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[[Page 118 STAT. 2379]]

Public Law 108-422
108th Congress

                                 An Act


 
To amend title 38, United States Code, to increase the authorization of 
   appropriations for grants to benefit homeless veterans, to improve 
 programs for management and administration of veterans' facilities and 
     health care programs, and for other purposes. <<NOTE: Nov. 30, 
                         2004 -  [H.R. 3936]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Veterans Health 
Programs Improvement Act of 2004.>> 

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) <<NOTE: 38 USC 101 note.>> Short Title.--This Act may be cited 
as the ``Veterans Health Programs Improvement Act of 2004''.

    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Reference to title 38, United States Code.

                TITLE I--ASSISTANCE TO HOMELESS VETERANS

Sec. 101. Authorization of appropriations.

               TITLE II--VETERANS LONG-TERM CARE PROGRAMS

Sec. 201. Assistance for hiring and retention of nurses at State 
           veterans' homes.
Sec. 202. Treatment of Department of Veterans Affairs per diem payments 
           to state homes for veterans.
Sec. 203. Extension of authority to provide care under long-term care 
           pilot programs.
Sec. 204. Prohibition on collection of copayments for hospice care.

                         TITLE III--MEDICAL CARE

Sec. 301. Sexual trauma counseling program.
Sec. 302. Centers for research, education, and clinical activities on 
           complex multi-trauma associated with combat injuries.
Sec. 303. Enhancement of medical preparedness of Department of Veterans 
           Affairs.

       TITLE IV--MEDICAL FACILITIES MANAGEMENT AND ADMINISTRATION

                Subtitle A--Major Medical Facility Leases

Sec. 401. Major medical facility leases.
Sec. 402. Authorization of appropriations.
Sec. 403. Authority for long-term lease of certain lands of University 
           of Colorado.

                    Subtitle B--Facilities Management

Sec. 411. Department of Veterans Affairs Capital Asset Fund.
Sec. 412. Annual report to Congress on inventory of Department of 
           Veterans Affairs historic properties.
Sec. 413. Authority to acquire and transfer real property for use for 
           homeless veterans.
Sec. 414. Limitation on implementation of mission changes for specified 
           Veterans Health Administration facilities.
Sec. 415. Authority to use project funds to construct or relocate 
           surface parking incidental to a construction or nonrecurring 
           maintenance project.
Sec. 416. Inapplicability of limitation on use of advance planning funds 
           to authorized major medical facility projects.

[[Page 118 STAT. 2380]]

Sec. 417. Improvements to enhanced-use lease authority.
Sec. 418. First option for Commonwealth of Kentucky on Department of 
           Veterans Affairs Medical Center, Louisville, Kentucky.
Sec. 419. Transfer of jurisdiction, General Services Administration 
           property, Boise, Idaho.

                  Subtitle C--Designation of Facilities

Sec. 421. Thomas E. Creek Department of Veterans Affairs Medical Center.
Sec. 422. James J. Peters Department of Veterans Affairs Medical Center.
Sec. 423. Bob Michel Department of Veterans Affairs Outpatient Clinic.
Sec. 424. Charles Wilson Department of Veterans Affairs Outpatient 
           Clinic.
Sec. 425. Thomas P. Noonan, Jr. Department of Veterans Affairs 
           Outpatient Clinic.

                    TITLE V--PERSONNEL ADMINISTRATION

Sec. 501. Pilot program to study innovative recruitment tools to address 
           nursing shortages at Department of Veterans Affairs health 
           care facilities.
Sec. 502. Technical correction to listing of certain hybrid positions in 
           Veterans Health Administration.
Sec. 503. Under Secretary for Health.

                         TITLE VI--OTHER MATTERS

Sec. 601. Extension and codification of authority for recovery audits.
Sec. 602. Inventory of medical waste management activities at Department 
           of Veterans Affairs health care facilities.
Sec. 603. Inclusion of all enrolled veterans among persons eligible to 
           use canteens operated by Veterans' Canteen Service.
Sec. 604. Annual reports on waiting times for appointments for specialty 
           care.
Sec. 605. Technical clarification.

SEC. 2. REFERENCE TO TITLE 38, UNITED STATES CODE.

    Except as otherwise expressly provided, whenever in this Act an 
amendment or repeal is expressed in terms of an amendment to, or repeal 
of, a section or other provision, the reference shall be considered to 
be made to a section or other provision of title 38, United States Code.

                TITLE I--ASSISTANCE TO HOMELESS VETERANS

SEC. 101. AUTHORIZATION OF APPROPRIATIONS.

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

               TITLE II--VETERANS LONG-TERM CARE PROGRAMS

SEC. 201. ASSISTANCE FOR HIRING AND RETENTION OF NURSES AT STATE 
            VETERANS' HOMES.

    (a) In General.--(1) Chapter 17 is amended by inserting after 
section 1743 the following new section:

``Sec. 1744. Hiring and retention of nurses: payments to assist States

    ``(a) Payment Program.--The Secretary shall make payments to States 
under this section for the purpose of assisting State homes in the 
hiring and retention of nurses and the reduction of nursing shortages at 
State homes.
    ``(b) Eligible Recipients.--Payments to a State for a fiscal year 
under this section shall, subject to submission of an application, be 
made to any State that during that fiscal year--

[[Page 118 STAT. 2381]]

            ``(1) receives per diem payments under this subchapter for 
        that fiscal year; and
            ``(2) has in effect an employee incentive scholarship 
        program or other employee incentive program at a State home 
        designed to promote the hiring and retention of nursing staff 
        and to reduce nursing shortages at that home.

    ``(c) Use of Funds Received.--A State may use an amount received 
under this section only to provide funds for a program described in 
subsection (b)(2). Any program shall meet such criteria as the Secretary 
may prescribe. In prescribing such criteria, the Secretary shall take 
into consideration the need for flexibility and innovation.
    ``(d) Limitations on Amount of Payment.--(1) A payment under this 
section may not be used to provide more than 50 percent of the costs for 
a fiscal year of the employee incentive scholarship or other employee 
incentive program for which the payment is made.
    ``(2) The amount of the payment to a State under this section for 
any fiscal year is, for each State home in that State with a program 
described in subsection (b)(2), the amount equal to 2 percent of the 
amount of payments estimated to be made to that State, for that State 
home, under section 1741 of this title for that fiscal year.
    ``(e) Applications.--A payment under this section for any fiscal 
year with respect to any State home may only be made based upon an 
application submitted by the State seeking the payment with respect to 
that State home. Any such application shall describe the nursing 
shortage at the State home and the employee incentive scholarship 
program or other employee incentive program described in subsection (c) 
for which the payment is sought.
    ``(f) Source of Funds.--Payments under this section shall be made 
from funds available for other payments under this subchapter.
    ``(g) Disbursement.--Payments under this section to a State home 
shall be made as part of the disbursement of payments under section 1741 
of this title with respect to that State home.
    ``(h) Use of Certain Receipts.--The Secretary shall require as a 
condition of any payment under this section that, in any case in which 
the State home receives a refund payment made by an employee in breach 
of the terms of an agreement for employee assistance that used funds 
provided under this section, the payment shall be returned to the State 
home's incentive program account and credited as a non-Federal funding 
source.
    ``(i) Annual Report From Payment Recipients.--Any State home 
receiving a payment under this section for any fiscal year, shall, as a 
condition of the payment, be required to agree to provide to the 
Secretary a report setting forth in detail the use of funds received 
through the payment, including a descriptive analysis of how effective 
the incentive program has been on nurse staffing in the State home 
during that fiscal year. The report for any fiscal year shall be 
provided to the Secretary within 60 days of the close of the fiscal year 
and shall be subject to audit by the Secretary. Eligibility for a 
payment under this section for any later fiscal year is contingent upon 
the receipt by the Secretary of the annual report under this subsection 
for the previous fiscal year in accordance with this subsection.

[[Page 118 STAT. 2382]]

    ``(j) Regulations.--The Secretary shall prescribe regulations to 
carry out this section. The regulations shall include the establishment 
of criteria for the award of payments under this section.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after section 1743 the following new item:

``1744. Hiring and retention of nurses: payments to assist States.''.

    (b) <<NOTE: 38 USC 1744 note.>> Implementation.--The Secretary of 
Veterans Affairs shall implement section 1744 of title 38, United States 
Code, as added by subsection (a), as expeditiously as 
possible. <<NOTE: Procedures. Deadline.>> The Secretary shall establish 
such interim procedures as necessary so as to ensure that payments are 
made to eligible States under that section commencing not later than 
June 1, 2005, notwithstanding that regulations under subsection (j) of 
that section may not have become final.

SEC. 202. TREATMENT OF DEPARTMENT OF VETERANS AFFAIRS PER DIEM PAYMENTS 
            TO STATE HOMES FOR VETERANS.

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

SEC. 203. EXTENSION OF AUTHORITY TO PROVIDE CARE UNDER LONG-TERM CARE 
            PILOT PROGRAMS.

    Subsection (h) of section 102 of the Veterans Millennium Health Care 
and Benefits Act (38 U.S.C. 1710B note) is amended--
            (1) by inserting ``(1)'' before ``The authority of''; and
            (2) by adding at the end the following new paragraph:

    ``(2) In the case of a veteran who is participating in a pilot 
program under this section as of the end of the three-year period 
applicable to that pilot program under paragraph (1), the Secretary may 
continue to provide to that veteran any of the services that could be 
provided under the pilot program. <<NOTE: Applicability.>> The authority 
to provide services to any veteran under the preceding sentence applies 
during the period beginning on the date specified in paragraph (1) with 
respect to that pilot program and ending on December 31, 2005.''.

SEC. 204. PROHIBITION ON COLLECTION OF COPAYMENTS FOR HOSPICE CARE.

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

                         TITLE III--MEDICAL CARE

SEC. 301. SEXUAL TRAUMA COUNSELING PROGRAM.

    (a) Permanent Authority for Program.--Section 1720D(a) is amended--
            (1) in paragraph (1), by striking ``During the period 
        through December 31, 2004, the'' and inserting ``The''; and

[[Page 118 STAT. 2383]]

            (2) in paragraph (2), by striking ``, during the period 
        through December 31, 2004,''.

    (b) Extension to Cover Active Duty for Training.--Such section is 
further amended by inserting ``or active duty for training'' in 
paragraph (1) before the period at the end.

SEC. 302. CENTERS FOR RESEARCH, EDUCATION, AND CLINICAL ACTIVITIES ON 
            COMPLEX MULTI-TRAUMA ASSOCIATED WITH COMBAT INJURIES.

    (a) In General.--(1) Subchapter II of chapter 73 of title 38, United 
States Code, is amended by adding at the end the following new section:

``Sec. 7327. Centers for research, education, and clinical activities on 
                        complex multi-trauma associated with combat 
                        injuries

    ``(a) Purpose.--The purpose of this section is to provide for the 
improvement of the provision of health care services and related 
rehabilitation and education services to eligible veterans suffering 
from complex multi-trauma associated with combat injuries through--
            ``(1) the development of improved models and systems for the 
        furnishing by the Department of health care, rehabilitation, and 
        education services to veterans;
            ``(2) the conduct of research to support the provision of 
        such services in accordance with the most current evidence on 
        multi-trauma injuries; and
            ``(3) the education and training of health care personnel of 
        the Department with respect to the provision of such services.

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