Page:United States Statutes at Large Volume 113 Part 2.djvu/34

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113 STAT. 1054 PUBLIC LAW 106-74r-OCT. 20, 1999 Deadline. Certification. Public information. the "Genered operating expenses" account for the cost of administration of the insurance progreims finginced through those accounts: Provided, That reimbursement shall be made only from the surplus earnings accumulated in an insurance program in fiscal year 2000, that are available for dividends in that program after claims have been psiid and actuarially determined reserves have been set aside: Provided further, That if the cost of administration of an insurance program exceeds the amoiuit of surplus eeirnings accimiulated in that program, reimbursement shall be made only to the extent of such surplus earnings: Provided further. That the Secretary shall determine the cost of administration for fiscal year 2000, which is properly allocable to the provision of each insurance program and to the provision of any total disability income insurance included in such insurance program. SEC. 108. (a) IN GENERAL.— The Congress supports efforts to implement improvements in health care services for veterans in rural areas. (b) REPORT REQUIRED. —(1) Not later than 6 months after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans' Affairs of the Senate and the House of Representatives a report on the impact of the allocation of funds under the Veterans Equitable Resource Allocation (VERA) funding formula on the rurgd subregions of the health care system administered by the Veterans Health Administration. (2) The report shall include the following: (A) AD. assessment of impact of the allocation of funds under the VERA formula on— (i) travel times to veterans health care in rural areas; (ii) waiting periods for appointments for veterans health care in rural areas; (iii) the cost associated with additional community- based outpatient clinics; (iv) transportation costs; and (v) the vmique challenges that Department of Vetersins Affsdrs medical centers in rural, low-poptdation subregions face in attempting to increase efficiency without large economies of scale. (B) The recommendations of the Secretary, if any, on how rural veterans' access to health Care services might be enhsinced. SEC. 109. The Secretary of Veterans Affairs may carry out a major medical facility project to renovate and construct facilities at the Olin E. Teague Department of Veterans Affairs Medical Center, Temple, Texas, for a joint venture Cardiovascular Institute, in an amount not to exceed $11,500,000. In order to carry out that project, the simount of $11,500,000 appropriated for fiscal year 1998 and programmed for the renovation of Building 9 at the Waco, Texas, Department of Veterans Affairs Medical Center is hereby made available for that project. SEC. 110. Notwithstanding any other provision of this Act, none of the funds appropriated or otherwise made available in this Act for the Medical Care appropriation of the Department of Veterans Affairs may be obligated for the realignment of the health care delivery system in VISN 12 until 60 days sifter the Secretary of Veterans Affairs certifies that the department has: (1) consiilted with vetereuis organizations, medical school affiliates, employee representatives. State veterans and health associations.