,000, but such term does not include an acquisition by exchange, nonrecurring maintenance projects of the Department, or the construction, alteration, or acquisition of a shared Federal medical facility for which the Department's estimated share of the project costs does not exceed $20,000,000.

(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 estimate of the total costs 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 detailed report 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. Such detailed estimate shall include an identification of each of the following:

(A) Total construction costs.

(B) Activation costs.

(C) Special purpose alterations (lump-sum payment) costs.

(D) Number of personnel.

(E) Total costs of ancillary services, equipment, and all other items.


(2) 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, a ten-year period, and a twenty-year period.

(3) Current and projected workload and utilization data regarding the facility, including information on projected changes in workload and utilization over a five-year period, a ten-year period, and a twenty-year period.

(4) Projected operating costs of the facility, including both recurring and non-recurring costs (including and identifying both recurring and non-recurring costs (including activation costs and total costs of ancillary services, equipment and all other items)) over a five-year period, a ten-year period, and a twenty-year period.

(5) 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.

(6) In the case of a prospectus proposing the construction of a new or replacement medical facility, each of the following:

(A) A detailed estimate of the total costs (including total construction costs, activation costs, special purpose alterations (lump-sum payment) costs, number of personnel and total costs of ancillary services, equipment and all other items) for each alternative to construction of the facility that was considered.

(B) A comparison of total costs to total benefits for each such alternative.

(C) An explanation of why the preferred alternative is the most effective means to achieve the stated project goals and the most cost-effective alternative.


(7) In the case of a prospectus proposing funding for a major medical facility lease, a detailed analysis of how the lease is expected to comply with Office of Management and Budget Circular A–11 and section 1341 of title 31 (commonly referred to as the "Anti-Deficiency Act"). Any such analysis shall include—

(A) an analysis of the classification of the lease as a "lease-purchase", "capital lease", or "operating lease" as those terms are defined in Office of Management and Budget Circular A–11;

(B) an analysis of the obligation of budgetary resources associated with the lease; and

(C) an analysis of the methodology used in determining the asset cost, fair market value, and cancellation costs of the lease.


(c)(1) 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.

(2) The Secretary shall—

(A) enter into a contract or agreement with an appropriate non-department Federal entity with the ability to conduct forensic audits on medical facility projects for the conduct of an external forensic audit of the expenditures relating to any major medical facility or super construction project for which the total expenditures exceed the amount requested in the initial budget request for the project submitted to Congress under section 1105 of title 31 by more than 25 percent; and

(B) enter into a contract or agreement with an appropriate non-department Federal entity with the ability to conduct forensic audits on medical facility projects for the conduct of an external audit of the medical center construction project in Aurora, Colorado.


(d)(1) Except as provided in paragraph (2), 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.

(2)(A) In any fiscal year, unobligated amounts in the Construction, Major Projects account that are a direct result of bid savings from a major construction project may only be obligated for major construction projects authorized for that fiscal year or a previous fiscal year.

(B) Whenever the Secretary obligates amounts for a major construction project under subparagraph (A), the Secretary shall submit to the Committee on Veterans' Affairs and the Committee on Appropriations of the Senate and the Committee on Veterans' Affairs and the Committee on Appropriations of the House of Representatives notice of the following:

(i) The major construction project that is the source of the bid savings.

(ii) If the major construction project that is the source of the bid savings is not complete—

(I) the amount already obligated by the Department or available in the project reserve for such project;

(II) the percentage of such project that has been completed; and

(III) the amount available to the Department to complete such project.


(iii) The other major construction project for which the bid savings amounts are being obligated.

(iv) The bid savings amounts being obligated for such other major construction project.


(C) The Secretary may not obligate an amount under subparagraph (A) to expand the purpose of a major construction project except pursuant to a provision of law enacted after the date on which the Secretary submits to the committees described in subparagraph (B) notice of the following:

(i) The major construction project that is the source of the bid savings.

(ii) The major construction project for which the Secretary intends to expand the purpose.

(iii) A description of such expansion of purpose.

(iv) The amounts the Secretary intends to obligate to expand the purpose.


(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).

(h)(1) Not less than 30 days before entering into a major medical facility lease, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and the House of Representatives—

(A) notice of the Secretary's intention to enter into the lease;

(B) a detailed summary of the proposed lease;

(C) a description and analysis of any differences between the prospectus submitted pursuant to subsection (b) and the proposed lease; and

(D) a scoring analysis demonstrating that the proposed lease fully complies with Office of Management and Budget Circular A–11.


(2) Each committee described in paragraph (1) shall ensure that any information submitted to the committee under such paragraph is treated by the committee with the same level of confidentiality as is required by law of the Secretary and subject to the same statutory penalties for unauthorized disclosure or use as the Secretary.

(3) Not more than 30 days after entering into a major medical facility lease, the Secretary shall submit to each committee described in paragraph (1) a report on any material differences between the lease that was entered into and the proposed lease described under such paragraph, including how the lease that was entered into changes the previously submitted scoring analysis described in subparagraph (D) of such paragraph.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 56, §5004; amended Pub. L. 99–166, title III, §§301, 303, Dec. 3, 1985, 99 Stat. 954, 955; Pub. L. 99–576, title II, §221(b), Oct. 28, 1986, 100 Stat. 3259; Pub. L. 100–322, title IV, §422, May 20, 1988, 102 Stat. 553; renumbered §8104 and amended Pub. L. 102–40, title IV, §402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–83, §4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 102–405, title III, §301(a), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 103–79, §3(a), Aug. 13, 1993, 107 Stat. 771; Pub. L. 104–262, title II, §§205(a), 206(a), (c), Oct. 9, 1996, 110 Stat. 3189, 3190; Pub. L. 105–368, title VII, §704, Nov. 11, 1998, 112 Stat. 3350; Pub. L. 108–170, title II, §201, Dec. 6, 2003, 117 Stat. 2047; Pub. L. 108–422, title IV, §416, Nov. 30, 2004, 118 Stat. 2393; Pub. L. 109–461, title VIII, §812, Dec. 22, 2006, 120 Stat. 3447; Pub. L. 110–387, title VII, §705, Oct. 10, 2008, 122 Stat. 4138; Pub. L. 111–275, title IX, §905, Oct. 13, 2010, 124 Stat. 2895; Pub. L. 112–37, §§6, 7, Oct. 5, 2011, 125 Stat. 394, 396; Pub. L. 113–146, title VI, §602(c), Aug. 7, 2014, 128 Stat. 1794; Pub. L. 114–315, title VIII, §801(b), (c), Dec. 16, 2016, 130 Stat. 1590; Pub. L. 115–182, title V, §503(b), June 6, 2018, 132 Stat. 1476.)

Amendments

2018—Subsec. (a)(3). Pub. L. 115–182, which directed the general amendment of par. (3) of section 8104(a), without specifying the Code title to be amended, was executed by amending par. (3) of subsec. (a) of this section, to reflect the probable intent of Congress. Prior to amendment, par. (3) read as follows: "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 $10,000,000, 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 $1,000,000."

2016—Subsec. (c). Pub. L. 114–315, §801(b), designated existing provisions as par. (1) and added par. (2).

Subsec. (d)(2)(B)(ii) to (iv). Pub. L. 114–315, §801(c), added cl. (ii), redesignated former cls. (ii) and (iii) as (iii) and (iv), respectively, and in cls. (iii) and (iv) substituted "bid savings amounts" for "amounts".

2014—Subsec. (b)(7). Pub. L. 113–146, §602(c)(1), added par. (7).

Subsec. (h). Pub. L. 113–146, §602(c)(2), added subsec. (h).

2011—Subsec. (b)(1). Pub. L. 112–37, §6(1)(A), substituted "detailed estimate of the total costs" for "detailed description" and "a detailed report of the consideration" for "a description of the consideration" and inserted at end "Such detailed estimate shall include an identification of each of the following:" and subpars. (A) to (E).

Subsec. (b)(2). Pub. L. 112–37, §6(1)(B), (C), struck out par. (2), redesignated par. (4) as (2), and substituted "a five-year period, a ten-year period, and a twenty-year period" for "a five-year period and a ten-year period". Prior to amendment, par. (2) read as follows: "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)."

Subsec. (b)(3). Pub. L. 112–37, §6(1)(B), (D), struck out par. (3), redesignated par. (5) as (3), and inserted before period at end ", including information on projected changes in workload and utilization over a five-year period, a ten-year period, and a twenty-year period". Prior to amendment, par. (3) read as follows: "An estimate of the cost to the United States of the equipment required for the operation of such facility."

Subsec. (b)(4). Pub. L. 112–37, §6(1)(B), (E), redesignated par. (6) as (4), substituted "Projected" for "Current and projected", and inserted before period at end "(including and identifying both recurring and non-recurring costs (including activation costs and total costs of ancillary services, equipment and all other items)) over a five-year period, a ten-year period, and a twenty-year period". Former par. (4) redesignated (2).

Subsec. (b)(5). Pub. L. 112–37, §6(1)(B), redesignated par. (7) as (5). Former par. (5) redesignated (3).

Subsec. (b)(6). Pub. L. 112–37, §6(1)(B), (F), redesignated par. (8) as (6), substituted "each of the following:" for "a description of each alternative to construction of the facility that was considered.", and added subpars. (A) to (C). Former par. (6) redesignated (4).

Subsec. (b)(7),(8). Pub. L. 112–37, §6(1)(B), redesignated pars. (7) and (8) as (5) and (6), respectively.

Subsec. (d). Pub. L. 112–37, §6(2)(A), substituted "major construction project" for "major medical facility project" wherever appearing.

Subsec. (d)(2)(A). Pub. L. 112–37, §6(2)(B)(i), substituted "major construction projects" for "major medical facility projects".

Subsec. (d)(2)(B). Pub. L. 112–37, §6(2)(B)(ii), substituted "major construction project" for "major medical facility" in introductory provisions.

Subsec. (d)(2)(C). Pub. L. 112–37, §7, added subpar. (C).

2010—Subsec. (d). Pub. L. 111–275 designated existing provisions as par. (1), substituted "Except as provided in paragraph (2), in any case" for "In any case", and added par. (2).

2008—Subsec. (a)(3)(B). Pub. L. 110–387 substituted "$1,000,000" for "$600,000".

2006—Subsec. (a)(3)(A). Pub. L. 109–461 substituted "$10,000,000" for "$7,000,000".

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, §206(a), substituted "$4,000,000" for "$3,000,000".

Subsec. (b). Pub. L. 104–262, §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, §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, §205(a)(5), added pars. (4) to (8).

Subsec. (f). Pub. L. 104–262, §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, §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, §301(a)(2), inserted "new" after "as a" and substituted "$300,000" for "$500,000".

Subsec. (c). Pub. L. 102–405, §301(a)(3), substituted "law" for "resolution" in two places.

1991Pub. L. 102–40, §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, §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, §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, §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, §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, §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, §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, §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

Pub. L. 104–262, title II, §205(b), Oct. 9, 1996, 110 Stat. 3190, 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

Pub. L. 104–262, title II, §206(b)(2), Oct. 9, 1996, 110 Stat. 3190, 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."

Pub. L. 102–405, title III, §301(b), Oct. 9, 1992, 106 Stat. 1984, 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, §206(b)(1), Oct. 9, 1996, 110 Stat. 3190.

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

Budgetary Treatment of Department of Veterans Affairs Major Medical Facilities Leases

Pub. L. 113–146, title VI, §602, Aug. 7, 2014, 128 Stat. 1794, provided that:

"(a) Findings.—Congress finds the following:

"(1) Title 31, United States Code, requires the Department of Veterans Affairs to record the full cost of its contractual obligation against funds available at the time a contract is executed.

"(2) Office of Management and Budget Circular A–11 provides guidance to agencies in meeting the statutory requirements under title 31, United States Code, with respect to leases.

"(3) For operating leases, Office of Management and Budget Circular A–11 requires the Department of Veterans Affairs to record up-front budget authority in an 'amount equal to total payments under the full term of the lease or [an] amount sufficient to cover first year lease payments plus cancellation costs'.

"(b) Requirement for Obligation of Full Cost.—

"(1) In general.—Subject to the availability of appropriations provided in advance, in exercising the authority of the Secretary of Veterans Affairs to enter into leases provided in this Act, the Secretary shall record, pursuant to section 1501 of title 31, United States Code, as the full cost of the contractual obligation at the time a contract is executed either—

"(A) an amount equal to total payments under the full term of the lease; or

"(B) if the lease specifies payments to be made in the event the lease is terminated before its full term, an amount sufficient to cover the first year lease payments plus the specified cancellation costs.

"(2) Self-insuring authority.—The requirements of paragraph (1) may be satisfied through the use of the self-insuring authority identified in title 40, United States Code, consistent with Office of Management and Budget Circular A–11.

"(c) Transparency.—[Amended subsecs. (b)(7) and (h) of this section.]

"(d) Rule of Construction.—Nothing in this section, or the amendments made by this section, shall be construed to in any way relieve the Department of Veterans Affairs from any statutory or regulatory obligations or requirements existing prior to the enactment of this section and such amendments."

§8105. Structural requirements

(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.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 57, §5005; amended Pub. L. 96–128, title V, §501(e), Nov. 28, 1979, 93 Stat. 987; renumbered §8105, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984.)

Amendments

1992—Subsec. (b)(3). Pub. L. 102–405 substituted "Under Secretary for Health" for "Chief Medical Director" in two places.

1991Pub. L. 102–40 renumbered section 5005 of this title as this section.

Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted "1720" for "620".

Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places.

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing.

Pub. L. 102–83, §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.

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 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.

§8106. Construction contracts

(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.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 58, §5006; renumbered §8106, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102–83, §4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.)

Amendments

1991Pub. L. 102–40 renumbered section 5006 of this title as this section.

Pub. L. 102–83 substituted "Secretary" for "Administrator" wherever appearing.

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

[§8107. Repealed. Pub. L. 111–163, title V, §501(b)(1), May 5, 2010, 124 Stat. 1157]

Section, added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 58, §5007; amended Pub. L. 99–166, title III, §302(a)–(c)(1), Dec. 3, 1985, 99 Stat. 955; Pub. L. 99–576, title II, §222, Oct. 28, 1986, 100 Stat. 3259; renumbered §8107 and amended Pub. L. 102–40, title IV, §402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–54, §14(f)(3), June 13, 1991, 105 Stat. 287; Pub. L. 102–83, §4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 104–262, title II, §204, Oct. 9, 1996, 110 Stat. 3188; Pub. L. 105–368, title X, §1005(b)(18), Nov. 11, 1998, 112 Stat. 3365; Pub. L. 108–170, title II, §203, Dec. 6, 2003, 117 Stat. 2048, related to operational and construction plans for medical facilities.

§8108. Contributions to local authorities

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.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 58, §5008; renumbered §8108, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102–83, §4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.)

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

1991Pub. L. 102–40 renumbered section 5008 of this title as this section.

Pub. L. 102–83 substituted "Secretary" for "Administrator".

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

§8109. Parking facilities

(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;

(3) may operate and maintain parking facilities; and

(4) notwithstanding subsection (a) of section 1344 of title 31, may use a passenger carrier (as such term is defined in subsection (h)(1) of such section) to transport such an employee between a parking facility and the medical facility of the Department at which the employee works.


(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.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 59, §5009; amended Pub. L. 99–576, title II, §223(a)(1), Oct. 28, 1986, 100 Stat. 3259; renumbered §8109 and amended Pub. L. 102–40, title IV, §402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–83, §4(a)(3), (4), (b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 103–79, §3(b), Aug. 13, 1993, 107 Stat. 771; Pub. L. 104–262, title II, §207(b), Oct. 9, 1996, 110 Stat. 3190; Pub. L. 105–368, title VII, §705, Nov. 11, 1998, 112 Stat. 3350; Pub. L. 108–422, title IV, §415, Nov. 30, 2004, 118 Stat. 2393; Pub. L. 115–141, div. J, title II, §234, Mar. 23, 2018, 132 Stat. 820.)

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

2018—Subsec. (b)(4). Pub. L. 115–141 added par. (4).

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".

1991Pub. L. 102–40, §402(b)(1), renumbered section 5009 of this title as this section.

Subsecs. (a) to (c). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing.

Subsec. (d)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in concluding provisions.

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" in subpar. (A).

Subsecs. (d)(2), (e), (f). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing.

Subsec. (i)(2). Pub. L. 102–40, §402(d)(1), substituted "8104(a)(2)" for "5004(a)(2)".

1986Pub. 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

Pub. L. 99–576, title II, §223(b), Oct. 28, 1986, 100 Stat. 3261, 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."

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

§8110. Operation of medical facilities

(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 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.

(d) 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.


(e) 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.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 59, §5010; amended Pub. L. 96–151, title III, §301(a), Dec. 20, 1979, 93 Stat. 1095; Pub. L. 97–66, title VI, §601(b), Oct. 17, 1981, 95 Stat. 1033; Pub. L. 97–72, title I, §108, Nov. 3, 1981, 95 Stat. 1053; Pub. L. 97–306, title IV, §409(b), Oct. 14, 1982, 96 Stat. 1446; Pub. L. 97–452, §2(e)(4), Jan. 12, 1983, 96 Stat. 2479; Pub. L. 98–160, title VII, §702(19), Nov. 21, 1983, 97 Stat. 1010; Pub. L. 98–528, title I, §102, Oct. 19, 1984, 98 Stat. 2688; Pub. L. 99–576, title VII, §702(15), Oct. 28, 1986, 100 Stat. 3302; Pub. L. 100–322, title II, §222(a), title IV, §401(a), May 20, 1988, 102 Stat. 531, 543; renumbered §8110 and amended Pub. L. 102–40, title IV, §402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 103–446, title XI, §1103, title XII, §1201(b)(1), (d)(17), (g)(7), Nov. 2, 1994, 108 Stat. 4681, 4682, 4684, 4687; Pub. L. 104–66, title I, §1141(c), Dec. 21, 1995, 109 Stat. 726; Pub. L. 104–262, title I, §101(e)(4), title III, §305, Oct. 9, 1996, 110 Stat. 3181, 3194; Pub. L. 106–117, title III, §301, Nov. 30, 1999, 113 Stat. 1571; Pub. L. 107–135, title I, §124, Jan. 23, 2002, 115 Stat. 2452; Pub. L. 107–314, div. A, title VII, §726(a), Dec. 2, 2002, 116 Stat. 2599; Pub. L. 115–251, title II, §207, Sept. 29, 2018, 132 Stat. 3173.)

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

2018—Subsecs. (c) to (f). Pub. L. 115–251 redesignated subsecs. (d) to (f) as (c) to (e), respectively, and struck out former subsec. (c) which read as follows: "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."

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, §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, §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, §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, §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, §101(e)(4), substituted "section 1710(a)" for "section 1712".

Subsec. (c). Pub. L. 104–262, §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, §1201(b)(1), substituted "Veterans Health Administration" for "Department of Medicine and Surgery" wherever appearing.

Subsec. (c)(3)(B). Pub. L. 103–446, §1201(d)(17), substituted "section 513 or 7409" for "section 213 or 4117".

Subsec. (c)(7). Pub. L. 103–446, §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, §1103. See below.

Pub. L. 103–446, §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, §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.

1991Pub. L. 102–40, §402(b)(1), renumbered section 5010 of this title as this section.

Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted "1712" for "612" in par. (2).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing.

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing.

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing.

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" in two places.

Subsec. (c). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" and "Secretary's" for "Administrator's" wherever appearing.

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing.

Pub. L. 102–40, §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, §222(a), added par. (6).

Subsec. (c)(2). Pub. L. 100–322, §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, §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, §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, §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, §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, §601(b)(1)(B), inserted "(or part of a fiscal year)" after "fiscal year" in two places.

Subsec. (a)(5). Pub. L. 97–66, §601(b)(2), added par. (5).

Subsecs. (b), (c). Pub. L. 97–72, §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, §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

Pub. L. 100–322, title II, §222(b), May 20, 1988, 102 Stat. 531, provided that: "The amendment made by subsection (a) [amending this section] shall apply with respect to fiscal years after fiscal year 1987."

Pub. L. 100–322, title IV, §401(b), May 20, 1988, 102 Stat. 543, 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

Pub. L. 96–151, title III, §301(b), Dec. 20, 1979, 93 Stat. 1096, 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."

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

Health Care in Underserved Areas

Pub. L. 115–182, title IV, §§401, 402, June 6, 2018, 132 Stat. 1470, 1471, as amended by Pub. L. 115–251, title II, §211(b)(8), Sept. 29, 2018, 132 Stat. 3177, provided that:

"SEC. 401. DEVELOPMENT OF CRITERIA FOR DESIGNATION OF CERTAIN MEDICAL FACILITIES OF THE DEPARTMENT OF VETERANS AFFAIRS AS UNDERSERVED FACILITIES AND PLAN TO ADDRESS PROBLEM OF UNDERSERVED FACILITIES.

"(a) In General.—Not later than 180 days after the date of the enactment of this Act [June 6, 2018], the Secretary of Veterans Affairs shall develop criteria to designate medical centers, ambulatory care facilities, and community based outpatient clinics of the Department of Veterans Affairs as underserved facilities.

"(b) Consideration.—Criteria developed under subsection (a) shall include consideration of the following with respect to a facility:

"(1) The ratio of veterans to health care providers of the Department of Veterans Affairs for a standardized geographic area surrounding the facility, including a separate ratio for general practitioners and specialists.

"(2) The range of clinical specialties covered by such providers in such area.

"(3) Whether the local community is medically underserved.

"(4) The type, number, and age of open consults.

"(5) Whether the facility is meeting the wait-time goals of the Department or the applicable access standards developed under section 1703B of title 38, United States Code.

"(6) Such other criteria as the Secretary considers important in determining which facilities are not adequately serving area veterans.

"(c) Analysis of Facilities.—Not less frequently than annually, directors of Veterans Integrated Service Networks of the Department shall perform an analysis to determine which facilities within that Veterans Integrated Service Network qualify as underserved facilities pursuant to criteria developed under subsection (a).

"(d) Annual Plan To Address Underserved Facilities.—

"(1) Plan required.—Not later than 1 year after the date of the enactment of this Act [June 6, 2018] and not less frequently than once each year, the Secretary shall submit to Congress a plan to address the problem of underserved facilities of the Department, as designated pursuant to criteria developed under subsection (a).

"(2) Contents.—Each plan submitted under paragraph (1) shall address the following:

"(A) Increasing personnel or temporary personnel assistance, including mobile deployment teams furnished under section 402 of this Act.

"(B) Providing special hiring incentives, including under the Education Debt Reduction Program under subchapter VII of chapter 76 of title 38, United States Code, and recruitment, relocation, and retention incentives.

"(C) Using direct hiring authority.

"(D) Improving training opportunities for staff.

"(E) Such other actions as the Secretary considers appropriate.

"SEC. 402. PILOT PROGRAM TO FURNISH MOBILE DEPLOYMENT TEAMS TO UNDERSERVED FACILITIES.

"(a) In General.—The Secretary of Veterans Affairs shall carry out a pilot program to furnish mobile deployment teams of medical personnel to underserved facilities.

"(b) Elements.—In furnishing mobile deployment teams under subsection (a), the Secretary shall consider the following elements:

"(1) The medical positions of greatest need at underserved facilities.

"(2) The size and composition of teams to be deployed.

"(3) Such other elements as the Secretary considers necessary for effective oversight of the program established under subsection (a).

"(c) Use of Annual Analysis.—The Secretary shall use the results of the annual analysis conducted under section 401(c) of this Act to form mobile deployment teams under subsection (a) that are composed of the most needed medical personnel for underserved facilities.

"(d) Reporting.—

"(1) Progress report.—Not later than 1 year after the date of the enactment of this Act [June 6, 2018], the Secretary shall submit a report to Congress on the implementation of the pilot program under this section.

"(2) Final report.—Not later than the termination of the pilot program under this section, the Secretary shall submit a final report to Congress that contains the recommendations of the Secretary regarding the feasibility and advisability of—

"(A) extending or expanding the pilot program; and

"(B) making the pilot program (or any aspect thereof) permanent.

"(e) Duration.—The pilot program under this section shall terminate 3 years after the date of the enactment of this Act [June 6, 2018].

"(f) Underserved Facility Defined.—In this section, the term 'underserved facility' means a medical center, ambulatory care facility, or community based outpatient clinic of the Department of Veterans Affairs designated by the Secretary of Veterans Affairs as underserved pursuant to criteria developed under section 401 of this Act."

Inventory of Medical Waste Management Activities at Department of Veterans Affairs Health Care Facilities

Pub. L. 108–422, title VI, §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

Pub. L. 100–322, title I, §136, May 20, 1988, 102 Stat. 507, 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

Pub. L. 97–306, title IV, §409(a), Oct. 14, 1982, 96 Stat. 1446, 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."

§8111. Sharing of Department of Veterans Affairs and Department of Defense health care resources

(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 plan of each Department under section 306 of title 5 and the performance plan of each Department under section 1115 of title 31.

(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, §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, 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, 2020.

(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 revised periodically as necessary. The two Secretaries 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.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 60, §5011; amended Pub. L. 97–174, §3(a), (b)(1), May 4, 1982, 96 Stat. 70, 73; Pub. L. 97–452, §2(e)(4), Jan. 12, 1983, 96 Stat. 2479; renumbered §8111 and amended Pub. L. 102–40, title IV, §402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 103–446, title XII, §1201(g)(8), (i)(10), Nov. 2, 1994, 108 Stat. 4687, 4688; Pub. L. 107–135, title II, §208(e)(6), Jan. 23, 2002, 115 Stat. 2464; Pub. L. 107–314, div. A, title VII, §721(a)(1), Dec. 2, 2002, 116 Stat. 2589; Pub. L. 108–136, div. A, title V, §583(b), (c), Nov. 24, 2003, 117 Stat. 1491, 1492; Pub. L. 108–422, title VI, §605, Nov. 30, 2004, 118 Stat. 2399; Pub. L. 109–163, div. A, title VII, §747(a), title X, §1056(g), Jan. 6, 2006, 119 Stat. 3363, 3440; Pub. L. 109–364, div. A, title VII, §743, Oct. 17, 2006, 120 Stat. 2308; Pub. L. 109–444, §8(a)(6), (7), Dec. 21, 2006, 120 Stat. 3313; Pub. L. 109–461, title X, §§1004(a)(6), (7), 1006(b), Dec. 22, 2006, 120 Stat. 3465, 3468; Pub. L. 111–84, div. A, title XVII, §1706, Oct. 28, 2009, 123 Stat. 2574; Pub. L. 114–58, title I, §107, Sept. 30, 2015, 129 Stat. 532; Pub. L. 114–92, div. A, title VII, §722, Nov. 25, 2015, 129 Stat. 869.)

References in Text

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 (§§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.

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

2015—Subsec. (d)(3). Pub. L. 114–92, which directed substitution of "September 30, 2020" for "September 30, 2015", was executed by making the substitution for "September 30, 2016" to reflect the probable intent of Congress and the intervening amendment by Pub. L. 114–58. See below.

Pub. L. 114–58 substituted "September 30, 2016" for "September 30, 2015".

2009—Subsec. (d)(3). Pub. L. 111–84 substituted "September 30, 2015" for "September 30, 2010".

2006Pub. L. 109–461, §1006(b), provided that as of the enactment of Pub. L. 109–461, the amendments made by Pub. L. 109–444 were deemed for all purposes not to have taken effect and that Pub. L. 109–444 ceased to be in effect. See Amendment notes below and section 1006(b) of Pub. L. 109–461, set out as a Coordination of Provisions With Pub. L. 109–444 note under section 101 of this title.

Subsec. (b)(1). Pub. L. 109–461, §1004(a)(6), substituted "into the strategic plan of each Department under section 306 of title 5 and the performance plan of each Department under section 1115 of title 31" for "into the strategic and performance plan of each Department under the Government Performance and Results Act of 1993".

Pub. L. 109–444, §8(a)(6), which substituted "into the strategic plan of each Department under section 306 of title 5 and the performance plan of each Department under section 1115 of title 31" for "into the strategic and performance plan of each Department under the Government Performance and Results Act of 1993", was terminated by Pub. L. 109–461, §1006(b). See Amendment notes above.

Pub. L. 109–163, §1056(g), inserted "of 1993" after "Government Performance and Results Act".

Subsec. (d)(2). Pub. L. 109–461, §1004(a)(7)(A), struck out "effective October 1, 2003," after "the incentive program,".

Pub. L. 109–444, §8(a)(7)(A), which struck out "effective October 1, 2003," after "the incentive program,", was terminated by Pub. L. 109–461, §1006(b). See Amendment notes above.

Subsec. (d)(3). Pub. L. 109–364 substituted "September 30, 2010" for "September 30, 2007".

Pub. L. 109–163, §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.

Subsec. (d)(4). Pub. L. 109–163, §747(a)(2), redesignated par. (4) as (3).

Subsec. (e)(2). Pub. L. 109–461, §1004(a)(7)(B), struck out "shall be implemented no later than October 1, 2003, and" after "Such schedule" in second sentence and ", following implementation of the schedule," after "The two Secretaries" in third sentence.

Pub. L. 109–444, §8(a)(7)(B), which struck out "shall be implemented no later than October 1, 2003, and" after "Such schedule" in second sentence and ", following implementation of the schedule," after "The two Secretaries" in third sentence, was terminated by Pub. L. 109–461, §1006(b). See Amendment notes above.

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, §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, §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, §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, §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, §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, §583(c), inserted "(Public Law 107–314)" after "for Fiscal Year 2003".

2002Pub. 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, §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, §208(e)(6)(B), substituted "section 1782, 1783, or 1784" for "section 1711(b) or 1713".

1994—Subsec. (b)(2). Pub. L. 103–446, §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, §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, §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.

1991Pub. L. 102–40, §402(b)(1), renumbered section 5011 of this title as this section.

Pub. L. 102–83, §4(a)(3), (4), substituted "Sharing of Department" for "Sharing of Veterans' Administration" in section catchline.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" in two places.

Pub. L. 102–40, §402(d)(1), substituted "8110(a)(1)" for "5010(a)(1)".

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in par. (4).

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing in pars. (1) and (2)(A).

Subsec. (c)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator".

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".

Subsec. (f). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in introductory provisions and in par. (6).

Subsec. (g). Pub. L. 102–83, §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, §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))".

1982Pub. L. 97–174, §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, §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, §3(a)(3), added subsecs. (b) to (g).

Effective Date of 2002 Amendment

Pub. L. 107–314, div. A, title VII, §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."

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

Guidelines for Combined Medical Facilities of the Department of Defense and the Department of Veterans Affairs

Pub. L. 110–417, [div. A], title VII, §706, Oct. 14, 2008, 122 Stat. 4500, provided that: "Before a facility may be designated a combined Federal medical facility of the Department of Defense and the Department of Veterans Affairs, the Secretary of Defense and the Secretary of Veterans Affairs shall execute a signed agreement that specifies, at a minimum, a binding operational agreement on the following areas:

"(1) Governance.

"(2) Patient priority categories.

"(3) Budgeting.

"(4) Staffing and training.

"(5) Construction.

"(6) Physical plant management.

"(7) Contingency planning.

"(8) Quality assurance.

"(9) Information technology."

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, §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, §722, Dec. 2, 2002, 116 Stat. 2595, as amended by Pub. L. 109–163, div. A, title VII, §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 to improve the sharing and coordination of health care and health care resources between the Department of Veterans Affairs and the Department of Defense. The project shall be carried out, as a minimum, at the sites identified under subsection (b).

"(2) Reimbursement between the two Departments with respect to the project under this section shall be made in accordance with the provisions of section 8111(e)(2) of title 38, United States Code, as amended by section 721(a).

"(b) Site Identification.—(1) Not later than 90 days after the date of the enactment of this Act [Dec. 2, 2002], the Secretaries shall jointly identify not less than three sites for the conduct of the project under this section.

"(2) For purposes of this section, a site at which the resource sharing project shall be carried out is an area in the United States in which—

"(A) one or more military treatment facilities and one or more VA health care facilities are situated in relative proximity to each other, including facilities engaged in joint ventures as of the date of the enactment of this Act; and

"(B) for which an agreement to coordinate care and programs for patients at those facilities could be implemented not later than October 1, 2004.

"(c) Conduct of Project.—(1) At sites at which the project is conducted, the Secretaries shall provide a test of a coordinated management system for the military treatment facilities and VA health care facilities participating in the project. Such a coordinated management system for a site shall include at least one of the elements specified in paragraph (2), and each of the elements specified in that paragraph must be included in the coordinated management system for at least one of the participating sites.

"(2) Elements of a coordinated management system referred to in paragraph (1) are the following:

"(A) A budget and financial management system for those facilities that—

"(i) provides managers with information about the costs of providing health care by both Departments at the site; and

"(ii) allows managers to assess the advantages and disadvantages (in terms of relative costs, benefits, and opportunities) of using resources of either Department to provide or enhance health care to beneficiaries of either Department.

"(B) A coordinated staffing and assignment system for the personnel (including contract personnel) employed at or assigned to those facilities, including clinical practitioners of either Department.

"(C) Medical information and information technology systems for those facilities that—

"(i) are compatible with the purposes of the project;

"(ii) communicate with medical information and information technology systems of corresponding elements of those facilities; and

"(iii) incorporate minimum standards of information quality that are at least equivalent to those adopted for the Departments at large in their separate health care systems.

"(d) Authority To Waive Certain Administrative Policies.—(1)(A) In order to carry out subsection (c), the Secretary of Defense may, in the Secretary's discretion, waive any administrative policy of the Department of Defense otherwise applicable to that subsection that specifically conflicts with the purposes of the project, in instances in which the Secretary determines that the waiver is necessary for the purposes of the project.

"(B) In order to carry out subsection (c), the Secretary of Veterans Affairs may, in the Secretary's discretion, waive any administrative policy of the Department of Veterans Affairs otherwise applicable to that subsection that specifically conflicts with the purposes of the project, in instances in which the Secretary determines that the waiver is necessary for the purposes of the project.

"(C) The two Secretaries shall establish procedures for resolving disputes that may arise from the effects of policy changes that are not covered by other agreements or existing procedures.

"(2) No waiver under paragraph (1) may alter any labor-management agreement in effect as of the date of the enactment of this Act [Dec. 2, 2002] or adopted by either Department during the period of the project.

"(e) Use by DOD of Certain Title 38 Personnel Authorities.—(1) In order to carry out subsection (c), the Secretary of Defense may apply to civilian personnel of the Department of Defense assigned to or employed at a military treatment facility participating in the project any of the provisions of subchapters I, III, and IV of chapter 74 of title 38, United States Code, determined appropriate by the Secretary.

"(2) For purposes of paragraph (1), any reference in chapter 74 of title 38, United States Code

"(A) to the 'Secretary' or the 'Under Secretary for Health' shall be treated as referring to the Secretary of Defense; and

"(B) to the 'Veterans Health Administration' shall be treated as referring to the Department of Defense.

"(f) Funding.—From amounts available for health care for a fiscal year, each Secretary shall make available to carry out the project not less than—

"(1) $3,000,000 for fiscal year 2003;

"(2) $6,000,000 for fiscal year 2004; and

"(3) $9,000,000 for each succeeding year during which the project is in effect.

"(g) Definitions.—For purposes of this section:

"(1) The term 'military treatment facility' means a medical facility under the jurisdiction of the Secretary of a military department.

"(2) The term 'VA health care facility' means a facility under the jurisdiction of the Veterans Health Administration of the Department of Veterans Affairs.

"(h) Termination.—(1) The project, and the authority provided by this section, shall terminate on September 30, 2007.

"(2) The two Secretaries jointly may terminate the performance of the project at any site when the performance of the project at that site fails to meet performance expectations of the Secretaries, as determined by the Secretaries based on information available to the Secretaries to warrant such action."

Access to Care for TRICARE-Eligible Military Retirees

Pub. L. 106–117, title I, §113, Nov. 30, 1999, 113 Stat. 1556, as amended by Pub. L. 108–7, div. K, title I, §113(d)(2), Feb. 20, 2003, 117 Stat. 483, provided that:

"(a) Interagency Agreement.—(1) The Secretary of Defense shall enter into an agreement (characterized as a memorandum of understanding or otherwise) with the Secretary of Veterans Affairs with respect to the provision of medical care by the Secretary of Veterans Affairs to eligible military retirees in accordance with the provisions of subsection (c). That agreement shall include provisions for reimbursement of the Secretary of Veterans Affairs by the Secretary of Defense for medical care provided by the Secretary of Veterans Affairs to an eligible military retiree and may include such other provisions with respect to the terms and conditions of such care as may be agreed upon by the two Secretaries.

"(2) Reimbursement under the agreement under paragraph (1) shall be in accordance with rates agreed upon by the Secretary of Defense and the Secretary of Veterans Affairs. Such reimbursement may be made by the Secretary of Defense or by the appropriate TRICARE Managed Care Support contractor, as determined in accordance with that agreement.

"(3) In entering into the agreement under paragraph (1), particularly with respect to determination of the rates of reimbursement under paragraph (2), the Secretary of Defense shall consult with TRICARE Managed Care Support contractors.

"(4) The Secretary of Veterans Affairs may not enter into an agreement under paragraph (1) for the provision of care in accordance with the provisions of subsection (c) with respect to any geographic service area, or a part of any such area, of the Veterans Health Administration unless—

"(A) in the judgment of that Secretary, the Department of Veterans Affairs will recover the costs of providing such care to eligible military retirees; and

"(B) that Secretary has certified and documented, with respect to any geographic service area in which the Secretary proposes to provide care in accordance with the provisions of subsection (c), that such geographic service area, or designated part of any such area, has adequate capacity (consistent with the requirements in section 1705(b)(1) of title 38, United States Code, that care to enrollees shall be timely and acceptable in quality) to provide such care.

"(5) The agreement under paragraph (1) shall be entered into by the Secretaries not later than nine months after the date of the enactment of this Act [Nov. 30, 1999]. If the Secretaries are unable to reach agreement, they shall jointly report, by that date or within 30 days thereafter, to the Committees on Armed Services and the Committees on Veterans' Affairs of the Senate and House of Representatives on the reasons for their inability to reach an agreement and their mutually agreed plan for removing any impediments to final agreement.

"(b) Depositing of Reimbursements.—Amounts received by the Secretary of Veterans Affairs under the agreement under subsection (a) shall be deposited in the Department of Veterans Affairs Medical Care Collections Fund established under section 1729A of title 38, United States Code.

"(c) Copayment Requirement.—The provisions of subsections (f)(1) and (g)(1) of section 1710 of title 38, United States Code, shall not apply in the case of an eligible military retiree who is covered by the agreement under subsection (a).

"(d) Phased Implementation.—(1) The Secretary of Defense shall include in each TRICARE contract entered into after the date of the enactment of this Act [Nov. 30, 1999] provisions to implement the agreement under subsection (a).

"(2) The provisions of the agreement under subsection (a)(2) and the provisions of subsection (c) shall apply to the furnishing of medical care by the Secretary of Veterans Affairs in any area of the United States only if that area is covered by a TRICARE contract that was entered into after the date of the enactment of this Act.

"(e) Eligible Military Retirees.—For purposes of this section, an eligible military retiree is a member of the Army, Navy, Air Force, or Marine Corps who—

"(1) has retired from active military, naval, or air service;

"(2) is eligible for care under the TRICARE program established by the Secretary of Defense;

"(3) has enrolled for care under section 1705 of title 38, United States Code; and

"(4) is not described in paragraph (1) or (2) of section 1710(a) of such title."

Health-Care Sharing Agreements Between Department of Veterans Affairs and Department of Defense

Pub. L. 106–398, §1 [[div. A], title VII, §741], Oct. 30, 2000, 114 Stat. 1654, 1654A-192, provided that:

"(a) Primacy of Sharing Agreements.—The Secretary of Defense shall—

"(1) give full force and effect to any agreement into which the Secretary or the Secretary of a military department entered under section 8111 of title 38, United States Code, or under section 1535 of title 31, United States Code, which was in effect on September 30, 1999; and

"(2) ensure that the Secretary of the military department concerned directly reimburses the Secretary of Veterans Affairs for any services or resources provided under such agreement in accordance with the terms of such agreement, including terms providing for reimbursement from funds available for that military department.

"(b) Modification or Termination.—Any agreement described in subsection (a) shall remain in effect in accordance with such subsection unless, during the 12-month period following the date of the enactment of this Act [Oct. 30, 2000], such agreement is modified or terminated in accordance with the terms of such agreement."

Pub. L. 104–262, title III, §302(b)(2), Oct. 9, 1996, 110 Stat. 3193, provided that: "Any services provided pursuant to agreements entered into under section 201 of such Act [Pub. L. 102–585] (38 U.S.C. 8111 note) during the period beginning on October 1, 1996, and ending on the date of the enactment of this Act [Oct. 9, 1996] are hereby ratified."

Pub. L. 102–585, title II, Nov. 4, 1992, 106 Stat. 4949, as amended by Pub. L. 103–446, title XII, §1202(e)(1), Nov. 2, 1994, 108 Stat. 4689; Pub. L. 104–262, title III, §302(a), (b)(1), (c), Oct. 9, 1996, 110 Stat. 3193, provided that:

"SEC. 201. TEMPORARY EXPANSION OF AUTHORITY FOR SHARING AGREEMENTS.

"(a) Authority.—The Secretary of Veterans Affairs may enter into an agreement with the Secretary of Defense under this section to expand the availability of health-care sharing arrangements with the Department of Defense under section 8111(c) of title 38, United States Code. Under such an agreement—

"(1) the head of a Department of Veterans Affairs medical facility may enter into agreements under section 8111(d) of that title with (A) the head of a Department of Defense medical facility, (B) with any other official of the Department of Defense responsible for the provision of care under chapter 55 of title 10, United States Code, to persons who are covered beneficiaries under that chapter, in the region of the Department of Veterans Affairs medical facility, or (C) with a contractor of the Department of Defense responsible for the provision of care under chapter 55 of title 10, United States Code, to persons who are covered beneficiaries under that chapter, in the region of the Department of Veterans Affairs medical facility; and

"(2) the term 'primary beneficiary' shall be treated as including—

"(A) with respect to the Department of Veterans Affairs, any person who is described in section 1713 [now 1781] of title 38, United States Code; and

"(B) with respect to the Department of Defense, any person who is a covered beneficiary under chapter 55 of title 10, United States Code.

"(b) Use of Funds.—Any amount received by the Secretary from a non-Federal entity as payment for services provided by the Secretary during a prior fiscal year under an agreement entered into under this section may be obligated by the Secretary during the fiscal year in which the Secretary receives the payment.

"SEC. 202. REQUIREMENT FOR IMPROVEMENT IN SERVICES FOR VETERANS.

"A proposed agreement authorized by section 201 that is entered into by the head of a Department of Veterans Affairs medical facility may take effect only if the Under Secretary for Health of the Department of Veterans Affairs finds, and certifies to the Secretary of Veterans Affairs, that implementation of the agreement—

"(1) will result in the improvement of services to eligible veterans at that facility; and

"(2) will not result in the denial of, or a delay in providing, access to care for any veteran at that facility.

"SEC. 203. EXPANDED SHARING AGREEMENTS WITH DEPARTMENT OF DEFENSE.

"Under an agreement under section 201, guidelines under section 8111(b) of title 38, United States Code, may be modified to provide that, notwithstanding any other provision of law, any person who is a covered beneficiary under chapter 55 of title 10 and who is furnished care or services by a facility of the Department of Veterans Affairs under an agreement entered into under section 8111 of that title, or who is described in section 1713 [now 1781] of title 38, United States Code, and who is furnished care or services by a facility of the Department of Defense, may be authorized to receive such care or services—

"(1) without regard to any otherwise applicable requirement for the payment of a copayment or deductible; or

"(2) subject to a requirement to pay only part of any such otherwise applicable copayment or deductible, as specified in the guidelines.

"[SEC. 204. Repealed. Pub. L. 104–262, title III, §302(b)(1), Oct. 9, 1996, 110 Stat. 3193.]

"SEC. 205. CONSULTATION WITH VETERANS SERVICE ORGANIZATIONS.

"In carrying out this title, the Secretary of Veterans Affairs shall consult with organizations named in or approved under section 5902 of title 38, United States Code.

"SEC. 206. ANNUAL REPORT.

"(a) In General.—For each of fiscal years 1993 through 1996, the Secretary of Defense and the Secretary of Veterans Affairs shall include in the annual report of the Secretaries under section 8111(f) of title 38, United States Code, a description of the Secretaries' implementation of this section.

"(b) Additional Matters for Fiscal Year 1996 Report.—In the report under subsection (a) for fiscal year 1996, the Secretaries shall include the following:

"(1) An assessment of the effect of agreements entered into under section 201 on the delivery of health care to eligible veterans.

"(2) An assessment of the cost savings, if any, associated with provision of services under such agreements to retired members of the Armed Forces, dependents of members or former members of a uniformed service, and beneficiaries under section 1713 [now 1781] of title 38, United States Code.

"(3) Any plans for administrative action, and any recommendations for legislation, that the Secretaries consider appropriate to include in the report.

"SEC. 207. AUTHORITY TO BILL HEALTH-PLAN CONTRACTS.

"(a) Right To Recover.—In the case of a primary beneficiary (as described in section 201(a)(2)(B)) who has coverage under a health-plan contract, as defined in section 1729(i)(1)(A) of title 38, United States Code, and who is furnished care or services by a Department medical facility pursuant to this title, the United States shall have the right to recover or collect charges for such care or services from such health-plan contract to the extent that the beneficiary (or the provider of the care or services) would be eligible to receive payment for such care or services from such health-plan contract if the care or services had not been furnished by a department or agency of the United States. Any funds received from such health-plan contract shall be credited to funds that have been allotted to the facility that furnished the care or services.

"(b) Enforcement.—The right of the United States to recover under such a beneficiary's health-plan contract shall be enforceable in the same manner as that provided by subsections (a)(3), (b), (c)(1), (d), (f), (h), and (i) of section 1729 of title 38, United States Code."

Congressional Findings

Pub. L. 97–174, §2(a), May 4, 1982, 96 Stat. 70, provided that: "The Congress makes the following findings:

"(1) There are opportunities for greater sharing of the health-care resources of the Veterans' Administration and the Department of Defense which would, if achieved, be beneficial to both veterans and members of the Armed Forces and could result in reduced costs to the Government by minimizing duplication and underuse of health-care resources.

"(2) Present incentives to encourage such sharing of health-care resources are inadequate.

"(3) Such sharing of health-care resources can be achieved without a detrimental effect on the primary health-care beneficiaries of the Veterans' Administration and the Department of Defense."

Executive Order No. 13214

Ex. Ord. No. 13214, May 28, 2001, 66 F.R. 29447, which established President's Task Force to Improve Health Care Delivery for Our Nation's Veterans, was revoked by Ex. Ord. No. 13316, §3(h), Sept. 17, 2003, 68 F.R. 55256, eff. Sept. 30, 2003.

§8111A. Furnishing of health-care services to members of the Armed Forces during a war or national emergency

(a)(1) During and immediately following a period of war, or a period of national emergency declared by the President or the Congress that involves the use of the Armed Forces in armed conflict, the Secretary may furnish hospital care, nursing home care, and medical services to members of the Armed Forces on active duty.

(2)(A) During and immediately following a disaster or emergency referred to in subparagraph (B), the Secretary may furnish hospital care and medical services to members of the Armed Forces on active duty responding to or involved in that disaster or emergency.

(B) A disaster or emergency referred to in this subparagraph is any disaster or emergency as follows:

(i) A major disaster or emergency declared by the President under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.).

(ii) A disaster or emergency in which the National Disaster Medical System established pursuant to section 2812 of the Public Health Service Act (42 U.S.C. 300hh1 is activated by the Secretary of Health and Human Services under that section or as otherwise authorized by law.


(3) The Secretary may give a higher priority to the furnishing of care and services under this section than to the furnishing of care and services to any other group of persons eligible for care and services in medical facilities of the Department with the exception of veterans with service-connected disabilities.

(4) For the purposes of this section, the terms "hospital care", "nursing home care", and "medical services" have the meanings given such terms by sections 1701(5), 101(28), and 1701(6) of this title, respectively, and the term "medical services" includes services under sections 1782 and 1783 of this title.

(b)(1) During a period in which the Secretary is authorized to furnish care and services to members of the Armed Forces under subsection (a) of this section, the Secretary, to the extent authorized by the President and subject to the availability of appropriations or reimbursements under subsection (c) of this section, may enter into contracts with private facilities for the provision during such period by such facilities of hospital care and medical services described in paragraph (2) of this subsection.

(2) Hospital care and medical services referred to in paragraph (1) of this subsection are—

(A) hospital care and medical services authorized under this title for a veteran and necessary for the care or treatment of a condition for which the veteran is receiving medical services at a Department facility under subsection (a) of section 1710 of this title, in a case in which the delay involved in furnishing such care or services at such Department facility or at any other Department facility reasonably accessible to the veteran would, in the judgment of the Under Secretary for Health, be likely to result in a deterioration of such condition; and

(B) hospital care for a veteran who—

(i) is receiving hospital care under section 1710 of this title; or

(ii) is eligible for hospital care under such section and requires such care in a medical emergency that poses a serious threat to the life or health of the veteran;


if Department facilities are not capable of furnishing or continuing to furnish the care required because of the furnishing of care and services to members of the Armed Forces under subsection (a) of this section.


(c)(1) The cost of any care or services provided by the Department under subsection (a) of this section shall be reimbursed to the Department by the Department of Defense at such rates as may be agreed upon by the Secretary and the Secretary of Defense based on the cost of the care or services provided.

(2) Amounts received under this subsection shall be credited to funds allotted to the Department facility that provided the care or services.

(d)(1) The Secretary of Veterans Affairs and the Secretary of Defense shall jointly review plans for the implementation of this section not less often than annually.

(2) Whenever a modification to such plans is agreed to, the Secretaries shall jointly submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on such modification. Any such report shall be submitted within 30 days after the modification is agreed to.

(e) The Secretary shall prescribe regulations to govern any exercise of the authority of the Secretary under subsections (a) and (b) of this section and of the Under Secretary for Health under subsection (b)(2)(A) of this section.

(Added Pub. L. 97–174, §4(a), May 4, 1982, 96 Stat. 74, §5011A; renumbered §8111A, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102–54, §14(f)(4), June 13, 1991, 105 Stat. 287; Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 104–262, title I, §101(e)(5), Oct. 9, 1996, 110 Stat. 3181; Pub. L. 106–419, title IV, §403(b), Nov. 1, 2000, 114 Stat. 1864; Pub. L. 107–135, title II, §208(e)(7), Jan. 23, 2002, 115 Stat. 2464; Pub. L. 107–287, §4(b), Nov. 7, 2002, 116 Stat. 2029; Pub. L. 109–444, §8(a)(8), Dec. 21, 2006, 120 Stat. 3313; Pub. L. 109–461, title X, §§1004(a)(8), 1006(b), Dec. 22, 2006, 120 Stat. 3466, 3468; Pub. L. 111–275, title X, §1001(p)(1), Oct. 13, 2010, 124 Stat. 2897.)

References in Text

The Robert T. Stafford Disaster Relief and Emergency Assistance Act, referred to in subsec. (a)(2)(B)(i), is Pub. L. 93–288, May 22, 1974, 88 Stat. 143, as amended, which is classified principally to chapter 68 (§5121 et seq.) of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 5121 of Title 42 and Tables.

Section 2812 of the Public Health Service Act, referred to in subsec. (a)(2)(B)(ii), is classified to section 300hh–11 of Title 42, The Public Health and Welfare.

Amendments

2010—Subsec. (a)(2)(B)(ii). Pub. L. 111–275 substituted "section 2812 of the Public Health Service Act (42 U.S.C. 300hh)" for "section 2811(b) of the Public Health Service Act (42 U.S.C. 300hh–11(b))" and struck out "paragraph (3)(A) of" before "that section".

2006—Subsec. (a)(2)(B)(i). Pub. L. 109–461, §1006(b), provided that as of the enactment of Pub. L. 109–461, the amendments made by Pub. L. 109–444 were deemed for all purposes not to have taken effect and that Pub. L. 109–444 ceased to be in effect. See Amendment notes below and section 1006(b) of Pub. L. 109–461, set out as a Coordination of Provisions With Pub. L. 109–444 note under section 101 of this title.

Pub. L. 109–461, §1004(a)(8), substituted "Robert T." for "Robert B.".

Pub. L. 109–444, which substituted "Robert T." for "Robert B.", was terminated by Pub. L. 109–461, §1006(b). See Amendment notes above.

2002—Subsec. (a). Pub. L. 107–287 redesignated second sentence of par. (1) as par. (3), added par. (2), and redesignated former par. (2) as (4).

Subsec. (a)(2). Pub. L. 107–135 inserted ", and the term 'medical services' includes services under sections 1782 and 1783 of this title" before period at end.

2000—Subsec. (f). Pub. L. 106–419 struck out subsec. (f) which read as follows: "Within thirty days after a declaration of a period of war or national emergency described in subsection (a) of this section (or as soon after the end of such thirty-day period as is reasonably practicable), the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on the Secretary's allocation of facilities and personnel in order to provide priority hospital care, nursing home care, and medical services under this section to members of the Armed Forces. Thereafter, with respect to any fiscal year in which the authority in subsection (b) of this section to enter into contracts with private facilities has been used, the Secretary shall report within ninety days after the end of such fiscal year to those committees regarding the extent of, and the circumstances under which, such authority was used."

1996—Subsec. (b)(2)(A). Pub. L. 104–262 substituted "subsection (a) of section 1710" for "subsection (f) of section 1712".

1992—Subsecs. (b)(2)(A), (e). Pub. L. 102–405 substituted "Under Secretary for Health" for "Chief Medical Director".

1991Pub. L. 102–40 renumbered section 5011A of this title as this section.

Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted "1701(5)" for "601(5)" and "1701(6)" for "601(6)" in par. (2).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places in par. (1).

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" in par. (1).

Subsec. (b). Pub. L. 102–83, §5(c)(1), substituted "1712" for "612" in par. (2)(A) and "1710" for "610" in par. (2)(B)(i).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places in par. (1).

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing in par. (2).

Pub. L. 102–54, §14(f)(4)(A), amended subsec. (b)(2)(A) as in effect immediately before the enactment of Pub. L. 102–40 by striking out "or (g)" after "subsection (f)".

Subsec. (c). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in par. (1).

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing.

Subsec. (d). Pub. L. 102–54, §14(f)(4)(B), amended section as in effect immediately before the enactment of Pub. L. 102–40 by adding subsec. (d) and striking out former subsec. (d) which read as follows:

"(1) Not later than six months after the date of the enactment of this section, the Administrator and the Secretary of Defense shall enter into an agreement to plan and establish procedures and guidelines for the implementation of this section. Not later than one year after the date of the enactment of this section, the Administrator and the Secretary shall complete plans for such implementation and shall submit such plans to the Committees on Veterans' Affairs and on Armed Services of the Senate and House of Representatives.

"(2) The Administrator and the Secretary of Defense shall jointly review such plans not less often than annually thereafter and shall report to such committees any modification in such plans within thirty days after the modification is agreed to."

Subsecs. (e), (f). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" and "Secretary's" for "Administrator's" wherever appearing.

Transfer of Functions

For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System, including the functions of the Secretary of Homeland Security and the Under Secretary for Emergency Preparedness and Response relating thereto, to the Secretary of Health and Human Services, see title III of Pub. L. 109–295, set out in part as a note under section 300hh–11 of Title 42, The Public Health and Welfare, and section 301(b) of Pub. L. 109–417, set out as a note under section 300hh–11 of Title 42.

For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System of the Department of Health and Human Services, including the functions of the Secretary of Health and Human Services and the Assistant Secretary for Public Health Emergency Preparedness [now Assistant Secretary for Preparedness and Response] relating thereto, to the Secretary of Homeland Security, and for treatment of related references, see former section 313(5) and sections 551(d), 552(d), and 557 of Title 6, Domestic Security, and the Department of Homeland Security Reorganization Plan of November 25, 2002, as modified, set out as a note under section 542 of Title 6.

Congressional Findings

Pub. L. 97–174, §2(b), May 4, 1982, 96 Stat. 70, provided that: "The Congress makes the following further findings:

"(1) During and immediately after a period of war or national emergency involving the use of the Armed Forces of the United States in armed conflict, the Department of Defense might not have adequate health-care resources to care for military personnel wounded in combat and other active-duty military personnel.

"(2) The Veterans' Administration has an extensive, comprehensive health-care system that could be used to assist the Department of Defense in caring for such personnel in such a situation."

Executive Order No. 12751

Ex. Ord. No. 12751, Feb. 14, 1991, 56 F.R. 6787, which related to health care services for Operation Desert Storm, was revoked by Ex. Ord. No. 13350, July 29, 2004, 69 F.R. 46055, listed in a table under section 1701 of Title 50, War and National Defense.

1 See References in Text note below.

§8112. Partial relinquishment of legislative jurisdiction

The Secretary, on behalf of the United States, may relinquish to the State in which any lands or interests therein under the supervision or control of the Secretary are situated, such measure of legislative jurisdiction over such lands or interests as is necessary to establish concurrent jurisdiction between the Federal Government and the State concerned. Such partial relinquishment of legislative jurisdiction shall be initiated by filing a notice thereof with the Governor of the State concerned, or in such other manner as may be prescribed by the laws of such State, and shall take effect upon acceptance by such State.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 60, §5012; renumbered §8112, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102–83, §4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.)

Prior Provisions

Provisions similar to those comprising this section were contained in former section 5007 of this title prior to the general revision of this subchapter by Pub. L. 96–22.

Amendments

1991Pub. L. 102–40 renumbered section 5012 of this title as this section.

Pub. L. 102–83 substituted "Secretary" for "Administrator" in two places.

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

§8113. Property formerly owned by National Home for Disabled Volunteer Soldiers

If by reason of any defeasance or conditional clause or clauses contained in any deed of conveyance of property to the National Home for Disabled Volunteer Soldiers, which property is owned by the United States, the full and complete enjoyment and use of such property is threatened, the Attorney General, upon request of the President, shall institute in the United States district court for the district in which the property is located such proceedings as may be proper to extinguish all outstanding adverse interests. The Attorney General may procure and accept, on behalf of the United States, by gift, purchase, cession, or otherwise, absolute title to, and complete jurisdiction over, all such property.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 61, §5013; renumbered §8113, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238.)

Prior Provisions

Provisions similar to those comprising this section were contained in former section 5006 of this title prior to the general revision of this subchapter by Pub. L. 96–22.

Amendments

1991Pub. L. 102–40 renumbered section 5013 of this title as this section.

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

§8114. Use of federally owned facilities; use of personnel

(a) The Secretary, subject to the approval of the President, may use as medical facilities such suitable buildings, structures, and grounds owned by the United States on March 3, 1925, as may be available for such purposes, and the President may by Executive order transfer any such buildings, structures, and grounds to the control and jurisdiction of the Department upon the request of the Secretary.

(b) The President may require the architectural, engineering, constructing, or other forces of any of the departments of the Government to do or assist in the construction and alteration of medical facilities, and the President may employ for such purposes individuals and agencies not connected with the Government, if in the opinion of the President such is desirable, at such compensation as the President may consider reasonable.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 61, §5014; renumbered §8114, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102–83, §4(a)(3), (4), (b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.)

Prior Provisions

Provisions similar to those comprising this section were contained in section 5001(e) of this title prior to the general revision of this subchapter by Pub. L. 96–22.

Amendments

1991Pub. L. 102–40 renumbered section 5014 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

§8115. Acceptance of certain property

The President may accept from any State or other political subdivision, or from any person, any building, structure, equipment, or grounds suitable for the care of disabled persons, with due regard to fire or other hazards, state of repair, and all other pertinent considerations. The President may designate which agency of the Federal Government shall have the control and management of any property so accepted.

(Added Pub. L. 96–22, title III, §301(a), June 13, 1979, 93 Stat. 61, §5015; renumbered §8115, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238.)

Prior Provisions

Provisions similar to those comprising this section were contained in former section 5005 of this title prior to the general revision of this subchapter by Pub. L. 96–22.

Amendments

1991Pub. L. 102–40 renumbered section 5015 of this title as this section.

Effective Date

Section effective Oct. 1, 1979, but not applicable with respect to the acquisition, construction, or alteration of any medical facilities if the acquisition, construction, or alteration (not including exchange) was approved by the President before Oct. 1, 1979, see section 302 of Pub. L. 96–22, set out as a note under section 8101 of this title.

§8116. Nursing home revolving fund

(a)(1) Amounts realized from a transfer pursuant to section 8122(a)(2)(C) 1 of this title 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.

(b)(1) The expenditure of funds from the revolving fund may be made only for the construction, alteration, and acquisition (including site acquisition) of nursing home 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 may be expended for a project involving a total expenditure of more than $2,000,000 for the construction, alteration, or acquisition (including site acquisition) of a nursing home facility shall be considered to be a bill, resolution, or amendment making an appropriation which may be expended for a major medical facility project.

(Added Pub. L. 100–322, title II, §205(a), May 20, 1988, 102 Stat. 512, §5016; renumbered §8116 and amended Pub. L. 102–40, title IV, §402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239.)

Repeal of Section

Pub. L. 108–422, title IV, §411(c)(1),(f), Nov. 30, 2004, 118 Stat. 2389, 2390, provided that this section is repealed 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.

References in Text

Section 8122(a)(2) of this title, referred to in subsec. (a)(1), was amended generally by Pub. L. 108–422, title IV, §411(e)(1), Nov. 30, 2004, 118 Stat. 2389, and, as so amended, no longer contains a subpar. (C).

Amendments

1991Pub. L. 102–40, §402(b)(1), renumbered section 5016 of this title as this section.

Pub. L. 102–40, §402(d)(1), substituted "8122(a)(2)(C)" for "5022(a)(2)(C)" in subsec. (a)(1) and "8104(a)(2)" for "5004(a)(2)" in subsec. (b)(2).

Effective Date of Repeal

Repeal 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, see section 411(f) of Pub. L. 108–422, set out as an Effective Date of 2004 Amendment note under section 1710B of this title.

Transfer of Nursing Home Revolving Fund Balances and Receipts

For provisions relating to the transfer of balances and receipts from the Nursing Home Revolving Fund to the "Medical services" account, see section 115 of Pub. L. 108–447, set out as a note under section 1729a of this title.

1 See References in Text note below.

§8117. Emergency preparedness

(a) Readiness of Department Medical Centers.—(1) The Secretary shall take appropriate actions to provide for the readiness of Department medical centers to protect the patients and staff of such centers from a public health emergency (as defined in section 2801 of the Public Health Service Act) or otherwise to respond to such an emergency so as to enable such centers to fulfill their obligations as part of the Federal response to such emergencies.

(2) Actions under paragraph (1) shall include—

(A) the provision of decontamination equipment and personal protection equipment at Department medical centers;

(B) the provision of training in the use of such equipment to staff of such centers;

(C) organizing, training, and equipping the staff of such centers to support the activities carried out by the Secretary of Health and Human Services under section 2801 of the Public Health Service Act in the event of a public health emergency and incidents covered by the National Response Plan developed pursuant to section 502(6) 1 of the Homeland Security Act of 2002, or any successor plan; and

(D) providing medical logistical support to the National Disaster Medical System and the Secretary of Health and Human Services as necessary, on a reimbursable basis, and in coordination with other designated Federal agencies.


(b) Security at Department Medical and Research Facilities.—(1) The Secretary shall take appropriate actions to provide for the security of Department medical centers and research facilities, including staff and patients at such centers and facilities.

(2) In taking actions under paragraph (1), the Secretary shall take into account the results of the evaluation of the security needs at Department medical centers and research facilities required by section 154(b)(1) of the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (Public Law 107–188; 116 Stat. 631), including the results of such evaluation relating to the following needs:

(A) Needs for the protection of patients and medical staff during emergencies, including a chemical or biological attack or other terrorist attack.

(B) Needs, if any, for screening personnel engaged in research relating to biological pathogens or agents, including work associated with such research.

(C) Needs for securing laboratories or other facilities engaged in research relating to biological pathogens or agents.


(c) Tracking of Pharmaceuticals and Medical Supplies and Equipment.—The Secretary shall develop and maintain a centralized system for tracking the current location and availability of pharmaceuticals, medical supplies, and medical equipment throughout the Department health care system in order to permit the ready identification and utilization of such pharmaceuticals, supplies, and equipment for a variety of purposes, including response to a public health emergency. The Secretary shall, through existing medical procurement contracts, and on a reimbursable basis, make available as necessary, medical supplies, equipment, and pharmaceuticals in response to a public health emergency in support of the Secretary of Health and Human Services.

(d) Training.—The Secretary shall ensure that the Department medical centers, in consultation with the accredited medical school affiliates of such medical centers, implement curricula to train resident physicians and health care personnel in medical matters relating to public health emergencies or attacks from an incendiary or other explosive weapon consistent with section 319F(a) of the Public Health Service Act.

(e) Participation in National Disaster Medical System.—(1) The Secretary shall establish and maintain a training program to facilitate the participation of the staff of Department medical centers, and of the community partners of such centers, in the National Disaster Medical System established pursuant to section 2812 of the Public Health Service Act (42 U.S.C. 300hh–11).

(2) The Secretary shall establish and maintain the training program under paragraph (1) in accordance with the recommendations of the working group on the prevention, preparedness, and response to public health emergencies established under section 319F of the Public Health Service Act (42 U.S.C. 247d–6).

(3) The Secretary shall establish and maintain the training program under paragraph (1) in consultation with the following:

(A) The Secretary of Defense.

(B) The Secretary of Health and Human Services.

(C) The Administrator of the Federal Emergency Management Agency.


(f) Mental Health Counseling.—(1) With respect to activities conducted by personnel serving at Department medical centers, the Secretary shall develop and maintain various strategies for providing mental health counseling and assistance, including counseling and assistance for post-traumatic stress disorder, following a bioterrorist attack or other public health emergency to the following persons:

(A) Veterans.

(B) Local and community emergency response providers.

(C) Active duty military personnel.

(D) Individuals seeking care at Department medical centers.


(2) The strategies under paragraph (1) shall include the following:

(A) Training and certification of providers of mental health counseling and assistance.

(B) Mechanisms for coordinating the provision of mental health counseling and assistance to emergency response providers referred to in paragraph (1).


(3) The Secretary shall develop and maintain the strategies under paragraph (1) in consultation with the Secretary of Health and Human Services, the American Red Cross, and the working group referred to in subsection (e)(2).

(g) Authorization of Appropriations.—There are authorized to be appropriated, $155,300,000 for each of fiscal years 2019 through 2023 to carry out this section.

(Added Pub. L. 107–287, §6(a)(1), Nov. 7, 2002, 116 Stat. 2030; amended Pub. L. 109–295, title VI, §612(c), Oct. 4, 2006, 120 Stat. 1410; Pub. L. 109–417, title III, §306, Dec. 19, 2006, 120 Stat. 2863; Pub. L. 110–387, title IX, §901(a)(7), Oct. 10, 2008, 122 Stat. 4142; Pub. L. 111–275, title X, §1001(p)(2), Oct. 13, 2010, 124 Stat. 2897; Pub. L. 113–5, title I, §105, Mar. 13, 2013, 127 Stat. 170; Pub. L. 116–22, title VII, §701(a), June 24, 2019, 133 Stat. 961.)

References in Text

Section 2801 of the Public Health Service Act, referred to in subsec. (a)(1), is classified to section 300hh of Title 42, The Public Health and Welfare.

Section 502 of the Homeland Security Act of 2002, referred to in subsec. (a)(2)(C), probably means section 502 of Pub. L. 107–296 prior to its redesignation as section 504 by Pub. L. 109–295, §611(8), and reclassification as section 314 of Title 6, Domestic Security, and not section 506 of Pub. L. 107–296 which was redesignated section 502 by Pub. L. 109–295, §611(9), and is classified to section 312 of Title 6. Provisions relating to the National Response Plan are contained in section 314(a)(6) of Title 6.

Section 154(b)(1) of the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, referred to in subsec. (b)(2), is section 154(b)(1) of Pub. L. 107–188, which is set out as a note below.

Amendments

2019—Subsec. (g). Pub. L. 116–22 substituted "2019 through 2023" for "2014 through 2018".

2013—Subsec. (g). Pub. L. 113–5 substituted "$155,300,000 for each of fiscal years 2014 through 2018 to carry out this section" for "such sums as may be necessary to carry out this section for each of fiscal years 2007 through 2011".

2010—Subsec. (e)(1). Pub. L. 111–275, §1001(p)(2)(A), substituted "(42 U.S.C. 300hh–11)" for "(42 U.S.C. 300hh–11(b))".

Subsec. (e)(2). Pub. L. 111–275, §1001(p)(2)(B), substituted "(42 U.S.C. 247d–6)" for "(42 U.S.C. 247d–6(a))".

2008—Subsec. (a)(1). Pub. L. 110–387 substituted "respond to such" for "respond to such such".

2006—Subsec. (a)(1). Pub. L. 109–417, §306(a)(1)(A), substituted "a public health emergency (as defined in section 2801 of the Public Health Service Act)" for "chemical or biological attack", "such an emergency" for "an attack", and "such emergencies" for "public health emergencies".

Subsec. (a)(2)(C), (D). Pub. L. 109–417, §306(a)(1)(B), added subpars. (C) and (D).

Subsec. (c). Pub. L. 109–417, §306(a)(2), substituted "a public health emergency. The Secretary shall, through existing medical procurement contracts, and on a reimbursable basis, make available as necessary, medical supplies, equipment, and pharmaceuticals in response to a public health emergency in support of the Secretary of Health and Human Services." for "a chemical or biological attack or other terrorist attack."

Subsec. (d). Pub. L. 109–417, §306(a)(3), struck out "develop and" before "implement curricula", substituted "public health emergencies" for "biological, chemical, or radiological attacks", and inserted "consistent with section 319F(a) of the Public Health Service Act" before period at end.

Subsec. (e)(1). Pub. L. 109–417, §306(a)(4)(A), substituted "2812" for "2811(b)".

Subsec. (e)(2). Pub. L. 109–417, §306(a)(4)(B), struck out "bioterrorism and other" after "response to" and substituted "319F" for "319F(a)".

Subsec. (g). Pub. L. 109–417, §306(b), added subsec. (g).

Change of Name

"Administrator of the Federal Emergency Management Agency" substituted for "Director of the Federal Emergency Management Agency" in subsec. (e)(3)(C) on authority of section 612(c) of Pub. L. 109–295, set out as a note under section 313 of Title 6, Domestic Security. Any reference to the Administrator of the Federal Emergency Management Agency in title VI of Pub. L. 109–295 or an amendment by title VI to be considered to refer and apply to the Director of the Federal Emergency Management Agency until Mar. 31, 2007, see section 612(f)(2) of Pub. L. 109–295, set out as a note under section 313 of Title 6.

Transfer of Functions

For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System, including the functions of the Secretary of Homeland Security and the Under Secretary for Emergency Preparedness and Response relating thereto, to the Secretary of Health and Human Services, see title III of Pub. L. 109–295, set out in part as a note under section 300hh–11 of Title 42, The Public Health and Welfare, and section 301(b) of Pub. L. 109–417, set out as a note under section 300hh–11 of Title 42.

For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System of the Department of Health and Human Services, including the functions of the Secretary of Health and Human Services and the Assistant Secretary for Public Health Emergency Preparedness [now Assistant Secretary for Preparedness and Response] relating thereto, to the Secretary of Homeland Security, and for treatment of related references, see former section 313(5) and sections 551(d), 552(d), and 557 of Title 6, Domestic Security, and the Department of Homeland Security Reorganization Plan of November 25, 2002, as modified, set out as a note under section 542 of Title 6.

Enhancement of Emergency Preparedness of Department of Veterans Affairs

Pub. L. 107–188, title I, §154, June 12, 2002, 116 Stat. 631, as amended by Pub. L. 107–287, §6(b), (c), Nov. 7, 2002, 116 Stat. 2032, provided that:

"[(a) Repealed. Pub. L. 107–287, §6(b), Nov. 7, 2002, 116 Stat. 2032.]

"(b) Security at Department Medical and Research Facilities.—(1) Not later than 180 days after the date of the enactment of this Act [June 12, 2002], the Secretary [of Veterans Affairs] shall carry out an evaluation of the security needs at Department medical centers and research facilities. The evaluation shall address the following needs:

"(A) Needs for the protection of patients and medical staff during emergencies, including a chemical or biological attack or other terrorist attack.

"(B) Needs, if any, for screening personnel engaged in research relating to biological pathogens or agents, including work associated with such research.

"(C) Needs for securing laboratories or other facilities engaged in research relating to biological pathogens or agents.

"(D) Any other needs the Secretary considers appropriate.

"[(2) Repealed. Pub. L. 107–287, §6(b), Nov. 7, 2002, 116 Stat. 2032.]

"[(c) to (f) Repealed. Pub. L. 107–287, §6(b), Nov. 7, 2002, 116 Stat. 2032.]

"(g) Authorization of Appropriations.—There is hereby authorized to be appropriated for the Department of Veterans Affairs amounts as follows:

"(1) To carry out activities required by subsection (a) of section 8117 of title 38, United States Code

"(A) $100,000,000 for fiscal year 2002; and

"(B) such sums as may be necessary for each of fiscal years 2003 through 2006.

"(2) To carry out activities required by subsection (b)(1) of this section and subsections (b) through (f) of section 8117 of title 38, United States Code

"(A) $33,000,000 for fiscal year 2002; and

"(B) such sums as may be necessary for each of fiscal years 2003 through 2006."

1 See References in Text note below.

§8118. Authority for transfer of real property; Department of Veterans Affairs Capital Asset Fund

(a)(1) The Secretary may transfer real property under the jurisdiction or control of the Secretary (including structures and equipment associated therewith) to another department or agency of the United States, to a State (or a political subdivision of a State), or to any public or private entity, including an Indian tribe. Such a transfer may be made only if the Secretary receives compensation of not less than the fair market value of the property, except that no compensation is required, or compensation at less than fair market value may be accepted, in the case of a transfer to a grant and per diem provider (as defined in section 2002 of this title). When a transfer is made to a grant and per diem provider for less than fair market value, the Secretary shall require in the terms of the conveyance that if the property transferred is used for any purpose other than a purpose under chapter 20 of this title, all right, title, and interest to the property shall revert to the United States.

(2) The Secretary may exercise the authority provided by this section notwithstanding sections 521, 522, and 541 through 545 of title 40. Any such transfer shall be in accordance with this section and section 8122 of this title.

(3) The authority provided by this section may not be used in a case to which section 8164 of this title applies.

(4) The Secretary may enter into partnerships or agreements with public or private entities dedicated to historic preservation to facilitate the transfer, leasing, or adaptive use of structures or properties specified in subsection (b)(3)(D).

(5) The authority of the Secretary under paragraph (1) expires on September 30, 2020.

(b)(1) There is established in the Treasury of the United States a revolving fund to be known as the Department of Veterans Affairs Capital Asset Fund (hereinafter in this section referred to as the "Fund"). Amounts in the Fund shall remain available until expended.

(2) Proceeds from the transfer of real property under this section shall be deposited into the Fund.

(3) To the extent provided in advance in appropriations Acts, amounts in the Fund may be expended for the following purposes:

(A) Costs associated with the transfer of real property under this section, including costs of demolition, environmental remediation, maintenance and repair, improvements to facilitate the transfer, and administrative expenses.

(B) Costs, including costs specified in subparagraph (A), associated with future transfers of property under this section.

(C) Costs associated with enhancing medical care services to veterans by improving, renovating, replacing, updating, or establishing patient care facilities through construction projects to be carried out for an amount less than the amount specified in 8104(a)(3)(A) for a major medical facility project.

(D) Costs, including costs specified in subparagraph (A), associated with the transfer, lease, or adaptive use of a structure or other property under the jurisdiction of the Secretary that is listed on the National Register of Historic Places.


(c) The Secretary shall include in the budget justification materials submitted to Congress for any fiscal year in support of the President's budget for that fiscal year for the Department specification of the following:

(1) The real property transfers to be undertaken in accordance with this section during that fiscal year.

(2) All transfers completed under this section during the preceding fiscal year and completed and scheduled to be completed during the fiscal year during which the budget is submitted.

(3) The deposits into, and expenditures from, the Fund that are incurred or projected for each of the preceding fiscal year, the current fiscal year, and the fiscal year covered by the budget.

(Added Pub. L. 108–422, title IV, §411(a)(1), Nov. 30, 2004, 118 Stat. 2388; amended Pub. L. 112–37, §10(g), Oct. 5, 2011, 125 Stat. 397; Pub. L. 115–251, title I, §105, Sept. 29, 2018, 132 Stat. 3168.)

Amendments

2018—Subsec. (a)(5). Pub. L. 115–251 substituted "September 30, 2020" for "December 31, 2018".

2011—Subsec. (a)(5). Pub. L. 112–37 substituted "December 31, 2018" for "the date that is seven years after the date of the enactment of this section".

Transfer of Unobligated Balances to Capital Asset Fund

Pub. L. 108–422, title IV, §411(d), Nov. 30, 2004, 118 Stat. 2389, provided that: "Any unobligated balances in the nursing home revolving fund under section 8116 of title 38, United States Code, as of the date of the enactment of this Act [Nov. 30, 2004] shall be deposited in the Department of Veterans Affairs Capital Asset Fund established under section 8118 of title 38, United States Code (as added by subsection (a))."

[Section 411(d) of Pub. L. 108–422, set out above, is 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, see section 411(f) of Pub. L. 108–422, set out as an Effective Date of 2004 Amendment note under section 1710B of this title.]

§8119. Annual report on outpatient clinics

(a) Annual Report Required.—The Secretary shall submit to the committees an annual report on community-based outpatient clinics and other outpatient clinics 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) Contents of Report.—Each report required under subsection (a) shall include the following:

(1) A list of each community-based outpatient clinic and other outpatient clinic of the Department, and for each such clinic, the type of clinic, location, size, number of health professionals employed by the clinic, workload, whether the clinic is leased or constructed and operated by the Secretary, and the annual cost of operating the clinic.

(2) A list of community-based outpatient clinics and other outpatient clinics that the Secretary opened during the fiscal year preceding the fiscal year during which the report is submitted and a list of clinics the Secretary proposes opening during the fiscal year during which the report is submitted and the subsequent fiscal year, together with the cost of activating each such clinic and the information required to be provided under paragraph (1) for each such clinic and proposed clinic.

(3) A list of proposed community-based outpatient clinics and other outpatient clinics that are, as of the date of the submission of the report, under review by the National Review Panel and a list of possible locations for future clinics identified in the Department's strategic planning process, including any identified locations in rural and underserved areas.

(4) A prioritized list of sites of care identified by the Secretary that the Secretary could establish without carrying out construction or entering into a lease, including—

(A) any such sites that could be expanded by hiring additional staff or allocating staff to Federal facilities or facilities operating in collaboration with the Federal Government; and

(B) any sites established, or able to be established, under sections 8111 and 8153 of this title.

(Added Pub. L. 110–387, title VII, §708(a), Oct. 10, 2008, 122 Stat. 4139.)

Deadline for First Annual Report

Pub. L. 110–387, title VII, §708(b), Oct. 10, 2008, 122 Stat. 4140, provided that: "The Secretary of Veterans Affairs shall submit the first report required under section 8119(a) of title 38, United States Code, as added by subsection (a), by not later than 90 days after the date of the enactment of this Act [Oct. 10, 2008]."

§8120. Quarterly report on super construction projects

(a) Quarterly Reports Required.—Not later than 30 days after the last day of each fiscal quarter the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on the super construction projects carried out by the appropriate non-Department Federal entity described in section 8103(e)(1) of this title during such quarter. Each such report shall include, for each such project—

(1) the budgetary and scheduling status of the project, as of the last day of the quarter covered by the report; and

(2) the actual cost and schedule variances of the project, as of such day, compared to the planned cost and schedules for the project.


(b) Super Construction Project Defined.—In this section, the term "super construction project" has the meaning given such term in section 8103(e)(3) of this title.

(Added Pub. L. 114–315, title VIII, §801(d)(1), Dec. 16, 2016, 130 Stat. 1591.)