To establish an office to oversee research compliance and assurance within the Veterans Health Administration of the Department of Veterans Affairs.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1720) to authorize the Secretary of Veterans Affairs to carry out construction projects for the purpose of improving, renovating, establishing, and updating patient care facilities at the Department of Veterans Affairs medical centers, as amended.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I am pleased that the House is today considering H.R. 1720, as amended, the Veterans Health Care Facilities Capital Improvement Act. Enactment of this measure would be a significant step in addressing the problem of crumbling and substandard health care facilities for our Nation's veterans.

I want to just say at the outset how very delighted and pleased I am that the gentleman from Connecticut (Mr. Simmons) is here. As the chairman of the Subcommittee on Health and the prime sponsor of this bill, he has worked many, many hours in crafting this legislation. I want to really pay him the highest compliment for the extraordinarily good work he did in writing this legislation. I thank the gentleman for his leadership on this. I would also like to thank my friends on the other side of the aisle for their good, hard work. This is a bipartisan bill that we present to the House today, and I hope it will get the full support and assent of this body.

Mr. Speaker, most VA hospitals, clinics, nursing homes, and research facilities have ongoing needs for maintenance, repair, and modernization to promote patient and employee safety and provide a higher standard of care for our Nation's veterans. For example, hundreds of millions of dollars are needed to address problems at many VA facilities that could suffer severe damage in the event of an earthquake. However, projects to address these and other deficiencies have been put on the shelf while VA contemplates and completes its CARES process.

The Department of Veterans Affairs is currently undertaking, as I think many Members know, a market-based national assessment to determine whether its present health care facilities meet current and future veterans' health care needs. The VA's process for achieving this goal, called the Capital Asset Realignment for Enhanced Services, or CARES, is intended to produce a national plan which the Secretary will then approve or disapprove by the end of the year. Members, I am sure, or at least some Members, are aware that while the VA has an aggressive schedule for completing the planning process, the implementation of this plan will take many years to complete. In the meantime, a number of pressing construction needs have been identified.

The committee has been vigilant to avoid authorizing projects at facilities that might not be needed to serve the future needs of our veterans. All of the projects authorized by our committee in recent authorization measures would serve veterans for many years after they have been completed. Similarly, the projects authorized in this bill would improve health care for veterans for 20 years or more and are a wise and, we believe, worthy investment for this Nation to make on behalf of our veterans.

Let me just say, Mr. Speaker, there are a number of additions to this bill that were made precisely because Members came to us and made very persuasive argument as to why they need to be included. The gentleman from Colorado (Mr. Hefley) and the gentleman from Colorado (Mr. Beauprez), a member of the committee, really pushed hard on the Fitzsimons project. That is included in here. The gentleman from New Jersey (Mr. LoBiondo) from my own State made a very strong estimate and gave us documentation for a study. That is included in here. There are others that came to us, again made their cases, cogent cases that they were; and those have been included in this authorization measure.

Mr. Speaker, I am pleased the House is considering H.R. 1720, as amended, the Veterans Health Care Facilities Capital Improvement Act. Enactment of this measure would be a significant step in addressing the problem

of crumbling and substandard health care facilities for our Nation's veterans.

Mr. Speaker, most VA hospitals, clinics, nursing homes and research facilities have ongoing needs for maintenance, repair and modernization to promote patient and employee safety and provide a higher standard of care for our Nation's veterans. For example, hundreds of millions of dollars are needed to address problems at many VA facilities that could suffer severe damage in the event of an earthquake. However projects to address these and other deficiencies have been ``put on the shelf'' while VA completes its CARES process.

The Department of Veterans Affairs is currently undertaking a market- based national assessment to determine whether its present health care facilities meet current and future veterans' health care needs. The VA's process for achieving this goal, called Capital Asset Realignment for Enhanced Services, or CARES, is intended to produce a national plan which the Secretary will then approve or disapprove by the end of this year. While VA has an aggressive schedule for completing the planning process, the implementation of this plan will take many years to complete. In the meantime, a number of pressing construction needs have been identified.

The VA Committee has been vigilant to avoid authorizing projects at facilities that might not be needed to serve the future needs of veterans. All of the projects authorized by our committee in recent authorization measures would serve veterans for many years after they have been completed. Similarly, the projects authorized in this bill would improve health care for veterans for 20 years or more, and are a wise and worthy investment for this Nation to make on behalf of veterans.

Mr. Speaker, we are coming to a crossroads in the pattern of funding for VA health care facilities. A consultant's report in June 1998 concluded that VA should be spending (at a minimum) from 2 percent to 4 percent of its ``plant replacement value'' on upkeep and replacement of its health care facilities. The value of VA facilities was estimated to be $35 billion in 1998; thus, VA should be spending from $700 million to $1.4 billion each year to keep pace with its capital needs. Sadly, VA only received $213 million in VA construction funding for fiscal year 2003 and only requested $421 million for fiscal year 2004.

When the Undersecretary for Health submitted his admittedly incomplete CARES plan to the Secretary's CARES commission earlier this year, it called for a minimum of $3.5 billion in new construction over the next 5 years. I say the plan was incomplete because it excluded funding for projects that would enhance VA's ability to provide veterans with long-term care. The VA Committee has called on the CARES Commission to address this serious shortcoming. Nevertheless, a plan to spend $3.5 to $4 billion over the next 5 years means that Congress will need to appropriate $700 to $800 million every year during that period. Mr. Speaker, even though the deficit outlook for the next several years is not good, this is an obligation that has been put off long enough. The failure to begin addressing this huge backlog in renovation and modernization projects can only lead to inefficiency and inferior care for veterans in the future.

Mr. Speaker, H.R. 1720, as amended, would authorize the Department of Veterans Affairs to improve, establish, restore or replace VA health care facilities where necessary. The Committee decided in the last Congress that there is a demonstrable need to provide a more flexible and responsive authorization process to address the overwhelming backlog of construction projects, and this bill continues with that approach.

Under this bill, the Secretary would be authorized to approve individual facility projects, based on the decisions of a capital investments board that must carefully and objectively consider each proposed construction project. The bill provides criteria to be used by the board that would place a premium on projects to protect patient safety and privacy, improve seismic protection, and provide barrier- free accommodations. It would also emphasize improving VA patient care facilities areas of particular concern, such as specialized care programs, in order to meet the contemporary standard of care veterans deserve and need.

H.R. 1720 would require the Secretary to report his actions on construction to this Committee and to the Committee on Appropriations, and would mandate a review of the delegated-project approach by the General Accounting Office, to ensure this is an effective mechanism to advance VA medical construction during and after the CARES process.

The bill also would authorize construction of a specific set of urgent major medical projects as follows: Clark County, NV--the lease of a multi-specialty outpatient clinic and Veterans Benefits Administration satellite office at an annual rent not to exceed $6,500,000; Columbus, OH--$90,000,000 to construct a new VA medical center; West Haven, CT--$50,000,000 to renovate inpatient wards and research facilities at the Wet Haven VA medical center; Chicago, IL-- $98,500,000 to consolidate inpatient care in a new bed tower at the West Side Division; San Diego, CA--$48,600,000 for seismic corrections to Building 1 at the San Diego VA medical center; and Pensacola, FL-- $45,000,000 to construct a joint-venture outpatient clinic at the Pensacola Naval Air Station. The bill would require the Secretary to move forward on these projects first before awarding construction contracts under the general construction delegation provided by the bill.

Mr. Speaker, this bill would authorize appropriations of $500 million in fiscal year 2004 and $600 million in fiscal year 2005 to accommodate construction projects under the various authorities provided. Additionally, the bill would authorize the appropriation of $300 million over 3 years for the replacement VA medical center near Denver CO, at the former Fitzsimons site.

Mr. Speaker, as I mentioned, H.R. 1720, as amended, includes the provisions of H.R. 116, a bill to authorize a joint VA-Air Force health care facility to be located on the grounds of the ``New Fitzsimons'' campus of the University of Colorado Health Sciences Center, in Aurora, CO. The bill would require the Secretary, after consulting with the Secretary of Defense, to decide how to replace the 57-year-old Denver medical center with a new Federal Regional Medical Center in Aurora. There is a unique opportunity at this location to enhance VA-DOD sharing by jointly constructing or leasing a premier health treatment facility as a joint venture of the VA, the Department of the Air Force, and the University. We certainly expect that both the Air Force and the VA will find a way to execute this plan in a manner that advances the interests of the American taxpayer and the beneficiaries served by the two Departments.

I want to commend Chairman Joel Hefley and Representative Bob Beauprez, a Member of the VA Committee, for spurring this project forward. We would not be considering this measure on the floor of the House today without their hard work and individual efforts to help make this project a reality.

H.R. 1720 would also require VA to conduct a study and report on the feasibility of constructing a new medical center for veterans in Charleston, SC, and a study for meeting the inpatient hospitalization needs of southern New Jersey veterans. The Committee appreciates the work of Mr. Brown, the chairman of our Subcommittee on Benefits, and Mr. LoBiondo, the distinguished chairman of the Subcommittee on Coast Guard and Maritime Transportation, for their insight in crafting these two provisions.

The final measures in the bill, Mr. Speaker, would designate the Department of Veterans Affairs Outpatient Clinic in New London, CT, as the John J. McGuirk Department of Veterans Affairs Outpatient Clinic, and the VA Medical Center at 820 S. Damon Street in Chicago, IL, the Jesse Brown Veterans Affairs Medical Center.

Our bipartisan bill would also honor the late Jesse Brown, former Secretary of Veterans Affairs, for his exemplary service to his country as a combat-wounded U.S. Marine Corps veteran of the Vietnam war and dedicated leader of the Department of Veterans. Mr. Brown enlisted in the Marine Corps in 1963 and was seriously wounded in Vietnam. Mr. Brown's career in veterans' advocacy spanned his entire remaining life. He served with distinction in the Clinton administration as the third Secretary of Veterans Affairs, and is buried at Arlington National Cemetery.

Naming the West Side VA Medical Center after Jesse Brown would appropriately memorialize his accomplishments and commitment to improving the quality of life of all veterans.

The final provision in this bill adds a new degree of accountability to the VA medical research program. The provision is the result of efforts by two of the Committee's Subcommittee chairmen, Mr. Buyer and Mr. Simmons. Their proposal is supported by Ms. Hooley and Mr. Rodriguez, their respective ranking members.

The language of section 11, which is taken from H.R. 1585 as revised by our Subcommittee on Health requires VA to maintain a permanent and independent research compliance and assurance office. While establishment of this office may not provide a complete shield against possible future abuses, it does send a clear message that the Congress expects compliance with rules already in place to assure protection of human subjects who participate in research sponsored by VA.

Finally, I want to thank the Committee's ranking member, Lane Evans, for his support of this legislation, and for the work of the chairman and ranking member of the Health Subcommittee, Rob Simmons and Ciro Rodriguez, respectively, for considering this bill in a timely fashion.

Mr. Speaker, I urge my colleagues to support H.R. 1720, as amended.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield for the purpose of making a unanimous consent request to the gentleman from Indiana (Mr. BUYER), who wrote section 11 dealing with human research protection.

(Mr. BUYER asked and was given permission to revise and extend his remarks, and include extraneous material.)

Mr. Speaker, I yield 5 minutes to the distinguished gentleman from Connecticut (Mr. Simmons), the prime sponsor of this legislation and the chairman of our Subcommittee on Health.

(Mr. SIMMONS asked and was given permission to revise and extend his remarks, and include extraneous material.)

Mr. Speaker, I yield 1 minute to my good friend and colleague, the gentleman from Nevada (Mr. Gibbons), and thank him for his work on behalf of the $6.5 million lease for the outpatient clinic in his area.

(Mr. GIBBONS asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield 2 minutes to my good friend and colleague, the gentleman from Florida (Mr. Miller), and thank him because he was very instrumental in helping us work on the language that provides $45 million for an outpatient clinic in Pensacola. I want to thank him for that outstanding work he did.

Mr. Speaker, I yield 2 minutes to the distinguished gentleman from Ohio (Mr. Hobson) and thank him for his work on the medical center, a $90 million authorization that he worked so hard to procure.

(Mr. HOBSON asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield 6 minutes to the distinguished gentleman from Colorado (Mr. Hefley), who is the author of H.R. 116, which is included as section 4 of this bill, which authorizes a $300 million Fitzsimons Hospital System, along

with the gentleman from Colorado (Mr. Beauprez), who is the chief cosponsor.

(Mr. HEFLEY asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield 6 minutes to the distinguished gentleman from Colorado (Mr. Hefley), who is the author of H.R. 116, which is included as section 4 of this bill, which authorizes a $300 million Fitzsimons Hospital System, along with the gentleman from Colorado (Mr. Beauprez), who is the chief cosponsor.

(Mr. HEFLEY asked and was given permission to revise and extend his remarks.)

And the university's move will create a state-of-the-art medical campus which, in turn, will develop many of the very best services of in the United States. The Anschutz Cancer Pavilion, which is already open, is among the best institutions in the Nation for all types of cancer treatment and research.

The University of Colorado Health Science Center is well known throughout the country for its organ transplant programs, for instance. Unfortunately, the University's move created an 8-mile separation between the University of Colorado and the old veterans hospital that had been so close before.

This 8-mile separation creates a very real and significant barrier to quality care for veterans who have been working in cooperation all these years, the two hospitals.

A study commissioned by the Veterans Integrated Service Network indicated that high demand for medical services by veterans at the Denver Veterans Medical Center will continue unabated for at least the next 20 years. The cost of maintaining the current Denver Veterans Medical Center, to satisfy minimal accreditation levels until 2020, has been estimated to be $233 million, and estimates to rebuild the facility in 2020 are $377 million in today's dollars.

So if we put this $233 million into it, at the end of this period, this 20-year period, we still have an old facility, and we have put almost as much into it as it would take to build a new facility.

Planning studies have shown that a move of the Denver Veterans Medical Center to the Fitzsimons campus is the most cost-effective of the reasonably accepted alternatives.

The Denver Veterans Medical Center relocation to the Fitzsimons campus will solve aging facilities issues, cap new facilities cost, enhance quality of medical care, increase flexibility and reduce operational costs. Veterans who have highly specialized medical needs must have easy access to the best diagnostic and treatment programs that America provides.

In a medical school environment, doctors tend to be better informed of the latest treatment procedures and protocols. They are closer to the cutting edge of modern medicine. Quality of medical care for veterans is enhanced in a medical school teaching hospital. University physicians and special residency programs provide a significant amount of care in the Denver veterans medical center. To date, some 90 percent of the physicians that work at the VA Medical Center also work at the University of Colorado Health Science Center. And most VA doctors have faculty appointments in the medical school.

Colocating the University of Colorado hospital in the Denver Veterans Medical Center will allow university doctors to continue their close relationship in treating veterans.

Mr. Speaker, let me just summarize real quickly. This is an opportunity that you do not get very often, to have a medical campus which is, in essence, right in the middle of a metropolitan area like Denver, Colorado. If it was not for the closing of Fitzsimons Hospital, which we all hated at the time, this would never have come about. But right here, in the middle of this metropolitan area, you will have the one of the finest, state-of-the-art, cutting edge health medical facilities in the whole United States. It is going to mean cutting edge, quality care for veterans. The gentleman from New Jersey (Mr. Smith) can take a lot of credit when this comes about.

The new VA Medical Center at Fitzsimons site will be veteran-friendly and will provide a practicable alternative to the Denver Veterans Medical Center remaining at its current, out-dated facility.

The new Veterans Medical Center at Fitzsimons will be a free-standing ambulatory and impatient care federal tower building for veterans, clearly identified as the Veterans Administration Medical Center.

New veterans research facilities will be constructed and there will be a new veterans long-term care unit located next to the new 180-bed State veterans nursing home currently being constructed at the site.

Given the rising demand for veterans health care, and the significant challenges of an aging and increasingly less-efficient Denver Veterans Medical Center facility, my interest and my efforts are aimed at continuing the collaboration between the Denver Veterans Medical Center, University of Colorado Health Sciences Center and University of Colorado Hospital.

I believe that the opportunity to co-locate the Denver Veterans Medical Center with the University of Colorado Health Sciences Center and the University of Colorado Hospital at the Fitzsimons campus will meet the demand for veteran care in this area through 2020 and beyond; provide significant savings in both capital and operational costs for the Department of Veterans Affairs and the taxpayer; continue to meet the Denver Veterans Medical Center commitment to education and research; and potentially create a national model for the future of veterans' care dealing with both a new concept for facilities and collaboration with long-established partners. More importantly, this move will retain veteran ``identity'' while also providing optimum patient care.

To date, over 45 local, state and national Veterans' Service Organizations and the American Federation of Government Employees, Local 2241, have expressed their support for this proposal.

I believe that co-locating the Denver Vetrans' Medical Cebter with the University of Colorado Hospital will achieve the goals of providing the up-most modern, comprehensive and cost-efficient medical care that we as a nation owe our veterans.

Congress has a duty to provide the best medical care it can to our nation's veterans

and we must always strive for the very best health care services it can by utilizing the most cost-effective measures available.

The fact is, aging facilities, lack of funds, and the growing demands on the veterans health system are proving to be daunting obstacles in meeting Congress' responsibilities to our nation's veterans.

However, the possibility for the Denver Veterans Medical Center to move to Fitzsimons and co-locate with University of Colorado Health Sciences Center and University of Colorado Hospital is a unique opportunity to provide solid and constructive solutions to these challenges.

Mr. Speaker, I want to thank the gentleman from Colorado (Mr. Hefley) again, Mr. Speaker, for the outstanding work that he has done. He has been indefatigable in promoting this project along with the gentleman from Colorado (Mr. Beauprez). And we are very, very grateful on the committee to have that kind of advocacy coming our way on behalf of the veterans.

Mr. Speaker, I would inquire as to our remaining time and ask if the gentlewoman from Nevada (Ms. Berkley) might yield some of her time. We have an additional speaker, the gentleman from Colorado (Mr. Beauprez).

Mr. Speaker, I thank the gentlewoman from Nevada (Ms. Berkley) for her gracious yielding.

Mr. Speaker, I yield 3 minutes to the gentleman from Colorado (Mr. Beauprez). He has been a very strong supporter of this legislation in general, but particularly for Fitzsimons.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I thank the gentleman from Colorado (Mr. Beauprez), a good friend, for his statement and for his fine work.

Mr. Speaker, I remind my colleagues we are at a crossroads. We have not done our due diligence in ensuring that sufficient funds were available to renovate, to update, to modernize our aging infrastructure of VA health care and other facilities within the VA, that is to say, those dealing with research and development.

There was a consultants' report as far as back as June of 1998 that suggested we spend 2 to 4 percent on plant replacement value to upkeep these vital facilities. We have not done that. We need to now do some hurry-up-and-catch-up baseball here. This legislation is certainly a step in the right direction. I hope it has the full support of our colleagues.

Mr. TIBERI. Mr. Speaker, I rise today to express my support

for H.R. 1720, the Veterans Health Care Facilities Capital

Improvement Act. I am pleased that the House of

Representatives acted today to approve this important bill.

H.R. 1720 includes language originally included in

legislation introduced by my colleague, Congressman David

Hobson, that authorizes the construction of an expanded VA

medical facility on the campus of the Defense Supply Center

in Columbus, OH.

I have been deeply and personally committed to improving

health care for veterans for nearly 20 years, going back to

my days as a congressional staffer handling veteran's

casework. I know first hand the difficulties our veterans

have had receiving the level of care they earned through

their service to our country.

Columbus is the 15th largest city in America. Central Ohio,

a metropolitan area of 1.2 million people, has over 135,000

veterans who reside here. Yet we have never had a VA

hospital, and our clinic has always been too small to provide

the services needed for our veterans. As one of the fastest

growing areas in the country, we continue to see the number

of veterans in central Ohio increase each year.

On the day it opened in 1995, our existing clinic was

already too small to meet all the health care needs of our

veterans. It was designed to handle 135,000 annual visits.

Last year there were 192,000 visits, and this year the clinic

is handling 823 visits per day, which will total

approximately 205,000 visits in 2003. Furthermore, the

current veterans population projection data does not account

for veterans of Operation Enduring Freedom, Noble Eagle or

Iraqi Freedom. In Ohio alone we have mobilized over 6,000

National Guard and Reserve Forces who are now eligible for

health care, as well as the hundreds of thousands of Active

Duty soldiers of those operations who will be returning home

in the near future. These new veterans will dramatically

swell the rolls at our local facilities.

While our local VA officials do the best they can with the

resources they have been given, the existing facility is

simply too small to meet our current needs, much less the

growing needs of the future.

A continued piecemeal approach to veterans' needs both

wastes taxpayer dollars, and provides substandard care to the

central Ohio men and women who have given so much to our

country. The VA spends nearly $3 million a year shipping our

veterans around the State, admitting emergency cases to a

local hospital, and paying for outpatient specialty care

because they lack adequate facilities. Additionally, the

current facility is leased, and the lease will expire in just

over 10 years. I believe it is not a good use of taxpayer

money to invest dollars in a facility the VA will not control

over the long term.

I want to tell you about a veteran I know who lives in

Pataskala, OH. Mr. Stanley Folk is 78 years old, and is a 60

percent service connected World War II veteran who is forced

to travel to the Cincinnati VA hospital twice a month. He

gets up at 4:30 a.m. to catch a shuttle down to Cincinnati to

get the treatment he needs. He is forced to stay there all

day until the shuttle returns him to Columbus. He does not

get home until well after 7 p.m. The strain of this trip

makes him so tired and ill that he is in bed for several days

after to recover. This would be a hardship on anyone, but is

doubly so for the elderly and disabled. It is unconscionable

that veterans must go through this to get the care they

deserve. The sad part is Mr. Folk is not alone. I could go on

and on with stories of veterans who have faced similar

hardship.

Furthermore, there are many veterans who will not seek

emergency care at night and on weekends, because the VAOPC is

closed, and they are afraid to go to private hospitals with

no prior guarantee the VA will pay the private hospital

expense. These veterans have no health insurance and they are

afraid they will be stuck with a large bill they cannot pay,

so they delay treatment at risk to their health.

I believe the facts clearly show that these facilities and

services are desperately needed to meet the health care needs

of veterans in central Ohio. I would like to thank Chairman

Smith and Ranking Member Evans, as well as Subcommittee

Chairman Simmons and Ranking Member Rodriguez for their hard

work on this legislation. My colleagues in the central Ohio

delegation, Congressman David Hobson and Congresswoman

Deborah Pryce, as well as Ohio Senators Mike DeWine and

George Voinovich, also deserve a great deal of credit for

their hard work on this issue and steadfast support for the

interests of central Ohio's veterans.

Mr. Speaker, I yield back the balance of our time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I also am proud to speak today in strong support of H.R. 1720, the Veterans Health Care Facilities Capital Improvement Act. Many facilities in the VA health care system are run- down, decrepit buildings that are not conducive to providing quality health care to our veterans.

The Denver Veterans Medical Center in Colorado was constructed approximately 50 years ago to provide fairly low-volume inpatient care to our veteran population. In Colorado today, as my distinguished colleague, the gentleman from Colorado (Mr. Hefley) just outlined, we have an opportunity to provide health care in a much more efficient manner.

The Denver Veterans Medical Center is in decaying state. It is faced with two main alternatives with regard to this facility. The first alternative is to invest in renovation of this facility and make it capable of handling the medical needs of our current veteran population and the changing needs of that population over the next 20 or so years. After such a renovation, not only would the VA still be left with a 50- year-old building, but as the gentleman from Colorado (Mr. Hefley) pointed out, it would also be an orphaned medical center.

The second alternative is to relocate the building to the new Fitzsimons campus. Such a relocation would allow for a modern facility to deliver modern health care on a state-of-the-art medical campus, one that we think will be a standard for the whole Nation.

The VA would be able to take advantage of the University of Colorado partnership which will provide numerous operational efficiencies, as well as access to an extensive staff of doctors, technicians, and specialists.

This legislation would also authorize this critical relocation. The cost to restore the Denver facility far outweighs the cost of constructing a new hospital. It is estimated that the savings in operational efficiencies at Fitzsimons itself will pay for construction of the new hospital. Regardless of where our veterans happen to live, they deserve the best care possible.

Mr. Speaker, I want to compliment the gentleman from New Jersey (Mr. Smith), the gentleman from Connecticut (Mr. Simmons), the gentleman from Colorado (Mr. Hefley), my colleague, for bringing this important legislation to the floor.

Again, Mr. Speaker, we believe that the Fitzsimons Veterans Hospital will become a standard for delivering better health care to our veterans for years and years to come.

Mr. Speaker, I am proud to speak today in support of H.R. 1720, the Veterans Health Care Facilities Capital Improvement Act. During my time serving on the Veterans Affairs Committee I have learned first hand the difficulties and challenges the VA faces in order to provide healthcare to our nations veterans. It is my belief H.R. 1720 is one of many steps we in Congress can take to address the challenges of the VA by authorizing major medical construction for certain VA facilities.

Many facilities in the VA healthcare system are run-down, decrepit buildings that are not conducive to providing quality healthcare to our veterans. It is inconceivable to think the VA system should be expected to handle an increased amount of patients without the proper medical facilities in which to do so. We must remember that before we place increased demands on the VA we must provide the system with the tools to succeed in their mission of quality, timely healthcare.

As military operations continue to be carried out by the United States overseas, we will be creating a new generation of veterans in need of medical services from the VA. As medical costs continue to rise in the United States, many people, unable to afford private medical care will enroll for medical care with the VA. Also, as described by Deputy Secretary Leo Mackay, ``the VA's record of achievement in medical care has been so dramatic that we are now confronted with unprecedented demand for our services.'' The population dynamics that have been taking place in terms of VA enrollment are staggering. We have record levels of enrollment for VA Health Care today. In many parts of the country, those numbers will be leveling off, and slowly decreasing in the years to come. In my home state of Colorado, the enrollment numbers will only continue to rise.

The history of the VA is a unique one, especially when it comes to the medical care of our Nation's veterans. The Denver Veterans Medical Center in Colorado was constructed primarily to provide low-volume inpatient care to our veteran population. Over time, the VA has worked to adapt this center to the ways of modern medicine, and to provide primarily high-volume outpatient care to our veterans. Unfortunately, the costs associated with the necessary renovations are extremely high, and this building is finding little potential for further renovation to address current medical needs with modern medical equipment.

The issues faced by this center are not unique, and are exactly the types of issues that prompted the CARES process to be initiated. In 1999, the General Accounting Office reported that the ``VA could enhance veterans' health care benefits if it reduced the level of resources spent on underused or inefficient buildings, and used these resources instead. To provide health care more efficiently.'' In Colorado today, we have just such an opportunity to provide health care in a much more efficient manner.

Since the construction of this medical center fifty years ago, the VA has established a partnership with the University of Colorado-Health Science Center to enhance the quality of care provided here. I am told that approximately 90 percent of the doctors providing care here are University doctors. Most research initiatives carried out in this hospital are carried out with the help of University researchers. Cutting edge medical procedures are carried out at this hospital through collaboration between the VA, and the University of Colorado. After the University's decision to relocate to Fitzsimons was made a few years ago, the 50-year partnership between CU and the VA has begun to erode. The VA is losing access to the fine medical staff from CU that they have relied upon for such a long time.

The University saw the potential to create numerous operational efficiencies in their move to Fitzsimons, and they acted on it. Today, the VA has the potential to benefit from many of these same efficiencies by moving to Fitzsimons, and create other ones through an extended collaboration with the University and the Department of Defense. Congress, through H.R. 1720, should authorize the VA to act on this opportunity in

much the same way the University did. This House has already begun the process of action by approving four million dollars in the DoD appropriation, and an additional nine million dollars in the VA/HUD appropriation this year.

The Denver Veterans Medical Center is faced with two main alternatives with regard to their facility. The first alternative is to invest in the renovation of this facility to make it capable of handling the medical needs of our current veteran population, and the changing needs of that population over the next 20 years. After such a renovation, not only would the VA still be left with a 50-year old building, but it would also be an orphaned medical center. The second alternative is to relocate to the new Fitzsimons campus. Such relocation would allow for a modern facility to deliver modern health care in a preferred location. The VA would once again be able to take advantage of the University partnership, which will provide numerous operational efficiencies as well as access to an extensive staff of doctors, technicians, and specialists.

It is my belief that the savings in operational efficiencies of Fitzsimons in itself will pay for the construction of the new hospital. Of greater importance, the quality of care that could be provided to our veterans will be much higher at Fitzsimons.

Construction of a new hospital at Fitzsimons also allows for the ability to build a much needed Spinal Cord Injury center. Such a center is highly desired not only by the veterans in our district, but it would also be well suited for ideal research opportunities with the university. Currently, the closest Spinal Cord Injury center to our region is a great distance away in Albuquerque, New Mexico.

One final reason construction of a new VA hospital at Fitzsimons is a better option, lies in the hospital's potential for cutting-edge enhancements in veteran health care through collaborative research with the university.

As you know, the Department of Defense has recently expressed an interest in joining in the collaborative arrangement already espoused by the University and the VA. The benefits of this arrangement for our active duty and their families currently stationed at Buckley Air Force Base would be profound. Aside from having access to a full spectrum of medical services not available on base, these soldiers and their family will not have to worry about the potential loss in medical care caused by deployments of those who serve in the medical corps. The benefits to the base doctors will also increase significantly, allowing them to experience medical situations not typically found in a military community, while also having quick access to some of the greatest medical resources, references, and research in the country.

Regardless of where our veterans happen to live, they deserve the best care possible. As the House votes on this measure today, I ask that we all keep in mind the long-term planning mission of the VA: ``to improve access to, and the quality and cost effectiveness of, veterans health care.'' This message cannot be forgotten when addressing the needs of our veterans living in rural and outlying network areas.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1385) to extend the provision of title 39, United States Code, under which the United States Postal Service is authorized to issue a special postage stamp to benefit breast cancer research, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks on the bill under consideration.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, H.R. 1385, introduced by my distinguished colleague from my home State of California (Mr. Baca), extends the life of the breast cancer research semipostal stamp.

Mr. Speaker, on the night of July 22, 1997, Dr. Ernie Bodai, Betsy Mullen, and David Goodman sat breathlessly in the House gallery awaiting the outcome of a vote that they had worked tirelessly to see become a reality. At that time, H.R. 1585, the Stamp Out Breast Cancer Act, was landmark legislation establishing the Breast Cancer Research Stamp Program and directing the U.S. Postal Service to issue a new first-class breast cancer stamp with proceeds benefiting breast cancer research at the National Institutes of Health and the Department of Defense Breast Cancer Research Programs.

This advocacy team, a surgeon, a survivor and a widower, used their own time and resources to convince lawmakers to pass this essential legislation.

Dr. Ernie Bodai of Carmichael, California, a constituent and personal friend of mine, led the charge. After 14 visits to Washington within 2 years, as well as spending over $100,000 of his personal savings, he succeeded, creating the lead for breast cancer fund-raising. Dr. Bodai is the pioneer of the breast cancer stamp, chief of general surgery for Kaiser Permanente, and CEO of CureBreastCancer, Inc.

Joining him in this crusade was Betsy Mullen. Ms. Mullen is one of slightly over 2 million women living in the United States who have been diagnosed with and treated for breast cancer. She was diagnosed with breast cancer in 1992 at age 33 and formed the Women's Information Network Against Breast Cancer, the acronym WIN ABC, which provides information and support for life-and-death decisions about treatment options.

The final member of this advocacy team is David Goodman, a WIN board member who lost his wife to breast cancer less than a year before appearing on the House floor.

H.R. 1585, the Stamp Out Breast Cancer Act, passed the House on a 433 to three vote; and on August 13, 1997, President Clinton signed this legislation into law. By May 9, 1998, the U.S. Postal Service unveiled the new 40 cent stamp, and August 9 the stamp officially went on sale to the public.

The legislation we are considering today, H.R. 1385, reauthorizes the breast cancer research stamp program through the year 2006. The stamp marks the first time that some of the proceeds of stamp sales have gone to fund research, and the awareness raised as a result of this historic stamp designed to save lives continues to be priceless. As of December of 2002, 421.3 million breast cancer research stamps have been sold dating from July 29, 1998, raising almost $30 million for biomedical breast cancer research at the National Institutes of Health and the Department of Defense.

The Department of Defense Breast Cancer Research Program receives 30 percent of the moneys raised from stamp sales. Since the breast cancer stamp was introduced, Department of Defense has received over $9 million from the stamp's sales, and the National Cancer Institute has received $24 million.

The breast cancer stamp functions like a regular first-class stamp and is purchased on a voluntary basis by the public. In 1997, when a person purchased the breast cancer stamp, 32 cents would be used for postage and the extra 8 cents from each stamp sold was turned over to research programs run by the National Institutes of Health and the Defense Department. Today, the stamp can be purchased for 45 cents.

The stamp is a line drawing of the Roman goddess Diana reaching back to retrieve an arrow from her quiver, and the words, ``Fund the fight. Find a cure,'' written across.

The exact cause of breast cancer is not known; therefore it is imperative that researchers continue to study the basic biology of cancer.

Research proposals funded by the Breast Cancer Research Stamp look at the basic biology of breast cancer, such as understanding the changes in breast cells, including DNA and proteins in the cells that result in the development of breast cancer. An increased understanding in cancer cells could lead to the development of new drugs to prevent or treat breast cancer.

Funding is directed to prevention, detection, diagnosis and treatment research projects. Studies examine the use of antibiotics to block breast cancer cell growth, to observe tumor behavior to keep the cancer from spreading, to explore immunotherapy and the potential to create a vaccine to stimulate the human immune system to protect itself from breast cancer, and search for alternatives to mammography for breast cancer detection.

The program's success encouraged Congress to appropriate additional funds to the Breast Cancer Research Program in subsequent years, totaling over $1.6 billion through fiscal year 2004. To date, the Breast Cancer Research Program supported awards in three categories: Research, Research Resources, and Training Recruitment, as well as the Innovator Award.

Projects are coordinated to specifically avoid duplication of research between the Department of Defense on the one hand and the National Institutes of Health on the other. Awards are meant to fill gaps in ongoing research and to compliment initiatives sponsored by other agencies. The Department of Defense Breast Cancer Research Program has emphasized support for research and training awards that encourage innovative approaches to breast cancer research to accomplish the program's vision of eradicating breast cancer.

In addition to research, the Department of Defense Breast Cancer Research Program has sponsored three Era of Hope meetings to publicly present results of DOD funded studies and provide researchers with the opportunity to share their results with the scientific community, with policymakers, and with the lay public. The most recent meeting, in 2003, was held in Orlando, Florida, with over 1,500 scientists, clinicians, and breast cancer survivors and advocates in attendance.

A National Cancer Institute report estimates that about one in eight women in the United States will develop breast cancer during her lifetime. It is the most commonly diagnosed cancer in women, accounting for 30 percent of all cancers in women. In 2004, more than 40,000 individuals are projected to die from breast cancer. In 2003, the American Cancer Society estimated 21,100 new cases of breast cancer will be diagnosed among women in my home State of California and, of these, 4,000 women will die from this disease.

An individual's breast cancer risk depends on a variety of factors, including family history, reproductive history, life-style factors such as heavy alcohol consumption and smoking, and a number of other factors that are not yet understood. A woman's risk for developing breast cancer increases if her mother, her sister, her daughter, or two or more other close relatives, such as cousins, have a history of breast cancer, especially at a young age. However, 85 percent of women who develop breast cancer have no known family history of the disease.

Early detection and treatment is the key to survival. Declining death rates caused by breast cancer are believed to be the result of early detection and improved treatment. Breast cancer prevention experts strongly encourage women of all ages to have regular mammograms and to conduct breast self-examinations monthly.

When people choose to purchase the Breast Cancer Stamp every day, they can turn that simple little act into a meaningful and effective way to participate in the fight against breast cancer.

Mr. Speaker, I would like to conclude by thanking my friend, Dr. Ernie Bodai, for his persistence in this fight against breast cancer. Driving through Sacramento, he can be easily spotted in his car, which is adorned by its license plate PL 105-41, the public law number that made the breast cancer fund-raising stamp official. It is in honor of this man and to honor the lives of the victims of breast cancer that I stand before my colleagues, supporting the reauthorization of H.R. 1385.

Mr. Speaker, I thank the gentleman from California (Mr. Baca) for his efforts towards stamping out breast cancer, and I urge all Members to support the passage of H.R. 1385.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I join the gentleman in complimenting the gentleman from California (Mr. Baca) for introducing this legislation, and I urge all Members to support its passage.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I thank the chairman and the ranking members of the Committee on Veterans' Affairs for all of their hard work on this legislation. I also thank my ranking member on the Health Subcommittee, the gentleman from Texas (Mr. Rodriguez), for all of his work. This legislation constitutes a bipartisan effort to fund medical health care facilities for our Nation's veterans.

When I first assumed the chair of the Committee on Veterans' Affairs Subcommittee on Health, I was committed to providing the resources necessary to improve these health care facilities for our veterans, and this has been a bipartisan enterprise for the past 9 months. This legislation is the fruit of that work, and I think this legislation speaks very well for the bipartisan effort that we made on the subcommittee and the committee.

Among other things, this legislation would authorize specific construction projects, such as in Clark County, Nevada, where we just heard about the multispecialty outpatient clinic; in Columbus, Ohio, a new VA medical center; and in West Haven, Connecticut, renovations of a facility that was first built in 1917.

Mr. Speaker, I am proud of the fact that the State of Connecticut built this facility in 1917 as a tuberculosis and a neuropsychiatric hospital, and I am proud of the fact it is affiliated with Yale University's School of Medicine, which is one of the premier schools of medicine in the United States. But the question we have to address to ourselves, not only with this facility but these other facilities, is how efficient are they in today's day and age? How is the morale of VA employees, when they work in facilities that are almost 100 years old? How can we clean them and maintain the standards of sanitation that we want as we treat our veterans population? How can old hospital wards become more user-friendly and accommodate the new technologies for dealing with our veterans? And is there enough renovated space for these purposes?

That is why we are moving forward to authorize certain construction projects, such as in Chicago, Illinois, consolidating inpatient care in a new bed tower in the West Side Division; or in San Diego, California, doing almost $50 million worth of seismic corrections to Building I at the VA medical center; or in Pensacola, Florida, a joint-venture outpatient clinic at the Pensacola Naval Air Station where the Veterans Administration and the Department of Defense are sharing resources and sharing technologies to come up with a joint facility, something that saves our taxpayers a tremendous amount of money.

In the aggregate, Mr. Speaker, this bill would authorize appropriations of $500 million in fiscal year 2004 and $600 million in fiscal year 2005 to accommodate the construction projects under the various authorities provided.

One of these major construction projects, and you will hear from some of our other Members shortly, is the ``New Fitzsimons'' Campus of the University of Colorado Health Sciences Center. What the bill would require is that the Secretary of Defense and the Veterans Administration work together to create a new medical center in that area to serve our veterans population.

We have also authorized a joint project in Charleston, South Carolina, where we will do a feasibility study for a new medical center, I commend my colleague, the gentleman from South Carolina (Mr. Brown) for his work on that project. And also an inpatient hospitalization needs study for southern New Jersey, something that my colleague, the gentleman from New Jersey (Mr. LoBiondo), has been involved with.

So as we work our way through the details of this legislation, Mr. Speaker, it should become clear that this is a joint effort and a joint product by all members of the Committee on Veterans' Affairs and the Subcommittee on Health to come up with a hospital authorization bill that serves the needs of all of our veterans, north and south, east and west, nationwide.

Mr. Speaker, this legislation we are voting on today will help us improve, upgrade and even replace VA facilities in specialized areas of concern, such as spinal cord injury care, hemodialysis, long term care and medical research. Our bill also gives the VA Secretary flexibility to move forward on both high priority projects and the CARES process together. So this is a compromise bill and one that all Members can support.

This bill would also improve protection and safety of VA medical research programs. VA research is internationally recognized and has made important contributions in virtually every area of medicine and health. But it still needs watchful oversight. I thank the gentleman from Indiana, Mr. Buyer, for his leadership in crafting these provisions as part of this legislation, which I strongly support, and I thank our Full Committee Chairman for agreeing to move this measure forward as a part of our construction bill.

Mr. Speaker, this legislation would also designate the Department of Veterans Affairs Outpatient Clinic in New London, Connecticut, the ``John J. McGuirk Department of Veterans Affairs Outpatient Clinic''.

I am very pleased that our bill would memorialize the life and work of Mr. John J. McGuirk of Connecticut. John was active in promoting improved care and more available VA clinics in his beloved State of Connecticut. He was a role model to many of us in the veterans' community, and was particularly committed to working on behalf of disabled and elderly veterans--those with the greatest need for ready access to VA health care. His death in 1999 was a loss to all the veterans of my State.

John J. McGuirk, a native of the Constitution State, enlisted in the United States Navy in World War II. He served as an enlisted man in the dangerous occupation of salvage diver. Hazarding death and injury every day of his Navy service, Mr. McGuirk worked across the South Pacific from Pearl Harbor to Manila, Philippines. He served aboard the salvage ship, USS Laysan Island, in clearing war devastation in Manila Bay. John McGuirk was decorated with the Philippines Liberation Medal, the American Theatre Medal, the Asiatic Pacific Theatre Medal and the World War II Victory Medal.

When Mr. McGuirk's obligation to the United States Navy was discharged at the war's end, his personal obligation to his country and fellow veterans endured and became his lifelong commitment.

Mr. McGuirk's advocacy resulted in VA activating a system of community-based clinics across the State, providing primary care to thousands of veterans. John McGuirk played an instrumental role in VA's opening of the community clinic on the grounds of the U.S. Coast Guard Academy in New London.

John actively served in Post Number Nine of the American Legion of Connecticut for the entirety of his adult life, including two stints as Post Commander, as well as Finance Officer and Service Officer. He was also a member of the Disabled Veterans of America and of U.S. Submarine Veterans, Inc.

I am proud to promote this effort to memorialize the name of a good man, a war veteran and a man of peace, John J. McGuirk of Connecticut. This gesture is but a token of the esteem and affection we hold for him and his lasting contribution to our State and his service to our veterans.

Mr. Speaker, I strongly urge my colleagues to support this bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise in support of H.R. 1720. I would like to thank VA Committee Chairman Smith and Health Subcommittee Chairman Simmons for working closely with all of us on this side of the aisle on this important issue. I also want to thank our ranking member, the gentleman from Illinois (Mr. Evans), for his steadfast support and hard work on this legislation. I also want to thank Chairman Smith and the entire staff for working with us to bring this measure before the House for consideration today.

This bill contains authorizations for many worthwhile, major medical construction projects.

Congress has put a virtual stop to appropriations for major medical construction projects over the last 4 years since the General Accounting Office released a report that suggested the VA was spending too much money maintaining buildings that were not being used to serve veterans.

Since fiscal year 2000, Congress has appropriated $121 million for major medical projects. That is about $6 million less than experts recommend for maintaining and enhancing capital assets. But while spending for major medical construction projects has declined, the number of veterans moving into States like my own, the State of Nevada, continues to explode, and the need for expanded facilities is not being met.

Southern Nevada's veterans population is one of the fastest glowing in the Nation, and is getting larger every day. The VA predicts that the number of annual visits by veterans in the Las Vegas Valley to their primary health care clinic will rise from 200,000 to more than half a million by 2010, that is a mere 7 years from now, and the number of hospital beds needed to serve the veterans in my community will increase by over 50 percent.

The VA is already struggling to address and meet the current demands of the VA health care structure in the Las Vegas Valley. Last year, 1,500 southern Nevada veterans were sent to neighboring States because they could not provide the needed services locally. This is an unfair burden on these veterans and their families. They should not have to travel hundreds much miles away for care.

In addition, due to the decrepit conditions and structural deficiencies, the VA evacuated the Guy Clinic, only 5 years old, forcing veterans to rely on a string of temporary clinics scattered across the Las Vegas Valley. Imagine, if you will, what it is like for an 80-year-old veteran waiting in the desert heat, sometimes up to 110 degrees, to be shuttled from clinic to clinic to receive the health care he needs.

For example, a veteran who needs a CT scan may have to shuttle from a temporary site which houses the CT scan technology to then another site to obtain a prescription for a controlled narcotic that he needs, and then to a third site for mental health services.

Female veterans who need mammograms have to shuttle to different clinics just for that one particular service.

As one 81-year-old World War II veteran described the situation, ``You are going from one place to another and it gets confusing. Don't our veterans deserve a permanent facility to meet all their health care needs?''

In short, southern Nevada is facing a veterans health care crisis. At the time H.R. 1720 was introduced and passed by the Committee on Veterans' Affairs, the VA recognized Las Vegas was in need of a new, multispecialty outpatient clinic. H.R. 1720 authorized $6.5 million for annual leases for that clinic. However, in the time since the legislation has been acted on by the committee, the Department of Veterans Affairs released the CARES document which proposed $4.6 billion worth of construction, reflecting only a portion of the growing backlog and veterans growing demand for services.

The VA's average healthcare facility is about 52 years old, so updates are essential. The failure to make investments has put the VA way behind in addressing such urgent needs as seismic corrections, renovations to address patient safety, and privacy concerns and problems that threaten VA's accreditation by outside quality assurance agencies.

To address the concern about underutilized buildings, the VA embarked upon a process to identify veterans needs for health care for the next 20 years. The CARES plan calls for the construction of a full-scale medical facility in Las Vegas, including a full-service patient care hospital, an outpatient clinic and a comprehensive long-term care nursing facility in Las Vegas.

In light of the VA's new plan for a veterans health care facility, I ask the committee to continue to work with me to update the authorization level to reflect the demands in southern Nevada and to allocate funds for a full-service VA medical complex.

America's veterans served our Nation, and now we must honor our commitment to those brave men and women. Providing high-quality health care is part of keeping our promise to these heroes and sends an important message to our troops now deployed at home and abroad in defense of our Nation. These future veterans, many of whom will soon call Nevada home, will also one day be eligible for VA care. Investing now will ensure that we will be able to serve the health care needs of our veterans, today and in the future.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 2 minutes to the distinguished gentleman from Illinois (Mr. Evans), the ranking member of the Committee on Veterans' Affairs.

Mr. Speaker, I yield 3 minutes to the gentleman from California (Mr. Filner).

Mr. Speaker, I yield 3 minutes to the distinguished gentleman from Illinois (Mr. Davis).

Mr. Speaker, I yield 3 minutes to the gentleman from Texas (Mr. Ortiz).

(Mr. ORTIZ asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I would be delighted to yield to the gentleman the balance of our time so that all of his members can speak on behalf of this legislation. If I could take 30 seconds to sum up.

Mr. Speaker, the gentleman from California (Mr. Filner) in his remarks referred to me as the not-so-gentlelady from Nevada. I take great pride in that characterization. I do not think any of us should be gentle when it comes to issues that affect the health care of our veterans.

We owe these veterans, men and women, a tremendous debt of gratitude. We are going to have far more veterans once our war against terrorism is over. I applaud my colleagues on both sides of the aisle for being steadfast on this piece of legislation. We should not rest. And none of us should be able to go back to our districts and look our veterans in the face if we do not deliver for them now.

Mr. Speaker, I yield the balance of my time to the gentleman from New Jersey (Mr. Smith).