Department of Veterans Affairs Medical Facilities Realignment Act of 1989

Department of Veterans Affairs Medical Facilities Realignment Act of 1989 - Directs the Secretary of Veterans Affairs to: (1) issue a charter establishing the Commission on Medical Facility Realignment and Major Mission Change; (2) realign all medical facilities recommended for realignment by the Commission; (3) change the major missions of medical facilities as recommended by the Commission; (4) initiate all such realignments and major mission changes no later than one year after receipt of the Commission's report; and (5) complete all such realignments and major mission changes no later than three years after receipt of such report. Prohibits any such realignment or major mission change from occurring unless: (1) the Commission recommends such realignment or change to the Senate and House Veterans' Affairs Committees; (2) the Secretary submits a report to such committees approving such recommendation or change; and (3) the Congress fails to enact a joint resolution disapproving such recommendation or change within 45 days after receiving the Secretary's report.

Outlines membership requirements and other administrative provisions concerning the Commission. Requires the Commission to report its recommendations to the Secretary and the veterans' committees. Authorizes the Secretary, in realigning or changing the major mission of a medical facility as recommended by the Commission, to: (1) carry out all necessary actions to implement such realignment or major mission change; (2) provide economic adjustment and community planning assistance to communities located near a medical facility being realigned or being affected by a major mission change; and (3) carry out activities for the purpose of environmental restoration.

Directs the Administrator of General Services to delegate certain authority to the Secretary, allowing the Secretary to manage and dispose of property for purposes under this Act. Directs the Secretary, before taking any action to dispose of any surplus real property at a medical facility in connection with a realignment, to consult with the Governor and heads of the local governments of the State affected to consider any plan for the use of such property by the local community concerned. Requires the Secretary to notify all other departments, agencies, and instrumentalities of the U.S. Government of the availability of property to be disposed. Requires all proceeds from the transfer or disposal or surplus property to be deposited in the Department of Veterans Affairs Medical Facility Realignment Account. Requires the Secretary to reimburse the Administrator for any expenses involved in connection with the management or disposal or any surplus property under this Act.

Requires the Secretary to make annual reports to the veterans' committees concerning realignments and major mission changes.

Establishes the Department of Veterans Affairs Medical Facility Realignment Account and provides for deposits into, and expenditures from, such Account. Requires the Secretary to notify the veterans' committees and the Senate and House Appropriations Committees when a decision is made to use Account funds to carry out a major medical facility project, to report to such committees on deposits into and expenditures from the Account, to make a final accounting to such committees when all actions necessary for realignments and major mission changes are completed, and to certify to the Secretary of the Treasury that all such actions have been completed. Requires the Secretary of the Treasury, upon receipt of such certification, to transfer all funds remaining in the Account to the Treasury miscellaneous receipts account.

Provides procedures for the consideration by the Congress of the recommendations of the Commission, including rules for the consideration of a joint resolution approving or disapproving such recommendations.

Defines a "major mission change" as any substantive change in clinical programs or patterns of delivery of medical care at a medical facility.